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Perrin claims 86% success rate diagnosing ME/CFS

Discussion in 'Latest ME/CFS Research' started by Marco, Nov 15, 2017.

  1. keenly

    keenly Senior Member

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    Perrin does NOT claim this is a cure. FACT. I spoke to him direct about this. It helps. EVERYONE on here right now is faced with a bombardment of toxins daily. How does our body clear these? Perrins technique helps, not cure.
     
    Scarecrow likes this.
  2. keenly

    keenly Senior Member

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    'What happens when the systems that controls ROS and limits its damage is itself compromised?
    Examples include SOD, GPx activity and GSH/GSSG ratios. The answer, I believe, is a grand move by the life-form to a lower energy state with less oxygen utilization and with less free energy G and that state is called CFS. It
    is a survival state not unlike hibernation. Any strong movement to a higher metabolic rate and greater oxygen utilization without addressing this problem or better still the cause of it can be dangerous and counter-productive. Do not awaken the hibernating bear unless winter has passed'- Dr Paul Cheney.
     
  3. ukxmrv

    ukxmrv Senior Member

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    They are looking at different points. From Hip's diagram I can see that the Perrin's point is further down the chest from where my doctor was examining me.
     
  4. Learner1

    Learner1 Forum Support Assistant

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    No tenderness at the Perrin point.

    While the lymphatic system is important to health, I'm skeptical that Perrin's technique could fix me or many of us.

    I've had extensive lymphatic massage, cranial sacral therapy and strain-countersstrain techniques which worked on all aspects of lymphatic flow. I'm still sick. And no one diagnosed me with ME/CFS with any of these, an ME/CFS expert did.

    No matter how wonderful the treatment is, It won't kill infections, fix nutrient deficiencies, get toxinsxdeeply embedded in mitochondria out, reverse autoantibodies, fix a broken immune system, etc.

    Its one modality that may provide limited benefit.
     
    perrier likes this.
  5. Hip

    Hip Senior Member

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    When examining for Perrin's point tenderness, I think you need to search around the Perrin's point area for tender spots, because the tenderness may not be exactly at Perrin's point. Not that I have any expertise in this matter, but that's what I found myself: when I press the spot that exactly corresponds to Perrin's point, there is only mild tenderness, but just slightly further away the tenderness is much stronger.

    The study discussed in this thread says that Perrin's point is located 2–3 cm left and 2–3 cm above the left nipple. That would correspond to a 45 degree diagonal distance of about 3.5 cm from the nipple to Perrin's point. See the diagram below.

    Location of Perrin's point
    Perrin's Point 2.jpg

    So when I press at the point at a diagonal distance of 3.5 cm from the center of my left nipple, there is only mild tenderness; but if I move my finger slightly further along the diagonal to 5.5 cm from the center of the nipple, then the tenderness is much more apparent.

    So I am guessing that you have to feel around the Perrin's point area for any spots of tenderness.
     
  6. Hip

    Hip Senior Member

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    I agree with your critique that in real world situations of clinical diagnosis, you are not differentiating ME/CFS patients from healthy people, but trying to differentiate ME/CFS from various other diseases that might present with ME/CFS-like clinical signs and symptoms, such as hypothyroidism, celiac disease, anemia and systemic lupus erythematosus — diseases which are often mistaken for ME/CFS.

    As @pattismith mentioned in this post, Perrin's diagnostic technique for ME/CFS has not been validated against the plethora of other diseases that doctors encounter in clinical practice. Indeed, we do not know whether these other diseases might also present with Perrin's point tenderness and the other clinical signs used by Raymond Perrin to distinguish ME/CFS.



    I should point out that tenderness at Perrin's point appears to be the central clinical sign used to diagnose ME/CFS: if you look at an earlier 2011 independent study, Perrin's point tenderness alone was able to distinguish ME/CFS patients from healthy people with 81% sensitivity. This current study also used Perrin's point tenderness, and added 4 extra clinical signs to the criteria, and but was only able to marginally increase the sensitivity to 86%. So it is clear that Perrin's point tenderness is the central diagnostic clinical sign.

    So far, the results of my poll are showing that Perrin's point tenderness is more often than not present in ME/CFS.
     
    Last edited: Nov 16, 2017
    John Mac likes this.
  7. Learner1

    Learner1 Forum Support Assistant

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    Thanks! Still no luck.... Maybe it works better on men. Or maybe its because I already have done these lymphatic modalities...

    Like I said, I'm a firm believer in the importance of the lymphatic system, but its ridiculous to think that clearing lymph out, which I'm pretty experienced at already, is going to fix most of us. It may be a component of a comprehensive solutuon, but its not a solution in itself...
     
  8. Hip

    Hip Senior Member

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    I tend to agree, and there is no information I could find about the success rate of Perrin's techniques for treating ME/CFS.

    Although I think we need to separate his treatment techniques from the diagnostic techniques. The studies discussed in this thread are more about the diagnostic value of Perrin's point tenderness.
     
  9. Londinium

    Londinium Senior Member

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    'Toxins' is one of those words that get thrown about by practioners of stuff like this which sound sciencey but in the context in which they're used are incredily unspecific. See also: 'energy'; 'natural'.

    Without specifying what one means by the term, it impossible to deny that 'everyone on here right now is faced by a bombardment of toxins daily'. But so is everyboody else on the planet. 'Toxins' is such a catch-all term as to be meaningless. If it were just exposure to 'toxins' that was the issue then everybody would be sick, rather than the 0.2-0.4% of the population that have ME/CFS.

    'Ah hah!' says the practioner. 'But people with ME/CFS have insufficient [insert sciencey term like 'lymphatic drainage' or similar]!'

    Which is fair enough if, y'know, said practioner can provide any evidence that the lymphatic system is actually impaired. Some evidence to support the underlying hypothesised mechanism would be nice. There would be plenty of ways to test this beyond the groundbreaking evidence that, er, sick people look different to healthy people and that it's quite uncomfortable to have a finger jabbed into one's boob.

    'But some people felt better after my therapeutic manipulation!' comes the reply. Well, um, yes. But cancer patients feel better after a hand massage, without it meaning that carcinomas are actually due to poor knuckle joint flexibility...
     
    rodgergrummidge likes this.
  10. rodgergrummidge

    rodgergrummidge Senior Member

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    @Hip , the 2011 study you quote above doesnt provide any credible evidence for the use 'tenderness' spots in diagnosing CFS. The science is so appalling that I thought it might be useful to discuss further, given that there are so many comments and interest in Perrin Spots.

    I have pasted the one (1) page from the 2011 paper that contains the entire Results Section below. Note the:
    • entire results are described in 1 paragraph (yellow highlight)
    • complete lack of scientific method used by the authors for measuring 'tenderness' (see Methods "Examination", yellow highlight)
    • the method of "Any undue unilateral tenderness was noted and compared to the contralateral side." is completely meaningless in terms of data collection and so the statistical analysis is also meaningless
    • authors do not even describe precisely which part of the thorax was examined (Methods, "Examination)
    • authors do not indicate whether the patients were randomized or whether the investigators were 'blinded'
    I appreciate that diagnosing CFS is difficult, but such papers dont offer an alternative that is backed by any scientific evidence. If an osteopath using the Perrin Technique can make a more accurate diagnosis of ME/CFS than a doctor, it would be a very simple matter of performing a well-designed study and backing the claims with solid evidence.

    Rodger
    upload_2017-11-17_10-17-17.png
     

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  11. Hip

    Hip Senior Member

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    As a medical term, tenderness means when pain or discomfort occurs on touching or pressing an area, but with pain or discomfort not being present when the area is not touched. Ref: here.

    Pain from pressing an area is often used as a clinical symptom in disease diagnosis, so I don't really see why you are saying it is meaningless.


    Presumably they examined all the thorax, but it was only in the third intercostal space on the left that tenderness was noted.


    I don't think it was blinded, as in the abstract it says:
    So that suggests the study was not blinded, but that the authors are aware that future replication studies should be blinded.

    I certainly agree that blinding would be necessary in order for Perrin's point tenderness to be properly tested as a clinical sign for ME/CFS.

    What I would like to see is a study in which not only do the investigators not know who are the patients and who are the healthy controls, but I'd like to see the entire face and body of the patients and healthy controls hidden behind a screen or cotton sheet, with only their torso visible for physical examination. This is so that the investigator does not pick up any other clues from the person's general body language and facial expression, which might give away whether they are an energy-sapped patient or a more vibrant healthy control.
     
    Last edited: Nov 16, 2017
  12. keenly

    keenly Senior Member

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    Most people are sick. Look around you. ME/CFS is a protective mechanism.
     

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