Relationship of the Pelvic Angle to the Sacral Angle: Measurement of Clinical Reliability and Validity

Gilliam, Jeff; Brunt, Denis; MacMillan, Michael; Kinard, Richard E.; Montgomery, William J.

doi:10.2519/jospt.1994.20.4.193

Cited by 42 publications

(26 citation statements)

References 12 publications

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“…Pelvic angle was measured in standing using a modified technique described by Gilliam et al 20 The inferior prominence of the anterior superior iliac spine and the most prominent portion of the posterior superior iliac spine were palpated, and the angle formed by a line from the anterior superior iliac spine to the posterior superior iliac spine relative to the inferior prominence of the anterior superior iliac spine was palpated, and the subject's finger was carefully and firmly placed over the prominence. The boundaries of the patella and tibial tuberosity were palpated, and the center positions were marked.…”

Section: Clinical Measuresmentioning

confidence: 99%

“…2,14,19,20,42,73 Of the few studies reporting mean values based on both males and females, sex differences were not examined. 2,20,73 We observed a significant difference between sexes, with females having 3° to 4° greater anterior pelvic angle than males. This sex difference was also noted in a retrospective study of anterior cruciate ligament (ACL) injury risk factors, regardless of injury status.…”

Section: Pelvic Anglementioning

confidence: 99%

“…Muscular tightness and shortening of the erector spinae and hip flexors, and elongation and weakening of the abdominals and gluteals have been suggested to result in greater anterior pelvic angle. 27,37 The relationship between pelvic angle and these muscles may potentially explain the sex difference in pelvic angle, as females have been observed to have decreased strength in hip abduction, 7,10,40,53 extension, 10 and external rotation, 10,40 and increased lumbar lordosis 14,16,19,20,37,42 compared to males.…”

Section: Pelvic Anglementioning

confidence: 99%

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Sex Differences in Clinical Measures of Lower Extremity Alignment

Nguyen¹,

Shultz²

2007

J Orthop Sports Phys Ther

173

135

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Selected lower limb injuries and, in particular, those of the knee have been reported to occur in greater prevalence in females compared to males. 4,29,49,60,61,85 Sex differences in lower extremity alignment (LEA) have been included among a myriad of risk factors as a potential cause for the prevalence of knee injury in females. 21,29,34,33,47 Anecdotally, females have been cited as having greater anterior pelvic tilt, femoral anteversion, tibiofemoral angle, quadriceps angle, genu recurvatum, tibial torsion, and foot pronation. 21,29 However, apart from the measure of quadriceps angle, there is little empirical data to support these sex differences in a healthy population.While the literature consistently demonstrates greater mean quadriceps angles in females, 1,23,24,26,28,84 limited studies support a sex difference in mean pelvic tilt 24 and genu recurvatum. 81 Conversely, no sex differences have been observed with measures of tibial torsion 57,77 and foot pronation as measured by navicular drop 6,24,51,81 t StuDy DeSign: Descriptive, cohort design.t ObJectiveS: To comprehensively examine sex differences in clinical measures of static lower extremity alignment (LEA).t bAckgrOunD: Sex differences in LEA have been included among a myriad of risk factors as a potential cause for the increased prevalence of knee injury in females. While clinical observations suggest that sex differences in LEA exist, little empirical data are available to support these sex differences or the normal values that should be expected in a healthy population.t MethODS AnD MeASureS: The right and left static LEA of 100 healthy college-age participants (50 males [mean 6 SD age, 23.3 6 3.6 years; height, 177.8 6 8.0 cm, body mass, 80.4 6 11.6 kg] and 50 females [mean 6 SD age, 21.8 6 2.5 years; height, 164.3 6 6.9 cm; body mass, 67.4 6 15.2 kg]) was measured. Each alignment characteristic was analyzed via separate repeated-measures analyses of variance, with 1 between-subject factor (sex) and 1 within-subject factor (side).t reSultS: There were no significant sex-byside interactions and no differences between sides. Females had greater mean anterior pelvic tilt, hip anteversion, quadriceps angles, tibiofemoral angles, and genu recurvatum than males (P<.0001). No sex differences were observed in tibial torsion (P = .131), navicular drop (P = .130), and rearfoot angle (P = .590).t cOncluSiOn: Sex differences in LEA indicate that females, on average, have greater anterior pelvic tilt, thigh internal rotation, knee valgus, and genu recurvatum. These sex differences were not accompanied by differences in the lower leg, ankle, and foot. Understanding these collective sex differences in LEA may help us to better examine the influence of LEA on dynamic lower extremity function and clarify their role as a potential injury risk factor.

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Section: Clinical Measuresmentioning

confidence: 99%

Section: Pelvic Anglementioning

confidence: 99%

Section: Pelvic Anglementioning

confidence: 99%

See 1 more Smart Citation

Sex Differences in Clinical Measures of Lower Extremity Alignment

Nguyen¹,

Shultz²

2007

J Orthop Sports Phys Ther

173

135

View full text Add to dashboard Cite

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“…A positive angle was defined as the ASIS positioned lower than the posterior superior iliac spine. (Modified from Gilliam et al 21 ) …”

mentioning

confidence: 99%

“…Further, it should be noted that 4 of 6 testers in this study had relatively few years of clinical experience (Table 1), which has been shown to impact reliability on some measures. 21,[32][33][34] Perhaps, more experienced clinicians would have achieved a higher degree of reliability with the level of training provided. Although not a purpose of this study, post-hoc comparisons of testers 4 and 6 (each with 6 years of clinical experience) support this conclusion.…”

mentioning

confidence: 99%

Intratester and Intertester Reliability of Clinical Measures of Lower Extremity Anatomic Characteristics: Implications for Multicenter Studies

Shultz

Nguyen²,

Windley³

et al. 2006

Clinical Journal of Sport Medicine

106

137

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Abstract:Objective: To determine whether multiple examiners could be trained to measure lower extremity anatomic characteristics with acceptable reliability and precision, both within (intratester) and between (intertester) testers. We also determined whether testers trained 18 months apart could perform these measurements with good agreement. Setting: University's Applied Neuromechanics Research Laboratory. Participants: Sixteen, healthy participants (7 men, 9 women). Assessment of Risk Factors: Six investigators measured 12 anatomic characteristics on the right lower extremity in the Fall of 2004. Four testers underwent training immediately preceding the study, and measured subjects on 2 separate days to examine intratester reliability. Two testers trained 18 months before the study (Spring 2002) measured each subject on day 1 to examine the consistency of intertester reliability when testers are trained at different times. Main Outcome Measurements: Knee laxity, genu recurvatum, quadriceps angle, tibial torsion, tibiofemoral angle, hamstring extensibility, pelvic angle, navicular drop, femur length, tibial length, and hip anteversion. Results: With few exceptions, all testers consistently measured each variable between test days (intraclass correlation coefficient>=0.80). Intraclass correlation coefficient values were lower for intertester reliability (0.48 to 0.97), and improved from day 1 to day 2. Intertester reliability was similar when comparing testers trained 18 months before those trained immediately before the study. Absolute measurement error varied considerably across individual testers. Conclusions: Multiple investigators can be trained at different times to measure anatomic characteristics with good to excellent intratester reliability. Intratester reliability did not always ensure acceptable intertester reliability or measurement precision, suggesting more training (or more experience) may be required to achieve acceptable measurement reliability and precision between multiple testers.Keywords: lower extremity alignment | risk factor assessment | posture | measurement stability Article:Little is known about the factors that predispose an individual to anterior cruciate ligament (ACL) injury.1,2 In part, this is because of the myriad of factors that have been proposed to explain the risk of ACL injury. Controlling and measuring multiple variables creates considerable challenges, as variables have the potential to interact with one another, and many of these variables are poorly defined or difficult to obtain reliably.3 Many of the potential risk factors cannot be measured after ACL disruption, because the injury modifies the risk factors, [4][5][6][7][8][9][10][11] and bilateral asymmetry cannot always be assumed. 12,13Because of these limitations, large prospective studies are recommended to identify ACL injury risk factors.14-17 However, prospective studies present their own challenges, as a large cohort of subjects is needed to yield sufficient ACL injuries. Uhorchak et al 16 prospectively fol...

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Measuring the human pelvis: A comparison of direct and radiographic techniques using a modern United States–based sample

Schroeder

Schmidtke

Bidez

1997

Am. J. Phys. Anthropol.

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Seven measurements were taken on a sample of 50 human cadaveric pelves, all white Texans born in the 20th century. Two separate methodologies were used to obtain these data: radiographs and direct measurements. These two methodologies were compared and contrasted, with the relative advantages and disadvantages of each explored. Results indicate that significant differences exist between the two methodologies. Pelvic height, breadth of symphysis, sacro-iliac breadth (P = 0.0001) and anterior upper spinal breadth (P = 0.0002) were larger when measured directly. Pelvic breadth, transverse diameter of the pelvic brim, and height of the ilium did not significantly differ between methodologies (P = 0.2037, P = 0.5253, P = 0.1752). Due to secular changes and inherent intrapopulational variation, taking measurements either directly from modern cadaveric specimens or radiographically on living volunteers in a limited geographic or socioeconomic grouping, rather than from skeletal collections or archived radiographs, may be more appropriate for providing data for current anthropometric applications.

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Relationship of the Pelvic Angle to the Sacral Angle: Measurement of Clinical Reliability and Validity

Cited by 42 publications

References 12 publications

Sex Differences in Clinical Measures of Lower Extremity Alignment

Sex Differences in Clinical Measures of Lower Extremity Alignment

Intratester and Intertester Reliability of Clinical Measures of Lower Extremity Anatomic Characteristics: Implications for Multicenter Studies

Measuring the human pelvis: A comparison of direct and radiographic techniques using a modern United States–based sample

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