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Reliability of bony anatomic landmark asymmetry assessment in the lumbopelvic region: application to osteopathic medical education

Journal: The Journal of the American Osteopathic Association Date: 2010/11, 110(11):Pages: 667-674. doi: Subito , type of study: observational study

Free full text   (https://www.degruyter.com/document/doi/10.7556/jaoa.2010.110.11.667/html)

Keywords:

lumbar vertebrae [16]
medical education [623]
osteopathic medicine [1540]
osteopathic physicians [163]
pelvis [34]
reliability [114]
inter rater reliability [12]
reproducibility of results [16]
observational study [126]

Abstract:

The objective of this review is to establish the current state of knowledge on the reliability of clinical assessment of asymmetry in the lumbar spine and pelvis. To search the literature, the authors consulted the databases of MEDLINE, CINAHL, AMED, MANTIS, Academic Search Complete, and Web of Knowledge using different combinations of the following keywords: palpation, asymmetry, inter or intraexaminer reliability, tissue texture, assessment, and anatomic landmark. Of the 23 studies identified, 14 did not meet the inclusion criteria and were excluded. The quality and methods of studies investigating the reliability of bony anatomic landmark asymmetry assessment are variable. The kappa statistic ranges without training for interexaminer reliability were as follows: anterior superior iliac spine (ASIS), -0.01 to 0.19; posterior superior iliac spine (PSIS), 0.04 to 0.15; inferior lateral angle, transverse plane (ILA-A/P), -0.03 to 0.11; inferior lateral angles, coronal plane (ILA-S/I), -0.01 to 0.08; sacral sulcus (SS), -0.4 to 0.37; lumbar spine transverse processes L1 through L5, 0.04 to 0.17. The corresponding ranges for intraexaminer reliability were higher for all associated landmarks: ASIS, 0.19 to 0.4; PSIS, 0.13 to 0.49; ILA-A/P, 0.1 to 0.2; ILA-S/I, 0.03 to 0.21; SS, 0.24 to 0.28; lumbar spine transverse processes L1 through L5, not applicable. Further research is needed to better understand the reliability of asymmetry assessment methods in manipulative medicine.


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