title: Reliability of lumbar spinal palpation, range of motion, and determination of position.
abstract: BACKGROUND
  The study purposes were to investigate the level of agreement of palpation of lumbar spinous processes between examiners, test-retest repeatability of lumbar spine range of motion, and the reliability of upright position measures in asymptomatic subjects.
  
  
  METHODS
  The modified CA 6000 spinal motion apparatus with a new skin fixation system was used by three operators for the test-retest spine measurements (3 days apart), and to obtain measures at one session of spinal position. Mean ranges of motion in all planes for 22 asymptomatic subjects were reported using the Intra-class Correlation Coefficient.
  
  
  RESULTS
  Overall, differences in palpation agreement for lumbar segments occurred in three subjects and did not affect range of motion values. For upright spinal position, ICC (2,3) values for sagittal, coronal, and horizontal plane positions were 0.96, 0.80, and 0.98 respectively. There were statistically significant differences between examiners for position values, determined by the Bonferroni t-test (p < 0.05), but the magnitude of the differences were 2 degrees or less, and not considered clinically important.
  
  
  CONCLUSIONS
  Results suggest that lumbar spinal motion measurements and position determination between different operators can be consistent particularly if utilizing the modified instrument. Static lumbar position also appears to be recorded reliably between different operators. Results justify progression to multi-center lumbar research using the modified CA 6000 and the work is considered relevant to medical clinicians working with spinal dysfunction, surgical interventions, or occupational health.
authors.affiliation: Division of Human Services, Programs in Physical Therapy, Concordia University Wisconsin, Mequon, Wisconsin, USA. M.troke@yorksj.ac.uk
authors.forename: Michael
authors.initials: M
authors.lastname: Troke
authors.forename: Dale
authors.initials: D
authors.lastname: Schuit
authors.forename: Cheryl M
authors.initials: CM
authors.lastname: Petersen
mesh_terms: D000328:Adult; D000367:Age Factors; D000886:Anthropometry / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008159:Lumbar Vertebrae / Q000033:anatomy & histology / Q000502:physiology*; D008297:Male; D015588:Observer Variation; D010173:Palpation / Q000295:instrumentation* / Q000379:methods* / Q000592:standards; D011187:Posture; D011237:Predictive Value of Tests; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012727:Sex Characteristics; D012984:Software