The science of spinal motion palpation

Spinal motion palpation (SMP) is a standard element of a manual therapy examination despite its reliability being uncertain. The research available at this time is not conclusive as to the relevance of the findings from SMP, as regards the patient’s pain complaints. Differences in the testing methods and interpretation of spinal mobility testing are problematic. If SMP is to be a meaningful component of a spinal examination, the methods for testing and interpretation must be examined with great scrutiny. The authors aim in this narrative review was to facilitate a better understanding of how SMP should provide the examiner with relevant information for assessment and treatment of patients with spinal pain disorders. The concept of just noticeable difference is presented and applied to SMP as a suggestion for determining the neutral zone behavior of a spinal segment. In addition, the use of a lighter, or more passive receptive palpation technique, is considered as a means for increasing tactile discrimination of spinal movement behavior. Further understanding of the scientific basis of testing SMP may improve intra- and inter-examiner reliability.

They concluded that significance of the findings from SMP should be considered in context of the patient’s functional problem. Methodological changes may be indicated for the performance of SMP techniques, such as central posterior-anterior (PA) pressure and passive intervertebral motion tests, in order to improve reliability. They added that instructors of manual therapy involved in teaching SMP should have thorough knowledge of the neurophysiological processes of touch sensation so that they might advise students in the application of the various testing techniques most effectively.