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Invited Commentary

RK Shields, PhD, PT, is Assistant Professor and Clinical Research Coordinator, Physical Therapy Graduate Program, The College of Medicine, The University of Iowa and University of Iowa Hospitals and Clinics, 2600 Steindler Bldg, Iowa City, IA 52242

This excerpt was created in the absence of an abstract.

Maher and Adams present a unique study assessing the reliability of a manual technique commonly used by physical therapists. The authors raise serious questions about the reliability of the ability to assess lumbar vertebral stiffness using posteroanterior (PA) central pressure testing. Conversely, they report that the assessment of pain during PA pressures is highly reliable and may be the most important measure to focus on when performing these manual techniques. The authors make many attempts to keep this reliability study within the context of the clinical setting to enhance its generalizability or external validity. There are several issues, however, that this study does not address and that consequently affect the clinical implications and conclusions.

Reliability studies of this type are beneficial but artificial by nature, which limits their generalizability to true clinical practice....

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Reliability of Pain and Stiffness Assessments in Clinical Manual Lumbar Spine Examination

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