An inter-rater reliability study assessing student’s ability to palpate and test the passive rotational range of motion on the knee joint.

Item

Title
An inter-rater reliability study assessing student’s ability to palpate and test the passive rotational range of motion on the knee joint.
Author(s)
Bisson, I
Abstract
Aim: All students are taught some skills such as palpation and testing of the joints from day one during a four year osteopathy degree at the European School of Osteopathy (ESQ). However, to what extent do they agree with each other having had exposure to similar training and clinical hours? Are their findings accurate? Although manual therapy can be subjective, surely students should agree on some of the basic testing that was instilled in them from the beginning. Hypothesis: 1. There will be inter rater-reliability between 4th Year ESQ student's assessment of tibial internal and external rotation. 2. There will be good correlation between student findings and what the camera observed. Rationale: Hopefully this experiment can show that osteopathy taught at the ESQ creates a good standard of basic skills required for clinical practice which would easily cross eference with other new graduates. This could also help to cement manual therapy as a very credible form of treatment if taught correctly and the right exposure to materials and experience is given to each student. Participants: ESQ Fourth Year students nearing completion of their degree volunteered to take part in this study. 11 raters were used to carry out examinations on 8 student subjects. Method: A blinded study was carried out where raters entered an examination room one at a time, performed their examination of the rotation of each knee as taught in year one. They noted down their findings on the sheet provided which was blinded from other raters. The process was repeated for each separate rater and then each separate subject. Markings were used on the subjects and each test was recorded so the actual amount of tibial rotation, each way, relative to the femur, could be calculated using Results: A Fleiss' Kappa (K) Co-efficient was used to calculate the K values for Inter-Rater Reliability (IRR). Internal rotation showed K values between 0.01 - 0.20 which indicates slight agreement- External rotation showed a lower K value which was just within the boundaries of slight agreement. Actual rotation of the tibia was calculated to see to what extent each rater was accurate with respect to their own examination of a knee. A Spearman's rank coefficient was used to calculate any significant correlation between the raters and what the camera observed. The results showed very good correlation for infernal rotation. However, external rotation showed poor correlation. The compressed data (see discussion) gave increased K values for internal rotation, showing boner IRR, but still within the boundaries of only slight agreement. However, a decreased K value for external rotation meant IRR was now borderline between slight and very poor. With regards to the Spearman's rank calculations, new p values continued to show very marked correlation for internal rotation and improved correlation for external rotation. Discussion: Further analysis of the results by way of compressing the data showed similar IRR and improved correlation between raters and what the camera observed. Methodological weaknesses were noted that may have undermined the veracity of this study. Conclusion: The IRR between students when testing the rotational movement of the knee is generally poor. However, students seem to show good accuracy within their own examination routine. Further studies info IRR need to be carried out in osteopathy and all manual therapies. Trials on ways to teach these skills better should also be looked at so agreement can be reached amongst practitioners on how to perform testing to an equal
presented at
European School of Osteopathy
Date Accepted
2013
Date Submitted
20.1.2015 16:42:44
Type
osteo_thesis
Language
English
Submitted by:
62
Pub-Identifier
15438
Inst-Identifier
1229
Keywords
Inter-rater of knee ROM.
Recommended
0
Item sets
Thesis

Bisson, I, “An inter-rater reliability study assessing student’s ability to palpate and test the passive rotational range of motion on the knee joint.”, Osteopathic Research Web, accessed May 6, 2024, https://www.osteopathic-research.com/s/orw/item/726