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Title: Motion palpation used as a postmanipulation assessment tool for monitoring end-feel improvement : a randomized controlled trial of test responsiveness
Authors: Lakhani, Ekta
Nook, Brian 
Haas, Mitchell 
Docrat, Aadil
Keywords: Research;Chiropractic;Palpation;Manipulation;Spinal;1103 Clinical Sciences;1104 Complementary and Alternative Medicine;Orthopedics;Evaluation;Reliability;Validity
Issue Date: Sep-2009
Publisher: Elsevier BV
Source: Lakhani, E. et al. 2009. Motion palpation used as a postmanipulation assessment tool for monitoring end-feel improvement: a randomized controlled trial of test responsiveness. 32(7): 549-555. doi:10.1016/j.jmpt.2009.08.004
Journal: Journal of Manipulative and Physiological Therapeutics Therapeutics; Vol. 32, Issue 7 
A tenet of motion palpation theory is the ability to confirm postadjustive segmental end-feel improvement (EFI). Only one previous trial has evaluated the responsiveness of EFI; this was a study of the thoracic spine. The purpose of this study was to evaluate the responsiveness of postadjustive end-feel for evaluating improvement in putative segmental spinal motion restriction after spinal manipulative therapy (SMT) of the cervical spine.


A prospective, blinded, randomized placebo-controlled pilot trial was conducted with 20 symptomatic and 10 asymptomatic participants recruited from a chiropractic teaching clinic. The treatment group received SMT, and the control group received placebo detuned ultrasound. Responsiveness was evaluated as the etiologic fraction (% of cases with EFI attributable to SMT) and as the sensitivity and specificity of change.


For the entire sample, the etiologic fraction was 63% (P = .002), sensitivity was 93%, and specificity was 67%. For symptomatic participants, a strong relationship appeared to exist between receiving SMT and EFI (etiologic fraction = 78%, P = .006; sensitivity = 90%; specificity = 80%). A strong relationship was not found for asymptomatic participants (etiologic fraction = 40%, P = .444; sensitivity = 100%; specificity = 40%), where EFI was recorded frequently, whether participants received SMT or detuned ultrasound.


The findings of this study showed that motion palpation of end-feel assessment appears to be a responsive postmanipulation assessment tool in the cervical spine for determining whether perceived motion restriction found before treatment improves after SMT. This observation may be limited to symptomatic participants.
ISSN: 0161-4754
1532-6586 (Online)
DOI: 10.1016/j.jmpt.2009.08.004
Appears in Collections:Research Publications (Health Sciences)

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