Leach Robert A, Parker Patrick L, Veal Paul S
J Manipulative Physiol Ther. 2003 Oct;26(8):493-501. doi: 10.1016/S0161-4754(03)00106-4.
To provide an entry-level, new technology reliability assessment of the PulStar computer-assisted, differential compliance spinal instrument.
Eighteen college students (9 male and 9 female) were recruited by announcements and personal contacts.
Following approval of the consent process by the Institutional Review Board of Mississippi State University, a PulStar Function Recording and Analysis System (PulStarFRAS) device was evaluated for clinical reliability. Two examiners, blinded from data collection, used the instrument on individual subjects in random order (lying prone with their backs exposed) to administer light impulses (approximately equal to .9 J which produced a 3- to 4-lb force) at each segmental level throughout the cervical, dorsal, and lumbar spine using probe tips spaced 3 cm apart, straddling the spinous processes, while a computer recorded the findings (resistance on a scale of 0 to 25.5 lb force). Data were analyzed by Exploratory Data Analysis (EDA) with analysis of variance (ANOVA) testing and by use of the intraclass correlation coefficient (ICC). In addition, a mean test (ANOVA) was conducted to determine if a trend in variation occurred as a result of repeated light thrusts to the spine, independent of variance explained by different examiners.
Using EDA analysis and ANOVA, intraexaminer reliability for the 2 practitioners was very high but not perfect. This was confirmed by ICC statistics demonstrating good to excellent reliability for both practitioners (0.89 for the experienced practitioner, 0.78 for the newly trained practitioner). Interexaminer reliability of PulStar was similarly very high but not perfect based on EDA/ANOVA analysis and good to excellent (ICC = 0.87).
The PulStar mechanical adjusting device set to analysis mode appears to have good to excellent reliability when used by either an experienced or a novice (but trained) examiner. In addition, as a measure for resistance to a light thrust or spinal compliance, reliability was similarly good to excellent between the 2 doctors using the PulStar instrument.
对PulStar计算机辅助、差异顺应性脊柱器械进行入门级新技术可靠性评估。
通过公告和个人联系招募了18名大学生（9名男性和9名女性）。
在密西西比州立大学机构审查委员会批准同意程序后，对PulStar功能记录与分析系统（PulStarFRAS）设备进行临床可靠性评估。两名对数据收集不知情的检查人员，以随机顺序对个体受试者使用该器械（俯卧位，背部暴露），在颈椎、胸椎和腰椎的每个节段水平，使用间距为3厘米的探头尖端跨棘突施加轻脉冲（约等于0.9焦耳，产生3至4磅力），同时计算机记录结果（阻力范围为0至25.5磅力）。数据通过探索性数据分析（EDA）、方差分析（ANOVA）测试以及组内相关系数（ICC）进行分析。此外，进行均值测试（ANOVA）以确定脊柱反复轻推是否导致变异趋势，而不考虑不同检查人员所解释的方差。
使用EDA分析和ANOVA，两名从业者的检查者内可靠性非常高但并不完美。ICC统计数据证实了两名从业者的可靠性良好至优秀（经验丰富的从业者为0.89，新培训的从业者为0.78）。基于EDA/ANOVA分析，PulStar的检查者间可靠性同样非常高但并不完美，且良好至优秀（ICC = 0.87）。
设置为分析模式的PulStar机械调节装置，无论是经验丰富的检查者还是新手（但经过培训）使用时，似乎都具有良好至优秀的可靠性。此外，作为对轻推阻力或脊柱顺应性的测量，使用PulStar器械的两名医生之间的可靠性同样良好至优秀。
