Factors affecting confidence and knowledge in spinal palpation among International Manual Physical Therapists

Abstract

Objectives: We sought to find if there was a relationship between the confidence in use of static palpation, passive physiological intervertebral motion (PPIVM) and passive accessory intervertebral motion (PAIVM) and the manual therapist's (MTs) knowledge of the literature on these topics. Methods: We designed an international survey to achieve our objectives. Each skill was surveyed for the cervical, thoracic and lumbar spines. We also included several other factors that we believed might influence the use of these skills. Results: We concluded that familiarity of the literature was significantly associated with a MTs' confidence in the use of static palpation, PPIVM and PAIVM techniques. We also found a relationship with the country of practice of the MT and their confidence using these techniques. Discussion: Spinal palpation is an integral part of the MT's evaluation and treatment abilities. The vast majority of MTs use spinal palpation and nearly all entry-level education programmes include it in their training. Knowing what factors influence MTs' confidence assessing and treating the spine may allow for more effective teaching and training, as well as improved patient outcomes.

Intra- and inter-rater reliability of thoracic spine mobility and posture assessments in subjects with thoracic spine pain

“…However, several studies have found the intra-rater reliability of thoracic spine mobility assessed manually to be at least moderate in symptomatic and asymptomatic subjects [ 19 , 42 – 44 ]. However, the skill of finding the desired spinal segment and identifying it similarly between observers seems to be difficult and unreliable [ 45 ]; there seems to be a great difference between observers [ 40 ], and none of the palpation methods seem to be superior to evaluating thoracic spine mobility manually [ 24 ]. Heiderscheitet et al [ 46 ] reposted in the asymptomatic subjects the intra-rater reliability of PA pressure of the thoracic spine has strong reliability (kappa = 0.61–0.75), whereas in interrater reliability kappa value was lower (0.59).…”

“…In clinical framework, examining spinal range of motion has been an important part of manual therapy practice [23,24]. It has been reported that 98% of manual therapists evaluates passive movement of spinal segments as part of their clinical assessment [24].…”

“…In clinical framework, examining spinal range of motion has been an important part of manual therapy practice [23,24]. It has been reported that 98% of manual therapists evaluates passive movement of spinal segments as part of their clinical assessment [24]. The major deficiency of earlier studies is a small sample size or without sample size calculations, wide variations of palpation protocols and measurement devices, and mostly performed with asymptomatic subjects.…”

Spinal manipulation after multiple fusions in an adult with scoliosis: a case report

“…Further, thrust manipulation (TM) has not been studied in the SF population. In non-surgical populations, there is disagreement regarding the benefit of regional versus specific TM [15,16]. Therefore, the purpose of this case report was to describe how specific TM was used to treat a patient with scoliosis after multilevel SF.…”