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The inter-rater reliability of the frontal, temporal, parietal bones, and the spheno-occipital synchrondrosis mobility test as assessed through manual therapy

Journal: Journal of Complementary and Integrative Medicine Date: 2018/12, 15(4):Pages: eA24. doi: Subito , type of study: observational study

Free full text   (https://www.degruyter.com/document/doi/10.1515/jcim-2018-2000/html)

Keywords:

cranium [51]
diagnosis [290]
inter-examiner reliability [16]
observational study [152]
palpation [190]

Abstract:

Background: Few studies have attempted to establish the inter-rater reliability of the manual mobility tests of the cranial bones. Those who have, have had limited success. Objectives: The aim of this study was to investigate the interrater reliability of manual mobility tests of the frontal, temporal and parietal bones, and the spheno-basilar synchrondrosis, as assessed in osteopathic manual therapy. Methods: Twenty-one subjects were evaluated by three experienced osteopaths, all on the same day, using a standard examination protocol. Prior to data collection, the three examiners relied on their clinical experience to review their anatomy palpation protocols and established a consensus of specific mobility requirements to identify a structure as restricted or not restricted. In groups of three, participants were evaluated separately by each osteopath who were blinded by a curtain. After each examination, the evaluators rotated tables to assess all three participants. Each structure was rated as restricted or not restricted. Examiners were blind to the subject and to each other's findings. Inter-rater reliability coefficients including the average pairwise percent agreements and the Fleiss’ Kappa coefficients were calculated. We applied Landis and Koch classification to describe the global level of inter-rater reliability. Results: All structures showed substantial reliability (Fleiss' Kappa coefficient between 0.6-0.8), with the exception of the lateral strain pattern of the SBS which was moderate (0.481), and an excellent pairwise percent agreements between 80-94%. Conclusion: The results demonstrate consistency when three experienced osteopaths evaluate cranial bone mobility restrictions. The results also highlight the importance of consensus among practitioners for consistent palpation which is critical for the examination and guiding the treatment intervention.


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