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The use of spinal and sacroiliac joint procedures within the British osteopathic profession. Part 1: Assessment
Fryer, G. [68]
Johnson, J. C. [42]
Fossum, C. [10]

Journal: International Journal of Osteopathic Medicine Date: 2010/12, 13(4):Pages: 143-151. doi: Subito , type of study: cross sectional study

Full text    (https://www.sciencedirect.com/science/article/pii/S1746068910001069)

Keywords:

British osteopathic profession [3]
assessment [94]
diagnosis [263]
manipulation [249]
lumbar spine [43]
sacroiliac joint [59]
osteopathic medicine [1540]
cross sectional study [597]

Abstract:

Background & objectives A wide range of procedures for the assessment of spinal and pelvic disorders has been described in the osteopathic literature, but little is known concerning the methods used by osteopaths in the United Kingdom (UK). This study examined the perception of usefulness and reported use of physical assessment procedures by UK osteopaths. Part 2 of this study will examine the commonly reported treatment methods. Methods A web-based questionnaire using a 5-point Likert scale and open-ended responses was developed and invitations were e-mailed to all registrants of the General Osteopathic Council in the UK with a listed e-mail address (approximately 2700). The available response categories (strongly disagree, disagree, etc.) were converted into numerically weighted scales. Responses in the “agree” and “strongly agree” categories and the “frequently” and “nearly always” categories were combined for summary reporting purposes. Friedman tests were used to determine if significant differences existed for the reported usage of each item. The effect of gender was analysed using Mann–Whitney tests. The effect of years of practice was examined by categorizing practice experience by decade (0–9, 10–19, 20+) and analysing using Kruskal–Wallis tests. Results 520 Osteopaths (56% male, 44% female) with a wide range of years of practice experience (0–36 years, mean 11.6 years, SD 9.7) participated in the survey. The majority of respondents (81%) agreed that the identification of dysfunction to the joints and tissues of the spine were important to their practice, but there was spread of opinion regarding the importance of identifying spinal dysfunctions affecting a single vertebral level. Respondents reported that paraspinal tissue texture changes (93%), range of joint motion (93%), and quality of joint motion (91%) were the most relevant and important clinical findings for the identification of segmental spinal dysfunction and that asymmetries of spinous or transverse processes were the least important of the offered choices (p < 0.001). Respondents deemed provocation of sacroiliac joint pain (82%), reduced range of sacroiliac motion (79%), and tenderness around the sacroiliac joint (80%) as the most highly relevant and important clinical findings for the identification of pelvic and sacroiliac somatic dysfunction (p < 0.001). Significant differences were found for the effect of years of experience and gender for many of these procedures. Conclusion Osteopathic practitioners in the UK who responded to this survey agreed that the identification of segmental disturbances to the joints and tissues of the spine were important to their practice. Clinical findings considered to be important for the identification of spinal and sacroiliac joint dysfunction have been reported.

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