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Journal: Unpublished MSc thesis Wiener Schule für Osteopathie, Date: 2010/01, Pages: 76, type of study: Intra- inter rater reliability study

Free full text   (https://www.osteopathicresearch.org/s/orw/item/2903)

Keywords:

cranio-sacral osteopathy [217]
diagnosis [371]
Lien Mechanik Osteopathy [2]
WSO [501]
intra-rater-reliability [4]
controlled clinical trial [314]

Abstract:

This study tests the examination record of Lien Mechanique Osteopatique (LMO) on its intra-intertester reliability. Study Design: Methodological Study. Outline/Problem Definition: Reliability is the guarantee for the quality of manual testing procedures. Results of existing studies on cranio sacral osteopathy so far are inadequate. This is due to a one-sided focus on PRM. Testing procedures on tension independent of testing PRM produce better results (Halma et al. 2008). Research Question & Objective The question is whether the diagnostic findings of LMO are reproducible to such a degree that they are to be considered reliable – on the one hand by single testers in repeated tests (intraexaminer), on the other hand between single testers. Hypothesis In LMO, we distinguished between the sum of lesions, partial lesion, and dominant lesion. From this, one hypothesis resulted on intratest reliability and one hypothesis on intertest reliability. Research hypothesis 1 (Intra-Rater): Test results on the partial lesion of cranial sutures according to the LMO-method in repeated tests performed by the same tester are systematically consistent. Research hypothesis 2 (Inter-Rater): Test results on the partial lesion of cranial sutures according to the LMO-method in repeated tests performed by the different testers are not systematically consistent. Research hypothesis 3 (Intra-Rater): Test results on the dominant lesion of cranial sutures according to the LMO-method in repeated tests performed by the same tester are not systematically consistent. Research hypothesis 4 (Inter-Rater): Test results on the dominant lesion of cranial sutures according to the LMO-method in repeated tests performed by different testers are not systematically consistent. Methodology: 36 test persons (n=36) were tested two times by 4 testers. The study report rests on 48 single tests of five minutes duration. To determine the degree of correlations, Cohen’s Kappa was calculated to determine the intra-rater reliability of measured values, since this was about the accordance between two raters of dichotomous distinguishing marks. In case of accordance between four raters as well as the dominant of multiple tiered nominal scaled distinguishing mark, the Kappa coefficient was calculated according to Fleiss. In order to calculate the Kappa coefficient according to Cohen, SPSS 17.0 was used. For calculating the Kappa coefficient Fleiss Stata 11.1 was used. For testing hypotheses, the coefficients were verified with regard to significance. The chosen level of significance of alpha = .05 were adjusted by means of Bonferroni because of multiple testing of each hypothesis as per the respective number of significance tests. Results The sole research hypothesis to be accepted was the hypothesis on the intratest reliability of dominant lesion. The level of significance of k = 0,219, however, cannot be considered reliable. Perspectives The LMO records did not deliver a reliable assessment record for the purposes of this study. Nevertheless, the study showed that the hypothesis on partial lesions were not reproducible in 8 testings because the therapeutic effect was too strong. The low degree of significance for the dominant lesion might give reason for further testing with an improved design.

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