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. 2021 Oct 1;16(5):1366–1375. doi: 10.26603/001c.27978

Table 1. Summary of Research on Methods to Assess Pelvic Tilt in a Rehabilitation Setting.

Method Reliability Validity
Visual Assessment
  • Fedorak et al (2003) found fair intra-rater (kappa= 0.50) and poor inter-rater reliability (kappa= 0.16) for visual assessment of lumbar lordosis with analysis of photographs of individuals with and without low back pain.

  • No studies directly assess reliability of visual assessment of pelvic tilt.

No studies
Hand-held inclinometer
  • Prushansky et al (2008) found good intra-rater reliability (ICC>0.87; SEM 0.9-2.26) for measuring anterior pelvic tilt, neutral pelvic tilt, posterior pelvic tilt, and total pelvic tilt in the standing position, and moderate inter-rater reliability (ICC=0.60; SEM=2.59) for the total pelvic tilt in male subjects with 30 healthy subjects (15 f; age 25.4 +/- 1.7) using a digital inclinometer (Fennel, Germany). They found no significant differences between testers indicating inter-rater reliability (p<0.05) for total pelvic tilt and all pelvic tilt measures in females.

No studies
Caliper-based pelvic inclinometer
  • Herrington (2011) found good intra-rater reliability (ICC=0.87; SEM=1.1) using the PALM palpation meter pelvic inclinometer with 120 healthy subjects (55 f; age 23.8 +/- 2.1) for measuring the standing pelvic position.

  • Crowell et al (1994) found excellent intra-rater (ICC=0.92-0.96) and inter-rater (ICC=0.95) reliability when using a non-commercialized caliper-based inclinometer and assessing 26 healthy males (average age 45) in a standing position.

  • Beardsley et al (2016) found good inter-rater reliability (ICC=0.81-0.88), good test-retest reliability within a single session (ICC=0.88-0.95) and moderate to good reliability for test-retest reliability between sessions (ICC=0.65-0.85) when using a digital pelvic inclinometer and assessing 18 healthy subjects (6 females, age 23.6 +/- 4.7) in a standing position.

  • Hagins et al (1998) found excellent intra-rater (ICC=0.98) and good inter-rater (ICC=0.89) reliability and a high SEM (3.6) using the PALM palpation meter pelvic inclinometer with 24 healthy subjects (15 female; age 27) in a standing position. The measurements in this study were done over clothing.

  • Crowell et al (1994) found high degree of agreement as compared to a roentgenographic measure (ICC=0.93) when using a non-commercialized caliper-based inclinometer and assessing 26 healthy males (average age 45) in a standing position.

  • Hayes et al (2016) found good correlation between pelvic tilt measurements with the PALM palpation meter and radiographic measures in 50 healthy subjects (age 18-79, sex not reported) for total pelvic tilt (r=.509; p<0.001) and changes in anterior pelvic tilt (r=.676; p<0.001) but poor correlation for changes in posterior pelvic tilt (r=.298; p=0.036).

Smartphone Application
  • Koumantakis et al (2016) found excellent intra-rater reliability (ICC=0.97; SEM=1.61) using an Android smartphone with the “iHandy Level” application with 183 healthy subjects (100 f; age 26.1 +/- 10.04) for measuring the standing pelvic position.

No studies

ICC: Intraclass Correlation Coefficient. SEM: Standard Error of Measurement.