Maintenance and improvement of interobserver reliability of osteopathic palpatory tests over a 4-month period

Document Type

Article

Publication Title

Journal of the American Osteopathic Association

Abstract

Context: Few studies have shown that diagnostic palpation is reliableNo studies have shown that the reliability of diagnostic palpatory skills can be maintained and improved over timeObjective: To investigate whether the reliability of selected palpatory tests used to identify lumbar somatic dysfunction was maintained during a 4-month period as part of a clinical observational studyMethods: Participants with low back pain and participants without low back pain, recruited from a rural Midwestern community, were examined during 6 separate sessions over a 4-month periodDuring each data collection session, two blinded examiners, who had previously completed comprehensive consensus training, evaluated the lumbar region with four tests: static segmental positional asymmetry of the transverse processes in the horizontal plane, tissue texture abnormalities, resistance to anterior springing on the spinous processes, and tenderness induced by pressure on the spinous processesDetailed protocols for each test were defined during a previous comprehensive consensus training period and were not revised during the current studyTo verify that established interobserver reliability was maintained throughout the clinical study, quality control sampling was performed on all dataWhen findings were inconsistent between the two examiners, focused consensus training was performed as a means of recalibration to understand why assessments were inconsistentInterobserver reliability for determining the presence or absence of somatic dysfunction was assessed using kappa coefficientsResults: The study enrolled 64 participants, and 14 to 33 participants were examined per sessionAll four tests had acceptable interobserver reliability by the final data collection sessionThe test for static segmental positional asymmetry of the transverse processes in the horizontal plane had moderate to substantial reliability in all 6 sessionsThe test for tissue texture abnormalities had moderate reliability in 5 of the 6 sessionsThe test for resistance to anterior springing on the spinous processes had moderate reliability for 3 of the 6 sessionsThe test for tenderness had substantial to almost perfect reliability for all 6 sessionsIn general, interobserver reliability improved over timeConclusions: Examiners were able to maintain and improve interobserver reliability of four lumbar diagnostic palpatory tests over a 4-month period.

First Page

579

Last Page

586

Publication Date

10-1-2010

This document is currently not available here.

Share

COinS