Abstract Background and purpose: Clinical examination of lumbar intervertebral mobility (LIVM) involves manual application of force on lumbar spinous processes to localize the symptoms while radiological examination involved functional (flexion-neutral-extension) radiography. The objective of this study was to evaluate the concurrent (criterion-related) validity of central postero-anterior (PA) pressure when compared to functional radiography in assessment of LIVM in asymptomatic participants. Materials and methods: Assessor-blinded cross-sectional study with random-order repeated-measures design was performed on 48 consented asymptomatic adult participants of either gender (34 male, 14 female), with mean age 23.6 ± 4.8 years. Central PA pressure assessment was done and graded using the seven-point joint play grading scale of Stanley Paris (0- ankylosed, 6- unstable) while functional radiography and manual tracing were done to measure intersegmental anterior and/or posterior rotations and/or translations. Karl-Pearson’s correlation co-efficient was used for analysis in SPSS version 11.5 for Windows. Results: It is evident that there was a comparable change in the segmental mobility measured using manual and radiological examination in all the subjects studied. This finding is specifically noted between the JPGS with posterior rotation and anterior translation. E.g., a normal mobility on JPGS at L1 was seen with normal anterior translation and posterior rotation values from X-ray but not in posterior translation and anterior rotation. Conclusion: The study showed that manual examination of intervertebral mobility using central PA pressure was comparable to the radiological assessment of intersegmental mobility of the spine in the five subjects studied. This significant correlation was noted especially for the anterior translation and posterior rotation radiological measurements with the manual assessment using the central PA pressure. The joint play grading scale was a useful clinical tool to measure and record intervertebral mobility in the normal subjects studied.
Keywords: Physical Examination; Concurrent Validity; Lumbar Spine Mobility; Manual Therapy.