Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015;2015:815407.
doi: 10.1155/2015/815407. Epub 2015 Jun 11.

Interrater Reliability of Motion Palpation in the Thoracic Spine

Free PMC article

Interrater Reliability of Motion Palpation in the Thoracic Spine

Bruce F Walker et al. Evid Based Complement Alternat Med. .
Free PMC article


Introduction. Manual therapists commonly use assessments of intervertebral motion to determine the need for spinal manipulation, but the reliability of these procedures demonstrates conflicting results. The objectives of this study were to investigate the interrater reliability of thoracic spine motion palpation for perceived joint restriction and pain. Methods. Twenty-five participants between the ages of 18 and 70, with or without mid-back pain, were enrolled. Two raters motion palpated marked T5-T12 levels using two methods (standardised and pragmatic) and noted any restricted or painful segments. We calculated agreement between two raters by generating raw agreement percentages and Kappa coefficients with 95% confidence intervals. Results. There was poor to low level of agreement between the raters for both joint stiffness and pain localization using both pragmatic and standardized approaches. The results did not improve significantly when we conducted a post hoc analysis where three spinal levels were collapsed as one and right and left sides were also combined. Conclusions. The results for interrater reliability were poor for motion restriction and pain. These findings may have unfavourable implications for all manual therapists who use motion palpation to select patients appropriate for spinal manipulation.


Figure 1
Figure 1
Motion palpation setup.

Similar articles

See all similar articles

Cited by 1 article


    1. Bergman T. F., Peterson D. H. Chiropractic Technique: Principles and Procedures. 3rd. St. Louis, Mo, USA: Mosby; 2010.
    1. Greenman P. E. Principles of Manual Medicine. Baltimore, Md, USA: Lippincott Williams & Wilkins; 1996.
    1. Maitland G. Maitland's Vertebral Manipulation. 6th. Butterworth-Heinemann; 2000.
    1. Henderson C. N. R. The basis for spinal manipulation: chiropractic perspective of indications and theory. Journal of Electromyography and Kinesiology. 2012;22(5):632–642. doi: 10.1016/j.jelekin.2012.03.008. - DOI - PubMed
    1. Abbott J. H., Flynn T. W., Fritz J. M., Hing W. A., Reid D., Whitman J. M. Manual physical assessment of spinal segmental motion: intent and validity. Manual Therapy. 2009;14(1):36–44. doi: 10.1016/j.math.2007.09.011. - DOI - PubMed

LinkOut - more resources