AIM: To evaluate the use of photogrammetry and identify the mathematical procedures applied when evaluating spinal posture. METHODS: A systematic search using keywords was conducted in the PubMed, EMBASE, Scopus, Science and Medicine^® databases. The following inclusion criteria adopted were: (1) the use of photogrammetry as a method to evaluate spinal posture; (2) evaluations of spinal curvature in the sagittal and/or frontal plane; (3) studies published within the last three decades; and (4) written entirely in English. The exclusion criteria were: (1) studies which objective involved the verification of some aspect of validation of instruments; (2) studies published as abstracts and those published in scientific events; and (3) studies using evaluation of the anteriorization of the head to determine the angular positioning of the cervical spine. The articles in this review were included and evaluated for their methodological quality, based on the Downs and Black scale, by two independent reviewers. RESULTS: Initially, 1758 articles were found, 76 of which were included upon reading the full texts and 29 were included in accordance with the predetermined criteria. In addition, after analyzing the references in those articles, a further six articles were selected, so that 35 articles were included in this review. This systematic review revealed that the photogrammetry has been using in observational studies. Furthermore, it was also found that, although the data collection methodologies are similar across the studies, in relation to aspects of data analysis, the methodologies are very different, especially regarding the mathematical routines employed to support different postural evaluation software. CONCLUSION: With photogrammetry, the aim of the assessment, whether it is for clinical, research or collective health purposes, must be considered when choosing which protocol to use to evaluate spinal posture.

Objective. to verify the validity and reproducibility of using the flexicurve to measure the angles of the thoracic and lumbar curvatures.Method. 47 subjects were evaluated by: (1) palpation and marking of the spinous processes using lead markers, (2) using X-rays in the sagittal plane to measure the Cobb angles, (3) molding the flexicurve to the spine, and (4) drawing the contour of the flexicurve onto graph paper. The angle of curvature was determined with the flexicurve based on a 3rd order polynomial.Results. No differences were found between the Cobb angles and the angles obtained using the flexicurve in thoracic and lumbar curvatures (). Correlations were strong and significant for the thoracic (, ) and lumbar (, ) curvatures. Excellent and significant correlations were found for both the intraevaluator and interevaluator measurements.Conclusion. The results show that there is no significant difference between the values obtained using the flexicurve and those obtained using the X-ray procedure and that there is a strong correlation between the two methods. This, together with the excellent level of inter- and intraevaluator reproducibility justifies its recommendation for use in clinical practice.

Background: According to the American Physical Therapy Association, there is strong evidence to show that vertebral mobilization and manipulation procedures can be used to improve spinal and hip mobility and reduce pain and incapacity in low back pain patients that fit the clinical prediction rule. Objectives: To evaluate the immediate effects of high-velocity low-amplitude (HVLA) manipulation on pain and postural control parameters in individuals with nonspecific low back pain. Methods: This study used a participant-blinded and assessor-blinded randomized controlled clinical trial involving a single session, in which 24 participants were randomly distributed into control (simulated manipulation) and intervention (HVLA lumbar manipulation) groups. The primary (pain: subjective pain intensity and pressure pain threshold) and secondary outcomes (postural control: ellipse area, center of pressure [COP] excursion, COP RMS velocity, and differences between the COP and center of projected gravity) were evaluated before and after the session using a numerical pain scale, algometer, and a force platform. For all outcomes, multiple mixed 2 (group) × 2 (time) ANOVAs were performed. Results: For the subjective pain intensity, only time was significant as a main effect, where pre-intervention presented a greater value then post-intervention (F [1.44] = 4.377; p = 0.042; r = 0.30). For the pressure pain threshold no significant effect was found. For the postural control parameters, as a main effect, only the ellipse area was significantly greater in the control group (F [1.44] = 6.760; p = 0.013; effect size = 0.36). Conclusions: There was a reduction in subjective pain intensity, evaluated using a numerical scale, in both the intervention and control groups immediately after the intervention, suggesting that the spinal manipulation had a similar effect to the placebo procedure. No effect of HVLA lumbar manipulation was identified for postural control variables in either the intervention or control groups. Trial registration: The study was registered at ClinicalTrials.gov under the number NCT02312778, registered at 14 September 2014.

The Back Pain and Body Posture Evaluation Instrument (BackPEI) was created in 2013 to assess back pain and its risk factors in school children. However, it does not assess neck pain or the habits of mobile device usage, which are aspects that are often part of school children’s lives. Therefore, we aimed to update the BackPEI questionnaire to include new questions assessing aspects related to neck pain and the use of mobile devices and to test the content validity and reliability of the new questions. The updated questionnaire was named Back Pain and Body Posture Evaluation Instrument for Children and Adolescents (BackPEI-CA). The content was validated by eight experts using the content validity index (CVI). To assess reliability, the BackPEI-CA questionnaire was applied at two different times in 105 school children, and Cohen’s kappa (k) and intraclass correlation coefficient (ICC) were calculated. All aspects assessed regarding content validity had a CVI higher than 0.8. The new questions presented moderate and good kappa values and excellent ICC values. The updated version of BackPEI-CA can be used as a clinic tool for assessing the presence, frequency, and intensity of back and neck pain and their risk factors.

Lack of alignment between the lower-limb structures, such as the hips, knees, and longitudinal arches of the feet, has been described as an important predisposing factor in musculoskeletal injury among classical ballet dancers. However, no studies were found that analyzed basic ballet movements with quantification of objective criteria of the movements. The purposes of this study were: 1. to establish a methodology to quantify, using kinematic evaluation, the technical criteria that guide the correct execution of all phases of the plié (simultaneous flexion of the hips, knees, and ankle joints); and 2. to explore whether experienced ballet dancers respect those criteria when performing the plié. The technical criteria considered were the following: 1. midfoot stability; 2. pelvic positioning in a neutral alignment; 3. pelvic stability, represented by pelvic angle variation; and 4. vertical alignment of the knee joint with the second toe of the ipsilateral foot. Twenty dancers from Porto Alegre, Brazil, with 18 years of uninterrupted ballet training, were filmed while performing plié using four synchronized cameras. The descriptive statistical analysis involved calculating the median, minimum, and maximum of each of the technical criteria. Results showed that for criterion 1, the 20 dancers showed great stabilization of the midfoot; for criteria 2 and 3, 18 dancers displayed pelvic instability tending toward retroversion throughout execution of the plié; and for criterion 4, 13 dancers presented with medial misalignment of the knees at all phases of the plié. Using these criteria, it was possible to characterize the plié from a kinematic point of view.