title: Intraexaminer and interexaminer reliability of manual palpation and pressure algometry of the lower limb nerves in asymptomatic subjects.
abstract: OBJECTIVE
  Nerve palpation is a method of clinically identifying mechanosensitivity of neural tissue by means of pressure algometry and manual palpation. There are few investigations of the reliability of lower limb nerve palpation, and femoral nerve palpation has never been previously reported. The aim of this study was to investigate the reliability of nerve palpation of the femoral, sciatic, tibial, and common peroneal nerves and to report normative values for the femoral nerve.
  
  
  METHODS
  The 4 lower limb nerves were palpated in 39 healthy volunteers using pressure algometry and manual digital palpation. Measurements were taken twice by 1 rater (intrarater reliability) and once by a second rater (interrater reliability).
  
  
  RESULTS
  Intraclass correlation coefficients for pressure pain thresholds (PPTs) via pressure algometry of the femoral, common peroneal, tibial, and sciatic nerves were 0.69, 0.84, 0.64, and 0.9 for intrarater reliability, respectively, and 0.82, 0.7, 0.56, and 0.75 for interrater reliability. κ Values for manual palpation were 0.59, 0.55, 0.42, and 0.60 for intrarater reliability and 0.30, 0.49, 0.37, and 0.60 for interrater reliability. Males demonstrated significantly higher PPTs than females for the femoral, sciatic, and tibial nerves, and differences in PPTs were present between right and left sides.
  
  
  CONCLUSIONS
  Nerve palpation of the femoral, common peroneal, and sciatic nerves using pressure algometry demonstrated good to excellent reliability, whereas the tibial nerve PPTs showed moderate to good reliability. Manual palpation measurements demonstrated fair to moderate reliability.
authors.affiliation: PhD Research Student, School of Public Health, Physiotherapy & Population Science, Health Sciences Centre, University College Dublin, Dublin, Ireland. Electronic address: caitriona.fingleton@ucdconnect.ie.
authors.forename: Caitriona P
authors.initials: CP
authors.lastname: Fingleton
authors.affiliation: Master Student in Advanced Physiotherapy, School of Public Health, Physiotherapy & Population Science, Health Sciences Centre, University College Dublin, Dublin, Ireland.
authors.forename: Lucy
authors.initials: L
authors.lastname: Dempsey
authors.affiliation: Clinical Specialist Physiotherapist, St Vincent's University Hospital Elm Park, Dublin, Ireland.
authors.forename: Keith
authors.initials: K
authors.lastname: Smart
authors.affiliation: Senior Lecturer, School of Public Health, Physiotherapy & Population Science, Health Sciences Centre, University College Dublin, Dublin, Ireland.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Doody
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000294:innervation*; D008160:Lumbosacral Plexus / Q000502:physiology*; D008297:Male; D010147:Pain Measurement / Q000295:instrumentation*; D017288:Pain Threshold / Q000502:physiology; D010173:Palpation; D011312:Pressure; D015203:Reproducibility of Results; D012737:Sex Factors; D055815:Young Adult
keywords: Musculoskeletal Pain; Peripheral Nerves; Reliability and Validity