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Activator Methods International Ltd.
2950 N. Seventh Street, Suite 200
Phoenix, AZ 85014
ofc 602-224-0220
fax 602-224-0230
toll free 1-800-598-0224
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Subject: Leg Length Inequality Assessment Studies
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.
Reference: Haas M, Peterson D, Rothman EH, Panzer D, Krein R, Johansen R, Solomon S. 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. J Manipulative Physiol Ther 1993b; 16(5): 306-11
Abstract
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.
Key words:
Adult; Double-Blind Method; Female; Human; Leg; Male; Manipulation, Orthopedic; Manometry; Middle Age; Pressure; Prospective Studies; Research Design; Spinal Diseases
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