Reliability of PHAS in Postural Hyperkyphosis

September 25, 2025 updated by: Ayse Zengin Alpozgen, Istanbul University - Cerrahpasa

Reliability Analysis of the Postural Habits and Awareness Scale (PHAS) in Patients With Postural Hyperkyphosis

This observational, cross-sectional study aims to evaluate the reliability of the Postural Habits and Awareness Scale (PHAS) in patients with postural hyperkyphosis. The PHAS is designed to assess individuals' postural awareness and habits through four subscales. A total of 128 participants diagnosed with postural hyperkyphosis will complete the PHAS and the Kyphosis-Specific Spinal Appearance Questionnaire (KSSA). Test-retest reliability will be assessed by reapplying the PHAS after two weeks. Internal consistency, test-retest reliability, and concurrent validity will be analyzed. The study aims to provide a valid and reliable tool for evaluating postural awareness in clinical practice and future rehabilitation studies.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This study is designed to assess the reliability of the Postural Habits and Awareness Scale (PHAS) in individuals diagnosed with postural hyperkyphosis. Postural hyperkyphosis is increasingly common due to sedentary lifestyles, prolonged sitting, and technological device use, leading to significant postural deviations and musculoskeletal complaints. Early detection and management of postural habits are essential to prevent long-term spinal deformities and functional limitations.

The PHAS was developed to systematically evaluate individuals' postural awareness and habits in daily life, focusing on factors that contribute to poor posture and spinal alignment. The scale assesses dimensions such as postural habits, awareness of posture-disturbing factors, positional awareness, and ergonomic considerations. However, its psychometric properties, particularly reliability in hyperkyphotic patients, have not yet been established.

This observational, cross-sectional methodological study will employ standardized psychometric methods to analyze the internal consistency and test-retest reliability of the PHAS. The scale's ability to produce stable and consistent results over time will be tested through repeated administration. Additionally, concurrent validity will be examined by comparing PHAS scores with the Kyphosis-Specific Spinal Appearance Questionnaire (KSSA), which measures patients' perception of their spinal deformity.

The findings will provide valuable insights into the scale's utility for clinical and research purposes. Establishing PHAS as a reliable tool could allow physiotherapists, ergonomists, and healthcare professionals to objectively assess postural habits and awareness, design personalized rehabilitation programs, and monitor treatment outcomes. Furthermore, the scale could be integrated into preventive strategies aimed at improving postural control and spinal health in both clinical practice and community settings.

Research Team:

Assoc. Prof. Dr. Ayşe Zengin Alpözgen (Principal Investigator) PhD. PT Kübra Kardeş (Istinye University) MSc PT Selin Uz Tunçay (Istanbul University-Cerrahpasa) MSc PT Merve Koyuncu Cenikli (Istanbul University-Cerrahpasa)

Study Type

Observational

Enrollment (Estimated)

128

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Turkey (Türkiye)
    • Istanbul
      • Istanbul, Istanbul, Turkey (Türkiye)
        • Recruiting
        • Istanbul University-Cerrahpasa
        • Contact:
        • Sub-Investigator:
          • Kübra Kardeş, Asst. Prof
        • Sub-Investigator:
          • Selin Uz Tunçay, Msc
        • Sub-Investigator:
          • Merve Koyuncu Cenikli, Msc.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population consists of individuals diagnosed with postural hyperkyphosis. Participants will include patients aged 8 to 65 years who have been clinically and radiologically confirmed to have postural hyperkyphosis with a Cobb angle of 50° or higher. All participants are expected to be capable of performing daily activities independently.

Description

Inclusion Criteria:

  • Age between 8 and 65 years
  • Diagnosed with postural hyperkyphosis (Cobb angle ≥ 50° confirmed by clinical and radiological evaluation)
  • Ability to perform daily activities independently
  • Voluntary participation and signed informed consent

Exclusion Criteria:

  • Presence of scoliosis or other spinal deformities
  • Kyphosis due to severe osteoporosis or pathological fractures
  • Diagnosis of ankylosing spondylitis or other inflammatory spinal diseases
  • Functional limitations due to acute or chronic pain
  • Previous postural awareness training or spinal rehabilitation within the last 6 months
  • Cognitive impairment or severe psychiatric disorder preventing independent questionnaire completion

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Hyperkyphosis Group
Participants diagnosed with postural hyperkyphosis completing the PHAS and KSSA for reliability analysis.
Behavioral: PHAS Assessment
Participants will complete the Postural Habits and Awareness Scale (PHAS) to assess postural awareness and habits. The scale will be administered twice, two weeks apart, to evaluate reliability.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Reliability of the Postural Habits and Awareness Scale (PHAS)
Time Frame: 2 weeks
Internal consistency will be evaluated using Cronbach's Alpha. Test-retest reliability will be assessed by calculating the Intraclass Correlation Coefficient (ICC) between two PHAS administrations. The PHAS consists of 19 items, each scored on a 5-point Likert scale (total score range: 19 to 95). Higher scores indicate better postural habits and awareness. Higher ICC values indicate better reliability.
2 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Kyphosis-Specific Spinal Appearance Questionnaire (KSSAQ)
Time Frame: Baseline
The KSSAQ is a 10-item, 5-point Likert scale (range: 1 to 5 per item, total score range: 10 to 50) designed to assess patients' perception of their spinal appearance related to thoracic hyperkyphosis. Higher scores indicate worse perceived deformity and greater concern about appearance. The correlation between PHAS and KSSAQ scores will be calculated to determine concurrent validity.
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Istanbul University - Cerrahpasa

Investigators

  • Principal Investigator: Ayse Zengin Alpozgen, Assoc. Prof., Istanbul University - Cerrahpasa

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 1, 2025

Primary Completion (Estimated)

May 1, 2026

Study Completion (Estimated)

June 1, 2026

Study Registration Dates

First Submitted

March 26, 2025

First Submitted That Met QC Criteria

March 26, 2025

First Posted (Actual)

April 2, 2025

Study Record Updates

Last Update Posted (Estimated)

October 1, 2025

Last Update Submitted That Met QC Criteria

September 25, 2025

Last Verified

March 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • aza_isu1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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