Inter and Intra Operator Reliability of Motor and Palpation Evaluation in Fascial Manipulation in individuals with coxarthrosis

ABSTRACT

Objective

An inter and intra rater reliability (INTERR and INTRAR) study was designed.

Methods

71 subjects, with primary hip coxarthrosis, were included and randomly divided in a study group (SG= 36) and a control group (CG= 35) to assess the efficacy of the Fascial Manipulation® (FM®) method. The primary objective was the assessment of INTERR and INTRAR about movement verification (MV) and palpation verification (PV) of FM® performed by two physiotherapists (PtA and PtB). The secondary objective was evaluate the efficacy of FM® through MV, PV and pain score. Pain was assessed using the Numeric Rating Scale (NRS). SG received three weekly sessions of FM® byPtA. PtB re-evaluated all the subjects at the end of the study.

Results

Results of the INTERR analysis showed for SG: MV (ICC= 0.92, k= 72.7%); PV (ICC= 0.91, k= 75.7%). For CG : MV (ICC= 0.95, k= 84.2%); PV (ICC= 0.90, k= 75%). Results of the INTRAR analysis for SG reported: MV (ICC= 0.82, k= 74,8%); PV (ICC= 0.60, k= 46.8%); for CG: MV (ICC= 0.93, k= 78.7%); PV (ICC= 0.84, k= 53.3%). Statistical significance were reported in NRS (p = 0.001), MV (p = 0.0003) and PV (p < 0.0001) with better results for SG using “Intention To Treat” method.

Discussion

This study demonstrates that FM® assessment procedures have a high reliability even if applied by practitioners with basic experience. Furthermore FM® treatment can improve pain and ROM in individuals with primary coxarthrosis

KEYWORDS:

• Fascial manipulation
• Inter reliability
• intra reliability
• movement evaluation
• motor evaluation
• palpation evaluation
• coxarthrosis
• pain

Acknowledgments

This study was made possible by the participation of the staff of the 'Unit of Orthopedics and Prosthesis of the Hip and the Knee of the Rizzoli Institute in Bologna'. We would like to acknowledge its director, Dr Alessandra Sudanese.

Disclosure statement

No potential conflict of interest was reported by the authors.

Consent

Written informed consent for publication of clinical details was obtained from the patients.

Additional information

Funding

The authors declared that no grants were involved in supporting this work.

Notes on contributors

Andrea Cotti

Andrea Cotti is a Physiotherapist, Clinical Coordinator in Rizzoli Orthopaedic Institute - Bologna, Master in “Management of the rehabilitative area

Massimiliano Del Corso

Massimiliano Del Corso is a 3rd year student of Physiotherapy degree course, University of Bologna.

Roberto Diana

Roberto Diana is a 3rd year student of Physiotherapy degree course, University of Bologna.

Luigi Cornale

Luigi Cornale is a 3rd year student of Physiotherapy degree course, University of Bologna.

Alessandra Sudanese

Alessandra Sudanese is a Orthopedist, Director of the Hip and Knee Prosthesis Surgery Unit in Rizzoli Orthopaedic Institute - Bologna.

Antonio Stecco

Antonio Stecco is a Physiatrist, Assistant Professor at Rusk Rehabilitation, New York University School of Medicine, New York, USA.

Mirco Branchini

Mirco Branchini is a Physiotherapist, Didactic Coordinator of the University of Bologna Physiotherapy Degree Course, High education in “Applied Statistics for clinical queries.”