Browsing by Subject "somatic dysfunction"
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Item Interexaminer Reliability of Somatic Palpatory Findings Associated with Chronic Low Back Pain(2002-05-01) Russo, David P.; Scott Stoll; John C. Licciardone; Russell GamberRusso, David P., Interexaminer Reliability of Somatic Palpatory Findings Associated with Chronic Low Back Pain. Master of Science, May 2002, 15 pp., 1 table, 1 figure, bibliography, 26 titles. Osteopathic physicians rely on specific clinical palpatory tests to diagnose somatic dysfunction of the neuromusculoskeletal system. The purpose of this study is to compare the interexaminer reliability of six common osteopathic clinical tests to severity ratings of somatic dysfunction in six body regions. Ten trained and clinically supervised predoctoral osteopathic manipulative medicine fellows collected palpatory data using the Standardized Outpatient Osteopathic Soap Note Form (SNF) and recorded findings for six pre-selected osteopathic clinical diagnostic tests as part of a randomized controlled trial of osteopathic manipulative treatment for chronic low back pain. Kappa coefficients were used to assess overall examiner agreement for the osteopathic clinical tests. Intraclass correlational coefficients (ICC) and Chronbach’s alpha were used to assess examiner agreement for the severity ratings. Kappa values for the six clinical tests ranged from 0 to 0.32. The single item ICC was 0.32, average item ICC was .74, and the coefficient alpha for internal consistency of the six body region scores was 0.80. These results indicate that diagnostic impressions of somatic dysfunction severity may be more reliable than outcomes from isolated osteopathic clinical tests.Item The Interactions Between Muscle Tension and Cold Induced Pain and Their Effects on the Sympathetic Nervous System(2009-05-01) DeLukie, Aleigha A.; Smith, Michael L.These studies tested 1) the hypothesis that muscle tension and pain produced at subthreshold intensities for provoking a pressor effect will produce a pressor effect when combined (synergism); and 2) that cold-induced pain applied to the forearm produces a similar pain and pressor effect as cold ice-bath immersion of the hand. Arterial pressure (AP) and perceived pain measurements were obtained in 17 volunteers during 10% static handgrip, 6ºC cold applied to the forearm and the combination of both stimuli. Neither stimulus produced a pressor effect alone (0.08 [less than] p [less than] 0.48), but evoked an increased systolic and mean arterial pressure when combined (p = 0.030 and p [less than] 0.001). An equivalent cold stimulus applied to the forearm produced less pain and pressor effects than hand immersion in ice (p [less than] 0.01, all variables). These findings suggest that combinations of mild muscle tension and pain (such as with somatic dysfunction) can act synergistically to provoke a significant pressor response.