柯伯角度、軀幹旋轉角度和三維胸椎和腰椎姿勢位置與活動度之再測信度

Background and Purpose: Mobility and dynamic control of spine has been the subject of much clinical discussion recently. Surveying instruments for the posture and mobility of spine are widely used in spinal assessment or exercise intervention related research. The purpose of the study was to explore within-day and between-days intra-rater reliability of Cobb angle, angle of axial trunk rotation, and 3D-ultrasound analysis system with pointer application in assessing mobility and posture of the thoracolumbar spine and bone landmarks. Methods: Twenty subjects with scoliosis (mean age: 23.95±6.81 years) were recruited for the reliability test of the X-ray Cobb angle and the angle of axial trunk rotation. Ten healthy adults (mean age: 23.98±1.26 years) were recruited for the reliability test of the posture parameters and the mobility of thoracolumbar spine. 3D ultrasound motion analysis system measurements were taken in natural standing position, maximum spinal extension, maximum spinal flexion and bilateral side flexion in standing position. Intraclass correlation coefficients (ICCs) and standard errors of measurements were used for statistical analyses. Pearson's correlation coefficient was used to determine the correlation between X-ray Cobb angle and the angle of axial trunk rotation. Results: The results showed that within-day and between-day intra-rater reliabilities of measuring the Cobb angle and the axial trunk rotation are good (ICCs=0.912~0.995). The 3D-ultrasound motion analysis system also provided good within-day and between-day intra-rater reliabilities in assessing thoracic kyphosis (ICC=0.868, 0.843), lumbar lordosis (ICC=0.886, 0.837), sagittal spinal curve (ICC=0.941, 0.912), pelvic and shoulder obliquity (ICC=0.875), pelvic height difference (ICC=0.883, 0.792), shoulder height difference (ICC=0.827), and the mobility of thoracic/lumbar flexion (ICC=0.778~0.921), thoracic extension (ICC=0.791, 0.781), thoracic side flexion (ICCs=0.722~0.868). However, the within-day reliabilities of measuring pelvic torsion, scapula distance difference, mobility of the lumbar extension and side flexion were low (ICCs=0.175~0.359). Between-day reliabilities of measuring pelvic inclination, pelvic/shoulder obliquity, shoulder height difference right/left, scapula distance difference and the mobility of the lumbar extension and side flexion were also low to moderate (ICCs=0.201~0.667). The correlation between the X-ray Cobb angle and the angle of axial trunk rotation was moderately high (Pearson r=0.73). Conclusion: The X-ray Cobb angle measurement, angle of axial trunk rotation, and most of the Zebris 3D-ultrasound analysis system measurement of the thoracolumbar spine posture showed good to high test-retest reliability. To further investigate the clinometric properties of these tests, more studies are needed to evaluate their validity.