Are chiropractic tests for the lumbo-pelvic spine reliable and valid? A systematic critical literature review.

نویسندگان

  • L Hestbaek
  • C Leboeuf-Yde
چکیده

OBJECTIVE To systematically review the peer-reviewed literature about the reliability and validity of chiropractic tests used to determine the need for spinal manipulative therapy of the lumbo-pelvic spine, taking into account the quality of the studies. DATA SOURCES The CHIROLARS database was searched for the years 1976 to 1995 with the following index terms: "chiropractic tests," "chiropractic adjusting technique," "motion palpation," "movement palpation," "leg length," "applied kinesiology," and "sacrooccipital technique." In addition, a manual search was performed at the libraries of the Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark, and the Anglo-European College of Chiropractic, Bournemouth, United Kingdom. STUDY SELECTION Studies pertaining to intraexaminer reliability, interexaminer reliability, and/or validity of chiropractic evaluation of the lumbo-pelvic spine were included. DATA EXTRACTION Data quality were assessed independently by the two reviewers, with a quality score based on predefined methodologic criteria. Results of the studies were then evaluated in relation to quality. DATA SYNTHESIS None of the tests studied had been sufficiently evaluated in relation to reliability and validity. Only tests for palpation for pain had consistently acceptable results. Motion palpation of the lumbar spine might be valid but showed poor reliability, whereas motion palpation of the sacroiliac joints seemed to be slightly reliable but was not shown to be valid. Measures of leg-length inequality seemed to correlate with radiographic measurements but consensus on method and interpretation is lacking. For the sacrooccipital technique, some evidence favors the validity of the arm-fossa test but the rest of the test regimen remains poorly documented. Documentation of applied kinesiology was not available. Palpation for muscle tension, palpation for misalignment, and visual inspection were either undocumented, unreliable, or not valid. CONCLUSION The detection of the manipulative lesion in the lumbo-pelvic spine depends on valid and reliable tests. Because such tests have not been established, the presence of the manipulative lesion remains hypothetical. Great effort is needed to develop, establish, and enforce valid and reliable test procedures.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Accuracy of spinal orthopaedic tests: a systematic review

BACKGROUND The purpose of this systematic review was to critically appraise the literature on the accuracy of orthopaedic tests for the spine. METHODS Multiple orthopaedic texts were reviewed to produce a comprehensive list of spine orthopaedic test names and synonyms. A search was conducted in MEDLINE, MANTIS, CINAHL, AMED and the Cochrane Library for relevant articles from inception up to D...

متن کامل

The reliability of palpating the posterior superior iliac spine: a systematic review.

INTRODUCTION Among pelvic landmarks routinely palpated by manual therapists, the posterior superior iliac spines (PSISs) are particularly important. In addition to serving as landmarks for identifying possible pelvic torsion, contacting the PSISs is integral to many other static and dynamic pelvic palpatory procedures. The primary study goal was to systematically review the literature on the in...

متن کامل

Chiropractic treatment of scoliosis; a systematic review of the scientific literature

Background Chiropractors are primary health care practitioners who specialise in the treatment of the spine using manual therapy, in particular spinal manipulation. Chiropractors are ideally placed to diagnose and treat scoliosis through conservative methods. However, in order for the chiropractic profession to assume this role, an understanding of the effectiveness of chiropractic treatment of...

متن کامل

Deaths after chiropractic: a review of published cases.

OBJECTIVE The aim of this study was to summarise all cases in which chiropractic spinal manipulation was followed by death. DESIGN This study is a systematic review of case reports. METHODS Literature searches in four electronic databases with no restrictions of time or language. MAIN OUTCOME MEASURE Death. RESULTS Twenty six fatalities were published in the medical literature and many ...

متن کامل

The effects of bending speed on the lumbo-pelvic kinematics and movement pattern during forward bending in people with and without low back pain

BACKGROUND Impaired lumbo-pelvic movement in people with low back pain during bending task has been reported previously. However, the regional mobility and the pattern of the lumbo-pelvic movement were found to vary across studies. The inconsistency of the findings may partly be related to variations in the speed at which the task was executed. This study examined the effects of bending speeds ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Journal of manipulative and physiological therapeutics

دوره 23 4  شماره 

صفحات  -

تاریخ انتشار 2000