title: Telediagnostic 3D school screening of back curvatures and posture using structured light method - pilot study.
abstract: BACKGROUND
  Several studies consider the school scoliosis screening as controversial. Many authors postulate to improve its clinical effectiveness.
  
  
  OBJECTIVE
  Authors assumed that three dimensional telediagnostic surface topography measurements allowing measuring several postural deformity indexes and angles of curvatures in sagittal plane may enhance current practice. The study was designed to determine usefulness of school screening back evaluation performed utilizing the three dimensional telediagnostic measurement system.
  
  
  METHODS
  The measurement module is based on structured light method using "3D Orthoscreen" system. The technique for 3D image acquisition of back shape is based on temporal phase shifting and Gray codes. Measurement data was securely archived for remote access by investigator over the secure Internet connection. Acquired "images" were transferred to Telediagnostic Center for clinical evaluation. Spine parameters and deformation indexes like Posterior Trunk Symmetry Index (POTSI), Deformity in the Axial Plane Index (DAPI), kyphosis and lordosis angle were measured. The preliminary study was performed in 2 selected schools (basic and middle schools). The study was approved by Bioethical Committee. Clouds of points representing back topography of assessed subjects were acquired at schools in March and May 2011 and stored for remote evaluation and analysis.
  
  
  RESULTS
  758 children averagely aged 11.1 years (from 5 to 16), 387 females and 371 males, were examined. Their average body mass was 45.13 kg [16-105; STD 16.4] and average height was 151.43 cm, [110-192; STD 18.3]. The average values of back assessment parameters were as follows: POTSI 15.97% [0-73.4; STD 10.3]; DAPI 0.88% [0-5.9; STD 0.76]; kyphosis angle 10.19° [0-32; STD 5.82]; and lordosis angle 32,82° [0-56; STD 9.86].
  
  
  CONCLUSIONS
  Technical and clinical issues of the practical implementation allowed to elaborate preliminary protocol for cohort studies addressed to subject (i.e. parents acceptance of examination of undressed back) and technical issues (i.e. upload data and retrieval, network transfer velocity). Postural telediagnostics was found sufficiently feasible for further implementation of remote, cohort 3D back shape evaluations including school screening. Permanently saved 3D data allow monitoring back surface of the individual subjects.
authors: Department of Orthopaedics, Medical University of Warsaw, Poland. w.glinkowski@teleorto.pl
authors: Wojciech
authors: W
authors: Glinkowski
authors: Jakub
authors: J
authors: Michoński
authors: Bożena
authors: B
authors: Glinkowska
authors: Agnieszka
authors: A
authors: Zukowska
authors: Robert
authors: R
authors: Sitnik
authors: Andrzej
authors: A
authors: Górecki
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008029:Lighting / Q000379:methods*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012600:Scoliosis / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D017216:Telemedicine / Q000379:methods*