Health & Wellness Services

STUDY 9

Completed

INTRODUCTION

Since 2016, the Centers for Disease Control and Prevention (CDC) and European guidelines have recommended manual therapy as first- line treatment for MSK ill-health.  Manual therapy is an approach where Practitioners of Manual Therapy (PoMT) use hands-on data acquisition and analysis (HODA-A) as a measurement instrument for research, diagnosis, prognosis, and a tool for treatment.  Yet manual therapy techniques fail all reliability studies, therefore without proof that hands-on is a valid and reliable method of data collection, this very much limits the conclusions that can be drawn from using the hands in MSK healthcare.

To test HODA-A concurrent validity a pilot study was chosen for multiple reasons: (1) there are currently no previous concurrent validity studies on HODA-A, therefore, there are no known effective experimental methodologies, (2) for achieving the best practices the experimental methodology needed to be iterative, and (3) to gain a preliminary estimate of whether HODA-A produces data that agree with the gold standard test, 3D Mocap.

HYPOTHESIS

A small-scale pilot study was conducted, using 3D Mocap as the independent gold standard test, to explore if a tester HODA-A has concurrent validity, and can be used as a valid measurement instrument when conducting manual MSK assessments.

RECRUITMENT

Single-subject case study (female age 33 years, height 161cm, and mass 75kg) with repeated measures and concurrent controls pilot study

Jo Abbott Blueprint Patient MSK Health Chat

Currently, the most relevant independent gold standard test to establish concurrent validity of spatial parameters is 3D Mocap (Garrido-Castro et al., 2012; Mündermann et al., 2006; Yoshida et al., 2022). This concurrent validity pilot study used 3D Mocap to compare spatial parameters gained by HODA-A when MSK manually assessing a testee’s pelvic position in quiet standing, and leg length discrepancy in supine. The data analysed from HODA-A and 3D Mocap were taken at the same point in time. The HODA-A methods the tester (author) applied in this study were a combination of the anecdotal evidence, the indirect evidence, and the experimental outcomes of HODA-A. Two MSK screens shall be used: (1) supine LLD, and (2) pelvic position in quiet standing, all trials will be measured against the gold standard, 3D Mocap.

The trajectories of passive reflective markers were tracked in three dimensions using a 10- camera wall mounted, opto-electronic motion analysis system (Vicon T40S, Vicon Motion Systems, Oxford, UK) sampling at 1000Hz. The three-dimensional marker trajectories were synchronised electronically within Vicon’s proprietary capture software (Vicon Nexus 2.5 OR 2.6, Vicon Motion Systems, Oxford, UK).

Quiet standing

The tester marker set consisted of 42 individual passive-reflective 12.6 mm diameter spherical markers affixed using double-sided tape to the selected anatomical locations, either direct to skin, nails, or on clothing.  The testee marker set consisted of 24 individual passive-reflective 12.6 mm diameter spherical markers of affixed to selected anatomical locations.

Leg length discrepancy (LLD)

The tester had no markers. The testee marker set consisted of six individual passive-reflective 12.6 mm diameter spherical markers affixed to specific pelvic anatomical locations.

Conclusion

It is possible, when HODA-A methodology is optimised, a tester’s HODA-A has capacity to reflect gold standard measurement instrument.

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