Limitations and Future Research
When considering the results of this study one must recognize potential limitations. This study used only healthy-young asymptomatic participants, thus the results may not correlate with a symptomatic cohort or among individuals of different age groups.
In regards to procedures for measuring PST, a 10-second rest period between repetitions one and two for each rater may not be sufficient to avoid rater bias
We attempted to control for this by using a trained assistant who recorded measurements and by blinding raters to the results. Additionally, a limitation of the procedures includes the use of AROM for validating the PST measurement as AROM may be limited as a result of soft tissue restrictions as well as neuromuscular impairments. Although our PST
measurement was passive we did not add overpressure thus eliminating the potential for a stretching effect. Moreover, we used healthy-asymptomatic controls with no neuromuscular impairments.
Lastly, one must be cautious in their interpretation of the MDC values reported in this investigation as they are not indicative of clinically meaningful change.
The MCID would be necessary to determine whether or not a clinically meaningful change occurs in patients or subjects.
Future investigations are warranted in order to study this technique on a symptomatic population and on populations of different age ranges, in order to determine if the results are generalizeable to the population.