J Manipulative Physiol Ther. 1997 (Nov); 20 (9): 583–589
Walker BF, Buchbinder R.
Department of Public Health and Tropical Medicine,
James Cook University,
Townsville, Queensland, Australia
PURPOSE: To determine the most commonly used diagnostic methods for detecting the spinal entity that chiropractors adjust/manipulate and the preferred term for describing this entity.
DESIGN: Postal survey (self-completed questionnaire).
SETTING: Victoria, Australia.
PARTICIPANTS: All 554 chiropractors registered May 30, 1994, with the Chiropractors and Osteopaths Registration Board of Victoria.
MAIN OUTCOME MEASURES: Frequency of use and opinion with respect to reliability of 16 specific methods, measured on a 7-point, Likert-type scale [never used (1) to always used (7) and very unreliable (1) to very reliable (7), respectively]; the respondent's preferred term for describing the spinal entity that chiropractors adjust/manipulate.
RESULTS: The response rate was 85%. The most commonly used method was static palpation (mean score 6.6 +/- 1.1). Seven other methods, including pain description of the patient, orthopedic tests, motion palpation, visual posture analysis, leg length discrepancy, neurological tests and plain static X-rays had mean scores greater than 4.0. All of these methods, as well as functional X-ray views and kinesiological muscle testing, were considered reliable, with mean reliability scores greater than 4.0. Motion palpation was regarded as the most reliable method (mean reliability score 5.9 +/- 1.2). Seventy-five different terms for describing the spinal entity were named by 440 respondents. "Subluxation" was included in the preferred term of 294 respondents (67%), 46 included "dysfunction" (11%), 35 included "fixation" (8%) and 20 included "manipulable" (4.5%).
CONCLUSION: Chiropractors commonly use a variety of methods to identify the spinal entity that they manipulate. There is no consensus as to the preferred term for describing this entity.