Department of Physical Therapy Student Theses, Dissertations and Capstones

Document Type

Thesis - NSU Access Only

Degree Name

Master of Physical Therapy (MPT)

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College of Health Care Sciences - Physical Therapy Department

Publication Date / Copyright Date



Nova Southeastern University


Purpose: The purpose of this study was to determine if experience affects physical therapists' ability to identify a lumbar spinous process by palpation. Previous studies indicate poor reliability in identification of lumbar spinous processes, citing examiner experience as one potential limitation.

Method: One arbitrary lumbar spinous process of a single prone subject was marked with a skin pen and a lead marker. An x-ray confirmed that the L3 spinous process was marked. Seven novice and six experienced physical therapists, blind to the x-ray findings, palpated the marked spinal level and were asked to identify the spinous process.

Results: Four of thirteen physical therapists correctly identified the L3 spinous process. Three were novice physical therapists. Fisher's exact test found insignificant p=0.599, with a low power of 0.17. Small sample size was a limitation.

Conclusion: This study is an agreement with other studies showing poor agreement between physical therapists in spinous process identification. No conclusion can be drawn regarding the effect of experience, although power analysis indicated that a larger sample might find significance in the direction of the novice therapist. Future studies with larger sample size are encouraged to determine if experience, positioning or palpation approach affect accuracy.


Physical Therapy

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