The AAO Journal, 2012/12, 22(4):16-19, type of study: ,irs,,,,,,,,,,,,,,,,,,,,,,,,,,

Free full text   (https://www.academyofosteopathy.org/aaoj)

Keywords:

intra-rater-reliability [3]
inter-rater reliability [15]
seated flexion test [3]
osteopathic test [11]
diagnosis [412]
controlled clinical trial [324]

Abstract:

Objective: The present study was designed to investigate the following: 1) whether the position of a subject’s feet (dangling freely versus fixed upon the floor) during the Seated Flexion Test (SFT)—a diagnostic test taught to osteopathic students to assess for pelvic dysfunction— makes a difference in the outcome of the SFT results; 2) the inter-examiner reliability of the SFT between two qualified examiners; and 3) the role examiner agreement on posterior superior iliac spine (PSIS) landmark prominence plays in inter-examiner reliability. Methods: Two predoctoral Osteopathic Manual Medicine teaching fellows assessed the SFT on the same 49 subjects in two different positions: one with the subjects’ feet fixed to the floor and the other with the subjects’ feet dangling freely. The data was then analyzed to test for intra-examiner reliability between the two positions, interexaminer reliability for both the two positions, and interexaminer reliability between the two positions. The effects of agreement of PSIS prominence were also incorporated into the inter-examiner reliability investigation to assess whether such a factor influenced the results. Results: There was no difference in the outcome of the SFT with respect to position when the intra-examiner results were analyzed. There was a statistical difference in interexaminer reliability between the two positions. However, inter-examiner reliability on the whole was low. There was fair agreement between the examiners with the subjects’ feet stabilized, as well as with the subjects’ feet dangling freely. (We interpreted strength of agreement between examiners based on the following scale proposed by Landis and Koch:18 ≤0= poor, .01–.20= slight, .21–.40= fair, .41– .60= moderate, .61–.80= substantial, and .81–1= almost perfect). Agreement on PSIS prominence was substantial, and did not effect inter-examiner reliability. Conclusions: There is no statistical difference in the intra-examiner determination of the SFT evaluation in regards to a patient’s foot positioning. The SFT had poor inter-examiner reliability, even when examiners agreeed on landmark PSIS prominence.