Background: Static or motion manual palpation of the low back is commonly used to assess pain location and reproduction in low back pain (LBP) patients. The purpose of this study is to review the reliability and validity of manual palpation used for the assessment of LBP in adults.
Method: We systematically searched five databases from 2000 to 2019. We critically appraised internal validity of studies using QAREL and QUADAS-2 instruments. We stratified results using best-evidence synthesis. Validity studies were classified according to Sackett and Haynes.
Results: We identified 2023 eligible articles, of which 14 were low risk of bias. Evidence suggests that reliability of soft tissue structures palpation is inconsistent, and reliability of bony structures and joint mobility palpation is poor. We found preliminary evidence that gluteal muscle palpation for tenderness may be valid in differentiating LBP patients with and without radiculopathy.
Conclusion: Reliability of manual palpation tests in the assessment of LBP patients varies greatly. This is problematic because these tests are commonly used by manual therapists and clinicians. Little is known about the validity of these tests; therefore, their clinical utility is uncertain. High quality validity studies are needed to inform the clinical use of manual palpation tests.
Author keywords: Manual palpation — Reliability — Validity — Assessment — Low back pain — Systematic review
Author affiliations: PSN: Department of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada;
PSN: School of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada; PSN: CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands; HY, PC, DS, NL: Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Ontario, Canada; HY, PC, DS: Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada; KM: Canadian Memorial Chiropractic College, Toronto, Ontario, Canada; A-LM: Institut Franco-Européen de Chiropraxie, Toulouse, France; VLK: EPID@Work Research Institute, Department of Health Sciences, and the Division of Human Sciences, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Ontario, Canada; VLK: Institute for Work and Health, Toronto, Ontario, Canada; NL: UMR1295, Université de Toulouse, UPS, Inserm, Toulouse, France
Corresponding author: PSN—firstname.lastname@example.org
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