Concurrent Validity of Flexicurve Instrument Measurements: Sagittal Skin Contour of the Cervical Spine Compared With Lateral Cervical Radiographic Measurements

Clinical methods for quantifying body segment posture: a literature review

“…The validity of distance measurements is only reported for shoulder protraction [51], knee varus and valgus [56] and indices of the foot [66][67][68][69] Another device called flexible curve (flexi-rule, flexible ruler or flexi-curve) has also been used to measure the posture of the pelvic and the sagittal spinal curves on normal persons and two studies were in persons with neck and back pain [70,71]. This tool is designed to adapt to the contour of the back and used to measure cervical and lumbar lordosis or thoracic kyphosis.…”

“…According to Hinman [72], this could be attributed to the difficulty in adapting the flexible curve to the smaller concave curvature of the lumbar spine and from some person's clothing. The level of reliability was lower when measurements were taken among persons with neck and back pain (ICCs: 0.23 and 0.18 for cervical lordosis and 0.35 to 0.62 for lumbar lordosis) [70,71]. The spinal pantograph which draws the shape of the back, was also used to measure kyphosis and lordosis [76].…”

Kyphosis index obtained in X-ray and with flexicurve assessment in children and young people

“…It is also important to emphasize that the children and young people has a body surface, as well as the size of the column (length and width), smaller in comparison to adults, increasing the chances of errors in the flexicurve instrument. A fact described in Harrison et al, 15 in which was found a weak assessment correlation of the flexicurve instrument with the X-ray examinations to evaluate the cervical region of the adults, finding it difficult in evaluating small regions.…”

“…Harrison et al 15 and McFarland et al 16 highlight that some inherent problems to the method may be responsible for any errors in the calculations generated from the flexicurve. For example, the authors cite the smallest modifications of the flexicurve form, which are related to the inherent flexibility of the instrument and the fact of the severity, or a slight pressure, in the metal band contained inside might deform the instrument, before the precise line of trace is needed to be done on paper.…”

Clinical measurements of cervical lordosis using flexirule and inclinometer methods in individuals with and without cervical spine dysfunction: A reliability and validity study

“…Radiogra-phy is expensive, is time-consuming and exposes patients to radiation [10,13,14,23]. However, a feasible clincial method to assess cervical lordosis from surface measures has not been validated [10,11,23]. Visual estimates of spinal posture, such as increased or decreased kyphosis or lordosis, are commonly used in the clinic, but these visual methods have been shown to have poor reliability and validity [12].…”