Test-re-test reliability and inter-rater reliability of a digital pelvic inclinometer in young, healthy males and females

Chris Beardsley, Tim Egerton, Brendon Skinner, Chris Beardsley, Tim Egerton, Brendon Skinner

Abstract

Objective. The purpose of this study was to investigate the reliability of a digital pelvic inclinometer (DPI) for measuring sagittal plane pelvic tilt in 18 young, healthy males and females. Method. The inter-rater reliability and test-re-test reliabilities of the DPI for measuring pelvic tilt in standing on both the right and left sides of the pelvis were measured by two raters carrying out two rating sessions of the same subjects, three weeks apart. Results. For measuring pelvic tilt, inter-rater reliability was designated as good on both sides (ICC = 0.81-0.88), test-re-test reliability within a single rating session was designated as good on both sides (ICC = 0.88-0.95), and test-re-test reliability between two rating sessions was designated as moderate on the left side (ICC = 0.65) and good on the right side (ICC = 0.85). Conclusion. Inter-rater reliability and test-re-test reliability within a single rating session of the DPI in measuring pelvic tilt were both good, while test-re-test reliability between rating sessions was moderate-to-good. Caution is required regarding the interpretation of the test-re-test reliability within a single rating session, as the raters were not blinded. Further research is required to establish validity.

Keywords: Pelvic tilt; Reliability.

Conflict of interest statement

Chris Beardsley is a Director of Strength and Conditioning Research Limited, a business that provides an online sports science encyclopedia, and Tim Egerton is the owner of Sport Science Tutor, a business that provides online sports science coaching for students.

Figures

Figure 1. Measuring pelvic tilt using the…
Figure 1. Measuring pelvic tilt using the DPI.
Standing position maintained by subject, while rater measured pelvic tilt using the DPI.

References

    1. Alviso DJ, Dong GT, Lentell GL. Intertester reliability for measuring pelvic tilt in standing. Physical Therapy. 1988;68(9):1347–1351.
    1. Barakatt E, Smidt GL, Dawson JD, Wei SH, Heiss DG. Interinnominate motion and symmetry: comparison between gymnasts and nongymnasts. Journal of Orthopaedic & Sports Physical Therapy. 1996;23(5):309–319. doi: 10.2519/jospt.1996.23.5.309.
    1. Batterham AM, George KP. Reliability in evidence-based clinical practice: a primer for allied health professionals? Physical Therapy in Sport. 2003;4(3):122–128. doi: 10.1016/S1466-853X(03)00076-2.
    1. Betsch M, Wild M, Große B, Rapp W, Horstmann T. The effect of simulating leg length inequality on spinal posture and pelvic position: a dynamic rasterstereographic analysis. European Spine Journal. 2012;21(4):691–697. doi: 10.1007/s00586-011-1912-5.
    1. Blondel B, Parratte S, Tropiano P, Pauly V, Aubaniac JM, Argenson JN. Pelvic tilt measurement before and after total hip arthroplasty. Orthopaedics & Traumatology: Surgery & Research. 2009;95(8):568–572.
    1. Burdett RG, Brown KE, Fall MP. Reliability and validity of four instruments for measuring lumbar spine and pelvic positions. Physical Therapy. 1986;66(5):677–684.
    1. Chaléat-Valayer E, Mac-Thiong JM, Paquet J, Berthonnaud E, Siani F, Roussouly P. Sagittal spino-pelvic alignment in chronic low back pain. European Spine Journal. 2011;20(5):634–640. doi: 10.1007/s00586-011-1931-2.
    1. Clayson SJ, Newman IM, Debevec DF, Anger RW, Skowlund HV, Kottke F. Evaluation of mobility of hip and lumbar vertebrae of normal young women. Archives of Physical Medicine and Rehabilitation. 1962;43:1–8.
    1. Cooperstein R, Lew M. The relationship between pelvic torsion and anatomical leg length inequality: a review of the literature. Journal of Chiropractic Medicine. 2009;8(3):107–118. doi: 10.1016/j.jcm.2009.06.001.
    1. Crowell RD, Cummings GS, Walker JR, Tillman LJ. Intratester and intertester reliability and validity of measures of innominate bone inclination. Journal of Orthopaedic & Sports Physical Therapy. 1994;20(2):88–97. doi: 10.2519/jospt.1994.20.2.88.
    1. Cummings G, Scholz JP, Barnes K. The effect of imposed leg length difference on pelvic bone symmetry. Spine. 1993;18(3):368–373. doi: 10.1097/00007632-199303000-00012.
    1. Day JW, Schmidt GL, Lehmann T. Effect of pelvic tilt on standing posture. Physical Therapy. 1984;64(4):510–516.
    1. Flint MM. Lumbar posture: a study of roentgenographic measurement and the influence of flexibility and strength. Research Quarterly. American Association for Health, Physical Education and Recreation. 1963;34(1):15–20.
    1. Fourchet F, Materne O, Rajeb A, Horobeanu C, Farooq A. Pelvic tilt: reliability of measuring the standing position and range of motion in adolescent athletes. British Journal of Sports Medicine. 2014;48(7):594–594.
    1. Gajdosik R, Simpson R, Smith R, DonTigny RL. Pelvic tilt intratester reliability of measuring the standing position and range of motion. Physical Therapy. 1985;65(2):169–174.
    1. Gamer M, Lemon J, Fellows I, Singh P. IRR: various coefficients of interrater reliability and agreement. (R package v. 0.70) 2007 Available at .
    1. Gnat R, Saulicz E. Induced static asymmetry of the pelvis is associated with functional asymmetry of the lumbo-pelvo-hip complex. Journal of Manipulative and Physiological Therapeutics. 2008;31(3):204–211. doi: 10.1016/j.jmpt.2008.02.012.
    1. Gnat R, Saulicz E, Biały M, Kłaptocz P. Does pelvic asymmetry always mean pathology? Analysis of mechanical factors leading to the asymmetry. Journal of Human Kinetics. 2009;21:23–32.
    1. Guenoun B, Zadegan F, Aim F, Hannouche D, Nizard R. Reliability of a new method for lower-extremity measurements based on stereoradiographic three-dimensional reconstruction. Orthopaedics & Traumatology: Surgery & Research. 2012;98(5):506–513.
    1. Gurney B. Leg length discrepancy. Gait & Posture. 2002;15(2):195–206. doi: 10.1016/S0966-6362(01)00148-5.
    1. Hagins M, Brown M, Cook C, Gstalder K, Kam M, Kominer G, Strimbeck K. Intratester and intertester reliability of the palpation meter (PALM) in measuring pelvic position. Journal of Manual & Manipulative Therapy. 1998;6(3):130–136. doi: 10.1179/jmt.1998.6.3.130.
    1. Hallgren KA. Computing inter-rater reliability for observational data: an overview and tutorial. Tutorials in Quantitative Methods for Psychology. 2012;8(1):23–34.
    1. Heino JG, Godges JJ, Carter CL. Relationship between hip extension range of motion and postural alignment. Journal of Orthopaedic & Sports Physical Therapy. 1990;12(6):243–247. doi: 10.2519/jospt.1990.12.6.243.
    1. Herrington L. Assessment of the degree of pelvic tilt within a normal asymptomatic population. Manual Therapy. 2011;16(6):646–648. doi: 10.1016/j.math.2011.04.006.
    1. Juhl JH, Cremin TMI, Russell G. Prevalence of frontal plane pelvic postural asymmetry—part 1. Journal of the American Osteopathic Association. 2004;104(10):411–421.
    1. Knutson GA. Anatomic and functional leg-length inequality: a review and recommendation for clinical decision-making. Part I, anatomic leg-length inequality: prevalence, magnitude, effects and clinical significance. Chiropractic & Manual Therapies. 2005;13(1):1–10.
    1. Krawiec CJ, Denegar CR, Hertel J, Salvaterra GF, Buckley WE. Static innominate asymmetry and leg length discrepancy in asymptomatic collegiate athletes. Manual Therapy. 2003;8(4):207–213. doi: 10.1016/S1356-689X(03)00012-2.
    1. Lalonde NM, Dansereau J, Pauget P, Cinquin P, Aissaoui R. Accessing the influence of repositioning on the pelvis’ 3-D orientation in wheelchair users. IEEE Transactions on Neural Systems and Rehabilitation Engineering. 2006;14(1):76–82.
    1. Lazennec JY, Rousseau MA, Rangel A, Gorin M, Belicourt C, Brusson A, Catonné Y. Pelvis and total hip arthroplasty acetabular component orientations in sitting and standing positions: measurements reproductibility with EOS imaging system versus conventional radiographies. Orthopaedics & Traumatology, Surgery & Research. 2011;97(4):373–380. doi: 10.1016/j.otsr.2011.02.006.
    1. Lee JH, Yoo WG, Gak HB. The immediate effect of anterior pelvic tilt taping on pelvic inclination. Journal of Physical Therapy Science. 2011;23(2):201–203. doi: 10.1589/jpts.23.201.
    1. Levine D, Walker JR, Tillman LJ. The effect of abdominal muscle strengthening on pelvic tilt and lumbar lordosis. Physiotherapy Theory and Practice. 1997;13(3):217–226. doi: 10.3109/09593989709036465.
    1. Levine D, Whittle MW. The effects of pelvic movement on lumbar lordosis in the standing position. Journal of Orthopaedic & Sports Physical Therapy. 1996;24(3):130–135. doi: 10.2519/jospt.1996.24.3.130.
    1. Lim HS, Roh SY, Lee SM. The relationship between pelvic tilt angle and disability associated with low back pain. Journal of Physical Therapy Science. 2013;25(1):65–68. doi: 10.1589/jpts.25.65.
    1. McGraw KO, Wong SP. Forming inferences about some intraclass correlation coefficients. Psychological Methods. 1996;1(1):30–46. doi: 10.1037/1082-989X.1.1.30.
    1. Moes CCM. Measuring the tilt of the pelvis. Ergonomics. 1998;41(12):1821–1831. doi: 10.1080/001401398185992.
    1. O’Sullivan P. It’s time for change with the management of non-specific chronic low back pain. British Journal of Sports Medicine. 2012;46(4):224–227. doi: 10.1136/bjsm.2010.081638.
    1. Petrone MR, Guinn J, Reddin A, Sutlive TG, Flynn TW, Garber MP. The accuracy of the palpation meter (PALM) for measuring pelvic crest height difference and leg length discrepancy. Journal of Orthopaedic & Sports Physical Therapy. 2003;33(6):319–325. doi: 10.2519/jospt.2003.33.6.319.
    1. Portney LG, Watkins MP. Foundations of clinical research: applications to practice. Upper Saddle River: Prentice Hall; 2008.
    1. Preece SJ, Willan P, Nester CJ, Graham-Smith P, Herrington L, Bowker P. Variation in pelvic morphology may prevent the identification of anterior pelvic tilt. Journal of Manual & Manipulative Therapy. 2008;16(2):113–117. doi: 10.1179/106698108790818459.
    1. Sanders G, Stavrakas P. A technique for measuring pelvic tilt. Physical Therapy. 1981;61(1):49–50.
    1. Schache AG, Bennell KL, Blanch PD, Wrigley TV. The coordinated movement of the lumbo–pelvic–hip complex during running: a literature review. Gait & Posture. 1999;10(1):30–47. doi: 10.1016/S0966-6362(99)00025-9.
    1. Schache AG, Blanch PD, Murphy AT. Relation of anterior pelvic tilt during running to clinical and kinematic measures of hip extension. British Journal of Sports Medicine. 2000;34(4):279–283. doi: 10.1136/bjsm.34.4.279.
    1. Schache AG, Blanch P, Rath D, Wrigley T, Bennell K. Three-dimensional angular kinematics of the lumbar spine and pelvis during running. Human Movement Science. 2002;21(2):273–293. doi: 10.1016/S0167-9457(02)00080-5.
    1. Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychological Bulletin. 1979;86(2):420–428. doi: 10.1037/0033-2909.86.2.420.
    1. Sprigle S, Flinn N, Wootten M, McCorry S. Development and testing of a pelvic goniometer designed to measure pelvic tilt and hip flexion. Clinical Biomechanics. 2003;18(5):462–465. doi: 10.1016/S0268-0033(03)00049-4.
    1. Vaz G, Roussouly P, Berthonnaud E, Dimnet J. Sagittal morphology and equilibrium of pelvis and spine. European Spine Journal. 2002;11(1):80–87. doi: 10.1007/s005860000224.
    1. Walker ML, Rothstein JM, Finucane SD, Lamb RL. Relationships between lumbar lordosis, pelvic tilt, and abdominal muscle performance. Physical Therapy. 1987;67(4):512–516.
    1. Walmsley RP, Amell TK. The application and interpretation of intraclass correlations in the assessment of reliability in isokinetic dynamometry. Isokinetics and Exercise Science. 1996;6(2):117–124.
    1. Weir JP. Quantifying test–re-test reliability using the intraclass correlation coefficient and the SEM. The Journal of Strength & Conditioning Research. 2005;19(1):231–240.
    1. Wild M, Kühlmann B, Stauffenberg A, Jungbluth P, Hakimi M, Rapp W, Betsch M. Does age affect the response of pelvis and spine to simulated leg length discrepancies? A rasterstereographic pilot study. European Spine Journal. 2014;23(7):1449–1456. doi: 10.1007/s00586-013-3152-3.
    1. Wolak ME, Fairbairn DJ, Paulsen YR. Guidelines for estimating repeatability. Methods in Ecology and Evolution. 2012;3(1):129–137. doi: 10.1111/j.2041-210X.2011.00125.x.
    1. Wolak M. Functions facilitating the estimation of the intraclass correlation coefficient. (R package v. 2.2.1) 2012 Available at .
    1. Youdas JW, Garrett TR, Egan KS, Therneau TM. Lumbar lordosis and pelvic inclination in adults with chronic low back pain. Physical Therapy. 2000;80(3):261–275.
    1. Youdas JW, Garrett TR, Harmsen S, Suman VJ, Carey JR. Lumbar lordosis and pelvic inclination of asymptomatic adults. Physical Therapy. 1996;76(10):1066.
    1. Young RS, Andrew PD, Cummings GS. Effect of simulating leg length inequality on pelvic torsion and trunk mobility. Gait & Posture. 2000;11(3):217–223. doi: 10.1016/S0966-6362(00)00048-5.

Source: PubMed

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