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

This study has been completed.
Information provided by:
Kirnan, Jaime
ClinicalTrials.gov Identifier:
First received: December 10, 2010
Last updated: June 9, 2011
Last verified: June 2011

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.

Condition Intervention
Inter-examiner Reliability
Location and Nature of Restriction or Lesion
Non-specific Back Pain
Other: General Osteopathic Evaluation

Study Type: Observational
Study Design: Observational Model: Case-Only
Time Perspective: Cross-Sectional
Official Title: Osteopathic Evaluation on Patients With Non-specific Back Pain: An Observational Inter-examiner Reliability Study

Resource links provided by NLM:

Further study details as provided by Kirnan, Jaime:

Primary Outcome Measures:
  • Inter-examiner reliability [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
    Inter-examiner reliability between two evaluators for nature and location of primary restriction(s), lesion(s) found during a global osteopathic evaluation

Enrollment: 20
Study Start Date: November 2010
Study Completion Date: January 2011
Primary Completion Date: January 2011 (Final data collection date for primary outcome measure)
Groups/Cohorts Assigned Interventions
Non-specific back pain Other: 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

Detailed Description:

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.


Ages Eligible for Study:   18 Years to 60 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population

Community Sample


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
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01258543

Canada, Quebec
Concordia Physio Sport
Brossard, Quebec, Canada, J4Z 1A7
Sponsors and Collaborators
Kirnan, Jaime
Study Director: René Pelletier, MSc., D.O
Study Director: Sabrina Silla, BSc., PT, DO
Principal Investigator: Jaime Kirnan, BSc., CAT(c)
  More Information

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
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. (1991). The reliability of reliability. Journal of Manipulative and Physiological Therapeutics: 14(3): 199-207
Huijbregts, P. A. (2002). Spinal motion palpation: a review of reliability studies. Manipulative and Physiological Therapeutics; 10(1): 24-39
Mior, S. A., McGregor, M., & Schut, B. (1990). The role of experience in clinical accuracy. Journal of Manipulative and Physiological Therapeutics; 13(2): 68-71
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
Vincent-Smith, B., & Gibbons, P. (1999). Inter-examiner and intra-examiner reliability of the standing forward flexion test. Manual Therapy; 10: 256-269

Responsible Party: Jaime Kirnan, Unaffiliated
ClinicalTrials.gov Identifier: NCT01258543     History of Changes
Other Study ID Numbers: JAK-OST-1
Study First Received: December 10, 2010
Last Updated: June 9, 2011
Health Authority: Canada: Comité central d'éthique de la recherche du ministre de la Santé et des Services sociaux

Keywords provided by Kirnan, Jaime:
Global osteopathic evaluation
Non-specific back pain
Inter-examiner reliability

Additional relevant MeSH terms:
Back Pain
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms

ClinicalTrials.gov processed this record on April 17, 2014