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Reliabilitätsstudie über die Befunderhebung der Wirbelsäule nach der Methode der Lien Mécanique Ostéopathique
(A reliability study on spine findings according to the LMO method)
Hafen-Bardella, C. [2]

Journal: Unpublished MSc thesis Wiener Schule für Osteopathie, Date: 2009/11, Pages: 115, type of study: controlled clinical trial

Free full text   (https://www.osteopathicresearch.org/s/orw/item/2915)

Keywords:

dominant lesion [1]
intra- and inter-rater reliability [1]
lien mécanique ostéopathique [1]
LMO finding method [1]
partial total lesion [1]
reproducibility [22]
spine findings [1]
WSO [433]
controlled clinical trial [283]

Abstract:

Study Design: A methodological study of the intra-rater and the inter-rater-reliability of the spine findings according to the LMO method. The Intra-Rater-reliability and the Inter-Rater-reliability in the findings of the spine by the LMO method for determining the partial total lesion and the dominant lesion are investigated. For this purpose four osteopaths and 36 test persons participate in this study. Each osteopath examines each test person two times. The results from the different osteopaths are compared, as well as the results of the two investigations by the individual osteopath. Outline/Problem Definition The reliability is one of the criteria for an empirical research (Mayring 2005), and according to Mayring (2005) the reliability of a testing method is a criterion for its quality. If the reliability of a method has been found, this is a characteristic to examine the validity of the method. The clinical examination is highly standardized. It is systematic and always done according to the same protocol. Therefore it is very well suited to verify the reliability of the results. Research Question & Objective The Lien Mécanique Ostéopathique (LMO method) is a manual examination and treatment method developed by P. Chauffour and E. Prat. With the spine findings the partial total lesion (sum of all positive tests found) and the dominant lesion (maximum positive test) are determined. Are the partial total lesion and the dominant lesion reproducible when they are determined by the spine findings according to the LMO method? Hypothesis The findings of the investigation of the partial total lesion and the dominant lesion of the spine by the LMO method in repeated implementation by the same or different investigators is predominantly equal (reproducible). Relevance for the Patients The reliability of osteopathic findings by the LMO method can be determined by this thesis. In my opinion it is important that manual findings are adjusted, assessed and conveyed. The osteopath has to know how well his present findings can be reproduced, so as to draw conclusions that are generally valid. This is to protect the patients from false information, based on overvalued manual findings. Avoiding inappropriate treatment by false findings. Relevance for Osteopathy Should the standardization of the method be high enough, the thesis serves for the further development of a promising findings model. If the reliability of the findings method of the spine according to LMO can be proved, it would be a sign of quality for these partial findings. The conveyance and learning of this findings method will get a new status. The results allow further studies: According to Mayring (2005: 185) it only makes sense to investigate the validity of the method if its reliability has previously been studied. Methodology The size of the sample has been fixed at 30 test persons at least. After applying the inclusion and the exclusion criteria 36 test persons could be included in the study. The homogeneity of the test persons could be guaranteed. Four testers, independent of this study, do the findings twice with every test person. The testers had no insight into the files of the test persons, neither before nor during the study. The correlation coefficient was determined with the formula of Holsti. For the confirmation of the intra-rater-reliability a coefficient of equal/greater than: r_H 0.75 is required, for the inter-rater-reliability r_H 0.6. An FME-analysis (Failure mode and effects analysis) was made in advance in order to find and avoid possible sources of errors. Results The hypothesis of the reproducibility of the determination of the partial total lesion was confirmed. The Intra-rater-reliability-coefficient showed an average of r_H: 0.794 (±0.098). The Inter-rater-reliability-coefficient showed an average of r_H: 0.677 (±0.068). For the findings of the dominant lesion, the hypothesis in both cases could not be confirmed. The mean average of the coefficient for the Intra-rater-reliability was r_H: 0.465 (±0.501) and for the Inter-rater-reliability r_H: 0.181 (±0.191). Critical Reflection/Perspectives/Conclusions There is a good reliability, for both the Intra-rater as well as the Inter-rater, for the determination of the partial total lesion with the spine findings according to the LMO method. There is no reproducibility for the determination of the dominant lesion. The results admit the assumption that the standardization and simplicity of the tests fulfil the requirements. For a secure statement about this reliability, we need studies which confirm the results. Additional Information In my practice I have been working since 2005 exclusively by the method of Lien Mécanique Ostéopathique (LMO) developed by Paul Chauffour and Eric Prat (2003) This method (Chauffour, Pratt; 2003) is characterized by detailed and systematized findings (approx. 350 tests. The development and further development of the method by the authors has been purely empirical so far. Since I use LMO every day, whether as osteopath or as assistant, my desire for a scientific basis to this method grew more and more. This prompted me to make this matter the theme of my master thesis and to examine the reproducibility = reliability of the spine findings by the LMO-method.

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