AbstractIntroduction: Spinal disorders encompass numerous clinical conditions of the spine that include spinal deformities, thoracic hyperkyphosis, increased or decreased lumbar lordosis and scoliosis amongst others. To enable the assessment and treatment of patients with spinal disorders, there is a need for appropriate valid and reliable, evidence-based objective tools. A further requirement for an objective measurement tool to be used within clinical practice is the need for it to be accepted by clinical practitioners.
Aims: The primary aim of this thesis was to evaluate the reliability and validity of the mobile surface topography system (MSTS) together with the assessment of the clinical acceptance of the tool by healthcare practitioners. The secondary aim was to conduct a randomised controlled trial (RCT) to evaluate the use of the MSTS to provide personalised educational biofeedback for the self-management of both acute and chronic low-back pain patients.
Methods: The current thesis consisted of four studies. (1) the evaluation of the intra- (n = 16) and inter-rater reliability (n = 5) of the MSTS for measuring posture and back shape variables (2) the appraisal of the validity (n = 25) of the MSTS with reference to the gold standard ‘Vicon’ system (3) the exploration of the clinical acceptance (n = 23) of the MSTS by clinical practitioners and (4) the evaluation of the effect of a personalised educational booklet for the management of patients with acute (n = 21) and chronic (n = 19) low-back pain (LBP) through a randomised control trial (RCT).
Results: The results of the current study suggest that the MSTS is reliable and valid to measure most of the three-dimensional posture and back shape variables in standing. This is the first study to quantify the MSTS in the measurement of standing posture. The results of the current study also detailed the magnitude of the postural and technical sources of error. Further, the clinical acceptance study confirmed the variables that contributed to the acceptance of the mobile-based MSTS; as well its application within clinical practice. Furthermore, the service users (patients with both acute and chronic LBP) of the personalised interactive educational booklet demonstrated greater improvement in the last majority of outcome measures (physical, behavioural and at work) as compared to the control group at the 4-week follow-up measurement.
Conclusion: The originality of this first comprehensive multifaceted study lies firstly in the development of a novel MSTS that is portable, low-cost and easy to use within current clinical practice. Secondly, in the confirmation of the reliability and validity of the tool. Thirdly, in the affirmation of the clinical acceptance of the tool by clinical practitioners and finally in the endorsement of the value of the output of the tool by patients for the self-management of their spinal disorders.
|Date of Award
|12 Apr 2019
|Josette Bettany-Saltikov (Supervisor), Paul Van Schaik (Supervisor) & Iain Spears (Supervisor)