Advances in Integrative Medicine, 2019/06, 6S70. doi: 10.1016/j.aimed.2019.03.199, type of study: ,irs,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.sciencedirect.com/science/article/abs/pii/S221295881930237X)

Keywords:

cranial bone mobility [2]
cranial osteopathy [64]
7-step palpation method [1]
inter-rater reliability [15]
diagnosis [412]
clinical trial [674]

Abstract:

Background: The World Health Organization benchmarks for osteopathic training considers cranial osteopathy as an important skill. Manual therapy generally exhibits poor reliability, including the cranial mobility tests. The aim of this study was to investigate the inter-rater reliability of manual mobility tests of the frontal, temporal, parietal bones, and the spheno-basilar synchrondrosis, as assessed in osteopathy. Methods: Twenty-one adults were assessed by three experienced osteopaths, all on the same day, using a standard assessment protocol. Prior to data collection, the osteopaths participated in a consensus training which included establishing the criteria for identifying a cranial bone mobility restriction; training using the 7-step palpation method; a pre-testing practice; and a calibration period before the assessment of the subjects. Three subjects were assessed simultaneously. After each assessment, the evaluators rotated tables to assess all three subjects. The evaluators were blinded to the subject by a curtain, and each other’s assessments. Each structure was rated as restricted or not restricted. We applied the Landis and Koch classification to describe the global level of inter-rater reliability. Results: Good reliability was established for the temporal bone and spheno-basilar synchondrosis strain patterns (Fleiss’ Kappa coefficient between 0.481–0.749), excellent reliability was established for the parietal and frontal bones (0.774 and 0.807), and an excellent pairwise percent agreements between 81–94%. 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.