Reliability study of detection of somatic dysfunctions in the cervical spine.

A reliability study was conducted to determine whether palpatory findings on the cervical spine, obtained under normal chiropractic clinical conditions were reproducible. Forty normal freshman chiropractic students underwent static and motion palpation of their cervical spines by three different chiropractors. Intra- and inter-examiner reliability of findings was assessed by concordance statistics (weighted kappa). There was statistically significant agreement of findings for all three examiners only for fixations in the lower cervical spine. There was a total lack of statistical agreement of fixation findings, both intra- and inter-examiner, in the middle cervical area. Agreement of fixation findings was intermediate for the upper cervicals and also for the other palpation parameters that were used (e.g. muscle spasms and pain) throughout the cervical spine. The results generally indicate a relatively high level of replicability of palpatory findings in a normal asymptomatic population by 'typical' chiropractors. The relation of these palpatory findings to vertebral lesions, or subluxations, are unknown.

Inter- and intra-examiner reliability of leg-length differential measurement: a preliminary study.

The phenomenon of "short leg" has long been used and debated clinically. A uniquely chiropractic measurement technique was not studied in any of the few studies of reliability of measurement which have been reported. An inter- and intra-examiner reliability study was therefore performed to validate a prone leg length-differential test. Naive students (n = 40) were called, in random order, into three adjacent examining rooms where three experienced chiropractic clinicians measured differential leg lengths. Using standard placement a tape measure was read to the nearest mm to detect inequalities at the shoe-sole interface. The leg length differences were recorded, for both the straight and flexed legs prone positions, twice by each of the three clinicians. Intraclass correlations were significant for the two independent readings for all three examiners, indicating high reliability of the test. Good agreement among examiners was indicated as well by significant intraclass correlation in two of the three possible examiner combinations. These results argue strongly for the reality of the leg length inequality phenomenon and also that it can be reliably measured.