Sensitivity for palpating lumbopelvic soft- tissues and bony landmarks and its associated factors: A single-blinded diagnostic accuracy study.

Autor: Ferreira APA; Instituto Brasileiro de Osteopatia, Centro, CEP 22440-901, RJ, Brasil.; Programa de Pós-graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Bonsucesso, CEP 21041-010, RJ, Brasil., Póvoa LC; Instituto Brasileiro de Osteopatia, Centro, CEP 22440-901, RJ, Brasil.; Programa de Pós-graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Bonsucesso, CEP 21041-010, RJ, Brasil., Zanier JFC; Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Vila Isabel, CEP 20551-030, RJ, Brasil., Machado DC; Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Vila Isabel, CEP 20551-030, RJ, Brasil., Ferreira AS; Programa de Pós-graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta, Bonsucesso, CEP 21041-010, RJ, Brasil.
Jazyk: angličtina
Zdroj: Journal of back and musculoskeletal rehabilitation [J Back Musculoskelet Rehabil] 2017 Aug 03; Vol. 30 (4), pp. 735-744.
DOI: 10.3233/BMR-150356
Abstrakt: Background: Evidence on the diagnostic performance of palpatory methods and possible confounding factors is scarce.
Objectives: To examine the sensitivity of palpatory methods for location of lumbopelvic landmarks and to assess its association with personal characteristics.
Methods: Eighty-three participants (41 men, 55.6 (16.5) years, 25.9 (4.8) kg/m2 [mean (SD)]) were enrolled in this single-blinded study. Fourteen body and softy-tissue landmarks were sequentially palpated from the spinous process of L4 to the ischial tuberosity. CT-scan images were used to assess what landmark was located.
Results: Sensitivity for location was in range 22-86% for soft-tissues and 26-69% for bony landmarks. Reduction in sensitivity was observed from the quadratus lumborum to the inferior and lateral angle of the sacrum (86-26% and 75-33%, left and right sides, respectively). Palpations of L4 and L5 spinous processes were systematically more cephalic than other landmarks. Gender was weakly correlated to almost all landmarks (rp⁢b= 0.333 or weaker). Body mass index was weakly correlated to the accurate location of ILAS and quadratus lumborum, great trochanter, PSIS, and piriformis (rp⁢b=-0.307 or weaker).
Conclusions: Systematic and propagation errors were present using sequential palpatory methods. Palpation in men was more sensitive and higher BMI was associated with lower sensitivity for lumbopelvic landmarks.
Databáze: MEDLINE
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