Lakhani E., Nook B., Haas M., Docrat A.
Chiropractic Department, Durban University of Technology [merger of Natal Technikon and ML Sultan Technikon], Durban, Kwazulu Natal, South Africa; Murdoch University, Perth, WA, Australia; Western States Chiropractic College, Portland, Ore, United States; Chiropractic Department, Durban University of Technology [merger of Natal Technikon and ML Sultan Technikon], Durban, Kwazulu Natal, South Africa
Lakhani, E., Chiropractic Department, Durban University of Technology [merger of Natal Technikon and ML Sultan Technikon], Durban, Kwazulu Natal, South Africa; Nook, B., Murdoch University, Perth, WA, Australia; Haas, M., Western States Chiropractic College, Portland, Ore, United States; Docrat, A., Chiropractic Department, Durban University of Technology [merger of Natal Technikon and ML Sultan Technikon], Durban, Kwazulu Natal, South Africa
Objective: 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. Methods: 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. Results: 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. Conclusion: 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. © 2009.
Chiropractic; Manipulation; Palpation, Reliability, and Validity; Research, Evaluation; Spinal
placebo; adult; article; cervical spine; chiropractic; clinical article; controlled study; echography; female; human; male; manipulative medicine; palpation; physiotherapy; prospective study; sensitivity and specificity; spinal motion restriction; spine disease; Adult; Cervical Vertebrae; Female; Follow-Up Studies; Humans; Male; Manipulation, Spinal; Monitoring, Physiologic; Pain Measurement; Palpation; Patient Satisfaction; Pilot Projects; Prospective Studies; Reference Values; Reproducibility of Results; Risk Assessment; Sensitivity and Specificity; Sensory Thresholds; Single-Blind Method; South Africa; Spinal Diseases; Treatment Outcome; Young Adult