Inter and Intra-Rater Reliability of Soft Tissue Palpation Scoring in the Equine Thoracic Epaxial Region.

Megan Merrifield-Jones, Gillian Tabor, Jane Williams

Research output: Contribution to journalJournal Article

Abstract

Abstract
Background: Back pain is a significant factor for horses and is challenging for professionals to diagnose, with assessment frequently utilising subjective tools such as manual palpation. Reliable and valid objective measures are required and pressure algometry (PA) has been investigated as an assessment tool, however it has limitations and other more realistic methods may be better suited for the task.
Objectives: To establish inter- and intra-rater reliability for PA, Flexiforce Sensor (FFS) and Manual Palpation for equine epaxial soft tissue, measuring mechanical nociception threshold responses.
Methods: In group 1, ten horses underwent three repeated tests with PA and FFS, and once for manual palpation, with three ACPAT Chartered Physiotherapists in the right thoracic epaxial region. Group 2 followed the same protocol using one ACPAT Chartered Physiotherapist and 22 horses. The order of palpation was randomly applied for each test and each experimenter.
Results: Manual palpation showed excellent inter-rater reliability with no significant differences between scores (p=0.64; ICC 90.0%). PA (p=0.002) and FFS (p=0.025) scores significantly differed between experimenters. Intra-rater testing showed significant differences (p=0.014) with horses increasing sensitivity over repeated PA measures. The FFS showed no significant differences (p=0.347; ICC 94.7%) in repeated measures with excellent reliability and consistency.
Conclusions: PA showed a lack of consistency in intra-rater reliability conflicting with 34 previous research findings, whereas the FFS showed greater reliability in comparison, however, it proved difficult to use in clinical practice. Manual palpation by physiotherapists was shown to have excellent inter-rater reliability when using a categorical scoring system.
Original languageEnglish
JournalJournal of Equine Veterinary Science
Publication statusAccepted/In press - 18 Oct 2019

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Palpation
chest
Horses
Thorax
horses
Pressure
Physical Therapists
nociception
Nociception
testing
Back Pain
tissues
pain
methodology
Research

Cite this

@article{070e6700480c4ab693b1780c93238b5b,
title = "Inter and Intra-Rater Reliability of Soft Tissue Palpation Scoring in the Equine Thoracic Epaxial Region.",
abstract = "Abstract Background: Back pain is a significant factor for horses and is challenging for professionals to diagnose, with assessment frequently utilising subjective tools such as manual palpation. Reliable and valid objective measures are required and pressure algometry (PA) has been investigated as an assessment tool, however it has limitations and other more realistic methods may be better suited for the task. Objectives: To establish inter- and intra-rater reliability for PA, Flexiforce Sensor (FFS) and Manual Palpation for equine epaxial soft tissue, measuring mechanical nociception threshold responses. Methods: In group 1, ten horses underwent three repeated tests with PA and FFS, and once for manual palpation, with three ACPAT Chartered Physiotherapists in the right thoracic epaxial region. Group 2 followed the same protocol using one ACPAT Chartered Physiotherapist and 22 horses. The order of palpation was randomly applied for each test and each experimenter. Results: Manual palpation showed excellent inter-rater reliability with no significant differences between scores (p=0.64; ICC 90.0{\%}). PA (p=0.002) and FFS (p=0.025) scores significantly differed between experimenters. Intra-rater testing showed significant differences (p=0.014) with horses increasing sensitivity over repeated PA measures. The FFS showed no significant differences (p=0.347; ICC 94.7{\%}) in repeated measures with excellent reliability and consistency.Conclusions: PA showed a lack of consistency in intra-rater reliability conflicting with 34 previous research findings, whereas the FFS showed greater reliability in comparison, however, it proved difficult to use in clinical practice. Manual palpation by physiotherapists was shown to have excellent inter-rater reliability when using a categorical scoring system.",
author = "Megan Merrifield-Jones and Gillian Tabor and Jane Williams",
year = "2019",
month = "10",
day = "18",
language = "English",
journal = "Journal of Equine Veterinary Science",
issn = "0737-0806",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Inter and Intra-Rater Reliability of Soft Tissue Palpation Scoring in the Equine Thoracic Epaxial Region.

AU - Merrifield-Jones, Megan

AU - Tabor, Gillian

AU - Williams, Jane

PY - 2019/10/18

Y1 - 2019/10/18

N2 - Abstract Background: Back pain is a significant factor for horses and is challenging for professionals to diagnose, with assessment frequently utilising subjective tools such as manual palpation. Reliable and valid objective measures are required and pressure algometry (PA) has been investigated as an assessment tool, however it has limitations and other more realistic methods may be better suited for the task. Objectives: To establish inter- and intra-rater reliability for PA, Flexiforce Sensor (FFS) and Manual Palpation for equine epaxial soft tissue, measuring mechanical nociception threshold responses. Methods: In group 1, ten horses underwent three repeated tests with PA and FFS, and once for manual palpation, with three ACPAT Chartered Physiotherapists in the right thoracic epaxial region. Group 2 followed the same protocol using one ACPAT Chartered Physiotherapist and 22 horses. The order of palpation was randomly applied for each test and each experimenter. Results: Manual palpation showed excellent inter-rater reliability with no significant differences between scores (p=0.64; ICC 90.0%). PA (p=0.002) and FFS (p=0.025) scores significantly differed between experimenters. Intra-rater testing showed significant differences (p=0.014) with horses increasing sensitivity over repeated PA measures. The FFS showed no significant differences (p=0.347; ICC 94.7%) in repeated measures with excellent reliability and consistency.Conclusions: PA showed a lack of consistency in intra-rater reliability conflicting with 34 previous research findings, whereas the FFS showed greater reliability in comparison, however, it proved difficult to use in clinical practice. Manual palpation by physiotherapists was shown to have excellent inter-rater reliability when using a categorical scoring system.

AB - Abstract Background: Back pain is a significant factor for horses and is challenging for professionals to diagnose, with assessment frequently utilising subjective tools such as manual palpation. Reliable and valid objective measures are required and pressure algometry (PA) has been investigated as an assessment tool, however it has limitations and other more realistic methods may be better suited for the task. Objectives: To establish inter- and intra-rater reliability for PA, Flexiforce Sensor (FFS) and Manual Palpation for equine epaxial soft tissue, measuring mechanical nociception threshold responses. Methods: In group 1, ten horses underwent three repeated tests with PA and FFS, and once for manual palpation, with three ACPAT Chartered Physiotherapists in the right thoracic epaxial region. Group 2 followed the same protocol using one ACPAT Chartered Physiotherapist and 22 horses. The order of palpation was randomly applied for each test and each experimenter. Results: Manual palpation showed excellent inter-rater reliability with no significant differences between scores (p=0.64; ICC 90.0%). PA (p=0.002) and FFS (p=0.025) scores significantly differed between experimenters. Intra-rater testing showed significant differences (p=0.014) with horses increasing sensitivity over repeated PA measures. The FFS showed no significant differences (p=0.347; ICC 94.7%) in repeated measures with excellent reliability and consistency.Conclusions: PA showed a lack of consistency in intra-rater reliability conflicting with 34 previous research findings, whereas the FFS showed greater reliability in comparison, however, it proved difficult to use in clinical practice. Manual palpation by physiotherapists was shown to have excellent inter-rater reliability when using a categorical scoring system.

M3 - Journal Article

JO - Journal of Equine Veterinary Science

JF - Journal of Equine Veterinary Science

SN - 0737-0806

ER -