Frontal-Mental Line Inclination Test for assessment of cervical curvature: validation and applicability

Abstract

Introduction: Alternative testing for X-rays in the assessment of spine have the advantage of not causing radiation problems, but need to be validated. Objective: To propose a clinical test for assessment of the cervical spine based on the frontal-mental line inclination, identifying its concurrent validity in relation to the gold standard and determining its clinical applicability. Methods: The present study was separated into two phases: [1] Test of Frontal-mental Line Inclination [TFMLI] validation protocol [evaluation of head position by means of X-rays and by computerized photogrammetry and assessment of cervical curvature using X-rays and TFMLI] [n = 35]; [2] testing the possibility of performing TFMLI with an universal goniometer [n = 23]. Results: In phase 1, for the evaluation of head position, the gold standard and the photogrammetry showed high and significant correlation [r = 0.602; p < 0.001]. When evaluating the cervical curvature, the gold standard and TFMLI showed high and significant correlation [r = 0.597; p = 0.019]. In phase 2, for the evaluation of head position, photogrammetry and goniometry showed high and significant correlation [r_s = 0.662; p < 0.001]. For the evaluation of the cervical curvature, the TFMLI performed by photographs and by goniometry presented almost perfect and significant correlation [r = 0.969; p < 0.001]. Conclusion: The TFMLI is suitable for an initial evaluation of the cervical spine posture of individuals who present an anterior head position and can be applied in clinical practice through the use of an universal goniometer.