RR-PL-0772

Wednesday 13:10, Palau de Congressos, Hall 5, Room 5

POSTEROANTERIOR MOTION TEST OF A LUMBAR VERTEBRA: ACCURACY OF PERCEPTION. Björnsdóttir SV, Kumar S; Department of Physical Therapy. University of Alberta. Edmonton. Canada. PURPOSE: The aim of this study was to determine the accuracy of perception of relatively inexperienced physical therapists and experienced manual therapists when estimating the forces applied and the magnitude of displacement that occurred when posteroanterior pressure was applied to a lumbar vertebra. A further aim was to determine whether practice on a spinal model led to improved accuracy of perception when estimating the forces applied and the magnitude of displacement. RELEVANCE: In today’s clinical practice, it is recognised that reliable, valid and accurate measurements are needed for decision making and for the purpose of documentation. Numerous studies have shown that there is a lack of reliability when posteroanterior motion testing is used. Practitioners have relied on their own perception of stiffness and end-feel to detect abnormalities in intervertebral motion. SUBJECTS: Participants in this experiment were 8 female and 2 male physical therapists, who graduated within a year from the investigation date, and experienced and qualified manual therapists including 6 female and 4 male participants. METHODS: The equipment used for the study was a spinal model constructed at the University of Alberta which measured the forces and the displacement. For the training session a digital oscilloscope was used to give direct feed-back. Each therapist visited the laboratory five times during a three-week period. The therapists’ first and last visits included an experimental testing where the therapists applied 30 oscillations to the vertebra where they reached defined Maitland's grade II.The therapists were asked to estimate the magnitude of the peak force and the corresponding displacement when force was applied to the spinal model using grade II. The 2nd, 3rd and 4th visits consisted of the training sessions where direct feedback on force and displacement was used when applying Maitland’s grade II mobilisation. ANALYSIS: The statistical analysis was carried out using a SPSS package. Two-way ANOVAs were selected to test for statistical significance. RESULTS: The results show that inexperienced physical therapists have accurate perception of the displacement (p<0.05). Experienced manual therapists, have poor perception of the displacement (p>0.05) and both groups have poor perception of the force (p>0.05). It is suggested that physical therapists, regardless of experience improve their accuracy of perception of the force applied towards a significant level (p<0.05), following a training session, and improve the accuracy of perception of the displacement (p<0.05), when applicable. CONCLUSION: Based on the results of this study, it is suggested that the forces applied and the displacement that occurs during posteroanterior mobilisation can be accurately  documented by physical therapists following a training session using appropriate equipment for measurements.