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Inter-examiner reliability of osteopathic cranial palpatory diagnostic test

Journal: Journal of Complementary and Integrative Medicine Date: 2016/10, 13(4):Pages: eA10. doi: Subito , type of study: clinical trial

Free full text   (https://www.degruyter.com/document/doi/10.1515/jcim-2016-0102/html)

Keywords:

children [232]
cranium [51]
diagnosis [290]
inter-examiner reliability [16]
observational study [152]
palpation [190]
pediatrics [387]
temporal bone [12]

Abstract:

Background: Manual therapy approaches use palpation to determine dysfunctions, apply effective treatments and monitor patient evolution. However, reliability of palpation is generally poor. Osteopathy is one of the manual therapies that struggle to establish good inter-examiner reliability for cranial palpatory diagnostic. Objectives: This study aims to evaluate the inter-examiner reliability of osteopathic cranial palpatory diagnostic test used to identify severe dysfunction on young children’s temporal bones. Methods: Children 5 to 18 months old were recruited from community for a double-blinded assessment of temporal bone dysfunction. Two osteopaths, using a seven-step palpation protocol, alternatively evaluate temporal bones (n=22) of each child. Definition of a severe temporal bone dysfunction was previously validated and no clinical information’s were available for the examiners. Inter-examiner reliability for determining the presence or absence of severe temporal bone dysfunction was assessed using Kappa (k) coefficient and reported in conjunction with observed agreement (Po). Kappa indice was interpreted as suggested by Landis and Koch: <0.40 poor-to-fair, 0.41-0.60 moderate, 0.61-0.80 substantial, and 0.80-1.00 almost perfect. Results: Estimate of inter-examiner reliability was k = 0.65, 95% CI [0.35-0.94] for all temporal bones with an observed agreement (Po) of 82%. According to Landis and Kock’s classification, results are considered as substantial agreement. Conclusion: Osteopathic cranial palpatory diagnostic test used to identify severe temporal bone dysfunction is a reliable test when performed by osteopaths following a protocol of palpation. It can be used to monitor evolution and treatment efficacy for young children in clinic as well as for research purpose.


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