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A Case Study of Postural Imbalance with Lymphatic Congestion Which Responded to OMT 体位失衡伴淋巴充血的OMT治疗一例
Pub Date : 2023-03-01 DOI: 10.53702/2375-5717-33.1.8
Wesley C. Lockhart
This case report covers a nonagenarian who was in otherwise good health before a significant ankle fracture that required surgery and a prolonged rehabilitation due to the trauma, surgery and colitis. She developed or exacerbated a postural imbalance due to deconditioning, unequal leg length due to immobilization, and shoulder pain due to the use of a walker. This case report also covers the osteopathic manipulative treatments used.
本病例报告涉及一位90多岁的老人,他在踝关节严重骨折之前健康状况良好,由于创伤、手术和结肠炎需要手术和长期康复。由于身体条件的改善,她出现或加重了姿势不平衡,由于固定导致腿长不均匀,以及由于使用助行器导致的肩部疼痛。本病例报告也涵盖了整骨疗法的手法治疗。
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引用次数: 0
From the Editor 来自编辑
Pub Date : 2022-11-30 DOI: 10.53702/2375-5717-32.4.10
R. J. Hruby
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引用次数: 0
Thomas L. Northup Lecture: Integrating Osteopathic Principles into Patient Care: An Approach for All Specialties 托马斯L.诺瑟普讲座:整合整骨疗法的原则到病人护理:一个方法为所有专业
Pub Date : 2022-11-30 DOI: 10.53702/2375-5717-32.4.33
Karen T. Snider
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引用次数: 0
The Touch Taboo: Origins for the Prohibition of Touch in Psychiatry and a Rational Osteopathic Approach 触摸禁忌:精神病学中禁止触摸的起源和理性的整骨疗法
Pub Date : 2022-11-30 DOI: 10.53702/2375-5717-32.4.19
Teodor Huzij
The prohibition of touch in psychiatry has multiple origins. The most prominent advocate for an interdiction on touch has been Sigmund Freud and the legacy of psychoanalysis. Scientism, dualism, and medicolegal concerns have also promoted a touch taboo in psychiatry. However, it is evident that non-sexual physical touch is vital for human health; studies of touch in children and adults have shown numerous health benefits physically and psychologically. A discussion of ethical principles in light of the use of touch in psychiatry is provided. Several theoretical paradigms do utilize touch in treating patients and are reviewed including the medical model, body-psychotherapies, and osteopathic medicine. The osteopathic philosophy provides a lens through which the osteopathic physician both assesses and provides rational treatment to the patient. In addition to this philosophy, osteopathic physicians are extensively trained in osteopathic manipulative treatment (OMT). Osteopathic physicians have treated patients with psychiatric disorders with OMT and other treatments for nearly 150 years. The unique osteopathic model of care contrasts with the long-standing prohibition of touch with psychiatric patients and thereby provides a rational approach to the use of touch in psychiatry. The reasoned recommendations for osteopathic psychiatrists using touch clinically include consent, context, and competency considerations.
精神病学禁止触摸有多重原因。西格蒙德·弗洛伊德(Sigmund Freud)和精神分析的遗产是禁止接触的最著名倡导者。科学主义、二元论和对医学法律的关注也促进了精神病学的触碰禁忌。然而,很明显,非性的身体接触对人类健康至关重要;对儿童和成人的研究表明,触摸对身体和心理健康都有许多好处。讨论了在精神病学中使用触摸的伦理原则。一些理论范例确实利用触摸治疗患者,并回顾了包括医学模型,身体心理疗法和整骨疗法。整骨疗法提供了一个视角,通过这个视角,整骨疗法医生既可以评估病人,也可以为病人提供合理的治疗。除了这一理念,整骨疗法医生在整骨疗法手法治疗(OMT)方面接受了广泛的培训。骨科医生用OMT和其他治疗方法治疗精神疾病患者已有近150年的历史。独特的整骨疗法模式的护理对比长期禁止触摸与精神病患者,从而提供了一个合理的方法,在精神病学中使用触摸。骨科精神科医生在临床上使用触摸的合理建议包括同意、背景和能力考虑。
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引用次数: 0
Quality of Care: An Assessment of the Contributions of Osteopathic Medicine 护理质量:对整骨医学贡献的评估
Pub Date : 2022-11-30 DOI: 10.53702/2375-5717-32.4.48
A. Chila
Since the advent of Medicare in 1965, the concept of quality of care in medical practice in the United States has been under review, and a revision of ideas and responsibilities to the patient (consumer) has had a major impact on the system of delivery. In little, more than ten years, there have been major changes in the health care system in the United States, with a necessary delineation of the contributions to total health care of followers of two separate and distinct philosophies of medicine that are coexistent and recognized equally by the legislation of the United States. The purpose of this paper is to consider the quality of care rendered by the minority school of medicine through the services of the osteopathic community hospital and possible methods of improving it.
自1965年医疗保险问世以来,美国医疗实践中护理质量的概念一直在审查之中,对患者(消费者)的观念和责任的修订对交付系统产生了重大影响。在短短十多年的时间里,美国的医疗保健系统发生了重大变化,对两种独立而独特的医学哲学的追随者对总体医疗保健的贡献进行了必要的描述,这两种哲学并存,并得到了美国立法的平等承认。本文的目的是考虑少数民族医学院通过骨科社区医院的服务提供的护理质量和可能的方法来提高它。
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引用次数: 0
The Role of Osteopathic Manipulative Medicine in the Rehabilitation of a Competitive Dancer after a Major Abdominal Surgery 整骨疗法在竞技性舞蹈家腹部大手术后康复中的作用
Pub Date : 2022-11-30 DOI: 10.53702/2375-5717-32.4.11
Gabriel Berenbeim, Jose S. Figueroa
Transmural inflammation in Crohn’s disease can lead to stricturing of the bowel which may result in an obstruction and perforation of the intestines. Emergent surgery is indicated to amend a perforation but complications, such as edema, can limit a surgeon’s ability to close the abdominal wall. In such a case, the open wounds may heal by secondary intent where new tissue is laid down from the base upwards. This case report describes a 23-year-old woman completing her Bachelor of Arts in dance with a past medical history of stricturing and inflammatory ileocolonic Crohn’s disease who presented to the osteopathic manipulative medicine (OMM)/Physical Medicine and Rehabilitation (PM&R) clinic for multiple open abdominal wounds and weakness. To the authors’ knowledge, this is the first case report detailing the benefits of osteopathic manipulative treatment (OMT) to healing open abdominal wounds, increasing flexibility and physical fitness, and improving the mental health of an individual who required prompt rehabilitation to return to the high-level of fitness required to pursue a career as a professional dancer.
克罗恩病的跨壁炎症可导致肠道狭窄,从而可能导致肠道阻塞和穿孔。紧急手术是指修补穿孔,但并发症,如水肿,可以限制外科医生的能力关闭腹壁。在这种情况下,开放性伤口可能会通过从基部向上铺设新组织的二次意图愈合。本病例报告描述了一名23岁的舞蹈文学学士,既往有狭窄和炎症性回肠克罗恩病病史,因腹部多处开放性伤口和虚弱来到整骨疗法(OMM)/物理医学和康复(PM&R)诊所。据作者所知,这是第一个详细介绍骨科手法治疗(OMT)在治疗腹部开放性伤口、增加柔韧性和身体健康以及改善个体心理健康方面的益处的病例报告,这些个体需要迅速康复,以恢复到追求职业舞者职业所需的高水平健康。
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引用次数: 0
Comparing In-person vs. Live-streamed Osteopathic Manual Medicine Lab Instruction 比较面对面与直播骨科医学实验室指导手册
Pub Date : 2022-09-01 DOI: 10.53702/2375-5717-32.3.9
Megan M. Ellis, Kaitlyn Finneran, Chunfa Jie, Drew D. Lewis
Practicing osteopathic manual medicine (OMM) requires medical students to learn a unique psychomotor skill. OMM techniques are taught during hands-on laboratory sessions in osteopathic medical schools across the country. Determining the optimal delivery of OMM training in the first and second years of medical school is instrumental in maximizing student engagement and confidence for future use in practice. In the academic year of 2020–2021, public health guidelines for COVID-19 forced Des Moines University College of Osteopathic Medicine to restructure their OMM laboratory sessions to include in-person and live-stream demonstrations of somatic dysfunction diagnoses and treatments. To determine if there was a difference in students’ perception of the learning experience and exam performance between in-person and live-streamed osteopathic manual medicine (OMM) laboratory instruction. An online 8-question survey was sent to 225 first year medical students from Des Moines University at the end of their first year. The survey contained a combination of Likert scale, dichotomous, and open-ended questions. Statistical analysis for the Likert scale questions included paired-t test given the nature of correlated responses by the same cohort of students. A non-parametric permutation test was used to compare Fall 2020 practical exam grades due to the heavy skewness and ties of the exam score distributions. All computations were also made using the statistical computing software R. Free text was qualitatively analyzed for recurrent themes. The survey response rate was 67.1% with 151 respondents. When students were asked to rate their learning experience (engagement, comfort asking questions, understanding of material, ability to retain and recall lab material) between in-person vs. live-stream delivery of OMM lab material on a 5-point Likert Scale, there was a statistically significant mean difference for all of the responses, indicating a preference for in-person delivery method. Comparisons of the mean practical exam scores revealed no statistically significant differences. When asked to choose between in-person vs. live-stream, 83% of students reported a preference for in-person OMM laboratory demonstrations. The students’ perceptions suggest that in-person delivery of OMM was superior to live-stream instruction based on higher rankings of engagement, comfort in asking questions, understanding material to practice, and recall of material in preparation of practical exams.
实践整骨疗法手工医学(OMM)要求医学生学习一种独特的精神运动技能。OMM技术在全国各地的骨科医学院的动手实验课程中教授。确定医学院第一年和第二年的最佳OMM培训方式有助于最大限度地提高学生的参与度和信心,以便将来在实践中使用。在2020-2021学年,2019冠状病毒病的公共卫生指南迫使得梅因大学骨科医学院重组了他们的OMM实验室课程,包括身体功能障碍诊断和治疗的现场和直播演示。确定学生对学习经验和考试成绩的感知在面对面和直播骨科手工医学(OMM)实验室教学之间是否存在差异。一份有8个问题的在线调查在得梅因大学医学院的225名一年级学生一年级结束时被发送。该调查包含李克特量表、二分法和开放式问题的组合。李克特量表问题的统计分析包括配对t检验,考虑到同一群学生的相关反应的性质。由于考试成绩分布的严重偏度和联系,使用非参数排列检验来比较2020年秋季实践考试成绩。所有计算均使用统计计算软件r进行。对反复出现的主题进行定性分析。调查回应率为67.1%,共有151名受访者。当学生被要求评价他们的学习体验(参与度、提问舒适度、对材料的理解、保留和回忆实验材料的能力)时,在5分李克特量表上,所有的回答都有统计学上显著的平均差异,这表明学生更喜欢面对面授课的方法。实践考试平均成绩的比较显示没有统计学上的显著差异。当被要求在现场和直播之间进行选择时,83%的学生表示更喜欢现场OMM实验室演示。学生们的看法表明,基于更高的参与度、提问的舒适性、对练习材料的理解以及准备实际考试时对材料的回忆,现场授课的OMM优于直播教学。
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引用次数: 0
Osteopathic Manipulative Treatment for Optic Pathway Glioma 视神经胶质瘤的整骨手法治疗
Pub Date : 2022-09-01 DOI: 10.53702/2375-5717-32.3.37
Samantha C Gordon, Stefan Hagopian
Optic gliomas are a known complication of neurofibromatosis type 1 (NF1) and can result in significant impairment. This case report centers around a 3-year-old girl with NF1 and optic glioma diagnosed by MRI, whose optic glioma has not increased in size since commencing treatment with osteopathic manipulative treatment (OMT) at regular intervals. We cover the rationale behind treating these patients with OMT with a thorough review of the relevant anatomy. We suggest a basis of treatment that could benefit patients with a number of intracranial and extracranial pathologies.
视神经胶质瘤是已知的1型神经纤维瘤病(NF1)的并发症,可导致严重损害。本病例报告的中心是一名3岁女孩,经MRI诊断为NF1和视神经胶质瘤,其视神经胶质瘤自定期接受整骨手法治疗(OMT)后没有增大。我们通过对相关解剖的全面回顾,介绍了使用OMT治疗这些患者的基本原理。我们提出了一种治疗基础,可以使许多颅内和颅外病变的患者受益。
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引用次数: 0
View from the Pyramids: Pay It Forward 从金字塔上看:传递爱
Pub Date : 2022-09-01 DOI: 10.53702/2375-5717-32.3.8
J. Blumer
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引用次数: 0
Osteopathic Medical Students’ Subjective Preparedness for LGBTQ+ Patient Care and Influencing Factors: A Multi-Institutional Survey Study 骨科医学生对LGBTQ+患者护理的主观准备及影响因素:一项多机构调查研究
Pub Date : 2022-09-01 DOI: 10.53702/2375-5717-32.3.26
Kaori Morimoto, Jann C. Uy, Lillie Blair, Hailey Barab, Wendi Wu, Claire Oosterbaan, Lauren Ozdowski, Elisabeth Guenther
This study aims to investigate what factors correlate with osteopathic medical students’ preparedness to provide care for the LGBTQ+ community through a multi-institutional survey. This is one of the few formal research projects to assess the impact of LGBTQ+ medical education on osteopathic students’ comfort level with caring for the community. This study was approved by the IRB at Western University of Health Sciences, Pomona, CA on 11/19/2020. An 18-question survey was created regarding the exposure to the LGBTQ+ population and healthcare education before and after attending osteopathic medical schools. The anonymous survey was electronically distributed at Western University of Health Sciences College of Osteopathic Medicine Pacific and Pacific Northwest, Idaho College of Osteopathic Medicine, Touro University, Philadelphia College of Osteopathic Medicine, Rocky Vista University College of Osteopathic Medicine, and Michigan State University College of Osteopathic Medicine between 1/6/21 and 5/8/21. The survey information was statistically analyzed via SAS University edition. The survey had 441 responses: 63% were female, 34% were male, and 3% selected other gender identities. From 441 responses to the survey, 378 responses were analyzed using a logistics regression model to comprehensively model a binary-dependent variable for the students’ preparedness. Students knowing the meaning of the acronym LGBTQ+ (p =0.04) and actively engaging in extracurricular activities for the LGBTQ+ population (p =0.01) showed the strongest correlation based on the logistic regression analysis. Additionally, Chi-square results identified 6 independent variables associated with students’ preparedness to care for the LGBTQ+ population: being a second year or a third year osteopathic medical student (p <0.01), having opportunities to learn about the LGBTQ+ population in college (p <0.01), having a formal presentation about LGBTQ+ health in medical school (p <0.01), the medical school offering extracurricular activities about the LGBTQ+ population (p <0.01), knowing what the LGBTQ+ acronym stands for (p =0.01), and actively being involved in extracurricular activities concerning the LGBTQ+ community (p=0.03). Our study indicates that medical students’ educational exposure through college and medical school is a more correlating influencing factor for their preparedness to care for the LGBTQ+ population in comparison with student’s gender, hometown size, or socioeconomic, geographical, and religious background. Future studies to objectively identify medical students’ preparedness and experience with LGBTQ+ patients, as well as studying effective curricula for filling in knowledge gaps, will be necessary.
本研究旨在通过一项多机构调查,探讨影响骨科医学生为LGBTQ+社区提供护理的相关因素。这是为数不多的正式研究项目之一,旨在评估LGBTQ+医学教育对整骨疗法学生照顾社区的舒适度的影响。本研究已于2020年11月19日获得西部健康科学大学IRB批准。一项包含18个问题的调查是关于LGBTQ+人群在进入骨科医学院之前和之后的接触和医疗保健教育。这项匿名调查于21年6月1日至21年8月5日在西部健康科学大学太平洋和西北太平洋骨科医学院、爱达荷州骨科医学院、图罗大学、费城骨科医学院、洛基维斯塔大学骨科医学院和密歇根州立大学骨科医学院进行电子分发。通过SAS大学版对调查信息进行统计分析。这项调查共有441人参与,其中63%为女性,34%为男性,3%选择了其他性别身份。从441份问卷反馈中,利用logistic回归模型对378份反馈进行分析,对学生备灾准备的二元因变量进行综合建模。logistic回归分析显示,LGBTQ+群体中,学生对LGBTQ+的首字母缩略词含义的了解程度(p =0.04)与积极参加课外活动的程度(p =0.01)的相关性最强。此外,卡方结果确定了与学生准备照顾LGBTQ+人群相关的6个自变量:二、三年级骨病医学专业学生(p <0.01),在大学有机会了解LGBTQ+人群(p <0.01),在医学院有关于LGBTQ+健康的正式演讲(p <0.01),医学院有关于LGBTQ+人群的课外活动(p <0.01),知道LGBTQ+的缩写是什么(p= 0.01),积极参与LGBTQ+社区的课外活动(p=0.03)。我们的研究表明,医学生在大学和医学院的教育经历与学生的性别、家乡规模或社会经济、地理和宗教背景相比,对他们照顾LGBTQ+人群的准备程度有更大的相关影响。未来有必要研究客观地确定医学生对LGBTQ+患者的准备和经验,以及研究有效的课程来填补知识空白。
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引用次数: 0
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The AAO Journal
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