2 Der viszeral assoziierte Schulterschmerz - Osteopathic Research
2 Der viszeral assoziierte Schulterschmerz - Osteopathic Research 2 Der viszeral assoziierte Schulterschmerz - Osteopathic Research
Viscerally Associated Shoulder Pain Subjective Perspectives and Diagnostic Procedures – the Osteopathic Point of View The question relating to the influence of the practical experience on the evaluation process showed some interesting results. Three interview partners indicate that their diagnosis and evaluation process has considerably changed and that they use fewer tests during the evaluation phase. One interview partner diagnoses and treats exclusively according to the biodynamic model. However, the osteopathic literature (cf. Croibier 2006; Dräger 2004; Kwakman 2005) underlines that it does not seem appropriate to extract a single aspect from the osteopathic therapy concept. According to tradition and especially Still and Sutherland, an osteopath should not work exclusively biomechanically, viscerally or craniosacrally (cf. Dräger et al 2004). Three interview partners also mention the aspect of “intuition”, “feeling” and “to be guided by”. According to Siedler (2010), it has been shown that in osteopathy it is, on the one hand, common practice and sometimes absolutely necessary to make intuitive decisions, on the other there is a big discrepancy since the subject of intuition is not sufficiently dealt with in the osteopathic literature. Still, the aspect of intuition also has to be considered critically. From the point of view of the philosophy of science, osteopathy needs to extend the concept of intuition by including the epistemological principles of empirical research and logic to be more widely accepted and recognized as a natural science. Questioned about their propositions for evidence based examination within the osteopathic diagnostic process, two interview partners consider the case history as an important criterion for the choice of the tests to be performed and the areas to be explored. Three interview partners indicate the aspect of osteopathic tests. One interview partner would like to see validated tests in osteopathy, since the tests used in osteopathy are lacking both reliability and validity. One osteopath mentions the Sotto-Hall test and asks for its verification or falsification. In her study Bohl-Mortier (1998) examined the Sotto-Hall test in reverse order, she performed the test on 40 patients (30 patients in the treatment group, 10 patients in the control group) with a confirmed abnormal liver function test. To control the effect of inhibition on the liver, the radialis pulse was measured with the help of an oscilloscope. The result showed a significant modification of the pulse indicating a change in the perfusion induced by an osteopathic treatment. However, the study did not provide a definite answer on the possible viscero-somatic treatment effect or relationship. 145 | S e i t e
Viscerally Associated Shoulder Pain Subjective Perspectives and Diagnostic Procedures – the Osteopathic Point of View In conclusion and within the limits of this small group of osteopaths, it could be clearly demonstrated how much importance the interview partners attach to organic factors in relation to shoulder joint dysfunctions. The theoretical, literature-based study of the viscerally associated pain in the shoulder area showed certain parallels with the explanation model and agreements among the interviewed osteopaths. As far as the identification of viscerally associated shoulder pain is concerned, a large spectrum of diagnostic steps and examination methods could be demonstrated. In the study, it could be demonstrated how the osteopathic examination process is used to identify viscerally associated shoulder pain, however and due to the limited agreement no standardized procedure could be deduced. A homogenous approach could only be demonstrated in individual areas of the examination process. Within the small group of osteopaths, only a few examination steps used to identify viscerally associated pain were considered particularly important and relevant. In this context, one should consider whether uniform examination methods and the use of recognized tests would contribute to establish osteopathy in the medical arena. The aim of the present master thesis was to reflect on the professional practice and the individual interpretation patterns as a starting point for therapeutic action. Due to the lack of agreement and the small sample size, this objective could only be met to some degree. Although the interviews achieved theoretical saturation, the sample size, seven expert interviews, was too small to allow for generalization, therefore making conclusions for a bigger group of osteopaths inadmissible. However and based on the sample size, it was possible to present a conclusive view of a small group of osteopaths and show some tendencies within the diagnostic process. Because the statements of the interview partners concerning certain subjects directed clearly in the same direction and the results showed an agreement with the results of other studies, the collected data can be considered reliable. The results of this study are relevant for the osteopaths and the students, since they present, based on the literature, possible explanation models for the viscerally associated shoulder pain and support them with the corresponding interpretation patterns und experience of the interview partners. Accordingly, visceral causes in shoulder joint dysfunctions have to be taken into consideration to introduce the appropriate therapy. The results of this study on the subjective perspectives and the 146 | S e i t e
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- Seite 127 und 128: Literaturverzeichnis Literaturverze
- Seite 129 und 130: Literaturverzeichnis Giamberardino
- Seite 131 und 132: Literaturverzeichnis Mayer-Fally E.
- Seite 133 und 134: Literaturverzeichnis Schwind P. (20
- Seite 135 und 136: Abbildungsverzeichnis Seite | 128
- Seite 137 und 138: Anhang Anhang Interviewleitfaden Ei
- Seite 139 und 140: Anhang 2.3 Zusammenhang Organ - Sch
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Viscerally Associated Shoulder Pain<br />
Subjective Perspectives and Diagnostic Procedures – the <strong>Osteopathic</strong> Point of View<br />
The question relating to the influence of the practical experience on the evaluation<br />
process showed some interesting results. Three interview partners indicate that their<br />
diagnosis and evaluation process has considerably changed and that they use fewer<br />
tests during the evaluation phase. One interview partner diagnoses and treats<br />
exclusively according to the biodynamic model. However, the osteopathic literature<br />
(cf. Croibier 2006; Dräger 2004; Kwakman 2005) underlines that it does not seem<br />
appropriate to extract a single aspect from the osteopathic therapy concept.<br />
According to tradition and especially Still and Sutherland, an osteopath should not<br />
work exclusively biomechanically, viscerally or craniosacrally (cf. Dräger et al 2004).<br />
Three interview partners also mention the aspect of “intuition”, “feeling” and “to be<br />
guided by”. According to Siedler (2010), it has been shown that in osteopathy it is, on<br />
the one hand, common practice and sometimes absolutely necessary to make<br />
intuitive decisions, on the other there is a big discrepancy since the subject of<br />
intuition is not sufficiently dealt with in the osteopathic literature.<br />
Still, the aspect of intuition also has to be considered critically. From the point of view<br />
of the philosophy of science, osteopathy needs to extend the concept of intuition by<br />
including the epistemological principles of empirical research and logic to be more<br />
widely accepted and recognized as a natural science.<br />
Questioned about their propositions for evidence based examination within the<br />
osteopathic diagnostic process, two interview partners consider the case history as<br />
an important criterion for the choice of the tests to be performed and the areas to be<br />
explored. Three interview partners indicate the aspect of osteopathic tests. One<br />
interview partner would like to see validated tests in osteopathy, since the tests used<br />
in osteopathy are lacking both reliability and validity. One osteopath mentions the<br />
Sotto-Hall test and asks for its verification or falsification. In her study Bohl-Mortier<br />
(1998) examined the Sotto-Hall test in reverse order, she performed the test on 40<br />
patients (30 patients in the treatment group, 10 patients in the control group) with a<br />
confirmed abnormal liver function test. To control the effect of inhibition on the liver,<br />
the radialis pulse was measured with the help of an oscilloscope. The result showed<br />
a significant modification of the pulse indicating a change in the perfusion induced by<br />
an osteopathic treatment. However, the study did not provide a definite answer on<br />
the possible viscero-somatic treatment effect or relationship.<br />
145 | S e i t e
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