Intraexaminer and interexaminer reliability of the Gillet test.
ABSTRACT The purpose of this study was to determine the intraexaminer and interexaminer reliability of the Gillet test.
In a test-retest study the incidence of asymmetric or symmetric sacroiliac joint motion was investigated with the Gillet test.
Forty-one male subjects volunteered for this study (mean age, 23 +/- 2.24 years). Thirty-eight subjects were examined in the first test procedure, and at least 4 days later 37 subjects were examined again. The subjects were subdivided into symptomatic and asymptomatic groups on the basis of certain criteria.
To obtain the intraexaminer and interexaminer reliability values, Cohen's kappa, the percentage agreement, bias-adjusted kappa, and prevalence-adjusted bias-adjusted kappa were used. The mean Cohen's kappa did not exceed the value of 0.081. Only the percentage agreement of the symptomatic group did exceed the minimum level of 80%. When kappa was positive, the prevalence-adjusted bias-adjusted kappa was markedly higher than kappa; when kappa was negative, the prevalence-adjusted bias-adjusted kappa was only slightly higher than kappa. Only small differences were found between kappa and bias-adjusted kappa.
The Gillet test, as performed in this study, does not appear to be reliable.
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ABSTRACT: With the development of increasing evidence for the use of manipulation in the management of musculoskeletal conditions, there is growing interest in identifying the appropriate indications for care. Recently, attempts have been made to develop clinical prediction rules, however the validity of these clinical prediction rules remains unclear and their impact on care delivery has yet to be established. The current study was designed to evaluate the literature on the validity and reliability of the more common methods used by doctors of chiropractic to inform the choice of the site at which to apply spinal manipulation. Structured searches were conducted in Medline, PubMed, CINAHL and ICL, supported by hand searches of archives, to identify studies of the diagnostic reliability and validity of common methods used to identify the site of treatment application. To be included, studies were to present original data from studies of human subjects and be designed to address the region or location of care delivery. Only English language manuscripts from peer-reviewed journals were included. The quality of evidence was ranked using QUADAS for validity and QAREL for reliability, as appropriate. Data were extracted and synthesized, and were evaluated in terms of strength of evidence and the degree to which the evidence was favourable for clinical use of the method under investigation. A total of 2594 titles were screened from which 201 articles met all inclusion criteria. The spectrum of manuscript quality was quite broad, as was the degree to which the evidence favoured clinical application of the diagnostic methods reviewed. The most convincing favourable evidence was for methods which confirmed or provoked pain at a specific spinal segmental level or region. There was also high quality evidence supporting the use, with limitations, of static and motion palpation, and measures of leg length inequality. Evidence of mixed quality supported the use, with limitations, of postural evaluation. The evidence was unclear on the applicability of measures of stiffness and the use of spinal x-rays. The evidence was of mixed quality, but unfavourable for the use of manual muscle testing, skin conductance, surface electromyography and skin temperature measurement. A considerable range of methods is in use for determining where in the spine to administer spinal manipulation. The currently published evidence falls across a spectrum ranging from strongly favourable to strongly unfavourable in regard to using these methods. In general, the stronger and more favourable evidence is for those procedures which take a direct measure of the presumptive site of care- methods involving pain provocation upon palpation or localized tissue examination. Procedures which involve some indirect assessment for identifying the manipulable lesion of the spine-such as skin conductance or thermography-tend not to be supported by the available evidence.01/2013; 21(1):36. DOI:10.1186/2045-709X-21-36
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ABSTRACT: To determine whether osteopathic medical students, fellows, residents, and practicing physicians differ in their ability to identify inanimate objects and if these skills relate to palpatory experience. Fifteen commonly known objects were fixed to a board and blinded with a cotton cloth. In Part I of testing, participants were asked to identify 9 objects, with choices provided. In Part II participants were asked to identify 6 objects using one word only. Part III consisted of identifying the shape of an object in Part II. Eighty-nine osteopathic medical students, fellows, residents, and practicing physicians participated in the study. Overall, correct identification of objects was higher in Part I with choices than in Part II without choices available. No statistically significant difference was found among osteopathic medical students, fellows, residents, and practicing physicians in the correct identification of the objects. Accuracy in tactile identification of objects among varying levels of palpatory experience was not found. Correlation with clinical palpation cannot be made as it requires a subset of palpatory skills not tested in this study. Accuracy and measurement of palpation should be studied further to demonstrate if palpatory experience improves palpatory accuracy.11/2013; 21(1):38. DOI:10.1186/2045-709X-21-38
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ABSTRACT: Objectives The purpose of this study was to determine the degree of inter-examiner and inter-test reliability in the diagnostic tests of sacroiliac dysfunction and in the signs of pelvic exploration. Material and methods Two examiners separately examined the sacroiliac joint in 30 university subjects (10 men, 20 women, mean age = 24.56, SD = 5.2). Four diagnostic sacroiliac dysfunction tests were performed: standing flexion test (StFT), sitting flexion test (SiFT) and Iliac Gillet test (IGT) and Sacral Gillet test (SGT). Assessment was completed with a visual examination and palpation of pelvic asymmetry and lower limb dysmetria. Results The Kappa inter-examiner rates obtained for StFT was –0.082, for the SiFT was –0.064, for the IGT was 0.262, for the SGT was 0.170, for pelvic asymmetry was –0.005, and for lower limb dysmetria was –0.220. The tests aimed at the evaluation of the same variable of sacroiliac dysfunction were matched to evaluate the inter-test reliability. For the binomial StFT-IGT, Kappa values were obtained for each examiner of –0.049 and 0.099, and for the binomial SiFT-SGT, values of 0.017 and 0.116 were obtained. Conclusions The results show that there is no significant reliability between examiners in the sacroiliac and pelvic examination and between the tests that evaluate the same variable of sacroiliac joint dysfunction.Fisioterapia 01/2013; DOI:10.1016/j.ft.2013.03.005