足姿指数评价青少年特发性脊柱侧弯患者足部位置的信度北大核心CSCD

目的 探究足姿指数(FPI-6)评价我国青少年特发性脊柱侧弯(AIS)患者足姿的信度。方法 2021年7月至2022年4月,从广东省第二中医院门诊及不定向招募AIS患者35例,两名评定者于同一天采用FPI-6进行足姿评定;1周后,其中一名评定者对35例患者再次进行评定。计算评定者间和重测组内相关系数,绘制Bland-Altman图,各项目评分与总分间行Spearman相关分析。结果 除距骨头触诊和距骨关节区隆起外,其他项目评定者间和重测组内相关系数均> 0.75,足姿分类无显著性差异(χ~2=4.000, P> 0.05)。各项目分与总分间相关系数均> 0.3 (P <0.01)。结论 FPI-6对轻度AIS患者足姿评估有较好信度。     

简易平衡评定系统测试的汉化及在脑卒中患者中的信度

目的汉化简易平衡评定系统测试(mini-BESTest),测试中文版的信度。方法遵循翻译、逆向翻译、文化调适、预试验的程序,翻译及修订mini-BESTest。由2 名专业人员对61 例脑卒中患者进行mini-BESTest 测试;在首次评估48 h 后,选取其中30 例进行第二次测试。分别计算评定者间及重测组内相关系数(ICC)。计算量表总分和4 个维度Cronbach's α系数。结果测量者间ICC=0.856~0.978 (P<0.01),重测ICC=0.795~0.951 (P<0.01);量表总分和4 个维度间Cronbach's α=0.794~0.905,4 个维度两两之间的相关系数=0.742~0.827。结论中文版mini-BESTest对脑卒中患者具有较好信度。     

香港版偏瘫上肢功能测试评定脑卒中患者上肢功能的效度和信度研究

目的探讨香港版偏瘫上肢功能测试(FTHUE-HK)评定脑卒中患者上肢功能的效度和信度。 方法采用FTHUE-HK、Fugl-Meyer量表上肢部分(FMA)和改良巴氏指数(MBI)对42例入选脑卒中患者在1周内进行2次评定,分析其FTHUE-HK、FMA和MBI评定结果,并验证FTHUE-HK的效度;分析2次FTHUE-HK的评定结果,验证FTHUE-HK的重测信度和评估者间信度。 结果2次FTHUE-HK评定结果与FMA总分具有高度相关性（r=0.981、0.982,P<0.01）,且与MBI总分高度相关（r=0.892、0.896,P<0.01）。FTHUE-HK的重测结果和组间结果高度相关,其重测组内相关系数ICC=0.983,组间相关系数ICC=0.985。 结论FTHUE-HK量表评定脑卒中后上肢功能状况具有良好的效度和信度。     

中文版躯干损伤量表评定脑卒中患者躯干功能的信度及效度研究

目的:探讨中文版躯干损伤量表(TIS)评定脑卒中患者躯干功能的信度及效度,为该量表的临床应用提供客观依据。方法:病例组和对照组各50例参加了本研究,病例组进行TIS、Fugl-Meyer中的平衡部分(FM-B)和Berg平衡量表(BBS)评定,并在2天内完成TIS第二次评定;对照组进行1次的TIS和FM-B评定。将两次TIS的结果做相关性分析测试其信度;将TIS结果与FM-B、BBS作相关性分析检验其效度。结果:TIS两次测试结果高度相关,重测信度组内相关系数(ICC)为0.899—0.971,测量者间ICC为0.843—0.973;TIS与FM-B、BBS总分高度相关(r=0.891,r=0.858);病例组和对照组的TIS总分分别为21.7±1.3分和13.5±4.3分,两者间差异具有显著性(P<0.01)。结论:中文版TIS具有良好的效度、信度和区分度,可用于脑卒中患者躯干功能的评价。     

扩展Barthel指数量表应用于脑卒中患者康复评定的信度研究

目的:研究扩展Barthel指数(EBI)评定脑卒中患者的重测信度及评测者间信度。方法:由第1位评定者应用EBI量表对30例脑卒中患者进行评定,3d内再次对该患者进行评定;第2位评定者在第1位评定者初次评定后2 d内再次对该患者进行评定。对不同评定者间的EBI结果进行等级间相关系数(ICC)分析以检验EBI的重测信度和评定者间信度。结果:第1位评定者两次评定总分的组内相关系数为0. 99(P 0. 01);第1位评定者与第2位评定者评定总分的组内相关系数为0. 98(P 0. 01)。结论:EBI量表应用于脑卒中患者康复评定时具有良好的重测信度及评测者间信度。     

中文版阿尔茨海默病联合注册表-神经心理学成套测试的测试者间信度与受试者工作特征

目的评价中文版阿尔茨海默病联合注册表-神经心理学成套测试(CERAD-NAB)判别轻度认知障碍(MCI)的测试者间信度和效度。方法52 例60 岁以上老年人采用中文版CERAD-NAB 进行测评,根据Petersen 等制定的标准确定MCI 诊断。计算不同测试者间组内相关系数(ICC);绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)。结果CERAD-NAB 各子测试ICC=0.945~1。CERAD-NAB 总分AUC 为0.747,在界值为62.5 时,敏感性和特异性分别为0.52 和0.90;CERAD-NAB 总分和子测试J3、J8 AUC较高。结论中文版CERAD-NAB测试者间信度很高,在判别MCI 方面效度满意。     

等速运动系统测试膝关节本体感觉功能的信度研究

目的 研究等速测试系统评定膝关节位置觉的重复测试信度和不同测试者间测试信度.方法 应用Biodex System 3型等速系统测试16例健康志愿者双侧膝关节位置觉(采用被动角度重建测试法),选择屈膝30°、45°和60°为目标角度,记录受试者实际角度与目标角度间的差值绝对值(误差角).由2名测试者负责重复测试和不同测试者间重复测试,前、后2次测试中间间隔3d.结果 受试者屈膝30°、45°和60°时,其误差角的重复测试信度组内相关系数(ICC)分别为0.728、0.780和0.807,不同测试者间信度Pearson相关系数分别为0.676、0.610和0.705,提示均具有显著相关性(P＜0.05).通过单因素方差分析发现受试者双膝、前后2次测试时各目标角度误差角间差异均无统计学意义(P＞0.05),所有受试者角度重建时误差角的95％可信区间上限均＜3°.结论 采用等速系统评定受试者膝关节位置觉具有较好的重复测试信度,在屈膝30 ～60°范围内选择1个目标角度测试即可,当受试者膝关节角度重建误差角＞3 a时应考虑其临床意义.     

正常人动态平衡能力测试的信度及效度分析

目的　对正常人平衡功能进行动态姿势图重复检测 ,分析各参数间的内在一致性、重测信度及不同测试者间的信度 ;并与Berg平衡量表、功能性前伸测量、起立行走计时测定结果比较 ,检验其效标效度。方法　 2名测试者应用BiodexBalanceSystem (BBS)分别对 40名正常受试者 ( 18～ 67岁 )进行 2次 8级平台稳定性动态姿势图测试及稳定性测试 ;同时还应用Berg平衡量表、功能性前伸距离及起立行走计时等方法进行检测。结果　研究结果发现年龄因素对所有检测参数均有影响 ,体重指数对稳定指数及平均方向控制能力有影响。各参数间内部存在一致性 (r =0 .2 2～ 0 .93 ,均P <0 .0 1) ,其重测信度 (r =0 .70～ 0 .99)及不同测试者间信度 (r =0 .71～ 0 .98)较佳 (ICC =0 .88～ 0 .99)。在测试过程中 ,发现不同跌下次数的受试者其年龄差异和测试结果间差异显著相关 (P <0 .0 0 1)。BBS测试数据与Berg平衡量表、功能性前伸测量、起立行走计时测评结果有较高的相关性 (r =0 .72～ 0 .86)。结论　BBS能反映受试者平衡能力的年龄变化趋势 ,具有较高的内在一致性、重测信度及不同测试者间的信度 ,与Berg平衡量表、起立行走计时及功能性前伸测量结果具有一致性 ,可用于平衡功能的定量评定。     

中文版爱丁堡视觉步态评分在脑瘫儿童中应用的信度和效度研究

目的验证中文版爱丁堡视觉步态评分(EVGS)在脑瘫儿童中应用的信度和效度。方法根据国际指南对原量表进行翻译和跨文化调适形成中文版, 选取30例脑瘫患者的步态视频, 由6位具有不同步态分析经验的评估师分别独立使用编译后的量表进行评分。测试者间和测试者内信度使用组内相关系数(ICC)进行评价, 采用相关性分析和分组比较评价校标关联效度、聚合效度和区分效度。结果中文版EVGS 17个条目的组间ICC为0.20～0.87, 组内ICC为0.41～0.90。有经验组的大部分条目具有良好的组间和组内信度, 无经验组的大部分条目具有中等的组间和组内信度。相关性分析结果显示, 中文版EVGS量表与PRS(r=0.77, P<0.001)和OGS(r=-0.85, P<0.001)呈强相关;与GMFM-D/E区总分(r=-0.55, P=0.002)呈中等程度相关, 与10MWT(r=-0.69, P<0.001)和TUG(r=0.60, P<0.001)呈强相关。EVGS评分在不同GMFCS分级之间以及不同受累侧下肢之间的差异具有统计学意义(P<0.05)。结论中文版EV...     

Alyn水中适应性测试量表2的汉化及在脊髓损伤患者中的信度与效度

目的翻译Alyn水中适应性测试量表2 (WOTA2),并检验其用于脊髓损伤患者的信度和效度。方法获得授权后,将英文版WOTA2及其培训手册翻译成中文。2018年1月至9月,采用汉化后的WOTA2对137例脊髓损伤患者进行评定。先由两名评定者独立进行WOTA2测试;3 d后,其中一名评定者再次进行测试。计算Cronbachα系数、Spearman-Brown系数、组内相关系数(ICC)和Kappa系数评估信度。利用单项内容效度指数(I-CVI)和量表内容效度指数(S-CVI)评价内容效度,利用因子分析评价结构效度。结果中文版WOTA2全部条目Cronbachα系数为0.947,心理适应条目为0.890,水中技能条目为0.954。奇偶折半法两部分评分之间Pearson相关系数为0.948,折半信度为0.973。重测ICC总分为0.965,百分制总分为0.965,心理适应部分为0.847,水中技能部分为0.970;评定者间ICC总分为0.964,百分制总分为0.965,心理适应部分为0.847,水中技能部分为0.970。27个条目重测Kappa系数为0.528～0.927,评定者间为0.478～0.936。I-CVI为0.8～1.0,S-CVI为0.63。因子分析提取4个公共因子,符合理论预设,累积方差贡献率67%。结论中文版WOTA2应用于脊髓损伤患者有良好的信度和效度,可在国内水中运动疗法临床实践中推广应用。     

The Foot Posture Index: Rasch analysis of a novel, foot-specific outcome measure

OBJECTIVE: To investigate the internal construct validity of a clinician-assessed measure of foot position, the Foot Posture Index (FPI), versions FPI-8 and FPI-6. DESIGN: Rasch analysis of baseline FPI scores from studies conducted during the development of the instrument. SETTING: A community-based and a hospital-based study, conducted at 2 institutions. PARTICIPANTS: Measures were obtained from 143 participants (98 men, 45 women; age range, 8-65y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Rasch analysis was undertaken using RUMM2020 software in order to evaluate the following properties of the FPI: unidimensionality of each item included in the FPI, the differential item functioning (DIF) of each item, and item and person separation indices. RESULTS: In the developmental draft of the instrument, the 8-item FPI-8 showed some misfit to the Rasch model (chi(16)(2) test=27.63, P=.03), indicating lack of unidimensionality. Two items were identified as problematic in the Rasch modeling: Achilles' tendon insertion (Helbing's sign), which showed illogical response ordering and "congruence of the lateral border of the foot," which showed misfit, indicating that this item may be measuring a different construct (chi(2)(2) test=15.35, P<.01). All FPI-8 items showed an absence of DIF, and the person separation index (PSI) was good (PSI=.88). The revised FPI-6, which does not include the 2 problematic items, showed unidimensionality (chi(12)(2) test=11.49, P=.49), indicating a good overall fit to the model, and improvement over the preliminary version. With the removal of the 2 problematic items, there were no disordered thresholds; all items remained DIF free and all individual items displayed a good fit to the model. The person-separation index for the FPI was similar for both the 8-item (FPI-8=.880) and 6-item (FPI-6=.884) versions. CONCLUSIONS: The original FPI-8 showed significant mismatching to the model. The 2 items in the FPI-8 that were identified as problematic in clinical validation studies were also found to be contributing to the lack of fit to the Rasch model. The finalized 6-item instrument showed good metric properties, including good individual item fit and good overall fit to the model, along with a lack of differential item functioning. This analysis provides further evidence for the validity of the FPI-6 as a clinical instrument for use in screening studies and shows that it has the potential to be analyzed using parametric strategies.     

Reliability of Different Clinical Techniques for Assessing Foot Posture

ObjectiveThe aim was to determine the interrater and intrarater reliability of navicular drop (NDP), navicular drift (NDT), and the Foot Posture Index-6 (FPI-6), and test–retest reliability of the static arch index (SAI) and dynamic arch index (DAI).MethodsSixty healthy individuals were assessed for intrarater and test–retest reliability. From 60 participants, 30 individuals were assessed for interrater reliability. A digital caliper was used to measure NDP and NDT. Electronic pedography was used to calculate SAI and DAI. The FPI-6 was also performed. All assessments were performed on the dominant foot. The NDP, NDT, SAI, and DAI were repeated 3 times. The NDP and NDT were analyzed separately using both first measurement and the average, but the SAI and DAI were analyzed using only the average. The NDP, NDT, and FPI-6 were conducted by 2 raters to determine interrater reliability and were repeated by a single rater after 5 days from initial assessment to determine intrarater reliability. The SAI and DAI were also repeated after 5 days to determine test–retest reliability.ResultsIntrarater intraclass correlation coefficients (ICCs) were 0.934 and 0.970 for NDP, 0.724 and 0.850 for NDT, and 0.945 for FPI. Interrater ICCs were 0.712 and 0.811 for NDP, 0.592 and 0.797 for NDT, and 0.575 for FPI. Test–retest ICCs of the SAI and DAI were 0.850 and 0.876, respectively.ConclusionNavicular drop is relatively more reliable than other traditional techniques. Also, the FPI-6 has excellent intrarater reliability, but only moderate interrater reliability. The results can provide clinicians and researchers with a reliable way to implement foot posture assessment.     

Reliability of the Physical Performance Test in People with Dementia

ABSTRACT

Purpose. Approximately 30% of older adults have dementia. Disease progression has been found to be the largest predictor of function, and dementia has been found to influence fall risk. In order to identify individuals with dementia who may benefit from interventions to increase function and decrease fall risk, assessment tools for these domains that are validated in this population are necessary. The 7-item Physical Performance Test (PPT) is a valid measure of balance and function in older adults; however, its reliability has not been established in those with dementia. The purpose of this study was to establish intra-tester, inter-tester, and test–retest reliability of the 7-item PPT in people with dementia. Methods. Thirty-three subjects with a diagnosis of dementia and a Mini-Mental State Examination (MMSE) score between 10 and 24 were tested with the PPT on two separate days with performance on the second day videotaped. One tester scored the videotaped performance on two separate occasions and intra-tester reliability was determined using an intraclass correlating coefficient (ICC) (3,1). Two testers independently scored the videotaped performances and inter-tester reliability was determined using an ICC (2,1). Scores from the first and second testing days were compared and test–retest reliability was determined using an ICC (3,1). Results. All subjects completed both testing sessions and reliability was established for intra-tester, inter-tester, and test–retest with ICCs of 0.99, 0.96, and 0.90, respectively. Conclusion. The 7-item PPT is reliable for use in people with mild to moderate dementia as defined by MMSE scores between 10 and 24.     

Measurement of functional ability following traumatic brain injury using the Clinical Outcomes Variable Scale: a reliability study

This study determined the inter-tester and intra-tester reliability of physiotherapists measuring functional motor ability of traumatic brain injury clients using the Clinical Outcomes Variable Scale (COVS). To test inter-tester reliability, 14 physiotherapists scored the ability of 16 videotaped patients to execute the items that comprise the COVS. Intra-tester reliability was determined by four physiotherapists repeating their assessments after one week, and three months later. The intra-class correlation coefficients (ICC) were very high for both inter-tester reliability (ICC > 0.97 for total COVS scores, ICC > 0.93 for individual COVS items) and intra-tester reliability (ICC > 0 97). This study demonstrates that physiotherapists are reliable in the administration of the COVS.     

复合感觉测试在慢性腰痛人群中的信度研究

目的:评估两点辨别测试(TPD)、点对点测试(PTP)和两点距离估算(TPE)三种测试在正常人和慢性腰痛人群(CLBP)中的重测信度和测试者间信度.方法:筛选30例正常人和30例CLBP患者,由两名物理治疗师分别对60例受试者进行TPD、PTP和TPE三种测试评估,测试者间测试间隔时间为10min,其中一人在24h后重...     

Reliability of two functional clinical tests to evaluate trunk and lumbopelvic neuromuscular control and proprioception in a healthy population

ObjectivesThe need to accurately assess trunk and lumbopelvic proprioception and neuromuscular control is widely accepted. However, based on current literature, there is a lack of reliable clinical tests to evaluate these aspects in clinical practice. The objective of this study is to investigate intra- and inter-tester reliability of the lateral step down test and the lumbopelvic position–reposition test in a healthy population.MethodsProtocol and scoring methods were developed for the lateral step down test and lumbopelvic position–reposition test, used to assess trunk and lumbopelvic neuromuscular control and proprioception respectively. Each test was performed once by thirty participants and video analysis for test scoring was performed. Three items on the lateral step down test were scored to evaluate neuromuscular control and, four items on the lumbopelvic position–reposition test were scored to evaluate proprioception. Aggregate scores for each test were calculated based on the separate item scores. Intraclass correlation coefficients and linear weighted kappa coefficients were determined for intra- and inter-tester reliability.ResultsBased on the aggregate score, excellent intra- and inter-tester reliability (ICC (2,1) = 0.73–0.88) was found for both tests. Moderate/almost perfect intra-and inter-tester agreement (K = 0.62–0.91) was found for the separate items of the lateral step down test and fair/substantial agreement (K = 0.25–0.76) for the items of the lumbopelvic position–reposition test.ConclusionCurrent testing protocol and scoring method for the lateral step down test is reliable. Adjustments for the scoring method of the lumbopelvic position–reposition test are warranted to improve reliability.     

Age,Sex, Body Mass Index,and Laterality in the Foot Posture of Adolescents: A Cross Sectional Study

ObjectiveTo investigate the relationship between the right and left foot posture in terms of body mass index (BMI), sex, and age in adolescents aged 10 to 14.MethodsA total of 1400 adolescents were included. For assessment, the Foot Posture Index (FPI-6) was used. Each foot was assessed and ranked as supinated, normal, or pronated by the sum of the FPI-6 criteria. Each criterion was scored on a scale of –2 to +2, with negative for supinated and positive for pronated posture. A linear mixed model with repeated measures was used for statistical analysis.ResultsSex, BMI, and right and left foot are associated with FPI-6. The total score attributed for male sex (β = 0.29, P = .04) and the left foot (β = 0.73, P < .001) was higher (male right foot: mean ± standard deviation [SD], 3.09 ± 2.84, male left foot: 3.76 ± 2.80; female right foot: mean ± SD, 2.28 ± 2.61, female left foot: 3.45 ± 2.66; laterality for left foot: mean ± SD, 3.55 ± 2.71, laterality for right foot: mean ± SD, 2.82 ± 2.7). On the other hand, the correlation coefficient for the BMI was negative (β = -0.08, P = < .001), which means that the higher the BMI the lower the score attributed to the FPI-6.ConclusionsThe FPI-6 is positively related to the male sex and the left foot—that is, the predicted score is higher, so the feet tend to present with a tendency to pronation. Although BMI is associated with FPI-6, it was not possible to establish a relationship between high BMI and pronation of the feet.     

NO ASSOCIATION BETWEEN Q-ANGLE AND FOOT POSTURE WITH RUNNING-RELATED INJURIES: A 10 WEEK PROSPECTIVE FOLLOW-UP STUDY

Background/Purpose:

There is a paucity of knowledge on the association between different foot posture quantified by Foot Posture Index (FPI) and Quadriceps angle (Q-angle) with development of running-related injuries. Earlier studies investigating these associations did not include an objective measure of the amount of running performed.Therefore, the purpose of this study was to investigate if kilometers to running-related injury (RRI) differ among novice runners with different foot postures and Q-angles when running in a neutral running shoe.

Methods:

A 10 week study was conducted including healthy, novice runners. At baseline foot posture was evaluated using the foot posture index (FPI) and the Q-angle was measured. Based on the FPI and Q-angle, right and left feet / knees of the runners were categorized into exposure groups. All participants received a Global Positioning System watch to allow them to quantify running volume and were instructed to run a minimum of two times per week in a conventional, neutral running shoe. The outcome was RRI.

Results:

Fifty nine novice runners of mixed gender were included. Of these, 13 sustained a running-related injury. No significant difference in cumulative relative risk between persons with pronated feet and neutral feet was found after 125 km of running (Cumulative relative risk = 1.65 [0.65; 4.17], p = 0.29). Similarly, no difference was found between low and neutral Q-angle (Cumulative relative risk = 1.25 [0.49; 3.23], p = 0.63).

Conclusion:

Static foot posture as quantified by FPI and knee alignment as quantified by Q-angle do not seem to affect the risk of injury among novice runners taking up a running regimen wearing a conventional neutral running shoe. These results should be interpreted with caution due to a small sample size.

Level of Evidence:

2a     

The Single Leg Squat Test: A “Top-Down” or “Bottom-Up” Functional Performance Test?

BackgroundMedial knee deviation (MKD) during the single leg squat test (SLST) is a common clinical finding that is often attributed to impairments of proximal muscular structures. Investigations into the relationship between MKD and the foot and ankle complex have provided conflicting results, which may impact clinicians’ interpretation of the SLST.PurposeThe purpose of this study was to compare ankle dorsiflexion range of motion (ROM) and foot posture in subjects that perform the SLST with MKD (fail) versus without MKD (pass).HypothesisThere will be a difference in ankle dorsiflexion ROM and/or foot posture between healthy individuals that pass and fail the SLST for MKD.Study DesignCross-sectional study.MethodsSixty-five healthy, active volunteers (sex = 50 female, 15 male; age = 25.2 +/- 5.6 years; height = 1.7 +/- .1 m; weight = 68.5 +/- 13.5 kg) who demonstrated static balance and hip abductor strength sufficient for performance of the SLST participated in the study. Subjects were divided into pass and fail groups based on visual observation of MKD during the SLST. Foot Posture Index (FPI-6) scores and measures of non-weight bearing and weight bearing active ankle dorsiflexion (ROM) were compared.ResultsThere were 33 individuals in the pass group and 32 in the fail group. The groups were similar on age (p = .899), sex (p = .341), BMI (p = .818), and Tegner Activity Scale score (p = .456). There were no statistically significant differences between the groups on the FPI-6 (pass group mean = 2.5 +/- 3.9; fail group mean = 2.3 +/- 3.5; p = .599), or any of the measures of dorsiflexion range of motion (non-weight bearing dorsiflexion with knee extended: pass group = 6.9^o +/- 3.7^o, fail group = 7.8^o +/- 3.0^o; non-weight bearing dorsiflexion with knee flexed: pass group = 13.5^o +/- 5.6^o, fail group = 13.9^o +/- 5.3^o; weight bearing dorsiflexion: pass group = 42.7^o +/- 6.0^o, 42.7^o +/- 8.3^o, p = .611).ConclusionsFailure on the SLST is not related to differences in clinical measures of active dorsiflexion ROM or foot posture in young, healthy individuals. These findings suggest that clinicians may continue using the SLST to assess neuromuscular performance of the trunk, hip, and knee without ankle dorsiflexion ROM or foot posture contributing to results.Level of EvidenceLevel 3.     

Neutral lumbar spine sitting posture in pain-free subjects

Sitting is a common aggravating factor in low back pain (LBP), and re-education of sitting posture is a common aspect of LBP management. However, there is debate regarding what is an optimal sitting posture. This pilot study had 2 aims; to investigate whether pain-free subjects can be reliably positioned in a neutral sitting posture (slight lumbar lordosis and relaxed thorax); and to compare perceptions of neutral sitting posture to habitual sitting posture (HSP). The lower lumbar spine HSP of seventeen pain-free subjects was initially recorded. Subjects then assumed their own subjectively perceived ideal posture (SPIP). Finally, 2 testers independently positioned the subjects into a tester perceived neutral posture (TPNP). The inter-tester reliability of positioning in TPNP was very good (intraclass correlation coefficient (ICC) = 0.91, mean difference = 3% of range of motion). A repeated measures ANOVA revealed that HSP was significantly more flexed than both SPIP and TPNP (p <0.05). There was no significant difference between SPIP and TPNP (p >0.05). HSP was more kyphotic than all other postures. This study suggests that pain-free subjects can be reliably positioned in a neutral lumbar sitting posture. Further investigation into the role of neutral sitting posture in LBP subjects is warranted.