Faking it in OMM.

[facetguy]

I once proposed a "study" in which randomly-assigned people visited 3 stations manned by OMM experts. Each expert assessed and diagnosed whether a dysfunction was present on the patient assigned. The order was randomized for each station. No treatment was administered. Then a comparison was made to check for consistency between each examiner.

Nobody wanted to do it.

There is some data on interexaminer reliability as it relates to palpation of joint dysfunction. This is not an exhaustive list:

http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/...nkpos=1&log$=relatedarticles&logdbfrom=pubmed

http://www.ncbi.nlm.nih.gov/pubmed/...nkpos=2&log$=relatedarticles&logdbfrom=pubmed

http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/...nkpos=2&log$=relatedarticles&logdbfrom=pubmed

Pain upon palpation seems to be the most reliable. This is helpful in real clinical practice, but may not be so helpful in a classroom exam situation where the "patient" cannot report symptoms and is "normal" to begin with.

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[DD214_DOC]

There is some data on interexaminer reliability as it relates to palpation of joint dysfunction. This is not an exhaustive list:

http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/...nkpos=1&log$=relatedarticles&logdbfrom=pubmed

http://www.ncbi.nlm.nih.gov/pubmed/...nkpos=2&log$=relatedarticles&logdbfrom=pubmed

http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/...nkpos=2&log$=relatedarticles&logdbfrom=pubmed

Pain upon palpation seems to be the most reliable. This is helpful in real clinical practice, but may not be so helpful in a classroom exam situation where the "patient" cannot report symptoms and is "normal" to begin with.

Well, I have no doubt something like pain would be good since it's objective. I think we're talking about when a DO palpates a supposed specific dysfunction, like T4 FSrRr (I think single segments are Type II, don't remember)

 

[newdoc15]

Sombody hollars consistently when 3 different people push on the same painful spot? Groundbreaking stuff here.

 

[Fermata]

Honestly, I approach OMM from the perspective of it at the very least augmenting my palpation skills. It dovetailed well when we had our neuromuskuloskeletal unit. It helps to connect some anatomy together. That's my limit, however. I will not be browbeaten about not being able to feel the "pulsative nature of CSF".

Seriously.


On another note, if you seriously plan on using this stuff in practice some day, then the stuff we learn in 2 years is not enough. In my opinion, you would at least need to do a fellowship in it or go into a well-integrated FP residency. OMM can be a good set of tools in your toolbox, a varied enrichment experience, or a waste of your time depending on your perspective. The best way for DO's to distinguish themselves is to be competent and empathetic, in that order.

 

[Old_Mil]

something like pain would be good since it's objective.

Pain is anything but objective.

A diplaced open fracture...now that's objective.