[Purpose] The sagittal shape of the spine is associated with back-pain, balance andquality of life. We developed, evaluated and report the responses of a graphical tool toassess sagittal spine shape knowledge (literacy). [Participants and Methods] Two hundredand fifty adults were randomly assigned, in a cross-sectional crossover study, tofree-hand draw and select the “ideal” sagittal spine shape. We evaluated the inter andintra-rater reliability and agreement between tests and the sagittal and lordotic spineliteracy between the drawing and selection test versions. [Results] Drawing test inter-and intra-rater agreement was 79% and 80% respectively. Drawing vs. selection agreementwas 43%. More participants drew than selected the correct spine (30% vs. 21%) (p<0.001)and lumbar lordosis shape (56% vs. 42%) (p<0.001). Test order did not affect spineshape literacy scores. A significantly poorer literacy trend was observed with spine painpresence (p=0.02). [Conclusion] We developed a reliable method to evaluate spine shapeliteracy and established that only 21% and 42% of our sample demonstrated correct sagittalspine and lordotic spine shape literacy, respectively. The low literacy scores suggeststhat consideration of including spine shape literacy in health literacy andself-management programs may be warranted, especially in ageing populations.
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