Pub Date : 2018-12-01DOI: 10.53702/2375-5717-28.4.16
Jesus Sánchez, Justin Brohard, Richard Thai
Zink’s Common Compensatory Pattern (CCP) is a pattern of somatic dysfunction that can be observed in the spinal transitional zones. The CCP can be described as left/right/left/right rotation in the regions of C0/C1/C2, C7/T1, T12/L1, and L5/S1, respectively. It has been proposed that Zink’s pattern can be identified by both myofascial and segmental assessments. This retrospective study investigates myofascial restrictions and spinal somatic dysfunctions to determine whether an agreement exists between myofascial rotation restrictions and osteopathic structural exam findings. Osteopathic manipulative medicine (OMM) screening exams were completed for incoming first-year osteopathic medical students at the Western University of Health Sciences College of Osteopathic Medicine of the Pacific in August 2012. In this retrospective study, there were 208 participants, of which 15 had documented significant previous medical history. For the structural exam, rotational restrictions were assessed at OA, C7, T12, and L5. Myofascial restrictions were assessed at the craniocervical, cervicothoracic, thoracolumbar, and lumbosacral transitional zones. This method of assessment creates 8 separate variables. These variables were recorded using a simple binomial system with 3 options: R for right rotation, L for left rotation, and O for lack of rotational restriction. The authors then evaluated these variables using kappa statistical analysis and the Fisher’s exact test to determine if there was any statistically or clinically significant correlation present between the structural findings and the myofascial restrictions. Of the 208 participants, 14 individuals (6.731%) matched all 4 of the structural exam restrictions with the myofascial restrictions, 24 (11.538%) matched 3 of the 4 transition zones, 62 (29.808%) matched 2 zones, 73 (35.096%) matched 1, and 35 (16.827%) exhibited 0 matches. Of the 15 individuals with documented significant previous medical history, 2 individuals (13.333%) had all 4 matches, 1 (6.667%) had 3 matches, 6 (40%) had 2 matches, and 6 (40%) had 1 match. Of the 198 individuals without significant limitations, 12 individuals (6.218%) had all 4 matches, 23 (11.917%) had 3 matches, 56 (29.016%) had 2 matches, 67 (34.715%) had 1 match, and 35 (18.135%) lacked any agreement between structural and myofascial findings. On initial kappa analysis with all 208 participants, the authors found a total of 325 matches within the data, yielding a kappa value of 0.0527 with a 95% confidence interval of 0.0025 to 0.1028. For the 15 participants with medical limitations, the authors found the kappa value to be 0.2450 with a 95% confidence interval of 0.0615 to 0.4284 (P=0.0063). For the 198 individuals without limitations, the authors found the kappa value to be 0.0373 with a 95% confidence interval of -0.0147 to 0.0893 (P=0.1488). Regarding the group of 208 participants, there is a weak, but statistically significant correlat
{"title":"An Exploration of Zink’s Common Compensatory Pattern: Comparing Myofascial Restrictions to Segmental Spinal Somatic Dysfunctions: A Retrospective Study","authors":"Jesus Sánchez, Justin Brohard, Richard Thai","doi":"10.53702/2375-5717-28.4.16","DOIUrl":"https://doi.org/10.53702/2375-5717-28.4.16","url":null,"abstract":"\u0000 \u0000 \u0000 Zink’s Common Compensatory Pattern (CCP) is a pattern of somatic dysfunction that can be observed in the spinal transitional zones. The CCP can be described as left/right/left/right rotation in the regions of C0/C1/C2, C7/T1, T12/L1, and L5/S1, respectively. It has been proposed that Zink’s pattern can be identified by both myofascial and segmental assessments. This retrospective study investigates myofascial restrictions and spinal somatic dysfunctions to determine whether an agreement exists between myofascial rotation restrictions and osteopathic structural exam findings.\u0000 \u0000 \u0000 \u0000 Osteopathic manipulative medicine (OMM) screening exams were completed for incoming first-year osteopathic medical students at the Western University of Health Sciences College of Osteopathic Medicine of the Pacific in August 2012. In this retrospective study, there were 208 participants, of which 15 had documented significant previous medical history. For the structural exam, rotational restrictions were assessed at OA, C7, T12, and L5. Myofascial restrictions were assessed at the craniocervical, cervicothoracic, thoracolumbar, and lumbosacral transitional zones.\u0000 This method of assessment creates 8 separate variables. These variables were recorded using a simple binomial system with 3 options: R for right rotation, L for left rotation, and O for lack of rotational restriction. The authors then evaluated these variables using kappa statistical analysis and the Fisher’s exact test to determine if there was any statistically or clinically significant correlation present between the structural findings and the myofascial restrictions.\u0000 \u0000 \u0000 \u0000 Of the 208 participants, 14 individuals (6.731%) matched all 4 of the structural exam restrictions with the myofascial restrictions, 24 (11.538%) matched 3 of the 4 transition zones, 62 (29.808%) matched 2 zones, 73 (35.096%) matched 1, and 35 (16.827%) exhibited 0 matches.\u0000 Of the 15 individuals with documented significant previous medical history, 2 individuals (13.333%) had all 4 matches, 1 (6.667%) had 3 matches, 6 (40%) had 2 matches, and 6 (40%) had 1 match.\u0000 Of the 198 individuals without significant limitations, 12 individuals (6.218%) had all 4 matches, 23 (11.917%) had 3 matches, 56 (29.016%) had 2 matches, 67 (34.715%) had 1 match, and 35 (18.135%) lacked any agreement between structural and myofascial findings.\u0000 On initial kappa analysis with all 208 participants, the authors found a total of 325 matches within the data, yielding a kappa value of 0.0527 with a 95% confidence interval of 0.0025 to 0.1028. For the 15 participants with medical limitations, the authors found the kappa value to be 0.2450 with a 95% confidence interval of 0.0615 to 0.4284 (P=0.0063). For the 198 individuals without limitations, the authors found the kappa value to be 0.0373 with a 95% confidence interval of -0.0147 to 0.0893 (P=0.1488).\u0000 \u0000 \u0000 \u0000 Regarding the group of 208 participants, there is a weak, but statistically significant correlat","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116565553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.53702/2375-5717-28.4.10
A. H. Tobey, Albert J. Kozar
The recent increase in breastfeeding has brought an increased awareness of potential causes for breastfeeding difficulties. Many parents are choosing frenectomy or laser revision for their infants with tongue-tie (ankyloglossia). This study aims to identify somatic dysfunctions commonly found in infants with tongue-tie as a first step in distinguishing infants with feeding issues caused by somatic dysfunction from infants with feeding issues directly related to tongue-tie. Since somatic dysfunction of the cranial base and occiput have direct implications for impacting the hypoglossal nerve, which provides motor control of intrinsic tongue musculature, it is our hypothesis that infants with tongue-tie and feeding issues will have a high incidence of cranial base dysfunction. A retrospective chart review was performed on 48 charts of infants diagnosed with tongue-tie who had been seen from June 2012 to January 2017 at a multispecialty practice. Thirty-one charts were excluded and 17 charts are reviewed here. Of the 17 infants with tongue-tie whose charts were included in the review, 76.4% had difficulties with latching and 35.3% had difficulty with suck or coordination of suck. All of the infants (100%) had occipital condylar dysfunction, 94.1% had restriction of at least 1 cranial suture, 94.1% had atlantooccipital (OA) joint dysfunction, and 23.5% had dysfunction at the sphenobasilar synchondrosis. All of the infants with tongue-tie had somatic dysfunction at the cranial base. This again raises the question of whether or not the feeding issues were directly related to the tongue-tie or to the somatic dysfunction or to a combination of both. This study was limited by sample size and limited diversity of patient sampling. Further studies are necessary. IRB #2017-007
{"title":"Frequency of Somatic Dysfunction in Infants With Tongue-Tie: A Retrospective Chart Review","authors":"A. H. Tobey, Albert J. Kozar","doi":"10.53702/2375-5717-28.4.10","DOIUrl":"https://doi.org/10.53702/2375-5717-28.4.10","url":null,"abstract":"\u0000 \u0000 \u0000 The recent increase in breastfeeding has brought an increased awareness of potential causes for breastfeeding difficulties. Many parents are choosing frenectomy or laser revision for their infants with tongue-tie (ankyloglossia). This study aims to identify somatic dysfunctions commonly found in infants with tongue-tie as a first step in distinguishing infants with feeding issues caused by somatic dysfunction from infants with feeding issues directly related to tongue-tie. Since somatic dysfunction of the cranial base and occiput have direct implications for impacting the hypoglossal nerve, which provides motor control of intrinsic tongue musculature, it is our hypothesis that infants with tongue-tie and feeding issues will have a high incidence of cranial base dysfunction.\u0000 \u0000 \u0000 \u0000 A retrospective chart review was performed on 48 charts of infants diagnosed with tongue-tie who had been seen from June 2012 to January 2017 at a multispecialty practice. Thirty-one charts were excluded and 17 charts are reviewed here.\u0000 \u0000 \u0000 \u0000 Of the 17 infants with tongue-tie whose charts were included in the review, 76.4% had difficulties with latching and 35.3% had difficulty with suck or coordination of suck. All of the infants (100%) had occipital condylar dysfunction, 94.1% had restriction of at least 1 cranial suture, 94.1% had atlantooccipital (OA) joint dysfunction, and 23.5% had dysfunction at the sphenobasilar synchondrosis.\u0000 \u0000 \u0000 \u0000 All of the infants with tongue-tie had somatic dysfunction at the cranial base. This again raises the question of whether or not the feeding issues were directly related to the tongue-tie or to the somatic dysfunction or to a combination of both. This study was limited by sample size and limited diversity of patient sampling. Further studies are necessary.\u0000 IRB #2017-007\u0000","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"184 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115700160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.53702/2375-5717-28.4.7
L. Ching
Introduction Generally, the purpose of osteopathic manipulative medicine (OMM) demonstrations is to show a screening or treatment approach or technique with a demonstration model, who is usually a volunteer. By showing this in front of a group of learners, this maximizes the learning experience. It is also helpful for the demonstration model since many kinesthetic learners learn best by tactile experience. It is important to keep medical ethics in mind for all professional interactions, including for physician instructors who are treating demonstration models, especially medical students, with OMM in group settings. Medical students are considered a vulnerable population in the language of medical research.1 In a group setting, they may feel coerced to be a treatment model, and student-teacher relationships may be affected as a result.
{"title":"Proposed Code of Ethics for Treating Osteopathic Manipulation Demonstration Models in Front of Groups","authors":"L. Ching","doi":"10.53702/2375-5717-28.4.7","DOIUrl":"https://doi.org/10.53702/2375-5717-28.4.7","url":null,"abstract":"Introduction Generally, the purpose of osteopathic manipulative medicine (OMM) demonstrations is to show a screening or treatment approach or technique with a demonstration model, who is usually a volunteer. By showing this in front of a group of learners, this maximizes the learning experience. It is also helpful for the demonstration model since many kinesthetic learners learn best by tactile experience. It is important to keep medical ethics in mind for all professional interactions, including for physician instructors who are treating demonstration models, especially medical students, with OMM in group settings. Medical students are considered a vulnerable population in the language of medical research.1 In a group setting, they may feel coerced to be a treatment model, and student-teacher relationships may be affected as a result.","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"380 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129618085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.53702/2375-5717-29.2.5
J. Blumer
{"title":"View From the Pyramids","authors":"J. Blumer","doi":"10.53702/2375-5717-29.2.5","DOIUrl":"https://doi.org/10.53702/2375-5717-29.2.5","url":null,"abstract":"","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134529327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-01DOI: 10.53702/2375-5717-28.3.5
J. Blumer
{"title":"View From the Pyramids: White Coats","authors":"J. Blumer","doi":"10.53702/2375-5717-28.3.5","DOIUrl":"https://doi.org/10.53702/2375-5717-28.3.5","url":null,"abstract":"","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127524566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-01DOI: 10.53702/2375-5717-28.3.7
Stephen I. Goldman
Osteopathic residency programs face many difficulties with incorporating osteopathic philosophy into their curricula. The author reviews the Accreditation Council for Graduate Medical Education (ACGME) requirements for philosophy and presents a strategy for developing and implementing osteopathic philosophy in residency programs utilizing the works of Andrew Taylor Still, MD, DO, reviewing the history of the osteopathic profession, and introducing healing philosophies.
整骨疗法住院医师项目在将整骨疗法哲学纳入其课程方面面临许多困难。作者回顾了研究生医学教育认证委员会(ACGME)对哲学的要求，并利用Andrew Taylor Still, MD, DO的作品，提出了在住院医师计划中发展和实施整骨疗法哲学的策略，回顾了整骨疗法职业的历史，并介绍了治疗哲学。
{"title":"Incorporating Osteopathic Philosophy Into Residency Programs","authors":"Stephen I. Goldman","doi":"10.53702/2375-5717-28.3.7","DOIUrl":"https://doi.org/10.53702/2375-5717-28.3.7","url":null,"abstract":"\u0000 Osteopathic residency programs face many difficulties with incorporating osteopathic philosophy into their curricula. The author reviews the Accreditation Council for Graduate Medical Education (ACGME) requirements for philosophy and presents a strategy for developing and implementing osteopathic philosophy in residency programs utilizing the works of Andrew Taylor Still, MD, DO, reviewing the history of the osteopathic profession, and introducing healing philosophies.","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132643483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-01DOI: 10.53702/2375-5717-28.3.18
D. R. Beatty
{"title":"Prescribing Herbal Medicines to Complement Osteopathic Manipulative Treatment for Chronic Pain and Dysfunction","authors":"D. R. Beatty","doi":"10.53702/2375-5717-28.3.18","DOIUrl":"https://doi.org/10.53702/2375-5717-28.3.18","url":null,"abstract":"","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121127215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-01DOI: 10.53702/2375-5717-28.3.12
Drew D. Lewis, G. Summers
A 16-year-old boy suffered a traumatic brain injury in a motor vehicle collision with resulting subdural hematoma, post-traumatic seizures, headaches, and cognitive dysfunction. In addition, he experienced severe acute low back, neck, and hip pain. The patient’s pediatrician identified him as likely to benefit from osteopathic manipulative medicine (OMM), and he was subsequently referred to the Des Moines University (DMU) specialty care clinic for further evaluation and management. The patient’s outpatient rehabilitation was impacted by multiple somatic dysfunctions and by onset of short leg syndrome. An OMM approach with direct techniques (muscle energy; low-velocity, moderate-amplitude; soft tissue), indirect techniques (counterstrain, Still, myofascial release), and cranial techniques were utilized to minimize his pain, maximize the neuromusculoskeletal recovery, and to assist in returning him to his prior level of functioning. The acute nature of the injury and apparent new-onset leg length discrepancy allowed for a rapid correction with a heel lift and an ongoing OMM approach to address somatic dysfunction associated with the condition. After 5 treatments with OMM and use of the heel lift, the patient’s low back pain substantially improved, and his headaches completely resolved.
{"title":"An Osteopathic Approach to Low Back Pain and Short Leg Syndrome in a Patient with Traumatic Brain Injury Following Motor Vehicle Crash: A Case Report","authors":"Drew D. Lewis, G. Summers","doi":"10.53702/2375-5717-28.3.12","DOIUrl":"https://doi.org/10.53702/2375-5717-28.3.12","url":null,"abstract":"\u0000 A 16-year-old boy suffered a traumatic brain injury in a motor vehicle collision with resulting subdural hematoma, post-traumatic seizures, headaches, and cognitive dysfunction. In addition, he experienced severe acute low back, neck, and hip pain. The patient’s pediatrician identified him as likely to benefit from osteopathic manipulative medicine (OMM), and he was subsequently referred to the Des Moines University (DMU) specialty care clinic for further evaluation and management.\u0000 The patient’s outpatient rehabilitation was impacted by multiple somatic dysfunctions and by onset of short leg syndrome. An OMM approach with direct techniques (muscle energy; low-velocity, moderate-amplitude; soft tissue), indirect techniques (counterstrain, Still, myofascial release), and cranial techniques were utilized to minimize his pain, maximize the neuromusculoskeletal recovery, and to assist in returning him to his prior level of functioning.\u0000 The acute nature of the injury and apparent new-onset leg length discrepancy allowed for a rapid correction with a heel lift and an ongoing OMM approach to address somatic dysfunction associated with the condition. After 5 treatments with OMM and use of the heel lift, the patient’s low back pain substantially improved, and his headaches completely resolved.","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"139 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121306580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.53702/2375-5717-28.2.9
Brian P. Peppers, J. Blumer, R. Hostoffer, M. Rowane, K. Thomas, Thomas R. Byrnes
Discrimination, whether by conscious or unconscious means, can have significant and often long-lasting negative consequences on the afflicted group or individual. The osteopathic culture and field of medical practice has long fought for equal rights and recognition among their allopathic medical peers. Almost 90 years have passed since Congress, in 1929, declared allopathic and osteopathic medical degrees equivalent. Despite this, key resources and positions within the medical and research profession continue to be inequitable for the osteopathic community. There exists a severe paucity of osteopathic involvement at the National Institutes of Health today and throughout its history. Herein, the historic and current unequal representation of the osteopathic culture from the National Institutes of Health and MEDLINE is investigated.
{"title":"National Institutes of Health and Osteopathic Medicine: Another call for action and equality in a legal struggle won long ago","authors":"Brian P. Peppers, J. Blumer, R. Hostoffer, M. Rowane, K. Thomas, Thomas R. Byrnes","doi":"10.53702/2375-5717-28.2.9","DOIUrl":"https://doi.org/10.53702/2375-5717-28.2.9","url":null,"abstract":"\u0000 Discrimination, whether by conscious or unconscious means, can have significant and often long-lasting negative consequences on the afflicted group or individual. The osteopathic culture and field of medical practice has long fought for equal rights and recognition among their allopathic medical peers. Almost 90 years have passed since Congress, in 1929, declared allopathic and osteopathic medical degrees equivalent. Despite this, key resources and positions within the medical and research profession continue to be inequitable for the osteopathic community. There exists a severe paucity of osteopathic involvement at the National Institutes of Health today and throughout its history. Herein, the historic and current unequal representation of the osteopathic culture from the National Institutes of Health and MEDLINE is investigated.","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125428438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.53702/2375-5717-28.2.29
D. J. Wilson, J. L. Gorham, Teri Lamb, Shanliang Lui, T. Daniel
Osteopathic manipulative treatment (OMT) is a widely used methodology for the clinical treatment of spine-related pain. Recent reports have been especially positive regarding the use of OMT for chronic back pain. However, published reports have been focused on populations available within large university-based institutions, with rural-based hospitals and their clientele unrepresented within the professional literature The objective of this multi-year study was to examine the effects of OMT on spine-related chronic pain and its effects on dimensions of functional ability in a rural setting served by a safety-net hospital. In this study, 151 participants with chronic (>6 months) spine-related pain (mean age 54.58 ± 11.88 years) completed at least 2 office visits. The Oswestry Disability Index (ODI) was used to assess 10 dimensions (pain intensity, personal care, lifting, walking, sitting, sleeping, standing, sex life, social life, and travel) and a total score of functional ability related to back pain. A 2-way mixed-model, repeated-measures analysis of variance (ANOVA) with time (pre- and post-office visit) as the within-participants factor and with sex as the between-participants factor resulted in a significant main effect from pretest to posttest, (F(1,149) = 67.12, P < .001, η2p = .311), but not a significant interaction between time and gender, (F(1,149) = .426, P = .515, η2p = .003). The results of this study support the hypothesis that OMT improved measures of functional ability related to pain intensity, unrelated to sex. The rural nature of the clinical setting provided a unique population for this study.
骨科手法治疗(OMT)是一种广泛应用于临床治疗脊柱相关疼痛的方法。最近的报告对使用OMT治疗慢性背痛特别积极。然而，已发表的报告主要集中在大型大学机构中可用的人群，而农村医院及其客户在专业文献中没有代表性。这项多年研究的目的是检查OMT对脊柱相关慢性疼痛的影响及其对农村环境中由安全网医院服务的功能能力维度的影响。在这项研究中，151名患有慢性(>6个月)脊柱相关疼痛的参与者(平均年龄54.58±11.88岁)完成了至少2次办公室就诊。采用Oswestry失能指数(ODI)评估疼痛强度、个人护理、举举、行走、坐姿、睡眠、站立、性生活、社交生活和旅行等10个维度以及与背痛相关的功能能力总分。以时间(就诊前后)为参与者内因素，以性别为参与者间因素的双向混合模型、重复测量方差分析(ANOVA)结果显示，从测试前到测试后，主效应显著(F(1149) = 67.12, P < 0.001， η2p = 0.311)，但时间与性别之间不存在显著交互作用(F(1149) = 0.426, P = 0.515， η2p = 0.003)。这项研究的结果支持了OMT改善与疼痛强度相关的功能能力的假设，与性别无关。临床环境的农村性质为本研究提供了一个独特的人群。
{"title":"Osteopathic Manipulation Improves Functional Status in Patients With Non-Specific Chronic Back Pain in a Rural Outpatient Setting","authors":"D. J. Wilson, J. L. Gorham, Teri Lamb, Shanliang Lui, T. Daniel","doi":"10.53702/2375-5717-28.2.29","DOIUrl":"https://doi.org/10.53702/2375-5717-28.2.29","url":null,"abstract":"\u0000 \u0000 \u0000 Osteopathic manipulative treatment (OMT) is a widely used methodology for the clinical treatment of spine-related pain. Recent reports have been especially positive regarding the use of OMT for chronic back pain. However, published reports have been focused on populations available within large university-based institutions, with rural-based hospitals and their clientele unrepresented within the professional literature\u0000 \u0000 \u0000 \u0000 The objective of this multi-year study was to examine the effects of OMT on spine-related chronic pain and its effects on dimensions of functional ability in a rural setting served by a safety-net hospital.\u0000 \u0000 \u0000 \u0000 In this study, 151 participants with chronic (>6 months) spine-related pain (mean age 54.58 ± 11.88 years) completed at least 2 office visits. The Oswestry Disability Index (ODI) was used to assess 10 dimensions (pain intensity, personal care, lifting, walking, sitting, sleeping, standing, sex life, social life, and travel) and a total score of functional ability related to back pain.\u0000 \u0000 \u0000 \u0000 A 2-way mixed-model, repeated-measures analysis of variance (ANOVA) with time (pre- and post-office visit) as the within-participants factor and with sex as the between-participants factor resulted in a significant main effect from pretest to posttest, (F(1,149) = 67.12, P < .001, η2p = .311), but not a significant interaction between time and gender, (F(1,149) = .426, P = .515, η2p = .003).\u0000 \u0000 \u0000 \u0000 The results of this study support the hypothesis that OMT improved measures of functional ability related to pain intensity, unrelated to sex. The rural nature of the clinical setting provided a unique population for this study.\u0000","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"176 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134322227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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