指压疗法评估颈椎问题的医师间可靠性——一项初步研究。第一部分:来自一个机构的毕业生。

P J Tuchin, C J Hart, C Johnson, R Colman, A Gee, I Edwards, M Plucknett, R Bonello
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引用次数: 0

摘要

目的:进行了一项初步研究,以确定未经训练的检查人员是否能就颈椎触诊结果达成一致。设计:53名大学生(其中大多数是脊椎指压专业的学生),由7名不同的脊椎指压师用他们自己的临床方法检查颈椎,其中运动触诊是常见的,但不是标准的组成部分。地点:麦考瑞大学捏脊中心。参与者:大学生志愿者。主要结果测量:个体临床方法,包括静态和/或运动触诊,椎体弹簧,运动范围和应用运动学。结果:统计上,对整个组来说,被测者间信度较差。在8名审查员中,4名没有显著的分歧,接下来的两名审查员彼此不同意,但只是在一个层面上,剩下的两名审查员不同意大多数其他审查员和彼此。结论:在颈椎中,C6似乎是最高的竞争水平,其次是C1和C5。基本上,结果表明,组合审查员在使用自己的典型考试技术时,在识别同一实体方面表现出合理的一致性。这些可触及的发现的性质,导致半脱位或椎体功能障碍的诊断是不明确的。有几个问题被认为是重要的:审查员的期望,研究设计,受试者依从性,无症状受试者的角色以及审查员实际检测到的内容。
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Interexaminer reliability of chiropractic evaluation for cervical spine problems--a pilot study. Part 1: Graduates from one institution.

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.

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Searching for the evidence: a practical guide to some online databases in chiropractic and osteopathy. A clinical model for the diagnosis and management of patients with cervical spine syndromes. Spinal musculoskeletal injuries associated with swimming: a discussion of technique. Spine cancer: a summary and review. Risk management for chiropractors and osteopaths: informed consent. A common law requirement.
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