Table 6

Spinal focus of the study, Reference standard used, Primary outcome, Statistics, and Author's conclusion.

Author (Year)

Spinal Focus

Reference Standard

Primary Outcome

Statistics

Author's Conclusion

Harvey D (1991)

Lumbar spine

Mechanical Model

Detect presence or absence of lumbar spine intersegmental motion restriction

Sensitivity Intern: 53.8%; Practitioner: 47.8%; Specificity Intern: 85.5%; Practitioner: 88% (PPV Pract. 42.3%, Interns 43.7%; NPV Pract. 90.3%, Interns 89.8%; +LR Pract. 4.05, Interns 3.7; -LR Pract. 0.592; Interns 0.54)

Intersegmental motion restriction palpation is more specific than sensitive

Moruzzi S (1993)

Lumbar spine

Mechanical Model

Detect accuracy of two types of spinal motion palpation procedures in correctly determining fixation

Sensitivity Lateral Flexion: 41.2%; PA springing: 42.8%; Specificity LF: 61.5%; PAS: 62.2% (PPV Post-Ant 28.6%; Lat. Flex. 30.6%; NPV Post-Ant 73.7%, Lat. Flex. 73.7%)

The palpation procedures as performed were not valid tests.

Jensen K (1993)

Lumbar spine

Mechanical Model

Detect presence or absence of single and multiple intersegmental motion restrictions

Sensitivity Interns: 72%; Practitioners: 52.6%; Specificity Interns: 83.2%; Practitioners 78.6% (PPV Interns 46.2%; Pract. 45.5%; NPV Interns 93.7%; Pract 83%)

Motion palpation is an accurate method for determining non-fixated segments but not accurate for determining fixated segments.

Sandmark H (1995)

Cervical spine

Pain reported by subjects

Assess presence or absence of pain upon palpation of facet joint

Sensitivity 82%; Specificity 79%; Positive Predictive Value = 62%; NPV = 91%

Palpation over the facet joint had better sensitivity and specificity than motion tests in study.

Kristiansson P (1996)

Lumbar spine

Visual Analog Scale

Assess the relationship between clinical back status and reported pain locations during and after pregnancy.

Thoracic DP Tenderness: Sensitivity 17.8%, Specificity 98.5%, Positive Predictive Value 72.2%, Negative Predictive Value 84.44%;; Lumbar DP Tenderness: Sens. 21.2%, Spec. 96.19%, PPV 61.76%, NPV 80.83%;;; Lumbar Percussion: Sens 5.1%, Spec. 100%, PPV 100%, NPV 78.44%.

Pain provocation tests were better at discriminating LBP than tests of configuration or mobility

DP = Digital Pressure +LR = positive Likelihood ratio Pract. = Practitioners -LR = negative Likelihood ratio Sens. = Sensitivity PPV = positive predictive value NPV = negative predictive value

Najm et al. BMC Complementary and Alternative Medicine 2003 3:1   doi:10.1186/1472-6882-3-1