Volume 19, Issue 4 (Winter 2019)
jrehab 2019, 19(4): 340-353 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
MohammadZadeh S, Jafarpisheh A S, Mokhtarinia H R, Oskouezadeh R, Nourozi M. Designing and Evaluating the Validity and Reliability of the Biofeedback Tool for Healthy People With Postural Kyphosis. jrehab 2019; 19 (4) :340-353
URL: http://rehabilitationj.uswr.ac.ir/article-1-2369-en.html
URL: http://rehabilitationj.uswr.ac.ir/article-1-2369-en.html
Shayesteh MohammadZadeh1 
, Amir Salar Jafarpisheh * 2, Hamid Reza Mokhtarinia1 , Reza Oskouezadeh1 , Mehdi Nourozi3
, Amir Salar Jafarpisheh * 2, Hamid Reza Mokhtarinia1 , Reza Oskouezadeh1 , Mehdi Nourozi3
1- Department of Ergonomics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Department of Ergonomics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. ,am.jafarpisheh@uswr.ac.ir
3- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Department of Ergonomics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. ,
3- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Abstract: (5042 Views)
Objective Kyphosis is one of the common abnormalities of the spine. However, correct preservation of the posture can play an important role in preventing and treating kyphosis. Biofeedback systems are among the methods used to prevent postural dysfunction. This study aimed to design a biofeedback tool to prevent kyphosis and evaluated reliability and validity of this tool.
Materials & Methods total of 17 students aged between 18 and 30 years participated in the study as inappropriately. In this study, a flexible ruler was used as a golden standard to measure the kyphosis. First, a microcontroller-based kyphosis control biofeedback device was designed using a flexural sensor. This device consists of a vibration generator that activates when microcontroller detects a kyphotic situation. In other words, by changing the physical condition, the flexural sensor resistance used in the smart biofeedback tool changes accordingly and the data collected by the flexural sensor are converted into a voltage variation with a simple resistance circuit. The output of the flexural sensor is input to the microcontroller so that as soon as the microcontroller detects an incorrect physical condition, it sends a control signal (based on the predefined threshold for the microcontroller) in a vibration feedback. If the curvature value is more than the threshold and lasts for at least 30 seconds, it will alert the user with vibration feedback. Vibration alert continues as long as the user is in the kyphotic situation and stops as soon as the user leaves the kyphotic situation and returns to the natural state. After installing the designed biofeedback tool on the target area of the body, the tool error is evaluated by counting the number of warnings in the normal state and lack of warning in the kyphotic condition. In addition, to check the repeatability of the biofeedback tool, measurements were made in two neutral conditions and a tissue for each situation twice, with a distance of 2 hours. In this research, the tool validity was measured by Kappa coefficient based on sensitivity, specificity, and reliability.
Results Correction of the physical condition is an effective technique used to reduce mechanical stress on the neck and shoulders by taking a natural state of the body. Wearable technology is a way to achieve this objective by continuously monitoring the physical condition of the person and giving him or her the needed feedback when the person’s physical condition deviates from normal condition. In this research, a wearable tool was designed that people can use it very easily. Therefore, it can be used as a useful, simple, and non-invasive tool for clinical evaluation and measurement of kyphotic postural information. With further development of data recordings and feedback mechanisms, this system can be transformed into a portable tracking and posturing system to educate patients with spine deviations. This system is an inexpensive user-friendly device.
The results showed that the sensitivity of the designed biofeedback tool was 17.64% and its property was 100%. The kappa index was calculated at 100% for both neutral states, but in the first one, 17.64% was measured in the first load and 12% in the second time. Regarding the repeatability of the biofeedback tool, the studies showed that the results of the first and second times did not differ significantly.
Conclusion To the results, the biofeedback tool has sufficient validity in the neutral state, but it was not sufficient in the paper situation . In other words, the designed biofeedback device does not correctly diagnose the physical condition of the body in accordance with the golden standard (flexible ruler). In this regard, further consideration should be given to address its deficiencies. In addition, Kappa index values showed that the biofeedback tool was not well-suited to the kyphotic condition. However, this tool has a great deal of reliability at the time.
Materials & Methods total of 17 students aged between 18 and 30 years participated in the study as inappropriately. In this study, a flexible ruler was used as a golden standard to measure the kyphosis. First, a microcontroller-based kyphosis control biofeedback device was designed using a flexural sensor. This device consists of a vibration generator that activates when microcontroller detects a kyphotic situation. In other words, by changing the physical condition, the flexural sensor resistance used in the smart biofeedback tool changes accordingly and the data collected by the flexural sensor are converted into a voltage variation with a simple resistance circuit. The output of the flexural sensor is input to the microcontroller so that as soon as the microcontroller detects an incorrect physical condition, it sends a control signal (based on the predefined threshold for the microcontroller) in a vibration feedback. If the curvature value is more than the threshold and lasts for at least 30 seconds, it will alert the user with vibration feedback. Vibration alert continues as long as the user is in the kyphotic situation and stops as soon as the user leaves the kyphotic situation and returns to the natural state. After installing the designed biofeedback tool on the target area of the body, the tool error is evaluated by counting the number of warnings in the normal state and lack of warning in the kyphotic condition. In addition, to check the repeatability of the biofeedback tool, measurements were made in two neutral conditions and a tissue for each situation twice, with a distance of 2 hours. In this research, the tool validity was measured by Kappa coefficient based on sensitivity, specificity, and reliability.
Results Correction of the physical condition is an effective technique used to reduce mechanical stress on the neck and shoulders by taking a natural state of the body. Wearable technology is a way to achieve this objective by continuously monitoring the physical condition of the person and giving him or her the needed feedback when the person’s physical condition deviates from normal condition. In this research, a wearable tool was designed that people can use it very easily. Therefore, it can be used as a useful, simple, and non-invasive tool for clinical evaluation and measurement of kyphotic postural information. With further development of data recordings and feedback mechanisms, this system can be transformed into a portable tracking and posturing system to educate patients with spine deviations. This system is an inexpensive user-friendly device.
The results showed that the sensitivity of the designed biofeedback tool was 17.64% and its property was 100%. The kappa index was calculated at 100% for both neutral states, but in the first one, 17.64% was measured in the first load and 12% in the second time. Regarding the repeatability of the biofeedback tool, the studies showed that the results of the first and second times did not differ significantly.
Conclusion To the results, the biofeedback tool has sufficient validity in the neutral state, but it was not sufficient in the paper situation . In other words, the designed biofeedback device does not correctly diagnose the physical condition of the body in accordance with the golden standard (flexible ruler). In this regard, further consideration should be given to address its deficiencies. In addition, Kappa index values showed that the biofeedback tool was not well-suited to the kyphotic condition. However, this tool has a great deal of reliability at the time.
Type of Study: Original |
Subject:
General
Received: 20/03/2018 | Accepted: 13/08/2018 | Published: 1/01/2019
Received: 20/03/2018 | Accepted: 13/08/2018 | Published: 1/01/2019
References
1. Sangtarash F, Dehghan-Manshadi F, Sadeghi AR, Tabatabaei SM. [Validity and reproducibility of dual digital inclinometer in measuring thoracic kyphosis in women over 45 years (Persian)]. Archives of Rehabilitation. 2014; 15(2):78-84.
2. Gaffney BM, Maluf KS, Davidson BS. Evaluation of novel EMG biofeedback for postural correction during computer use. Applied Psychophysiology and Biofeedback. 2016; 41(2):181-9. [DOI:10.1007/s10484-015-9328-3] [PMID] [DOI:10.1007/s10484-015-9328-3]
3. Arab AM. [Relationship between thoracic kyphosis and respiratory capacities (Persian)]. Physical Treatments. 2013; 3(2):57-61.
4. Kermani MT, Atri AE, Yazdi NK. [The effect of eight weeks corrective exercise on the functional kyphosis curvature in the teenager girls (Persian)]. Journal of Rehabilitation Medicine. 2017; 6(1):161-8.
5. Omidianidost A, Hosseini SY, Jabari M, Poursadeghiyan M, Dabirian M, Charganeh SS, et al. The relationship between individual, occupational factors and LBP (Low Back Pain) in one of the auto parts manufacturing workshops of Tehran in 2015. Journal of Engineering and Applied Sciences. 2016; 11(5):1074-7. [DOI:10.3923/jeasci.2016.1074.1077]
6. Faghfourian H, Anbarian M, Faradmal J, Heydari Moghadam R. Muscular response of females with kyphosis in balance recovery from postural perturbation. Physical Treatments. 2015; 5(1):11-8.
7. Cunha Henriques S, Cost Paiva L, Pinto Neto AM, Fonsechi Carvesan G, Nanni L, Morais SS. Postmenopausal women with osteoporosis and musculoskeletal status: A comparative cross-sectional study. Journal of Clinical Medicine Research. 2011; 3(4):168-76. [DOI:10.4021/jocmr537w] [DOI:10.4021/jocmr537w]
8. Murray P, Weinstein S, Spratt K. The natural history and long-term follow-up of Scheuermann kyphosis. The Journal of Bone and Joint Surgery (American Volume). 1993; 75(2):236-48. [DOI:10.2106/00004623-199302000-00011] [PMID] [DOI:10.2106/00004623-199302000-00011]
9. Teixeira F, Carvalho G. Reliability and validity of thoracic kyphosis measurements using flexicurve method. Brazilian Journal of Physical Therapy. 2007; 11(3):199-204. [DOI:10.1590/S1413-35552007000300005] [DOI:10.1590/S1413-35552007000300005]
10. Meamari H, Koushkie Jahromi M, Fallahi A, Sheikholeslami R. Influence of structural corrective and respiratory exercises on cardiorespiratory indices of male children afflicted with kyphosis. Archives of Rehabilitation. 2017; 18(1):51-62. [DOI:10.21859/jrehab-180151] [DOI:10.21859/jrehab-180151]
11. Briggs A, Wrigley T, Tully E, Adams P, Greig A, Bennell K. Radiographic measures of thoracic kyphosis in osteoporosis: Cobb and vertebral centroid angles. Skeletal Radiology. 2007; 36(8):761-7. [DOI:10.1007/s00256-007-0284-8] [PMID] [DOI:10.1007/s00256-007-0284-8]
12. Ghasemi V, Ahmadi A, Dashti Rostami K, Savoroliya M. [The study of kyphosis angle changes, the position of the shoulder and upper extremity range of motion after 8-week exercise in students kyphotic (Persian)]. Journal of Applied Exercise Physiology. 2016; 11(22):63-74. [DOI:10.22080/JAEP.2016.1209]
13. Poursadeghiyan M, Azrah K, Biglari H, Ebrahimi MH, Yarmohammadi H, Baneshi MM, et al. The effects of the manner of carrying the bags on musculoskeletal symptoms in school students in the city of Ilam, Iran. Annals of Tropical Medicine and Public Health. 2017; 10(3):600-5.
14. Culham E, Peat M. Spinal and shoulder complex posture. II: Thoracic alignment and shoulder complex position in normal and osteoporotic women. Clinical Rehabilitation. 1994; 8(1):27-35. [DOI:10.1177/026921559400800104] [DOI:10.1177/026921559400800104]
15. Bansal S, Katzman WB, Giangregorio LM. Exercise for improving age-related hyperkyphotic posture: A systematic review. Archives of Physical Medicine and Rehabilitation. 2014; 95(1):129-40. [DOI:10.1016/j.apmr.2013.06.022] [PMID] [PMCID] [DOI:10.1016/j.apmr.2013.06.022]
16. Fathi A. Prevalence rate of postural damages, disorders and anomalies among computer users. Physical Treatments-Specific Physical Therapy Journal. 2016; 6(1):59-65. [DOI:10.18869/nrip.ptj.6.1.59] [DOI:10.18869/nrip.ptj.6.1.59]
17. Pfab I. A wearable intervention for posture improvement [MSc. thesis]. Enschede: University of Twente; 2016.
18. Mirbagheri SS, Rahmani Rasa A, Farmani F, Amini P, Nikoo MR. Evaluating kyphosis and lordosis in students by using a flexible ruler and their relationship with severity and frequency of thoracic and lumbar pain. Asian Spine Journal. 2015; 9(3):416-22. [DOI:10.4184/asj.2015.9.3.416] [PMID] [PMCID] [DOI:10.4184/asj.2015.9.3.416]
19. 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 hyper kyphotic patients (Persian)]. Archives of Rehabilitation. 2003; 4(3):18-23.
20. Torkaman O, Kamyab M, Babayi T, Ghandhari H. [Effect of new kypho-remainder orthosis on curve intensity in adults with postural hyper kyphosis (Persian)]. Archives of Rehabilitation. 2017; 18(3):212-9. [DOI:10.21859/jrehab-1803212] [DOI:10.21859/jrehab-1803212]
21. Wong WY, Wong MS. Measurement of postural change in trunk movements using three sensor modules. IEEE Transactions on Instrumentation and Measurement. 2009; 58(8):2737-42. [DOI:10.1109/TIM.2009.2016289] [DOI:10.1109/TIM.2009.2016289]
22. Ma C, Szeto GP, Yan T, Wu S, Lin C, Li L. Comparing biofeedback with active exercise and passive treatment for the management of work-related neck and shoulder pain: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2011; 92(6):849-58. [DOI:10.1016/j.apmr.2010.12.037] [PMID] [DOI:10.1016/j.apmr.2010.12.037]
23. Lou E, Hill DL, Moreau MJ, Mahood JK, Hedden DM, Raso JV. A smart garment for the treatment of kyphosis. Paper presented at: Orthopaedic Proceedings. 21 September 2018; New York, United States of America.
24. Zheng Y, Morrell JB. Comparison of visual and vibrotactile feedback methods for seated posture guidance. IEEE Xplore: IEEE Transactions on Haptics. 2013; 6(1):13-23. [DOI:10.1109/TOH.2012.3] [PMID] [DOI:10.1109/TOH.2012.3]
25. MacIntyre N, Lorbergs A, Adachi J. 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. Osteoporosis International. 2014; 25(2):721-8. [DOI:10.1007/s00198-013-2484-5] [PMID] [DOI:10.1007/s00198-013-2484-5]
26. Bai VDM, Surendran A. Microcontroller based scoliosis prevention equipment using flex sensor. International Innovative Research Journal of Engineering and Technology. 2017; 28(1):2-7. [PMID] [PMCID]
27. Hermanis A, Nesenbergs K, Cacurs R, Greitans M. Wearable posture monitoring system with biofeedback via smartphone. Journal of Medical and Bioengineering. 2013; 2(1):40-4. [DOI:10.12720/jomb.2.1.40-44] [DOI:10.12720/jomb.2.1.40-44]
28. Teitelbaum HS. American osteopathic college of occupational and preventive medicine. Paper presented at: 2012 Mid-Year Educational Conference. 24-26 February 2016; Florida, United State of America.
29. Sangtarash F, Dehghan Manshadi F, Sadeghi AR, Tabatabaei SM. [Validity and reproducibility of dual digital inclinometer in measuring thoracic kyphosis in women over 45 years (Persian)]. Archives of Rehabilitation. 2014; 15(2):78-84.
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Copyright © The Author(s);
This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Contact Information
This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Contact Information
