title: Validity and reliability of a dental operator posture assessment instrument (PAI).
abstract: OBJECTIVE
  Basic operating posture is considered an important occupational health issue for oral health care clinicians. It is generally agreed that the physical posture of the operator, while providing care, should be such that all muscles are in a relaxed, well-balanced, and neutral position. Postures outside of this neutral position are likely to cause musculoskeletal discomfort. To date, the range of the neutral operator position has not been well-defined; nor have any specific instruments been identified that can quantitatively or semi-quantitatively assess dental operator posture. This paper reports on the development of an instrument that can be used to semi-quantitatively evaluate postural components.
  
  
  METHODS
  During the first phase of the study, an expert panel defined the basic parameters for acceptable, compromised, and harmful operator postures and established face validity of a posture assessment instrument (PAI). During the second phase, the PAI was tested for reliability using generalizability theory. Four raters tested the instrument for reliability.
  
  
  RESULTS
  Overall, total PAI scores were similar amongst three of the raters, with the fourth rater's scores being slightly greater than the other three. The main effect of the rater on individual postural components was moderate, indicating that rater variance contributed to 11.9% of total variance.
  
  
  CONCLUSIONS
  The PAI measures posture as it occurs and will have numerous applications when evaluating operator performance in the dental and dental hygiene education setting. Also, the PAI will prove useful when examining the effects of operator posture and musculoskeletal disorders.
authors.affiliation: Division of Dental Hygiene, University of Missouri-Kansas City, USA.
authors.forename: Bonnie G
authors.initials: BG
authors.lastname: Branson
authors.forename: Karen B
authors.initials: KB
authors.lastname: Williams
authors.forename: Kimberly Krust
authors.initials: KK
authors.lastname: Bray
authors.forename: Sandy L
authors.initials: SL
authors.lastname: Mcllnay
authors.forename: Diana
authors.initials: D
authors.lastname: Dickey
mesh_terms: D003797:Dental Staff; D006801:Humans; D009140:Musculoskeletal Diseases / Q000517:prevention & control; D015588:Observer Variation; D009784:Occupational Diseases / Q000517:prevention & control; D016273:Occupational Exposure / Q000517:prevention & control; D011187:Posture; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis