Comparison of Concordance between Chuna Manual Therapy Diagnostic Methods (Palpation, X-ray, Artificial Intelligence Program) in Lumbar Spine: An Exploratory, Cross-Sectional Clinical Study

Abstract

Before Chuna manual therapy (CMT), a manual therapy applied in Korean medicine, CMT spinal diagnosis using palpation or X-ray is performed. However, studies on the inter-rater concordance of CMT diagnostic methods, concordance among diagnostic methods, and standard CMT diagnostic methods are scarce. Moreover, no clinical studies have used artificial intelligence (AI) programs for X-ray image-based CMT diagnosis. Therefore, this study sought a feasible and standard CMT spinal diagnostic method and explored the clinical applicability of the CMT-AI program. One hundred participants were recruited, and the concordance within and among different diagnostic modalities was analyzed by dividing them into manual diagnosis (MD), X-ray image-based diagnosis (XRD) by experts and non-experts, and XRD using a CMT-AI program by non-experts. Regarding intra-group concordance, XRD by experts showed the highest concordance (used as a gold standard when comparing inter-group concordance), followed by XRD using the AI program, XRD by non-experts, and then MD. Comparing diagnostic results between the groups, concordance with the gold standard was the highest for XRD using the AI program, followed by XRD by non-experts, and MD. Therefore, XRD is a more reasonable CMT diagnostic method than MD. Furthermore, the clinical applicability of the CMT-AI program is high.

Failed back surgery syndrome successfully ameliorated with Chiropractic Biophysics^® structural rehabilitation improving pain, disability as well as sagittal and coronal balance: a Chiropractic Biophysics^® case report with a 6 year follow-up

“…This case demonstrates that surgical and non-surgical treatments should focus on improving the altered loads on pain sensitive tissues of the spine and surrounding structures by improving coronal and sagittal imbalance and reducing abnormal intervertebral segmental angles and segmental translations. Reducing these loads have been the focus of many recent studies on ASD and pre-treatment diagnostics show that the criterion standard of upright radiographs are crucial in determining the surgical and non-surgical approach to care 29 , 30 , 31 , 32 ) .…”

The Subjective and Objective Improvement Using Chiropractic Biophysics® Protocols

“…It is important to appreciate that spine radiography with a high-quality structural analysis EMR is critical in order to properly diagnose a patient's biomechanical condition, enable better differential diagnosis, and provide feedback on treatment progress [31][32][33][34][35]. Indeed, X-ray diagnosis is more accurate than non-radiographical diagnosis [36]; this is obviously more important for patients having a history of spine surgery.…”