Journal of Manipulative and Physiological Therapeutics
Volume 32, Issue 5 , Pages 379-386 , June 2009

A Review of Intraexaminer and Interexaminer Reliability of Static Spinal Palpation: A Literature Synthesis

  • Michael T. Haneline, DC, MPH

      Affiliations

    • Professor, Palmer College of Chiropractic West, San Jose, Calif
    • Corresponding Author InformationSubmit requests for reprints to: Michael T. Haneline, DC, MPH, Professor, 90 E. Tasman Drive, San Jose, CA 95134
    • ,
  • Morgan Young, DC

      Affiliations

    • Instructor, Palmer College of Chiropractic West, San Jose, Calif

Received 25 November 2008 ,Revised 2 January 2009 ,Accepted 12 January 2009.

References 

  1. Hollerwoger D. Methodological quality and outcomes of studies addressing manual cervical spine examinations: a review. Man Ther. 2006;11:93–98
  2. Seffinger MA, Najm WI, Mishra SI, et al. Reliability of spinal palpation for diagnosis of back and neck pain: a systematic review of the literature. Spine. 2004;29:E413–E425
  3. Stochkendahl MJ, Christensen HW, Hartvigsen J, et al. Manual examination of the spine: a systematic critical literature review of reproducibility. J Manipulative Physiol Ther 2006;29:475-85, 85 e1-10.
  4. Maclure M, Willett WC. Misinterpretation and misuse of the kappa statistic. Am J Epidemiol. 1987;126:161–169
  5. Rosner B. In: Fundamentals of biostatistics. 4th ed.. Belmont (Calif): Duxbury Press; 1995;p. 518
  6. Haas M. Statistical methodology for reliability studies. J Manipulative Physiol Ther. 1991;14:119–132
  7. Portney LG, Watkins MP. Foundations of clinical research: applications to practice, 2nd ed. Upper Saddle River (NJ): Prentice Hall; 2000. p. xiv, 768.
  8. Chakraverty R, Pynsent P, Isaacs K. Which spinal levels are identified by palpation of the iliac crests and the posterior superior iliac spines?. J Anat. 2007;210:232–236
  9. Atula TS, Grenman R, Varpula MJ, et al. Palpation, ultrasound, and ultrasound-guided fine-needle aspiration cytology in the assessment of cervical lymph node status in head and neck cancer patients. Head Neck. 1996;18:545–551
  10. Brantingham J, Hubka M, Snyder W, Diballa S, Wilke P, Biedebach D. Interexaminer reliability of palpation for foot and ankle joint tenderness: a pilot study. J Neuromusculoskelet Syst. 1995;3:188–191
  11. Gemmell H, Paydar D, Thiel H. Intra- and interexaminer reliability of certain pelvic palpatory procedures and the sitting flexion test for sacroiliac joint mobility. J Neuromusculoskelet Syst. 1994;2:65–69
  12. Jende A, Peterson CK. Validity of static palpation as an indicator of atlas transverse process asymmetry. Eur J Chiropr. 1997;45:35–42
  13. Hubka MJ. Palpation for spinal tenderness: a reliable and accurate method for identifying the target of spinal manipulation. J Chiropr Tech. 1994;6:5–8
  14. Cooperstein R, Lisi A. Pelvic torsion: anatomic considerations, construct validity, and chiropractic examination procedures. Top Clin Chiropr. 2000;7:38–49
  15. Hart J. Comparison of x-ray listings and palpation listings of the upper cervical spine. J Vertebral Subluxation Res. 2000;4:
  16. Jull G, Bogduk N, Marsland A. The accuracy of manual diagnosis for cervical zygapophysial joint pain syndromes. Med J Aust. 1988;148:233–236
  17. Downey B, Taylor N, Niere K. Can manipulative physiotherapists agree on which lumbar level to treat based on palpation?. Physiotherapy. 2003;89:74–81
  18. Phillips DR, Twomey LT. A comparison of manual diagnosis with a diagnosis established by a uni-level lumbar spinal block procedure. Man Ther. 1996;1:82–87
  19. Sebastian D, Chovvath R. Reliability of palpation assessment in non-neutral dysfunctions of the lumbar spine. Orthop Phys Ther Pract. 2004;16:23–26
  20. Tong HC, Heyman OG, Lado DA, et al. Interexaminer reliability of three methods of combining test results to determine side of sacral restriction, sacral base position, and innominate bone position. J Am Osteopath Assoc. 2006;106:464–468
  21. French SD, Green S, Forbes A. Reliability of chiropractic methods commonly used to detect manipulable lesions in patients with chronic low-back pain. J Manipulative Physiol Ther. 2000;23:231–238
  22. Hawk C, Phongphua C, Bleecker J, et al. Preliminary study of the reliability of assessment procedures for indications for chiropractic adjustments of the lumbar spine. J Manipulative Physiol Ther. 1999;22:382–389
  23. McPartland JM, Goodridge JP. Counterstrain and traditional osteopathic examination of the cervical spine compared. J Bodywork Move Ther. 1997;1:173–178
  24. Tuchin P, Hart C, Johnson C, et al. Interexaminer reliability of chiropractic evaluation for cervical spine problems—a pilot study. Australasian Chiropr Osteopat. 1996;5:23–29
  25. Haig AJ, Moffroid M, Henry S, et al. A technique for needle localization in paraspinal muscles with cadaveric confirmation. Muscle Nerve. 1991;14:521–526
  26. Braun B, Schiffman EL. The validity and predictive value of four assessment instruments for evaluation of the cervical and stomatognathic systems. J Craniomandib Disord. 1991;5:239–244
  27. Drerup B, Hierholzer E. Objective determination of anatomical landmarks on the body surface: measurement of the vertebra prominens from surface curvature. J Biomech. 1985;18:467–474
  28. Geelhoed MA, McGaugh J, Brewer PA, et al. A new model to facilitate palpation of the level of the transverse processes of the thoracic spine. J Orthop Sports Phys Ther. 2006;36:876–881
  29. Karim A, Mukherjee D, Gonzalez-Cruz J, et al. Accuracy of pedicle screw placement for lumbar fusion using anatomic landmarks versus open laminectomy: a comparison of two surgical techniques in cadaveric specimens. Neurosurgery. 2006;59:ONS13–ONS19
  30. Burton AK, Edwards VA, Sykes DA. Invisible skin marking for testing palpatory reliability. J Man Med. 1990;5:27–29
  31. Kim HW, Ko YJ, Rhee WI, et al. Interexaminer reliability and accuracy of posterior superior iliac spine and iliac crest palpation for spinal level estimations. J Manipulative Physiol Ther. 2007;30:386–389
  32. Boline P, Keating J, Brist J, et al. Interexaminer reliability of palpatory evaluations of the lumbar spine. Am J Chiropr Med. 1988;1:5–11
  33. Boline PD, Haas M, Meyer JJ, et al. Interexaminer reliability of eight evaluative dimensions of lumbar segmental abnormality: part II. J Manipulative Physiol Ther. 1993;16:363–374
  34. Christensen HW, Vach W, Vach K, et al. Palpation of the upper thoracic spine: an observer reliability study. J Manipulative Physiol Ther. 2002;25:285–292
  35. Deboer KF, Harmon R, Tuttle CD, et al. Reliability study of detection of somatic dysfunctions in the cervical spine. J Manipulative Physiol Ther. 1985;8:9–16
  36. Hubka MJ, Phelan SP. Interexaminer reliability of palpation for cervical spine tenderness. J Manipulative Physiol Ther. 1994;17:591–595
  37. Keating J, Bergmann T, Jacobs G, et al. Interexaminer reliability of eight evaluative dimensions of lumbar segmental abnormality. J Manipulative Physiol Ther. 1990;13:463–470
  38. Lundberg G, Gerdle B. The relationships between spinal sagittal configuration, joint mobility, general low back mobility and segmental mobility in female homecare personnel. Scand J Rehabil Med. 1999;31:197–206
  39. McCombe PF, Fairbank JC, Cockersole BC, et al. Volvo Award in clinical sciences. Reproducibility of physical signs in low-back pain. Spine. 1989;14:908–918
  40. Paydar D, Thiel H, Gemmell H. Intra- and interexaminer reliability of certain pelvic palpatory procedures and the sitting flexion test for sacroiliac joint mobility and dysfunction. J Neuromusculoskelet Syst. 1994;2:65–69
  41. Strender LE, Lundin M, Nell K. Interexaminer reliability in physical examination of the neck. J Manipulative Physiol Ther. 1997;20:516–520
  42. Strender LE, Sjoblom A, Sundell K, et al. Interexaminer reliability in physical examination of patients with low back pain. Spine. 1997;22:814–820
  43. Van Suijlekom HA, De Vet HC, Van Den Berg SG, et al. Interobserver reliability in physical examination of the cervical spine in patients with headache. Headache. 2000;40:581–586
  44. Viikari-Juntura E. Interexaminer reliability of observations in physical examinations of the neck. Phys Ther. 1987;67:1526–1532
  45. Waddell G, Main CJ, Morris EW, et al. Normality and reliability in the clinical assessment of backache. Br Med J (Clin Res Ed). 1982;284:1519–1523
  46. Billis EV, Foster NE, Wright CC. Reproducibility and repeatability: errors of three groups of physiotherapists in locating spinal levels by palpation. Man Ther. 2003;8:223–232
  47. Binkley J, Stratford PW, Gill C. Interrater reliability of lumbar accessory motion mobility testing. Phys Ther. 1995;75:786–792
  48. Broadbent CR, Maxwell WB, Ferrie R, et al. Ability of anaesthetists to identify a marked lumbar interspace. Anaesthesia. 2000;55:1122–1126
  49. Byfield D, Humphreys K. Intra- and inter-examiner reliability of bony landmark identification in the lumbar spine. Eur J Chiropr. 1992;40:13–17
  50. Downey BJ, Taylor NF, Niere KR. Manipulative physiotherapists can reliably palpate nominated lumbar spinal levels. Man Ther. 1999;4:151–156
  51. Holmgren U, Waling K. Inter-examiner reliability of four static palpation tests used for assessing pelvic dysfunction. Man Ther. 2007;
  52. McKenzie A, Taylor N. Can physiotherapists locate lumbar spinal levels by palpation?. Physiotherapy. 1997;83:235–239
  53. O'Haire C, Gibbons P. Inter-examiner and intra-examiner agreement for assessing sacroiliac anatomical landmarks using palpation and observation: pilot study. Man Ther. 2000;5:13–20
  54. Simmonds M, Kumar S. Health care ergonomics. Part II: location of bony structures by palpation—a reliability study. 11(2):145-151. Int J Ind Ergon. 1993;11:145–151
  55. Collaer JW, McKeough DM, Boissonnault WG. Lumbar isthmic spondylolisthesis detection with palpation: interrater reliability and concurrent criterion-related validity. J Man Manipulative Ther. 2006;14:22–29
  56. Fryer GM, McPherson H, O'Keefe P. The effect of training on the interexaminer and intra-examiner reliability of the seated flexion test and assessment of pelvic anatomical landmarks with palpation. Int J Osteopat Med. 2005;8:131–138
  57. Hart J. Palpation and X-ray of the upper cervical spine: a reliability study. J Vertebral Subluxation Res. 2006;
  58. Potter NA, Rothstein JM. Intertester reliability for selected clinical tests of the sacroiliac joint. Phys Ther. 1985;65:1671–1675
  59. Spring F, Gibbons P, Tehan P. Intra-examiner and inter-examiner reliability of a positional diagnostic screen for the lumbar spine. J Osteopat Med. 2001;4:47–55
  60. Herzog W, Kats M, Symons B. The effective forces transmitted by high-speed, low-amplitude thoracic manipulation. Spine. 2001;26:2105–2110

PII: S0161-4754(09)00118-3

doi: 10.1016/j.jmpt.2009.04.010

Journal of Manipulative and Physiological Therapeutics
Volume 32, Issue 5 , Pages 379-386 , June 2009

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