Reliability and validity of a palpation technique for identifying the spinous processes of C7 and L5

Roar Robinson, Hilde Stendal Robinson, Gustav Bjørke and Alice Kvale

The objective of this study was was to examine inter-tester reliability and validity of two therapists identifying the spinous processes (SP) of C7 and L5, using one predefined surface palpation procedure for each level.  Two manual therapists examined 49 patients aged between 26 and 79 years, 18 were cervical and 31 lumbar patients. An invisible marking pen and ultraviolet light were used, and the findings were compared. X-rays were taken as an objective measure of the correct spinal level.  The best inter-therapist agreement was found for the skin marks. Percentage agreement within 10 mm and 20 mm was 67% and 85%, respectively. The inter-tester reliability for identifying a radiological nominated SP by palpation was found to be poor for C7 and moderate for L5.

The results indicated acceptable inter-therapist surface palpation agreement, but the chosen procedures did not identify the correct SP. This indicates that the procedures are not precise enough.

Manual Therapy, 2009, 14(4), 409-414

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