Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 3831
  Title Short-term responsiveness of manual thoracic end-play assessment to spinal manipulation: A randomized controlled trial of construct validity
Journal J Manipulative Physiol Ther. 1995 Nov-Dec;18(9):582-589
Peer Review Yes
Publication Type Randomized Controlled Trial

OBJECTIVE: To evaluate the short-term responsiveness of rotatory thoracic end-play assessment to spinal manipulation and, thereby, motion palpation construct validity.

DESIGN: Prospective, single-blind, randomized, controlled trial (randomized blocks design).

SETTING: Laboratory, Center for Technique Research.

PARTICIPANTS: Sixty first-year chiropractic college student volunteers; seventy-three possible candidates were screened.

INTERVENTIONS: The treatment group received manual high-velocity, low-amplitude rotatory manipulation. The control group received no intervention to minimize nonspecific effects of sham treatment.

MAIN OUTCOME MEASURES: End-play response, defined as the change from restricted to normal end play immediately after intervention. Responsiveness, defined as the percentage of the end-play response attributable to spinal manipulation: relative response attributable to the maneuver, RRAM = (treatment group response--control group response)/treatment group response.

RESULTS: Ten percent of the tests were positive for restriction of end play in left or right rotation from T3-T4 to T12-L1; the average rate was 2.1 restrictions per subject (SD = 1.4). End-play response was 60% in the treatment group, in contrast to the 37% response in the control group (z = 1.86, p = .04). More than a third of the response in the treatment group was attributable to spinal manipulation (RRAM = 39%). For one examiner, RRAM = 51%. Mild symptomatology did not affect responsiveness.

CONCLUSIONS: The data suggest a moderate short-term responsiveness of rotatory thoracic end-play restriction to spinal manipulation, hence it has utility as a posttreatment evaluative test. This study was the first to use an external standard (manipulation) to demonstrate that segmental end-play restriction changes, hence end-play restriction itself, are detectable in human subjects with manual palpation by chiropractors. Further research is required to determine the generalizability of the study findings.

This abstract is reproduced with the permission of the publisher. Article only available in print.


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