The strongest levels of evidence for reliability exists in support of the Debrunner kyphometer , Spinal Mouse and Flexicurve index , and for validity supports the arcometer and Flexicurve index .
BACKGROUND A wide array of instruments are available for non-invasive thoracic kyphosis measurement .
Guidelines for selecting outcome measures for use in clinical and research practice recommend that properties such as validity and reliability are considered .
This systematic review reports on the reliability and validity of non-invasive methods for measuring  thoracic kyphosis .
Radiographic measures of thoracic kyphosis in osteoporosis: Cobb and vertebral centroid angles
ObjectiveS everal measures can quantify thoracic kyphosis from radiographs , yet their suitability for people with osteoporosis remains uncertain . The aim of this study was to examine the validity and reliability of the vertebral centroid and Cobb angles  in people with osteoporosis . Design and patients  Lateral radiographs of the thoracic spine  were captured in 31 elderly women with osteoporosis .  Thoracic kyphosis was measured globally ( T1–T12 ) and regionally ( T4–T9 ) using Cobb and vertebral centroid angles . Multisegmental curvature was also measured by fitting polynomial functions to the thoracic curvature profile . Canonical and Pearson correlations were used to examine correspondence ; agreement between measures was examined with linear regression . Results Moderate to high intra- and inter-rater reliability was achieved ( SEM = 0.9–4.0 ° ) . Concurrent validity of the simple measures was established against multisegmental curvature ( r = 0.88–0.98 ) . Strong association was observed between the Cobb and centroid angles globally ( r = 0.84 ) and regionally ( r = 0.83 ) . Correspondence between measures was moderate for the Cobb method r = 0.72 ) , yet stronger for the centroid method ( r = 0.80 ) . The Cobb angle was 20 % greater for regional measures due to the influence of endplate tilt . Conclusions Regional Cobb and centroid angles are valid and reliable measures of thoracic kyphosis in people with osteoporosis . However , the Cobb angle is biased by endplate tilt , suggesting that the centroid angle is more appropriate for this population
The strongest levels of evidence for reliability exists in support of the Debrunner kyphometer , Spinal Mouse and Flexicurve index , and for validity supports the arcometer and Flexicurve index .
BACKGROUND A wide array of instruments are available for non-invasive thoracic kyphosis measurement .
Guidelines for selecting outcome measures for use in clinical and research practice recommend that properties such as validity and reliability are considered .
This systematic review reports on the reliability and validity of non-invasive methods for measuring  thoracic kyphosis .