The Arm Fossa Test: “Are chiropractic tests for the lumbo-pelvic spine reliable and valid? A systematic critical literature review”

In a recent study just published in the May 2000 issue of the Journal of Manipulative and Physiological Therapeutics:

Hestìk L, Leboeuf-Yde C, Are chiropractic tests for the lumbo-pelvic spine reliable and valid? A systematic critical literature review, Journal of Manipulative and Physiological Therapeutics 2000 (May);23:258–75

there was some very interesting information deduced from an extensive review of the chiropractic literature regarding sacro occipital technique’s (SOT) “arm fossa test”. I found it fascinating that of the various chiropractic tests evaluated that other than palpation for pain, which had consistently acceptable results, the arm fossa test was the only other test that was considered to have, “some evidence in favor of validity”. Other chiropractic tests were evaluated as follows:

“Motion Palpation of the lumbar spine might be valid but showed poor reliability, whereas motion palpation of the sacroiliac joints seemed to be slightly reliable but was not shown to be valid.”

“Measures of leg length inequality seemed to correlate with x-ray measurements, but consensus on method and interpretation was lacking.”

Regarding applied kinesiology, they concluded that “documentation of applied kinesiology was not available.”

“Palpation for muscle tension, palpation for misalignment and visual inspection were all either undocumented, unreliable, or not valid”

The following is excerpted from the article regarding sacrooccipital technique:

“Results from the different reliability studies vary widely. Some evidence favors the validity of the arm-fossa test, but the validity of the rest of the sacrooccipital technique test regimen has not been investigated.

Two intraexaminer reliability studies of sacrooccipital technique tests both scored greater than 80% (88% and 100%). One examined the arm- fossa test and demonstrated excellent agreement, whereas the other examined a variety of tests with good results for one examiner and poor for the other.

For interexaminer reliability, four tests have been evaluated, scoring 75% to 100%. Two scored greater than 80%. One examined the sway-test with reasonable result, and the other examined the full test regimen, with 3 of the 10 tests showing fair results and the rest showing poor results.

Two studies were found of the validity of the arm-fossa test (80% and 90%), both demonstrating some validity of the method.”

Of significance is that of all the various studies reviewed, SOT’s arm fossa test came up as the most reliable test other than palpation for pain. Ironically, this is based on only two studies. Can you imagine if we were able to have greater studies based on our common SOT tests, such as the psoas hand check, iliofemoral leg check, cervical compaction and others. The way it looks, two well designed studies of each could put SOT in the upper echelon of chiropractic techniques treating and diagnosing the lumbopelvic spine. This is imperative for SOT’s survival inthe 21st century.

The authors of the study laid down the gauntlet to SOT practitioners and researchers as well as to the whole chiropractic profession:

“Surely, it is time that an expert panel designs a series of acceptable study protocols for different types of study designs. Furthermore, it is time that the various chiropractic institutions divide the tasks of systematic testing of the most commonly used chiropractic test procedures among themselves. Procedures found to be useless should then be excluded from our clinical repertoire and useful tests (if any) should be promoted at undergraduate and postgraduate levels. “

Please, let’s take this on with action.

Charles L. Blum, DC, FICS

President SOTO-USA

drcblum@aol.com

Hestìk L, Leboeuf-Yde C, Are chiropractic tests for the lumbo-pelvic spine reliable and valid? A systematic critical literature review, Journal of Manipulative and Physiological Therapeutics 2000 (May);23:258–75

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