Touching Reliability

Item

Title
Touching Reliability
Author(s)
Sommerfeld Peter
Abstract
Objectives: Inevitable subjectivity makes interexaminer reliability of manual assessment proce-dures a special matter of concern. The Cranial Concept, a part of osteopathy, deals with very subtle changes that have to be palpated. One of the main principles of the Cranial Concept is the Primary Respiratory Mechanism (PRM), which is hypothesised to be a palpable physiological phenomenon that occurs in rhythmic cycles, called flexion-phase and extension-phase, which are independent from cardiac and respiratory rates. Palpation of the PRM is one of the first steps in assessment within the Cranial Concept.
Design: An inter- and intraexaminer reliability study design for repeated measures has been used to assess, how much two examiners and one examiner within her/himself, palpating the same subject, do agree with respect to the PRM. In addition possible effects of the examiners’ and subjects’ respiratory rates on the palpated PRM-rates were tested. The PRM rates were recorded by using silent footswitches. The respiratory rates have been recorded simultaneously by using strain gauges.
Participants: 49 healthy subjects have been palpated by two experienced examiners simultane-ously twice at the head and the pelvis.
Main outcome measures: PRM-frequency (f ), the mean duration of the flexion phase and the mean ratio of flexion- to extension-phase have been described as the main outcome-parameters. Inter- and intraexaminer reliability and correlations to the respiratory rates were analysed for all three parameters.Results: Inter- as well as intraexaminer agreement could not be described beyond chance agree-ment, as the 95% limits of agreement showed an expected difference (e.g. for f &#61617; 3.3 cycles/90 sec) which for all cases resembled the total range of values (e.g. for f 7 cycles/90 sec) that has been produced. A significant effect of the examiners’ respiration was found for both examiners at the pelvis (P = 0.004 for one examiner, P<0.0001 for the other examiner), for one examiner only at the head (P = 0.0017). No correlation could be found for the subjects’ respiratory rates.
Conclusions: PRM-rates could not be palpated reliably and under certain conditions were influ-enced by the examiners’ respiratory rates. These results do not support the hypotheses behind the PRM. The role of PRM palpation for clinical decision making and the models explaining the PRM should therefore be thought over. Further research has to be done.
Key words: palpation, Primary respiratory Mechanism, interexaminer reliability
Date Accepted
0
Date Submitted
1.1.2007 00:00:00
Type
osteo_thesis
Language
English
Submitted by:
62
Pub-Identifier
12368
Inst-Identifier
781
Keywords
Palpation
Recommended
1
Medium
Sommerfeld-MasterThesis.pdf
Sommerfeld-MasterThesis.pdf
Item sets
Thesis

Sommerfeld Peter, “Touching Reliability”, Osteopathic Research Web, accessed March 28, 2024, https://www.osteopathic-research.com/s/orw/item/3046