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Re: Craniosacral therapy
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Re: Craniosacral therapy - August 21, 2006 7:26:00 PM
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tucker
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From: Texas
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Here is Moran and Gibbon's abstract Karie:
BACKGROUND: A range of health care practitioners use cranial techniques. Palpation of a cranial rhythmic impulse (CRI) is a fundamental clinical skill used in diagnosis and treatment with these techniques. There has been little research establishing the reliability of CRI rate palpation. OBJECTIVE: This study aimed to establish the intraexaminer and interexaminer reliability of CRI rate palpation and to investigate the "core-link" hypothesis of craniosacral interaction that is used to explain simultaneous motion at the cranium and sacrum. DESIGN: Within-subjects, repeated-measures design. SUBJECTS: Two registered osteopaths, both with postgraduate training in diagnosis and treatment, using cranial techniques, palpated 11 normal healthy subjects. METHODS: Examiners simultaneously palpated for the CRI at the head and the sacrum of each subject. Examiners indicated the "full flexion" phase of the CRI by activating silent foot switches that were interfaced with a computer. Subject arousal was monitored using heart rate. Examiners were blind to each other's results and could not communicate during data collection. RESULTS: Reliability was estimated from calculation of intraclass correlation coefficients (2,1). Intrarater reliability for examiners at either the head or the sacrum was fair to good, significant intraclass correlation coefficients ranging from +0.52 to +0.73. Interexaminer reliability for simultaneous palpation at the head and the sacrum was poor to nonexistent, ICCs ranging from -0.09 to +0.31. There were significant differences between rates of CRI palpated simultaneously at the head and the sacrum. CONCLUSIONS: The results fail to support the construct validity of the "core-link" hypothesis as it is traditionally held by proponents of craniosacral therapy and osteopathy in the cranial field.
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Re: Craniosacral therapy - August 21, 2006 7:35:00 PM
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Karie
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From: Wisconsin
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Tucker,
Thanks for the abstract. I will look at it more closely tommorrow and also try to get a hold of the full article. But on first read through, I see the same problem as the other one.
I can palpate a occiput in flexion phase and find the sacrum is "out of phase" going into extension, or not moving at all. So the fact the raters did not feel flexion in the occiput and the sacrum at the same time with reliability would make sense to me. Again, that's how assessment of the rhythm is used to determine where there is a problem.
Why 2 post doctorate osteopaths didn't suggest that was a problem...I don't know??????
I'll keep reading though Tucker. :-)
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Re: Craniosacral therapy - August 21, 2006 7:56:00 PM
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dfjpt
Posts: 238
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Valerie hunt is hunting auras, is she not? They don't interest me much. Pert.. I kinda liked Pert until she showed up in the Bleep movie, which I thought was mostly a cult ad.
With my 24 hours a day, same as everyone else has, I like to use it studying what's already been consolidated, has already been subjected to Occam's Razor, and can account for every physiological change one can possibly feel through the hands, i.e. the live nervous system, just being itself and responding to novel input.
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Re: Craniosacral therapy - August 22, 2006 1:25:00 AM
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Sebastian Asselbergs
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Karie, MY main beef with CST (I took two courses in the mid 80's and received Rx with the technique), is that thus far in addition to all the before-mentioned issues with reliability, no-one has yet been able to objectively measure the "rhythm" at the cranial bones or in the tissues of the body.
We can measure photons from outer space in an array 2 miles under the Canadian shield, and micro-microns of size - yet there is NO measurement of the motion at the cranium or the flexion/extension in the tissues. ONLY in the hands of a practitioner of CST .
Let's not forget that ANYTHING you feel (with or without your hands) is a cerebrally processed phenomenon - and not at all requiring an actual peripheral input....To me, CST is a complex explanation and interpretation of what gentle hands-on techniques elicit in a human with a nervous system. The work being done in the neurology and neuro-anatomy is only supportive of that - even CST practitioners FIRST access and interact the SKIN of the patient; a direct input into the nervous system (esp. the brain). Even the "emotional" releases are evidence to this - and NOT of "energy storage" in tissues. A clear case of the brain getting triggered by gentle skin contact. Diane is so right about Occams' razor here.
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Mundi vult decipi
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Re: Craniosacral therapy - August 22, 2006 3:06:00 AM
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Karie
Posts: 107
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From: Wisconsin
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Diane,
Valerie Hunt is definately not into aura's, and Candace Pert's research is contained in a Nobel Prize for Biochemistry, I forget which year, sorry. One of her books regarding the research is called, "Molecules of Emotion." If you haven't thoroughly researched the real literature on these people, and yes you don't have to if your not interested, but don't suppose based on heresay or some blurb you saw somewheres that that is what they are about. We know how easily the media/Hollywood distorts truth.
I don't know what Occams' razor is, maybe a generational gap thing LOL
Sebastian
The premise of CST is that the body is correcting itself, neuro input etc. I do appreciate your comments. I don't deny that my brain is making decisions based upon what "I" feel. I started in the early 90's with it.
Side note to Diane, is quantum physics not a science in your book then? I believe that astrophysics and aeronautical physics/engineering, space program etc. all use it's concepts. It's postulated in calculus....It's okay if you don't think so, I just feel the people in these fields would not appreciate being thought of as "not scientific."
Thanks for the information, I'm digesting it all and find it very helpful. I'm always open to learning, never want to stop. :-)
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Re: Craniosacral therapy - August 22, 2006 3:39:00 AM
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Karie
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From: Wisconsin
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Sebastian,
I will find Upledgers research for having measured the CSR that he did at Michigan State. I thought that the major problem was that his information hasn't been replicated, not that it was ever measured in the first place.
Please let me know what you think of it then, when you have time.
:-)
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Re: Craniosacral therapy - August 22, 2006 4:00:00 AM
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dfjpt
Posts: 238
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Karie, I bought both those books, Hunt's and Pert's over ten years ago, from the Upledger Institute's table. What have these people published since?
There's been an absolute explosion of credible research re: the brain, the nervous system, pain.. time has marched on since the 80's. Meanwhile, Upledger divides his offering into more and more levels of classes he can make more and more money from, a business model that Barnes copied, and the same books appear over and over.. infinite mind indeed. Caught in a time warp maybe. Cult-building material perhaps.
Please google Occam's Razor and read up on it, get informed. Wikipedia has several links. It's a principle; find the most likely and sensible ("parsimonious") explanation for a group of phenomena to account for their existence. Occam's Razor is a valuable tool to think through what manual therapy is about, what it does. Physiotherapy/physical therapy in general needs several applications of Occam's Chainsaw.
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Re: Craniosacral therapy - August 22, 2006 4:32:00 AM
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Karie
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From: Wisconsin
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Diane,
I just gave you the beginnings of their information, because that is generally where one starts.
Why the hostility?
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Re: Craniosacral therapy - August 22, 2006 4:40:00 AM
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Karie
Posts: 107
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From: Wisconsin
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I appreciate the reference Junction 13, I will check it out.
Agreed on the sidenote... :-) we just haven't found ways possibly to measure them ????, but that would be a different thread, maybe not in this site. LOL
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Re: Craniosacral therapy - August 22, 2006 5:46:00 AM
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dfjpt
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Alopogies if you think I seem hostile. I'm not, but there's no way to know is there? without sound or sight. Please don't feel that way. It's just info Karie, that's all. I happen to think it's improved info, for whatever that's worth..
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Re: Craniosacral therapy - August 22, 2006 6:51:00 AM
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Karie
Posts: 107
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From: Wisconsin
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That's the problem with just words Diane, I agree. I'm glad I misunderstood where you were coming from. I am happy to be given new insights and understanding of what I am doing. That's why I am posting here. I have my office manager busy pulling research others have suggested and getting research I am aware of.
In the process I may have found Upledgers response to the original APTA journal I was referring to in the begging and it was possibly printed in the Journal. That's a great find already, I'm excited. Wouldn't have happened without dialouging with all of you, just think what else I will discover. :-)
So yes Diane, I do appreciate you and the others giving me good leads to continue my learning, plus please don't think because of my words in this thread that I stopped learning in the 80's. As I have said in another thread, I have a successful private practice of more than 5 years now with a large % of my patients being medical referrals that include nueurosurgeons, orthopedists, oncologists, pediatricians, physiatrists, and of course regular primary care people. My hands are doing something and if not by the methods I understand at present, I am happy to venture into learning what else it may be about. This can only result in improving my skills further and my patiets potential outcomes. Maybe my input will give you all something as well.
Okay, back to work...I promise I will get those other postings to the rest of you that I promised! :-)
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Re: Craniosacral therapy - August 22, 2006 9:46:00 AM
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dfjpt
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[QUOTE]My hands are doing something and if not by the methods I understand at present, I am happy to venture into learning what else it may be about. [/QUOTE]Karie, you're my kind of people. :)
That peoples' nervous systems love and crave handling is a fact. We need to learn to align how we think about this fact, and interpret it, with what actually is science-based and real, in the real world of actual physiology. And physiology is maintained by the nervous system. So, if you are interested in learning more, PM me and we can go from there.
Cheers, Diane
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Re: Craniosacral therapy - September 19, 2006 6:36:00 PM
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Karie
Posts: 107
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From: Wisconsin
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Hello Everyone!
Tucker, Sebastian Asselbergs, and Jon Newman the following I hope is the responses you were requesting from me. Thank you for your time and constructive dialouge!
Diane and Sarah you know where I am headed in my research and learning....thanks a bunch!
I have chosen three specific studies to discuss regarding CST. Since my training is through the Upleger Institute, my discussion is based on my interpretation of what I have learned through them. There are other educational institutions and universities/colleges that teach Cranial Sacral concepts and I don't pretend to know if there content holds the same constructs that I will be putting forth here.
With respect to the Rogers et al. study that was in the APTA Journal Novemeber 1998, the following are the problems with the study beginning with the basic premise of the study being wrong form it's inception.
The CSR (Cranial Sacral Rhythm) was presumed to be precisely the same at the head and the feet. It is a "reflected rhythm" through tissue that is palpated and therefore is subjected to any number of changes that those tissue structures may have. The main components of the CSR, namely: Amplitude, Rate, Quality, Symmetry, and Vitality, are all variables never even considered.
Subjects were not defined by any parameters, just basically grabbed off the street so to speak. No control group which is part of a "good" scientific study.
The examiners were not described as having similar educational backgrounds for CST or experience, plus they were from two different disciplines of medicine. More variables not accounted for.
Hand placements and methods of palpation style was left up to the examiners, more variables.
Delay/timing between examiners when palpating the rhythm and pressing the footswitches inter and intra-reliablity were not addressed..more variables.
An assumption, "because it has been suggested that craniosacral motion may change for a few second up to 1 minute follwoing palpation, we allowed 2 minutes to transpire between measurements." Why 2 minutes, why not four etc....again variables.
Why is the CSR changing? It will only change if treatment is elicited or a still point is manually induced or spontaneously induced by the CS system itself. Therefore, how are they ensuring that the examiners are not treating, since all treatment needs is to touch the person...more variables not taken into account with their methodology.
I think you are getting my drift on this study.
The Moran and Gibbon's study has the same inherent problem of measuring from the feet and head to determine reliablity inter/intra. They did a little better in defining their subjects and having examiners that had similar experience and background, but still the other problems I stated from the previous study are inherent in this study.
The best study I have found to reproduce John Upledger's findings come from the following study that you can download once at the site:
[URL=http://www.jaoa.org/cgi/content/abstract/106/6/337]www.jaoa.org/cgi/content/abstract/106/6/337[/URL]
This is a well thought out study and exemplifies the technology needed in measuring the CSR and also takes into account other ryhthms in the body and compares. It also still speaks to the problems that are inherent in the CSR variablity that create difficulty in doing these studies and therefore, giving credence via scientific method to this theory.
One other concept to note is that since CST is a "reflected rhythm," a number of tissue characteristics can change what is palpated and is the reason it is used in assessment of potential tissue restrictions. A simple analogy I would like to use with you is that of a pebble in a still pond. Concentric circles spread out from where the core (pebble landed in the still pond) uninterrupted until it hits up against something. When that happens, say with a "stick" poking out of the water, the pattern is changed at that point. That's what a CST practioner is feeling for, is a change from what is expected for movement of the tissue/structures in various areas. Just like in PT school we first learn "normal" movement of structures and function, before we study "abnormal" movement. Where the CSR isn't what is expected, a problem is thought to be occurring in those tissue structures to not allow the core CSR, that is unchanged (unless in stillpoint) to be moving in the "normal" rhythmic pattern. "Sticks" in the tissue can be vascular compression, nerve compression, myofascial restrictions, lymphatic congestion, bony composition changes or structural positioning...the list really is endless. Studies measuring CSR has to take these "sticks" into account or accuracy is not going to attempt to be possible.
Okay, I have tried to figure out how to address the multitude of studies that John Upledger sites to validate his theory and have decided to give you the information in this way.
If you truly want to research and understand the "theory" put forth for CST to prove or disprove it, the following publications are the best place to do thoroughly research it.
All are available through Upledger.com; they are copyrighted materials. (No I don't get anything for you ordering it, so please don't go there)
18 page document with pages of cited references to journals, studies etc. called:
"Research and Observations support the existence of a Cranioasacral System." by John E. Upleder, D.O., O.M.M. 1995
Two textbooks written for the academia world:
Craniosacral Therapy by Upledger and Vredevoogd
Craniosacral Therapy II, Beyond the Dura by Upldeger.
In closing, to dialouge on what a theory or method is and it's validity, I believe we need to come from a place of being educated in it's complete perspective via reading materials from the author, taking course work, and/or doing extensive research from a variety of sources concerning the theory. From this place, we then can really discuss the true nature of theories and be the professionals that we all are to debate the accuracies and inaccuracies of the theoretical model.
Lastly, I understand from pulling many research articles about CST that this theory has many studies that are both pro and con. The jury,therefore, is still out on this theoretical construct. But with more research I am presently undertaking at the direction of Diane and Sarah I may come to find a better "theory" that explains why what I do is so effective. I will never stop learning and will always embrace knowledge that better helps me understand how to best assist the people who entrust their care to me.
Peace to all!
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Re: Craniosacral therapy - September 20, 2006 2:11:00 AM
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Sebastian Asselbergs
Posts: 1206
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From: Barrie, Canada
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Karie - kudos for doing this work. Only one issue I want to mention: the very basis of CST is the rhythm. This rhythm has NOT been clearly proven to exist, in a time where neutrinos are measured, muons and photons are tracked, and metal objects are being produced to within microns of thickness - and no-one has been able to establish beyond a doubt that the rhythm is there......
If the basis of a theoretical construct is still not confirmed after so many years, its credibility suffers even more.
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Mundi vult decipi
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Re: Craniosacral therapy - September 20, 2006 3:58:00 AM
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jbird007
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From: USA
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God has not been "proven" to exist either, just some scribbled writings.
Shall we dismiss Him?
:)JBird
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Re: Craniosacral therapy - September 20, 2006 5:07:00 AM
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jlharris
Posts: 477
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From: Nebraska
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jbird,
Didn't realize we were charging insurance companies and leading people to believe theire improvements were a result of God treatment. Sorry, yours is a bad analogy.
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My PT Blog
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Re: Craniosacral therapy - September 20, 2006 5:18:00 AM
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jbird007
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From: USA
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It wasn't an analogy, just a question. :)
J
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Re: Craniosacral therapy - September 20, 2006 7:11:00 AM
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Karie
Posts: 107
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From: Wisconsin
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Thank you Sebastian and I respectfully agree with your opinion!
Junction 13 your perception of the study is correct, that's why I stated that it was the best thought about design in premise but the actual nuts and bolts of the study ran in to the same problem I see in alot of studies, the irregularity that the rhythm poses. You are correct that data should not be excluded, it just means we need to figure out what it is about. I think that is the great excitement about research, that is when we attain new data that doesn't support what was originally thought and then we are led into new oceans of discoveries.
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Re: Craniosacral therapy - September 20, 2006 7:49:00 AM
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Karie
Posts: 107
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From: Wisconsin
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All good points Junction 13;
This was the best study I could find that did the best job of trying to proove John's theory, besides his references, and was more recent. As you point out, if this is the best there is (from what I could find in my recent researching), there is a big problem in research attempting to prove/disprove the theory. Is the problem then in the theory or the way it's researched? Probably both! Many unanswered questions I agree thus the need to keep looking for the answers.
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Re: Craniosacral therapy - September 20, 2006 7:55:00 AM
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Sebastian Asselbergs
Posts: 1206
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jbird, sure I will dismiss Him/Her. IF we are talking about scientific proof and levels of evidence. No proof at all. In this case - none is needed.
Little green men from mars have been described - ditto "Qi", and you must be comfortable with the idea that we are all descendents from aliens (reference: Tom Cruise).
What does all of this have to do with CST-research?
But then again -- aren't you the person who drags NSAIDS use and mortality in a discussion about manipulation?
I think so - that explains it.
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