MOTION PALPATION
Essential Literature
CRITERION VALIDITY OF MANUAL ASSESSMENT OF SPINAL STIFFNESS
Koppenhaver et. al 2014
Conclusion:
This study showed fair to substantial reliability for the individual motion palpation or pain provocation tests. Our data demonstrated moderate to substantial intra- and inter-examiner reliability for clusters of motion palpation or pain provocation tests. Considering excellent reliability for composites of motion palpation together with pain provocation tests from this study, it seems that composites of them could be used as a reliable method for SIJ assessment in clinical practice.
DOES INTER-VERTEBRAL RANGE OF MOTION INCREASE AFTER SPINAL MANIPULAITON?
Branney et. al 2014
Conclusion:
This study found no differences in cervical sagittal IVRoM between patients with mild non-specific neck pain and matched healthy controls and motion palpation over-estimated the prevalence of hypomobile segments. There was, however, a modest positive relationship between the number of spinal manipulations given and detectable increases in sagittal segmental IV-RoM. The patient-reported outcomes of spinal manipulation were not related to this, nor was there any relationship between increase in range and improvement in pain and disability, even though these improvements were generally large.
INTEREXAMINER RELIABILITY OF CERVICAL MOTION PALPATION USING CONFIDENCE LEVELS
Cooperstein et. al 2013
Conclusion:
The palpators in this study of cervical end-feel MP exhibited good interexaminer agreement, with findings generally within one level of each other, despite having used industry- standard methods that previous studies had found mostly unreliable. Examiner confidence levels seemed to have a modest impact on the reliability of cervical spine motion palpation.
INVESTIGATION OF COUPLED BENDING OF THE LUMBAR SPINE DURING DYNAMIC AXIAL ROTATION OF THE BODY
Shin et.al 2013
Conclusion:
This study demonstrated that a dynamic lumbar axial rotation coupling with lateral bendings is segment-dependent and can create a coordinated dynamic coupling to maintain the global dynamic balance of the body. The results could improve our understanding of the normal physiologic lumbar axial rotation and to establish guidelines for diagnosing pathological lumbar motion.
INTEREXAMINER RELIABILITY OF THORACIC MOTION PALPATION USING CONFIDENCE LEVELS
Cooperstein et. al 2009
Conclusion:
When each examiner was “very confident” as to the most fixated thoracic segment, the levels they identified were very close. This corresponds to “good” agreement, an uncommon result in most interexaminer motion palpation studies. Thus, the confidence level of examiners had an effect on the interexaminer reliability of thoracic spine.
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MOTION PALPATION AND PAIN PROVICATION TESTS FOR SACROILIAC JOINT
Arab AM et. al. 2009
Conclusion:
This study showed fair to substantial reliability for the individual motion palpation or pain provocation tests. Our data demonstrated moderate to substantial intra- and inter-examiner reliability for clusters of motion palpation or pain provocation tests. Considering excellent reliability for composites of motion palpation together with pain provocation tests from this study, it seems that composites of them could be used as a reliable method for SIJ assessment in clinical practice.
MOTION PALPATION USED AS A POST-MANIPULATION ASSESSMENT TOOL
Lakhani et. al. 2009
Conclusion:
The findings of this study showed that motion palpation of end-feel assessment appears to be a responsive postmanipulation assessment tool in the cervical spine for determining whether perceived motion restriction found before treatment improves after SMT. This observation may be limited to symptomatic participants.
COUPLING BEHAVIOR OF THE THORACIC SPINE
Sizer et. al. 2007
Conclusion:
Findings suggest that the coupling of the thoracic spine is inconsistent and, if used in clinical reasoning and methodology, may merit specific segmental testing. More rigorous, in vivo investigations are needed to evaluate the coupling pattern of the thoracic spine in symptomatic subjects prepositioned in both thoracic flexion and extension. Present studies on coupling behavior may yield some useful information, but clinicians need to recognize that not all individuals will display the same mechanical behaviors.
COUPLING BEHAVIOR OF THE CERVICAL SPINE
Cook et. al. 2006
Conclusion:
These findings suggest that use of 3-dimensional analyzed cervical coupling patterns for the lower cervical vertebral during apposition and treatment application may show clinical use for manual clinicians. The use of directional coupling based on 2-dimensional cervical coupling patterns or upper cervical spine coupling that addresses C1-2 should be questioned.
AN INVESTIGATION INTO THE VALIDITY OF CERVICAL MOTION PALPATION
Humphreys et. al. 2004
Conclusion:
This study indicates that relatively inexperienced examiners are capable of correctly identifying inter-segmental fixations (CBV) in the cervical spine using 2 commonly employed motion palpation tests. The use of a ‘gold standard’ (Congenital Block Vertebrae) in this study and the substantial agreement achieved lends support to the validity of motion palpation in detecting major spinal fixation
EFFICACY OF CERVICAL ENDPLAY ASSESSMENT AS AN INDICATOR FOR SMT
Haas et. al. 2003
Conclusion:
Endplay assessment in and of itself did not contribute to the same-day pain and stiffness relief observed in neck pain patients receiving spinal manipulation. The impact on a longer course of treatment remains to be investigated. The data suggest that pain modulation may not be limited to mechanisms associated with manipulation of putative motion restrictions.