**6. Limitations**

The Microscribe is a manual measurement tool and although is very easy to use in a research setting it is not really ideal to use in a clinical setting at the current time. More research as well as instrument development is needed before this Microscribe can be used within a clinical setting. It should be particularly well suited to use in small clinical units owing to its simplicity of operation, size and cost. In today's climate of evidence based medicine there is an increasing emphasis on objective assessment to monitor treatment effectiveness. Our results stress the need for clinicians to objectively assess back shape and posture in three dimensions, as our study shows that changes in one dimension are associated with changes in other dimensions.

Future studies should focus on measuring normal back shape and posture throughout the life cycle as well as evaluating the effectiveness of different management strategies on back shape and posture. This is necessary to provide a positive shift toward a more objective and evidence based profession. More work is necessary to determine an appropriate set of clini‐ cally relevant measures to be implemented for use in clinical practice.
