Table of Contents
ISRN Rheumatology
Volume 2011, Article ID 571698, 8 pages
Research Article

Optimizing Reliability of Digital Inclinometer and Flexicurve Ruler Measures of Spine Curvatures in Postmenopausal Women with Osteoporosis of the Spine: An Illustration of the Use of Generalizability Theory

School of Rehabilitation Science, McMaster University, IAHS, Room 403, 1400 Main Street West, Hamilton, ON, Canada L8S 1C7

Received 1 December 2010; Accepted 2 January 2011

Academic Editors: A. Adebajo and K. Uusi-Rasi

Copyright © 2011 Norma J. MacIntyre et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The study illustrates the application of generalizability theory (G-theory) to identify measurement protocols that optimize reliability of two clinical methods for assessing spine curvatures in women with osteoporosis. Triplicate measures of spine curvatures were acquired for 9 postmenopausal women with spine osteoporosis by two raters during a single visit using a digital inclinometer and a flexicurve ruler. G-coefficients were estimated using a G-study, and a measurement protocol that optimized inter-rater and inter-trial reliability was identified using follow-up decision studies. The G-theory provides reliability estimates for measurement devices which can be generalized to different clinical contexts and/or measurement designs.