Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 6072
Title Responsiveness of leg alignment changes associated with articular pressure testing to spinal manipulation: The use of a randomized clinical trial design to evaluate a diagnostic test with a dichotomous outcome
Journal J Manipulative Physiol Ther. 1993 Jun;16(5):306-311
Peer Review Yes
Publication Type Randomized Controlled Trial

OBJECTIVE: A study was undertaken to assess the stability of leg alignment reaction to a pressure challenge and its responsiveness to an adjustive intervention.

DESIGN: Prospective, double-blind clinical trial of a diagnostic test.

SETTING: Laboratory: Center for Technique Research.

PARTICIPANTS: Forty-two chiropractic college students, faculty and staff.

INTERVENTIONS: A high-velocity, low-amplitude, short lever adjustment of a single vertebra from among C1 and T3-T7; or a sham adjustment similar to a manual diagnostic pressure test at C1, T3-T7 or T9-T10.

MAIN OUTCOME MEASURES: Leg alignment reactivity: An increase in leg alignment discrepancy (yes or no) following a metered pressure challenge to a vertebra.

RESULTS: On average, stability was poor at T3-T7 (Kappa = 0.04), moderate at C1 (K = 0.47), and fair for sham pressure tests (K = 0.30). Responsiveness: The proportion of positive baseline leg alignment reactions that responded (became negative) to sham adjustment was 95% at T3-T7 and 55% at C1. Further analysis was untenable since too few vertebrae were implicated for an adjustment.

CONCLUSIONS: For the population investigated, the majority of the responsiveness of the leg alignment diagnostic test to a rotatory adjustment appears to be a diagnostic illusion (i.e., background noise unrelated to a treatment intervention). Further research with different subject populations, regions of investigation, leg alignment measurement techniques and vertebral challenge techniques are indicated.

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


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