Lumbar Diagnosis and Pressure Difference Variance
| Autor: | Navya Voleti, Nicole Angelo, Michael A. Gaspari, Elizabeth George, Sheldon C. Yao |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Complementary and Manual Therapy
030222 orthopedics Lumbar Somatic Dysfunction medicine.medical_specialty Palpation medicine.diagnostic_test business.industry New York Somatic dysfunction Context (language use) Osteopathic medicine in the United States 030205 complementary & alternative medicine 03 medical and health sciences Prone position 0302 clinical medicine Lumbar Complementary and alternative medicine Pressure Physical therapy Humans Medicine Medical diagnosis business Osteopathic Medicine |
| Zdroj: | Journal of Osteopathic Medicine. 120:e86-e91 |
| ISSN: | 2702-3648 |
| DOI: | 10.7556/jaoa.2020.066 |
| Popis: | Context There is no consensus on the correlation between clinical experience and accuracy in diagnosing somatic dysfunctions, which makes it difficult to justify the use of more subjective measures to evaluate this important association. To better understand this relationship, palpatory forces can be observed while diagnosing a somatic dysfunction. Objective To quantify the pressure applied in diagnosing lumbar somatic dysfunction, find a correlation between accuracy of diagnosis and palpation pressure, set the standards for palpation, and develop precise palpatory skills for osteopathic medical students. Methods The palpatory forces were evaluated between participants with varying experience levels (osteopathic medical students and attending physicians from the New York Institute of Technology College of Osteopathic Medicine). Two osteopathic physicians confirmed an L5 somatic dysfunction diagnosis in a volunteer standardized patient (SP), who served as the control. Participants then palpated the lumbar segment of the SP in a prone position with F-Scan System (TekScan) sensors, which recorded the amount of pressure and time used to reach a full diagnosis. Results Participants (11 osteopathic medical students and 10 attending physicians) who diagnosed an L5 somatic dysfunction consistent with the SP's diagnosis had less of a difference in peak force (mean [SD] difference, 62.50 [325.7] g/cm2) between the contact points (right hand vs left hand). In contrast, participants with a dissimilar L5 diagnosis from the SP's had a mean (SD) difference in peak force of 319.38 (703.1) g/cm2. Similarly, the difference in the mean (SD) force of palpation between the contact points was lower in participants who made the correct diagnosis (16.81 [117.4] g/cm2) vs those who made an incorrect diagnosis (123.92 [210.3] g/cm2). No statistical significance was found between the diagnostic accuracy of the students and physicians (P=.387) or the time taken to reach a diagnosis (P=.199). Conclusion We observed that using equal pressures in both hands while palpating a lumbar segment correlates to more accurate somatic dysfunction diagnoses. |
| Databáze: | OpenAIRE |
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