Bl. Jackson et al., CHIROPRACTIC BIOPHYSICS LATERAL CERVICAL FILM ANALYSIS RELIABILITY, Journal of manipulative and physiological therapeutics, 16(6), 1993, pp. 384-391
Objective: To determine the degree to which the geometric line drawing
s used in Chiropractic Biophysics Technique (CBP) on lateral cervical
radiographs are reliable. Design: A blind, delayed repeated measures d
esign was used. Three examiners were presented radiographs in random o
rder. All identifying marks were removed prior to each examiner's indi
vidual marking and measurement. Each examiner was blinded as to how th
e previous examiners marked and measured the radiographs. Setting: Pri
mary care private chiropractic clinic. Patients, Participants: Sixty-f
ive subject films were provided from the patient records of a primary
care private chiropractic clinic. The 65 radiographs qualified for inc
lusion in the study based on two criteria: C1 through C7 had to be cle
arly visible, and there had to be no identifying artifacts. Main Outco
me Measures: Anterior head translation in millimeters, atlas plane to
horizontal, Ruth Jackson's cervical stress lines, and five relative ro
tation angles for C2-C3, C3-C4. C4-C5, C5-C6, C6-C7. Inter- and intrar
eliability of the three examiners were statistically analyzed. Results
: Intraexaminer for a) C1 to horizontal reliability was .98-.99 with c
onfidence intervals of .96-.99, b) absolute rotation angle from C2 to
C7 reliability was .82-.95 with confidence intervals of .80-.99, c) an
terior head translation [+S(z)] reliability was.86-.99, with confidenc
e intervals of .74-.99, d) relative rotation angle reliability ranges
were (C2-C3) .99, and (C3-C4) .98. 99, (C4-C5) .88-.99, (C5-C6) .80-.9
9, and (C6-C7) .94-.98. Interexaminer reliabilities across examiners r
anged from a) Winer: .89-.99 and b) Bartko: .72-.96. Conclusions: The
reliabilities for intra- and interexaminer were all greater than .70,
indicating that these measurements in CBP technique would be considere
d accurate enough to provide measurements for future clinical studies.
The data indicated that the C6-C7 relative rotation angle was the lea
st reliable measurement. This might be due to the very small angles fo
und at this level.