Evidence map›Paper›PMID 38814967›Full record

Trial reportPloS one2024

Static palpation ain't easy: Evaluating palpation precision using a topographical map of the lumbar spine as a reference.

Inge Strøh Hvidkær, Steen Harsted, Maliheh Hadizadeh, Søren O'Neill, Gregory Neil Kawchuk, Casper Nim

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Inge Strøh HvidkærMedical Research Unit, Spine Center of Southern Denmark, University Hospital of Southern Denmark, Odense, Denmark.
Steen HarstedMedical Research Unit, Spine Center of Southern Denmark, University Hospital of Southern Denmark, Odense, Denmark.ORCID 0000-0002-1879-2224
Maliheh HadizadehSchool of Public Health, University of Alberta, Edmonton, Canada.
Søren O'NeillMedical Research Unit, Spine Center of Southern Denmark, University Hospital of Southern Denmark, Odense, Denmark.
Gregory Neil KawchukFaculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Canada.ORCID 0000-0001-9487-1779
Casper NimMedical Research Unit, Spine Center of Southern Denmark, University Hospital of Southern Denmark, Odense, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionClinicians commonly use manual therapy to treat low back pain by palpating the spine to identify the spinous processes. This study aims to evaluate the ability of experienced clinicians to consistently locate the spinous processes from S1 to T12 through palpation. The results will be compared to topographical data representing the lumbar lordosis at baseline and four follow-up time points. MATERIALS AND

methodsIn a prior prospective randomized trial, experienced clinicians used palpation to locate the lumbar spinous processes (S1-T12) and then digitized these locations in three-dimensional space. The same digitizing equipment was then used to continuously collect three-dimensional position data of a wheel that rolled along the back's surface through a trajectory that connected the previously digitized locations of the spinous processes. This process was repeated at 4 days, 1, 4, and 12 weeks. The resulting lordosis trajectories were plotted and aligned using the most anterior point in the lordosis to compare the locations of the spinous processes identified in different trials. This way, spinous palpation points could be compared to surface topography over time. Intra- and interrater reliability and agreement were estimated using intraclass correlations of agreement and Bland-Altman limits of agreement.

resultsFive clinicians palpated a total of 119 participants. The results showed a large degree of variation in precision estimates, with a mean total value of 13 mm (95%CI = 11;15). This precision error was consistent across all time points. The smallest precision error was found at L5, followed by S1 File, after which the error increased superiorly. Intra- and interrater reliability was poor to moderate.

conclusionsComparison of palpation results to a topographic standard representing the lumbar lordosis is a new approach for evaluating palpation. Our results confirm the results of prior studies that find palpation of lumbar spinous processes imprecise, even for experienced clinicians.

Indexed as

LordosisLumbar VertebraePalpationAdultFemaleHumansLow Back PainMaleMiddle AgedProspective Studies

Identifiers

PMID38814967
PMCPMC11139336

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.