A common feature of methodological quality checklists is that studies in which some or all participants are not blinded are downgraded. Blinding in RCTs („randomized controlled trials“) has been postulated as a criterion for methodological quality for decades, without studies having provided sufficiently robust results in this context. The results of a meta-epidemiological study impressively question the current practice.
Background – Research results show that functional somatic disorders are subject to biological, psychological and behavioural influences. In the field of osteopathy, the symptom burden of patients has not been sufficiently studied from a multidimensional perspective.
Methods – As part of a questionnaire study with two runs, patients in the osteopathic teaching practice of OSD Berlin were surveyed. Based on the first run (n = 121), the frequency of fulfilled cut-off criteria for anxiety and depression (HADS-D) was calculated and the distribution to the severity levels of chronic pain (CPG) was determined. For the second run (n = 167), average values for biopsychosocial stress (KPD-38) were calculated. Screening for somatic stress disorder according DSM-V was performed by using cut-off criteria for SSS-8 and SSD-12. Moreover, a correlation test was carried out between selected psychosocial, behavioural and physical scales as well as the duration of symptoms and the age.
Results – The current physical complaints persisted for an average of about 5.6 years (median – 3 years). The study participants most often feel severely to very severely impaired by fatigue or lack of energy (29.4 %), followed by back pain (28.2 %) and pain in the extremities (17.4 %). 12.6 % of the study participants met the criteria for somatic stress disorder. Significant correlations were shown between factors of the psychosocial or behavioural dimension and the physical impairment dimension. Furthermore, 22,3 % of the first run showed a clear anxiety issue and the anxiety cut-off-criteria were met more frequently with an increasing degree of pain chronification.
Conclusion – The results indicate that the patients in the osteopathic teaching practice mainly suffer from chronic complaints that manifest themselves on a physical as well as on a psychosocial and behavioural level, and that there are clear connections across these levels.
The orofacial functions emerge in the course of a long development and maturation process. These are sucking, swallowing, chewing, ventilation and phonation. This article deals with the physiological process of swallowing.
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