Reliability of Body Landmark Analyzer (BLA) System for Measuring Hyperkyphosis and Hyperlordosis Abnormalities

Document Type: Original research papers


1 Department of Physical Education and Sport Sciences, Faculty of Sport Sciences, University of Birjand, Birjand, Iran.

2 Department of Sport Biomechanics, Faculty of Sport Sciences, Bu-Ali Sina University, Hamedan, Iran.

3 Department of Physical Education and Sport Sciences, Faculty of Sport Sciences, University of Birjand, Birjand, Iran

4 Department of Physical Education and Sport Sciences, Faculty of Sport Sciences, Allameh Tabataba'i University, Tehran,Iran


Among the several postural alterations, the thoracic hyperkyphosis and lumbar hyperlordosis are the most common ones. Hyperkyphosis is defined as an outward curvature of the thoracic spine and hyperlordosis is defined as an inward curvature of the lumbar. There are many methods as invasive and non- invasive for calculating of spinal column abnormalities. The purpose of the present research was to study the reliability of the Body Landmark Analyzer (BLA) method for measuring of the thoracic kyphosis and lumbar lordosis curvatures of the spinal column. Seventeen healthy males participated in this study. Intra-class correlation coefficient (ICC) two-way mixed model on absolute agreement was used to identify the inter/intra raters’ reliability and 95% confidence intervals. Considering the results of this research indicated high Intra-class correlation coefficients for the thoracic kyphosis and lumbar lordosis 0.87- 0.90 and 0.84- 0.88 respectively, therefore it can emphasized that BLA method has succeeded to make a high reliability for both of the thoracic kyphosis and lumbar lordosis curvatures of the spinal column. Based on the mentioned capabilities and reliability of this method, it can suggest along with other non-invasive methods for diagnosing of kyphosis and lordosis abnormalities.


Main Subjects

1. Yazici AG, Mohammadi M. The effect of corrective exercises on the thoracic kyphosis and lumbar lordosis of boy students. Turkish Journal of Sport and Exercise. 2017;19(2):177-81.

2. Yousefi M, Ilbeigi S, Mehrshad N, Afzalpour ME, Naghibi SE. Comparing the validity of non-invasive methods in measuring thoracic kyphosis and lumbar lordosis. zahedan journal of research in medical sciences.2012; 14(4):37-42.

3. Yousefi M, Ilbeigi S. The intelligent estimating of spinal column abnormalities by using artificial neural networks and characteristics vector extracted from image processing of reflective markers. African Journal of Biotechnology.2013; 12(4):419-426.

4. Lee MC, Solomito M, Patel A. Supine magnetic resonance imaging Cobb measurements for idiopathic scoliosis are linearly related to measurements from standing plain radiographs. Spine.2013; 38(11):E656-61.

5. Singla D, Veqar Z. Methods of postural assessment used for sports persons. Journal of clinical and diagnostic research: JCDR.2014; 8(4):1-4.

6. Rajabi R, Seidi F, Mohamadi F. Which method is accurate when using the flexible ruler to measure the lumbar curvature angle? deep point or mid point of arch. World Applied Sciences Journal.2008; 4(6):849-52.

7. Guermazi M, Ghroubi S, Kassis M, Jaziri O, Keskes H, Kessomtini W, Ben IH, Elleuch MH. Validity and reliability of Spinal Mouse to assess lumbar flexion. InAnnales de réadaptation et de médecine physique: revue scientifique de la Société française de rééducation fonctionnelle de réadaptation et de médecine physique. 2006 ;. 49(4) :172-177.

8. Kellis E, Adamou G, Tzilios G, Emmanouilidou M. Reliability of spinal range of motion in healthy boys using a skin-surface device. Journal of manipulative and physiological therapeutics.2008; 31(8):570-6.

9. Ripani M, Di Cesare A, Giombini A, Agnello L, Fagnani F, Pigozzi F. Spinal curvature: comparison of frontal measurements with the Spinal Mouse and radiographic assessment. Journal of Sports Medicine and Physical Fitness.2008; 48(4):488-94.

10. Leroux MA, Zabjek K, Simard G, Badeaux J, Coillard C, Rivard CH. A noninvasive anthropometric technique for measuring kyphosis and lordosis: an application for idiopathic scoliosis. Spine.2000; 25(13):1689-94.

11. Farahpour, N., Jafarnezhad, A., Damavandi, M., Bakhtiari, A., & Allard, P. Gait ground reaction force characteristics of low back pain patients with pronated foot and able-bodied individuals with and without foot pronation. Journal of biomechanics.2016; 49(9): 1705-1710.

12. Jafarnezhadgero, A., Alavi-Mehr, S. M., & Granacher, U. Effects of anti-pronation shoes on lower limb kinematics and kinetics in female runners with pronated feet: The role of physical fatigue. PloS one, 2018; 14(5): e0216818.

13. Porto AB, Okazaki VH. Thoracic kyphosis and lumbar lordosis assessment by radiography and photogrammetry: a review of normative values and reliability. Journal of manipulative and physiological therapeutics.2018; 41(8):712-23.

14. Norasteh A, Hajihosseini E, Emami S, Mahmudi H. Assessing Thoracic and Lumbar Spinal Curvature Norm: A Systematic Review. Physical Treatments. 2019; 9(4): 183-192.

15. Seidi F, Rajabi R, Ebrahimi E, Tavanai AR, Moussavi SJ. The Iranian flexible ruler reliability and validity in lumbar lordosis measurements. World J Sport Sci.2009; 2(2):95-9.

16. Hart DL, Rose SJ. Reliability of a noninvasive method for measuring the lumbar curve. Journal of Orthopaedic & Sports Physical Therapy.1986; 8(4):180-4.

17. Walker ML, Rothstein JM, Finucane SD, Lamb RL. Relationships between lumbar lordosis, pelvic tilt, and abdominal muscle performance. Physical therapy.1987; 67(4):512-6.

18- Youdas JW, Suman VJ, Garrett TR. Reliability of measurements of lumbar spine sagittal mobility obtained with the flexible curve. Journal of Orthopaedic & Sports Physical Therapy.1995; 21(1):13-20.

19. Harrison DE, Harrison DD, Cailliet R, Janik TJ, Holland B. Radiographic analysis of lumbar lordosis: centroid, Cobb, TRALL, and Harrison posterior tangent methods. Spine. 2001; 26(11): 235-42.

20. Khakhali-Zavieh M, Parnian-Pour M, Karimi H, Mobini B, Kazem-Nezhad A. The validity and reliability of measurement of thoracic kyphosis using flexible ruler in postural hyperkyphotic patients. Archives of Rehabilitation. 2003; 4(3):18-23.

21. Letafatkar A, Amirsasan R, Abdolvahabi Z, Hadadnezhad M. RETRACTED: Reliability and validity of the AutoCAD software method in lumbar lordosis measurement. J Chiropr Med, 2011; 10(4): 240–247.

22. Azadinia F, Kamyab M, Behtash H, Ganjavian MS, Javaheri MR. The validity and reliability of noninvasive methods for measuring kyphosis. Clinical Spine Surgery.2014; 27(6):E212-8.

23. McFarland C, Wang-Price S, Richard S. Clinical measurements of cervical lordosis using flexirule and inclinometer methods in individuals with and without cervical spine dysfunction: A reliability and validity study. Journal of back and musculoskeletal rehabilitation.2015; 28(2):295-302.

24. Sedrez JA, Candotti CT, Rosa MI, Medeiros FS, Marques MT, Loss JF. Test-retest, inter-and intra-rater reliability of the flexicurve for evaluation of the spine in children. Brazilian journal of physical therapy.2016; 20(2):142-7.

25. Lakshmi VV, Deepika J, Logeswari S. Evaluation of thoracic kyphosis and lumbar lordosis among vdt workers and kitchen workers. Int J Educ Sci Res.2017; 7(1):101-8.

26. Lee ES, Ko CW, Suh SW, Kumar S, Kang IK, Yang JH. The effect of age on sagittal plane profile of the lumbar spine according to standing, supine, and various sitting positions. Journal of orthopaedic surgery and research.2014; 9(1):9-11.

27. Kado DM, Christianson L, Palermo L, Smith-Bindman R, Cummings SR, Greendale GA. Comparing a supine radiologic versus standing clinical measurement of kyphosis in older women: the Fracture Intervention Trial. Spine.2006; 31(4):463-7.