Manuelle Untersuchung der Wirbelsäule. Ein systematischer, kritischer. Review zur Reproduzierbarkeit

Objective: Poor reproducibility of spinal palpation is continuously being reported and authors of recent reviews have criticized the quality of studies. This article critically analyzes the literature pertaining to the interobserver and intraobserver reproducibility of spinal palpation to investigate the consistency of study results and assess the level of evidence for reproducibility. Methods: A systematic review and meta-analysis was performed on relevant literature published from 1965 to 2005, identified using the electronic databases MEDLINE, MANTIS, and CINAHL and checking of reference lists. Descriptive data from included articles were extracted independently by 2 reviewers. A 6-point scale was constructed to assess the methodological quality of original studies. A meta-analysis was conducted among the high-quality studies to separately examine the consistency of data on motion palpation, static palpation, osseous pain, soft tissue pain, soft tissue changes and global assessment. A standardized method was used to determine the level of evidence. Results: The quality score of the 48 studies included in this analysis ranged from 0% to 100%. There was strong evidence to suggest that the interobserver reproducibility of osseous and soft tissue pain, the intraobserver reproducibility of soft tissue pain and global assessments are all clinically acceptable. Other spinal procedures are either not reproducible or the evidence is conflicting or preliminary.