Reliability of a quantitative clinical posture assessment tool among persons with idiopathic scoliosis

Objective To determine overall, test–retest and inter-rater reliability of posture indices among persons with idiopathic scoliosis. Design A reliability study using two raters and two test sessions. Setting Tertiary care paediatric centre. Participants Seventy participants aged between 10 and 20 years with different types of idiopathic scoliosis (Cobb angle 15 to 60°) were recruited from the scoliosis clinic. Main outcome measures Based on the XY co-ordinates of natural reference points (e.g. eyes) as well as markers placed on several anatomical landmarks, 32 angular and linear posture indices taken from digital photographs in the standing position were calculated from a specially developed software program. Generalisability theory served to estimate the reliability and standard error of measurement (SEM) for the overall, test–retest and inter-rater designs. Bland and Altman's method was also used to document agreement between sessions and raters. Results In the random design, dependability coefficients demonstrated a moderate level of reliability for six posture indices (ϕ = 0.51 to 0.72) and a good level of reliability for 26 posture indices out of 32 (ϕ ≥ 0.79). Error attributable to marker placement was negligible for most indices. Limits of agreement and SEM values were larger for shoulder protraction, trunk list, Q angle, cervical lordosis and scoliosis angles. The most reproducible indices were waist angles and knee valgus and varus. Conclusions Posture can be assessed in a global fashion from photographs in persons with idiopathic scoliosis. Despite the good reliability of marker placement, other studies are needed to minimise measurement errors in order to provide a suitable tool for monitoring change in posture over time.

Health promotion program implementation, a socio-technical networking process : a case study of a school-based nutrition intervention

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal.

Elementary School Principals in Low-Socioeconomic-Status Schools: A University-Based Research Program Designed to Support Mandated Reform

This paper presents a reform initiative, the Supporting Montreal Schools Program (SMSP), created by the government of Quebec to assist 184 low socio-economic-status schools in Montreal implement seven reform strategies prescribed by the government. On a regular basis, the professional team of the SMSP engages in reflection and research with universities concerning one or more of the strategies they are charged with helping schools implement or the functioning of the SMSP more generally. The present research programme is part of the team’s ongoing reflection on a component of Strategy 4: professional development of school administrators and the school team. In this paper, we detail results from this initial and subsequent studies on the work of principals in low-performing schools. We also describe our collaborative relationship with the SMSP team, discuss the effectiveness of the SMSP in promoting the implementation of the seven governmentmandated strategies and critique the utility of our partnership with the SMSP and our use of that programme as a vehicle for linking research to practice.