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 | |
|---|---|---|---|---|
| Â | Â | evidence | Â | |
Complaint History | Â | Gives context to the complaint and increases the reliability of the interpretation of physical findings. | Moderate | Favourable |
Pain provocation | Â | Â | Â | Â |
Tenderness | Localizes region/tissues of involvement | High | Favourable | |
Orthopedic manoeuver | Pain with movement localizes region/tissue of involvement | High | Favourable | |
Asymmetry | Â | Â | Â | Â |
| Â | 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 | Â | Pelvic assessment; method dependent | High | Favourable with limitations |
Manual Muscle Testing | Â | Strength grading to localize root involvement. | Moderate | Favourable |
| Â | Non-pathologic altered function | Moderate | Unfavourable | |
Range of motion | Â | Localization to region | High | Favourable |
Tissue temperature, texture, tone | Â | Thermography/thermometry of the lower limb in confirming frank sciatica | High | Favourable |
| Â | Paraspinal skin temperature to locate site of care | High | Unfavourable | |
| Â | 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 | |
| Â | Localizing to site of care | Moderate | Unfavourable | |
Radiographic imaging | Localizing to site of care | High | Unfavourable | |
Integrated P.A.R.T.S. Montages | Â | Localizing to site of care beyond individual component contributions | Moderate | Unclear |