Are chiropractic tests for the lumbo-pelvic spine reliable and valid? A systematic critical literature review

Hestœk L, Leboeuf-Yde CJournal of Manipulative and Physiological Therapeutics2000 (May);23:258–75

Objective: To systematically review the peer-reviewed literature about the reliability and validity of chiropractic tests used to determine the need for spinal manipulative therapy of the lumbo-pelvic spine, taking into account the quality of the studies.

Data Sources: The CHIROLARS database was searched for the years 1976 to 1995 with the following index terms: “chiropractic tests,” “chiropractic adjusting technique,” “motion palpation,” “movement palpation,” “leg length,” “applied kinesiology,” and “sacrooccipital technique.” In addition, a manual search was performed at the libraries of the Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark, and the Anglo-European College of Chiropractic, Bournemouth, United Kingdom.Study.

Selection: Studies pertaining to intraexaminer reliability, interexaminer reliability, and/or validity of chiropractic evaluation of the lumbo-pelvic spine were included.

Data Extraction: Data quality were assessed independently by the two reviewers, with a quality score based on predefined methodologic criteria. Results of the studies were then evaluated in relation to quality.

Data Synthesis: None of the tests studied had been sufficiently evaluated in relation to reliability and validity. Only tests for palpation for pain had consistently acceptable results. Motion palpation of the lumbar spine might be valid but showed poor reliability, whereas motion palpation of the sacroiliac joints seemed to be slightly reliable but was not shown to be valid. Measures of leg-length inequality seemed to correlate with radiographic measurements but consensus on method and interpretation is lacking. For the sacrooccipital technique, some evidence favors the validity of the arm-fossa test but the rest of the test regimen remains poorly documented. Documentation of applied kinesiology was not available. Palpation for muscle tension, palpation for misalignment, and visual inspection were either undocumented, unreliable, or not valid.

Conclusion: The detection of the manipulative lesion in the lumbo-pelvic spine depends on valid and reliable tests. Because such tests have not been established, the presence of the manipulative lesion remains hypothetical. Great effort is needed to develop, establish, and enforce valid and reliable test procedures.

SOTO | USA > SOT Literature > Peer Reviewed > Are chiropractic tests for the lumbo-pelvic spine reliable and valid? A systematic critical literature review

Editor Recommends
Most Read Articles

Editor Recommends

This SOT Literature Page and all its contents herein are published by SOTO-USA solely for the purpose of education. All rights reserved by SOTO-USA to accept, reject or modify any submission for publication. The opinions stated in the electronically printed material herein are those of the authors and do not necessarily represent the opinions of SOTO-USA or other individuals associated with SOTO-USA. SOTO-USA does not guarantee or make any representation that the printed material contained herein is valid, reliable or accurate. SOTO-USA does not assume any responsibility for injury arising from any use or misuse of the printed material herein. The printed material contained herein is assumed to be from reliable sources and there is no implication that the printed material herein present the only, or the best methodologies or procedures for the care or treatment of conditions discussed. It is incumbent upon the reader to verify the accuracy of any diagnosis and treatment information contained herein, and to make modifications as new information and/or research arises.