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Osteopathic Evaluation on Patients With Non-specific Back Pain: An Inter-examiner Reliability Study

Last Updated: 2011-06-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

20 participants

Study Classification

OBSERVATIONAL

Study Start Date

2010-11-30

Study Completion Date

2011-01-31

Brief Summary

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The purpose of this study is to determine whether two osteopathic evaluators with less than 5 years experience will be able to determine the same location and nature of the primary lesion(s) or restriction(s)in patients with chronic non-specific back pain using a global osteopathic evaluation approach.

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Detailed Description

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Back pain is one of the leading causes of consultation for rehabilitation. Establishing a diagnosis in the initial patient assessment is essential to choosing a specific treatment plan for that patient, regardless of the type of therapy the patient chooses to pursue. Evidence based medicine is the current gold standard for most manual-therapy professions, and there has been a great deal of research performed in an attempt to give credibility to the one tool that all manual therapy professions share in common: palpation. Few studies have been able to demonstrate an acceptable rate of inter-examiner reliability for palpation. This study will combine a global testing regime, consensus training for evaluators, and access to history of injury with symptomatic subjects to verify the inter-examiner reliability of an osteopathic evaluation on patients with chronic, non-specific low back pain.

Conditions

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Inter-examiner Reliability Location and Nature of Restriction or Lesion Non-specific Back Pain

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Non-specific back pain

General Osteopathic Evaluation

Intervention Type OTHER

2 general osteopathic evaluations of approximately 1 hour in duration done consecutively on the same day with a 15 minute break between evaluations

Interventions

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General Osteopathic Evaluation

2 general osteopathic evaluations of approximately 1 hour in duration done consecutively on the same day with a 15 minute break between evaluations

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Men and women ages 18-60
* Must have a history of non-specific back pain (not due to any known pathology eg. disc herniation or disc degenerative disease) that is currently not irritated and has not been, in the past 8 weeks
* Must be available for 3 consecutive hour

Exclusion Criteria

* Patients with a known cause for their back pain
* Patients who have had a flare up of symptoms within the last 8 weeks
* Patients who are currently undergoing any rehabilitation or who have received manual treatment in the last 8 weeks.
* Patients who are taking daily medications for pain
* Pregnant women
* Major medical conditions: fractures, degenerative arthritis, inflammatory disorders, ankylosing spondylitis, multiple sclerosis, cancer, paralysis stroke or recent concussion history
* Any other conditions that would prevent the participant from completing the evaluation

Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Responsible Party

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Unaffiliated

Principal Investigators

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René Pelletier, MSc., D.O

Role: STUDY_DIRECTOR

Sabrina Silla, BSc., PT, DO

Role: STUDY_DIRECTOR

Jaime Kirnan, BSc., CAT(c)

Role: PRINCIPAL_INVESTIGATOR

Locations

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Concordia Physio Sport

Brossard, Quebec, Canada

Site Status

Countries

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Canada

References

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Beal MC, Patriquin DA. Interexaminer agreement on palpatory diagnosis and patient self-assessment of disability: a pilot study. J Am Osteopath Assoc. 1995 Feb;95(2):97-100, 103-6.

Reference Type BACKGROUND

PMID: 7890559 (View on PubMed)

Bertilson BC, Grunnesjo M, Strender LE. Reliability of clinical tests in the assessment of patients with neck/shoulder problems-impact of history. Spine (Phila Pa 1976). 2003 Oct 1;28(19):2222-31. doi: 10.1097/01.BRS.0000089685.55629.2E.

Reference Type BACKGROUND

PMID: 14520035 (View on PubMed)

Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians; American College of Physicians; American Pain Society Low Back Pain Guidelines Panel. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007 Oct 2;147(7):478-91. doi: 10.7326/0003-4819-147-7-200710020-00006.

Reference Type BACKGROUND

PMID: 17909209 (View on PubMed)

Christensen HW, Vach W, Vach K, Manniche C, Haghfelt T, Hartvigsen L, Hoilund-Carlsen PF. Palpation of the upper thoracic spine: an observer reliability study. J Manipulative Physiol Ther. 2002 Jun;25(5):285-92. doi: 10.1067/mmt.2002.124424.

Reference Type BACKGROUND

PMID: 12072848 (View on PubMed)

Cleland JA, Childs JD, Fritz JM, Whitman JM. Interrater reliability of the history and physical examination in patients with mechanical neck pain. Arch Phys Med Rehabil. 2006 Oct;87(10):1388-95. doi: 10.1016/j.apmr.2006.06.011.

Reference Type BACKGROUND

PMID: 17023251 (View on PubMed)

Comeaux, Z., Eland, D., Chila, A., Pheley, A., & Tate, M. (2001). Measurement challenges in physical diagnosis: refining inter-rater palpation, perception and communication. Journal of Bodywork and Movement Therapies; 5(4): 245-253

Reference Type BACKGROUND

Degenhardt BF, Snider KT, Snider EJ, Johnson JC. Interobserver reliability of osteopathic palpatory diagnostic tests of the lumbar spine: improvements from consensus training. J Am Osteopath Assoc. 2005 Oct;105(10):465-73.

Reference Type BACKGROUND

PMID: 16314679 (View on PubMed)

French SD, Green S, Forbes A. Reliability of chiropractic methods commonly used to detect manipulable lesions in patients with chronic low-back pain. J Manipulative Physiol Ther. 2000 May;23(4):231-8. doi: 10.1067/mmt.2000.106101.

Reference Type BACKGROUND

PMID: 10820295 (View on PubMed)

Fritz JM, Delitto A, Vignovic M, Busse RG. Interrater reliability of judgments of the centralization phenomenon and status change during movement testing in patients with low back pain. Arch Phys Med Rehabil. 2000 Jan;81(1):57-61. doi: 10.1016/s0003-9993(00)90222-3.

Reference Type BACKGROUND

PMID: 10638877 (View on PubMed)

Freyer, G., McPherson, H. C., & O'Keefe, P. (2005). The effect of training on the inter-examiner and intra-examiner reliability of the seated flexion test and assessment of pelvic anatomical landmarks with palpation. International Journal of Osteopathic Medicine; 8: 131-138.

Reference Type BACKGROUND

Ghoukassian, M., Nicholls, B., & McLaughlin, P. (2001). Inter-examiner reliability of the Johnson and Friedman percussion scan of the thoracic spine. Journal of Osteopathic Medicine; 4(1): 15-20

Reference Type BACKGROUND

Haas M. Interexaminer reliability for multiple diagnostic test regimens. J Manipulative Physiol Ther. 1991 Feb;14(2):95-103.

Reference Type BACKGROUND

PMID: 2019826 (View on PubMed)

Haas M. Statistical methodology for reliability studies. J Manipulative Physiol Ther. 1991 Feb;14(2):119-32.

Reference Type BACKGROUND

PMID: 2019821 (View on PubMed)

Haas M. The reliability of reliability. J Manipulative Physiol Ther. 1991 Mar-Apr;14(3):199-208.

Reference Type BACKGROUND

PMID: 2045731 (View on PubMed)

Hall H, McIntosh G, Boyle C. Effectiveness of a low back pain classification system. Spine J. 2009 Aug;9(8):648-57. doi: 10.1016/j.spinee.2009.04.017. Epub 2009 Jun 4.

Reference Type BACKGROUND

PMID: 19501026 (View on PubMed)

Hestbaek L, Leboeuf-Yde C. Are chiropractic tests for the lumbo-pelvic spine reliable and valid? A systematic critical literature review. J Manipulative Physiol Ther. 2000 May;23(4):258-75. doi: 10.1067/mmt.2000.106097.

Reference Type BACKGROUND

PMID: 10820299 (View on PubMed)

Hicks GE, Fritz JM, Delitto A, Mishock J. Interrater reliability of clinical examination measures for identification of lumbar segmental instability. Arch Phys Med Rehabil. 2003 Dec;84(12):1858-64. doi: 10.1016/s0003-9993(03)00365-4.

Reference Type BACKGROUND

PMID: 14669195 (View on PubMed)

Horneij E, Hemborg B, Johnsson B, Ekdahl C. Clinical tests on impairment level related to low back pain: a study of test reliability. J Rehabil Med. 2002 Jul;34(4):176-82. doi: 10.1080/16501970213235.

Reference Type BACKGROUND

PMID: 12201613 (View on PubMed)

Huijbregts, P. A. (2002). Spinal motion palpation: a review of reliability studies. Manipulative and Physiological Therapeutics; 10(1): 24-39

Reference Type BACKGROUND

Jull G, Zito G, Trott P, Potter H, Shirley D. Inter-examiner reliability to detect painful upper cervical joint dysfunction. Aust J Physiother. 1997;43(2):125-129. doi: 10.1016/s0004-9514(14)60406-2.

Reference Type BACKGROUND

PMID: 11676679 (View on PubMed)

Keating JC Jr, Bergmann TF, Jacobs GE, Finer BA, Larson K. Interexaminer reliability of eight evaluative dimensions of lumbar segmental abnormality. J Manipulative Physiol Ther. 1990 Oct;13(8):463-70.

Reference Type BACKGROUND

PMID: 2146357 (View on PubMed)

Kokmeyer DJ, Van der Wurff P, Aufdemkampe G, Fickenscher TC. The reliability of multitest regimens with sacroiliac pain provocation tests. J Manipulative Physiol Ther. 2002 Jan;25(1):42-8. doi: 10.1067/mmt.2002.120418.

Reference Type BACKGROUND

PMID: 11898017 (View on PubMed)

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977 Mar;33(1):159-74.

Reference Type BACKGROUND

PMID: 843571 (View on PubMed)

Laslett M, Williams M. The reliability of selected pain provocation tests for sacroiliac joint pathology. Spine (Phila Pa 1976). 1994 Jun 1;19(11):1243-9. doi: 10.1097/00007632-199405310-00009.

Reference Type BACKGROUND

PMID: 8073316 (View on PubMed)

Leboeuf-Yde C, Kyvik KO. Is it possible to differentiate people with or without low-back pain on the basis of test of lumbopelvic dysfunction? J Manipulative Physiol Ther. 2000 Mar-Apr;23(3):160-7. doi: 10.1016/s0161-4754(00)90245-8.

Reference Type BACKGROUND

PMID: 10771500 (View on PubMed)

Licciardone JC, Brimhall AK, King LN. Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2005 Aug 4;6:43. doi: 10.1186/1471-2474-6-43.

Reference Type BACKGROUND

PMID: 16080794 (View on PubMed)

Maher C, Adams R. Reliability of pain and stiffness assessments in clinical manual lumbar spine examination. Phys Ther. 1994 Sep;74(9):801-9; discussion 809-11. doi: 10.1093/ptj/74.9.801.

Reference Type BACKGROUND

PMID: 8066107 (View on PubMed)

Meijne W, van Neerbos K, Aufdemkampe G, van der Wurff P. Intraexaminer and interexaminer reliability of the Gillet test. J Manipulative Physiol Ther. 1999 Jan;22(1):4-9. doi: 10.1016/s0161-4754(99)70098-9.

Reference Type BACKGROUND

PMID: 10029942 (View on PubMed)

Mior SA, McGregor M, Schut B. The role of experience in clinical accuracy. J Manipulative Physiol Ther. 1990 Feb;13(2):68-71.

Reference Type BACKGROUND

PMID: 2307923 (View on PubMed)

Murphy DR, Hurwitz EL, Nelson CF. A diagnosis-based clinical decision rule for spinal pain part 2: review of the literature. Chiropr Osteopat. 2008 Aug 11;16:7. doi: 10.1186/1746-1340-16-7.

Reference Type BACKGROUND

PMID: 18694490 (View on PubMed)

Perreault N, Brisson C, Dionne CE, Montreuil S, Punnett L. Agreement between a self-administered questionnaire on musculoskeletal disorders of the neck-shoulder region and a physical examination. BMC Musculoskelet Disord. 2008 Mar 17;9:34. doi: 10.1186/1471-2474-9-34.

Reference Type BACKGROUND

PMID: 18366656 (View on PubMed)

Pool JJ, Hoving JL, de Vet HC, van Mameren H, Bouter LM. The interexaminer reproducibility of physical examination of the cervical spine. J Manipulative Physiol Ther. 2004 Feb;27(2):84-90. doi: 10.1016/j.jmpt.2003.12.002.

Reference Type BACKGROUND

PMID: 14970808 (View on PubMed)

Robinson HS, Brox JI, Robinson R, Bjelland E, Solem S, Telje T. The reliability of selected motion- and pain provocation tests for the sacroiliac joint. Man Ther. 2007 Feb;12(1):72-9. doi: 10.1016/j.math.2005.09.004. Epub 2006 Jul 12.

Reference Type BACKGROUND

PMID: 16843031 (View on PubMed)

Schneider M, Erhard R, Brach J, Tellin W, Imbarlina F, Delitto A. Spinal palpation for lumbar segmental mobility and pain provocation: an interexaminer reliability study. J Manipulative Physiol Ther. 2008 Jul-Aug;31(6):465-73. doi: 10.1016/j.jmpt.2008.06.004.

Reference Type BACKGROUND

PMID: 18722203 (View on PubMed)

Seffinger MA, Najm WI, Mishra SI, Adams A, Dickerson VM, Murphy LS, Reinsch S. Reliability of spinal palpation for diagnosis of back and neck pain: a systematic review of the literature. Spine (Phila Pa 1976). 2004 Oct 1;29(19):E413-25. doi: 10.1097/01.brs.0000141178.98157.8e.

Reference Type BACKGROUND

PMID: 15454722 (View on PubMed)

Seffinger, M., Adams, A., Najm, W., Dickerson, V., Mishra, S. I., Reinsch, S., & Murphy, L. (2003). Spinal palpatory diagnostic procedures utilized by practitioners of spinal manipulation: annotated bibliography of content validity and reliability studies. Journal of the Canadian Chiropractic Association; 47(2): 93-109

Reference Type BACKGROUND

Smedmark V, Wallin M, Arvidsson I. Inter-examiner reliability in assessing passive intervertebral motion of the cervical spine. Man Ther. 2000 May;5(2):97-101. doi: 10.1054/math.2000.0234.

Reference Type BACKGROUND

PMID: 10903585 (View on PubMed)

Stochkendahl MJ, Christensen HW, Hartvigsen J, Vach W, Haas M, Hestbaek L, Adams A, Bronfort G. Manual examination of the spine: a systematic critical literature review of reproducibility. J Manipulative Physiol Ther. 2006 Jul-Aug;29(6):475-85, 485.e1-10. doi: 10.1016/j.jmpt.2006.06.011.

Reference Type BACKGROUND

PMID: 16904495 (View on PubMed)

Viikari-Juntura E. Interexaminer reliability of observations in physical examinations of the neck. Phys Ther. 1987 Oct;67(10):1526-32. doi: 10.1093/ptj/67.10.1526.

Reference Type BACKGROUND

PMID: 3659137 (View on PubMed)

Vincent-Smith B, Gibbons P. Inter-examiner and intra-examiner reliability of the standing flexion test. Man Ther. 1999 May;4(2):87-93. doi: 10.1054/math.1999.0173.

Reference Type BACKGROUND

PMID: 10509062 (View on PubMed)

Vroomen PC, de Krom MC, Wilmink JT, Kester AD, Knottnerus JA. Diagnostic value of history and physical examination in patients suspected of lumbosacral nerve root compression. J Neurol Neurosurg Psychiatry. 2002 May;72(5):630-4. doi: 10.1136/jnnp.72.5.630.

Reference Type BACKGROUND

PMID: 11971050 (View on PubMed)

Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine (Phila Pa 1976). 2003 Jan 1;28(1):52-62. doi: 10.1097/00007632-200301010-00014.

Reference Type BACKGROUND

PMID: 12544957 (View on PubMed)

Walter SD, Eliasziw M, Donner A. Sample size and optimal designs for reliability studies. Stat Med. 1998 Jan 15;17(1):101-10. doi: 10.1002/(sici)1097-0258(19980115)17:13.0.co;2-e.

Reference Type BACKGROUND

PMID: 9463853 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

JAK-OST-1

Identifier Type: -

Identifier Source: org_study_id

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Study Results

Basic Information

Brief Summary

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Detailed Description

Conditions

Study Design

Study Groups

Non-specific back pain

General Osteopathic Evaluation

Interventions

General Osteopathic Evaluation

Eligibility Criteria

Inclusion Criteria

Exclusion Criteria

Sponsors

Kirnan, Jaime

Responsible Party

Principal Investigators

René Pelletier, MSc., D.O

Sabrina Silla, BSc., PT, DO

Jaime Kirnan, BSc., CAT(c)

Locations

Concordia Physio Sport

Countries

References

Beal MC, Patriquin DA. Interexaminer agreement on palpatory diagnosis and patient self-assessment of disability: a pilot study. J Am Osteopath Assoc. 1995 Feb;95(2):97-100, 103-6.

Bertilson BC, Grunnesjo M, Strender LE. Reliability of clinical tests in the assessment of patients with neck/shoulder problems-impact of history. Spine (Phila Pa 1976). 2003 Oct 1;28(19):2222-31. doi: 10.1097/01.BRS.0000089685.55629.2E.

Christensen HW, Vach W, Vach K, Manniche C, Haghfelt T, Hartvigsen L, Hoilund-Carlsen PF. Palpation of the upper thoracic spine: an observer reliability study. J Manipulative Physiol Ther. 2002 Jun;25(5):285-92. doi: 10.1067/mmt.2002.124424.

Cleland JA, Childs JD, Fritz JM, Whitman JM. Interrater reliability of the history and physical examination in patients with mechanical neck pain. Arch Phys Med Rehabil. 2006 Oct;87(10):1388-95. doi: 10.1016/j.apmr.2006.06.011.

Comeaux, Z., Eland, D., Chila, A., Pheley, A., & Tate, M. (2001). Measurement challenges in physical diagnosis: refining inter-rater palpation, perception and communication. Journal of Bodywork and Movement Therapies; 5(4): 245-253

Degenhardt BF, Snider KT, Snider EJ, Johnson JC. Interobserver reliability of osteopathic palpatory diagnostic tests of the lumbar spine: improvements from consensus training. J Am Osteopath Assoc. 2005 Oct;105(10):465-73.

French SD, Green S, Forbes A. Reliability of chiropractic methods commonly used to detect manipulable lesions in patients with chronic low-back pain. J Manipulative Physiol Ther. 2000 May;23(4):231-8. doi: 10.1067/mmt.2000.106101.

Fritz JM, Delitto A, Vignovic M, Busse RG. Interrater reliability of judgments of the centralization phenomenon and status change during movement testing in patients with low back pain. Arch Phys Med Rehabil. 2000 Jan;81(1):57-61. doi: 10.1016/s0003-9993(00)90222-3.

Freyer, G., McPherson, H. C., & O'Keefe, P. (2005). The effect of training on the inter-examiner and intra-examiner reliability of the seated flexion test and assessment of pelvic anatomical landmarks with palpation. International Journal of Osteopathic Medicine; 8: 131-138.

Ghoukassian, M., Nicholls, B., & McLaughlin, P. (2001). Inter-examiner reliability of the Johnson and Friedman percussion scan of the thoracic spine. Journal of Osteopathic Medicine; 4(1): 15-20

Haas M. Interexaminer reliability for multiple diagnostic test regimens. J Manipulative Physiol Ther. 1991 Feb;14(2):95-103.

Haas M. Statistical methodology for reliability studies. J Manipulative Physiol Ther. 1991 Feb;14(2):119-32.

Haas M. The reliability of reliability. J Manipulative Physiol Ther. 1991 Mar-Apr;14(3):199-208.

Hall H, McIntosh G, Boyle C. Effectiveness of a low back pain classification system. Spine J. 2009 Aug;9(8):648-57. doi: 10.1016/j.spinee.2009.04.017. Epub 2009 Jun 4.

Hestbaek L, Leboeuf-Yde C. Are chiropractic tests for the lumbo-pelvic spine reliable and valid? A systematic critical literature review. J Manipulative Physiol Ther. 2000 May;23(4):258-75. doi: 10.1067/mmt.2000.106097.

Hicks GE, Fritz JM, Delitto A, Mishock J. Interrater reliability of clinical examination measures for identification of lumbar segmental instability. Arch Phys Med Rehabil. 2003 Dec;84(12):1858-64. doi: 10.1016/s0003-9993(03)00365-4.

Horneij E, Hemborg B, Johnsson B, Ekdahl C. Clinical tests on impairment level related to low back pain: a study of test reliability. J Rehabil Med. 2002 Jul;34(4):176-82. doi: 10.1080/16501970213235.

Huijbregts, P. A. (2002). Spinal motion palpation: a review of reliability studies. Manipulative and Physiological Therapeutics; 10(1): 24-39

Jull G, Zito G, Trott P, Potter H, Shirley D. Inter-examiner reliability to detect painful upper cervical joint dysfunction. Aust J Physiother. 1997;43(2):125-129. doi: 10.1016/s0004-9514(14)60406-2.

Keating JC Jr, Bergmann TF, Jacobs GE, Finer BA, Larson K. Interexaminer reliability of eight evaluative dimensions of lumbar segmental abnormality. J Manipulative Physiol Ther. 1990 Oct;13(8):463-70.

Kokmeyer DJ, Van der Wurff P, Aufdemkampe G, Fickenscher TC. The reliability of multitest regimens with sacroiliac pain provocation tests. J Manipulative Physiol Ther. 2002 Jan;25(1):42-8. doi: 10.1067/mmt.2002.120418.

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977 Mar;33(1):159-74.

Laslett M, Williams M. The reliability of selected pain provocation tests for sacroiliac joint pathology. Spine (Phila Pa 1976). 1994 Jun 1;19(11):1243-9. doi: 10.1097/00007632-199405310-00009.

Leboeuf-Yde C, Kyvik KO. Is it possible to differentiate people with or without low-back pain on the basis of test of lumbopelvic dysfunction? J Manipulative Physiol Ther. 2000 Mar-Apr;23(3):160-7. doi: 10.1016/s0161-4754(00)90245-8.

Licciardone JC, Brimhall AK, King LN. Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2005 Aug 4;6:43. doi: 10.1186/1471-2474-6-43.

Maher C, Adams R. Reliability of pain and stiffness assessments in clinical manual lumbar spine examination. Phys Ther. 1994 Sep;74(9):801-9; discussion 809-11. doi: 10.1093/ptj/74.9.801.

Meijne W, van Neerbos K, Aufdemkampe G, van der Wurff P. Intraexaminer and interexaminer reliability of the Gillet test. J Manipulative Physiol Ther. 1999 Jan;22(1):4-9. doi: 10.1016/s0161-4754(99)70098-9.

Mior SA, McGregor M, Schut B. The role of experience in clinical accuracy. J Manipulative Physiol Ther. 1990 Feb;13(2):68-71.

Murphy DR, Hurwitz EL, Nelson CF. A diagnosis-based clinical decision rule for spinal pain part 2: review of the literature. Chiropr Osteopat. 2008 Aug 11;16:7. doi: 10.1186/1746-1340-16-7.

Perreault N, Brisson C, Dionne CE, Montreuil S, Punnett L. Agreement between a self-administered questionnaire on musculoskeletal disorders of the neck-shoulder region and a physical examination. BMC Musculoskelet Disord. 2008 Mar 17;9:34. doi: 10.1186/1471-2474-9-34.

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Other Identifiers

JAK-OST-1

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