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Europa Medicophysica 2001 September;37(3):135-42

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: English

Postural variability of clinical parameters evaluated in orthostatic position in idiopathic scoliosis

Negrini S., Negrini A. *, Atanasio S. **, Carabalona R., Grosso C., Santambrogio G. C. ***, Sibilla P. **

From the Rehabilitation Unit, *Bioengineering Centre, and Centro Scoliosi Vigevano **Orthopaedic Unit *** Bioengeneering Centre Don Gnocchi Fnd. ONLUS, Care & Research Institute, Milano, Italy


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Back­ground. In the ­last 10-15 ­years ­many ­devices ­have ­been devel­oped for objec­tively quan­ti­fying the clin­ical exam­ina­tion. Nev­er­the­less to ­date the ­source and ­size of poten­tial ­errors in ­patients exam­ined in ­standing posi­tion (orthos­tatic pos­ture) has not ­been estab­lished. There­fore the aim of ­this ­work is to ­assess the var­i­ability of the param­e­ters usu­ally col­lected in orthos­tatic pos­ture ­during clin­ical assess­ment of scol­i­otic ­patients.
­Methods. In a con­sec­u­tive ­group of ­patients ­affected by ado­les­cen­tial ­idiopathic sco­li­osis, we ­made ­repeated meas­ure­ments of var­ious clin­ical param­e­ters ­using an optoel­ec­tronic ­device. The adop­tion of an optoel­ec­tronic meas­ure­ment ­device (AUto­matic SCo­li­osis ANa­lyzer, ­AUSCAN) ­allowed the rep­li­ca­tion of the clin­ical pro­cess for ­obtaining ­data in orthos­tatic pos­ture ­from ­some sur­face ana­tom­ical land­marks. The ­source error due to the meas­ure­ment ­device was quan­ti­fied by ­assessing 4 dum­mies, ­with 50 meas­ure­ments each. Two con­sec­u­tive ­groups of ­patients ­were exam­ined ­after a ­first acqui­si­tion: ­group A (N=86) ­after 24 sec, ­group B (N=31) ­after 6 sec and 167 sec (the ­last meas­ure­ment ­after per­forming ­some move­ments of the ­trunk).
­Results. The ­weight of the meas­uring ­system ­errors is ­less ­than 1 mm. Two in ­vivo source ­error ­due to pos­ture ­have ­been iden­ti­fied: pos­tural adjust­ments (­between 2.59 and 20.14 mm, ­according to the con­sid­ered param­eter) and pos­tural posi­tioning (­between 4.38 and 22.95 mm).
Con­clu­sions. The find­ings of ­this ­study sus­tain the hypoth­esis ­that pos­ture is the ­major ­source of var­i­ability in ­repeated clin­ical meas­ures on the ­human ­being. ­These vari­a­tions are ­inherent the clin­ical eval­u­a­tion, but pre­sum­ably ­they are ­involved in any ­other ­measure col­lected in orthos­tatic pos­ture.

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