Fiabilidad interobservador del test de movilidad pasiva accesoria intervertebral lumbar y su correlación con la galvanopalpación en sujetos sanos

Abstract

Introduction

The physical therapy diagnosis of a vertebral dysfunction is essential in order to classify musculoskeletal diseases. Passive assessment of quantity and quality of movement on the different vertebral segments guides the decision-making process relative to manual therapy treatment.

The aims of this present study have been to determine the interobserver reliability of passive accessory intervertebral postero-anterior unilateral lumbar motion test as a test to identify subjects with joint dysfunction, and to analyze galvanic current as a diagnostic tool to identify joint dysfunction in the lumbar spine with the motion test.

Material and methods

Two physiotherapists, experts in manual therapy, carried out the test in 30 asymptomatic subjects at L1 to L5 levels (right and left sides), performing a total of 300 tests. To determine the diagnostic value of galvanic current, two other physiotherapists performed galvanic palpation consecutively to the motion test in lumbar zygapophysial joints in the same asymptomatic subjects.

Results

Percentage agreement was 86.3% for the motion test. The Kappa index showed substantial agreement (according to Landis and Koch, 1977) (k=0.5). PA accessory motion test was more reliable to identify symptomatic spinal L4-L5 and L5-S1 level.

Regarding galvanic palpation, the agreement percentage was 83%. Kappa coefficient (k) showed moderate agreement for identification of joint dysfunction (k=0.41). Sensitivity was high in the lumbar level L3-L4 and L4-L5 and was low in L1-L2 level; specificity was high (82.7–96.3%) throughout the lumbar spine.

Conclusions

Interobserver reliability of the passive motion test is moderate (k=0.5).

Galvanic palpation identifies joint dysfunction, however sensitivity is low in the upper lumbar spine.