TY - JOUR
T1 - Manual examination of the spine
T2 - a systematic critical literature review of reproducibility
AU - Stochkendahl, Mette Jensen
AU - Christensen, Henrik Wulff
AU - Hartvigsen, Jan
AU - Vach, Werner
AU - Haas, Mitchell
AU - Hestbaek, Lise
AU - Adams, Alan
AU - Bronfort, Gert
PY - 2006/1/1
Y1 - 2006/1/1
N2 - Objective: Poor reproducibility of spinal palpation has been reported in previously published literature, and authors of recent reviews have posted criticism on study quality. This article critically analyzes the literature pertaining to the inter- and intraobserver reproducibility of spinal palpation to investigate the consistency of study results and assess the level of evidence for reproducibility. Methods: Systematic review and meta-analysis were performed on relevant literature published from 1965 to 2005, identified using the electronic databases MEDLINE, MANTIS, and CINAHL and checking of reference lists. Descriptive data from included articles were extracted independently by 2 reviewers. A 6-point scale was constructed to assess the methodological quality of original studies. A meta-analysis was conducted among the high-quality studies to investigate the consistency of data, separately on motion palpation, static palpation, osseous pain, soft tissue pain, soft tissue changes, and global assessment. A standardized method was used to determine the level of evidence. Results: The quality score of 48 included studies ranged from 0% to 100%. There was strong evidence that the interobserver reproducibility of osseous and soft tissue pain is clinically acceptable (κ ≥ 0.4) and that intraobserver reproducibility of soft tissue pain and global assessment are clinically acceptable. Other spinal procedures are either not reproducible or the evidence is conflicting or preliminary.
AB - Objective: Poor reproducibility of spinal palpation has been reported in previously published literature, and authors of recent reviews have posted criticism on study quality. This article critically analyzes the literature pertaining to the inter- and intraobserver reproducibility of spinal palpation to investigate the consistency of study results and assess the level of evidence for reproducibility. Methods: Systematic review and meta-analysis were performed on relevant literature published from 1965 to 2005, identified using the electronic databases MEDLINE, MANTIS, and CINAHL and checking of reference lists. Descriptive data from included articles were extracted independently by 2 reviewers. A 6-point scale was constructed to assess the methodological quality of original studies. A meta-analysis was conducted among the high-quality studies to investigate the consistency of data, separately on motion palpation, static palpation, osseous pain, soft tissue pain, soft tissue changes, and global assessment. A standardized method was used to determine the level of evidence. Results: The quality score of 48 included studies ranged from 0% to 100%. There was strong evidence that the interobserver reproducibility of osseous and soft tissue pain is clinically acceptable (κ ≥ 0.4) and that intraobserver reproducibility of soft tissue pain and global assessment are clinically acceptable. Other spinal procedures are either not reproducible or the evidence is conflicting or preliminary.
KW - Diagnostic Tests
KW - Literature Review
KW - Meta-Analysis
KW - Palpation
KW - Reproducibility of Results
KW - Spine
UR - http://www.scopus.com/inward/record.url?scp=33747028753&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33747028753&partnerID=8YFLogxK
U2 - 10.1016/j.jmpt.2006.06.011
DO - 10.1016/j.jmpt.2006.06.011
M3 - Review article
C2 - 16904495
AN - SCOPUS:33747028753
VL - 29
SP - 475-485.e10
JO - Journal of Manipulative and Physiological Therapeutics
JF - Journal of Manipulative and Physiological Therapeutics
SN - 0161-4754
IS - 6
ER -