Journal of Osteopathic Medicine, 2001/04, 4(1):15-20. doi: 10.1016/S1443-8461(01)80039-3, type of study: ,irs,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.sciencedirect.com/science/article/pii/S1443846101800393)

Keywords:

diagnosis [412]
inter-examiner reliability [19]
controlled clinical trial [324]
palpation [217]
thoracic spine [98]

Abstract:

Motion palpation is an assessment tool utilised by the majority of manual medicine practitioners as an aid in the diagnosis and treatment of spinal dysfunction. However, the clinical usefulness of motion palpation is in doubt with the majority of scientific evidence suggesting that it is an unreliable examination tool. Manual therapists are now posed with the problem of adopting other more reliable assessment procedures. The aim of this study was to examine the inter-examiner reliability of Johnston & Friedman's thoracic spinal percussion scan. Ten examiners performed the percussion scan once on each of the 19 asymptomatic male subjects, resulting in 190 assessments in total. Analysis yielded 'slight' inter-examiner reliability (k = 0.07) significant at the 0.01 level. This result suggests that the reliability of this examination procedure used in isolation remains questionable. Further research is required before it can be relied upon as an accurate indicator of altered tissue tension. It is suggested that the reliability of this procedure should be investigated in association with other portions of the Johnston & Friedman 'screen, scan, segmental definition' approach, together with other commonly used osteopathic examination techniques such as palpation of asymmetry and motion restriction in an attempt to improve inter-examiner reliability in identifying areas of spinal dysfunction.