Osteoporosis International

, Volume 25, Issue 2, pp 721–728 | Cite as

Inclinometer-based measures of standing posture in older adults with low bone mass are reliable and associated with self-reported, but not performance-based, physical function

  • N. J. MacIntyreEmail author
  • A. L. Lorbergs
  • J. D. Adachi
Original Article



The association between posture and physical function during daily activities in people at risk for osteoporotic fracture is not clear. We report the reliability of measuring posture using the digital inclinometer and how these measures relate to performance-based and self-reported physical function.


This study aims to determine the reliability of a simple clinical method for assessing spine curvatures in people with low bone mass and the association between spine curvature measures and pain, physical function (mobility/activities of daily living (ADL)) and quality of life.


One rater assessed 36 high-functioning adults, aged 52–82 years, attending an outpatient osteoporosis clinic. A digital inclinometer was used to measure lumbosacral angle (S), lumbar standing posture (L), and thoracic standing posture (T) and ADL performance was assessed using the short form of the Safe Functional Motion test (SFM-6), on two occasions approximately 8.7 days apart. Participants reported average pain intensity over the past week and completed the Timed Up and Go test (TUGT) and the mini-Osteoporosis Quality of Life questionnaire (mini-OQLQ). Acceptable reliability was determined using the intraclass correlation coefficient (ICC). Associations were determined using Pearson’s correlation coefficients (r) (and Spearman’s rho (r s), for non-normal data).


ICC (95 % CI) for S, L, and T = 0.91 (0.82, 0.95), 0.90 (0.82, 0.95), and 0.91 (0.84, 0.95), respectively, for test–retest reliability. Thoracic standing posture was associated with the ADL domain of the mini-OQLQ (r s = −0.39) and the TUGT (r = 0.42). Standing posture was not related to pain or total SFM-6 score.


Digital inclinometer measures provide a quick highly reliable, valid, direct assessment of kyphosis. Use of these measures in the clinical setting is expected to facilitate identification and effective management of postural impairments (e.g., trunk extensor muscle weakness, vertebral fracture) associated with osteoporosis.


Balance Inter-trial reliability Osteoporosis Physical performance Quality of life Standing posture 



We thank the participants who volunteered for this study and our research assistant, Carrie Stavness, for collecting these data. Amanda Lorbergs is supported by the Ontario Graduate Scholarship and the Joint Motion Program, a Canadian Institutes of Health Research Training Program in Musculoskeletal Health Research and Leadership.

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2013

Authors and Affiliations

  • N. J. MacIntyre
    • 1
    Email author
  • A. L. Lorbergs
    • 1
  • J. D. Adachi
    • 2
  1. 1.School of Rehabilitation ScienceMcMaster UniversityHamiltonCanada
  2. 2.Department of MedicineMcMaster UniversityHamiltonCanada

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