The Experts below are selected from a list of 321 Experts worldwide ranked by ideXlab platform
Robert Cooperstein - One of the best experts on this subject based on the ideXlab platform.
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Interexaminer Reliability of Seated Motion Palpation for the Stiffest Spinal Site.
Journal of manipulative and physiological therapeutics, 2018Co-Authors: Kelly Holt, David Russell, Robert Cooperstein, Morgan Young, Matthew W. Sherson, Heidi HaavikAbstract:Abstract Objectives The purpose of this study was to assess the Interexaminer Reliability of palpation for stiffness in the cervical, thoracic, and lumbar spinal regions. Methods In this secondary data analysis, data from 70 patients from a chiropractic college outpatient clinic were analyzed. Two doctors of chiropractic palpated for the stiffest site within each spinal region. Each were asked to select the stiffest segment and to rate their confidence in their palpation findings. Reliability between examiners was calculated as Median Absolute Examiner Differences (MedianAED) and data dispersion as Median Absolute Deviation (MAD). Interquartile analysis of the paired examiner differences was performed. Results In total, 210 paired observations were analyzed. Nonparametric data precluded Reliability determination using intraclass correlation. Findings included lumbar MedianAED = 0.5 vertebral equivalents (VE), thoracic = 1.7 VE, and cervical = 1.4 VE. For the combined dataset, the findings were MedianAED = 1.1 VE; MAD was lowest in the lumbar spine (0.3 VE) and highest in thoracic spine (1.4 VE), and for the combined dataset, MAD = 1.1 VE. Examiners agreed on the segment or the motion segment containing the stiffest site in 54% of the observations. Conclusions Interexaminer Reliability for palpation was good between 2 clinicians for the stiffest site in each region of the spine and in the combined dataset. This is consistent with previous studies of motion palpation using continuous analysis.
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The Reliability of palpating the posterior superior iliac spine: a systematic review
The Journal of the Canadian Chiropractic Association, 2016Co-Authors: Robert Cooperstein, Michael HickeyAbstract:Introduction Among pelvic landmarks routinely palpated by manual therapists, the posterior superior iliac spines (PSISs) are particularly important. In addition to serving as landmarks for identifying possible pelvic torsion, contacting the PSISs is integral to many other static and dynamic pelvic palpatory procedures. The primary study goal was to systematically review the literature on the intra- and Interexaminer Reliability of PSIS palpation. Methods Electronic databases and secondary searches led to the retrieval of articles that satisfied inclusion criteria. Two investigators rated the quality of included articles using the QAREL instrument. Results The search identified 13 articles, one judged high quality, satisfying the inclusion criteria. Intraexaminer exceeded Interexaminer Reliability. Among 8 studies that reported Interexaminer agreement using kappa, mean ϰ=0.27 (adjusted for sample size). Discussion and conclusion Current methods of palpating for PSIS asymmetry do not result in levels of Interexaminer Reliability supporting clinical utility. Improved methods should be sought.
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Mapping intended spinal site of care from the upright to prone position: an Interexaminer Reliability study.
Chiropractic & manual therapies, 2014Co-Authors: Robert Cooperstein, Morgan YoungAbstract:Background Upright examination procedures like radiology, thermography, manual muscle testing, and spinal motion palpation may lead to spinal interventions with the patient prone. The Reliability and accuracy of mapping upright examination findings to the prone position is unknown. This study had 2 primary goals: (1) investigate how erroneous spine-scapular landmark associations may lead to errors in treating and charting spine levels; and (2) study the Interexaminer Reliability of a novel method for mapping upright spinal sites to the prone position.
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Interexaminer Reliability of the Johnston and Friedman percussion scan of the thoracic spine: secondary data analysis using modified methods
2012Co-Authors: Robert CoopersteinAbstract:Objective: The purpose of this study is to perform a secondary analysis using modified methods of previously reported data to analyze the amount of examiner concordance in the Johnston and Friedman percussion scan of the most fixated spinal level. Method: A 2001 study evaluated Interexaminer Reliability of the percussive method of Johnston and Friedman for detecting altered segmental mobility (somatic dysfunction, spinal/segmental dysfunction, or chiropractic subluxation) in the thoracic spine. The original reported level of agreement using the κ statistic for discrete measures was only 0.07, judged “slight.” The data were reformatted to permit recalculating the degree of Interexaminer agreement using the intraclass correlation coefficient statistic, which uses continuous analysis, unlike κ that performs discrete analysis. Following an initial calculation, the data were modified to reflect the caudally increasing vertebral height of the thoracic vertebrae. Results: The reformatted and modified data, intraclass correlation coefficient (2,1) = 0.253 (0.100,0.482), showed the findings as “poor,” which is better Interexaminer agreement for percussion motion palpation than the original reported κ value judged as “slight.” Conclusions: Reanalyzing the data using an alternative statistical method showed greater Interexaminer Reliability than was originally reported. This secondary analysis demonstrates how study results may vary depending on the experimental design and statistical methods chosen for analysis. © 2012 National University of Health Sciences.
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An annotated bibliography of spinal motion palpation Reliability studies.
The Journal of the Canadian Chiropractic Association, 2009Co-Authors: Michael T. Haneline, Robert Cooperstein, Morgan Young, Kristopher BirkelandAbstract:Background Several literature reviews have addressed the Reliability of spinal and sacroiliac (SI) motion palpation (MP), finding that, in general, Interexaminer Reliability is slight and intraexaminer Reliability is moderate.
Scott F. Nadler - One of the best experts on this subject based on the ideXlab platform.
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Provocative Tests in Cervical Spine Examination: Historical Basis and Scientific Analyses Focused Review
2003Co-Authors: Gerard A. Malanga, Phillip Landes, Scott F. NadlerAbstract:and clinical use of these tests. Each of the tests described in this manuscript apparently originated from the anecdotal observations of experienced, well respected clinicians. However, only few studies have been performed addressing the Interexaminer Reliability or validity of these tests. The existing literature appears to indicate high specifici ty, low sensitivity, and good to fair Interexaminer Reliability for Spurling’s Neck Compression Test, the Neck Distraction Test, and The Shoulder Abduction (Relief) Test when performed as described. For Hoffman’s Sign, the existing literature does not address Interexaminer Reliability but appears to indicate fair sensitivity and fair to good specific ity. For L’hermitte’s Sign and Adson’s Test, not even tentative statements can be made with regard to Interexaminer Reliability, sensitivity, and specificity, based on the exist ing literature. It is concluded that more research is indicated to understand the clinical utility of all the provocative tests employed in the physical examination of the neck and cervical spine.
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Provocative tests in cervical spine examination: historical basis and scientific analyses.
Pain physician, 2003Co-Authors: Gerard A. Malanga, Phillip Landes, Scott F. NadlerAbstract:The majority of the provocative tests described for physical examination of the neck and cervical spine relate to identification of radiculopathy, spinal cord, or brachial plexus pathology. These tests are often performed routinely by many providers with variable methods and interpreted in a variety of ways. Several commonly performed provocative tests include Spurling's Neck Compression Test, Shoulder Abduction (Relief) Test, Neck Distraction Test, L'hermitte's Sign, Hoffmann's Sign and Adson's Test. This review describes some specialized provocative tests with comprehensive literature review. The goal of this review is to develop standardization in the performance and clinical use of these tests. Each of the tests described in this manuscript apparently originated from the anecdotal observations of experienced, well respected clinicians. However, only few studies have been performed addressing the Interexaminer Reliability or validity of these tests. The existing literature appears to indicate high specificity, low sensitivity, and good to fair Interexaminer Reliability for Spurling's Neck Compression Test, the Neck Distraction Test, and The Shoulder Abduction (Relief) Test when performed as described. For Hoffman's Sign, the existing literature does not address Interexaminer Reliability but appears to indicate fair sensitivity and fair to good specificity. For L'hermitte's Sign and Adson's Test, not even tentative statements can be made with regard to Interexaminer Reliability, sensitivity, and specificity, based on the existing literature. It is concluded that more research is indicated to understand the clinical utility of all the provocative tests employed in the physical examination of the neck and cervical spine.
Morgan Young - One of the best experts on this subject based on the ideXlab platform.
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Interexaminer Reliability of Seated Motion Palpation for the Stiffest Spinal Site.
Journal of manipulative and physiological therapeutics, 2018Co-Authors: Kelly Holt, David Russell, Robert Cooperstein, Morgan Young, Matthew W. Sherson, Heidi HaavikAbstract:Abstract Objectives The purpose of this study was to assess the Interexaminer Reliability of palpation for stiffness in the cervical, thoracic, and lumbar spinal regions. Methods In this secondary data analysis, data from 70 patients from a chiropractic college outpatient clinic were analyzed. Two doctors of chiropractic palpated for the stiffest site within each spinal region. Each were asked to select the stiffest segment and to rate their confidence in their palpation findings. Reliability between examiners was calculated as Median Absolute Examiner Differences (MedianAED) and data dispersion as Median Absolute Deviation (MAD). Interquartile analysis of the paired examiner differences was performed. Results In total, 210 paired observations were analyzed. Nonparametric data precluded Reliability determination using intraclass correlation. Findings included lumbar MedianAED = 0.5 vertebral equivalents (VE), thoracic = 1.7 VE, and cervical = 1.4 VE. For the combined dataset, the findings were MedianAED = 1.1 VE; MAD was lowest in the lumbar spine (0.3 VE) and highest in thoracic spine (1.4 VE), and for the combined dataset, MAD = 1.1 VE. Examiners agreed on the segment or the motion segment containing the stiffest site in 54% of the observations. Conclusions Interexaminer Reliability for palpation was good between 2 clinicians for the stiffest site in each region of the spine and in the combined dataset. This is consistent with previous studies of motion palpation using continuous analysis.
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Mapping intended spinal site of care from the upright to prone position: an Interexaminer Reliability study.
Chiropractic & manual therapies, 2014Co-Authors: Robert Cooperstein, Morgan YoungAbstract:Background Upright examination procedures like radiology, thermography, manual muscle testing, and spinal motion palpation may lead to spinal interventions with the patient prone. The Reliability and accuracy of mapping upright examination findings to the prone position is unknown. This study had 2 primary goals: (1) investigate how erroneous spine-scapular landmark associations may lead to errors in treating and charting spine levels; and (2) study the Interexaminer Reliability of a novel method for mapping upright spinal sites to the prone position.
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An annotated bibliography of spinal motion palpation Reliability studies.
The Journal of the Canadian Chiropractic Association, 2009Co-Authors: Michael T. Haneline, Robert Cooperstein, Morgan Young, Kristopher BirkelandAbstract:Background Several literature reviews have addressed the Reliability of spinal and sacroiliac (SI) motion palpation (MP), finding that, in general, Interexaminer Reliability is slight and intraexaminer Reliability is moderate.
Gerard A. Malanga - One of the best experts on this subject based on the ideXlab platform.
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Provocative Tests in Cervical Spine Examination: Historical Basis and Scientific Analyses Focused Review
2003Co-Authors: Gerard A. Malanga, Phillip Landes, Scott F. NadlerAbstract:and clinical use of these tests. Each of the tests described in this manuscript apparently originated from the anecdotal observations of experienced, well respected clinicians. However, only few studies have been performed addressing the Interexaminer Reliability or validity of these tests. The existing literature appears to indicate high specifici ty, low sensitivity, and good to fair Interexaminer Reliability for Spurling’s Neck Compression Test, the Neck Distraction Test, and The Shoulder Abduction (Relief) Test when performed as described. For Hoffman’s Sign, the existing literature does not address Interexaminer Reliability but appears to indicate fair sensitivity and fair to good specific ity. For L’hermitte’s Sign and Adson’s Test, not even tentative statements can be made with regard to Interexaminer Reliability, sensitivity, and specificity, based on the exist ing literature. It is concluded that more research is indicated to understand the clinical utility of all the provocative tests employed in the physical examination of the neck and cervical spine.
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Provocative tests in cervical spine examination: historical basis and scientific analyses.
Pain physician, 2003Co-Authors: Gerard A. Malanga, Phillip Landes, Scott F. NadlerAbstract:The majority of the provocative tests described for physical examination of the neck and cervical spine relate to identification of radiculopathy, spinal cord, or brachial plexus pathology. These tests are often performed routinely by many providers with variable methods and interpreted in a variety of ways. Several commonly performed provocative tests include Spurling's Neck Compression Test, Shoulder Abduction (Relief) Test, Neck Distraction Test, L'hermitte's Sign, Hoffmann's Sign and Adson's Test. This review describes some specialized provocative tests with comprehensive literature review. The goal of this review is to develop standardization in the performance and clinical use of these tests. Each of the tests described in this manuscript apparently originated from the anecdotal observations of experienced, well respected clinicians. However, only few studies have been performed addressing the Interexaminer Reliability or validity of these tests. The existing literature appears to indicate high specificity, low sensitivity, and good to fair Interexaminer Reliability for Spurling's Neck Compression Test, the Neck Distraction Test, and The Shoulder Abduction (Relief) Test when performed as described. For Hoffman's Sign, the existing literature does not address Interexaminer Reliability but appears to indicate fair sensitivity and fair to good specificity. For L'hermitte's Sign and Adson's Test, not even tentative statements can be made with regard to Interexaminer Reliability, sensitivity, and specificity, based on the existing literature. It is concluded that more research is indicated to understand the clinical utility of all the provocative tests employed in the physical examination of the neck and cervical spine.
Claus G. Roehrborn - One of the best experts on this subject based on the ideXlab platform.
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Interexaminer Reliability of transrectal ultrasound for estimating prostate volume.
The Journal of urology, 2001Co-Authors: Scott M. Sech, Juan D. Montoya, Cynthia J. Girman, Thomas Rhodes, Claus G. RoehrbornAbstract:Purpose: We investigated the Interexaminer Reliability of transrectal ultrasound measurement of total prostate and transition zone volume among 3 examiners with various levels of experience.Materials and Methods: A total of 121 patients 39 to 82 years old (average plus or minus standard deviation 60.7 ± 10.3) from a single urology clinic volunteered to participate. Patients with prostate cancer, previous prostate surgery or recent invasive prostatic examination were excluded from study. Each individual was examined independently by each of 3 examiners with various levels of experience, including an attending urologist, a PGY-2 resident in the second year of general surgery before urology training and a PGY-4 resident in the second year of urology training. Transrectal ultrasound was performed in each case by each examiner in pre-specified random order.Results: Mean total prostate and transition zone volume was 35.9 ± 27.2 and 15.6 ± 18.8 ml., respectively. Interexaminer agreement or Reliability of the ult...
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Interexaminer Reliability and validity of a three-dimensional model to assess prostate volume by digital rectal examination
Urology, 2001Co-Authors: Claus G. Roehrborn, Scott M. Sech, Juan D. Montoya, Thomas Rhodes, Cynthia J. GirmanAbstract:Objectives. To evaluate the Interexaminer Reliability and accuracy compared with transrectal ultrasound (TRUS) of a three-dimensional (3D) model and other scales to improve the estimation of prostate volume by digital rectal examination (DRE). Methods. Volunteers from a urology clinic (n = 121) were examined independently by three examiners with different levels of experience in randomized order. During DRE, the examiners estimated the prostate size in increments of 5 g, using various rating scales and a 3D sizing model, without access to the findings of the other investigators. TRUS was then performed by each examiner. Results. The 121 volunteers were 39 to 82 years old, with a mean ± SD total TRUS prostate size of 35.9 ± 27.2 g. The DRE size estimates ranged from 15 to 100 g across all examiners and patients. The Interexaminer Reliability across examiners for the best DRE prostate size estimates (in grams) was 0.78 (95% confidence interval 0.70 to 0.84), and the correlation coefficients (rs) with the TRUS volume ranged from 0.61 to 0.72 for the three examiners. A 3D model showed good Reliability (intraclass correlation coefficient 0.86, 95% confidence interval 0.75 to 0.93), and correlated well with the TRUS volume (rs = 0.67 to 0.75). Other scales showed fair Reliability (0.58 to 0.68) and correlated with the TRUS measurements (0.57 to 0.67). The area under the receiver operating characteristic curve to identify prostate volumes greater than 40 g ranged from 0.78 to 0.90 for DRE estimates (in grams) and 0.69 to 0.89 for the 3D model. Conclusions. DRE size estimates and TRUS volume were moderately to highly correlated in men without prostate cancer. A 3D sizing model showed comparable Reliability and correlation with TRUS. Although the DRE estimates generally tend to underestimate the TRUS-measured prostate volume, these tools may be useful in identifying men with enlarged prostate glands.