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Chiropractic Research Review

Limitations to Manual Palpation?

Manual palpation techniques have been used for more than a century to assess joint motion. While articular facet asymmetry of the upper cervical spine has been considered in relation to joint disease, the effects of such asymmetry on joint motion require further investigation.

To that end, a study of six human cervical spine specimens explored motion palpation of joint restrictions and the implied link to disease at the C1/C2 level.

Forces (5-25 N) were applied along the mediolateral axes, and the corresponding displacement along three axes was documented. Specimen geometry and asymmetry were obtained by way of plain radiographic film and a gimbal apparatus.

Results: Each of the six specimens displayed different behavior and differing degrees of asymmetry; asymmetrical and discontinuous force-displacement correlations were linked to anatomic asymmetry that appeared to be of natural occurrence.

The authors caution that clinicians attempting to palpate vertebral motion should not assume that perceived restriction indicates pathological motion; it may in fact reflect normal anatomy. The results of this study challenge assumptions of palpation theory that joints are symmetrical and therefore should feel symmetrical upon motion palpation.

Ross JK, Bereznick DE, McGill SM. Atlas-axis facet asymmetry: implications in manual palpation. Spine, June 15, 1999:24(12), pp1203-1209.

Chiropractic Research Review

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