Intra and interrater reliability for lower limb flexibility assessment using photogrammetry.

INTRODUCTION: Photogrammetry represents an advancement in the flexibility evaluation, and although it was highly explored for postural assessment, there is a scarcity of studies analyzing lower limb angular measurements using it. The purpose of this study is to verify the reliability of intrarater and interrarater photogrammetry in assessing lower limb flexibility. METHODS: This was a randomized cross-sectional observational study with test-retest design and a two-day interval. Thirty healthy, physically active adults were included. Three novice raters assessed the participants through flexibility tests of iliopsoas, hamstring, quadriceps and gastrocnemius on two occasions, and independently analyzed the captured images to establish reliability. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated. RESULTS: Intrarater reliability was excellent for iliopsoas (ICC = 0.96; SEM = 1.4; MDC = 3.8), hamstring (ICC = 0.99; SEM = 1.1; MDC = 3.1), quadriceps (ICC = 0.99; SEM = 0.8; MDC = 2.3) and gastrocnemius (ICC = 0.98; SEM = 0.9; MDC = 2.5). Interrater reliability was excellent for iliopsoas (ICC = 0.94; SEM = 1.7; MDC = 4.6) and gastrocnemius (ICC = 0.91; SEM = 2.1; MDC = 5.8), but good for hamstring (ICC = 0.90; SEM = 2.8; MDC = 7.9) and quadriceps (ICC = 0.85; SEM = 3.0; MDC = 8.3). CONCLUSIONS: The excellent intrarater and good to excellent interrater reliability suggest that photogrammetry assessment of lower limb flexibility by novice raters is reliable. However, clinicians should consider the higher threshold of range of motion change necessary to outweigh measurement error due to interrater variability.

Application of photogrammetry reconstruction for hyperthermia quality control measurements.

PURPOSE: Hyperthermia is a cancer treatment in which the target region is heated to temperatures of 40-44 °C usually applying external electromagnetic field sources. The behavior of the hyperthermia applicators (antennas) in clinical practice should be periodically checked with phantom experiments to verify the applicator's performance over time. The purpose of this study was to investigate the application of photogrammetry reconstructions of 3D applicator position in these quality control procedure measurements. METHODS: Photogrammetry reconstruction was applied at superficial hyperthermia scenario using the Lucite cone applicator (LCA) and phased-array heating in the head and neck region using the HYPERcollar3D. Wire-frame models of the entire measurement setups were created from multiple-view images and used for recreation of the setup inside 3D electromagnetic field simulation software. We evaluated applicator relation (Ra) between measured and simulated absolute specific absorption rate (SAR) for manually created and photogrammetry reconstructed simulation setups. RESULTS: We found a displacement of 7.9 mm for the LCA and 8.2 mm for the HYPERcollar3D setups when comparing manually created and photogrammetry reconstructed applicator models placements. Ra improved from 1.24 to 1.18 for the LCA and from 1.17 to 1.07 for the HYPERcollar3D when using photogrammetry reconstructed simulation setups. CONCLUSION: Photogrammetry reconstruction technique holds promise to improve measurement setup reconstruction and agreement between measured and simulated absolute SAR.

Analysis of postural asymmetry on sagittal plane between right and left side views using photogrammetry.

BACKGROUND: Postural asymmetry is natural and expected during postural assessment. Besides, there are conditions that exacerbate the difference between right and left side views, such as Idiopathic Scoliosis (IS). However, the photogrammetric postural assessment on sagittal plane is usually performed using only one side view. This study aimed testing if there are differences between the right and the left-side views in photogrammetric postural assessment of adults on sagittal plane. METHODS: Patients with and without scoliosis were assessed and were grouped into Control Group (CG) and Positive Adam's test Group (PAG) according to Adam's forward bending test. After screening, participants were assessed using the right and the left-side views according DIPA© protocol. Descriptive and inferential analysis were made using Paired t-Test and Independence Chi-square Test (χ2). RESULTS: Significant differences were found between right and left side views to knee angle and head position angle to overall sample. The mean difference was low, about 1° on head position and 2.6° on knee angle and did not affect the classification of body segments. CONCLUSION: We conclude that the postural assessment on sagittal plane of adults without IS can be performed using only one side view, becoming the photogrammetric postural assessment an easy-to-use tool.

Stereophotogrammetry to evaluate young adults with and without cleft lip and palate after orthodontic and restorative treatment.

STATEMENT OF PROBLEM: Patients with cleft lip and palate generally present with lateral incisor agenesis, which may be treated with an implant-supported prosthesis. However, whether implants can stabilize the dental arches in patients with cleft lip and palate is unclear. PURPOSE: The purpose of this retrospective clinical study was to analyze the stability of the maxillary dental arch after orthodontic treatment and oral rehabilitation in the cleft area with an implant-supported prosthesis or a fixed partial denture. MATERIAL AND METHODS: Fifty-five participants, 20 with unilateral cleft lip and palate rehabilitated with implants (CLPI), 15 with unilateral cleft lip and palate rehabilitated with fixed partial dentures (CLPFP), and 20 in the noncleft group (NCLP) and their gypsum casts (N=110) were digitized and evaluated through 3D stereophotogrammetry. Measurements were made on casts obtained immediately after the orthodontic treatment (T1); for the cleft lip and palate group, casts were made 1 year after implant-supported restoration placement (T2), and for the noncleft group, 1 year after the conclusion of the orthodontic treatment (T2). The dimensions of the dental arches were measured digitally. Formula Δ=T2-T1 evaluated the stability of dental arches for intercanine distances, intermolar distances, arch length, palate surface, and volume (3D). Stability (Δ) was compared through 1-way ANOVA in all groups (α=.05). RESULTS: A statistically significant difference was found in the stability of the CLPI and CLPFP groups for intercanine measurement (P=.002). For the intermolar measurement, a statistically significant difference was detected between the CLPFP and NCLP groups (P=.002). From the 3D measurements, the stability was similar in all groups. CONCLUSIONS: In patients with clefts, a fixed partial denture may provide better stability of the orthodontic outcomes than an implant-supported prosthesis. However, greater instability occurred at the molar area.

Terapia miofuncional, maloclusión y disfunción orofacial: Evaluación fotogramétrica del perfil / Myofunctional therapy, malocclusion and orofacial dysfunction: Profile photogrammetric evaluation

RESUMEN: El objetivo de este estudio observacional analítico es determinar el efecto de la Terapia Miofuncional en el perfil facial de voluntarios con maloclusión y disfunción orofacial, mediante fotogrametría. En una muestra de 15 pacientes, se midieron indirectamente mediante fotogrametría en el Software Blue Sky Plan® las siguientes variables cefalométricas: Ángulo Nasolabial, Prominencia Labial y Plano Estético. Se realizó toma de fotografías al comenzar la Terapia Miofuncional (primera sesión) y al finalizarla (décima sesión). Para comparar valores obtenidos en el mismo voluntario en cada variable cefalométrica entre principio y final de terapia, análisis estadísticos fueron realizados. Se determinó que no hay diferencia estadística en valores obtenidos en ninguna de las variables cefalométricas al comparar el inicio con el final de terapia. Por consiguiente, se concluyó que la Terapia Miofuncional no tiene un efecto significativo en estas variables de perfil facial en voluntarios con maloclusión y disfunción orofacial medidas mediante fotogrametría, pese a cambios funcionales percibidos por pacientes y evaluadores. Es fundamental poder realizar un diagnóstico riguroso y posterior derivación a Fonoaudiología, si corresponde, para lograr equilibrio funcional en los pacientes y reducir riesgo de progresión o reaparición de Anomalías Dentomaxilares.

ABSTRACT: This analytical observational study aimed to determine the effect of Myofunctional Therapy on the facial profile in volunteers with malocclusion and orofacial dysfunction, through photogrammetry. Fifteen patients were recruited, and the following cephalometric variables were measured indirectly through photogrammetry in the Blue Sky Plan Software (Blue Sky Bio®): Nasolabial Angle, Lip Prominence and Aesthetic Plane. Previous photographs were taken, at the beginning of Myofunctional Therapy (first session) and the end (tenth session). To compare the values of each variable in a volunteer between the beginning and end of therapy, statistical analyses were performed. There was no statistical difference in the values obtained in any of these variables when comparing the beginning and the end of myofunctional therapy. Therefore, it was concluded that myofunctional therapy does not have a statistically significant effect on these facial profile variables in volunteers with malocclusion and orofacial dysfunction measured by photogrammetry, despite the functional changes perceived by patients and evaluators. However, it is essential to perform a rigorous diagnosis and subsequent referral to speech therapy, if applicable, to achieve functional balance in the patients and reduce progression or recurrence risk of Dentomaxillary Abnormalities.

Computer photogrammetry as a postural assessment in Schwartz-Jampel syndrome: A case report.

The Schwartz-Jampel Syndrome (SJS) is a rare genetic disorder characterized by myotonia and bone dysplasia, which may change the posture. The subject of this case report was a seven-year-old boy diagnosed with SJS and presenting generalized muscle and joints contractures. The purpose of the present case report was to identify postural asymmetries in a patient with SJS through photogrammetry. Postural analysis was conducted using photogrammetry with the Postural Assessment Software (SAPO®). Photogrammetry is a postural assessment system performed through photographic images. These images are acquired by camera and transported to the computer. SAPO® software performs the assessment of this photograph throughout 3D analysis and compares with a predefined protocol. The results of the present case report document several recurrent postural imbalances seen in SJS including myotonia, facial dysmorphism, and skeletal deformities. Thus, even with little evidence in the literature, physical therapy treatment is indicated to increase the functionality of the individual.

Kickboxers and crossfitters vertebral column curvatures in sagittal plane: Crossfit practice influence in kickboxers body posture.

BACKGROUND: In combat sports, long-term training load can lead to sport-specific functional and body posture adaptations. The most often observed changes are in the shape of the anterior-posterior spinal curvatures. The abnormal inclination of the thoracic and lumbar regions of the spine may lead to an additional overload of the musculoskeletal system and spinal pain or decrease sports performance. Therefore it is crucial to prevent disadvantageous body posture features. AIM: The aim was to examine differences in vertebral column's sagittal curves parameters between kickboxing fighters, kickboxing fighters who also trained CrossFit and CrossFit athletes and evaluate these parameters' predictive ability to predict sport disciplines. Received results show if CrossFit training influences vertebral column curvatures in the sagittal plane among Kickboxers is an effective method in proper body posture shaping. METHODS: The study involved 45 men aged 25.2 years divided into three groups depending on the sport they practiced: group kickboxing (KB), kickboxing and CrossFit (KBCF), and CrossFit (CF). The body posture was observed using the photogrammetric method. The parameters of the sagittal plane were analyzed. RESULTS: Among the kickboxers, it was observed that the angle of the thoracolumbar region, the angle of inclination of the thoracolumbar and lumbosacral regions significantly increased compared to other groups of athletes (p < 0.05). CONCLUSION: Practicing kickboxing can be a factor in increasing the risk of postural defects. It was found that CrossFit training has a beneficial effect on the shape of physiological curvatures of the spine in combat sports athletes.

Craniocervical Posture Assessed With Photogrammetry and the Accuracy of Palpation Methods for Locating the Seventh Cervical Spinous Process: A Cross-sectional Study.

OBJECTIVE: The purpose of this study was to compare craniocervical posture assessed by photogrammetry using 2 distinct palpation methods for locating the spinous process of the seventh cervical vertebra (C7SP). METHODS: This cross-sectional study was conducted in 2 phases. In phase I (n = 42), the assessor's accuracy in locating the C7SP using the flexion-extension and the modified thorax-rib static methods was compared to radiography. In phase II (n = 68), the craniocervical posture was analyzed with photogrammetry after palpation using the 2 methods. Neck pain intensity and disability were also determined. RESULTS: The accuracy in locating the C7SP was higher using the modified thorax-rib static method (67%, 95% confidence interval [CI], 55-79) compared to the flexion-extension method (38%, 95% CI, 26-50, P = .016). Lower values of the craniocervical angle were obtained with the flexion-extension method than the modified thorax-rib static method (mean difference = -1.1°, 95% CI, -1.6 to -0.6, P < .001). However, both palpation methods resulted in similar classifications of participants as with or without forward head posture (P = .096). Weak correlations were observed between the craniocervical angle and neck pain intensity (ρ = -0.088 and -0.099, respectively) and disability (ρ = -0.231 and -0.249, respectively). CONCLUSION: Craniocervical angles obtained using palpation methods with different accuracies were different, although the magnitude of the difference was insufficient to lead to different classifications of a forward head posture in adults with mild neck pain and disability. Craniocervical posture was weakly correlated with neck-pain intensity and disability.

Validation of the Measurement of the Angle of Trunk Rotation in Photogrammetry.

OBJECTIVE: The purpose of this study was to validate the photogrammetric measurement of the angle of trunk rotation in relation to the scoliometer instrument. METHODS: Fifty-eight prominences from individuals with ages between 7 and 18 and with suspicion of spinal asymmetry (SA) were evaluated through the scoliometer and photogrammetry. The photographs were analyzed in the Digital Image-based Postural Assessment software. For statistical purposes, we used Pearson's correlation test (r), root mean square error, Bland-Altman graphical analysis, and receiver operating characteristic curve. The level of significance was P ≤ .05. RESULTS: Excellent correlation for the angle of trunk rotation was obtained between the scoliometer and photogrammetry, with a root mean square error of 3°. The Bland-Altman graphical analysis showed equally dispersed data with no participants outside the limits of agreement. The receiver operating characteristic curve evidenced that (1) the cutoff point for the identification of the presence of spinal asymmetry is 4°; (2) mild to moderate SA is between 4° and 7°; (3) moderate to severe SA is above 8°; and (4) sensitivity and specificity were above 83% and 78%, respectively, with an area under the curve ≥ 90%. CONCLUSION: Photogrammetry is validated for measuring the angle of trunk rotation, being an accurate and accessible tool for the evaluation of patients with spinal asymmetries.

Microstomia: Aplicação da fotogrametria para mensurar a eficiência da órtese oral associada à terapia fonoaudiológica / Microstomy: Application of photogrammetry to measure the efficiency of oral orthosis associated with speech therapy

OBJETIVO: Esse estudo teve como propósito verificar, por meio da fotogrametria computadorizada, a eficácia do uso da órtese oral como auxiliar na terapia fonoaudiológica. MÉTODO: Após a documentação fotográfica, cada paciente foi submetido a terapia fonoaudiológica, por meio da terapia miofuncional orofacial, associada ao uso da órtese oral, confeccionada segundo Borges et al. (2011). Ao término do tratamento, foi realizado novo registro fotográfico, em seguida, a mensuração da dimensão vertical (distância entre lábio superior/inferior) e horizontal (distância entre comissuras direita/esquerda), com o uso do programa Corel Draw X3. RESULTADOS: As médias da abertura bucal aumentaram da avaliação inicial para a avaliação final, tendo aumentado 5,1 mm no sentido horizontal (67,3 mm para 72,4 mm) e 13,9 mm no sentido vertical (de 32,7 mm para 46,6 mm). Essas diferenças se revelam significativas para as avaliações (p <0,05). CONCLUSÃO: O uso da órtese oral associado a terapia fonoaudiológica demonstrou ser eficaz como mais um instrumento na prevenção da microstomia.

OBJECTIVES: The aim of this study was to through computerized photogrammetry, the efficacy of oral orthosis as an aid in speech therapy. METHODS: After the photographic documentation, each patient underwent speech therapy, through orofacial myofunctional therapy, associated with the use of an oral orthosis, made according to Borges et al. (2011). At the end of the treatment, a new photographic record was taken, then the vertical dimension measurement (distance between upper lip) and horizontal (distance between corners right/left), using the program Corel Draw X3. RESULTS: The mean mouth opening increased from the initial evaluation to the final evaluation, increasing 5.1 mm in the horizontal direction (67.3 mm to 72.4 mm) and 13.9 mm in the vertical direction (from 32.7 mm to 46.6 mm). These differences are significant for the evaluations (p<0.05). CONCLUSION: The use of oral orthosis associated with speech therapy proved to be effective as another tool in the prevention of microstomia.

Photogrammetric evaluation of body posture of 6-year-old boys training judo, in three repeated assessments.

PURPOSE: The purpose of this work was to assess changes in body posture in a group of 6-year-old boys training judo, compared to a control group, in three repeated examinations. METHODS: The study included 88 boys aged 6. Fifty-one of them started judo training in sports clubs at the beginning of the school year (JU). The control group included 37 boys attending reception classes in primary schools, selected at random (NT). Body posture was assessed 3 times at 3-month intervals, according to the general methodology of the Moire's technique, and 15 body posture indices were obtained as a result: 7 in the sagittal plane, 1 in the axial plane and 7 in the coronal plane. The system for photogrammetric body posture assessment of CQ Elektronik System was used in this study. RESULTS: The ANOVA test showed that neither the group factor - the fact of judo training - nor the time factor had any significant effect on the number of "deviations from normal values" of body posture (p > 0.05). Statistically significant intergroup differences were noted for six body posture indices measured with the Moire's method. CONCLUSIONS: Steadily decreasing numbers of "deviations from normal values" of body posture indices in the JU group were observed over the three examinations. Regular 6-month judo training had a statistically significant effect on a decrease of body rotation in the axial plane - the effect of judo training may be considered corrective in this case.

Photogrammetric Variables Used by Physical Therapists to Detect Neck Pain and to Refer for Physiotherapeutic Intervention: A Cross-Sectional Study.

OBJECTIVE: The purpose of this study were as follows (1): to investigate photogrammetry variables that physiotherapists may detect by visually inspecting the static body posture that distinguishes young adults with or without neck pain, which may lead to referral to a physiotherapy intervention, and (2) to assess the reliability of postural assessment and clinical decision-making. METHODS: We conducted a cross-sectional, observational, balanced, controlled, single-blinded study. Fourteen physiotherapists aged 33 (6) years were recruited as raters for postural assessment of adults aged 28 (7) years with (n = 30) or without neck pain (n = 30). Photogrammetry was performed to quantify the static body posture alignments and angles. Visual inspection was performed to indicate the presence of postural misalignment and neck pain and to refer to physiotherapy intervention. RESULTS: Symptomatic participants showed low- to moderate-intensity neck pain, a high frequency of chronic neck pain, and low disability scores. Photogrammetry analysis revealed no statistically significant difference between groups. Classification of the participants according to the raters' visual inspection yielded sets of photogrammetry variables with significant differences, with a large variability among those sets. Intrarater and interrater reliability of photogrammetry varied from moderate to excellent (intraclass correlation coefficient2,1 = [0.502; 0.995]; intraclass correlation coefficient2,2 = [0.564; 0.996). Interrater reliability for visual inspection was no better than chance (κLight = -0.013 to 0.011; ι = -0.002). CONCLUSION: Neither photogrammetry nor visual inspection distinguished the presence of neck pain in young adults. Using visual inspection, physiotherapists had unreliable clinical decision-making owing to high variability of photogrammetry variables used to distinguish postural misalignments, the presence of neck pain, and whether to refer young adults for physiotherapy intervention.

Repeatability and Reproducibility of Postural Variables by Photogrammetry.

OBJECTIVE: This study aimed to examine the reliability of postural variables analyzed by photogrammetry obtained at different instances on the same day and between 2 different days. METHODS: A sample composed of 24 healthy adult individuals of both sexes was submitted to photogrammetric postural assessment. From 35 seconds of filming, 7 photographs (of time instance at 0 second, 05 seconds, 10 seconds, 15 seconds, 20 seconds, 25 seconds, and 30 seconds) were extracted and digitalized on digital image-based postural assessment software. One factor repeated-measures analysis of variance quantified the alterations in the magnitude of the variables within and between sessions (factor time and factor day, respectively). The intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated to verify the repeatability and reproducibility. RESULTS: The repeatability shows that postural variables did not present significant differences in the comparison among the 7 instances; all the variables had excellent and significant ICCs, and SEM and MDC values indicated measurement errors lower than 5%. The intrarater reproducibility shows that postural variables did not present significant differences between 2 days of evaluation; most of the variables had excellent and significant ICCs, and SEM and MDC values were between 0.9% and 12.5%. CONCLUSION: The results for repeatability and reproducibility show that most of the variables have excellent and significant ICCs. Postural evaluation by photogrammetry can be performed at any time within a 30-second interval counting from the positioning of the participant for assessment. Therefore, we conclude that a single photograph can represent the static posture of an individual in the postural evaluation, which is reliable enough and useful to determine the effects of an intervention either in clinical practice or in research.

Reliability in Mandibular Movement Evaluation Using Photogrammetry in Patients With Temporomandibular Disorders.

OBJECTIVE: The purpose of this study was to propose a quantitative evaluation for mandibular opening-closing movement asymmetries and to verify the intraexaminer and interexaminer reliability using photogrammetry in individuals with and without myogenic temporomandibular disorders. METHODS: Forty-nine female participants between ages 18 and 40 were enrolled in this study. They were assigned to 2 different groups: a temporomandibular disorder group, (n = 25; 28.1 ± 3.6 years) and an asymptomatic group (n = 24; 25.6 ± 5.1 years). Data were collected through photogrammetry using Corel Draw X3 software (Corel Corp, Ottawa, Ontario, Canada) for angle measurements. Reliability analysis was done on the total sample, and the photographs were obtained by a singular examiner on 2 occasions (intraexaminer) 1 month apart and from measurement made by another examiner (interexaminer) on different days. The intraclass correlation coefficient (ICC) was applied with a significance level of 5%. RESULTS: The photogrammetry had excellent intrarater and inter-rater reliability for the evaluation of opening and closing movements of the jaw (intrarater: opening ICC = 0.99; closing ICC = 0.98; inter-rater: opening ICC = 0.89 and closing ICC = 0.82). Photogrammetry also demonstrated excellent intra- and inter-rater reliability in the evaluation of head posture (intra-rater: head deviation ICC = 0.96; head position ICC = 0.75; inter-rater: head deviation ICC = 0.98; head position ICC = 0.98). CONCLUSION: Under these experimental conditions, most angular values presented excellent intra- and interexaminer reliability.

Assessing the potential of photogrammetry to monitor feed intake of dairy cows.

We address the hypothesis that individual cow feed intake can be measured in commercial farms through the use of a photogrammetry method. Feed intake and feed efficiency have a significant economic value for the farmer. A common method for measuring feed mass in research is a feed mass weighing system, which is excessively expensive for commercial farms. However, feed mass can be estimated by its volume, which can be measured by photogrammetry. Photogrammetry applies cameras along the feed-lane, photographing the feed before and after the cow visits the feed-lane, and calculating the feed volume. In this study, the precision of estimating feed mass by its volume was tested by comparing measured mass and calculated volume of feed heaps. The following principal factors had an impact on the precision of this method: camera quality, lighting conditions, image resolution, number of images, and feed density. Under laboratory conditions, the feed mass estimation error was 0·483 kg for heaps up to 7 kg, while in the cowshed the estimation error was 1·32 kg for up to 40 kg. A complementary experiment showed that the natural feed compressibility causes about 85% of uncertainty in the mass estimation error.

Computerized photogrammetric assessment of postural alignment in visually impaired athletes.

OBJECTIVE: The aim of the study was to provide a computerized photogrammetric description of the postural alignment of visually impaired athletes. METHODS: Twenty-six athletes were evaluated. Athletes were asked to stand at easy with styrofoam balls placed on selected anatomical landmarks, and photographic images were acquired in four viewpoints. Postural Assessment Software (PAS/SAPO) was applied for image analysis. Body's angles and distances were calculated and transformed in absolute (nonnegative) values for analysis. Factor analysis was applied for data reduction. RESULTS: Absolute values of PAS/SAPO variables resulted in lower coefficient of variation (CV) than raw values (average of 57% versus 500%, respectively), which potentially enhances the comparative use of these measures. Head's forward positioning and rightward inclination were among the most prevalent postural deviation, being observed in more than 70% of the athletes. With respect to the magnitude of the deviation, large variability was observed in data derived from anterior/posterior compared with lateral viewpoint. For instance, head's rightward inclination (head horizontal alignment in the anterior view) achieved 2.9 ±â€¯2.5° (mean ±â€¯SD), with a CV of 86%, while head's forward positioning (C7 horizontal alignment in left viewpoint) reaches 42.7 ±â€¯6.6°, with a CV of only 16%. Factor analysis did not result in significant data reduction, although anterior body's angles and distances were identified as important sources of data variability. CONCLUSIONS: The PAS/SAPO values described here can be adopted as reference for future investigations of postural alignment in visually impaired athletes.

Concordance and Reliability of Photogrammetric Protocols for Measuring the Cervical Lordosis Angle: A Systematic Review of the Literature.

OBJECTIVE: The aim of this study was to examine and interpret the concordance, accuracy, and reliability of photogrammetric protocols available in the literature for evaluating cervical lordosis in an adult population aged 18 to 59 years. METHODS: A systematic search of 6 electronic databases (MEDLINE via PubMed, LILACS, CINAHL, Scopus, ScienceDirect, and Web of Science) located studies that assessed the reliability and/or concordance and/or accuracy of photogrammetric protocols for evaluating cervical lordosis, compared with radiography. Articles published through April 2016 were selected. Two independent reviewers used a critical appraisal tool (QUADAS and QAREL) to assess the quality of the selected studies. RESULTS: Two studies were included in the review and had high levels of reliability (intraclass correlation coefficient: 0.974-0.98). Only 1 study assessed the concordance between the methods, which was calculated using Pearson's correlation coefficient. To date, the accuracy of photogrammetry has not been investigated thoroughly. CONCLUSION: We encountered no study in the literature that investigated the accuracy of photogrammetry in diagnosing hyperlordosis of cervical spine. However, both current studies report high levels of intra- and interrater reliability. To increase the level of evidence of photogrammetry in the evaluation of cervical lordosis, it is necessary to conduct further studies using a larger sample to increase the external validity of the findings.

Thoracic Kyphosis and Lumbar Lordosis Assessment by Radiography and Photogrammetry: A Review of Normative Values and Reliability.

OBJECTIVE: The purpose of this study was to review referential values for thoracic kyphosis and lumbar lordosis for radiography and photogrammetry analysis and search for information about the interrater and intrarater reliability. METHODS: The databases PubMed/Medline and LILACS were searched using the following keywords: radiograph and posture, postural alignment, and photogrammetry or photometry or biophotogrammetry. Studies containing values of thoracic kyphosis and lumbar lordosis or a reliability test assessed by radiography and photogrammetry were selected. Random numbers were generated in MATLAB from each study individually to establish normative values for the thoracic kyphosis and lumbar lordosis for both methods. After that, frequencies (median, first quartile, and third quartile) were obtained in SPSS 20.0 (IBM Corp, Armonk, New York). RESULTS: Twenty-six articles were selected, of which 23 studies contained values for thoracic kyphosis and lumbar lordosis and 10 tested the intra- and interrater reliability of both methods. For the studies with radiography that calculated the angle by the same method of assessment, the mean was 44.07° (4.75) for L1 to L5 and 58.01° (5.75) for L1 to S1, and for T1 to T12 the mean was 48.33° (6.24). Most studies used the intraclass correlation coefficient test, showing strong reliability. CONCLUSION: No concordance among the results for both methods was shown. Also, it was not possible to perform the same procedure with the photogrammetry studies because of the great discrepancy in procedures and angle calculations. To assess the reliability, it is necessary to use the proper statistical test.

Estimulação pulsada de alta voltagem reduz a área de úlceras de diferentes etiologias: um estudo piloto / High voltage pulsed stimulation reduces the area of ulcers of different etiologies: a pilot study

As úlceras, independente de sua etiologia, são caracterizadas pela perda circunscrita ou irregular da epiderme e/ou derme, podendo atingir o tecido subcutâneo e seus tecidos adjacentes. A estimulação elétrica de alta voltagem (EEAV) pode auxiliar na cicatrização de tecidos. O objetivo desse estudo foi avaliar o efeito de 30 sessões de EEAV na cicatrização de úlceras de diferentes etiologias. Participaram 6 voluntários e foram tratadas 10 úlceras cutâneas. Para quantificar a área das lesões (cm2 ) foi realizada a fotogrametria a cada 10 sessões. A intervenção consistiu na aplicação da EEAV (T = 100 ms; f = 100 Hz; tensão de 100 a 150 V), 2 a 3x/semana, por 30 minutos. Os eletrodos ativos (negativo) foram fixados sobre a lesão e o dispersivo (positivo) fixado no trajeto vascular. Com relação à área das lesões por pressão, a úlcera sacral reduziu 84,10% da sua área, a trocanteriana e do maléolo medial cicatrizaram completamente em 10 sessões. As úlceras neuropáticas fecharam completamente em 20 sessões. As cinco úlceras venosas (região do tornozelo), apresentaram redução em sua área de 26,29%, 80%, 44,69%, 28,23% e 6,27%. A EEAV foi eficaz pois promoveu a cicatrização completa de quatro úlceras e auxiliou a redução na área de outras seis lesões. (AU)

Ulcers, regardless of their etiology, are characterized by the circumscribed or irregular loss of the epidermis or dermis, which can reach the subcutaneous tissue and its adjacent tissue. The high voltage pulsed stimulation (HVPS) has been used to stimulate tissue cicatrization. The aim of this study was to evaluate the effect of 30 sessions of HVPS in the cicatrization of cutaneous ulcers from different causes. Six volunteers participated in the study and ten ulcers were treated. Photogrammetry was held every ten sessions to quantify the injuries areas (cm²). The intervention consisted in the application of HVPS (T = 100 us; f = 100 Hz; intensity = 100 to 150 V), twice or three times a week, 30 minutes long. The active electrodes (negative) were put on the ulcer and the dispersive electrode (positive) was positioned on the vascular path. Concerning the area of pressure ulcers, the sacral ulcer reduced 84.10% of its area, the trochanteric and the medial malleolus were completely closed after 10 sessions. The neuropathic ulcers closed after 20 sessions. The five venous ulcers (ankle region) showed, after 30 stimulation sessions, reduction of wounded areas of 26,29%, 80%, 44,69%, 28,23% and 6,27%. HVPS was effective to promoted complete cicatrization of four ulcers and helped in the reduction of other six ulcers areas. (AU)

Procedures of assessment on the quantification of thoracic kyphosis and lumbar lordosis by radiography and photogrammetry: A literature review.

The quantification of thoracic kyphosis and lumbar lordosis can be assessed in different ways; among them radiography and photogrammetry. However, the assessment procedures are not consistent in the literature for either method. The objective of this study was to conduct a literature review about postural assessment through radiography and photogrammetry, for delineating the procedures for both methods. In total 38 studies were selected by an online search in the MEDLINE and LILACS databases with the keywords: radiograph and posture, postural alignment, photogrammetry or photometry or biophotogrammetry. For the radiographic method, the results showed divergences in arm positioning and in the calculation of thoracic and lumbar angles. The photogrammetry demonstrated differences in relation to the camera, tripod, plumb line and feet positioning, angle calculation, software utilization, and the use of footwear. Standardization is proposed for both methods to help establish normative values and comparisons between diagnoses.