Validity and Reliability of a Non-Radiographic Postural Analysis Device Based on an RGB-Depth Camera Comparing EOS 3D Imaging: A Prospective Observational Study

The posture-analyzing and virtual reconstructing device (PAViR) used a Red Green Blue-Depth camera as a sensor and skeleton reconstruction images were produced. This PAViR quickly analyzed the whole posture from multiple repetitive shots without radiation exposure in clothes and provided a virtual skeleton within seconds. This study aims to evaluate the reliability when shooting repeatedly and to assess the validity compared to parameters of full-body, low-dose X-rays (EOSs) when applied as diagnostic imaging. As a prospective and observational study, 100 patients with musculoskeletal pain underwent an EOS to obtain whole body coronal and sagittal images. The outcome measures were human posture parameters, which were divided by the standing plane in both EOSs and PAViRs as follows: (1) a coronal view (asymmetric clavicle height, pelvic oblique, bilateral Q angles of the knee, and center of seventh cervical vertebra-central sacral line (C7-CSL)) and (2) a sagittal view (forward head posture). A validation of the PAViR compared to the EOSs revealed that C7-CSL showed a moderate positive correlation with that of the EOS (r = 0.42, p < 0.01). The forward head posture (r = 0.39, p < 0.01), asymmetric clavicle height (r = 0.37, p < 0.01), and pelvic oblique (r = 0.32, p < 0.01) compared to those of the EOS had slightly positive correlations. The PAViR has excellent intra-rater reliability in people with somatic dysfunction. Except for both Q angles, the PAViR has fair-to-moderate validation when compared to EOS diagnostic imaging in the parameter representing coronal and sagittal imbalance. Although the PAViR system is not yet available in the medical field, it has the potential to become a radiation-free, accessible, and cost-effective postural analysis diagnostic tool after the EOS era.