INTERRATER RELIABILITY OF CRANIOSACRAL RATE MEASUREMENTS AND THEIR RELATIONSHIP WITH SUBJECTS AND EXAMINERS HEART AND RESPIRATORY RATE MEASUREMENTS

Background and Purpose. The evaluation of craniosacral motion is an ap proach used by physical therapists and other health professionals to a ssess the causes of pain and dysfunction, but evidence for the existen ce of this motion is lacking and the reproducibility of the results of this palpatory technique has not been studied. This study examined th e interexaminer reliability of craniosacral rate and the relationships among craniosacral rate and subjects' and examiners' heart and respir atory rates. Subjects. Participants were 12 children and adults with h istories of physical trauma, surgery, or learning disabilities. Three physical therapists with expertise in craniosacral therapy were the ex aminers. Methods. One of three nurses recorded heart and respiratory r ates of both subjects' and examiner. The examiner then palpated the su bject to determine craniosacral rate and reported the findings to the nurse. Each subject was examined by each of the three examiners. Resul ts. Reliability was estimated using a repeated measures analysis of va riance and the intraclass correlation coefficient (2,1). Significant d ifferences among examiners and the scatter plot of rates showed lack o f agreement among examiners. The ICC was -.02. The correlations betwee n subject craniosacral rate and subject and examiner heart and respira tory rates were analyzed with Pearson correlation coefficients and wer e low and not statistically significant. Discussion and Conclusions. M easurements of craniosacral motion did not appear to be related to mea surements of heart and respiratory rates, and therapists were not able to measure it reliably. Measurement error may be sufficiently large t o render many clinical decisions potentially erroneous Further studies are needed to verify whether craniosacral motion exists, examine the interpretations of craniosacral assessment, determine the reliability of all aspects of the assessment, and examine whether craniosacral the rapy is an effective treatment.