INTRA- AND INTEREXAMINER RELIABILITY OF COMPRESSIVE LEG CHECKING AND CORRELATION WITH THE SIT-STAND TEST FOR ANATOMIC LEG LENGTH INEQUALITY
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Abstract
Introduction: Most forms of leg checking are for functional short leg, believed related to a treatable clinical entity, such as pelvic subluxation. However, a short leg may be anatomic in nature, which could lead to different treatment procedures. A variant termed compressive leg checking is thought to identify an anatomic short leg. The primary objective of the present study was to study the intra- and interexaminer reliability of compressive leg checking. The secondary objective was to assess the inter-method agreement of compressive leg checking and the sit-stand test, another test for anatomic leg length inequality.
Methods: A convenience sample of asymptomatic chiropractic college students was recruited. Each wore modified surgical boots capable of measuring LLI to the nearest millimeter, prone. To assess interexaminer reliability, each subject was measured 3 times, at 2.5-minute intervals. A subset of subjects entered an interexaminer module, and another subset an intermethod module comparing the results of compressive leg checking and the sit-stand test.
Results: Intraexaminer reliability module: ICC=.71 (0.48, 0.85). Mean of the absolute values for 31 subjects, 3 measures per subject (93 paired examiner differences) was 2.8mm and the median of these absolute values was 2.0mm. The Median Absolute Deviation = 1.0 mm. Intraexaminer module: ICC=0.67 (0.25, 0.87). Mean of the absolute values of the 15 examiner differences was 3.1mm, and the median of the absolute values of these absolute values was 3.0mm. The Median Absolute Deviation=1.0mm. Inter-method module: Weighted kappa for n= 22 subjects agreement between compressive leg checking and the sit-stand test was 0.65 (0.38, 0.91).
Conclusion: Compressive leg checking demonstrated good intra- and interexaminer reliability, and correlates well with the sit-stand test. While compressive leg checking is reliable and valid for detecting artificially created LLI, its accuracy compared with a radiological reference standard has not been determined. (Chiropr J Australia 2017;45:184-195)
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