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A call for improving the internal validity and the reporting of manual therapy trials self-labelled as pragmatic: A methodological review
IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-02-08 DOI: 10.1016/j.ijosm.2025.100754
S. Roura , G. Alvarez , D. Hohenschurz-Schmidt , I. Solà , R. Núñez-Cortés , J. Bracchiglione , C. Fernández-Jané , J. Phalip , I. Gich , M. Sitjà-Rabert , G. Urrútia

Objectives

This study provides further data from a review assessing methodological characteristics of pragmatic randomised controlled trials (pRCTs) published in manual therapy (MT). In this second part, we aim to assess the report, the risk of bias (RoB), and the relationship between these items and the pragmatism scores of the self-labelled pRCTs in the MT field.

Study design and setting

We searched MEDLINE and the Cochrane Central Register of Controlled Trials for pRCTs in the MT field from inception to January 2024. Two independent reviewers screened the trials using several CONSORT extensions and assessed them using the Cochrane Risk of Bias tool. We performed a descriptive analysis using frequencies and percentages and a relation analysis between the trials' pragmatism, their reporting, and their RoB.

Results

We included 39 self-labelled MT pRCTs. Compliance with CONSORT items was higher than 70 % in one-third of the included trials (13/39) but varied across items. Performance and detection bias were the main threats to internal validity (we rated 90 %, 35/39, and 77 %; 30/39 of trials at high risk of bias, respectively). Selective reporting bias was unclear in almost half of the sample (46 %; 18/39). No relation was found between the highly pragmatic attitude and good reporting except for CONSORT item 25 (Sources of funding and other support) (p = 0.006). No relation was found between the RoB and the pragmatic attitude of the studies. The percentage of compliance with CONSORT items was higher in the trials with low RoB.

Conclusion

Pragmatic trials in MT have significant methodological limitations, and their reporting is suboptimal. Nonetheless, trials with less risk of bias had higher compliance with CONSORT items.
{"title":"A call for improving the internal validity and the reporting of manual therapy trials self-labelled as pragmatic: A methodological review","authors":"S. Roura ,&nbsp;G. Alvarez ,&nbsp;D. Hohenschurz-Schmidt ,&nbsp;I. Solà ,&nbsp;R. Núñez-Cortés ,&nbsp;J. Bracchiglione ,&nbsp;C. Fernández-Jané ,&nbsp;J. Phalip ,&nbsp;I. Gich ,&nbsp;M. Sitjà-Rabert ,&nbsp;G. Urrútia","doi":"10.1016/j.ijosm.2025.100754","DOIUrl":"10.1016/j.ijosm.2025.100754","url":null,"abstract":"<div><h3>Objectives</h3><div>This study provides further data from a review assessing methodological characteristics of pragmatic randomised controlled trials (pRCTs) published in manual therapy (MT). In this second part, we aim to assess the report, the risk of bias (RoB), and the relationship between these items and the pragmatism scores of the self-labelled pRCTs in the MT field.</div></div><div><h3>Study design and setting</h3><div>We searched MEDLINE and the Cochrane Central Register of Controlled Trials for pRCTs in the MT field from inception to January 2024. Two independent reviewers screened the trials using several CONSORT extensions and assessed them using the Cochrane Risk of Bias tool. We performed a descriptive analysis using frequencies and percentages and a relation analysis between the trials' pragmatism, their reporting, and their RoB.</div></div><div><h3>Results</h3><div>We included 39 self-labelled MT pRCTs. Compliance with CONSORT items was higher than 70 % in one-third of the included trials (13/39) but varied across items. Performance and detection bias were the main threats to internal validity (we rated 90 %, 35/39, and 77 %; 30/39 of trials at high risk of bias, respectively). Selective reporting bias was unclear in almost half of the sample (46 %; 18/39). No relation was found between the highly pragmatic attitude and good reporting except for CONSORT item 25 (Sources of funding and other support) (p = 0.006). No relation was found between the RoB and the pragmatic attitude of the studies. The percentage of compliance with CONSORT items was higher in the trials with low RoB.</div></div><div><h3>Conclusion</h3><div>Pragmatic trials in MT have significant methodological limitations, and their reporting is suboptimal. Nonetheless, trials with less risk of bias had higher compliance with CONSORT items.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"55 ","pages":"Article 100754"},"PeriodicalIF":1.1,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advancing Equitable Osteopathic Practice: Integrating Person-Centredness & Addressing Racial Biases Through the Lens of Critical Theory
IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-28 DOI: 10.1016/j.ijosm.2025.100752
Hakim Mhadhbi , Andrew MacMillan , Jerry Draper-Rodi , Mathieu Ménard , Niklas Sinderholm Sposato
As osteopaths, many of us ideally endeavour to minimise biased interpretations when evaluating the pain and distress expressed by individuals seeking treatment. However, as a product of the society we live in, we acknowledge that various unconscious biases, including racial bias, may unintentionally and spontaneously influence our view of a patient's condition and perception of pain. This paper explores the intersection of Person-Centred Care (PCC) and racial biases through critical theory in the context of osteopathic practice. It emphasises the ethical duty of healthcare professionals to deliver PCC that recognizes individual experiences, values, needs, and abilities. Racial biases within healthcare settings are identified as contributors to disparities in access, quality, and outcomes. They can also lead to bias in the clinical decision-making process requiring attention in osteopathic clinical practice.
The critical theory framework allows for the identification of opportunities and barriers to implementing PCC and equity in osteopathic practice, highlighting factors such as the impact of implicit bias and structural barriers.
As a result, osteopaths are recommended to take a proactive approach through self-awareness, challenging personal beliefs and actively engaging in cultural humility to minimise racial biases. Osteopathic education could contribute to the cultivation of cultural humility and awareness in training programmes, fostering a passion for fair healthcare among future osteopathic professionals. Ultimately, the integration of critical theory and PCC through cultural humility is presented as an approach to promoting equitable healthcare that empowers individuals.
{"title":"Advancing Equitable Osteopathic Practice: Integrating Person-Centredness & Addressing Racial Biases Through the Lens of Critical Theory","authors":"Hakim Mhadhbi ,&nbsp;Andrew MacMillan ,&nbsp;Jerry Draper-Rodi ,&nbsp;Mathieu Ménard ,&nbsp;Niklas Sinderholm Sposato","doi":"10.1016/j.ijosm.2025.100752","DOIUrl":"10.1016/j.ijosm.2025.100752","url":null,"abstract":"<div><div>As osteopaths, many of us ideally endeavour to minimise biased interpretations when evaluating the pain and distress expressed by individuals seeking treatment. However, as a product of the society we live in, we acknowledge that various unconscious biases, including racial bias, may unintentionally and spontaneously influence our view of a patient's condition and perception of pain. This paper explores the intersection of Person-Centred Care (PCC) and racial biases through critical theory in the context of osteopathic practice. It emphasises the ethical duty of healthcare professionals to deliver PCC that recognizes individual experiences, values, needs, and abilities. Racial biases within healthcare settings are identified as contributors to disparities in access, quality, and outcomes. They can also lead to bias in the clinical decision-making process requiring attention in osteopathic clinical practice.</div><div>The critical theory framework allows for the identification of opportunities and barriers to implementing PCC and equity in osteopathic practice, highlighting factors such as the impact of implicit bias and structural barriers.</div><div>As a result, osteopaths are recommended to take a proactive approach through self-awareness, challenging personal beliefs and actively engaging in cultural humility to minimise racial biases. Osteopathic education could contribute to the cultivation of cultural humility and awareness in training programmes, fostering a passion for fair healthcare among future osteopathic professionals. Ultimately, the integration of critical theory and PCC through cultural humility is presented as an approach to promoting equitable healthcare that empowers individuals.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"55 ","pages":"Article 100752"},"PeriodicalIF":1.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of pain education delivered through telerehabilitation on pain and disability in patients with chronic musculoskeletal pain: A systematic review protocol
IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-08 DOI: 10.1016/j.ijosm.2025.100751
Gabriel Velho, Francisco Xavier de Araujo, Carlos Vicente da Silva, Jodelle Chagas Machado, Fabiana Cristina da Silva, Morten Sebastian Hoegh, Marcelo Faria Silva

Background

Chronic musculoskeletal (MSK) pain is an urgent global public health concern. Pain education (PE) is an intervention used in the management of MSK pain. Traditionally delivered in-person, PE can be challenging for those in remote areas. Telerehabilitation has emerged as a viable alternative for providing pain management support. Despite the individual benefits of PE and telerehabilitation, no systematic review has evaluated the impact of these interventions combined on chronic MSK pain.

Objective

To systematically review the literature on the effects of pain education delivered through telerehabilitation on pain and disability in patients with chronic musculoskeletal pain.

Methods

This systematic review protocol will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement and is registered with the Prospective Register of Systematic Reviews (PROSPERO). We will systematically search the MEDLINE, PEDro, Cochrane Central Register of Controlled Trials, Scopus, Web of Science and EMBASE databases from their inception to present time. We will include only randomized controlled trials involving adults with chronic MSK pain, that received PE delivered through telerehabilitation. The primary outcomes will be pain and/or disability, while secondary outcomes will assess the impact of pain on daily living, workability and mental health. Two authors independently will select studies, rate risk of bias, extract data, and judge the overall certainty of evidence using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). A structured narrative synthesis will be used for data analysis. When possible, quantitative findings will be pooled and meta-analyses will be performed.

Discussion

This review will comprehensively examine existing literature to identify research gaps and provide evidence to help clinicians make informed, evidence-based decisions for managing chronic musculoskeletal pain.

Review registration

CRD42024534188.
{"title":"Effects of pain education delivered through telerehabilitation on pain and disability in patients with chronic musculoskeletal pain: A systematic review protocol","authors":"Gabriel Velho,&nbsp;Francisco Xavier de Araujo,&nbsp;Carlos Vicente da Silva,&nbsp;Jodelle Chagas Machado,&nbsp;Fabiana Cristina da Silva,&nbsp;Morten Sebastian Hoegh,&nbsp;Marcelo Faria Silva","doi":"10.1016/j.ijosm.2025.100751","DOIUrl":"10.1016/j.ijosm.2025.100751","url":null,"abstract":"<div><h3>Background</h3><div>Chronic musculoskeletal (MSK) pain is an urgent global public health concern. Pain education (PE) is an intervention used in the management of MSK pain. Traditionally delivered in-person, PE can be challenging for those in remote areas. Telerehabilitation has emerged as a viable alternative for providing pain management support. Despite the individual benefits of PE and telerehabilitation, no systematic review has evaluated the impact of these interventions combined on chronic MSK pain.</div></div><div><h3>Objective</h3><div>To systematically review the literature on the effects of pain education delivered through telerehabilitation on pain and disability in patients with chronic musculoskeletal pain.</div></div><div><h3>Methods</h3><div>This systematic review protocol will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement and is registered with the Prospective Register of Systematic Reviews (PROSPERO). We will systematically search the MEDLINE, PEDro, Cochrane Central Register of Controlled Trials, Scopus, Web of Science and EMBASE databases from their inception to present time. We will include only randomized controlled trials involving adults with chronic MSK pain, that received PE delivered through telerehabilitation. The primary outcomes will be pain and/or disability, while secondary outcomes will assess the impact of pain on daily living, workability and mental health. Two authors independently will select studies, rate risk of bias, extract data, and judge the overall certainty of evidence using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). A structured narrative synthesis will be used for data analysis. When possible, quantitative findings will be pooled and meta-analyses will be performed.</div></div><div><h3>Discussion</h3><div>This review will comprehensively examine existing literature to identify research gaps and provide evidence to help clinicians make informed, evidence-based decisions for managing chronic musculoskeletal pain.</div></div><div><h3>Review registration</h3><div>CRD42024534188.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"55 ","pages":"Article 100751"},"PeriodicalIF":1.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does manual therapy improve pain, disability, and glenohumeral motion in overhead athletes? Systematic review and meta-analysis
IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-07 DOI: 10.1016/j.ijosm.2025.100747
Sávio Douglas Ferreira Santana , Vander Gava , Valéria Mayaly Alves de Oliveira , Gabriel Alves dos Santos , Tássio Augusto Soares Lima , Danilo Harudy Kamonseki

Objectives

To systematically review the effects of manual therapy (MT) on pain intensity, disability, internal rotation (IR), external rotation (ER), and horizontal adduction (HA) range of motion (ROM) in overhead athletes.

Data sources

Databases (Medline, EMBASE, SPORTDiscus, CINAHL, CENTRAL, Web of Science, and SCOPUS) were searched from inception up to May 2023.

Study selection

Randomized controlled trials (RCTs) comparing MT to a non-treatment group or other treatment groups were selected.

Data extraction

Two reviewers independently selected RCTs that investigated the effects of MT on pain intensity, disability, IR, ER, and HA ROM.

Data synthesis

Mean difference or Standardized Mean Differences, along with 95 % confidence intervals, were calculated for the meta-analysis of each outcome of interest. The level of evidence was synthesized using GRADE.

Results

Twelve RCTs were included, with a pooled sample of 401 athletes. MT was not superior (p > 0.05) to no treatment in improving pain, disability, IR ROM, and ER ROM, but it was superior to no treatments in improving HA. MT was not superior (p > 0.05) to other treatments in improving ER ROM and HA ROM, but it was superior other treatments in improving IR ROM and disability. Those findings were based on very low certainty of evidence.

Conclusion

MT may not effectively improve pain and ER ROM. The very low quality of evidence, conflicting findings regarding the effects of MT on disability and IR, and the small, likely clinically irrelevant effects on HA, do not provide sufficient support for a definitive recommendation regarding the effectiveness of MT for treating overhead athletes.

Implications for practice

  • -
    Manual therapy may not effectively improve pain intensity and glenohumeral external rotation range of motion.
  • -
    Manual therapy showed conflicting effects on disability and glenohumeral internal rotation range of motion.
  • -
    Manual therapy showed small and clinically irrelevant effects on horizontal adduction range of motion.
  • -
    No significant difference was observed among different manual therapy techniques.
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引用次数: 0
Categorizing treatment mechanisms for Complementary and Integrative Musculoskeletal Interventions
IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-07 DOI: 10.1016/j.ijosm.2025.100749
Chad E. Cook , Victoria E. Abraira , John Burns , Brian F. Degenhardt , Greg Kawchuk , Damian Keter , M. Terry Loghmani , William R. Reed , Beth A. Winkelstein , Amy McDevitt
Treatment mechanisms (TM) reflect the steps or processes through which a treatment unfolds. However, TM research faces challenges due to inconsistent terminology and varying measurement approaches for each mechanism, which creates confusion and controversy among clinicians and scientists. In this paper, we: 1) define key terms associated with TM, 2) provide recommended categories of study that reflect intervention domains, and 3) present examples of measures of TM within the defined categories. Our recommended definitions differentiate associated TM (a finding that occurs following administration of a treatment that may or may not influence outcomes) from causal TM (which directly affects the clinical outcome). When measuring causal TM, we recommend that researchers consider three potential categories of interventional domains: a) anatomical, b) psychological/cognitive and c) behavioral. Lastly, we argue that within each interventional domain, TM can be measured across a spectrum that includes physiological (e.g., brain activity, nerve activity, biomarkers, etc.) and functional (e.g., range of motion, stiffness, cognition measures, etc.) mechanisms. Measuring both physiological and functional mechanisms improves the likelihood of understanding the complexity of clinical recovery. Harmonizing TM terminology, categories, and measurements across a spectrum, while providing examples of each, may reduce confusion and assist researchers and funding sources in targeting specific mechanistic-related questions.
{"title":"Categorizing treatment mechanisms for Complementary and Integrative Musculoskeletal Interventions","authors":"Chad E. Cook ,&nbsp;Victoria E. Abraira ,&nbsp;John Burns ,&nbsp;Brian F. Degenhardt ,&nbsp;Greg Kawchuk ,&nbsp;Damian Keter ,&nbsp;M. Terry Loghmani ,&nbsp;William R. Reed ,&nbsp;Beth A. Winkelstein ,&nbsp;Amy McDevitt","doi":"10.1016/j.ijosm.2025.100749","DOIUrl":"10.1016/j.ijosm.2025.100749","url":null,"abstract":"<div><div>Treatment mechanisms (TM) reflect the steps or processes through which a treatment unfolds. However, TM research faces challenges due to inconsistent terminology and varying measurement approaches for each mechanism, which creates confusion and controversy among clinicians and scientists. In this paper, we: 1) define key terms associated with TM, 2) provide recommended categories of study that reflect intervention domains, and 3) present examples of measures of TM within the defined categories. Our recommended definitions differentiate associated TM (a finding that occurs following administration of a treatment that may or may not influence outcomes) from causal TM (which directly affects the clinical outcome). When measuring causal TM, we recommend that researchers consider three potential categories of interventional domains: a) anatomical, b) psychological/cognitive and c) behavioral. Lastly, we argue that within each interventional domain, TM can be measured across a spectrum that includes physiological (e.g., brain activity, nerve activity, biomarkers, etc.) and functional (e.g., range of motion, stiffness, cognition measures, etc.) mechanisms. Measuring both physiological and functional mechanisms improves the likelihood of understanding the complexity of clinical recovery. Harmonizing TM terminology, categories, and measurements across a spectrum, while providing examples of each, may reduce confusion and assist researchers and funding sources in targeting specific mechanistic-related questions.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"55 ","pages":"Article 100749"},"PeriodicalIF":1.1,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of preoperative exercise rehabilitation for patients after total knee arthroplasty: An updated systematic review and meta-analysis
IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-06 DOI: 10.1016/j.ijosm.2025.100748
Yang Zhou, Shengying Wang

Background

Total knee replacement is a common surgical intervention in orthopedic practice. However, the well-known postoperative complications limit the mobility and activity of patients. The efficacy of preoperative exercise rehabilitation might be an alternative solution for this issue.

Methods

Preoperative exercise rehabilitation vs. routine care control comparison for postoperative range of motion, postoperative knee joint scores, and quality of life scores were set for the updated systematic review and meta-analysis, which can help us determine the differences in postoperative range of motion, postoperative knee joint scores, and quality of life scores between the 2 groups. Randomized controlled trials (RCT) were only eligible type of studies to be included. Finally, 16 RCTs (688 patients with the preoperative exercise rehabilitation, and 678 patients with routine control care) were included, with the focused outcome on postoperative range of motion, postoperative knee joint scores, and quality of life scores after total knee arthroplasty.

Results

The meta-analytic results showed that preoperative exercise rehabilitation might be associated with a better status of postoperative range of motion in the knee joints. In addition, the postoperative knee joint scores were lower and the postoperative quality of life was better in the preoperative exercise rehabilitation group when compared to routine care group.

Conclusions

Preoperative exercise rehabilitation might be beneficial for patients with total knee arthroplasty when compared to routine care from the perspective of postoperative knee joint range of motion, knee joint scores, and quality of life. Practitioners can apply preoperative exercise rehabilitation to improve the postoperative outcome.
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引用次数: 0
Context is complex: Challenges and opportunities addressing contextual factors in manual therapy mechanisms research
IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-03 DOI: 10.1016/j.ijosm.2025.100750
Damian L. Keter , Jorge E. Esteves , M. Terry Loghmani , Giacomo Rossettini , Chad E. Cook
Mechanistic studies on manual therapy (MT) have potential to allow better understanding of ‘why’ and ‘how’ MT interventions provide an effect. Contextual factors (CF) include the multitude of intrinsic and extrinsic inputs outside of the specific intervention which influence response. CFs must be accounted for within both clinical and mechanistic trials. The influence of CFs provides several challenges and opportunities which are outlined within this commentary. Researchers should consider the specific purpose of their research when developing mechanistic trials to establish if controlling versus recording CF is warranted based on their aim(s).
{"title":"Context is complex: Challenges and opportunities addressing contextual factors in manual therapy mechanisms research","authors":"Damian L. Keter ,&nbsp;Jorge E. Esteves ,&nbsp;M. Terry Loghmani ,&nbsp;Giacomo Rossettini ,&nbsp;Chad E. Cook","doi":"10.1016/j.ijosm.2025.100750","DOIUrl":"10.1016/j.ijosm.2025.100750","url":null,"abstract":"<div><div>Mechanistic studies on manual therapy (MT) have potential to allow better understanding of ‘why’ and ‘how’ MT interventions provide an effect. Contextual factors (CF) include the multitude of intrinsic and extrinsic inputs outside of the specific intervention which influence response. CFs must be accounted for within both clinical and mechanistic trials. The influence of CFs provides several challenges and opportunities which are outlined within this commentary. Researchers should consider the specific purpose of their research when developing mechanistic trials to establish if controlling versus recording CF is warranted based on their aim(s).</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"55 ","pages":"Article 100750"},"PeriodicalIF":1.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Integration of osteopathy in the Portuguese National Health Service: Perceptions and expectations of citizens and health professionals
IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-25 DOI: 10.1016/j.ijosm.2024.100744
Beatriz Maria , Sílvia Gomes , Ana Rita Goes

Background

Osteopathy's framework varies globally in healthcare systems due to context-specific factors like legal status, healthcare system integration, and implementation levels. With osteopathy expanding in Portugal and recognising the importance of defining its role in the National Health Service, it is essential to understand public perceptions and expectations in the Portuguese context even for more significant equity of access.

Objective

Explore citizen and healthcare professionals' perceptions and expectations regarding integrating osteopathy into the Portuguese National Health Service.

Methods

The study used a qualitative design. Two focus groups were conducted—a citizens' focus group (n = 8) and a health professional's focus group (n = 6). Citizens' focus group was in-person, and the health professional's focus group was online. Analysis of focus group transcripts followed a constructivist paradigm utilising thematic analysis.

Results

Thematic analysis resulted in four principal themes: osteopathy concept; competent osteopath; concerns and expectations, and National Health Service integration. Despite diverse and limited perspectives on its scope, participants generally held positive attitudes towards osteopathy. Nevertheless, barriers to NHS integration were noted, along with suggestions for improving osteopathy's integration into the healthcare system.

Conclusion

This study highlights a positive attitude among participants towards the integration of osteopathy into the National Health Service. However, they acknowledge that the profession faces significant challenges in achieving this integration. Overcoming these obstacles may require a gradual approach, which includes focusing on evidence of effectiveness, wider dissemination, and the establishment of supportive reimbursement systems.

Implication for practice

  • The findings highlight the importance of ensuring credible training, practical experience, and relational skills in osteopathy. These factors are key in influencing how individuals choose osteopaths and can guide practitioners in building trust with patients and positioning their services effectively.
  • Addressing concerns related to diagnostic capacity, technique safety, and quality assurance is crucial for improving the safety and quality of osteopathic care, as well as reducing public concerns.
  • The study provides valuable insights into the potential benefits and challenges of integrating osteopathy into the National Health Service, offering useful guidance for policymakers and healthcare professionals involved in this decision-making process.
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引用次数: 0
Assessing the effects of manual therapy on pain in patients living with persistent non-specific low back pain (PNSLBP): Which evaluation criteria and measurement tools are used in randomised controlled clinical trials? A systematic review
IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-20 DOI: 10.1016/j.ijosm.2024.100741
Agathe Bilhaut , Anne-Hélène Olivier , Jerry Draper Rodi , Armel Cretual , Mathieu Ménard

Objective

To identify the evaluation criteria and measurement tools that are used in Randomised Controlled Trials (RCT) to assess the effects of manual therapy on pain in adults living with PNSLBP.

Methods

RCT were included if: participants were adults (18–65 years old) with PNSLBP, experimental group received manual therapies (osteopathy, physiotherapy and chiropractic) and they had been published in English or French since 2010. The search was conducted between May 2021 and April 2023, using the Cochrane Library, Ebscohost, EMBASE, MEDLINE Pubmed, PEDro, ScienceDirect and Scopus databases. Three independent reviewers have checked eligibility. The PEDro scale have been used for quality appraisal.

Results

In the 29 studies included, 131 measurement tools were identified in three main areas: 76 % of the measurement tools were related to life impact (which 24 % related to pain intensity and 23 % to functional difficulties) and 24 % were related to pathophysiological manifestations (which 8 % related to Range of motion).

Conclusion

Most measurement tools focus on pain intensity and physical functioning using scales and questionnaires. Two perspectives must be considered: responding to current recommendations by standardizing the measurement tools relating to life impact and physiopathological manifestations, and using biomechanical markers making it possible to evaluate patients in daily life situations.
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引用次数: 0
The development of the National Council for Osteopathic Research - Research Network (NCOR-RN): A qualitative focus group study of osteopaths’ views 国家骨科研究委员会-研究网络(NCOR-RN)的发展:对骨科医生观点的定性焦点小组研究
IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-12 DOI: 10.1016/j.ijosm.2024.100742
Daniel Bailey , Carol Fawkes , Dawn Carnes , Jerry Draper-Rodi

Background

Practice Based Research Networks (PBRNs) are groups of clinicians working with academic organisations to conduct research that answers questions relevant to clinical practice. A PBRN for osteopathy in the UK would be a suitable approach for the National Council for Osteopathic Research to achieve its mission statement of ‘developing a culture of research’.

Objective

We aimed to explore osteopaths’ views on the utility of creating a PBRN and to identify barriers and facilitators to their involvement in a PBRN.

Methods

Focus groups were conducted as part of a free CPD day advertised nationally to all osteopaths to collect qualitative data. A reflexive thematic analysis framework was used to develop themes from the data.

Results

Forty osteopaths took part in 5 focus groups conducted at three locations around the UK. Six themes were developed describing the utility, barriers, and facilitators to developing a PRBN for osteopathy: research experience, finance and time, developing osteopathy, insecurity and identity, integration into practice, and PBRN organisation.

Conclusions

Osteopaths perceived a PBRN had the potential for increasing the evidence base for osteopathy, enhancing the status of the profession, and improving patient care. Various barriers and facilitators to their involvement with a PBRN were identified.
背景基于实践的研究网络(PBRN)是临床医生与学术组织合作开展研究的团体,旨在回答与临床实践相关的问题。在英国,为骨病学建立 PBRN 将是国家骨病学研究委员会实现其 "发展研究文化 "使命宣言的合适方法。我们旨在探讨骨病学家对建立 PBRN 的实用性的看法,并找出他们参与 PBRN 的障碍和促进因素。结果40名骨科医生参加了在英国三个地点举行的5个焦点小组。形成了六个主题,分别描述了为骨病学建立公共卫生网络的效用、障碍和促进因素:研究经验、资金和时间、发展骨病学、不安全感和身份认同、融入实践以及公共卫生网络的组织。研究还发现了他们参与 PBRN 的各种障碍和促进因素。
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引用次数: 0
期刊
International Journal of Osteopathic Medicine
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