palpate

Christensen (32) considered motion palpators to agree when their findings were [+ or -] 1 spinal segment; as did Harlick (33) in a study of the accuracy of static spinal palpation.

In 3 of the studies the palpators examined a mannequin which featured variable and controllable segmental stiffness; the other 2 studies used pain as a reference standard.

To calculate accuracy expansively, the palpator was judged to have been accurate when the center of the marker was placed closer to the most lateral aspect of the C1 TVP than to either the inferior aspect of the mastoid process or the most lateral aspect of the C2 TVP.

To determine if the palpator errors on the left and right were correlated, the authors obtained their Pearson's product moment correlation value for their signed values: r= 0.63 (two tailed p=.001).

Chakraverty (7) explains why the discrepancy between the imaged TL and palpated TL is greater in women: "Adult females who have more percentage body fat for equivalent BMIs, different fat distribution and who develop progressively greater waist to hip ratios with age than adult males were found to have proportionately more higher levels identified on palpation." The palpator's fingers overlay soft tissue situated above the iliac crests, especially in obese patients or those with relatively abundant subcutaneous fat tissue relative to their body mass index.

Among the imaging studies that included an arm addressing the ability of a palpator to numerate the lumbar spinal level associated with TL, one of them (10) did not provide sufficient detailed information to be included among the palpation articles.