Interexaminer Reliability of Seated Motion Palpation for the Stiffest Spinal Site (original) (raw)
Related papers
Spinal Motion Palpation: A Comparison of Studies That Assessed Intersegmental End Feel Vs Excursion
Journal of Manipulative and Physiological Therapeutics, 2008
Objective: Spinal motion palpation (MP) is a procedure used to detect intersegmental hypomobility/hypermobility. Different means of assessing intersegmental mobility are described, assessing either excursion of the segments (quantity of movement) or end feel (quality of motion when stressed against the paraphysiological space). The objective of this review was to classify and compare studies based on method of MP used, considering that some studies may have used both methods. Methods: Four databases were searched: MEDLINE-PubMed, Manual Alternative and Natural Therapy System, Index to Chiropractic Literature, and Cumulative Index to Nursing and Allied Health Literature databases for the years 1965 through January 2007. Retrieved citations were independently screened for inclusion by 2 of the authors consistent with the inclusion and exclusion criteria. Included studies were appraised for quality, and data were extracted and recorded in tables. Results: The search strategy generated 415 citations, and 29 were harvested from reference lists. After removing articles that did not meet the inclusion criteria, 44 were considered relevant and appraised for quality. Fifteen studies focused on MP excursion, 24 focused on end feel, and 5 used both. Eight studies reported high levels of reproducibility (κ = ≥0.4), although 4 were not of acceptable quality, and 2 were only marginally acceptable. When only high-quality studies were considered, 3 of 24 end-feel studies reported good reliability compared with 1 of 15 excursion studies. There was no statistical support for a difference between the 2 groupings. Conclusions: A difference in reported reliability was observed when the method of MP varied, although it was not statistically significant. There was no support in the literature for the advantage of one MP method over the other. (J Manipulative Physiol Ther 2008;31:616-626)
The Journal of the Canadian Chiropractic Association, 2013
Motion palpators usually rate the movement of each spinal level palpated, and their reliability is assessed based upon discrete paired observations. We hypothesized that asking motion palpators to identify the most fixated cervical spinal level to allow calculating reliability at the group level might be a useful alternative approach. Three examiners palpated 29 asymptomatic supine participants for cervical joint hypomobility. The location of identified hypomobile sites was based on their distance from the T1 spinous process. Interexaminer concordance was estimated by calculating Intraclass Correlation Coefficient (ICC) and mean absolute differences (MAD) values, stratified by degree of examiner confidence. For the entire participant pool, ICC [2,1] = 0.61, judged "good." MAD=1.35 cm, corresponding to mean interexaminer differences of about 75% of one cervical vertebral level. Stratification by examiner confidence levels resulted in small subgroups with equivocal results. ...
Journal of Chiropractic Medicine, 2010
Objective: Motion palpation is integral to most chiropractic techniques and can be found in curricula of most every chiropractic college. Paradoxically, most studies do not show strong reliability for motion palpation. The purpose of this study was to determine if allowing motion palpators to rate their confidence in their findings, as well using a continuous data analytic method, would influence the level of concordance. Methods: Subjects were 52 asymptomatic chiropractic student volunteers. Two palpators assessed posterior to anterior glide of T3-10 in the prone position, alternating in their order and blinded as to each other's results. Each examiner identified the location of maximal restriction in this range and also whether they were "very confident" or "not confident" in their finding. Results: For all subjects combined, the examiners' calls were "poor": intraclass correlation coefficient [2,1] = .3110 (95% CI, .0458-.5358). In contrast, interexaminer agreement was "good" when both examiners were very confident: intraclass correlation coefficient [2,1] = .8266 (95% CI, 0.6257-0.9253). Conclusion: When each examiner was "very confident" as to the most fixated thoracic segment, the levels they identified were very close. This corresponds to "good" agreement, an uncommon result in most interexaminer motion palpation studies. Thus, the confidence level of examiners had an effect on the interexaminer reliability of thoracic spine. Our novel continuous measures, statistical methodology, and subtyping the subjects according to the confidence of the palpators seem more capable than level-by-level discrete analysis of detecting interexaminer agreement.
Palpation of the upper thoracic spine: An observer reliability study
Journal of Manipulative and Physiological Therapeutics, 2002
Objective: To assess the intraobserver reliability (in terms of hour-to-hour and day-to-day reliability) and the interobserver reliability with 3 palpation procedures for the detection of spinal biomechanic dysfunction in the upper 8 segments of the thoracic spine.
Intrasubject reliability of spinal range of motion and velocity determined by video motion analysis
Physical therapy, 1993
The purpose of this study was to investigate the repeatability of spinal range of motion (ROM) and movement velocity measurements of patients with chronic low back pain, using a two-dimensional motion analysis system. This apparatus uses reflective markers placed on anatomical landmarks and video digitization to derive ROM measurements from three segments of the spine and associated velocities through the respective ROMs. Forty-two patients with chronic LBP underwent ROM and movement velocity testing. Each subject was tested twice without removal of the markers to minimize error contribution from differences in marker placement. Results indicated that both the ROM measures and the velocity measures were highly repeatable. Intraclass correlations for the ROM measures ranged from .77 to .96. Velocity measures were also reliable, with intraclass correlation coefficients ranging from .75 to .97. Overall, the results seem to indicate that the video motion analysis system used in this stu...
Rheumatology, 2000
Objectives. To assess the inter-observer and intra-observer reliability of a new threedimensional measurement system, the FASTRAK, in measuring cervical spine flexion/ extension, lateral flexion and rotation and shoulder flexion/extension, abduction and external rotation in healthy subjects. Methods. The study was conducted in two parts. One part assessed inter-observer reliability with two observers measuring 40 subjects. The other part assessed intra-observer reliability with one observer measuring 32 subjects on three occasions. All subjects had unrestricted, pain-free cervical spine and shoulder movement. Reliability was measured by the intraclass correlation coefficient [ICC(2,1)]. Results. The inter-observer ICCs for the cervical spine ranged from 0.61 to 0.89 and for the shoulder from 0.68 to 0.75. After removal of outliers, all ICCs were above 0.70. Intraobserver ICCs for the cervical spine ranged from 0.54 to 0.82 and for the shoulder from 0.62 to 0.81. After removal of outliers, all ICCs were above 0.70 except for shoulder abduction (0.62). Conclusions. Whilst all movements measured by the FASTRAK showed good reliability, the reliability of the whole movement in a plane (e.g. left plus right lateral flexion) was better than for the separate movements (e.g. left and right lateral flexion taken separately). Interobserver reliability was generally better than intra-observer reliability for most cervical spine movements, suggesting that variability of movement within subjects (e.g. over a period of days) for these movements was greater than variability between measures on the same occasion.
2019
1 Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada 2 Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada 3 Musculoskeletal Health Sydney, School of Public Health, Sydney Medical School, University of Sydney, Australia. Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Australia Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada Institute for Musculoskeletal Research and Clinical Implementation, Anglo-European College of Chiropractic. Bournemouth, UK Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
Brazilian Journal of Kinanthropometry and Human Performance, 2019
The postural evaluation software (SAPO) has been used as a valuable tool for the analysis of postural alterations, however, such a tool depends on palpation performed by the evaluator. The aim of the present study was to evaluate the inter-and intra-examiner reliability of experienced and inexperienced examiners in measurements derived from the palpation method, and its possible influence on measurements obtained by SAPO. Nine evaluators participated in the study, which were divided into three groups according to experience with respect to palpation (GI: inexperienced group, GSE: semi-experienced group and GE: experienced group). Each evaluator performed the postural analysis of 10 volunteers, which were photographed in orthostatic position, following the SAPO recommendations. The intra-examiner reliability analysis indicated that all three groups had higher, good and moderate mean correlation values for each examiner than low correlations. In the inter-examiner reliability assessment, GE and GSE groups exhibited higher correlation values. The intra-class correlation coefficient, in the single-measure analysis, presented correlation coefficients <0.70 in 9 of the variables analyzed, indicating non-significant correlation. It was concluded that the measures analyzed by SAPO have high intra-examiner reliability. However, regarding inter-examiner reliability, the group composed of inexperienced evaluators presented lower values, suggesting that the experience time may have influenced the inter-examiner reliability regarding postural evaluation. Resumo-O Software de avaliação postural (SAPO) vem sendo utilizado como uma ferra-menta valiosa para a análise das alterações posturais, porém tal ferramenta depende da palpação realizada pelo examinador. O objetivo do presente estudo foi avaliar a fidedignidade inter e intraexaminadores experientes e inexperientes nas medidas derivadas do método de palpação, e sua possível influência sobre as medidas obtidas pelo SAPO. Participaram do estudo nove avaliadores, divididos em três grupos de acordo com a experiência com relação a palpação (GI: grupo inexperiente, GSE: grupo semi experiente e GE: grupo experiente). Cada avaliador re-alizou a análise postural de 10 voluntários, os quais foram fotografados em posição ortostática, seguindo as recomendações do SAPO. A análise da fidedignidade intraexaminadores indicou que os três grupos apresentaram valores de correlação em média mais altos, bons e moderados, do que correlações baixas. Na avaliação da fidedignidade interexaminadores os grupos GE e GSE exibiram valores de correlação mais altos. O coeficiente de correlação intraclasse, na análise de medida única, apresentou índices de correlação <0,70 em 9 das variáveis analisadas, indicando correlação não considerável. Concluiu-se que as medidas analisadas pelo SAPO possuem uma alta fidedignidade intraexaminadores. No entanto, em relação a fidedignidade interexaminadores o grupo composto por examinadores inexperientes com relação a palpação apresentou valores mais baixos, sugerindo que o tempo de experiência dos examinadores pode ter influenciado na fidedignidade interexaminadores da avaliação postural.
Manual therapy, 2009
This study presents data on the intra-and inter-rater reliability of palpation on normal and overweight subjects and shows the influence of palpation discrepancy on angular variability for a collected data set, using computer simulation. Thirty healthy males were recruited. Two physiotherapists identified 12 anatomical landmarks that enabled measurement of eight joint angles. Palpation discrepancy was determined by photographic recordings under ultraviolet light. Angular discrepancies were determined from photos of the subject's orthostatic posture. A computer simulation was developed to predict expected angular variation according to observed palpation discrepancy. The results showed that the inter-rater reliability was lower than the intra-rater reliability for both palpation and angle measurements. Palpation of the greater trochanter (GT), anterior superior iliac spine (ASIS), seventh cervical vertebra (C7) and femoral epicondyle (FE) showed larger discrepancies. The overweight group presented a significant difference in palpation discrepancy for ASIS (P < 0.03). Angular variations were associated with palpation discrepancies for trunk flexion (TF), hip flexion (HF) and pelvic inclination (PI). Therefore, measurements should be performed by a single rater, rather than by different raters, if reliable angular measurements are intended. Specific anatomical landmarks require careful identification. Simulation was useful for providing estimates of variations due to palpation discrepancy.
Physiotherapy Canada, 2015
Purpose: To investigate inter- and intra-observer agreement in the assessment of lumbar vertebral rotational (VR) asymmetry by a motion palpation test. Methods: For this prospective and descriptive test–retest study, 51 asymptomatic participants (40 women, 11 men; mean age 23.3 [SD 5.6] years) were recruited from the community. Each participant was assessed in two sessions by the same three observers, who assessed VR by means of a palpatory test for movement asymmetry. This test is performed by applying posteroanterior pressure in an alternating manner to the left and right transverse processes of a vertebra to determine motion asymmetry in the transverse plane and thus the vertebral position. Observers classified the vertebral position as neutral, rotation to the right, and rotation to the left; they were blinded to which participant was being assessed and to any previous results. Results: Intra- and inter-observer agreement was verified by the kappa coefficient (κ) and the weighte...