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A Comparison of Methods for Measuring Trunk List: A Simple Plumbline Is the Best

McLean, Ian P., FRCS*; Gillan, Maureen G. C., PhD; Ross, Jennifer C., MEd; Aspden, Richard M., PhD; Porter, Richard W., FRCS

Physical Examination and Measurement

Study Design Trunk list was measured using three different techniques to compare accuracy, precision, and ease of use.

Objective To obtain a reproducible technique for further studies of the nature, cause, and clinical relevance of trunk list.

Summary of Background Data Gravity-induced trunk list is a clinical sign that is frequently observed in patients with low back pain and has been associated with intervertebral disc lesions.

Methods Patients with trunk list participated in a comparison of three techniques to determine list magnitude and direction. Paired measurements of trunk list were obtained from each patient using three techniques: a plumbline, a projected shadow, and the 3SPACE lsotrak (McDonnell Douglas Electronics Company, Colchester, VT). In addition, intra- and interobserver reliability of list measurement was assessed by comparison of paired measurements by each of two observers.

Results List measurements assessed by the plumbline and the projected shadow techniques were not significantly different, but the lsotrak produced data that differed significantly (P < 0.05) from both of these techniques. Comparison of intra- and interobserver repeatability of list measurement using the plumbline technique indicated no significant difference between repeated measures by each observer or between two observers.

Conclusions A plumbline is the most useful instrument for measuring static trunk list, but its limitations and the need for standardization of measurement technique must be recognized.

From the *Princess Margaret Rose Orthopaedic Hospital, Edinburgh, the Department of Orthopaedic Surgery, University of Aberdeen, Aberdeen, and the Department of Physiotherapy, School of Health Studies, Robert Gordon University, Aberdeen.

Support was received from the Sir Jules Thorn Charitable Trust (IPM), London, United Kingdom, and the New Zealand Back Pain Foundation (MGCG), Waikanae, New Zealand.

Acknowledgment date: April 21, 1995.

First revision date: September 5, 1995.

Acceptance date: November 14, 1995.

Device status category: 1.

Address reprint requests to: Maureen G. C. Gillan, PhD; Department of Orthopaedic Surgery; University of Aberdeen; Aberdeen AB9 2ZD; UK

© Lippincott-Raven Publishers.