Validação do protocolo DIPA (Digital Image-based Postural Assessment) como metodologia de avaliação da coluna vertebral no plano sagital e estimativa de valores de referência para a postura padrão da coluna vertebral

FURLANETTO, T. S. Validação do protocolo DIPA (Digital Image-Based Postural Assessment) como metodologia de avaliação da coluna vertebral no plano sagital e estimativa de valores de referência para a postura padrão da coluna vertebral. Tese de Doutorado. Programa de Pós-Graduação em Ciências do Movimento Humano. Universidade Federal do Rio Grande do Sul. 2017. Contextualização: Os capítulos 1, 2, 3, 4 e 5 estão apresentados em formato de artigos, sendo dois de revisão de literatura e três artigos originais. Os capítulos 1, 2 e 3 correspondem ao embasamento teórico do Capítulo 4. O Capítulo 1 é uma revisão sistemática da literatura acerca da aplicabilidade da fotogrametria e dos procedimentos matemáticos inerentes na utilização dessa técnica como meio de avaliação postural da coluna vertebral. O Capítulo 2 apresenta uma revisão sistemática com meta-análise dos valores de referência das curvaturas sagitais da coluna vertebral, utilizando o método Cobb em radiografias. O Capítulo 3 apresenta o artigo que desenvolve e valida uma equação de predição para estimar as curvaturas internas sagitais da coluna vertebral a partir da superfície da pele, tanto para crianças quanto para adultos. O Capítulo 4 apresenta a validação do protocolo DIPA para avaliação da coluna vertebral de adultos (valores angulares das curvaturas, bem como a respectiva classificação da postura da coluna vertebral). E, por fim, o Capítulo 5 apresenta a quantificação da geometria vertebral e análise da concordância da palpação dos processos espinhosos da coluna vertebral, utilizando os exames radiográficos.FURLANETTO, T. S. Validation of DIPA© (Digital Image-Based Postural Assessment) protocol as a methodology of spine evaluation in the sagittal plane and estimation of reference values for the spinal posture pattern. Doctoral Dissertation. Graduate Program in Human Movement Sciences. Universidade Federal do Rio Grande do Sul. 2017. Contextualization: Chapters 1, 2, 3, 4 and 5 are presented as articles, two of which are literature review and three original articles. Chapters 1, 2 and 3 correspond to the theoretical basis of Chapter 4. Chapter 1 is a systematic review of the literature on the applicability of photogrammetry and the mathematical procedures inherent in the use of this technique as a postural assessment of the spine. Chapter 2 presents a systematic review with meta-analysis of the reference values of the sagittal curvatures of the spine using the Cobb method in radiographs. Chapter 3 presents the article that develops and validates a prediction equation to estimate sagittal internal curvatures of the spine from the surface of the skin for children and adults. Chapter 4 presents the validation of the DIPA protocol for evaluation of the adult spine (angular values of curvatures, and classification of spine posture). Finally, Chapter 5 presents the quantification of the vertebral geometry and analysis of the palpation concordance of the spinal processes, using the radiographic examinations

Prevalência de dor nas costas e hábitos posturais inadequados em escolares do Ensino Fundamental do Colégio de Aplicação da UFRGS

O objetivo do estudo foi verificar a prevalência e a associação da dor nas costas e dos hábitos posturais inadequados em escolares do Ensino Fundamental do Colégio de Aplicação da Universidade Federal do Rio Grande do Sul. 197 escolares (a partir do 5º Ano) foram avaliados com o questionário Back Pain and Body Posture Evaluation Instrument (BackPEI), o qual visa identificar a presença de dor nas costas e avalia fatores de risco demográficos (idade e sexo) e comportamentais (hábitos de vida diários). Os resultados demonstraram uma prevalência de dor nas costas dos escolares de 55,3%, tendo associação significativa com o sexo feminino. Foi encontrada prevalência superior a 90% de hábitos posturais inadequados nas atividades de sentar para escrever, sentar em uma cadeira e/ou banco, sentar para utilizar o computador e pegar objeto do chão. Houve associação significativa entre sentar para escrever inadequadamente e dormir adequadamente com a dor nas costas.

Validity and reliability of smartphones in assessing spinal kinematics: a systematic review and meta-analysis

Objective Advances in mobile technology have led to the development of smartphones, whose applications present numerous utilities, such as the analysis of human movement based on inertial sensors. The purpose of this review was to investigate validity and reliability of smartphones in assessing the kinematics of the human spine. Methods A systematic search was performed on MEDLINE, Embase, Scopus, and LILACS databases, as well as manual searches. The included studies evaluated psychometric properties of smartphones in assessing kinematic variables of the spine (range of motion [ROM], speed, and acceleration). Two independent reviewers performed the selection, reading, data extraction, and risk of bias assessment of the studies. Results Of the 2651 articles initially found, 9 were included and had their results for ROM analyzed. The meta-analyses for validity showed very high correlation coefficients in the evaluation of cervical flexion, extension, and lateral flexion; high ones in the evaluation of cervical rotation; and also high ones for intrarater and interrater reproducibility of all cervical movements. The meta-analyses for interrater reproducibility showed high correlation coefficients in the evaluation of lumbar flexion and very high ones for intrarater reproducibility. Conclusion The use of smartphones for assessing the ROM of cervical flexion, extension, and lateral flexion and lumbar flexion is feasible. Their use for assessing thoracic rotation is potentially viable, but further validation studies are still needed to ensure a safe use. There is a lack of validation studies that evaluate the applicability of this device in assessing other kinematic characteristics, such as speed and acceleration

Association between spine alterations and hypertrophy training of the flexor and extensor horizontal muscles of the shoulder

Objetivos: 1) Identificar se existem alterações posturais na cifose torácica e lordose lombar da coluna verte- bral, no plano sagital, de praticantes de musculação com o objetivo de hipertrofia; 2) Identificar se existe associação entre as essas alterações posturais com o tipo de treino dos músculos flexores e extensores horizontais do ombro; 3) Verificar se existe associação entre essas alterações posturais com a dor nas costas. Metodologia: praticantes de mus- culação há no mínimo dois anos, com objetivo de hipertrofia, participaram de três procedimentos: (1) entrevista para identificar o tipo de treino dos músculos flexores e extensores horizontais do ombro; (2) avaliação da dor nas costas; e (3) avaliação das curvaturas torácica e lombar da coluna vertebral utilizando o instrumento Flexicurva. A análise estatística foi realizada através do teste de Qui-quadrado e o coeficiente Phi. (α = 0,05). Resultados: Os praticantes de musculação com o objetivo de hipertrofia não apresentaram alterações posturais na curvatura torácica, porém, a maioria apresentou uma retificação da curvatura lombar. As associações entre todas as variáveis analisadas foram fracas e não significativas. Conclusão: Não se pode afirmar que o treinamento de hipertrofia muscular, com ênfase na ação dos músculos flexores horizontais do ombro, possa desenvolver alterações posturais na coluna vertebral, bem como favorecer a instalação da dor nas costas.Objectives: (i) to identify if there are spine alterations in the thoracic kyphosis and lumbar lordosis in bodybuilders who practice hypertrophy training; (ii) to verify an association between postural alterations and the type of the training program for flexor and extensor horizontal muscles of the shoulder; (iii) to verify if there is an association between postural alterations with back pain. Methods: bodybuilders, who practice hypertrophy training for two years, participated in three procedures: (1) interview to identify the training type for flexor and extensor horizontal muscles, (2) back pain measurement, and (3) thoracic kyphosis and lumbar lordosis measurement using the flexicurve. The statistical analyses were realized by Chi-Square test and Phi Coefficient. (α = 0.05). Results: The bodybuilders who practice hypertrophy training showed no postural alterations in thoracic curvature, but most of them showed lumbar curvature decreased. The associations between all variables were weak and not significant. Conclusion: we cannot say that the training hypertrophy with emphasis on the action of the flexors horizontal muscles of the shoulder can develop postural alterations in the spine

A ASSOCIAÇÃO ENTRE ALTERAÇÕES POSTURAIS DA COLUNA VERTEBRAL COM O TREINAMENTO DE HIPERTROFIA DOS MÚSCULOS FLEXORES E EXTENSORES HORIZONTAIS DO OMBRO

Objectives: (i) to identify if there are spine alterations in the thoracic kyphosis and lumbar lordosis in bodybuilders who practice hypertrophy training; (ii) to verify an association between postural alterations and the type of the training program for flexor and extensor horizontal muscles of the shoulder; (iii) to verify if there is an association between postural alterations with back pain. Methods: bodybuilders, who practice hypertrophy training for two years, participated in three procedures: (1) interview to identify the training type for flexor and extensor horizontal muscles, (2) back pain measurement, and (3) thoracic kyphosis and lumbar lordosis measurement using the flexicurve. The statistical analyses were realized by Chi-Square test and Phi Coefficient. (α = 0.05). Results: The bodybuilders who practice hypertrophy training showed no postural alterations in thoracic curvature, but most of them showed lumbar curvature decreased. The associations between all variables were weak and not significant. Conclusion: we cannot say that the training hypertrophy with emphasis on the action of the flexors horizontal muscles of the shoulder can develop postural alterations in the spine

Reference values for Cobb angles when evaluating the spine in the sagittal plane: a systematic review with meta-analysis

The present systematic review of observational studies with meta-analysis aim to identify the reference values of the spinal curvatures in the sagittal plane, as evaluated using the Cobb angle in X-rays, in healthy individuals. Electronic searches were undertaken in MEDLINE, Scopus, ScienceDirect and LILACS. Studies that evaluated the spinal curvature of healthy children, adolescents, adults, and elderly using Cobb method and presented reference values for those curvatures were incluced. Thirty-one studies were eligible for inclusion. The reference values found (confidence interval 95%) were: for children, thoracic (28.7°-37.9°), lumbar L1-L5 (34.5o-44.8º), and lumbar L1-S1 (41.7o-54.1o); for adolescents: thoracic (31.5o-39.2o), lumbar L1-L5 (39.8o-45.6o), and lumbar L1-S1 (51.9o-59.1o); for adults: thoracic (33.7o-40.3o), lumbar L1-L5 (38.1o-45.6o), and lumbar L1-S1 (54.2o-61.7o); and for the elderly: thoracic (37.7º-50.4o), and lumbar L1-S1 (56.6º-65.9o). For the cervical region, it was impossible to establish consistent reference values. The present study supports that precise reference intervals were identified for the sagittal curvatures of the thoracic and lumbar spine in healthy children, adolescents, adults and elderly, as evaluated by means of the Cobb Method

Reference values for Cobb angles when evaluating the spine in the sagittal plane : a systematic review with meta-analysis

The present systematic review of observational studies with meta-analysis aim to identify the reference values of the spinal curvatures in the sagittal plane, as evaluated using the Cobb angle in X-rays, in healthy individuals. Electronic searches were undertaken in MEDLINE, Scopus, ScienceDirect and LILACS. Studies that evaluated the spinal curvature of healthy children, adolescents, adults, and elderly using Cobb method and presented reference values for those curvatures were incluced. Thirty-one studies were eligible for inclusion. The reference values found (confidence interval 95%) were: for children, thoracic (28.7°-37.9°), lumbar L1-L5 (34.5o-44.8º), and lumbar L1-S1 (41.7o-54.1o); for adolescents: thoracic (31.5o-39.2o), lumbar L1-L5 (39.8o-45.6o), and lumbar L1-S1 (51.9o-59.1o); for adults: thoracic (33.7o-40.3o), lumbar L1-L5 (38.1o-45.6o), and lumbar L1-S1 (54.2o-61.7o); and for the elderly: thoracic (37.7º-50.4o), and lumbar L1-S1 (56.6º-65.9o). For the cervical region, it was impossible to establish consistent reference values. The present study supports that precise reference intervals were identified for the sagittal curvatures of the thoracic and lumbar spine in healthy children, adolescents, adults and elderly, as evaluated by means of the Cobb Method

Concurrent validity of digital image-based postural assessment as a method for measuring thoracic kyphosis : a cross-sectional study of healthy adults

To analyze the concurrent validity of the Digital Image-based Postural Assessment (DIPA) method for identifying the magnitude and classification of thoracic kyphosis in adults. Methodology On the same day and in the same place, thoracic kyphosis was assessed in 68 adults using 2 methods: the DIPA software protocol and radiography. The DIPA software provided angular values of thoracic kyphosis based on trigonometric relations, while with the radiograph, the curvature was calculated using the Cobb method. The following tests were applied in the statistical analysis: Pearson's correlation, Bland-Altman's graphic representation, root mean square error, and receiver operating characteristic (ROC) curve; α = 0.05. The reference angular values for the standard thoracic posture used in DIPA were determined with the ROC curve based on the Cobb angles. Results The correlation between the angles obtained for thoracic kyphosis using the DIPA and Cobb methods was found to be high (r = 0.813, P < .001), and the accuracy was ±4°. According to Bland-Altman's representation, the magnitudes provided by the DIPA software were in agreement with those of the Cobb method. In reference values for determining the standard posture of the thoracic spine, the ROC curve indicated good accuracy in diagnosing a decrease in thoracic kyphosis (with a value of 33.9°) and excellent accuracy in diagnosing thoracic hyperkyphosis (with a value 39.9°) when using DIPA. Conclusion The DIPA postural assessment method is valid in the sagittal plane for identifying the magnitude of thoracic kyphosis in adults. Furthermore, it is accurate in diagnosing alterations in thoracic kyphosis