Interrater reliability in evaluating the body language based on the Fascial Distortion Model (FDM)
Stefan Anker – Masterthesis – Vienna School of Osteopathy, Danube University Krems – Centre for Traditional Chinese Medicine and Complementary Medicine
BACKGROUND: The Fascial Distortion Model (FDM) is an anatomical model applied in osteopathy which seeks the cause of physical symptoms in pathological deformations of fascia. These fascial distortions can be evaluated with a special system of diagnosis. The visual utilisation of the patient’s body language is concisely different to the common osteopathic approach through manual diagnosis. This study examines this visual diagnostic approach in terms of its interrater reliability.
Objective: To investigate the interrater reliability of the visual FDM-Body language diagnosis and to observe whether the inter-rater reliability is influenced by pro- fession and experience of the tester and verbal statements of patients.
METHODS: Patient videos were presented using online questionnaires, in which most patients described their physical complaints nonverbally, to twenty-five osteopaths from Germany, Austria and Switzerland. The testers diagnose of fascial distortions is based on the FDM guidelines. The results are statistically analyzed using the kappa index according to Siegel and Castellan.
RESULTS: The results are statistically analyzed using the kappa index, according to Siegel and Castellan, and show acceptable levels of reliability (k = 0.51). Here, the results of osteopaths with either medical or non-medical backgrounds are si- gnificantly better than the results of osteopaths who are physical therapist by trade. Verbal statements that are made by patients parallel to the non-verbal communi- cation do have a significant impact on reliability, in contrast to the duration of the experience of the tester with FDM, which does not.
CONCLUSION: Seen against the background of a lack of information about validity, this study presents an acceptable interrater reliability of visual FDM diagnosis. The results concerning the influence of verbal statements can only be seen as an encouragement for further research.