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Old 22-11-2007, 10:42 PM   #1
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Default Accuracy of detecting location of audible pops

Today I had a discussion with a colleague about cranial manipulation. My colleague told me he once read a book about cranial techniques and tried one of them on a friend. He said he got an audible pop somewhere from the cranium. My take was that it could have been the sound from the separation of occipute from C1 since the described manipulation was a traction like movement with the hands holding the cranium (i.e. a manipulation of C0/C1). My colleague on the other hand said that he could swear the sound came from the cranium and that “he knows where the C0/C1 is located and this was not aimed to target those joints”
Now, my question to you is: Do you happen to know/have any references where you could find a discussion about the accuracy of therapists detecting where the audible pop occur?
I have the following references:

"The audible pop from high-velocity thrust manipulation and outcome in individuals with low back pain.Flynn TW, Childs JD, Fritz JM.
Department of Physical Therapy, Regis University, Denver, CO 80221-1099, USA."

"The audible pop is not necessary for successful spinal high-velocity thrust manipulation in individuals with low back pain.Flynn TW, Fritz JM, Wainner RS, Whitman JM.
US Army-Baylor University Graduate Program in Physical Therapy, San Houston, Texas, 78234-6138, USA."

I only have the abstracts and I don’t think they discuss the accuracy of the therapist detecting from where the audible pop is coming. Since we know that the reliability (both inter- and intra-) of most manual examination procedures is quite poor and that we can not be so specific in our treatment with manipulation (exact target one joint etc). Doesn’t it also make you wonder if the audible pop also can “fool” us and maybe occur somewhere else from where we think?
I think I have read somewhere about how sound can “travel” in the body, but now I can’t find it.

Thanks in advance if you have the time to send some thoughts regarding this.

Kindly regards


Last edited by mike; 23-11-2007 at 12:08 AM. Reason: more suitable titel, missleding title
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