Preliminary study of the reliability of assessment procedures for indications for chiropractic adjustments of the lumbar spine

Hawk, Cheryl; Phongphua, Chutima; Bleecker, James; Swank, Larry; López, Dennis M.; Rubley, Todd

doi:10.1016/s0161-4754(99)70083-7

Cited by 43 publications

(24 citation statements)

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“…There seems to be a general tendency towards higher intraobserver reliability compared to interobserver results. [24][25][26][27][28][29][30][31][32] The present results point somewhat in the same direction. In a recent systematic review of the literature on this topic, higher reproducibility of regional compared to segmental manual mobilizations has been reported.…”

Section: Discussion Reproducibilitysupporting

confidence: 73%

Reproducibility of global three-dimensional motion during manual atlanto-axial rotation mobilization: anin vitrostudy

Cattrysse

Provyn²,

Kool³

et al. 2010

Journal of Manual & Manipulative Therapy

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The reproducibility of the three-dimensional (3D) kinematic aspects of motion coupling patterns during manual mobilizing techniques is still a debatable matter. The present in vitro study analysed segmental 3D motion of the atlanto-axial joint during manual axial rotation mobilization. Twenty fresh frozen human cervical specimens were studied in a test-retest situation with two examiners. The specimens were manually mobilized using three different techniques: (1) a regional mobilization technique of the cervical spine; (2) a segmental mobilization technique of the atlas with manual fixation of the axis; and (3) a segmental mobilization of the atlas on the axis applying a locking technique. Segmental atlanto-axial kinematics was registered with a Zebris CMS-20 ultrasound-based tracking system. The Euclidian norm was used as a representation of overall 3D motion. The results indicated good reproducibility (mean intraclass correlation coefficient, ICC: 0.87). Intraobserver reproducibility was slightly higher (mean ICC: 0.91; range: 0.76-0.99) than interobserver reproducibility (mean ICC: 0.85; range: 0.56-0.98) (P , 0.05). The total range of motion expressed as the Euclidean norm of 3D motion components was a parameter with good reproducibility in the study of segmental kinematics of manual atlanto-axial mobilization. Although previous studies have demonstrated poor inter-rater reliability of manual examination and mobilization of segmental motion components, the results of the present study shed a new and more positive light on the reproducibility of techniques for manual mobilization of the upper cervical spine.

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Section: Discussion Reproducibilitysupporting

confidence: 73%

Reproducibility of global three-dimensional motion during manual atlanto-axial rotation mobilization: anin vitrostudy

Cattrysse

Provyn²,

Kool³

et al. 2010

Journal of Manual & Manipulative Therapy

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show abstract

“…This could not be concluded from a previous test of precise diagnosis of segmental dysfunctions because of low to moderate kappa values in the range 0.27-0.47 [5]. Although a significant inter-observer association was demonstrated, the two examiners had somewhat different approaches to the examination as exemplified by the systematic variation in the levels of diagnosis, which is also experienced in former studies [5,8]. This is reflected in the clinical experience of different treatment strategies, and as long as no 'bottom line' method for examination has been found, no general guidelines for manual therapy can be given.…”

Section: Discussionmentioning

confidence: 82%

“…Very few results have been presented to support the possibility of an exact clinical diagnosis of a more specific pathology in the low back [21]. To a certain degree, this contrasts the fact that segmental manipulation based on such examination is a well accepted and effective therapy of LBP [8,23].…”

Section: Introductionmentioning

confidence: 99%

Intra-observer and inter-observer agreement of the manual examination of the lumbar spine in chronic low-back pain

et al. 2006

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Examination is a cornerstone in the manual procedures leading to mobilisation/manipulation of the low back. The observer variation of the more specific segmental tests remains to be investigated. Two skilled specialists in manual medicine examined the segmental changes in the lumbar spine. The patients were unknown to the examiners and no information of the case history was given. All test results were recorded by an observer present in the room who ensured that no conversation was allowed during the examination. The primary outcome measures were the kappa values for each test. The matching was defined as acceptable (acc) within two neighbouring levels and perfect (per) on the same level. Intra-observer variation (tested in 33 patients and 10 subjects without low-back pain): The agreement between first and second segmental diagnosis examination was 70% (per) and 82% (per + acc).

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“…Hawk et al have found that subjective techniques such as manual palpation yield little consensus between practitioners [6]. It was found that inexperienced examiners were more likely to diagnose a greater number of subluxations in pain free patients than their more experienced counterparts.…”

Section: Introductionmentioning

confidence: 99%

Application of the Familiarization, Functionality and Testing Design Method

Keech¹,

Fauvel²,

Johnston³

et al. 2011

PCEEA

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Preliminary study of the reliability of assessment procedures for indications for chiropractic adjustments of the lumbar spine

Cited by 43 publications

References 1 publication

Reproducibility of global three-dimensional motion during manual atlanto-axial rotation mobilization: anin vitrostudy

Reproducibility of global three-dimensional motion during manual atlanto-axial rotation mobilization: anin vitrostudy

Intra-observer and inter-observer agreement of the manual examination of the lumbar spine in chronic low-back pain

Application of the Familiarization, Functionality and Testing Design Method

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