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Evidence-Based Complementary and Alternative Medicine
Volume 2015, Article ID 815407, 6 pages
Research Article

Interrater Reliability of Motion Palpation in the Thoracic Spine

1School of Health Professions, Murdoch University, Perth, WA 6150, Australia
2US Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX 78234-6100, USA
3School of Psychology and Exercise Science, Murdoch University, Perth, WA 6150, Australia

Received 18 March 2015; Accepted 25 May 2015

Academic Editor: Lise Hestbaek

Copyright © 2015 Bruce F. Walker et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.