Reliability and Validity of Nonradiologic Measures of Forward Flexed Posture in Parkinson’s Disease

Publication date: Available online 1 July 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Prajakta Nair, Richard W. Bohannon, Laurie Devaney, Catherine Maloney, Alexis Romano
ObjectiveTo examine the inter-tester reliability and validity of 5 nonradiologic measures of forward flexed posture in individuals with Parkinson's disease (PD).DesignCross-sectional observational study.SettingUniversity outpatient facility and community centers.ParticipantsIndividuals (n=28) with PD. Hoehn and Yahr scores: 1-4.InterventionsNot applicable.Main outcome measuresOcciput to wall (OTW) status, tragus to wall (TTW) distance, C7 to wall (C7W) distance, photographically derived trunk flexion angle (FA) and the inclinometric kyphosis measure (IKM)ResultsParticipants were older adults (mean [SD] = 69.7 [10.6] years) with a 14 month to 15 year (mean [SD] = 5.9 [3.5]) history of PD. Inter-tester reliability was excellent for all measures (kappa=0.89 and 1.0 for OTW; intraclass correlation coefficients = 0.779-0.897 for TTW, C7W, FA and IKM). Convergent validity was supported for all measures by significant correlations between the same measures obtained during relaxed and cued conditions (e.g., OTW-relaxed and OTW-cued) and for most measures by significant correlations between measures obtained under the same condition (e.g., OTW-cued and TTW-cued). Significant correlations between TTW, C7W, FA, and IKM and the Unified Parkinson's Disease Rating Scale 'Item 28- Posture' also supported convergent validity. Significant differences between TTW, C7W and IKM values under relaxed and cued conditions supported known condition validity. Known group validity was demonstrated by significant differences in TTW, C7W, and IKM measures obtained from individuals able and individuals unable to touch their OTW when cued to stand tall.ConclusionsTTW, C7W, and IKM are reliable and valid nonradiologic measures of FFP in PD.



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