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Identification of the correct lumbar level using passive intersegmental motion testing
R C Chakraverty1, P B Pynsent, A Westwood
1Spinal Unit, Royal Orthopaedic Hospital, Birmingham B31 2AP, UK. rob.chakraverty@virgin.net
Anaesthesia
|October 11, 2007
Summary
Passive intersegmental motion testing, a common physical therapy technique, showed poor accuracy in identifying lumbar spinal levels. Accuracy was only 54-57%, highlighting its unreliability for precise anatomical localization.
Area of Science:
- Orthopedics
- Physical Therapy
- Spinal Anatomy
Background:
- Passive intersegmental motion testing is frequently utilized by physical therapists for lumbar spine assessment.
- Accurate identification of specific lumbar spinal levels is crucial for effective diagnosis and treatment.
Purpose of the Study:
- To evaluate the accuracy and inter-examiner agreement in identifying a single lumbar spinal level using passive intersegmental motion testing.
- To compare the performance of an experienced clinician versus a novice clinician.
Main Methods:
- Thirty-five adult participants underwent independent examination by an experienced and a novice clinician.
- Examiners marked the perceived lumbar interspace, with marks concealed from the subsequent examiner.
- Fluoroscopic imaging was used to determine the true spinal level for accuracy verification.
Main Results:
- The accuracy of identifying the correct lumbar spinal level ranged from 54% to 57%.
- Interobserver agreement between the two clinicians was found to be poor.
- A significant learning effect was observed in the experienced examiner, with accuracy improving from 31% to 79% across the study phases.
Conclusions:
- Passive intersegmental motion testing demonstrates limited reliability for accurately identifying specific lumbar spinal levels.
- The findings suggest that this technique may not be a dependable method for precise anatomical localization in the lumbar spine.
