Reliability of Spinal Palpation for Diagnosis of Back and Neck Pain

Seffinger, Michael A.; Najm, Wadie I.; Mishra, Shiraz I.; Adams, Alan H.; Dickerson, Vivian M; Murphy, Linda S; Reinsch, Sibylle

doi:10.1097/01.brs.0000141178.98157.8e

Cited by 282 publications

(181 citation statements)

References 51 publications

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“…Tests of joint-mobility are considered an important tool in physical therapy and manual therapy, but it seems difficult to obtain good inter-examiner agreement, most probably because the tests are based on palpation. The results of the tests for TMJ-mobility in the present study are slightly better than what have been reported on palpation tests for other joints/structures [22][23][24][25]. Robinson and co-workers (2009) found poor to moderate inter-tester reliability on palpation tests for identifying the spinous processes of C7 and L5.…”

Section: Functional Testscontrasting

confidence: 49%

“…Robinson and co-workers (2009) found poor to moderate inter-tester reliability on palpation tests for identifying the spinous processes of C7 and L5. The same group also found poor reliability for the joint-play test for the sacroiliac joint [23]. Generally, joint-mobility tests involving palpation seem to have lower reliability than pain provocation tests, and it has been hypothesized that this might depend on the experience and skills of the assessors [25,26].…”

Section: Functional Testsmentioning

confidence: 96%

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Inter-tester reliability of selected clinical tests for long-lasting temporomandibular disorders

Julsvoll

Vøllestad

Opseth

et al. 2017

Journal of Manual & Manipulative Therapy

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Section: Functional Testscontrasting

confidence: 49%

Section: Functional Testsmentioning

confidence: 96%

Inter-tester reliability of selected clinical tests for long-lasting temporomandibular disorders

Julsvoll

Vøllestad

Opseth

et al. 2017

Journal of Manual & Manipulative Therapy

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“…Systematic reviews have previously addressed the reliability of some palpatory tests; [17][18][19] however, the studies within the systematic reviews are difficult to compare because of variations in testing technique and interpretation, as well as in the methodological approaches used. In our study, the values for k and k w showed unsatisfactory agreement, both within and between observers, for the palpatory test investigated.…”

Section: Discussionmentioning

confidence: 99%

Inter- and Intra-observer Agreement of the Motion Palpation Test for Lumbar Vertebral Rotational Asymmetry

Bracht

Nunes

Celestino

et al. 2015

Physiotherapy Canada

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Purpose: To investigate inter-and intra-observer agreement in the assessment of lumbar vertebral rotational (VR) asymmetry by a motion palpation test. Methods: For this prospective and descriptive test-retest study, 51 asymptomatic participants (40 women, 11 men; mean age 23.3 [SD 5.6] years) were recruited from the community. Each participant was assessed in two sessions by the same three observers, who assessed VR by means of a palpatory test for movement asymmetry. This test is performed by applying posteroanterior pressure in an alternating manner to the left and right transverse processes of a vertebra to determine motion asymmetry in the transverse plane and thus the vertebral position. Observers classified the vertebral position as neutral, rotation to the right, and rotation to the left; they were blinded to which participant was being assessed and to any previous results. Results: Intra-and inter-observer agreement was verified by the kappa coefficient (k) and the weighted kappa coefficient (k w ). Values of k and k w varied from 0.07 (95% CI, À0.10 to 0.245) to 0.37 (95% CI, 0.11-0.63) for intra-observer agreement and from 0.12 (95% CI, À0.06 to 0.29) to 0.30 (95% CI, 0.08-0.52) for inter-observer agreement. Conclusion: The motion palpation test used to assess VR asymmetry has low agreement levels; therefore, its clinical significance for measuring vertebral position is questionable.Key Words: lumbar vertebrae; motion palpation test; reproducibility of results; spine. RÉ SUMÉObjet: Analyser la convergence interobservateurs et intra-observateur dans l'é valuation de l'asymé trie de la rotation des vertè bres (RV) lombaires par palpation du mouvement. Mé thodes: Pour cette é tude test-retest prospective et descriptive, on a recruté dans la communauté 51 participants asymptomatiques (40 femmes, 11 hommes; â ge moyen de 23,3 [ET de 5,6] ans). Les trois mê mes observateurs ont é valué chaque participant au cours de deux sé ances et dé terminé la RV par palpation afin de dé terminer l'asymé trie du mouvement. On pratique ce test en appliquant une pression anté rieure en alternance sur les apophyses transverses gauche et droite d'une vertè bre afin de dé terminer l'asymé trie du mouvement dans le plan transversal et, par consé quent, la position de la vertè bre. Les observateurs ont classé la position de la vertè bre comme neutre, en rotation vers la droite et en rotation vers la gauche. Ils ne savaient pas quel participant é tait é valué et ne connaissaient pas les ré sultats anté rieurs. Ré sultats: On a vé rifié la convergence interobservateurs et intra-observateur au moyen du coefficient kappa (k) et du coefficient kappa pondé ré (k p ). Les valeurs de k et k p ont varié de 0,07 (IC à 95% de 0,10 à 0,245) à 0,37 (IC à 95% de 0,11 à 0,63) dans le cas de la convergence intra-observateur et de 0,12 (IC à 95% de À0,06 à 0,29) à 0,30 (IC à 95% de 0,08 à 0,52) dans celui de la convergence interobservateurs. Conclusion: La palpation du mouvement utilisé e pour é valuer l'asymé trie de la RV produit de fa...

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“…83 The diagnostic reliability of many of the indicators of somatic dysfunction is poor. [84][85][86] Palpation of tenderness has acceptable inter-examiner reliability, but reliability for palpation of segmental motion restriction or tissue texture changes is generally poor. [84][85][86] The reliability for assessment of asymmetrical bony landmarks is fair to poor, 87 unless substantial asymmetry exists.…”

Section: Diagnostic Reliability and Validitymentioning

confidence: 99%

Somatic dysfunction: An osteopathic conundrum

Fryer

2016

International Journal of Osteopathic Medicine

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Somatic dysfunction is considered a central concept for the theory and practice of osteopathy, but its relevance to the modern profession is questionable due to its unclear pathophysiology and poor reliability of detection. This article will explore the factors that may produce clinical signs attributed to somatic dysfunction and discuss the plausibility of the concept. A conceptual model is presented for the clinical diagnostic cues attributed to intervertebral somatic dysfunction, where signs of dysfunction arise from tissue and neurological factors related by a cycle of tissue injury and nociceptive-driven functional changes. Finally, the relevance of the concept of somatic dysfunction to the modern osteopathic profession is discussed and recommendations for the osteopathic profession are made.

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Reliability of Spinal Palpation for Diagnosis of Back and Neck Pain

Abstract: The quality of the research on interreliability and intrareliability of spinal palpatory diagnostic procedures needs to be improved. Pain provocation tests are most reliable. Soft tissue paraspinal palpatory diagnostic tests are not reliable.

Cited by 282 publications

References 51 publications

Inter-tester reliability of selected clinical tests for long-lasting temporomandibular disorders

Inter-tester reliability of selected clinical tests for long-lasting temporomandibular disorders

Inter- and Intra-observer Agreement of the Motion Palpation Test for Lumbar Vertebral Rotational Asymmetry

Somatic dysfunction: An osteopathic conundrum

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