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Table 6

Summary of recommendations for each category of evaluation method

Evaluation method
Summary
Quality of
Recommendation
  evidence 
Complaint History
 
Gives context to the complaint and increases the reliability of the interpretation of physical findings.
Moderate
Favourable
Pain provocation
 
 
 
 
Tenderness
Localizes region/tissues of involvement
High
Favourable
Orthopedic manoeuver
Pain with movement localizes region/tissue of involvement
High
Favourable
Asymmetry
 
 
 
 
 
Posture
Antalgia, kyphosis, lordosis, scoliosis
High
Favourable
Localizing to site of care
High
Unfavourable
Stiffness
Palpatory manual
Passive physiologic/accessory motion, joint springing, overpressure testing
High
Unclear
Instrumented
Questions of generalizability
Low
Favourable with limitations
Palpation
Static
Identifying major anatomical landmarks
High
Favourable with limitations
Localizing to site of care
High
Unclear
Motion
Enhanced if pain provocation present
High
Favourable with limitations
Leg Length Inequality
 
Pelvic assessment; method dependent
High
Favourable with limitations
Manual Muscle Testing
 
Strength grading to localize root involvement.
Moderate
Favourable
 
Non-pathologic altered function
Moderate
Unfavourable
Range of motion
 
Localization to region
High
Favourable
Tissue temperature, texture, tone
 
Thermography/thermometry of the lower limb in confirming frank sciatica
High
Favourable
 
Paraspinal skin temperature to locate site of care
High
Unfavourable
 
Texture-skin rolling
Moderate
Favourable
Specialized Tests
Current Perception Threshold
Frank neuropathy with sensory deficit
High
Favourable
Galvanic skin response
Localizing to site of care
Moderate
Unfavourable
Surface EMG
Flexion-relaxation phenomenon to target lumbar region
High
Favourable
 
Localizing to site of care
Moderate
Unfavourable
Radiographic imaging
Localizing to site of care
High
Unfavourable
Integrated P.A.R.T.S. Montages Localizing to site of care beyond individual component contributionsModerateUnclear
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