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Accuracy of Lumbar Somatic Dysfunction Diagnosis in Comparison to Muscle Stiffness Measured by Myotonometry

Journal: Journal of Osteopathic Medicine Date: 2023/12, 123(12):Pages: A61-A62. doi: Subito , type of study: observational study

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2023-2000/html)

Keywords:

diagnosis [263]
lumbar spine [43]
muscle stiffness [3]
mytonometry [1]
observational study [126]

Abstract:

Statement of Significance: Accuracy of osteopathic diagnosis is necessary for proper evaluation of osteopathic manipulative treatment (OMT). Poor interexaminer reliability in lumbar spine diagnosis has been shown. Interexaminer reliability can be improved over time with training. The MyotonPRO myotonometer is proven to accurately assess muscle tension [3]. This study examined the correlation of somatic dysfunction diagnosis by NMM/OMM specialist and tissue texture changes measured as muscle stiffness/tone overlying the area. To investigate whether the MyotonPro reading for stiffness compares to the segmental lumbar rotational diagnoses made by a physician. Research Methods: Three NMM/OMM board-certified physicians diagnosed lumbar somatic dysfunctions in subjects in the L1 and L3 segments of the lumbar spine. Stiffness and frequency (tone) was measured bilaterally at the levels of paraspinal muscle via the MyotonPro by a separate research team investigator blinded to the physician diagnosis. Data Analysis: MyotonPro data was analyzed from 7 healthy female subjects, 168 unique measurements using statistical analysis. 38.8% of all the somatic dysfunction (SD) diagnosis made by the physicians correlated with the MyotonPro’s measurement of increased stiffness, while 41% of the diagnoses correlated with increased measured tone. 28.6% of type 1 somatic dysfunction diagnosis correlated with measured tone and 34.3% correlated with measured stiffness. While 50% of type 2 somatic dysfunctions correlated with measured tone and 43.8% correlated with measured stiffness. Conclusion: Less than half of all somatic dysfunctions diagnoses made by the physician aligned with the objective readings of stiffness and tone. Type 2 SD had a higher correlation to the myotonometer-measured tone and stiffness. This may be due to increased muscle hypertonicity and stiffness because rotation and side bending are in the same direction. However, this displays the need for a way to cross-check readings and have a non-biased form of objective measurement during OMT treatments. Other possibilities include the inability of the myotonometer to assess type 1 and type 2 dysfunctions of the lumbar spine. Limitations include small sample size and varying physician diagnostic styles. Further research is required to determine the benefits of utilizing the MyotonPro to assist in confirming somatic dysfunction diagnosis.


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