Date of Award

January 2018

Document Type

Thesis

Degree Name

Master of Science (MS)

Department

Kinesiology & Public Health Education

First Advisor

Grant Tomkinson

Abstract

Background: While lumbar lordosis is often indirectly (visually) assessed by practitioners to guide treatment, it is not clear how well direct and indirect assessments agree. The aims of this study were to (a) determine the intra- and inter-rater reliability of two indirect assessments (visual assessments of real and 3D body scanned people), and (b) determine the agreement between direct and indirect assessments (3D scan-extracted vs. visual assessments).

Methods: Fifty asymptomatic participants were physically landmarked and scanned with and without landmarks using the Vitus Smart 3D whole body scanner, after which 10 practitioners visually assessed the lumbar lordosis of each participant. One week later, practitioners visually assessed the scanned images of the 50 participants plus 15 duplicates, and two weeks later, practitioners and participants again presented with practitioners repeating their visual assessments. Lumbar lordosis was also directly assessed from scan-extracted data. Cohen’s Kappa was used to determine the intra- and inter-rater reliability of indirect assessments, with polyserial correlation (ps) used to determine the agreement between direct and indirect assessments.

Results: The intra- and inter-rater reliability of indirect assessments of real people was fair ( [95%CI]: 0.37 [0.20, 0.54]) and slight ( [95%CI]: 0.01 [−0.09, 0.11]), respectively. The intra- and inter-rater reliability of indirect assessments of scanned people was moderate ( [95%CI]: 0.56 [0.45, 0.67]) and slight ( [95%CI]: 0.13 [0.08, 0.19]), respectively. The agreement between direct and indirect assessment was moderate (ps=−0.41, p=0.04).

Conclusion: Intra-rater reliability of indirect assessments of lumbar lordosis was fair to moderate, inter-rater reliability was slight, and the agreement between direct and indirect assessments was moderate. It appears that most of the error in indirect assessments is due to technical error, highlighting that efforts to improve reliability should focus on minimizing technical errors. 3D body scanning technology could be used as a training and teaching tool to improve measurement reliability.

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