Criterion validity of manual assessment of spinal stiffness

S.L. Koppenhaver; J.J. Hebert; G.N. Kawchuk; J.D. Childs; D.S. Teyhen; T. Croy; J.M. Fritz

doi:10.1016/j.math.2014.06.001

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Criterion validity of manual assessment of spinal stiffness

Journal article

Open access

Peer reviewed

Criterion validity of manual assessment of spinal stiffness

S.L. Koppenhaver, J.J. Hebert, G.N. Kawchuk, J.D. Childs, D.S. Teyhen, T. Croy and J.M. Fritz

Manual Therapy, Vol.19(6), pp.589-594

2014

DOI: https://doi.org/10.1016/j.math.2014.06.001

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Abstract

Assessment of spinal stiffness is widely used by manual therapy practitioners as a part of clinical diagnosis and treatment selection. Although studies have commonly found poor reliability of such procedures, conflicting evidence suggests that assessment of spinal stiffness may help predict response to specific treatments. The current study evaluated the criterion validity of manual assessments of spinal stiffness by comparing them to indentation measurements in patients with low back pain (LBP). As part of a standard examination, an experienced clinician assessed passive accessory spinal stiffness of the L3 vertebrae using posterior to anterior (PA) force on the spinous process of L3 in 50 subjects (54% female, mean (SD) age ¼ 33.0 (12.8) years, BMI ¼ 27.0 (6.0) kg/m2) with LBP. A criterion measure of spinal stiffness was performed using mechanized indentation by a blinded second examiner. Results indicated that manual assessments were uncorrelated to criterion measures of stiffness (spearman rho ¼ 0.06, p ¼ 0.67). Similarly, sensitivity and specificity estimates of judgments of hypomobility were low (0.20 e0.45) and likelihood ratios were generally not statistically significant. Sensitivity and specificity of judgments of hypermobility were not calculated due to limited prevalence. Additional analysis found that BMI explained 32% of the variance in the criterion measure of stiffness, yet failed to improve the relationship between assessments. Additional studies should investigate whether manual assessment of stiffness relates to other clinical and biomechanical constructs, such as symptom reproduction, angular rotation, quality of motion, or end feel.

Details

Title: Criterion validity of manual assessment of spinal stiffness
Authors/Creators: S.L. Koppenhaver (Author/Creator) - Baylor University
J.J. Hebert (Author/Creator) - Murdoch University
G.N. Kawchuk (Author/Creator) - University of Alberta
J.D. Childs (Author/Creator) - Keesler Medical Center
D.S. Teyhen (Author/Creator) - Baylor University
T. Croy (Author/Creator) - Baylor University
J.M. Fritz (Author/Creator) - Intermountain Healthcare
Publication Details: Manual Therapy, Vol.19(6), pp.589-594
Publisher: Elsevier Ltd.
Identifiers: 991005546337207891
Murdoch Affiliation: School of Psychology and Exercise Science
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.129 Back pain; 1.129.98 Low Back Pain
Web Of Science research areas: Rehabilitation
ESI research areas: Clinical Medicine