Pub Date : 2022-02-28DOI: 10.53702/2375-5717-32.1.18
Gabriel Berenbeim, Megan M. Ellis, Kaitlyn Finneran, Isaac Metzler, Drew D. Lewis, Chunfa Jie
Predoctoral Osteopathic Manual Medicine Fellowships (pOMMFs) are an additional year of medical training that frequently involve direct patient care, educating medical students, and research. Research has supported that a pOMMF can increase student satisfaction with, and understanding of, Osteopathic Manual Medicine (OMM) curriculum at their respective medical institution. In the interest of identifying programs that improve OMM utilization in practice and promote osteopathic leaders in medicine, pOMMFs might play a significant role. Overall, there is little known research on pOMMFs. To investigate the impact of the Des Moines University (DMU) pOMMF on the medical and professional careers of its graduates. A 26-question survey to be completed online was sent to 88 graduates of the DMU pOMMF who represented graduating classes from 1979 to 2020. The survey contained a combination of Likert scale, yes-no, and free text questions. Statistical analysis included descriptive statistics, Chi-square test of goodness-of-fit, and simultaneous 95% confidence intervals. Free text was qualitatively analyzed for recurrent themes. Out of 61 respondents, 90.2% of participants reported that the pOMMF significantly improved their ability to teach medical students and residents, along with 77.1% of participants teaching residents/attendings OMM during residency. Of those eligible, 79.2% of alumni held at least one of the following leadership positions: chief resident, clinical preceptor, department chair, medical director. Most participants (83.6%) report providing OMT to their patients, along with 80.7% of respondents attributing the fellowship to significantly improving their ability to incorporate OMT into their medical practice. The study supports that the DMU pOMMF may create positive downstream effects in the medical careers of its graduates by providing abundant teaching opportunities, encouraging leadership roles, and promoting the utilization of OMT within residency and future practice. Graduates drew from the DMU pOMMF experiences to promote their medical and professional careers. Limitations include potential selection bias and inability to establish causal effect without a control population of non-pOMMF graduates from DMU or other institutions. Further research could corroborate these findings by investigating other pOMMFs and compare responses to non-pOMMF osteopathic medicine graduates.
{"title":"Professional Impact of the DMU Predoctoral OMM Fellowship","authors":"Gabriel Berenbeim, Megan M. Ellis, Kaitlyn Finneran, Isaac Metzler, Drew D. Lewis, Chunfa Jie","doi":"10.53702/2375-5717-32.1.18","DOIUrl":"https://doi.org/10.53702/2375-5717-32.1.18","url":null,"abstract":"\u0000 \u0000 \u0000 Predoctoral Osteopathic Manual Medicine Fellowships (pOMMFs) are an additional year of medical training that frequently involve direct patient care, educating medical students, and research. Research has supported that a pOMMF can increase student satisfaction with, and understanding of, Osteopathic Manual Medicine (OMM) curriculum at their respective medical institution. In the interest of identifying programs that improve OMM utilization in practice and promote osteopathic leaders in medicine, pOMMFs might play a significant role. Overall, there is little known research on pOMMFs.\u0000 \u0000 \u0000 \u0000 To investigate the impact of the Des Moines University (DMU) pOMMF on the medical and professional careers of its graduates.\u0000 \u0000 \u0000 \u0000 A 26-question survey to be completed online was sent to 88 graduates of the DMU pOMMF who represented graduating classes from 1979 to 2020. The survey contained a combination of Likert scale, yes-no, and free text questions. Statistical analysis included descriptive statistics, Chi-square test of goodness-of-fit, and simultaneous 95% confidence intervals. Free text was qualitatively analyzed for recurrent themes.\u0000 \u0000 \u0000 \u0000 Out of 61 respondents, 90.2% of participants reported that the pOMMF significantly improved their ability to teach medical students and residents, along with 77.1% of participants teaching residents/attendings OMM during residency. Of those eligible, 79.2% of alumni held at least one of the following leadership positions: chief resident, clinical preceptor, department chair, medical director. Most participants (83.6%) report providing OMT to their patients, along with 80.7% of respondents attributing the fellowship to significantly improving their ability to incorporate OMT into their medical practice.\u0000 \u0000 \u0000 \u0000 The study supports that the DMU pOMMF may create positive downstream effects in the medical careers of its graduates by providing abundant teaching opportunities, encouraging leadership roles, and promoting the utilization of OMT within residency and future practice. Graduates drew from the DMU pOMMF experiences to promote their medical and professional careers. Limitations include potential selection bias and inability to establish causal effect without a control population of non-pOMMF graduates from DMU or other institutions. Further research could corroborate these findings by investigating other pOMMFs and compare responses to non-pOMMF osteopathic medicine graduates.\u0000","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130500304","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 : 2022-02-28DOI: 10.53702/2375-5717-32.1.44
Thomas Balint, Jeremy Jones, Mark Paquette, J. Amalfitano
Patellofemoral pain syndrome (PFPS) is a common yet complicated clinical presentation. The first objective of this paper is to review the literature related to the pathogenesis and diagnostic testing for evaluating for PFPS. The second objective is to investigate how the five models of osteopathic medicine relate to the development and treatment of PFPS. The last objective is to outline several effective osteopathic manipulative techniques that can aid in the treatment of PFPS.
{"title":"Patellofemoral Pain Syndrome: A Review of the Literature with Osteopathic Emphasis","authors":"Thomas Balint, Jeremy Jones, Mark Paquette, J. Amalfitano","doi":"10.53702/2375-5717-32.1.44","DOIUrl":"https://doi.org/10.53702/2375-5717-32.1.44","url":null,"abstract":"\u0000 Patellofemoral pain syndrome (PFPS) is a common yet complicated clinical presentation. The first objective of this paper is to review the literature related to the pathogenesis and diagnostic testing for evaluating for PFPS. The second objective is to investigate how the five models of osteopathic medicine relate to the development and treatment of PFPS. The last objective is to outline several effective osteopathic manipulative techniques that can aid in the treatment of PFPS.","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130110891","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 : 2021-12-01DOI: 10.53702/2375-5717-31.4.17
J. Price
Lateral epicondylosis is the most prevalent cause of lateral elbow pain, occurring in 4 per 1000 patients. The aim of most treatments is to reduce inflammation even with histological evidence demonstrating that lateral epicondylosis is a non-inflammatory condition. To determine the relative merits of the different regimens used to diminish lateral epicondylosis pain using a mixed treatment comparison/network meta-analysis (NMA). A thorough literature search was performed. The eligibility criteria for this mixed treatment comparison were: randomized controlled clinical trials; human subjects; working age population (16 to 70 years); the outcome measure was an objective pain assessment; measured at a 1- to 3-month follow-up. The NMA were performed using the GeMTC user interface for automated NMA utilizing a Bayesian Hierarchical Model of random effects. The evaluation of confidence in the findings from NMA was performed using a semi-automated platform called CINeMA (Confidence in Network Meta-Analysis). The model suggests that articulation technique is the most effective measure for decreasing lateral epicondylalgia followed by topical nitrates, acupuncture, kinesiology taping and low-level laser therapy, respectively. Muscle energy technique, local corticosteroid injection, prolotherapy and counterforce bracing displayed a trend toward being less effective than placebo. The results suggest that the most effective modalities for improving lateral epicondylalgia are those that decrease muscle tone and those that improve circulation, while measures meant to decrease inflammation appear to be of no or limited benefit.
{"title":"A Network Meta-Analysis of Randomized Controlled Trials Directed at Treating Lateral Epicondylalgia","authors":"J. Price","doi":"10.53702/2375-5717-31.4.17","DOIUrl":"https://doi.org/10.53702/2375-5717-31.4.17","url":null,"abstract":"\u0000 \u0000 \u0000 Lateral epicondylosis is the most prevalent cause of lateral elbow pain, occurring in 4 per 1000 patients. The aim of most treatments is to reduce inflammation even with histological evidence demonstrating that lateral epicondylosis is a non-inflammatory condition.\u0000 \u0000 \u0000 \u0000 To determine the relative merits of the different regimens used to diminish lateral epicondylosis pain using a mixed treatment comparison/network meta-analysis (NMA).\u0000 \u0000 \u0000 \u0000 A thorough literature search was performed. The eligibility criteria for this mixed treatment comparison were: randomized controlled clinical trials; human subjects; working age population (16 to 70 years); the outcome measure was an objective pain assessment; measured at a 1- to 3-month follow-up. The NMA were performed using the GeMTC user interface for automated NMA utilizing a Bayesian Hierarchical Model of random effects. The evaluation of confidence in the findings from NMA was performed using a semi-automated platform called CINeMA (Confidence in Network Meta-Analysis).\u0000 \u0000 \u0000 \u0000 The model suggests that articulation technique is the most effective measure for decreasing lateral epicondylalgia followed by topical nitrates, acupuncture, kinesiology taping and low-level laser therapy, respectively. Muscle energy technique, local corticosteroid injection, prolotherapy and counterforce bracing displayed a trend toward being less effective than placebo.\u0000 \u0000 \u0000 \u0000 The results suggest that the most effective modalities for improving lateral epicondylalgia are those that decrease muscle tone and those that improve circulation, while measures meant to decrease inflammation appear to be of no or limited benefit.\u0000","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129407655","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 : 2021-12-01DOI: 10.53702/2375-5717-31.4.55
Edward Goering, Maranda Herner, Meagan Smith, Mary Galka, Samuel Kammerzell, Kaitlin Best, Pamela Anderson, M. Steinauer
This study explores the effects of one Compression of the 4th Ventricle (CV4) treatment performed by experienced osteopathic physicians on reactive anxiety in healthy medical students. Anxiety was assessed with heart rate, blood pressure, and the Hamilton Anxiety Scale (HAM-A). Western University of Health Sciences IRB #15/IRB/113 was obtained for this single blind study. Volunteer first and second year medical students naïve to Osteopathic Cranial Manipulative Medicine, both in curriculum and as a patient, were recruited for this two-day study. Students were de-identified and demographic information was collected. On the first day, all 64 students received a sham treatment. Eight practitioners agreed on CV4 and sham techniques (mastoid cranial hold). In the CV4 technique, the operator’s thenar eminences contact the lateral angles of the occiput, and the operator encouraged the extension phase and discouraged the flexion phase of the CRI. Compression continued until a still point was reached in each student as identified by the practitioner. Students were evaluated before and after treatment using heart rate, blood pressure, and the Hamilton Anxiety Rating Scale (HAM-A). No significant difference was found in demographics of the two groups. A significant difference between sham and CV4 treatments was found for heart rate (p=0.036), but not for systolic or diastolic blood pressure (p=0.446 and p=0.799, respectively). Average heart rate reduction of CV4 group was 3.11 and of sham group was 1.12, with p=0.036 (Mann Whitney U = 1271). Heart rate increased in a few students after both CV4 and sham treatments. Average HAM-A score for students before and after CV4 treatment were 21.9 and 18.3, with an average net reduction of 3.58 compared to the sham’s 2.77, but results were not found to be statistically significant (p=0.09, U=1172). A statistically significant average reduction in heart rate, but not in blood pressure or HAM-A scores, was found after CV4 treatment compared to sham treatment. More studies with larger samples are needed to further investigate the effects of CV4.
本研究探讨了由经验丰富的骨科医生进行的第四心室压迫治疗对健康医学生反应性焦虑的影响。用心率、血压和汉密尔顿焦虑量表(HAM-A)评估焦虑。本单盲研究获得了Western University of Health Sciences的IRB #15/IRB/113。志愿者一年级和二年级的医学生naïve骨科颅推拿医学，无论是在课程中还是作为患者，都被招募参加为期两天的研究。学生被去识别，人口统计信息被收集。第一天，所有64名学生都接受了假治疗。8位从业者同意CV4和假技术(乳突颅骨保持)。在CV4技术中，操作人员的大鱼际隆起接触枕骨的外侧角，操作人员鼓励CRI的伸展期，不鼓励CRI的屈曲期。持续压缩，直到每个学生达到一个由医生确定的静止点。在治疗前后用心率、血压和汉密尔顿焦虑量表(HAM-A)对学生进行评估。两组人口统计学差异无统计学意义。假手术和CV4治疗在心率方面有显著差异(p=0.036)，但在收缩压和舒张压方面没有显著差异(p=0.446和p=0.799)。CV4组平均心率降低3.11次，假手术组平均心率降低1.12次，p=0.036 (Mann Whitney U = 1271)。在CV4和假治疗后，一些学生的心率增加了。CV4治疗前后学生的HAM-A平均得分分别为21.9分和18.3分，与对照组的2.77分相比，平均净减少3.58分，但结果没有统计学意义(p=0.09, U=1172)。与假治疗相比，CV4治疗后发现心率的平均降低具有统计学意义，但血压或HAM-A评分没有下降。需要更多的研究和更大的样本来进一步调查CV4的影响。
{"title":"Effects of Compression of the 4th Ventricle (CV4) Treatment on Medical Student Anxiety","authors":"Edward Goering, Maranda Herner, Meagan Smith, Mary Galka, Samuel Kammerzell, Kaitlin Best, Pamela Anderson, M. Steinauer","doi":"10.53702/2375-5717-31.4.55","DOIUrl":"https://doi.org/10.53702/2375-5717-31.4.55","url":null,"abstract":"\u0000 \u0000 \u0000 This study explores the effects of one Compression of the 4th Ventricle (CV4) treatment performed by experienced osteopathic physicians on reactive anxiety in healthy medical students. Anxiety was assessed with heart rate, blood pressure, and the Hamilton Anxiety Scale (HAM-A).\u0000 \u0000 \u0000 \u0000 Western University of Health Sciences IRB #15/IRB/113 was obtained for this single blind study. Volunteer first and second year medical students naïve to Osteopathic Cranial Manipulative Medicine, both in curriculum and as a patient, were recruited for this two-day study. Students were de-identified and demographic information was collected. On the first day, all 64 students received a sham treatment. Eight practitioners agreed on CV4 and sham techniques (mastoid cranial hold). In the CV4 technique, the operator’s thenar eminences contact the lateral angles of the occiput, and the operator encouraged the extension phase and discouraged the flexion phase of the CRI. Compression continued until a still point was reached in each student as identified by the practitioner. Students were evaluated before and after treatment using heart rate, blood pressure, and the Hamilton Anxiety Rating Scale (HAM-A).\u0000 \u0000 \u0000 \u0000 No significant difference was found in demographics of the two groups. A significant difference between sham and CV4 treatments was found for heart rate (p=0.036), but not for systolic or diastolic blood pressure (p=0.446 and p=0.799, respectively). Average heart rate reduction of CV4 group was 3.11 and of sham group was 1.12, with p=0.036 (Mann Whitney U = 1271). Heart rate increased in a few students after both CV4 and sham treatments. Average HAM-A score for students before and after CV4 treatment were 21.9 and 18.3, with an average net reduction of 3.58 compared to the sham’s 2.77, but results were not found to be statistically significant (p=0.09, U=1172).\u0000 \u0000 \u0000 \u0000 A statistically significant average reduction in heart rate, but not in blood pressure or HAM-A scores, was found after CV4 treatment compared to sham treatment. More studies with larger samples are needed to further investigate the effects of CV4.\u0000","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115224042","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 : 2021-12-01DOI: 10.53702/2375-5717-31.4.34
Precious L Barnes, Hillary Haas, Bryan Beck
Controlling a headache (HA) secondary to a subarachnoid hemorrhage (SAH) can be challenging for most physicians. At Maine Medical Center in Portland, Maine, the neurointensivist and staff noticed a trend in decreasing HA pain caused by a SAH in patients treated with osteopathic cranial manipulative medicine and osteopathic manipulative medicine (OMM), more so than those treated solely with the traditional opioid approach. It was requested that a chart review of these patients be evaluated for an objective analysis of this observation. A decrease in HA caused by SAH will be observed in the group treated with OMM in comparison to those treated with opioids alone. A retrospective, IRB approved, and exempted study reviewed 21 subjects with a SAH that were treated with OMM. This population was analyzed for a decrease in pain score following osteopathic treatment as well as for adverse events 6-month post treatment. Pain scores were consistently reduced when comparing pre-and-post OMM treatment. After the first treatment, pain scores decreased by an average of 4 points, after the second treatment scores decreased by an average of 3 points and after the third treatment pain scores decreased by an average of 2.5 points. The number of adverse events recorded were found to be less than the national averages. The use of OMM as an adjunct with traditional treatments for a SAH can lead to a decrease in HA pain caused by a SAH. Minimal adverse events were observed.
{"title":"Decreasing Headache Pain Secondary to a Subarachnoid Hemorrhage with the use of Osteopathic Manipulative Medicine","authors":"Precious L Barnes, Hillary Haas, Bryan Beck","doi":"10.53702/2375-5717-31.4.34","DOIUrl":"https://doi.org/10.53702/2375-5717-31.4.34","url":null,"abstract":"\u0000 \u0000 \u0000 Controlling a headache (HA) secondary to a subarachnoid hemorrhage (SAH) can be challenging for most physicians. At Maine Medical Center in Portland, Maine, the neurointensivist and staff noticed a trend in decreasing HA pain caused by a SAH in patients treated with osteopathic cranial manipulative medicine and osteopathic manipulative medicine (OMM), more so than those treated solely with the traditional opioid approach. It was requested that a chart review of these patients be evaluated for an objective analysis of this observation.\u0000 \u0000 \u0000 \u0000 A decrease in HA caused by SAH will be observed in the group treated with OMM in comparison to those treated with opioids alone.\u0000 \u0000 \u0000 \u0000 A retrospective, IRB approved, and exempted study reviewed 21 subjects with a SAH that were treated with OMM. This population was analyzed for a decrease in pain score following osteopathic treatment as well as for adverse events 6-month post treatment.\u0000 \u0000 \u0000 \u0000 Pain scores were consistently reduced when comparing pre-and-post OMM treatment. After the first treatment, pain scores decreased by an average of 4 points, after the second treatment scores decreased by an average of 3 points and after the third treatment pain scores decreased by an average of 2.5 points. The number of adverse events recorded were found to be less than the national averages.\u0000 \u0000 \u0000 \u0000 The use of OMM as an adjunct with traditional treatments for a SAH can lead to a decrease in HA pain caused by a SAH. Minimal adverse events were observed.\u0000","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122158721","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 : 2021-12-01DOI: 10.53702/2375-5717-31.4.10
J. Blumer
{"title":"View from the Pyramids: The Upside of Stress?","authors":"J. Blumer","doi":"10.53702/2375-5717-31.4.10","DOIUrl":"https://doi.org/10.53702/2375-5717-31.4.10","url":null,"abstract":"","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121679453","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 : 2021-12-01DOI: 10.53702/2375-5717-31.4.39
Pascal J. Grolaux, T. Sparrow, F. Lalonde
Historically, Andrew Taylor Still, MD, DO, differentiated osteopathic medicine from allopathic medicine with its unique approach to treatment using manual therapy. Those treatments, known as osteopathic manipulative treatment (OMT), are currently used to treat somatic dysfunction. The Educational Council on Osteopathic Principles (ECOP) includes different treatment methods, such as muscle energy, high-velocity, low-amplitude, Still techniques, myofascial release, and counterstrain, amongst others, under the category of OMT. Conversely, osteopathic practitioners outside the USA, mostly from Europe, use some techniques that are not necessarily documented as OMT by the ECOP. This is the case of the General Osteopathic Treatment (GOT). The GOT found its origin with Dr. Still and was promoted, amongst his contemporaries, by Dr. John Martin Littlejohn, DO, who founded the British School of Osteopathy in London. The general treatment, based on a strong biomechanical background, was further spread in Europe by John Wernham, DO, a British osteopath and one of Littlejohn’s students. Wernham developed and taught the GOT in its original form based on the principles and philosophy of osteopathic medicine. The goals of this article are to give an historical perspective of the GOT, to describe the foundation and concepts behind it, and to provide a review of the scientific literature of this treatment approach. The GOT can be used to diagnose and directly treat somatic dysfunction using the TART principle in a clinical setting. Besides the recognized contra-indications of treating somatic dysfunction, there are no clear scientifically published findings of contraindications for the use of the GOT. Like other OMTs, the GOT needs more scientific evidence to better understand its clinical applications.
从历史上看，Andrew Taylor Still, MD, DO，将整骨疗法与对抗疗法区分开来，其独特的方法是使用手工疗法。这些疗法被称为整骨疗法(OMT)，目前用于治疗躯体功能障碍。骨科原理教育委员会(ECOP)包括不同的治疗方法，如肌肉能量、高速、低振幅、静止技术、肌筋膜释放和反张力等，在OMT的类别下。相反，美国以外的骨科医生，主要来自欧洲，使用一些不一定被ECOP记录为OMT的技术。这就是一般整骨疗法(GOT)的情况。《权游》的起源是斯蒂尔博士，并由约翰·马丁·利特尔约翰博士(John Martin Littlejohn, DO)在伦敦创立了英国整骨疗法学校，在他的同时代人中得到了提升。基于强大的生物力学背景的一般治疗方法，由英国整骨医生、利特尔约翰的学生约翰·韦纳姆(John Wernham)在欧洲进一步传播开来。韦纳姆根据整骨疗法的原理和哲学发展并教授了GOT的原始形式。本文的目标是给出GOT的历史视角，描述其背后的基础和概念，并对这种治疗方法的科学文献进行回顾。GOT可用于诊断和直接治疗躯体功能障碍，在临床设置中使用TART原理。除了公认的治疗躯体功能障碍的禁忌症外，没有明确的科学发表的关于使用GOT的禁忌症的发现。像其他omt一样，GOT需要更多的科学证据来更好地理解其临床应用。
{"title":"Traditional Osteopathy and the General Osteopathic Treatment: A Historical Concept and a Modern Application","authors":"Pascal J. Grolaux, T. Sparrow, F. Lalonde","doi":"10.53702/2375-5717-31.4.39","DOIUrl":"https://doi.org/10.53702/2375-5717-31.4.39","url":null,"abstract":"\u0000 Historically, Andrew Taylor Still, MD, DO, differentiated osteopathic medicine from allopathic medicine with its unique approach to treatment using manual therapy. Those treatments, known as osteopathic manipulative treatment (OMT), are currently used to treat somatic dysfunction. The Educational Council on Osteopathic Principles (ECOP) includes different treatment methods, such as muscle energy, high-velocity, low-amplitude, Still techniques, myofascial release, and counterstrain, amongst others, under the category of OMT. Conversely, osteopathic practitioners outside the USA, mostly from Europe, use some techniques that are not necessarily documented as OMT by the ECOP. This is the case of the General Osteopathic Treatment (GOT). The GOT found its origin with Dr. Still and was promoted, amongst his contemporaries, by Dr. John Martin Littlejohn, DO, who founded the British School of Osteopathy in London. The general treatment, based on a strong biomechanical background, was further spread in Europe by John Wernham, DO, a British osteopath and one of Littlejohn’s students. Wernham developed and taught the GOT in its original form based on the principles and philosophy of osteopathic medicine. The goals of this article are to give an historical perspective of the GOT, to describe the foundation and concepts behind it, and to provide a review of the scientific literature of this treatment approach. The GOT can be used to diagnose and directly treat somatic dysfunction using the TART principle in a clinical setting. Besides the recognized contra-indications of treating somatic dysfunction, there are no clear scientifically published findings of contraindications for the use of the GOT. Like other OMTs, the GOT needs more scientific evidence to better understand its clinical applications.","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134437765","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 : 2021-12-01DOI: 10.53702/2375-5717-31.4.47
Navneet Deol, Victor Nuño, Molly K. Schuman, Cristian Contreras
Complex Regional Pain Syndrome (CRPS) is a chronic neuropathic pain condition in a region of the body where the pain experienced by the patient is disproportionate to the stimuli preceding the pain. In this case, a 52-year-old post-menopausal woman presents with chronic distal limb pain due to a left ankle contusion from a work injury. Previous treatments that focused on specific symptoms failed. However, the patient was then evaluated and treated comprehensively by an osteopathic physician. Treatment was tailored to individual patient needs based on the five models of osteopathic care. Within a 1.5 years period of integrative osteopathic treatment that utilized osteopathic manipulative treatment (OMT) in addition to medications and supplements, the patient was able to start walking again with only mild discomfort. This individualized approach seemed to improve her quality of life, and overall satisfaction with her health, psyche, and well-being. The patient is now discharged from the practice, has resumed normal daily activities, and is working full-time as a cashier.
{"title":"An Osteopathic Approach to Complex Regional Pain Syndrome (CRPS)","authors":"Navneet Deol, Victor Nuño, Molly K. Schuman, Cristian Contreras","doi":"10.53702/2375-5717-31.4.47","DOIUrl":"https://doi.org/10.53702/2375-5717-31.4.47","url":null,"abstract":"\u0000 Complex Regional Pain Syndrome (CRPS) is a chronic neuropathic pain condition in a region of the body where the pain experienced by the patient is disproportionate to the stimuli preceding the pain. In this case, a 52-year-old post-menopausal woman presents with chronic distal limb pain due to a left ankle contusion from a work injury. Previous treatments that focused on specific symptoms failed. However, the patient was then evaluated and treated comprehensively by an osteopathic physician.\u0000 Treatment was tailored to individual patient needs based on the five models of osteopathic care. Within a 1.5 years period of integrative osteopathic treatment that utilized osteopathic manipulative treatment (OMT) in addition to medications and supplements, the patient was able to start walking again with only mild discomfort. This individualized approach seemed to improve her quality of life, and overall satisfaction with her health, psyche, and well-being. The patient is now discharged from the practice, has resumed normal daily activities, and is working full-time as a cashier.","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126484749","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 : 2021-09-01DOI: 10.53702/2375-5717-31.3.17
Kyrstin T. Ball, D. Kraft, Karen T. Snider
Cystic fibrosis (CF) is a genetic disease that affects multiple organ systems, and symptoms include chronic cough, gastrointestinal (GI) malabsorption, exercise intolerance, and chronic pain. Examples of standard treatments are nebulizers, supplementary enzymes, chest percussive therapy, respiratory therapy, and lifestyle modifications. The purpose of the current review was to determine whether manual therapies, such as osteopathic manipulative treatment (OMT), in conjunction with standard treatments, provide symptom relief for patients with CF. PubMed was searched to identify studies investigating the role of manual medicine in the care of CF patients. Search terms included chiropractic, physical therapy, physiotherapy, osteopathic, manipulation, massage, and manual medicine. All terms were searched in combination with cystic fibrosis. Studies investigating only exercise or chest percussive therapy as adjunctive treatments were excluded. Eight studies were found that investigated manual therapies alone or in conjunction with exercise for treatment of CF symptoms. All studies reported improvement after manual therapy in 1 or more symptoms, such as posture, GI symptoms, peak airflow, anxiety, back or chest pain, or breathing. Study types included a case study, prospective observational studies, and randomized controlled trials. Most studies were small and statistically underpowered. In an inpatient/outpatient observational study of adults with CF, patients reported a significant reduction in pain after a single physiotherapy treatment, and inpatients also reported significantly improved breathing after treatment. In a randomized controlled trial involving adult CF outpatients, there was a significant improvement in chest and back pain scores between the OMT and control groups. Results of the current review suggested patients with CF can experience symptom relief after OMT and similar manual therapies. Patients subjectively reported improvement with manual therapies, and studies found statistically significant decreases in pain after a single treatment. However, larger studies with sufficient statistical power are needed to further define the role of manual therapies as adjunctive treatment for symptom relief in CF patients.
{"title":"Effects of Osteopathic Manipulation and Other Manual Manipulative Treatments on Cystic Fibrosis","authors":"Kyrstin T. Ball, D. Kraft, Karen T. Snider","doi":"10.53702/2375-5717-31.3.17","DOIUrl":"https://doi.org/10.53702/2375-5717-31.3.17","url":null,"abstract":"\u0000 \u0000 \u0000 Cystic fibrosis (CF) is a genetic disease that affects multiple organ systems, and symptoms include chronic cough, gastrointestinal (GI) malabsorption, exercise intolerance, and chronic pain. Examples of standard treatments are nebulizers, supplementary enzymes, chest percussive therapy, respiratory therapy, and lifestyle modifications.\u0000 \u0000 \u0000 \u0000 The purpose of the current review was to determine whether manual therapies, such as osteopathic manipulative treatment (OMT), in conjunction with standard treatments, provide symptom relief for patients with CF.\u0000 \u0000 \u0000 \u0000 PubMed was searched to identify studies investigating the role of manual medicine in the care of CF patients. Search terms included chiropractic, physical therapy, physiotherapy, osteopathic, manipulation, massage, and manual medicine. All terms were searched in combination with cystic fibrosis. Studies investigating only exercise or chest percussive therapy as adjunctive treatments were excluded.\u0000 \u0000 \u0000 \u0000 Eight studies were found that investigated manual therapies alone or in conjunction with exercise for treatment of CF symptoms. All studies reported improvement after manual therapy in 1 or more symptoms, such as posture, GI symptoms, peak airflow, anxiety, back or chest pain, or breathing. Study types included a case study, prospective observational studies, and randomized controlled trials. Most studies were small and statistically underpowered. In an inpatient/outpatient observational study of adults with CF, patients reported a significant reduction in pain after a single physiotherapy treatment, and inpatients also reported significantly improved breathing after treatment. In a randomized controlled trial involving adult CF outpatients, there was a significant improvement in chest and back pain scores between the OMT and control groups.\u0000 \u0000 \u0000 \u0000 Results of the current review suggested patients with CF can experience symptom relief after OMT and similar manual therapies. Patients subjectively reported improvement with manual therapies, and studies found statistically significant decreases in pain after a single treatment. However, larger studies with sufficient statistical power are needed to further define the role of manual therapies as adjunctive treatment for symptom relief in CF patients.\u0000","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127083657","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 : 2021-09-01DOI: 10.53702/2375-5717-31.3.23
Thomas Kincheloe, Christina Cherry, Francis Yoo
Functional immobility has demonstrated a higher risk of all-cause mortality in geriatric population. It is noted that musculoskeletal pain is one major factor involved with geriatric functional immobility. The fascial distortion model (FDM) utilizes pathognomonic physical gestures to diagnose and treat musculoskeletal pain. In this case study, a long-term nursing facility patient with significantly prolonged wheelchair-to-bed transfer presented with several upper and lower extremity fascial distortions. After FDM treatment, the patient demonstrated a moderate return of functional mobility. This case presents the utility of FDM treatment in cases of decreased functional mobility due to musculoskeletal pain as well as treatment for patients in skilled nursing facility settings.
{"title":"Recovery of Functional Mobility with a Long-Term Nursing Facility Patient Utilizing the Fascial Distortion Model: A Case Study","authors":"Thomas Kincheloe, Christina Cherry, Francis Yoo","doi":"10.53702/2375-5717-31.3.23","DOIUrl":"https://doi.org/10.53702/2375-5717-31.3.23","url":null,"abstract":"\u0000 Functional immobility has demonstrated a higher risk of all-cause mortality in geriatric population. It is noted that musculoskeletal pain is one major factor involved with geriatric functional immobility. The fascial distortion model (FDM) utilizes pathognomonic physical gestures to diagnose and treat musculoskeletal pain. In this case study, a long-term nursing facility patient with significantly prolonged wheelchair-to-bed transfer presented with several upper and lower extremity fascial distortions. After FDM treatment, the patient demonstrated a moderate return of functional mobility. This case presents the utility of FDM treatment in cases of decreased functional mobility due to musculoskeletal pain as well as treatment for patients in skilled nursing facility settings.","PeriodicalId":341091,"journal":{"name":"The AAO Journal","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122945144","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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