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Validity of Palpation of the C1 Transverse Process

Validity of Palpation of the C1 Transverse Process: Comparison with a Radiographic Reference Standard

The Chiro.Org Blog


J Can Chiropr Assoc 2015 (Jun);   59 (2):   91–100 ~ FULL TEXT

Robert Cooperstein,MA, DC, Morgan Young,DC, and
Makani Lew,DC

Palmer West College of Chiropractic
Palmer Center for Chiropractic Research


Primary goal:   to determine the validity of C1 transverse process (TVP) palpation compared to an imaging reference standard.

METHODS:   Radiopaque markers were affixed to the skin at the putative location of the C1 TVPs in 21 participants receiving APOM radiographs. The radiographic vertical distances from the marker to the C1 TVP, mastoid process, and C2 TVP were evaluated to determine palpatory accuracy.

RESULTS:   Interexaminer agreement for radiometric analysis was “excellent.” Stringent accuracy (marker placed ±4mm from the most lateral projection of the C1 TVP) = 57.1%; expansive accuracy (marker placed closer to contiguous structures) = 90.5%. Mean Absolute Deviation (MAD) = 4.34 (3.65, 5.03) mm; root-mean-squared error = 5.40mm.

CONCLUSIONS:   Manual palpation of the C1 TVP can be very accurate and likely to direct a manual therapist or other health professional to the intended diagnostic or therapeutic target. This work is relevant to manual therapists, anesthetists, surgeons, and other health professionals.

KEYWORDS:   C1 TVP; chiropractic; palpation; radiograph; validity


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