Reliability and validity of manual palpation for the assessment of patients with low back pain: a systematic and critical review

P.S. Nolet*, H.N. Yu, P. Cote, A.L. Meyer, V.L. Kristman, D. Sutton, K. Murnaghan, N. Lemeunier

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

3 Citations (Web of Science)

Abstract

Background Static or motion manual palpation of the low back is commonly used to assess pain location and reproduction in low back pain (LBP) patients. The purpose of this study is to review the reliability and validity of manual palpation used for the assessment of LBP in adults. Method We systematically searched five databases from 2000 to 2019. We critically appraised internal validity of studies using QAREL and QUADAS-2 instruments. We stratified results using best-evidence synthesis. Validity studies were classified according to Sackett and Haynes. Results We identified 2023 eligible articles, of which 14 were low risk of bias. Evidence suggests that reliability of soft tissue structures palpation is inconsistent, and reliability of bony structures and joint mobility palpation is poor. We found preliminary evidence that gluteal muscle palpation for tenderness may be valid in differentiating LBP patients with and without radiculopathy. Conclusion Reliability of manual palpation tests in the assessment of LBP patients varies greatly. This is problematic because these tests are commonly used by manual therapists and clinicians. Little is known about the validity of these tests; therefore, their clinical utility is uncertain. High quality validity studies are needed to inform the clinical use of manual palpation tests.
Original languageEnglish
Article number33
Number of pages20
JournalChiropractic and Manual Therapies
Volume29
Issue number1
DOIs
Publication statusPublished - 26 Aug 2021

Keywords

  • Manual palpation
  • Reliability
  • Validity
  • Assessment
  • Low back pain
  • Systematic review
  • INTERRATER RELIABILITY
  • INTEREXAMINER RELIABILITY
  • PROVOCATION TESTS
  • MOTION PALPATION
  • DIAGNOSTIC-ACCURACY
  • SPINAL PALPATION
  • GLOBAL BURDEN
  • EXAMINER RELIABILITY
  • PHYSICAL-EXAMINATION
  • TRIGGER POINTS

Cite this