Sagittal spine shape literacy in the general adult population, assessed by a novel, simple graphical tool.
Larry Cohen, Evangelos Pappas, Milena Simic and 2 others
PMID 34219964WHAT IT FOUND
Only 21-30% of adults correctly identified the ideal sagittal spine shape.
The drawing test was more reliable than the selection test, and the two are not interchangeable. Lower spine literacy was associated with reported spinal pain, but this does not prove cause.
Key findings
01Only 21% to 30% of the general adult sample demonstrated correct sagittal spine literacy.
02The drawing test showed excellent inter-rater and intra-rater reliability, whereas agreement between drawing and selection methods was low.
03Participants reporting spinal pain had lower overall spine literacy scores than those without pain, though this association was not seen for lumbar lordosis literacy alone.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was cross-sectional, so it cannot determine if low literacy causes pain or if pain reduces literacy. The sample was from the general population with a mean age of 40, so findings may not apply to older adults or clinical populations with specific spinal deformities. The agreement between the two testing methods was low, meaning the selection test may not accurately reflect what the drawing test measures. Seven participants worked in allied health, which might slightly skew results towards higher literacy, although this was a small proportion.
Declared interests
Author LC is a physiotherapist with a financial interest in a physiotherapy practice in Sydney, Australia.
The easy way to misread this
Do not assume that a patient's ability to pick the correct spine picture from a list reflects their actual understanding of spinal posture. The study found low agreement between selection and drawing tasks, and the drawing task was more reliable. Also, do not infer that teaching spine literacy will reduce pain; the study only found an association in a general population, not a causal link.