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Table 6 Summary of recommendations for each category of evaluation method

From: Review of methods used by chiropractors to determine the site for applying manipulation

Evaluation method Summary Quality of Recommendation
   evidence  
Complaint History   Gives context to the complaint and increases the reliability of the interpretation of physical findings. Moderate Favourable
Pain provocation     
Tenderness Localizes region/tissues of involvement High Favourable
Orthopedic manoeuver Pain with movement localizes region/tissue of involvement High Favourable
Asymmetry     
  Posture Antalgia, kyphosis, lordosis, scoliosis High Favourable
Localizing to site of care High Unfavourable
Stiffness Palpatory manual Passive physiologic/accessory motion, joint springing, overpressure testing High Unclear
Instrumented Questions of generalizability Low Favourable with limitations
Palpation Static Identifying major anatomical landmarks High Favourable with limitations
Localizing to site of care High Unclear
Motion Enhanced if pain provocation present High Favourable with limitations
Leg Length Inequality   Pelvic assessment; method dependent High Favourable with limitations
Manual Muscle Testing   Strength grading to localize root involvement. Moderate Favourable
  Non-pathologic altered function Moderate Unfavourable
Range of motion   Localization to region High Favourable
Tissue temperature, texture, tone   Thermography/thermometry of the lower limb in confirming frank sciatica High Favourable
  Paraspinal skin temperature to locate site of care High Unfavourable
  Texture-skin rolling Moderate Favourable
Specialized Tests Current Perception Threshold Frank neuropathy with sensory deficit High Favourable
Galvanic skin response Localizing to site of care Moderate Unfavourable
Surface EMG Flexion-relaxation phenomenon to target lumbar region High Favourable
  Localizing to site of care Moderate Unfavourable
Radiographic imaging Localizing to site of care High Unfavourable
Integrated P.A.R.T.S. Montages   Localizing to site of care beyond individual component contributions Moderate Unclear