{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T05:40:08Z","timestamp":1775108408190,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>(1) Background: Idiopathic scoliosis is a three-dimensional deformity, yet clinical and research decision-making still relies largely on radiographic Cobb angle measurements. As a radiation-free alternative, clinical assessment of transverse and sagittal plane deformities has gained importance. This study evaluated the concurrent validity and intra- and interrater reproducibility of continuous measurements of rib hump, thoracic kyphosis, and lumbar lordosis obtained using a smartphone application in adolescents with spinal deformities. (2) Methods: Adolescents aged 10\u201317 years with scoliosis (&gt;10\u00b0 Cobb) or hyperkyphosis (&gt;50\u00b0 Cobb) were recruited. Continuous measurements of angle of trunk rotation (ATR) during the Adams forward bend test and in standing position, as well as sagittal profile, were collected using the ISICO app mounted on a standardized plastic tool. Concurrent validity was assessed against a scoliometer using Spearman correlation, root mean square error, and Bland\u2013Altman analysis, while reproducibility was evaluated using intraclass correlation coefficients, standard error of measurement, and minimal detectable change. (3) Results: Thirty-two adolescents were included for validation and intrarater analyses and 34 for interrater analyses. ATR measured during the Adams test showed very high correlation with the scoliometer and minimal bias, while standing ATR showed moderate correlation. Reliability was excellent for rib hump during forward bending and moderate for sagittal parameters, with the lowest values observed for lumbar lordosis. (4) Conclusions: These findings support the clinical use of continuous app-based ATR assessment and suggest that sagittal measurements may be useful with appropriate examiner training.<\/jats:p>","DOI":"10.3390\/s26072099","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T15:45:42Z","timestamp":1774626342000},"page":"2099","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation and Reproducibility of an App for Continuous Measurement as an Assessment Tool for Idiopathic Scoliosis"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6158-8018","authenticated-orcid":false,"given":"Isis Juliene Rodrigues Leite","family":"Navarro","sequence":"first","affiliation":[{"name":"ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"Jacob","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Lariboisi\u00e8re-Fernand Widal Hospital, AP-HP, Universit\u00e9 Paris Cit\u00e9, 75010 Paris, France"},{"name":"Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Inserm U1153, Universit\u00e9 Paris Cit\u00e9, 75010 Paris, France"},{"name":"Research and Development Unit, Parc Sanitari Sant Joan de D\u00e9u, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Masetto","sequence":"additional","affiliation":[{"name":"ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2092-5945","authenticated-orcid":false,"given":"Francesco","family":"Dulio","sequence":"additional","affiliation":[{"name":"ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Negrini","sequence":"additional","affiliation":[{"name":"ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1878-2747","authenticated-orcid":false,"given":"Stefano","family":"Negrini","sequence":"additional","affiliation":[{"name":"ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy"},{"name":"University of Milan, 20122 Milan, Italy"},{"name":"IRCCS Galeazzi S.Ambrogio Hospital, 20161 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1256-5362","authenticated-orcid":false,"given":"Fabio","family":"Zaina","sequence":"additional","affiliation":[{"name":"ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9195-9019","authenticated-orcid":false,"given":"Alessandra","family":"Negrini","sequence":"additional","affiliation":[{"name":"ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Wang, S., Li, M., Ren, J., Tao, J., Fang, M., and Kong, L. (2025). Global Prevalence and Associated Risk Factors of Scoliosis in Children and Adolescents: A Systematic Review and Meta-Analysis. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-24905-4"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"437","DOI":"10.2340\/17453674.2025.43706","article-title":"Effectiveness of Nighttime vs. Full-Time Bracing in the Treatment of Moderate-Grade Adolescent Idiopathic Scoliosis: A Secondary Analysis of the CONTRAIS Trial","volume":"96","author":"Charalampidis","year":"2025","journal-title":"Acta Orthop."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/0268-0033(87)90039-8","article-title":"Analysis of Cobb Angle Measurements in Scoliosis","volume":"2","author":"Scholten","year":"1987","journal-title":"Clin. Biomech."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1056\/NEJMcp1209063","article-title":"Idiopathic Scoliosis in Adolescents","volume":"368","author":"Hresko","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s13013-018-0150-6","article-title":"Torsion Bottle, a Very Simple, Reliable, and Cheap Tool for a Basic Scoliosis Screening","volume":"13","author":"Romano","year":"2018","journal-title":"Scoliosis Spinal Disord."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3798","DOI":"10.1007\/s00586-024-08410-7","article-title":"Repeatability and Intra and Interrater Reproducibility of the DIPA-S eHealth\u00a9 Capture and Analysis System for Clinical Assessment of Scoliosis","volume":"33","author":"Navarro","year":"2024","journal-title":"Eur. Spine J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/1748-7161-4-26","article-title":"Methodology of Evaluation of Morphology of the Spine and the Trunk in Idiopathic Scoliosis and Other Spinal Deformities\u20146th SOSORT Consensus Paper","volume":"4","author":"Kotwicki","year":"2009","journal-title":"Scoliosis"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.2106\/00004623-198466090-00010","article-title":"An Objective Criterion for Scoliosis Screening","volume":"66","author":"Bunnell","year":"1984","journal-title":"J. Bone Jt. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jmpt.2019.05.005","article-title":"Validation of the Measurement of the Angle of Trunk Rotation in Photogrammetry","volume":"43","author":"Navarro","year":"2020","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1093\/ptj\/pzz123","article-title":"Clinical Evaluation of Spinal Coronal and Sagittal Balance in 584 Healthy Individuals: Normal Plumb Line Values and Their Correlation with Radiographic Measurements","volume":"99","author":"Negrini","year":"2019","journal-title":"Phys. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.bjpt.2018.02.005","article-title":"Is the Inclinometer a Valid Measure of Thoracic Kyphosis? A Cross-Sectional Study","volume":"22","author":"Hunter","year":"2018","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1590\/1806-93042017000100005","article-title":"Kyphosis Index Obtained in X-Ray and with Flexicurve Assessment in Children and Young People","volume":"17","author":"Ribeiro","year":"2017","journal-title":"Rev. Bras. Sa\u00fade Matern. Infant."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1590\/bjpt-rbf.2014.0139","article-title":"Test-Retest, Inter-and Intra-Rater Reliability of the Flexicurve for Evaluation of the Spine in Children","volume":"20","author":"Sedrez","year":"2016","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e2518","DOI":"10.1002\/pdi3.2518","article-title":"Advances in Examination Methods for Adolescent Idiopathic Scoliosis","volume":"3","author":"Li","year":"2025","journal-title":"Pediatr. Discov."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/j.ijnurstu.2011.01.016","article-title":"Guidelines for Reporting Reliability and Agreement Studies (GRRAS) Were Proposed","volume":"48","author":"Kottner","year":"2011","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"325","DOI":"10.3233\/BMR-160541","article-title":"Goniometric Evaluation of the Spinal Sagittal Curves in Children and Adolescents: A Reliability Study","volume":"30","author":"Gravina","year":"2017","journal-title":"J. Back Musculoskelet. Rehabil."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1080\/09638280801889519","article-title":"Evaluation of Scoliosis Today: Examination, X-Rays and Beyond","volume":"30","author":"Kotwicki","year":"2008","journal-title":"Disabil. Rehabil."},{"key":"ref_18","first-page":"69","article-title":"A Guide to Appropriate Use of Correlation Coefficient in Medical Research","volume":"24","author":"Mukaka","year":"2012","journal-title":"Malawi Med. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1748-7161-9-4","article-title":"SOSORT 2012 Consensus Paper: Reducing X-Ray Exposure in Pediatric Patients with Scoliosis","volume":"9","author":"Knott","year":"2014","journal-title":"Scoliosis"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.jcm.2019.01.001","article-title":"Validation of a Mathematical Procedure for the Cobb Angle Assessment Based on Photogrammetry","volume":"18","author":"Navarro","year":"2019","journal-title":"J. Chiropr. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.spinee.2018.06.362","article-title":"Accuracy of Photogrammetry for Detecting Adolescent Idiopathic Scoliosis Progression","volume":"19","author":"Leal","year":"2019","journal-title":"Spine J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"14273","DOI":"10.1038\/s41598-023-41267-2","article-title":"A Feasibility Study of Applying Two-Dimensional Photogrammetry for Screening and Monitoring of Patients with Adolescent Idiopathic Scoliosis in Clinical Practice","volume":"13","author":"Zheng","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.rehab.2019.10.008","article-title":"Construct Validity of the Trunk Aesthetic Clinical Evaluation (TRACE) in Young People with Idiopathic Scoliosis","volume":"63","author":"Negrini","year":"2020","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.jcm.2025.09.022","article-title":"Validity and Diagnostic Accuracy of Using a Smartphone for the Measurement of the Angle of Trunk Rotation and the Stiffness Scoliosis Test in Adolescents with Scoliosis","volume":"24","author":"Navarro","year":"2025","journal-title":"J. Chiropr. Med."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Aulisa, A.G., Bandinelli, D., Marsiolo, M., Falciglia, F., Giordano, M., and Toniolo, R.M. (2023). Is Surface Topography Useful in the Diagnosis of Scoliosis? Validation of the Biometrical Holistic of Human Body (BHOHB). Children, 10.","DOI":"10.3390\/children10020320"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1007\/s00586-015-3945-7","article-title":"The Validity and Reliability of \u201cSpinal Mouse\u201d Assessment of Spinal Curvatures in the Frontal Plane in Pediatric Adolescent Idiopathic Thoraco-Lumbar Curves","volume":"25","author":"Livanelioglu","year":"2016","journal-title":"Eur. Spine J."},{"key":"ref_27","first-page":"251","article-title":"Validity and Reliability of Non-Invasive Methods for Evaluating Kyphosis and Lordosis Curvatures: A Literature Review","volume":"17","author":"Zanguie","year":"2023","journal-title":"J. Mod. Rehabil."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"O16","DOI":"10.1186\/1748-7161-7-S1-O16","article-title":"Complete Validation of Plumbline Distances as a Screening Tool for Sagittal Plane Deformities","volume":"7","author":"Negrini","year":"2012","journal-title":"Scoliosis"},{"key":"ref_29","first-page":"e35886","article-title":"Reliability of the Smartphone Application Inclinometer and Flexicurve in Measuring Thoracic Kyphosis","volume":"15","author":"Elpeze","year":"2023","journal-title":"Cureus"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/7\/2099\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T04:14:08Z","timestamp":1775103248000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/7\/2099"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":29,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["s26072099"],"URL":"https:\/\/doi.org\/10.3390\/s26072099","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]}}}