Miller S, Buchanan D, McCormack K, Rutledge M; State University of New York Upstate Medical University, Syracuse, NY. Millers@upstate.edu.

PURPOSE: The purpose of this study was to investigate the reliability of a laser level for postural screening. Used for years in construction, the laser projects self-leveling visible vertical and horizontal lines on whatever surface they strike. It is small, easy to use and if reliable, could be valuable for clinical postural assessment. SUBJECTS: A convenience sample of 24 students, over eighteen years old, able to stand still with feet together without an assistive device for seven minutes and sit without back support for three minutes, three times in succession was recruited. METHODS: After obtaining consent, selected anatomical sites were marked using small round stickers with a six-millimeter diameter hole. The laser was mounted on a pole allowing for quick height and lateral adjustments. Barefoot subjects stood 1.5 meters from the laser, hands at sides for posterior and side view assessment. Posterior sitting view was assessed with subject sitting on a stool, hips and knees flexed to 90, feet together, hands on thighs. The vertical laser line was centered between the malleoli posteriorly, at the calcaneocuboid joint at the side, and at the top of the gluteal cleft in sitting. Horizontally, the laser was adjusted to the right side landmarks and the left judged to be on the same level, above or below in comparison. Three testers independently examined each subject consecutively. The order in which the testers examined the subjects was subsequently rotated. Data was recorded in a standard order. With the vertical laser, a marker was considered centered if the laser line, ~2 mm wide, was within the marker, or to the left or right if outside. Each tester recorded 42 parameters, including some marked and unmarked landmarks, and estimations of spinal curvature. ANALYSIS: Kappa values were computed for each parameter with each subject for each of three tester pairs for the 24 subjects to generate a range of Kappa values for analysis. An average was computed for each of the tester pairs. RESULTS: Kappa values ranged from .34 to .89. Averaged kappa values between all three pairs were .59 CONCLUSIONS: This indicates a moderate level of agreement and reliability. Factors were identified that might further improve reliability. However, normal postural sway may inherently limit information that can be reliably gathered through postural screening regardless of the instrument used. FUNDING SOURCE: None; no potential for material gain.

Copyright 2004 by the American Physical Therapy Association

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