Original researchPhotogrammetric Assessment of Upper Body Posture Using Postural Angles: A Literature Review
Introduction
Postural angles are variables that can be measured to quantify posture. These are different from linear measurements, which express postural deviations as distances between 2 bony landmarks.1 Comparisons between 2 different values of a particular angle have yielded significant information regarding posture in many studies,2, 3, 4, 5 as normative values for postural angles of the sagittal plane do not exist in the literature.6 Quantitative data obtained with postural angles can be used to evaluate and monitor the changes that occur during the rehabilitation process by comparing the previous and present values of an angle.
Measurement of various postural angles by using goniometry, photography, photogrammetry, and radiography has been reported in the literature. Photogrammetry is the most widely used method for noninvasive measurement of postural measures, as it eliminates the risk of exposure to harmful radiation encountered with the radiographic method,7 and it does not require printing of photographs. Photogrammetry quantifies postural assessment by measuring linear distances and angles (formed between lines produced through body markers and horizontal or vertical lines) on digital photographs by using software specifically designed for this purpose.7, 8 Goniometry, which uses a handheld goniometer, has a disadvantage when used to record values for postural angles, since it becomes difficult to read the goniometer while the goniometer’s arm is held by the therapist in a horizontal manner.1
There are a number of different postural angles routinely used by the authors in a clinical setting for patients presenting with biomechanical faults. The objective of this study was to review the measurement properties of various angles used for postural assessment of the head, neck, shoulder, and thorax and to discuss the utility of these measures.
Section snippets
Methods
A literature review was performed using the following keywords: head, posture, shoulder, kyphosis, and photogrammetry; PubMed Central, PubMed, ResearchGate, Springer Link, ScienceDirect, Google Scholar, and Scielo, in addition to other sources, were searched through February 20, 2016. The keywords were used individually and in various combinations to search for papers. No additional terms were used while searching. Because of their prior clinical experience, the authors were particularly
Results
A formal record of studies obtained, accepted, and rejected after database searching was not kept. A total of 21 papers were selected by using the keywords and the inclusion and exclusion criteria. Table 19, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21 summarizes the various studies that were included in this review and in which postural angles were measured. The various postural angles that can be measured for the upper body are listed below:
- 1
Craniovertebral angle10, 14, 19, 20: Where a line
Discussion
This review aimed to verify the measurement properties and the utility of certain angles used for the assessment of posture of the head, neck, shoulder, and thoracic regions. To our knowledge, this review is first of its kind to highlight the quality and usage of postural angles for the assessment of upper body posture.
Several examples from the literature may help illustrate how these various postural angles can be used. Lau et al.10 used the Electronic Head Posture Instrument (EHPI) to
Conclusions
The CV angle, sagittal head tilt, sagittal shoulder-C7 angle, and thoracic kyphosis angle provide reliable and easy assessment of head, neck, shoulder and thoracic regions, respectively, in the sagittal plane. However, only subsequent values of a particular angle can be compared to ascertain changes in posture. Nonuniformity found in studies regarding methods used to obtain values of angles precludes the availability of normative data for postural angles in different populations; hence, some
Funding Sources and Conflicts of Interest
No funding sources or conflicts of interest were reported for this study.
Contributorship Information
Concept development (provided idea for the research): D.S., Z.V.
Design (planned the methods to generate the results): D.S., M.E.H.
Supervision (provided oversight, responsible for organization and implementation, writing of the manuscript): Z.V., D.S.
Data collection/processing (responsible for experiments, patient management, organization, or reporting data): D.S., M.E.H.
Analysis/interpretation (responsible for statistical analysis, evaluation, and presentation of the results): D.S., Z.V., M.E.H.
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