Interexaminer Reliability Study of a Standardized Myofascial Diagnostic Technique of the Superior Thoracic Inlet

Regional fascial motion palpation is often incorporated by osteopathic practitioners to enable them to identify superior thoracic inlet (STI) myofascial somatic dysfunction motion patterns; however without standardized instruction, diagnostic outcomes may vary between examiners. This study proposes a protocol for diagnosing the STI motion pattern that standardizes examiner hand placement, palpatory discrimination, posture, and relative body positioning. The study design incorporated useful infrastructure recommended by the Fédération Internationale de Médecine Manuelle (FIMM) including protocol agreement steps prior to conducting the formal interexaminer reliability study with the goals of attaining >80% interexaminer agreement and kappa values >0.6 for each cardinal plane. The agreement phase comprised of testing 52 participants acquired agreements of 92.3% (rotation), 88.9% (translation), and 94.2% (sagittal). Kappa value testing involving an additional 82 participants obtained values of 0.65 (rotation), 0.59 (translation), and 0.70 (sagittal). Such kappa values endorse fair-to-excellent positive interexaminer correlations, demonstrating utility of this standardized palpatory protocol for STI myofascial dysfunctional diagnosis.