These ICC results differed from those obtained in our prior thoracic motion palpation
study (12) in which shared examiner confidence was clearly associated with increased interexaminer reliability, and our prior cervical study (13) in which re-analysis of the published data also shows higher agreement with more examiner confidence.
was chosen by about XA of respondents for most/some, while static palpation was chosen most by 12% and some by 4%.
In addition to the context of static spinal palpation, accuracy in identifying spinal levels has also manifested as an issue in the context of motion palpation
, where sometimes the palpators have agreed on the locations of dysfunction, but disagreed on numerating the level.
Possible explanations for the general poor reliability of previous motion palpation
studies have included poor interexaminer spinal level localization leading to possible misreported discrepancies.
Many respondents indicated they AA/O perform a straight leg raise, motion palpation
, Kemp's, and rib springing.
revealed restriction and tenderness at C0-1 on the right, C2-3 on the left, T3-4, and over the third and fourth right costovertebral joints.
Mobilizations of the bones of the wrist, specifically the scaphoid, as it was noted on motion palpation
to have insufficient normal motion, were done to re-establish normal motion of the wrist articulations in an attempt to decrease pressure on the surrounding tendons which lead back to the medial and lateral elbow.
Subtalar motion palpation
also demonstrated limited, although not completely absent, mobility.
(24) Crepitus during chest wall palpation is another common physical exam finding, (24) as well as costovertebral and costotransverse joint restrictions upon joint play assessment (25) and motion palpation
(26,27) similar to that discovered in the current case.
Spinal motion units and extremity joints were adjusted to correct altered motion as determined by motion palpation
, static palpation and joint play analysis.
The doctor might palpate down from where he or she believes the vertebra prominens (VP) is located, according to the common belief that it lies at either C7 or T1 (depending on which level is determined using motion palpation
to be lowest movable segment on extension), or perhaps might palpate up from the level of the iliac crest, according to the common belief that the SP of L4 lines up with the iliac crest.
Several literature reviews have addressed the reliability of spinal and sacroiliac motion palpation
(MP), (1-4) finding that, in general, interexaminer reliability is slight and intraexaminer reliability is moderate.