Validation of palpatory methods for evaluating anatomical bone landmarks of the cervical spine: a systematic review.

OBJECTIVE: The aim of this study was to systematically review the literature for validity of palpatory procedures for evaluating anatomical bone landmarks in the cervical spine. METHODS: A systematic search of electronic databases identified observational studies assessing validity and/or accuracy regarding evaluation of anatomical bone landmarks of cervical spine palpatory procedures. The databases used in the search included the US National Library of Medicine of the National Institutes of Health (MEDLINE/PubMed), the Regional Library of Medicine (Bireme), the Scientific Electronic Library Online (SciELO), the Physiotherapy Evidence Database (PEDro), the Latin American and Caribbean Health Sciences Literature database (LILACS), the Cochrane Library, and Coordination of Personnel Improvement of Higher Education (CAPES/Brazil). Data were extracted by a primary reviewer, and 2 independent reviewers used a critical appraisal tool to estimate the quality of the retrieved studies. The results were synthesized qualitatively within the Quality Assessment of Diagnostic Accuracy Studies criteria. After completing the synthesis and scoring, the reviewers applied classifications such as "low," "fair," and "good." RESULTS: The initial search yielded 69860 articles. After selection criteria were applied, 5 studies satisfied the eligibility criteria. Three studies verified the validity of the manual palpatory procedure, and 2 studies correlated the findings of the palpatory procedures with other measured results. According to Quality Assessment of Diagnostic Accuracy Studies criteria, 3 studies presented good methodological quality, and 2 presented fair methodological quality. Studies demonstrated an accuracy range from 51% to 87.8%. CONCLUSION: There are few studies that evaluate the validity of manual palpatory procedures for examining boney landmarks of the cervical spine. The 5 that were found showed fair to good methodological quality. However, we note that there may be poor external validity due to the sampling heterogeneity of these studies.

Intervenção osteopática em idosos e o impacto na qualidade de vida / Osteopathic intervention in the elderly and its impact on quality of life

INTRODUÇÃO: O envelhecimento evidencia a necessidade do idoso do controle das doenças e do bem-estar físico, psíquico e social. OBJETIVO: Avaliar o impacto da intervenção osteopática na qualidade de vida de idosos. MATERIAIS E MÉTODOS: Vinte e um indivíduos (72,1 ± 4,7 anos, 18 mulheres) completaram este estudo. Foi aplicado o questionário de qualidade de vida WHOQOL-bref no primeiro e sexto atendimentos no intervalo de 48 [39; 66] dias. A avaliação e o tratamento das disfunções somáticas encontradas foram feitos em todas as sessões e as técnicas de domínio osteopático foram utilizadas. Os dados foram analisados por meio do teste de Wilcoxon com significância em p < 0,05. RESULTADOS: Foi encontrada diferença significativa no domínio físico (pré-tratamento: 58,67 ± 12,91 por cento; pós-tratamento: 64,64 ± 13,75 por cento; p < 0,05). Não foram encontradas diferenças significativas nos domínios: psicológico (pré-tratamento: 63,10 ± 15,38 por cento; pós-tratamento: 64,38 ± 11,67 por cento; p = 0,846), relações sociais (pré-tratamento: 62,30 ± 14,34 por cento; pós-tratamento: 62,50 ± 12,82 por cento; p = 1,000) e meio ambiente (pré-tratamento: 52,08 ± 11,91 por cento; pós-tratamento: 52,19 ± 11,02 por cento; p = 0,806). O nível de escolaridade apresentou associação significativa com a pontuação total do questionário antes (r = 0,457; p = 0,019) e após (r = 0,380; p = 0,049) a intervenção. CONCLUSÃO: A medicina osteopática, com sua ampla abordagem, interferiu positivamente no domínio físico da qualidade de vida. Outros domínios (meio ambiente, psicológico e relações pessoais) não foram modificados pela intervenção osteopática, contribuindo para a manutenção da qualidade de vida geral.

INTRODUCTION: The aging process evidence the need to provide to the elderly either disease control and physical, psychological, and social well-being. OBJECTIVE: To evaluate the osteopathic intervention and its impact in quality of life of aged people. MATERIALS AND METHODS: Twenty-one subjects (72.1 ± 4.7 years, 18 women) were enrolled in and completed this study. The WHOQOL-bref questionnaire was applied at first and sixth session with an average time interval of 48 [39; 66] days. At each session, screening tests and treatment were performed for somatic dysfunctions; treatment techniques were selected among osteopathic domain. Data from questionnaire were analyzed with Wilcoxon test with significance established at p < 0.05. RESULTS: Significant difference was found in the physical domain (before: 58.67 ± 12.91 percent; after: 64.64 ± 13.75 percent; p < 0.05). No significant difference was found in psychological domain (before: 63.10 ± 15.38 percent; after: 64.38 ± 11.67 percent; p = 0.846), social relations (before: 62.30 ± 14.34 percent; after: 62.50 ± 12.82 percent; p = 1.000) and environment (before: 52.08 ± 11.91 percent; after: 52.19 ± 11.02 percent; p = 0.806). Educational level presented significant association with total scoring of the questionnaire before (r = 0.457; p = 0.019) and after (r = 0,380; p = 0,049) osteopathic intervention. CONCLUSION: Osteopathic medicine, in a broad approach, positively contributed to the physical domain of quality of life. Other domains (environmental, psychological, and social relations) were not modified by osteopathic intervention, resulting in unchanged overall quality of life.