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1、ReviewINTEREXAMINERRELIABILITYANDCRANIALOSTEOPATHYSteveE.HartmanandJamesM.NortonWeassessthemechanismpurportedtounderliethehealthtreatmentregimelabeled"cranialosteopathy"or"craniosacraltherapy."Wethensummarizeallpublishedreportsoninterexaminerreliabilityassociatedwiththismodality,reanalyz
2、esomepreviouslypublisheddata,andcritiqueUpiedger'sioften-citedstudy.Ourownandpre-viouslypublishedfindingssuggestthattheproposedmechanismforcranialosteopathyisinvalidandthatin-terexaminer(and,therefore,diagnostic)reliabilityisapproximatelyzero.Sincenoproperlyrandomized,blinded,andplacebo-
3、controlledoutcomestudieshavebeenpublished,weconcludethatcranialosteopathyshouldbere-movedfromcurriculaofcollegesofosteopathicmedicineandfromosteopathiclicensingexaminations....forbothpatientandpractitionertobeblindtothegiventhename"craniosacralmechanism"or"primaryclinicalrealitiesisanuna
4、cceptableversionofthe"double-.respiratorymechanism"(PRM)4(p24)andincludesthefol-blind."llowingelements:3(ppI0-11),4(pp51-53),5.6(ppI65-166),7,8(p23)(1)inherentrhythmicmotilityofthebrainandTHEPRIMARYRESPIRATORYMECHANISMspinalcord;C(2)rhythmicfluctuationofcerebrospinalfluidranialosteopathy
5、andcraniosacraltherapTare(3)articular(CSF);mobilityofcranialbones;variantsofahealthtreatmentregimethatorigi-(4)mobilityofintracranialandintraspinalduralnatedwithSutherland.4Physicians(primarilyos-membranes;andteopaths),physicaltherap~sts,occupationaltherapists,(5)mobilityofthesacrumbetwe
6、entheilia.chiropractors,dentists,andotherscurrentlyuseformsofthismethod.Althoughsomepractitionersmakedis-Accordingtothemodel,intrinsicrhythmicmove-tinctionsamongvarioustypesofcranialtherapy,webe-mentsofthebrain(independentofrespiratoryandcar-lieveobservationsrecordedherepertaintoall.Beca
7、usediovascularrhythms)causerhythmicfluctuationsofCSFSutherlandwasanosteopathandbecauseallvariantsandspecificrelationalchangesamongduralmembranes,knowntoushavetheirrootsinhisideas,herewerefercranialbones,andthesacrum.Becauseseveralofthesetothemallas"cranialosteopathy."elem
