The effects of experience on the inter-reliability of osteopaths to detect changes in posterior superior iliac spine levels using a hidden heel wedge

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• 作者：Claire Sutton ; M.Ost ; BSc (Hons) ; D.O ; N.D^a ; Lazarus Nono ; BSc (Hons) Ost^a ; Ross G. Johnston ; MSc ; BSc (Hons) Ost Med ; D.O^b ; Oliver P. Thomson ; MSc ; BSc (Hons) Ost Med ; D.O^a ; ^c ; ^{OThomson@brookes.ac.uk}
• 关键词：Reliability ; Validity ; Diagnosis ; Osteopathy ; Manual therapy ; Palpation ; Sacroiliac
• 刊名：Journal of Bodywork and Movement Therapies
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：17
• 期：2
• 页码：143-150
• 全文大小：581 K

文摘

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Summary

Background

The use of palpation to diagnose musculoskeletal dysfunction is commonly taught within osteopathy and other manual therapies. However the clinical tests used to detect sacroiliac joint dysfunction have not shown good reliability.

Objectives

To investigate the inter-examiner reliability of osteopaths to detect asymmetries of the posterior superior iliac spine (PSIS), and to determine if inter-examiner reliability was affected by the level of practitioner experience.

Methods

Fifteen final year osteopathic students (n?=?15), fifteen third year osteopathic students (n?=?15) and ten experienced osteopaths (n?=?10) manually palpated the levels of the PSIS in one model nine consecutive times. A hidden 5?mm heel wedge was used to alter the height of the PSIS which was hidden from the examiners. Scores were analysed using Fleiss Kappa (F¦Ê) statistics and one way analysis of variance on ranks (ANOVA).

Results

All three groups produced F¦Ê results below 0.4 (0.025-0.065), indicating poor inter-examiner reliability. F¦Ê values less than 0.4 are considered to be clinically unreliable. ANOVA testing did not show any significant difference between groups.

Conclusion

This study showed ¡®poor¡¯ inter-examiner reliability in detecting asymmetries of the PSIS. This is in accordance with other studies in the field. It is suggested that the inclusion of this osteopathic model within osteopathic education should be reviewed.