Somatic dysfunction: osteopathic examination ae,curacy and clinical measures. An observational study.
Item
- Title
- Somatic dysfunction: osteopathic examination ae,curacy and clinical measures. An observational study.
- Author(s)
- Fishlock, L
- Abstract
- Background: osteopathic diagnosis utilises the model of somatic dysfunction (SD) to obtain functional assessment of musculoskeletal structures. Cardinal signs of tenderness, landmark asymmetry, altered range of motion (ROM) and tissue texture change (TART) can be observed. Focus on palpation within this approach may challenge inter-rater reliability and diagnostic accuracy, although examiner experience may improve sensitivity to anatomical structures. The threshold measures for SD are poorly understood and objective reporting on all TART criteria is insufficient. Objectives: To investigate the efiect which rater experience has on SD and whether this is supported by objective measures. Design: A single-blinded approach, with a comparative observational design. Method: The lumbar spines of male models were assessed using objective measures mapped to the TART criteria. A Shapiro-Wilk test was used to assess normal distribution of outcome measure and baseline characteristics. Models were examined in the observational phase and positioned on a numeric rater scale for SD severity and tissue texture quality. The raters were blinded to each other and the TART baseline. Scores were recorded and analysed for inter-rater agreement using Gwet's AC score. Results: lnter-rater reliability for SD (AC1 0.0944; 95% Cl 0:0.245) and tissue texture change (AC1 0.0273; 95o/o Cl 0:0.136) was 'poor', no statistical significance was found between the groups, however postgraduates demonstrated 'substantial' repeatability of accurate measures compared to undergraduates score of 'fair'. Validity of outcome measures was scored 'poor’ to 'moderate' and subjective measures 'poor'. Discussion: This study suggests the diagnosis of SD based on rater experience showed no statistically significant difference, between subjective findings of rater groups and outcome measures. These results are in alignment with previous studies. Several factors may have limited this study rncluding the sample, the use of non-validated objective tests, the environmental setting and the experimental approach used. Conclusion: Comparison of objective measures and lnter-rater reliability for both groups was 'low', although clinical experience was shown to improve accuracy. Considerations for subsequent research should ensure SD is further quantified and mapped to objective measures to develop evidence based approach and unique application in osteopathic practice upheld.
- presented at
- European School of Osteopathy
- Date Accepted
- 2017
- Date Submitted
- 4.12.2017 17:06:20
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 16035
- Inst-Identifier
- 1229
- Keywords
- Low back pain, Palpation, Somatic dysfunction, TART criteria
- Recommended
- 0
- Item sets
- Thesis
Fishlock, L, “Somatic dysfunction: osteopathic examination ae,curacy and clinical measures. An observational study.”, Osteopathic Research Web, accessed May 5, 2025, https://www.osteopathicresearch.com/s/orw/item/501