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Interexaminer reliability of chiropractic evaluation for cervical spine problems--a pilot study. Part 1: Graduates
Objective:
A pilot study was conducted to determine whether untrained examiners could agree on palpatory findings in the cervical spine.
Design:
Fifty-three university students, (most of whom were chiropractic students), had their cervical spines examined by seven different chiropractors using their own clinical methods, of which motion palpation was a common, but not standard component.
Setting:
Chiropractic Centre in Macquarie University.
Participants:
Volunteer university students.
Main Outcome Measures:
Individual clinical methods, which included static and/or motion palpation, vertebral springing, range of motion and applied kinesiology.
Results:
Statistically, for the total group, there was poor interexaminer reliability. Of eight examiners, four did not disagree significantly, the next two examiners disagreed with each other but only at a single level and the remaining two examiners disagreed with most of the other examiners and each other.
Conclusion:
In the cervical spine, it appears that C6 is the level of highest contention, followed by C1 and C5. Essentially the results suggest that combinations of examiners show reasonable consistency at identifying the same entity while using their own typical examination techniques. The nature of these palpable findings, leading to a diagnosis of subluxation or vertebral dysfunction is ill defined. Several issues were considered as important: expectations of examiners, research design, subject compliance, role of asymptomatic subjects and what the examiners were actually detecting.
