Auger et al., J Spine 2015, 4:4 DOI: 10.4172/2165-7939.1000245 Research Article Open Access Volume 4 • Issue 4 • 1000245 J Spine, an open access journal ISSN: 2165-7939 Intra and Inter Examiner Reliability Study for the Characteristics of Evaluation of the SA201 Francois Auger 1 , Alain Steve Comtois 2 and Richard ROY 3 1 Chiropractor, 378 rue Chef Max Gros-Louis, Wendake, Québec, G0A 4V0, Canada 2 Head of the Kinanthropology department, Faculty of Sciences, Université du Québec à Montréal 141 avenue du Président-Kennedy, Local SB-4290, Montréal, Québec, H2X 1Y4, Canada 3 Chiropractor, 7655 Boul. Newman, Montréal, Québec, H8N 1X7, Canada Abstract Introduction: There is no published account of the reliability of the percussion technology on human participants. Our goal was to measure the reliability of the instrument’s analysis protocol on an inert substance and on human participants with expert and novice evaluators. Method: 15 participants were evaluated by six evaluators, three experienced and three novices. Results: No participants were excluded from the analysis, based on the NDI, ODI and BMI. Even if the global result from the durometer testing were surprising in their range, the effect size score for the pre and post value on the durometer indicate very good reliability. Conclusion: The intra-evaluator reliability is very good when testing on the durometer but less predominant when evaluating the participant. In addition a novice chiropractor can use the instrument with a certain degree of ability that will develop over time if he uses this technology on a regular basis. Keywords: Chiropractic; Spinal manipulation; Percussion; Examination Introduction Te introduction of tools to assist chiropractors in the treatment of spinal dysfunctions started in 1910 with radiology and was followed in 1913 with the frst pneumatic percussion [1]. Te ancestor of contemporary instrumentation utilization in chiropractic was born. Te SA201 (Sigma Instruments Inc. (Crawnberry Township, Pennsylvania, USA) is homologated in Canada, by Health Canada. Te SA201 has an analysis and a treatment function. In this study only the analysis portion was analysed. Te SA201 technology is based on tissue resonance properties that stipulate that tissue vibration is a scientifc measurable entity [2-6]. Te piezoelectric sensor of the SA201 device relays the analog data to be transformed into digital data that is presented onto a computer screen. In the literature the piezoelectric sensor has been utilized as a non- invasive tool to study bone dynamic movement [7] (Figures 1 and 2). Te wavelength corresponds to the frequency of the area under investigation. In the SA201 the ideal frequency for the spine is considered to be between 45 and 55 Hz with an average around 48 Hz [2] (Figure 3). Te height of the wavelength corresponds to the resistance to movement in the area evaluated. Te ideal resistance based on a duromètre 40 [3] would be situated between 15 and 25. Finally, Sigma Inc. concluded from their in house studies [2,3] that; the precision of the analysis of the instrument was at 99.62% reproducible, there was an evaluator error of 3.3% and that repeat factor created an augmentation of the mobility and once this factor was corrected the inter-evaluator precision was 94.8%. Te literature review on clinical studies in relation to the SA201 is limited to three published studies and the literature on the analysis protocol of the SA201 is limited to the in house studies from the manufacturer [8-10]. Tere is no published account of the reliability of this technology on an inert substance like the durometer 40 or on human participants. Our goal was to measure the reliability of the *Corresponding author: Dr Francois Auger DC MSc, Chiropractor, 378 rue Chef Max Gros-Louis, Wendake, Québec, G0A 4V0, Canada, Tel: +1 418- 454-6393; E-mail: drfrankauger@gmail.com Received July 17, 2015; Accepted August 06, 2015; Published August 08, 2015 Citation: Auger F, Comtois AS, Roy R (2015) Intra and Inter Examiner Reliability Study for the Characteristics of Evaluation of the SA201. J Spine 4: 245. doi:10.4172/21657939.1000245 Copyright: © 2015 Auger F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. instrument’s analysis protocol on an inert substance and on human participants with expert and novice evaluators. Methods Participants 15 adult participants were selected. Tey received an information session where it was explained what was expected of them before and during the experimentation. A research consent form was explained and signed by each participant. Te sample size was based on previous studies from the literature [11,12]. Inclusion criteria were: adult between the age of 18 and 65, in good health. Exclusion criteria were: a score above 40% on the Oswestry disability index (ODI) and a score above 48% on the neck disability index (NDI) on the day of the experimentation; presentation of asymmetric range of motion of more than 10 degrees or uncomfortable pain either in the cervical or lumbar region on the day of the experimentation and fnally a body mass index (BMI) superior to 40. All participants were evaluated by a licensed chiropractor. Te French ODI (version 2) used was validated by Baker et al. [13]. Te scoring is presented as a percentage of disability [14]. Te NDI is scored in the same way [15]. And the French version was validated by Wlodyka et al. [16]. Te head of the instrument was at an approximate angle of 45 degrees and the entire spine was evaluated. Te only variant was the J o u r n a l o f S p i n e ISSN: 2165-7939 Journal of Spine