Abstract
Objective: To assess the intraexaminer and interexaminer reliability of clinicians trained in
flexion-distraction technique to determine the need for chiropractic adjustment of
each segment of the lumbar spine. Design: This was an intraexaminer and interexaminer reliability study of commonly used chiropractic
assessment procedures, including static and motion palpation and visual observation.
Setting: Chiropractic college; by four licensed chiropractors trained in flexion-distraction
technique, two with more than 20 years' experience and two with 3 or fewer years'
experience. Subjects: Subjects were 18 volunteers; 16 were symptom free, and 2 had low back pain at the
time the study was conducted. Main Outcome Measure: The kappa statistic was computed for all comparisons and interpreted in categories
ranging from “poor” (<0.00) to “almost perfect” (>0.80). Results: Intraexaminer reliability was greater than interexaminer reliability. For intraexaminer
reliability there was considerable variation by segment and among the four examiners,
but intraexaminer reliability appeared generally higher than interexaminer reliability.
Overall, more subluxations were identified on the second examination than on the first.
For interexaminer reliability, kappa scores were generally in the “poor” to “slight”
categories. Discussion: The results of this study, similar to those of other studies, indicate that even
chiropractors trained in the same technique seem to show little consensus on the indications
for the necessity to adjust specific segments of the spine. A more standardized assessment
approach might be helpful in improving the reliability of diagnostic assessments.
(J Manipulative Physiol Ther 1999;22:382–9)
Keywords
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Article info
Publication history
Received in revised form:
November 9,
1998
Received:
October 16,
1998
Footnotes
☆Submit reprint requests to: Cheryl Hawk, DC, PhD, Palmer Center for Chiropractic Research, 741 Brady St, Davenport, IA 52803. E-mail: [email protected]
Identification
Copyright
© 1999 JMPT. Published by Elsevier Inc. All rights reserved.
