Diagnostic Validity of Passive Accessory Intervertebral Movements (PAIVMs)

Clinical Scenario: When assessing patients\u27 spines in an outpatient clinic, we learned to use the manual technique of PAIVMs to determine general mobility of the spine, appreciation of an end-feel, a painful vertebral segment, and the patients\u27 response to manual technique. After practicing the technique in the clinic and developing the skill of appreciating segmental motion, we questioned if the PAIVM technique actually measures what we think it is measuring. In other words, is a PAIVM assessment of the spine valid? Clinical Question Population: Individuals with complaints of pain in the spine Intervention: Segmental mobility testing via PAIVMs Comparison: Diagnostic ability of PAIVM assessment for painful segmental level (pain generator), instability of segmental level in the lumbar spine, identifying a type of headache, and predicting response to treatment Outcomes: Sensitivity, specificity, positive and negative likelihood ratio