M. Haas et al., REACTIVITY OF LEG ALIGNMENT TO ARTICULAR PRESSURE TESTING - EVALUATION OF A DIAGNOSTIC-TEST USING A RANDOMIZED CROSSOVER CLINICAL-TRIAL APPROACH, Journal of manipulative and physiological therapeutics, 16(4), 1993, pp. 220-227
Objective: A study was undertaken to assess the reliability of detecti
ng leg alignment changes (reactivity) and to determine if the observed
leg alignment reactivity can be attributed to a rotatory articular pr
essure challenge. Design: Prospective double-blind crossover trial of
a diagnostic test. Setting: Laboratory: Center for Technique Research.
Participants: Forty-two chiropractic college students, faculty and st
aff. Interventions: A standardized force of 2 or 3 kg was applied with
a 1 cm2 rubber-tipped pressure algometer on the lateral aspect of the
T3-T7 spinous processes and the posterior aspect of the lateral masse
s of C 1. Main Outcome Measures: Leg alignment reactivity: an increase
in leg alignment discrepancy (yes or no) following a diagnostic inter
vention. Results: The reliability for detecting leg alignment reactivi
ty was poor: on average, Kappa = 0.05 in the thoracics and 0.06 at Cl.
On average, the attributable risk of leg alignment reactivity (pressu
re test risk - sham test risk) was less than 4%. In many cases, the sh
am rate was greater than the pressure test rate. Conclusions: For the
population investigated, leg alignment reactivity to rotatory pressure
testing can, in the majority of cases. be attributable to background
noise. This procedure was not found to be viable for identifying verte
brae for adjustment. Further research with different subject populatio
ns, regions of investigation, leg alignment measurement techniques and
vertebral challenge techniques are indicated.