Background
Human body posture
Methods
Standardization of posture assessment with digital photography
Preparing a patient to photogrammetry
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The center of the sternal notch
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Anterior superior iliac spine (ASIS)—right and left
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Posterior superior iliac spine (PSIS)—right and left
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Spinous process of C7
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The point between T12 and L1 spinous process
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The point between L5 and S1 spinous process
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The center of acromion—right and left
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The center of greater trochanter—right and left
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The center of external malleolus of the ankle joint
Photographic parameters for the frontal plane evaluation
Photographic parameters for the sagittal plane evaluation
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Trochanter-ankle angle (TA)—the angle between the vertical line drawn from the center of external malleolus of the ankle joint and the line drawn from the center of external malleolus of the ankle joint to the top of the greater trochanter (Fig. 10b).
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Acromion-ankle angle (AA)—the angle between the vertical line drawn from the center of external malleolus of the ankle joint and the line drawn from the center of external malleolus of the ankle joint to the center of acromion (Fig. 10c).
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Ear-ankle angle (EA)—the angle between the vertical line drawn from the center of external malleolus of the ankle joint and the line drawn from the center of external malleolus of the ankle joint to the external auditory meatus (Fig. 10d).
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Enlarged photos of coronal and sagittal parameters are presented in Additional file 1: Appendix 1.
Semi-automatic measurements of postural photographic parameters
Validation of the photographic technique
Intra-observer reproducibility
Inter-observer reliability
Validation of the photographic technique against Rippstein plurimeter
Variability of photographic sagittal parameters over time
Variability of photographic coronal parameters over time
Normative values of sagittal photographic parameters in children aged 7–10
Statistical analysis
Results
Photogrammetry reliability studies
Validation of the photographic technique
Variables | Intraobserver reproducibility | Interobserver reliability | ||||||||
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ICC | 95% | CI | SEM [°] |
P value | ICC | 95% | CI | SEM [°] |
P value | |
Left side of the body | ||||||||||
SS | 0.93 | 0.88 | 0.97 | 1.0 | 0.957 | 0.93 | 0.86 | 0.97 | 0.9 | 0.658 |
LL | 0.97 | 0.95 | 0.99 | 1.0 | 0.975 | 0.97 | 0.95 | 0.99 | 1.0 | 0.987 |
TK | 0.93 | 0.87 | 0.96 | 1.2 | 0.974 | 0.94 | 0.89 | 0.97 | 0.9 | 0.811 |
CI | 0.96 | 0.92 | 0.98 | 0.7 | 0.953 | 0.92 | 0.83 | 0.96 | 0.9 | 0.540 |
HP | 0.90 | 0.83 | 0.95 | 1.0 | 0.990 | 0.84 | 0.74 | 0.92 | 1.2 | 0.984 |
Right side of the body | ||||||||||
SS | 0.93 | 0.88 | 0.97 | 1.0 | 0.952 | 0.92 | 0.86 | 0.96 | 1.1 | 0.954 |
LL | 0.96 | 0.93 | 0.98 | 1.2 | 0.936 | 0.96 | 0.92 | 0.98 | 1.1 | 0.852 |
TK | 0.91 | 0.85 | 0.95 | 1.3 | 0.990 | 0.92 | 0.86 | 0.96 | 1.2 | 0.726 |
CI | 0.93 | 0.87 | 0.96 | 0.9 | 0.931 | 0.88 | 0.79 | 0.94 | 1.1 | 0.689 |
HP | 0.94 | 0.89 | 0.97 | 0.7 | 0.989 | 0.85 | 0.75 | 0.92 | 1.0 | 0.913 |
Mean of the left and right side of the body | ||||||||||
SS | 0.95 | 0.91 | 0.97 | 0.9 | 0.977 | 0.94 | 0.89 | 0.97 | 0.9 | 0.836 |
LL | 0.97 | 0.95 | 0.98 | 1.0 | 0.952 | 0.98 | 0.95 | 0.99 | 0.9 | 0.936 |
TK | 0.93 | 0.88 | 0.97 | 1.1 | 0.986 | 0.92 | 0.86 | 0.96 | 0.9 | 0.777 |
CI | 0.96 | 0.92 | 0.98 | 0.7 | 0.950 | 0.92 | 0.84 | 0.96 | 0.9 | 0.622 |
HP | 0.94 | 0.89 | 0.97 | 0.8 | 0.995 | 0.89 | 0.80 | 0.94 | 1.0 | 0.979 |
Variables | ICC | 95% | CI | SEM [°] |
P value |
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Plurimeter SS—photo SS | 0.93 | 0.89 | 0.95 | 1.2 | 0.712 |
Plurimeter LL—photo LL | 0.97 | 0.93 | 0.98 | 0.9 | 0.425 |
Plurimeter TK—photo TK | 0.95 | 0.93 | 0.97 | 1.4 | 0.945 |
Measurements | SS | LL | TK | CI | HP | ATSI | POTSI | |||||||
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Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | |
Zero time | 24.7 | 7.0 | 41.7 | 9.5 | 44.5 | 6.7 | 27.1 | 7.1 | 53.3 | 3.1 | 21.6 | 11.6 | 21.3 | 10.0 |
After 1 h | 25.3 | 7.2 | 42.0 | 8.3 | 43.6 | 7.6 | 27.6 | 7.5 | 52.8 | 5.8 | 21.8 | 11.4 | 21.9 | 10.6 |
After 1 week | 26.8 | 8.1 | 43.0 | 9.1 | 45.0 | 8.9 | 29.3 | 6.8 | 52.8 | 5.1 | 20.1 | 8.8 | 18.3 | 6.1 |
P
| 0.533 | 0.854 | 0.786 | 0.478 | 0.926 | 0.798 | 0.288 |
Percentile | SS | LL | TK | CI | HP |
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97 | 44 | 52 | 62 | 41 | 71 |
90 | 39 | 45 | 55 | 36 | 66 |
75 | 33 | 37 | 48 | 32 | 63 |
50
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27
|
29
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42
|
27
|
58
|
25 | 22 | 23 | 35 | 22 | 54 |
10 | 17 | 18 | 28 | 18 | 49 |
3 | 12 | 13 | 23 | 14 | 45 |
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Protraction of the shoulders—the upper limbs cover the body contours and anatomical points (Fig. 15)
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Incorrect head position and gaze direction—impact on cervical spine parameters (Fig. 16)
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Inability to adopt spontaneous relaxed posture—impact on lumbar lordosis and thoracic kyphosis angles (Fig. 17)
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Hair covering the body contours—impossibility of measuring photographic parameters (Fig. 18)
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Gluteal cleft covered with underpants—impossible calculation of POTSI index (Fig. 19)
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Bra or swimsuit with limited body contact and obscuring the trunk—sagittal angles design and calculation not possible (Fig. 20)
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One-leg standing—impact on coronal plane symmetry (Fig. 21)
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Incorrect rotational foot positioning—introduction of rotation to the whole body (Fig. 22)
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Digital camera not level—possible photographic parameters modification (Fig. 23)
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Limited communication with the child can be treated as a contraindication for photographical measurements—standardized position not possible (Fig. 24)
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Insufficient image sharpness—difficulties with photographic angle measurement (Fig. 25)