# Intra and inter-rater reproducibility of the Remote Static Posture Assessment (ARPE) protocol’s Postural Checklist

## TL;DR

This study evaluated the consistency of a remote posture assessment tool, finding it reliable for most items but with some inconsistencies when used by different raters.

## Contribution

The study provides evidence for the reproducibility of a remote static posture assessment protocol under pandemic conditions.

## Key findings

- Intra-rater reliability was high for all checklist items with k values from 0.921 to 1.0.
- Inter-rater reliability was acceptable for most items but poor for four specific posture elements.
- The ARPE protocol is reproducible but some items should be excluded when used by different raters.

## Abstract

With the enforcement of social distancing due to the pandemic, a need to conduct postural assessments through remote care arose. So, this study aimed to assess the intra- and inter-rater reproducibility of the Remote Static Posture Assessment (ARPE) protocol’s Postural Checklist. The study involved 51 participants, with the postural assessment conducted by two researchers. For intra-rater reproducibility assessment, one rater administered the ARPE protocol twice, with an interval of 7–days between assessments (test–retest). A second independent rater assessed inter-rater reproducibility. Kappa statistics (k) and percentage agreement (%C) were used, with a significance level of 0.05. The intra-rater reproducibility analysis indicated high reliability, k values varied from 0.921 to 1.0, with %C ranging from 94% to 100% for all items on the ARPE protocol’s Postural Checklist. Inter-rater reproducibility indicates reliability ranging from slight to good, k values exceeded 0.4 for the entire checklist, except for four items: waists in the frontal photograph (k = 0.353), scapulae in the rear photograph (k = 0.310), popliteal line of the knees in the rear photograph (k = 0.270), and foot posture in the rear photograph (k = 0.271). Nonetheless, %C surpassed 50% for all but the scapulae item (%C = 47%). The ARPE protocol’s Postural Checklist is reproducible and can be administered by the same or different raters for static posture assessment. However, when used by distinct raters, the items waists (front of the frontal plane), scapulae, popliteal line of the knees, and feet (rear of the frontal plane) should not be considered.