The Palpation Reliability Debate: the experts respond

Abstract In the October 2001 issue of JBMT the editorial raised questions as to the value, validity and accuracy of palpation methods in assessing musculoskeletal dysfunction. The reason for the topic of palpatory reliability being of current interest results from a steady series of published papers, which cast doubt on inter- and intra-rater reliability, and accuracy, in the performance of manual forms of assessment. The trigger for the exercise, which has resulted in this collection of responses on that theme, was an article by Comeaux et al. (2001), which noted relatively poor inter-rater reliability when three similarly trained practitioners evaluated the lower cervical and upper thoracic spine. In the interest of clarification JBMT invited a number of eminent clinicians and researchers to answer a series of questions, which had been compiled in consultation with various experts. Professions represented in the responses include medicine (David Simons and Karel Lewit), osteopathy (Peter Gibbons and Philip Tehan), chiropractic (Craig Liebenson and Don Murphy), physiotherapy (Joanne Bullock-Saxton and Dianne Lee) and massage therapy (Shannon Goosen).