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Clinicians' Ability to Detect a Palpable Difference in Spinal Stiffness Compared With a Mechanical Device.

Kawchuk, G.N., Miazga, S., Pagé, I., Swain, M., De Carvalho, D., Funabashi, M., Breen, A. C. and Wong, A., 2019. Clinicians' Ability to Detect a Palpable Difference in Spinal Stiffness Compared With a Mechanical Device. Journal of Manipulative and Physiological Therapeutics, 42 (2), 89-95.

Full text available as:

Manuscript - Limits of palpation - REVISED v2 CLEAN.pdf - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.


DOI: 10.1016/j.jmpt.2019.02.002


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.

Item Type:Article
Uncontrolled Keywords:Chiropractic; Manipulation, Spinal; Palpation ; Physical Therapy Modalities; Spine
Group:Faculty of Science & Technology
ID Code:32240
Deposited By: Symplectic RT2
Deposited On:07 May 2019 08:17
Last Modified:14 Mar 2022 14:16


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