Index to Chiropractic Literature
Index to Chiropractic Literature
My ICL     Sign In
Saturday, July 13, 2024
Index to Chiropractic LiteratureIndex to Chiropractic LiteratureIndex to Chiropractic Literature

For best results switch to Advanced Search.
Article Detail
Return to Search Results
ID 25772
  Title Clinicians' ability to detect a palpable difference in spinal stiffness compared with a mechanical device
Journal J Manipulative Physiol Ther. 2019 Feb;42(2):89-95
Peer Review Yes
Publication Type Article

OBJECTIVE: The purpose of this study was to quantify the threshold at which clinicians can detect a difference in spinal stiffness of the thoracic and lumbar spine via palpation and then determine if this detection threshold would affect a clinician's ability to identify changes in spinal stiffness as measured by an objective instrument.

METHODS: In this study, the threshold at which a change in spinal stiffness was detected was quantified in 12 experienced clinicians (physical therapists and doctors of chiropractic) by changing the differential stiffness in 2 inflatable targets until the clinician could no longer identify which was stiffer. In the second part of the study, clinicians then were asked to palpate pre-identified pairs of vertebrae in an asymptomatic volunteer and to identify the stiffer of the pair (T7 and L3, T7 and L4, L3 and L4), and the biomechanical stiffness of each vertebral pair was quantified objectively by a validated instrument.

RESULTS: The mean stiffness detection threshold for the clinicians was 8%. Objective measurement of the stiffness differential between vertebral pairs was 30% for T7* and L3, 20% for T7* and L4, and 10% for L3* and L4 (*denotes the stiffer of the pair). Ten of 12 clinicians correctly identified T7 as stiffer when compared with L3 and T7 as stiffer than L4. Alternatively, when the differential vertebral pair stiffness was similar to the stiffness detection threshold (~8%), clinicians were less successful in identifying the stiffer vertebra of the pair; 4 of 12 clinicians correctly identified L3 as being stiffer compared with L4.

CONCLUSION: These results suggest that the physiological limits of human palpation may limit the ability of clinicians to identify small alterations in spine stiffness.

Author keywords: Palpation, Manipulation, Spinal, Spine, Chiropractic, Physical Therapy Modalities

Author affiliations: GNK: Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada; SM: Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; IP: Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada; MS: Sydney Medical School, University of Sydney, Sydney, Australia; DDC: Department of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; MF: AECC University College, Bournemouth, England; AW: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong

This abstract is reproduced with the permission of the publisher; full text is available by subscription. Click on the above link and select a publisher from PubMed's LinkOut feature.


   Text (Citation) Tagged (Export) Excel
Email To
HTML Text     Excel

To use this feature you must register a personal account in My ICL. Registration is free! In My ICL you can save your ICL searches in My Searches, and you can save search results in My Collections. Be sure to use the Held Citations feature to collect citations from an entire search session. Read more search tips.

Sign Into Existing My ICL Account    |    Register A New My ICL Account
Search Tips
  • Enclose phrases in "quotation marks".  Examples: "low back pain", "evidence-based"
  • Retrieve all forms of a word with an "asterisk*", also called a wildcard or truncation.  Example: "chiropract*" retrieves chiropractic, chiropractor, chiropractors
  • Register an account in My ICL to save search histories (My Searches) and collections of records (My Collections)
Advanced Search Tips