Postural pattern recognition in children with unilateral cerebral palsy

Figures & data

Figure 1 Moiré topography examination and pedobarographic measurements of the distribution of body mass between the body sides.

Notes: (A) Example of complex moiré fringe image of the subject’s back. Anatomic landmarks used for back surface measurements were those suggested by the society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT).²² 2: Spinous process of C7; 8: spinous process of L4, 0, 4: acromial angle of shoulders; 1, 3: superior angle of scapulae; 5, 6: inferior angle of scapulae; 7, 9: posterior superior iliac spine. (B) Examples of graphical representation of weight distribution in percentage between the unaffected and affected body sides while in quiet standing condition.
Abbreviations: C7, seventh cervical vertebra; L4, fourth lumbar vertebra.

Table 1 Definitions of the outcome measures collected from MT examination

MT index	Definition	Measurement
SP	The angle of inclination contained between two adjacent lines: a line situated within the sagittal plane and a line of spinous processes from C7 through S1.	If the line of spinous processes or apex of the lateral curve is on the right side of the vertical line, the value of SP and ALC ranges from 0° to 180°. If the SP or apex of the lateral curve is on the left side of the vertical line, the index value ranges from −180° to 0°.
ALC	The angle of vertebral lateral curvature.
SHL	The angle of inclination contained between two adjacent lines: a line situated within the sagittal plane and a line connecting bilateral AAOS.	The angle of inclination is contained between two adjacent lines: a line situated within the horizontal plane and a line connecting the SAOS and the PSIS lying on the back surface. This line is situated symmetrically on the left and right sides; the angle has a value ranging from −180° to 0° when the right AAOS or PSIS is higher than that of the left or from 0° to 180° when the left AAOS or PSIS is higher than that of the right.
PL	The angle of inclination contained between two adjacent lines: a line situated within the sagittal plane and a line connecting bilateral PSIS.
Dmax	The maximum of the horizontal distances measured from the vertical line to the SP (mm).	The angle of surface rotation is contained between two adjacent lines: a line situated within the frontal plane and a line that connects two points on the back surface, and is situated symmetrically on the left and right sides of the bilateral IAOS, AAOS, or the PSIS. The angle of rotation values range from 0° to 180° if the right IAOS, AAOS, or the PSIS are rotated far forward and ranges from −180° to 0° in the opposite case.
ATR	The angle of trunk rotation.
SHR	The angle of shoulder rotation.
PR	The angle of pelvic rotation.
Kmax	The magnitude of the maximum kyphosis (mm).	These indices refer to the location and the magnitude of the maximum kyphosis and lordosis.
Lmax	The magnitude of the maximum lordosis (mm).

Abbreviations: AAOS, acromial angle of the shoulders; ALC, angle of vertebral lateral curvature; ATR, angle of trunk rotation; C7, seventh cervical vertebra; D_max, maximum of the horizontal distances measured from the vertical line to the SP (mm); IAOS, inferior angle of the scapula; K_max, magnitude of maximum kyphosis; L_max, magnitude of maximum lordosis; MT, moiré topography; PL, pelvic line inclination; PR, angle of pelvic rotation; PSIS, posterior superior iliac spine; S1, first sacral vertebra; SAOS, superior angle of the scapula; SHL, shoulder line inclination; SHR, angle of shoulder rotation; SP, spinous process line inclination.

Table 2 Nonhierarchical k-means clustering

Subgroup	Cluster 1	Cluster 2	Cluster 3	Cluster 4	Total
RR
N	0	0	9	4	13
%	0.00	0.00	100.00	40.00	28.89
RL
N	14	2	0	0	16
%	73.68	28.57	0.00	0.00	35.56
LR
N	0	0	0	6	6
%	0.00	0.00	0.00	60.00	13.33
LL
N	5	5	0	0	10
%	26.32	71.43	0.00	0.00	22.22
Total
N	19	7	9	10	45
%	42.22	15.56	20.00	22.22	100.00

Abbreviations: RR, right side hemiplegic with tendency to overload the affected body side; RL, right side hemiplegic with tendency to overload the unaffected body side; LR, left side hemiplegic with tendency to overload the unaffected body side; LL, left side hemiplegic with tendency to overload the affected body side.

Table 3 Parameter data

MT index	Cluster	Mean	N	SD	Minimum	Maximum
SP (°)	1	−4.584	19	5.265	−11.300	3.500
	2	−3.671	7	5.676	−11.900	3.600
	3	9.889	9	2.824	5.200	13.400
	4	3.190	10	3.924	−0.700	10.200
	Total	0.180	45	7.337	−11.900	13.400
PL (°)	1	9.300	19	4.266	−0.700	14.300
	2	7.971	7	4.081	2.100	13.100
	3	−6.300	9	7.045	−13.800	10.600
	4	−9.930	10	3.293	−13.900	−4.100
	Total	1.700	45	9.797	−13.900	14.300
SHR (°)	1	−11.089	19	10.354	−31.000	2.200
	2	3.529	7	10.713	−16.600	15.900
	3	4.167	9	3.957	−0.700	10.600
	4	8.670	10	5.356	0.000	18.000
	Total	−1.373	45	11.917	−31.000	18.000
ALC (°)	1	178.084	19	3.260	169.900	180.000
	2	172.620	10	4.085	165.500	180.000
	3	160.311	9	5.396	152.700	167.600
	4	173.157	7	5.887	162.800	180.000
	Total	172.549	45	7.855	152.700	180.000

Note: Bold font indicate cluster 2 and 3, which represent PGPP; while cluster 1 and 4 (not bold) represent AGPP.

Abbreviations: ALC, angle of vertebral lateral curvature; MT, moiré topography; PL, pelvic line inclination; SD, standard deviation; SHR, angle of shoulder rotation; SP, spinous process line inclination.

Table 4 Differences between the means of the various MT parameter clusters (ANOVA)

MT index	Comparison	Sum of squares	df	Mean square	F	P
SP (°)	Between groups	1,474.055	3	21.822	22.517	0.001
	Within groups	491.352	41
	Total	894.657	44
PL (°)	Between groups	3,301.325	3	22.489	48.932	0.001
	Within groups	1,100.442	41
	Total	922.055	44
SHR (°)	Between groups	3,246.775	3	73.216	14.782	0.001
	Within groups	1,082.200	41
	Total	3,001.853	44
ALC (°)	Between groups	1,046.310	3	23.798	14.655	0.001
	Within groups	348.770	41
	Total	975.738	44

Abbreviations: ALC, angle of vertebral lateral curvature; ANOVA, analysis of variance; df, degrees of freedom; MT, moiré topography; PL, pelvic line inclination; SHR, angle of shoulder rotation; SP, spinous process line inclination.

GrivasTBWadeMHNegriniSSOSORT consensus paper: school screening for scoliosis. Where are we today?Scoliosis200721718039374

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