Interexaminer concordance in detecting joint-play asymmetries in the cervical spines of otherwise asymptomatic subjects.
Interexaminer concordance for motion-based palpation of the middle and lower cervical spine was investigated. The palpatory task consisted of determining whether end-range joint resistance on lateral flexion was greater on one side of a given cervical segment when compared to that of the contralateral joint. Palpators also were asked to indicate the relative magnitude of the asymmetry, when detected. All experiments were carried out using reasonably healthy, pain-free, chiropractic college students. Three series of experiments involving two pairs of practitioners and a total of 270 subjects were carried out. Interexaminer agreement rates with respect to the side of greatest fixation were not found to be significantly different from those expected by chance alone. Furthermore, this was the case regardless of whether palpators had rated the magnitude of the asymmetry as being slight, moderate or severe. These poor agreement rates did not appear to be due to significant interexaminer differences with respect to the distributions of right vs. left calls, to a preponderance of agreements occurring more on one side over the other, or to differences with respect to the distribution of severity ratings. More importantly, there appeared to be no consistent relationships between the degree of severity indicated by the first examiner and that indicated by the second, nor were there any significant correlations between right vs. left agreement rates obtained for various combinations of severity ratings.(ABSTRACT TRUNCATED AT 250 WORDS)
Nansel
D D
DD
Department of Physiology/Pathology, Palmer College of Chiropractic-West, Sunnyvale, CA 94087.
Peneff
A L
AL
Jansen
R D
RD
Cooperstein
R
R
D000328:Adult; D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000503:physiopathology*; D002684:Chiropractic; D005260:Female; D006801:Humans; D007596:Joints / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009068:Movement; D015588:Observer Variation; D010173:Palpation