The effect of training on the inter-examiner and intra-examiner reliability of static palpation for assessing pelvic landmarks

The aim os this study was to investigate the effect of training on the inter-examiner and intra-examiner reliability of static palpation of pelvic landmarks. Two groups of final year osteopathic students examined ten asymptomatic female participants for symmetry of pelvic landmarks. One group of examiners attended two training sessions to standardise examination findings whereas those in the untrained group did not. Three separate examinations of the anterior superior iliac spine (ASIS), posterior superior iliac spine (PSIS), medial malleoli and sacral inferior lateral angle (SILA) were performed on every landmark on every participant by all examiners. The trained group produced slightly higher intra-examiner reliability for the ASIS, PSIS and medial malleoli, and slightly higher inter-examiner reliability for the ASIS ans SILA. Generalises Kappa (Kg) scores indicated fair inter-examiner agreement for palpation of the ASIS and medial malleoli and slight agreement for the PSIS and SILA in the trained group. The mean level of intra-examiner agreement was sunstantial for the ASIS and medial malleoli, moderate for the PSIS and slight for the SILA in the trained group. Intra-examiner reliability was higher than inter-examiner reliability. The training sessions produced a marginal increase in both inter-examiner and intra-examiner reliability, but agreement was still less than acceptable for a clinical test. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program