Abstract
BackgroundThe study purposes were to investigate the level of agreement of palpation of lumbar spinous processes between examiners, test-retest repeatability of lumbar spine range of motion, and the reliability of upright position measures in asymptomatic subjects.MethodsThe modified CA 6000 spinal motion apparatus with a new skin fixation system was used by three operators for the test-retest spine measurements (3 days apart), and to obtain measures at one session of spinal position. Mean ranges of motion in all planes for 22 asymptomatic subjects were reported using the Intra-class Correlation Coefficient.ResultsOverall, differences in palpation agreement for lumbar segments occurred in three subjects and did not affect range of motion values. For upright spinal position, ICC (2,3) values for sagittal, coronal, and horizontal plane positions were 0.96, 0.80, and 0.98 respectively. There were statistically significant differences between examiners for position values, determined by the Bonferroni t-test (p < 0.05), but the magnitude of the differences were 2 degrees or less, and not considered clinically important.ConclusionResults suggest that lumbar spinal motion measurements and position determination between different operators can be consistent particularly if utilizing the modified instrument. Static lumbar position also appears to be recorded reliably between different operators. Results justify progression to multi-center lumbar research using the modified CA 6000 and the work is considered relevant to medical clinicians working with spinal dysfunction, surgical interventions, or occupational health.
Highlights
The study purposes were to investigate the level of agreement of palpation of lumbar spinous processes between examiners, test-retest repeatability of lumbar spine range of motion, and the reliability of upright position measures in asymptomatic subjects
Comparison with the asymptomatic male and female age-related normative database [6] suggested that all subjects achieved ranges of motion which might be expected of 80% of the age-related general population
Two of the purposes of this study were to investigate the levels of agreement of independent palpation, and measurement of spinal motion between 3 separate operators using the modified CA 6000 spinal motion analysis system
Summary
The study purposes were to investigate the level of agreement of palpation of lumbar spinous processes between examiners, test-retest repeatability of lumbar spine range of motion, and the reliability of upright position measures in asymptomatic subjects. Previous work on the development of a new form of skin fixation for use with the CA 6000 has been fully described [1]. The reliability and repeatability of the CA 6000 measures produced with the new fixation system have been reported for the lumbar and thoracic spinal regions [2,3]. Inter-rater reliability using multiple investigators performing individual palpation with skin fixation has not yet been assessed with the modified instrument. The previous intra/inter-rater reliability work [2,3], which involved standardized palpation by one examiner, was focused on establishing the instrument's repeatability when operated by different clinicians
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