Non-invasive postural assessment of the spine in the sagittal plane: a systematic review

Abstract

The objective of this review was to examine the scientific evidence regarding the aspects of validation in non-invasive methods of assessing the spine in the sagittal plane. A systematic search was conducted in following data bases Scopus, Science Direct, PubMed and Medline. To be included the papers must have: conducted a non-invasive assessment of thoracic kyphosis and/or lumbar lordosis; evaluated at least one aspect of validity; been written in English; and been published in the previously three decades. Papers that score less than three in the QUADAS scale were excluded. Initially, 70 articles were pre-selected. Of this, 52 were finally included as they met the quality criterion. Based on this review, the following techniques/instruments were found to present satisfactory results for all aspects of validity in the assessment of thoracic kyphosis: photogrammetry, flexible ruler, archometer, and DeBrunner’skyphometer. Similarly, photogrammetry, inclinometer, flexible ruler, archometer and kypholordometer were found to present satisfactory results in the assessment of lumbar lordosis. Therefore, it is suggested that these instruments be adopted as first choice for evaluating the spine in the sagittal plane, since they present adequate reproducibility and concurrent validity.