FAQ

Scoliosis is a sideways curvature of the spine that is also accompanied by rotation, which makes it a three-dimensional condition rather than a simple bend. The term is descriptive, like the word headache: it names the finding, not its cause.

Because the vertebrae rotate as well as bend, one side of the trunk sits higher than the other when a person bends forward. That trunk asymmetry is what a scoliometer measures. Curves range from very mild and stable to severe, and appropriate management depends on age, skeletal maturity, curve type and how the curve behaves over time.

The Scoliometer App turns a smartphone into a digital scoliometer. Using the motion sensors already inside the phone, it measures the Angle of Trunk Rotation (ATR) during the Adam’s Forward Bend Test — the same measurement a physical scoliometer takes.

It is a screening aid, not a diagnostic device. ATR may indicate trunk asymmetry associated with scoliosis, but it is not the same as the Cobb angle and it cannot diagnose scoliosis. Its purpose is to help parents, clinicians and school screeners decide when a professional assessment is worth seeking, and to follow how a reading changes over time.

Learn more: what a scoliometer measures.

The app measures the Angle of Trunk Rotation (ATR) — how much one side of the trunk rises relative to the other when a person bends forward during the Adam’s Forward Bend Test.

The phone is laid flat across the back, perpendicular to the spine, and moved slowly from the upper back (thoracic) through the mid back to the lower back (lumbar). The highest reading, and the region it came from, is what screening guidelines refer to.

ATR is a surface measurement of rotation. It is not the Cobb angle, which is measured on an X-ray, and it cannot diagnose scoliosis. See what a normal scoliometer reading is.

A scoliometer is a simple instrument laid flat across the back during the Adam’s Forward Bend Test to measure the Angle of Trunk Rotation (ATR) in degrees. Traditional scoliometers use a rolling ball or fluid level; a digital scoliometer app reproduces the same measurement using a smartphone’s motion sensors.

What it measures is trunk rotation — the asymmetry produced when rotated vertebrae push the ribs and muscles on one side further back — not the sideways curve of the spine itself. It is a screening tool and does not replace an X-ray or a professional examination.

Full guide: what is a scoliometer and what does it measure?

The screening test itself is simple, and most parents can perform it carefully at home. The standard method is the Adam’s Forward Bend Test: the person bends forward at the waist with arms hanging and palms together, while the examiner gets their eyes level with the back and looks for one side sitting higher than the other.

Technique matters more than the instrument. Keeping the same tester, the same bend depth and the same level surface between measurements is what makes readings comparable. Step-by-step instructions: how to use a scoliometer.

Home screening is a starting point for deciding whether to seek assessment, not a substitute for one.

Scoliosis is three-dimensional: the spine bends sideways and the vertebrae also rotate. That rotation pushes the ribs and muscles on one side further back, so when a person bends forward one side of the trunk sits higher than the other. The Angle of Trunk Rotation, or ATR, is the angle of that difference, measured in degrees.

ATR is not the same as spinal curvature. “Spinal curvature” in a clinical report usually means the Cobb angle, measured on an X-ray. ATR is measured on the surface of the back. A higher ATR tends to accompany a larger curve, but the relationship is approximate and varies between individuals.

No. The Cobb angle is measured on an X-ray by a clinician and is the diagnostic measurement for scoliosis. The app measures the Angle of Trunk Rotation, a surface indicator of trunk rotation.

The two are related — a higher ATR tends to accompany a larger curve — but they are not interchangeable, and an ATR reading cannot be converted into a Cobb angle. A raised reading is a reason to seek assessment, which may include imaging. See ATR versus the Cobb angle.

For children and adolescents, roughly every two to four weeks is common, because scoliosis most often progresses during the adolescent growth spurt. For adults, monthly is usually enough to follow degenerative or age-related change.

Consistency matters more than frequency: the same tester, the same technique and the same interval. A trend across several measurements is more informative than any single reading. See what a normal scoliometer reading is.

Have the person stand straight with feet together on a level floor, then bend forward from the hips with arms hanging loosely and palms together, until the back is roughly horizontal. Get your eyes level with the back, rest the phone flat across the back and perpendicular to the spine, and move slowly from the thoracic region down to the lumbar region, pausing at each. Record the highest reading and note which region it came from.

A tutorial video by Dr Kevin Lau is also available inside the app, on the MORE page under “Play Tutorial”.

Detailed instructions, and the mistakes that most often distort a reading: how to use a scoliometer.

The commonly accepted screening guideline is to refer at a scoliometer reading of 7° or more. A lower threshold of 5° is used for children who are overweight, because curves are more easily missed and a substantial curve can present with a modest reading.

Referral is also appropriate when readings are rising across measurements, or when you notice uneven shoulders, a prominent shoulder blade, an uneven waistline or a visible rib hump on forward bending.

These are population screening thresholds, not diagnoses. If in doubt, consult a healthcare professional. See what a normal scoliometer reading is.

Below 5° is generally considered low. 5°–6° deserves attention and is the usual referral point for overweight children. 7° or more is the commonly accepted threshold for referral. An increase of about 5° between measurements warrants review even when the absolute number still looks modest.

Screening research indicates that higher ATR readings tend to accompany larger spinal curves, but the relationship is approximate and varies between individuals — a scoliometer reading cannot be converted into a Cobb angle.

Keep a dated record of each reading and the region measured, and bring it to your appointment. Full explanation: what is a normal scoliometer reading?

The management options for scoliosis fall into three main categories: observation of the scoliosis, non-operative therapy and surgical.

1. Observation: This is for curves that have a small degree measurement when you are growing (adolescent scoliosis), or for moderate size curves (< 40-45 degrees) when you are done growing. For adults, observation and physical therapy are for those patients who have mild symptoms and have curves which are not large.
2. Bracing: This is for curves between 25 and 45 degrees in growing children to prevent further progression of the curve while growth of the spine continues. The goal of bracing is to prevent further progression since the brace cannot correct curves.
3. Surgery: This is reserved for curves that are generally greater than 50 degrees for adolescent patients and adults. Surgery can be performed for smaller curves if the appearance of the curvature is bothersome to the patient or if symptoms are associated with scoliosis in the adult patient. The goals of surgery are to obtain curve correction and to prevent curve progression. This is generally achieved by placing metal implants onto the spine which are then attached to rods which correct the spine curvature and hold it in the corrected position until fusion, or knitting of the spine elements together.
4. Non-Surgical Treatment: Dr. Kevin Lau offers an innovative and new therapy option for scoliosis which focuses on trying to control how the scoliosis gene is expressed using diet and exercise. To find out more read his book: ScolioLife – Your Plan for Natural Scoliosis Prevention and Treatment.

The measurement uses the phone’s motion sensors, so anything that tilts the device changes the number. A thick or uneven case is the most common cause and introduces a consistent offset in every reading.

Measure with the phone flat against the back and, where possible, without a case. Pressing the phone into the back compresses soft tissue and usually reads low. Whichever setup you choose, keep it identical between sessions so readings stay comparable.

A rising trend matters as much as any single reading. An increase of around 5° between measurements warrants professional review even if the absolute value still looks modest.

First confirm the technique was identical — same tester, same bend depth, same level surface, same phone without a case — because method changes can move a reading by several degrees on their own. If the increase holds on a careful repeat measurement, arrange an assessment.

Mild curves can progress without pain and without being obvious, particularly during a growth spurt, which is why consistent monitoring and a dated record are worth keeping.

According to the app’s Data safety information on Google Play, the Scoliometer App collects no user data and shares no data with third parties. Readings you record stay on your own device.

Because readings are held on the device rather than on our servers, we cannot retrieve them for you. If you are following a curve over months, keep your own dated record — date, region measured, reading and who took the measurement — and bring it to your appointments.

Scoliometer supports multi-lingual versions.

We currently serve in English, French, German, Greek, Italian, Indonesian, Portuguese, Russian, Finnish, Swedish, Spanish, Japanese, Chinese (Simplified and Traditional), Vietnamese, Thai, Korean, and Malay.

The language is automatically selected based on the iPhone’s language. The language of Scoliometer can be changed through the iPhone’s settings.

Setting the language:

Settings > General > International > Language

Choose the language you want to use, and tap Done.

Once you purchase an application, you can download it without charge.

Application update is a new release that can be purchased or downloaded through App Store on iPhone or Android device App Stores.

If you were charged for Scoliometer by Apple iTunes after purchasing a subscription within the Scoliometer app on your phone and would like a refund, you must contact Apple or Google directly, as they do not provide us with the ability to process refunds. Only Apple or Google customer support can process refunds for purchases made through their App Stores account.

There may be times when you accidentally delete a purchased app before you get a chance to back up your purchase. See the steps to re-download your App Store purchase.

In this case, you can re-download what you have purchased previously through your phones App store.