The difference in the relationship of spinal sagittal alignment between individuals with flat lumbar and normal lordosis posture based on global and regional angles.

BACKGROUND: According to previous studies, the relationship between lumbar lordosis and thoracic kyphosis or that between pelvic parameters and thoracic kyphosis have been inconsistent. OBJECTIVE: The purpose of this study was to investigate spinal sagittal alignment and its relationship to global and regional lumbar and thoracic angles, pelvic and sway angles, and C7-S1 distance measurements, followed by a detailed subgroup analysis using an inertial measurement unit system. METHODS: A total of 51 asymptomatic volunteers stood in a comfortable posture with inertial measurement units attached to the T1, T7, T12, L3, and S2 vertebrae. T1, T7, T12, L3, and S2 sagittal angles were acquired during standing posture using the Eulerian angle coordinate system. All angles are reported as the mean of three 5-s measurements. Following the measurement of lumbar lordosis angles (T12 relative S2), participants were divided into the flat lumbar and normal lordosis groups. RESULTS: There were different correlation patterns between groups because of spinal sagittal imbalance, which was greater in the flat lumbar group than in the normal lordosis group. In addition, sacral inclination proved the ideal parameter to evaluate reciprocal balance in lumbar lordosis, showing a stronger correlation with lower than with upper lumbar lordosis. T1 was the key element in assessing thoracic kyphosis, which showed a stronger correlation with upper than with lower thoracic kyphosis. CONCLUSION: We suggest that when assessing posture, it is necessary to identify the global and regional angles and it is useful to classify spinal sagittal alignment into subgroups according to lumbar lordosis and evaluate the groups separately.

Assessing the effects of sway-back posture on global and regional spinal sagittal angles using inertial measurement units.

BACKGROUND: Sway-back posture in the sagittal profile is a commonly adopted poor standing posture. Although the terms, definitions, and adverse health problems of sway-back posture are widely used clinically, few studies have quantified sway-back posture. OBJECTIVE: To investigate spinal sagittal alignment in sway-back posture while standing based on global and regional angles using inertial measurement units (IMUs). METHODS: This cross-sectional study recruited 30 asymptomatic young adults. After measuring the sway angle while standing, the participants were divided into sway-back and non-sway-back groups (normal thoracic group). Each participant stood in a comfortable posture for 5 seconds with IMUs at the T1, T7, T12, L3, and S2 levels. Then, we measured the global and regional lumbar and thoracic angles and sacral inclination in the standing position. RESULTS: Although there was no difference in the global lumbar angle, there was a difference in regional lumbar angles between the two groups. The normal thoracic group had balanced lumbar lordosis between the upper and lower lordotic arcs, whereas the sway back group tended to have a flat upper lumbar angle and increased lower lumbar angle. CONCLUSION: It is useful to assess the global and regional angles in the spinal sagittal assessment of individuals with sway-back posture.

Effects of lower trunk movement in flat-back syndrome during stair climbing: A technical note.

OBJECTIVE: This study investigated the differences in trunk sway during stair climbing between people with normal spinal alignment and people with flat-back syndrome. METHODS: Twelve male volunteers with flat-back syndrome (global angle < 20 degrees) and 12 male volunteers with normal spinal alignment (global angle between 20 degrees and 30 degrees) were enrolled. An accelerator was attached to the third lumbar spine and the sway of each participant's trunk was measured during stair climbing. RESULT: Participants with flat-back syndrome showed significant differences in vector, anteroposterior sway, and vertical sway of the trunk during stair climbing (p< 0.05). However, mediolateral sway of the trunk and gait time did not significantly differ between groups (p> 0.05). CONCLUSION: Our findings can be used as baseline data for prevention of back pain. Furthermore, increased trunk sway can cause increased energy usage, leading to inefficient gait. Further research is needed to prevent this problem.

Effects of the abdominal drawing-in maneuver on hamstring rotational activity and pelvic stability in females.

BACKGROUND: The medial hamstring (MH) and lateral hamstring (LH) can be selectively trained through tibial internal and external rotation during prone knee flexion. However, no study has identified how a combined tibial rotation and lumbo-pelvic stability strategy influences MH and LH muscle activities. OBJECTIVE: To investigate the combined effects of tibial rotation and the abdominal drawing-in maneuver (ADIM) on MH and LH muscle activities as well as pelvic rotation during prone knee flexion. METHODS: Fifteen female volunteers performed prone knee flexion with tibial internal and external rotation, with and without the ADIM. Under each condition, MH and LH muscle activities were measured by surface electromyography (EMG), and the pelvic rotation angle by a smartphone inclinometer application. RESULTS: The results showed increased MH (without the ADIM: p< 0.001, effect size (d) = 2.05; with the ADIM: p< 0.001, d= 1.71) and LH (without the ADIM: p< 0.001, d= 1.64; with the ADIM: p= 0.001, d= 1.58) muscle activities under internal and external tibial rotation, respectively. However, addition of the ADIM led to increased MH (internal tibial rotation: p= 0.001, d= 0.67; external tibial rotation: p= 0.019, d= 0.45) and LH (internal tibial rotation: p= 0.003, d= 0.79; external tibial rotation: p< 0.001, d= 1.05) muscle activities combined with reduced pelvic rotation (internal tibial rotation: p< 0.001, d= 3.45; external tibial rotation: p< 0.001, d= 3.01) during prone knee flexion. CONCLUSIONS: These findings suggest that the ADIM could be useful for reducing compensatory pelvic rotation and enhancing selective muscle activation in the MH and LH, according to the direction of tibial rotation, during prone knee flexion.

Differences in regional and global lumbar angle during slumped sitting and upright sitting among global three subgroups.

OBJECTIVE: The purpose of this study was to investigate differences in regional lumbar lordosis (RLL) and global lumbar lordosis (GLL) angle during slumped sitting and upright sitting among three global subgroups. METHODS: A total of 48 young asymptomatic volunteers stood in a comfortable posture, sat upright, and sat in a slumped position for 5 seconds, with inertial measurement units attached to the T10, L3, and S2 vertebrae. According to standing measurement, the participants were categorized into flat-back (GLL < 20∘), normal lordosis (20∘⩽ GLL < 30∘), and hyper-lordosis (30∘⩽ GLL < 40∘) groups. RESULTS: Both the GLL and RLL in the flat-back group were reduced lumbar lordosis in the upright sitting posture and increased lumbar kyphosis in the slumped sitting postures compared to the other groups (p< 0.05), but the range of motion during the transition from upright sitting to slumped sitting was lower than that of the normal and hyper-lordosis groups (p< 0.05). GLL in standing was a moderate correlation with GLL and RLL during upright sitting (p< 0.05). However, there was a strong correlation between GLL and RLL kinematics during upright and slumped sitting (p< 0.05). CONCLUSIONS: Flat-back posture is a potential source of low back pain during both upright and slumped sitting compared to the normal and hyper-lordosis groups. Posture measurements in a standing and sitting position conducted to assess lordosis should consider the relationship between GLL and RLL.

The effects of differences on sagittal kinematics and muscle coordination during step up and step down in patients with spinal stenosis.

BACKGROUND AND OBJECTIVE: Lumbar spinal stenosis (LSS) is a common spinal disorder that causes patients to assume a forward-trunk posture. Spinal alignment affects swing limb angles and stance limb muscle activities. Therefore, we investigated the effects of differences in step up (SU) and step down (SD) tasks on the kinematics of the trunk and swing limb as well as stance limb muscle coordination in patients with LSS. METHODS: Nine elderly female patients diagnosed with LSS were recruited for this study. The sagittal kinematics of the trunk and swing limb and isolated contraction ratio of the gluteus medius (GMed) and vastus lateralis (VL) during SU and SD tasks were measured using a motion analysis system and surface electromyography system. RESULTS: Thoracic (17.71∘± 7.77∘) and spine angles (13.64∘± 11.34∘) as well as swing hip (48.48∘± 12.76∘) and pelvic angles (7.52∘± 10.33∘) were significantly greater during SU than SD (10.14∘± 8.41∘, 10.03∘± 11.03∘, 29.42∘± 10.57∘, 3.21∘± 10.11∘, all P< 0.05, respectively). The isolated contraction ratio of the GMed of the stance limb (34.12% ± 13.28%) was significantly higher during SU than during SD (26.65% ± 10.02%), whereas that of the VL of the stance limb (65.88% ± 13.28%) was significantly lower during SU than during SD (73.35% ± 10.02%, P= 0.011 for both comparisons). CONCLUSIONS: Patients with LSS demonstrated trunk compensatory mechanisms to address swing hip and knee angles. Trunk position affected pelvic limb muscle coordination in the standing support limb. These findings demonstrate that SD are more challenging than SU for patients with LSS, possibly due to reduced ability to generate adequate leg extensor muscular output to safely control the motion of the body's center of mass. Therefore, trunk positions must be considered when patients with LSS undergo rehabilitation programs, particularly those involving SD or descending stairs, so that healthcare professionals can better assist patients with LSS. In addition, this study provides a background for further studies.

Immediate effect of a wearable foot drop stimulator to prevent foot drop on the gait ability of patients with hemiplegia after stroke.

The purpose of this study was to compare the effects of a foot drop stimulator (FDS) and ankle-foot orthosis (AFO) on the gait ability of patients with hemiplegia after stroke. This study recruited 10 patients with hemiplegia after stroke. All patients performed gait under two conditions (AFO and FDS gait). Gait parameters were measured with the GAITRite® system to analyze the spatial and temporal parameters of the patients' gaits. No significant differences in cadence, velocity, swing time, stance time, or step length of the affected or less-affected limbs were found between the two conditions (all, p > .05). These findings demonstrate that AFO and FDS have a similar effect on the gait ability of patients with hemiplegia after stroke.

Inter-tester Reliability of Lumbar Lordosis Posture Classification Using a Novel Screening Device.

OBJECTIVE: The purpose of this study was to investigate the inter-tester reliability of lumbar lordosis posture using a novel screening device. METHODS: A total of 33 healthy young male participants participated in the study. Two examiners measured the regional upper and lower lumbar lordosis angles of the participants in the standing position using a flexible ruler. The bent flexible ruler maintained a fixed shape and was transferred to a protractor for angle measurement. Two examiners classified each participant into one of 4 lumbar spine categories and measured the upper and lower regional lumbar lordosis angles. RESULTS: The agreement level between the 2 examiners in assessing healthy participants was 87.9%. The calculated kappa coefficient was 0.79 (95% CI = 0.86-0.97), reflecting a substantial level of agreement. CONCLUSION: Our results suggest that our novel screening device for assessing upper and lower lumbar angles showed good inter-tester reliability in posture classification. Our findings may be useful for health care professionals for managing sagittal lumbar posture in asymptomatic younger individuals; however, more testing is still needed.

Lumbar Movement Dysfunction Based on Movement Control Impairment Classification System in Those Who Do and Do Not Develop Transient Low Back Pain During Prolonged Sitting.

OBJECTIVE: Long-term sitting triggers movement-related disorders. We used a movement control impairment (MCI) system to investigate lumbar movement dysfunction in those who did and did not develop transient low back pain (LBP) during prolonged sitting. METHODS: Twelve patients who did and did not develop transient LBP during sitting for 2 hours were enrolled. We tested the movement control abilities of the 2 groups using 6 MCI tests (12 test items). RESULTS: The mean MCI test score in the transient LBP developer group was significantly higher than that in the LBP non-developer group (P = .03). Lumbar flexion movement control as the backward rocking test was significantly more common in the transient LBP developer than in the LBP non-developer group (P < .027). Pelvic shifting and asymmetry during side-bending of the trunk were evident in both groups (all P > .05). However, pelvic shifting during side-bending of the trunk was evident only in the LBP group (33%; P = .093). CONCLUSION: The group exhibiting transient LBP had higher positive MCI test scores and exhibited more asymmetry than the other group. Even the non-LBP group exhibited poor lumbar flexion and rotation. Therefore, subjects with subclinical dysfunction caused by prolonged sitting may require homogenous subgroups classification for the early detection of mechanical risk factors and health and functional interventions.

The Intertester Reliability of a Modified Movement System Impairment Classification System Used to Evaluate Individuals With Prolonged Sitting: A Preliminary Study.

OBJECTIVE: Prolonged sitting while working at a computer leads to poor sitting postures, which can aggravate low back pain in many individuals. We examined the intertester reliability of using the modified musculoskeletal impairment schema for classifying participants sitting at computers for prolonged times. METHODS: Fifty participants were examined independently by each therapist using a test-retest design. Each therapist assigned an musculoskeletal impairment classification upon completion of the examination. The agreement percentages and the kappa coefficient were used to evaluate intertester reliability in classifying participants with prolonged sitting. RESULTS: The percentage agreement between the 2 examiners for participants who maintained the sitting posture for prolonged times was 84%. The calculated kappa coefficient was 0.73, reflecting a substantial level of agreement. CONCLUSIONS: The present findings provide some evidence to support the classification of individuals who sit at computers for prolonged times and participants with rotation with flexion pattern would need to manage asymmetry pattern in a subclinical group.

Reliability, standard error of measurement, and minimal detectable change of the star excursion balance test in children with cerebral palsy.

OBJECTIVE: The present study aimed to estimate the reliability, standard error of measurement (SEM), and minimum detectable change (MDC) of the star excursion balance test (SEBT) in children with cerebral palsy (CP). METHODS: Eight children with CP (five boys and three girls, sixteen legs) participated in this study. Each child carried out the SEBT and was assessed by two examiners. To determine intra-rater reliability, the intra-class correlation coefficient (ICC) model (3, 3) was calculated. To determine the inter-rater reliability, the ICC model (2, 3) was computed. RESULTS: In terms of the intra-rater reliability of the SEBT, the ICC varied from 0.98 to 0.99 and the total ICC score was 0.99 (p< 0.001). For the inter-rater reliability, the ICC varied from 0.98 to 1.00 and the total ICC score was 0.99 (p< 0.001). The SEBT had an SEM of 2.63 and an MDC of 7.31. CONCLUSION: The SEBT is not only reliable with a small SEM, but is also a simple and cheap assessment of dynamic balance in children with CP.

The effect of sagittal hip angle on lumbar and hip coordination and pelvic posterior shift during forward bending.

PURPOSE: The purpose of this study was to investigate the effects of dynamic sagittal hip angle on lumbar and hip coordination and pelvic posterior shift during forward bending. METHODS: A total of 44 asymptomatic younger female volunteers were recruited to this study. Following measurement of trunk forward bending, participants were divided into three groups based on hip flexion angle: group 1, < 30°; group 2, ≥ 30° and < 50°; and group 3, ≥ 50°. Lumbar spine and hip coordination and pelvic backward shift were recorded during trunk forward bending using a three-dimensional ultrasonic motion analysis system. RESULTS: Pelvic and total angles increased with hip angle (group 3 > group 2 > group 1; p = 0.003 and p < 0.001, respectively), whereas lumbar/hip and pelvic/hip angle ratios decreased significantly (p < 0.001). The degree of pelvic posterior shift increased to a limited extent, whereas the pelvic posterior shift/hip angle ratio decreased significantly (p < 0.05). CONCLUSIONS: Asymptomatic subjects with limited hip flexion showed reduced total pelvic anterior rotation and greater relative proportion of pelvic motion than insufficient hip motion. These subjects tended to increase the pelvic posterior shift/hip angle ratio during trunk forward bending, possibly increasing passive tension by elongating the hamstring muscles to increase hip motion. The results of this study provide information that will improve the assessment of lumbar spine and hip coordination patterns and facilitate movement strategies by determining the specific requirements of individuals. These slides can be retrieved under Electronic Supplementary Material.

Inertial Measurement Unit-based Evaluation of Global and Regional Lumbar Spine and Pelvis Alignment in Standing Individuals With a Flat Lumbar Posture.

OBJECTIVE: The purpose of this study was to investigate the global and regional lumbar spine and pelvis postural alignment in standing individuals with a flat lumbar posture using an inertial measurement unit (IMU) system. METHODS: A total of 80 symptomatic young volunteers (25 men and 55 women in their early 20s) were recruited at Inje University in Gimhae, South Korea for this study. Participants stood in a comfortable posture for 5 seconds with IMUs on the T10, L3, and S2 level. Participants were then categorized into 3 groups according to the global lumbar lordosis (GLL) angle (T10-S2): <20°, 20° ≤ GLL angle < 30°, and 30° ≤ GLL angle < 40°. We compared the GLL and regional lumbar lordosis (RLL) angles among the 3 groups. RESULTS: As GLL increased, RLL angles (upper, P = .001; lower, P < .001) tended to increase, whereas the sacrum angle decreased (P < .001). A stepwise regression model showed that the sacrum angle was the single best predictor of GLL in standing participants. Based on IMU measurements, participants with GLL <20° are considered representative of participants with a flat lumbar posture. CONCLUSION: Posture measurements in a standing position conducted to assess lordosis should consider the relationship between GLL and RLL rather than GLL or RLL alone. We found that S2 was the best predictor of GLL.

Outcomes of the lower trapezius muscle activities during various narrow-base push-up exercises.

BACKGROUND: In clinics, training of the lower trapezius muscle for the rehabilitation of the shoulder is often applied. The narrow-base push-up exercise is considered suitable training of the proximal shoulder complex, but the effect on the lower trapezius muscle has not yet been investigated. OBJECTIVE: The purpose of this study was to investigate the effect of push-up, push-up plus, and support surfaces on the lower trapezius muscle during the narrow-base push-up exercise. METHODS: A total of 11 males participated in this study. Surface electromyographic response of the lower trapezius muscle was examined during the narrow-base push-up exercise. RESULTS: The lower trapezius muscle activity increased significantly in both the stable and the unstable conditions during the narrow-base push-up phase compared with both conditions during the narrow-base push-up plus phase. CONCLUSIONS: The narrow-base push-up is considered a suitable exercise for strengthening the lower trapezius muscle regardless of support surfaces.

Stepping over an obstacle in patients with lumbar spinal stenosis: Trunk and lower extremities of kinematic and muscle activation normalized by double limb support. A preliminary study.

BACKGROUND: Patients with LSS tend to adopt a flexed lumbar posture and trunk position, particularly when stepping over an obstacle, as this activity alters the biomechanical demands placed on the trunk and lower extremities. OBJECTIVE: To investigate the effects of lumbar spinal stenosis (LSS) on patients' trunk and lower-extremity kinematics, and on activities involving the gluteus medius (GMed) and vastus lateralis (VL). METHODS: All participants (9 older adult patients with LSS and 11 control subjects) were required to negotiate an obstacle while walking. Trunk and lower-extremity kinematic data and GMed and VL activities were recorded using a synchronized 3D motion capture system and surface electromyography. RESULTS: The thoracic (12.01∘± 8.82∘ and 16.45∘± 10.80∘) and spinal (9.92∘± 14.03∘ and 5.99∘± 15.94∘) flexion angles of the leading and trailing swing limbs were higher, and the pelvic anterior tilting angle (2.37∘± 7.76∘ and 10.38∘± 8.07∘) was lower in the LSS group than in the control group (p< 0.05). With the exception of toe-off and normalized GMed activities in the contralateral leading limb (p> 0.05), all GMed (256.73 ± 112.22%, 174.00 ± 75.79%, and 270.57 ± 114.45%, respectively) and VL (208.98 ± 124.81%, 182.97 ± 93.23%, 283.91 ± 154.71%, and 394.42 ± 108.94%, respectively) activities of the contralateral leading and trailing swing limb (heel-strike and toe-off normalized activities) were significantly higher in the LSS group than in the control group (p< 0.05). CONCLUSIONS: Patients with LSS exhibited trunk-flexed postures when stepping over an obstacle, and these trunk alignments placed higher demands on the GMed and VL activities normalized by double-limb support during joint loading in the single-leg stance. These findings support clinical recommendations for regulating the physical activity of obstacle negotiation that may be beneficial in the management of patients with LSS.

The effects of a posterior superior iliac spine support device on upper trunk acceleration during gait in individuals with flat lumbar back posture.

BACKGROUND: The orientation of the pelvis is of particular importance to the sagittal curve of the spine and has geometric relationships with the top of the spine and lumbar lordosis. Changes in spinal shape or disruptions of sagittal balance in the spine, such as a flattened lumbar spine, have significant negative effects. OBJECTIVE: The aim of this study was to investigate the effects of the posterior superior iliac spine support device (PSD) on upper trunk acceleration during gait in individuals with flat lumbar back posture. METHODS: In total, 10 young male subjects with reduced lumbar lordosis (global lumbar lordosis angle (T10-S2): <-20∘) were recruited for this study. Participants walked 7 m with and without wearing a PSD at a self-selected speed while fitted with an accelerometer attached over the T7 spinous process. RESULTS: The normalized AP acceleration of T7 with PSD (40.57 ± 11.22%) was significantly higher than those without PSD (37.10 ± 10.46%, p= 0.035). CONCLUSIONS: We found that wearing the PSD immediately improved pelvic physiological movement during walking in individuals with lumbar flat back posture. Our findings may help healthcare professionals manage flat back posture in asymptomatic younger individuals.

The effects of a reciprocal hip exercise on trunk flexion angle and sit-to-stand time in participants with flat backs.

[Purpose] This study developed a reciprocal hip exercise using Thera-Band for those with flat lumbar spines and observed changes in standing and movement angles during sit-to-stand. [Participants and Methods] Eleven females participated in this study. The participants performed the reciprocal hip exercise using Thera-Band. [Results] The trunk flexion angle increased significantly after reciprocal hip exercise. The sit-to-stand time after reciprocal hip exercise was significantly faster than that before exercise. [Conclusion] The reciprocal hip exercise would useful for patients with flat back who can then sit and work for long periods.

Effects of manual therapy with functional electrical stimulation on scoliosis curve in children with cerebral palsy.

[Purpose] The purpose of this study was to investigate the effect of manual therapy with functional electrical stimulation (FES) on scoliosis curve and quality of life in children with cerebral palsy (CP). [Participants and Methods] Two children with CP performed 30 minutes of manual therapy and 30 minutes of FES three times a week for 3 months. The Cobb's angle and Pediatric Quality of Life Inventory (PedsQL) score were assessed before and after the intervention. [Results] The Cobb's angle and PedsQL score were improved after intervention. [Conclusion] Our results indicate that manual therapy with FES was effective for improving scoliosis curve and quality of life.

Strategy on navigating obstacle in patients with lumbar spinal stenosis: Relationship among trunk and pelvic movement, swing toe clearance, and muscle coordination of the stance limb.

BACKGROUND AND OBJECTIVE: Lumbar spinal stenosis (LSS) is a common spinal disorder that causes patients to assume a forward-trunk posture. Spinal alignment affects gait, muscle activity, and trunk-pelvis-limb coordination because the lumbar spine and muscles interact to allow load transfer between the lower back and pelvis during sagittal trunk movement. Therefore, we investigated the relationships among trunk and pelvic movement, swing toe clearance, and muscle coordination (isolated contraction ratios) of the stance limb during obstacle-crossing by patients with LSS. METHODS: Ten patients with LSS and ten control subjects were enrolled. All navigated an obstacle during walking. Kinematic data from the trunk and lower extremities were monitored using a three-dimensional motion analysis system. In addition, we measured the isolated contraction ratios of the gluteus medius (GMed) and vastus lateralis (VL) using surface electromyography. RESULTS: The normalized lead limb distance was significantly lower in the LSS group than in controls. The spine flexion angle when the swinging limb toe was above the obstacle was higher, but the pelvic anterior tilting angle was lower, in the LSS group. LSS patients also had a significantly lower isolated contraction ratio of the GMed in the trailing stance limb but a significantly higher VL. CONCLUSIONS: Patients with LSS adapted a poor posture and their thoracic and spinal regions were hyperflexed with restricted pelvic obliquity. This created an inefficient gait, a shorter leading limb step, and less stable muscle coordination in the stance limb. Our findings may help healthcare professionals manage patients with LSS.

Changes in trunk sway and impairment during sitting and standing in children with cerebral palsy.

BACKGROUND: Poor postural control constitutes a major impairment in children with cerebral palsy (CP), compromising everyday activities such as sitting- and standing-position. PURPOSE: In this study, we measured trunk sway during sitting- and standing-position. Additionally, we assessed trunk control ability using the trunk impairment scale (TIS), trunk control measurement scale (TCMS), and sitting assessment test for children with neuromotor dysfunction (SACND), in children with CP. METHODS: Fifteen children (10 boys and 5 girls) were recruited for this study. Trunk sway was measured using a triaxial accelerometer that recorded variation in movement acceleration during quiet sitting- and standing-position. RESULTS: Anterior-posterior (AP) acceleration was significantly greater in the standing position than the sitting position (p= 0.001). Medio-lateral (ML) acceleration was significantly greater in the standing position than in the sitting position (p= 0.012). The TIS total score showed a moderate negative relationship with AP acceleration (r=-0.635, p= 0.011). The TCMS total score moderately and negatively correlated with AP acceleration (r=-0.582, p= 0.023). The SACND total score moderately and positively correlated with AP acceleration (r= 0.670, p= 0.006). CONCLUSION: Measurement of trunk sway using a triaxial accelerometer revealed a moderate correlation with trunk control test data and excellent reliability. Our findings suggest that measurement of trunk sway using a triaxial accelerometer is not time-consuming, and is simple and easy. Our approach can be applied in clinical settings to gain information on trunk control in children with CP.