Clara Driaï-Allègre , Fanny Coste , Clara Olmière , Marilyne Grinand , Aymeric Le Nohaïc , François Romanet , Géraud Gourjon
{"title":"Evidence of anchoring bias in novice (first year) osteopathic French students in the context of the primary respiratory mechanism: A randomized-experimental study","authors":"Clara Driaï-Allègre , Fanny Coste , Clara Olmière , Marilyne Grinand , Aymeric Le Nohaïc , François Romanet , Géraud Gourjon","doi":"10.1016/j.ijosm.2024.100717","DOIUrl":"10.1016/j.ijosm.2024.100717","url":null,"abstract":"<div><h3>Background</h3><p>Cognitive biases appear to be one of the most common causes of incorrect medical diagnosis. It affects students during their training and could persist after post-graduation. This could deteriorate patient care. Among them, anchoring bias can impair haptic perception and lead to a biased diagnosis.</p></div><div><h3>Objective</h3><p>Our study assessed the anchoring bias of first-year osteopathic students by determining whether information regarding the PRM rhythm could influence their haptic perception.</p></div><div><h3>Methods</h3><p>Forty first-year osteopathic students were randomly assigned to three groups. They were given different anchoring values during a PRM rhythm evaluation (3, 10 or 17 movements per minute, mpm). All information were given through video documents. Perceived rhythms were collected before and after anchoring. Wilcoxon and Kruskal-Wallis tests were used to compare intra and intergroup values.</p></div><div><h3>Results</h3><p>Before receiving the anchor, groups significantly (p = 0.105) perceived the same rhythms (11.8 ± 6.6mpm; 20.9 ± 9.9mpm; 18.2 ± 10.6mpm; respectively) with high variance among students. After receiving the anchor, students perceived significantly different rhythms; 3.5 ± 1.7mpm; 11.4 ± 2.8mpm; 16.8 ± 6.6mpm, respectively (p < 0.0001). Variance decreased significantly.</p></div><div><h3>Conclusion</h3><p>An anchoring bias might occur among first-year osteopathic students regarding their perception of the PRM rhythm. These results provide insights into the importance of the way of presenting information to students, especially controversial ones. Indeed, the way in which changing the ontological framework can modify the epistemological approach needs to be investigated. This could have implications on a student's clinical diagnosis. Students are encouraged to believe in their haptic ability, but also to use critical thinking.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"52 ","pages":"Article 100717"},"PeriodicalIF":1.9,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139951369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pseudoscience: A skeleton in osteopathy's closet?","authors":"Oliver P. Thomson , Carlo Martini","doi":"10.1016/j.ijosm.2024.100716","DOIUrl":"10.1016/j.ijosm.2024.100716","url":null,"abstract":"<div><p>Pseudoscience has harmful effects on individual patient care, professions and society more broadly. The propagation of pseudoscience and spread of misinformation by a healthcare discipline raises questions as to their legitimacy and ethical standing as a profession. Osteopaths and osteopathic physicians are regulated by law as healthcare professionals in many parts of the world with an expectation that relevant aspects of practice are suitably aligned with the scientific paradigm in the form of a commitment to the values of evidence-based practice. This article discusses the system of pseudoscience and considers its historic, present and potential negative impacts on osteopathy and professional progress. We identify possible incentives for some aspects of osteopathy and osteopaths to engage in pseudoscientific thinking and in doing so we discuss osteopathy's susceptibility to pseudoscience and how practitioners may become more aware of and recognise pseudoscientific information and pseudoexpertise.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"52 ","pages":"Article 100716"},"PeriodicalIF":1.9,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139922192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diego F. Hidalgo , Andrew MacMillan , Oliver P. Thomson
{"title":"‘It's all connected, so it all matters’ - the fallacy of osteopathic anatomical possibilism","authors":"Diego F. Hidalgo , Andrew MacMillan , Oliver P. Thomson","doi":"10.1016/j.ijosm.2024.100718","DOIUrl":"10.1016/j.ijosm.2024.100718","url":null,"abstract":"<div><p>Anatomy has been a cornerstone of osteopathic theory, practice and identity since the discipline's emergence in the 1800s and continues to be viewed as core knowledge to the present day. The domain of anatomical knowledge has provided seemingly endless rationales and explanations to justify osteopathic diagnosis, assessment and treatment. Moreover, knowledge of anatomy has been foundational for osteopaths' professional identity and conception of healthcare practice. Anatomical possibilism refers to the imagined, exaggerated, implausible and unproven relationships which are claimed to exist between anatomical structures. In persisting with such an approach to theory, practice and reasoning osteopathy may waste time, energy and intellectual capital and as a result fail to take advantage of opportunities to develop more plausible, ethical and person-focused approaches to patient care.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"52 ","pages":"Article 100718"},"PeriodicalIF":1.9,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139922468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New Zealand osteopaths’ use of patient-reported outcome measures with patients who have chronic low back pain: A cross-sectional survey","authors":"Evania Vallyon , Saeideh Aminian , Samantha Heath","doi":"10.1016/j.ijosm.2024.100719","DOIUrl":"10.1016/j.ijosm.2024.100719","url":null,"abstract":"<div><h3>Background and Objectives</h3><p>Patient-Reported Outcome Measures (PROMs) are instruments that capture patients' perspectives of their own health status and quality of life. As part of rising advocacy for their use in clinical practice, PROMs are said to hold promise for the management of long-term conditions. This study aimed to describe and explore New Zealand osteopaths’ use of PROMs for patients with chronic low back pain.</p></div><div><h3>Methods</h3><p>An online survey was adapted to investigate New Zealand osteopaths’ use of PROMs with patients who have chronic LBP. Topics included frequency of use, purposes for use, and determinants to use. Respondents were recruited via anonymous and non-randomised sampling across multiple platforms. Frequencies, means, and standard deviations were calculated for all numerical data. Content analysis was used to analyse textual data on determinants to use.</p></div><div><h3>Results</h3><p>In total, 79 osteopaths were included in data analysis. These respondents most often used PROMs to monitor patients’ pain intensity (80%) and sometimes also functional disability (27%). Although the respondents had some regard for their capability to use PROMs, they also claimed to be constrained by limited time and social or professional norms. Respondents were more attentive to the consequences of PROMs for patients than for other stakeholders.</p></div><div><h3>Conclusions</h3><p>Although New Zealand osteopaths may use PROMs to monitor the burden of chronic LBP, they probably do not use PROMs for the multidimensional assessment of pain or psychosocial factors. New Zealand osteopaths may be most receptive to adopting PROMs if they are presented with relevant interventions and evidence of their benefits for patients.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"52 ","pages":"Article 100719"},"PeriodicalIF":1.9,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139922188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A 25-year-old woman with 7 years of intractable hiccups treated with OMT – A case report","authors":"Derek E. Bowman, Christopher Pohlod","doi":"10.1016/j.ijosm.2024.100712","DOIUrl":"10.1016/j.ijosm.2024.100712","url":null,"abstract":"<div><p><em>Background:</em> Persistent and intractable hiccups are poorly understood and reduce the quality of life of afflicted patients. Hiccups lasting longer than 48 hours are defined as “persistent,” and those lasting longer than 30 days as “intractable.” Both persistent and intractable hiccups are rare diseases included in the National Organization for Rare Disorders (NORD) registry, with cases of intractable hiccups being extremely rare. There are limited effective treatment options currently available for both persistent and intractable hiccups.</p><p><em>Clinical features:</em> Reported here is the case of a 25-year-old female patient with a 7-year history of intractable hiccups that were successfully treated with osteopathic manipulative treatment (OMT). Her hiccups began in 2015, typically occurring in couplets, with upwards of 50 hiccups per day. In 2016, she was treated by her primary care physician for <em>H. pylori</em>, with no improvement. Referred to a gastroenterologist, she underwent an endoscopy that showed normal findings, and she was subsequently referred to a neurologist. A CT scan of the brain was performed and showed normal findings, prompting the neurologist to suggest muscle relaxants (which were refused at the time) and various breathing and relaxation techniques, including talk therapy. With the continued failure of these treatments, the patient attempted acupuncture without benefit. In early 2022, the patient decided to try the muscle relaxant baclofen and found no benefit after two months of treatment.</p><p><em>Intervention and outcomes:</em> In August 2022, osteopathic manipulative treatment (OMT) was administered over five sessions. After the third session, the patient noticed a complete absence of her typical hiccups but began experiencing frequent “micro” hiccups that produced little-to-no sound. After the fourth treatment and continuing past the fifth treatment, the patient has had a near complete cessation of her hiccups, about 1–2 “micro” hiccups per week. Follow up with the patient on May 1, 2023, confirmed the continued resolution of her intractable hiccups.</p><p><em>Conclusion:</em> In a 25-year-old female patient without prior or concurrent medical conditions, OMT techniques successfully treated intractable hiccups of a 7-year duration. This case supports a potential role for OMT in the care of intractable hiccups.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"52 ","pages":"Article 100712"},"PeriodicalIF":1.9,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139814204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The double facets of osteopathy's identity","authors":"Pierre-Luc L'Hermite","doi":"10.1016/j.ijosm.2024.100715","DOIUrl":"10.1016/j.ijosm.2024.100715","url":null,"abstract":"<div><p>Questions relating to osteopathic identity are likely to be characterised by double facets made up of both traditional and contemporary elements. The analysis conducted aims to be robust by presenting these components as elements able to dialogue. It is through Paul Ricoeur's concept that we propose as an approach: the idem identity concerns the elements that provide a certain temporal stability whilst the ipse identity embodies the variable aspects of the constitutive elements of osteopathy. Osteopathy's identity would thus be modelled by the association of these two regularly interacting influences insofar as they serve both issues: shaping a disciplinary specificity, and the requirements focused on the improvement of patient care.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"52 ","pages":"Article 100715"},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139657784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Osman Tufekci , Kamil Yilmaz , Hasan Gercek , Bayram Sonmez Unuvar
{"title":"The effectiveness of manipulation in combination with exercise for patients with coccydynia: Six months follow-up of a randomized controlled trial","authors":"Osman Tufekci , Kamil Yilmaz , Hasan Gercek , Bayram Sonmez Unuvar","doi":"10.1016/j.ijosm.2024.100711","DOIUrl":"10.1016/j.ijosm.2024.100711","url":null,"abstract":"<div><h3>Background</h3><p>Limited evidence exists concerning the long-term follow-up of pain management in individuals with coccydynia.</p></div><div><h3>Objective</h3><p>This study aimed to examine the effectiveness of combining manipulation and exercise as a treatment approach for patients with coccydynia, while also assessing its long-term outcomes.</p></div><div><h3>Design</h3><p>Six months follow-up of a randomized controlled trial.</p></div><div><h3>Setting</h3><p>This study was conducted in a private hospital.</p></div><div><h3>Methods</h3><p>The control group (n = 23) received exercise alone, while the experimental group (n = 23) received both exercise and manipulation. All participants performed exercises three days a week for four weeks, and the manipulation sessions were conducted once a week for a total of four sessions. Pain levels were assessed using the Visual Analog Scale (VAS), coccydynia symptoms were evaluated using the Paris questionnaire, and pain-related disability was measured with the Oswestry Disability Index (ODI).</p></div><div><h3>Participants</h3><p>Forty-six participants were enrolled in the study.</p></div><div><h3>Results</h3><p>No statistically significant differences were observed in the demographic characteristics between the two groups (p > 0.05). However, participants in the manipulation group showed a statistically significant improvement in pain, symptoms, and ODI scores compared to the control group, both immediately after treatment and at the 6-month follow-up (p < 0.05).</p></div><div><h3>Conclusion</h3><p>This study demonstrates that the combination of exercise and intrarectal manipulation over a four-week period significantly reduced pain, coccydynia-related symptoms, and disability scores in chronic coccydynia patients. However, no therapeutic superiority was observed in the long-term follow-up of six months.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"51 ","pages":"Article 100711"},"PeriodicalIF":1.9,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139635587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Alice Mainenti Pagnez , Maria Silveira Mello , Juliana Valentim Bittencourt , François Ricard , Leandro Alberto Calazans Nogueira
{"title":"Different exposure times of flexion distraction technique in the L5-S1 distance and local pain of patients with chronic low back pain: A feasibility study","authors":"Maria Alice Mainenti Pagnez , Maria Silveira Mello , Juliana Valentim Bittencourt , François Ricard , Leandro Alberto Calazans Nogueira","doi":"10.1016/j.ijosm.2024.100714","DOIUrl":"10.1016/j.ijosm.2024.100714","url":null,"abstract":"<div><h3>Background</h3><p>Low back pain (LBP) is a worldwide public health problem. The flexion-distraction technique (FDT) has been considered to treat LBP. However, the adequate dosage and the treatment effects are not clearly understood. This feasibility study aimed to assess the effects of different exposure times with 5 and 10 min of the FDT on the L5-S1 distance and pressure pain threshold (PPT) of patients with chronic LBP.</p></div><div><h3>Methods</h3><p>A two-arm, examiner-blinded, randomized controlled feasibility trial with participants with chronic LBP enrolled in an outpatient clinic. Participants were randomly assigned to FDT-T5 (5 min) or FDT-T10 (10 min). The distance between the L5 lamina and the sacral promontory, and the PPT at the L5 spinous process was measured before and immediately after FDT. Ultrasound imaging was used to measure L5-S1 distance, and the pressure algometry examined the PPT. Pre- and post-intervention data were compared between two groups by two-way analysis of variance (ANOVA) for repeated measures. We also calculated the intra- and inter-rater reliability of the L5-S1 measurement.</p></div><div><h3>Results</h3><p>Seventeen participants [10 (58.8 %) females, mean age 45 (±12) years] completed all procedures. Improvements in the intervertebral space [FDT-T5 mean change = 2.65 (95 %CI 1.45, 3.85) mm; FDT-T10 mean change = 1.88 (95 %CI -1.86, 5.63) mm] and decreases in PPT values [FDT-T5 mean change = −0.55 (95 %CI -1.35, 0.26) Kgf; FDT-T10 mean change = −0.79 (95 %CI -1.92, 0.34) Kgf] were observed, although there was no significant difference between the two groups for the distance between the L5 lamina and the sacral promontory (p = 0.595) or the spinous process L5 PPT (p = 0.672) after the intervention. Good reliability values were found for inter- and intra-rater measurements ranging between ICC = 0.81 to ICC = 0.88).</p></div><div><h3>Conclusion</h3><p>In this feasibility trial, both groups showed an increased distance between L5-S1 and decreased the PPT in the L5 spinous process, indicating greater pain sensitivity after the intervention. These quantitative methods may measure distance and pain in definitive studies.</p></div><div><h3>Implications for practice</h3><p></p><ul><li><span>•</span><span><p>This is the first study to compare the distance between the L5 lamina and the sacral promontory after the flexion-distraction technique (FDT) using ultrasound imaging (USI).</p></span></li><li><span>•</span><span><p>The present study could not determine the effect of a particular time of exposure to FDT (FDT-T5 or FDT-T10 min).</p></span></li><li><span>•</span><span><p>Both groups (FDT-T5 and FDT-T10 min) increased the lumbar distance, corresponding to mobilization of the lumbar region.</p></span></li><li><span>•</span><span><p>Both groups presented decreased values of PPT in the L5 spinous process immediately after the technique.</p></span></li><li><span>•</span><span><p>A single session of FDT showed i","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"51 ","pages":"Article 100714"},"PeriodicalIF":1.9,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139552100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nathaniel J. Leavitt, Rachel S. Sundman, Jessica R. Mazzi, Johannie M. Spaan, Glen E. Kisby
{"title":"A pilot study to assess medical students' perception of their osteopathic manipulative therapy (OMT) education","authors":"Nathaniel J. Leavitt, Rachel S. Sundman, Jessica R. Mazzi, Johannie M. Spaan, Glen E. Kisby","doi":"10.1016/j.ijosm.2024.100713","DOIUrl":"10.1016/j.ijosm.2024.100713","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this pilot study was to determine which factors (both positive and negative) of a medical students' OMT training influenced their perception of OMT and their intent to use it in the future.</p></div><div><h3>Methods</h3><p>A computer-based survey was distributed to medical students (years 1–4) at two different campuses of an Osteopathic Medical School based in the United States. Multiple factors affecting students' perception of OMT were assessed, including experiences prior to medical school or during their pre-clinical years, virtual/in-person learning, OMT club, OMT clerkship, and OMT fellowship. Students were also asked about their confidence in using OMT, overall perception of OMT, and future intent to use OMT.</p></div><div><h3>Results</h3><p>Factors that appeared to positively influence medical students' perception of OMT were in-person hands-on training (76 %), prior medical school experiences (31 %), OMT club activities (19 %), and OMT fellowship (9 %). Those that appeared to negatively influence their perception were virtual learning (47 %) and pre-clinical lecture hours (46 %). Medical students' overall perception of OMT diminished when comparing first-year to third- and fourth-year students. Selecting an osteopathic school for OMT training also had a positive influence on a students' perception of OMT. Students who were satisfied and confident in their training reported a higher likelihood of using OMT in the future.</p></div><div><h3>Conclusions</h3><p>Students' attitude toward OMT and their reported likelihood of future use of OMT were improved by hands-on/in-person learning, clinical OMT opportunities, and OMT experiences prior to medical school. Greater attention must be focused on these forms of OMT education.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"51 ","pages":"Article 100713"},"PeriodicalIF":1.9,"publicationDate":"2024-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139515174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inter-rater and intra-rater reliability of manual assessment of respiratory motion in patients with unilateral cervical radiculopathy: A cross-sectional study","authors":"Amin Kordi Yoosefinejad , Raziyeh Yousefiyan , Raziyeh Nazari , Iman Rezaei","doi":"10.1016/j.ijosm.2024.100708","DOIUrl":"10.1016/j.ijosm.2024.100708","url":null,"abstract":"<div><h3>Background</h3><p><span>Altered breathing pattern is a consequence of dysfunctional breathing. The respiratory pattern might be impaired </span>in patients<span> with cervical radiculopathy<span> due to the involvement of common nerve roots with the phrenic nerve (C3– C5).</span></span></p></div><div><h3>Objective</h3><p>The aim of this study was to investigate the inter-rater and intra-rater reliability of a technique for evaluating the breathing pattern known as manual assessment of respiratory motion (MARM) in patients with unilateral cervical radiculopathy.</p></div><div><h3>Design</h3><p>Cross-sectional study.</p></div><div><h3>Setting</h3><p>Rehabilitation Sciences Research Center</p></div><div><h3>Participants</h3><p>Twenty-five patients with unilateral cervical radiculopathy aged 30–55 years participated in this study.</p></div><div><h3>Methods</h3><p>Two experienced physical therapists investigated the respiratory pattern of the patients during normal and deep breathing using MARM, separately. Assessments were repeated again a week apart by each examiner. The inter- and intra-rater reliability of the MARM were calculated.</p></div><div><h3>Results</h3><p>“Very good” inter-rater and intra-rater reliability were found with the MARM values during both normal and deep breathing patterns. (Inter-rater: ICC range = 0.71 to 0.82; intra-rater: ICC range = 0.72 to 0.80).</p></div><div><h3>Conclusions</h3><p>MARM is a reliable clinical and research tool for assessing breathing patterns with very good inter- and intra-rater reliability in patients with unilateral cervical radiculopathy.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"51 ","pages":"Article 100708"},"PeriodicalIF":1.9,"publicationDate":"2024-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139373877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}