Pub Date : 2025-12-01Epub Date: 2025-11-11DOI: 10.1016/j.ijosm.2025.100800
Riza Amalia
{"title":"The metaverse as a pedagogical clinic: Re-envisioning human presence, empathy, and touch in digital care training","authors":"Riza Amalia","doi":"10.1016/j.ijosm.2025.100800","DOIUrl":"10.1016/j.ijosm.2025.100800","url":null,"abstract":"","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100800"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571585","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}
Pub Date : 2025-12-01Epub Date: 2025-10-03DOI: 10.1016/j.ijosm.2025.100792
François Rosenzweig , Rémi Feruglio , Thibault Marin
Palpation is a cornerstone of osteopathic practice, serving both diagnostic and therapeutic purposes. In France, the professionalization of osteopathy accelerated in 2014, when regulatory decrees mandated structured, competency-based teaching. This aligns with broader trends in science education emphasizing curriculum academization, professional collaboration, and skills-oriented learning. Among the six core competencies in osteopathy, “Performing an osteopathic intervention” includes palpation, assessed on precision, relevance, and clinical efficacy. Pedagogical guidelines underscore the need to regularly update teaching methods in light of scientific advances.
Physiologically, palpation involves complex neurobiological mechanisms. Specialized receptors in the fingertips process shape, pressure, and vibration, while affective touch engages psychoemotional dimensions that can influence therapeutic outcomes. Targeted training improves inter-examiner reproducibility and may even induce structural brain changes.
From an educational perspective, socio-constructivist and professionalization frameworks are particularly relevant. They highlight the interplay between individual development, guided practice, and communal learning. Students benefit from sensitive training and cognitive scaffolding that fosters reflection and skill refinement.
Beyond individual effort, peer learning and mentorship are equally vital. Interactions with teachers and peers nurture shared values, feedback, and role modeling, all of which reinforce confidence and self-efficacy. The emergence of a shared vocabulary and use of standardized tools further support diagnostic precision.
Ultimately, palpation is a technical skill embedded in social meaning and professional identity. Its development contributes to integrating learners into the osteopathic community of practice. As a structured, evidence-based, and patient-centered modality, palpation continues to evolve within a broader network of clinicians and educators.
{"title":"Palpation and its learning: A professionalization approach to acquiring a complex skill","authors":"François Rosenzweig , Rémi Feruglio , Thibault Marin","doi":"10.1016/j.ijosm.2025.100792","DOIUrl":"10.1016/j.ijosm.2025.100792","url":null,"abstract":"<div><div>Palpation is a cornerstone of osteopathic practice, serving both diagnostic and therapeutic purposes. In France, the professionalization of osteopathy accelerated in 2014, when regulatory decrees mandated structured, competency-based teaching. This aligns with broader trends in science education emphasizing curriculum academization, professional collaboration, and skills-oriented learning. Among the six core competencies in osteopathy, “Performing an osteopathic intervention” includes palpation, assessed on precision, relevance, and clinical efficacy. Pedagogical guidelines underscore the need to regularly update teaching methods in light of scientific advances.</div><div>Physiologically, palpation involves complex neurobiological mechanisms. Specialized receptors in the fingertips process shape, pressure, and vibration, while affective touch engages psychoemotional dimensions that can influence therapeutic outcomes. Targeted training improves inter-examiner reproducibility and may even induce structural brain changes.</div><div>From an educational perspective, socio-constructivist and professionalization frameworks are particularly relevant. They highlight the interplay between individual development, guided practice, and communal learning. Students benefit from sensitive training and cognitive scaffolding that fosters reflection and skill refinement.</div><div>Beyond individual effort, peer learning and mentorship are equally vital. Interactions with teachers and peers nurture shared values, feedback, and role modeling, all of which reinforce confidence and self-efficacy. The emergence of a shared vocabulary and use of standardized tools further support diagnostic precision.</div><div>Ultimately, palpation is a technical skill embedded in social meaning and professional identity. Its development contributes to integrating learners into the osteopathic community of practice. As a structured, evidence-based, and patient-centered modality, palpation continues to evolve within a broader network of clinicians and educators.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100792"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265926","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}
Pub Date : 2025-12-01Epub Date: 2025-11-12DOI: 10.1016/j.ijosm.2025.100801
Parinita Anand Kusnur , Sahana HN , Mark P. Jensen , Dharmanand Balebail Gopalakrishna , Reepa Avichal Ughreja , Debasis Behera , Prem Venkatesan
Background
Fibromyalgia (FM) is a condition characterized by widespread chronic pain, sleep disturbance, excessive fatigue, and cognitive and psychological dysfunction. The most common treatments for FM include patient education, pharmacotherapy, and non-pharmacological treatments such as therapeutic exercise. Complementary and alternative therapies (CAT) have begun to take precedence over more traditional pharmacological treatments due to their modest and associated adverse effects. Craniosacral therapy (CST) and clinical hypnosis are two CATs that have demonstrated beneficial effects on pain and other symptoms such as sleep quality, fatigue, and cognitive and psychological dysfunction in individuals with FM.
Case presentation
This report describes the case of a patient with FM, presenting primary complaints of sleep disturbance, pain, breathing difficulty, and fatigue. A combination treatment plan, which included CST, clinical hypnosis, and exercise therapy was administered for 8 weeks. The outcomes measured included sleep quality, pain pressure threshold, quality of life, and breathing dysfunction, pre- and post-treatment.
Conclusions
The results of the current case report supported the potential benefits of an integrative approach to the treatment of FM, involving both CAT and traditionally accepted FM treatments like therapeutic exercise, that can be provided by a physical therapist.
{"title":"Combination of craniosacral therapy, clinical hypnosis, and therapeutic exercise for fibromyalgia: A case report","authors":"Parinita Anand Kusnur , Sahana HN , Mark P. Jensen , Dharmanand Balebail Gopalakrishna , Reepa Avichal Ughreja , Debasis Behera , Prem Venkatesan","doi":"10.1016/j.ijosm.2025.100801","DOIUrl":"10.1016/j.ijosm.2025.100801","url":null,"abstract":"<div><h3>Background</h3><div>Fibromyalgia (FM) is a condition characterized by widespread chronic pain, sleep disturbance, excessive fatigue, and cognitive and psychological dysfunction. The most common treatments for FM include patient education, pharmacotherapy, and non-pharmacological treatments such as therapeutic exercise. Complementary and alternative therapies (CAT) have begun to take precedence over more traditional pharmacological treatments due to their modest and associated adverse effects. Craniosacral therapy (CST) and clinical hypnosis are two CATs that have demonstrated beneficial effects on pain and other symptoms such as sleep quality, fatigue, and cognitive and psychological dysfunction in individuals with FM.</div></div><div><h3>Case presentation</h3><div>This report describes the case of a patient with FM, presenting primary complaints of sleep disturbance, pain, breathing difficulty, and fatigue. A combination treatment plan, which included CST, clinical hypnosis, and exercise therapy was administered for 8 weeks. The outcomes measured included sleep quality, pain pressure threshold, quality of life, and breathing dysfunction, pre- and post-treatment.</div></div><div><h3>Conclusions</h3><div>The results of the current case report supported the potential benefits of an integrative approach to the treatment of FM, involving both CAT and traditionally accepted FM treatments like therapeutic exercise, that can be provided by a physical therapist.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100801"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571592","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}
Pub Date : 2025-12-01Epub Date: 2025-08-11DOI: 10.1016/j.ijosm.2025.100782
John J. Fraser , Elaine Lonnemann
Background
Manual therapy is frequently used in the treatment of cervical-spine conditions. Due to the critical neurovascular structures in the cervical region, there are potential risks associated.
Methods
The PearlDiver Patient Record Database was used to evaluate a cohort of patients with cervical-spine conditions between 2007 and 2011 using International Classification of Disease codes (721.x, 722.x, 723.x, 739.1). Current Procedural Terminology codes were used to identify Manual Therapy Techniques (97140), Osteopathic Manipulation (98925–98927), and Chiropractic Manipulation (98940–98942). Medical encounters for Vertebral-Basilar Artery Syndrome or Transient Ischemic Attack (ICD-9435.x), Carotid or Vertebral Artery Dissection (ICD-9443.21 & 443.24), Cerebral Artery Thrombosis or Embolus (ICD-9434.x), or Arterial Occlusion with or without Cerebral Infarct (ICD-9433.x) were assessed the same day, 14-days, 30-days, and 90-days following treatment exposure. For each event, prevalence ratios (PR) and 95 % confidence intervals (CI) were calculated comparing those receiving manual therapy to those not.
Results
4,781,968 unique patients (15.9 %) were diagnosed with a cervical-spine condition, with 2,477,117 (51.8 %) of these patients provided MT from 2007 to 2011. Patients provided MT had an 11 % increased prevalence of arterial occlusion observed within 90-days post-intervention (PR: 1.11 95 % CI 1.02–1.21, NNT Harm: 27,762) and a 11–45 % lower prevalence of being diagnosed with a neurovascular complication 30-days (PR: 0.89, 95 % CI 0.84–0.95), 14-days (PR = 0.82, 95 % CI 0.76–0.88), and the same day (PR: 0.55, 95 % CI 0.52–0.59) following treatment compared to patients not treated with MT.
Conclusion
This study presents population-level statistics on the occurrence of neurovascular complication after MT for cervical-spine conditions.
Level of evidence
Treatment, level 2a.
背景：手工疗法常用于治疗颈椎疾病。由于关键的神经血管结构在颈椎区域，有潜在的风险相关。方法采用PearlDiver患者记录数据库，使用国际疾病分类代码（International Classification of Disease codes, 721）对2007年至2011年间的一组颈椎疾病患者进行评估。x, 722。x, 723。x 739.1)。使用现行程序术语代码来识别手工治疗技术（97140）、整骨疗法（98925-98927）和捏脊疗法（98940-98942）。椎-基底动脉综合征或短暂性脑缺血发作的医学遭遇（ICD-9435）。x)，颈动脉或椎动脉夹层（ICD-9443.21和443.24），脑动脉血栓形成或栓子（ICD-9434）。x)，或动脉闭塞伴或不伴脑梗死（ICD-9433.x）在治疗暴露后的当天、14天、30天和90天进行评估。对于每个事件，计算接受手工治疗的患者与未接受手工治疗的患者的患病率比（PR）和95%置信区间（CI）。结果2007 - 2011年有4,781,968例特殊患者（15.9%）被诊断为颈椎疾病，其中2,477,117例（51.8%）患者接受了MT治疗。接受MT治疗的患者在干预后90天内观察到的动脉闭塞患病率增加了11% (PR: 1.11 95% CI 1.02-1.21， NNT危害：27,762)，30天（PR: 0.89, 95% CI 0.84-0.95）， 14天（PR = 0.82, 95% CI 0.76-0.88）和同一天（PR: 0.76-0.88）被诊断为神经血管并发症的患病率降低了11 - 45%。0.55, 95% CI 0.52-0.59)。结论本研究对颈椎疾病行MT后神经血管并发症的发生率进行了人群水平的统计。证据水平：治疗，2a级。
{"title":"Association of neurovascular events with cervical manual therapy: A cohort study","authors":"John J. Fraser , Elaine Lonnemann","doi":"10.1016/j.ijosm.2025.100782","DOIUrl":"10.1016/j.ijosm.2025.100782","url":null,"abstract":"<div><h3>Background</h3><div>Manual therapy is frequently used in the treatment of cervical-spine conditions. Due to the critical neurovascular structures in the cervical region, there are potential risks associated.</div></div><div><h3>Methods</h3><div>The PearlDiver Patient Record Database was used to evaluate a cohort of patients with cervical-spine conditions between 2007 and 2011 using International Classification of Disease codes (721.x, 722.x, 723.x, 739.1). Current Procedural Terminology codes were used to identify Manual Therapy Techniques (97140), Osteopathic Manipulation (98925–98927), and Chiropractic Manipulation (98940–98942). Medical encounters for Vertebral-Basilar Artery Syndrome or Transient Ischemic Attack (ICD-9435.x), Carotid or Vertebral Artery Dissection (ICD-9443.21 & 443.24), Cerebral Artery Thrombosis or Embolus (ICD-9434.x), or Arterial Occlusion with or without Cerebral Infarct (ICD-9433.x) were assessed the same day, 14-days, 30-days, and 90-days following treatment exposure. For each event, prevalence ratios (PR) and 95 % confidence intervals (CI) were calculated comparing those receiving manual therapy to those not.</div></div><div><h3>Results</h3><div>4,781,968 unique patients (15.9 %) were diagnosed with a cervical-spine condition, with 2,477,117 (51.8 %) of these patients provided MT from 2007 to 2011. Patients provided MT had an 11 % increased prevalence of arterial occlusion observed within 90-days post-intervention (PR: 1.11 95 % CI 1.02–1.21, NNT Harm: 27,762) and a 11–45 % lower prevalence of being diagnosed with a neurovascular complication 30-days (PR: 0.89, 95 % CI 0.84–0.95), 14-days (PR = 0.82, 95 % CI 0.76–0.88), and the same day (PR: 0.55, 95 % CI 0.52–0.59) following treatment compared to patients not treated with MT.</div></div><div><h3>Conclusion</h3><div>This study presents population-level statistics on the occurrence of neurovascular complication after MT for cervical-spine conditions.</div></div><div><h3>Level of evidence</h3><div>Treatment, level 2a.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100782"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907309","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}
<div><h3>Background</h3><div>Osteoarthritis (OA) is a chronic degenerative disorder mainly affecting the knee joint.</div></div><div><h3>Objective</h3><div>The objective of the study was to evaluate the effectiveness of manual therapy (MT) with neuromuscular training (NMT) and conventional physical therapy (CPT) with NMT for chronic knee OA.</div></div><div><h3>Methods</h3><div>Randomized, double-blinded controlled study design conducted at government hospitals for the period of 12 months. Sixty subjects aged 40 and 70 were randomly assigned into experimental (MT + NMT) and control (CPT + NMT) groups using the block randomization method. The outcome measures are pain, Knee Flexion ROM, disability, balance, and quality of life, which were measured at baseline, three and six weeks. The effects of treatment were examined utilizing separate 2-by-3 mixed-model analyses of variance using SPSS 25.0.</div></div><div><h3>Results</h3><div>Demographic characteristics such as age, gender, height and weight did not show any statistically significant differences between the groups (p > 0.05). The experimental group (EG) showed a significant reduction in pain compared to the control group (CG) after 3 weeks of intervention (mean between-group difference 1.5 (95 %CI: 1.21to1.78). This was maintained during a 6-week follow-up of 2.6 (95 %CI: 2.31–2.88). At three weeks, patients showed a significantly greater flexion ROM improvement in the EG as well as in the six-week follow-up. Similarly, functional disability, balance and quality of life were significantly better in the EG at the 3 and 6-week follow-ups respectively.</div></div><div><h3>Conclusions</h3><div>Our study results showed a significant improvement in the clinical outcomes following the application of manual therapy with neuromuscular training in managing chronic Knee Osteoarthritis.</div><div><strong><em>Clinical significance of the study:</em></strong> The clinical significance of studies on OA knee physical therapy for researchers, physicians, and patients resides in the potential to optimize care, reduce pain and disability, and enhance quality of life. Research shows the efficacy of exercise therapy and educational programs in enhancing clinical practice, empowering patients in self-management, and reducing healthcare costs.</div><div><strong><em>For researchers:</em></strong> Research on physical therapy for OA knee contributes to the growing body of evidence supporting targeted therapies, such as exercise therapy and educational programs. Recent studies inform physical therapy practices, creating an essential evidence base for developing and refining clinical recommendations. This research can identify the most effective types of exercises, appropriate dosages, and delivery methods tailored to various subgroups of individuals with knee OA.</div><div><strong><em>For clinicians:</em></strong> By employing evidence-based therapies, clinicians can enhance measures of outcomes, such as pain, mobil
{"title":"Effectiveness of manual therapy vs conventional physical therapy with neuromuscular training in the management of knee osteoarthritis: A randomized clinical controlled trial","authors":"Shahul Hameed Pakkir Mohamed , Hani Fahad Albalawi , Gopal Nambi , Kholood Matouq Shalabi , Mohammed Obaid Albalawi","doi":"10.1016/j.ijosm.2025.100787","DOIUrl":"10.1016/j.ijosm.2025.100787","url":null,"abstract":"<div><h3>Background</h3><div>Osteoarthritis (OA) is a chronic degenerative disorder mainly affecting the knee joint.</div></div><div><h3>Objective</h3><div>The objective of the study was to evaluate the effectiveness of manual therapy (MT) with neuromuscular training (NMT) and conventional physical therapy (CPT) with NMT for chronic knee OA.</div></div><div><h3>Methods</h3><div>Randomized, double-blinded controlled study design conducted at government hospitals for the period of 12 months. Sixty subjects aged 40 and 70 were randomly assigned into experimental (MT + NMT) and control (CPT + NMT) groups using the block randomization method. The outcome measures are pain, Knee Flexion ROM, disability, balance, and quality of life, which were measured at baseline, three and six weeks. The effects of treatment were examined utilizing separate 2-by-3 mixed-model analyses of variance using SPSS 25.0.</div></div><div><h3>Results</h3><div>Demographic characteristics such as age, gender, height and weight did not show any statistically significant differences between the groups (p > 0.05). The experimental group (EG) showed a significant reduction in pain compared to the control group (CG) after 3 weeks of intervention (mean between-group difference 1.5 (95 %CI: 1.21to1.78). This was maintained during a 6-week follow-up of 2.6 (95 %CI: 2.31–2.88). At three weeks, patients showed a significantly greater flexion ROM improvement in the EG as well as in the six-week follow-up. Similarly, functional disability, balance and quality of life were significantly better in the EG at the 3 and 6-week follow-ups respectively.</div></div><div><h3>Conclusions</h3><div>Our study results showed a significant improvement in the clinical outcomes following the application of manual therapy with neuromuscular training in managing chronic Knee Osteoarthritis.</div><div><strong><em>Clinical significance of the study:</em></strong> The clinical significance of studies on OA knee physical therapy for researchers, physicians, and patients resides in the potential to optimize care, reduce pain and disability, and enhance quality of life. Research shows the efficacy of exercise therapy and educational programs in enhancing clinical practice, empowering patients in self-management, and reducing healthcare costs.</div><div><strong><em>For researchers:</em></strong> Research on physical therapy for OA knee contributes to the growing body of evidence supporting targeted therapies, such as exercise therapy and educational programs. Recent studies inform physical therapy practices, creating an essential evidence base for developing and refining clinical recommendations. This research can identify the most effective types of exercises, appropriate dosages, and delivery methods tailored to various subgroups of individuals with knee OA.</div><div><strong><em>For clinicians:</em></strong> By employing evidence-based therapies, clinicians can enhance measures of outcomes, such as pain, mobil","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100787"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415781","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}
Pub Date : 2025-12-01Epub Date: 2025-09-05DOI: 10.1016/j.ijosm.2025.100785
Garrett B. Gianneschi , Sarthak Patel , Patrick Hinfey
Introduction
Chest pain (CP) is a common and challenging complaint in the emergency department (ED), often requiring rapid assessment to rule out serious conditions. While medication-based treatments are frequently used, there is a growing need for alternative therapies, particularly for non-cardiac chest pain. The sternal brace, an osteopathic manipulative technique, may serve as an adjunctive therapy for chest pain in the ED.
Objective
This prospective observational cohort study aimed to explore the effect of the sternal brace maneuver in reducing CP of any etiology in ED patients.
Methods
Data were reanalyzed from 34 adult patients presenting with CP at Newark Beth Israel ED. The Numerical Rating Scale (NRS) was used to measure pain levels before and after the maneuver. Patients were classified as responders if their NRS decreased.
Results
In 34 patients presenting with CP, the maneuver led to a statistically significant average reduction in pain of 1.32 points (18.5 %) (z = 3.124; p = 0.0009; alpha = 0.01; confidence interval = 1.047). 38.2 % (13/34) were classified as responders, experiencing an average NRS decrease of 3.7 points (64.0 %). The remaining 61.8 % (21/34) were non-responders. Subgroup analysis showed decrease in noncardiac CP was 1.5 points (21.3 %), while cardiac CP decreased 0.9 points (12.7 %). No major adverse outcomes were observed.
Conclusion
This small study suggests the sternal brace provides modest effectiveness in pain reduction in ED patients with a chief complaint of CP.
胸痛（CP）是急诊科（ED）常见且具有挑战性的主诉，通常需要快速评估以排除严重情况。虽然经常使用药物治疗，但越来越需要替代疗法，特别是对非心源性胸痛。胸骨支具是一种骨科手法，可以作为ED胸痛的辅助治疗方法。目的：本前瞻性观察队列研究旨在探讨胸骨支具手法在降低任何病因的ED患者CP中的作用。方法对34例在纽瓦克贝斯以色列急诊科就诊的CP成年患者的数据进行再分析。采用数值评定量表（NRS）测量手法前后的疼痛水平。如果患者的NRS下降，则将其归类为应答者。结果34例CP患者的疼痛平均减轻1.32点（18.5%），差异有统计学意义（z = 3.124, p = 0.0009, alpha = 0.01，可信区间= 1.047）。38.2%（13/34）被归为应答者，NRS平均下降3.7点（64.0%）。其余61.8%（21/34）无应答。亚组分析显示，非心脏CP下降1.5点（21.3%），心脏CP下降0.9点（12.7%）。未观察到主要不良结果。结论：这项小型研究表明，胸骨支具对以CP为主诉的ED患者疼痛减轻有一定效果。
{"title":"A prospective observational cohort study of a standardized osteopathic maneuver for chest pain relief","authors":"Garrett B. Gianneschi , Sarthak Patel , Patrick Hinfey","doi":"10.1016/j.ijosm.2025.100785","DOIUrl":"10.1016/j.ijosm.2025.100785","url":null,"abstract":"<div><h3>Introduction</h3><div>Chest pain (CP) is a common and challenging complaint in the emergency department (ED), often requiring rapid assessment to rule out serious conditions. While medication-based treatments are frequently used, there is a growing need for alternative therapies, particularly for non-cardiac chest pain. The sternal brace, an osteopathic manipulative technique, may serve as an adjunctive therapy for chest pain in the ED.</div></div><div><h3>Objective</h3><div>This prospective observational cohort study aimed to explore the effect of the sternal brace maneuver in reducing CP of any etiology in ED patients.</div></div><div><h3>Methods</h3><div>Data were reanalyzed from 34 adult patients presenting with CP at Newark Beth Israel ED. The Numerical Rating Scale (NRS) was used to measure pain levels before and after the maneuver. Patients were classified as responders if their NRS decreased.</div></div><div><h3>Results</h3><div>In 34 patients presenting with CP, the maneuver led to a statistically significant average reduction in pain of 1.32 points (18.5 %) (z = 3.124; p = 0.0009; alpha = 0.01; confidence interval = 1.047). 38.2 % (13/34) were classified as responders, experiencing an average NRS decrease of 3.7 points (64.0 %). The remaining 61.8 % (21/34) were non-responders. Subgroup analysis showed decrease in noncardiac CP was 1.5 points (21.3 %), while cardiac CP decreased 0.9 points (12.7 %). No major adverse outcomes were observed.</div></div><div><h3>Conclusion</h3><div>This small study suggests the sternal brace provides modest effectiveness in pain reduction in ED patients with a chief complaint of CP.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100785"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415783","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}
Pub Date : 2025-12-01Epub Date: 2025-07-01DOI: 10.1016/j.ijosm.2025.100777
Jasemin Todri, Orges Lena, Carolina Vázquez-Villa, Juan Martínez-Fuentes, Alberto Ciferri, María Antonia Murcia-González
Objective
To compare the effectiveness of three manual therapy protocols (Jones, Lewit, and Chaitow) with a sham group in terms of pain pressure threshold and intensity.
Participants
Fifty-two physiotherapy bachelor students with neck pain lasting more than 3 days were recruited.
Outcomes: Pain was assessed with Numerical Rating Scale and Pressure Algometer, while cervical range of motion was evaluated with the Baiobit Inertial sensor.
Intervention
An investigator, independent of the assessment and randomization, conducted all the interventions and sham procedures. Specifically, the Jones group received pincer palpation with a 1-min duration of ischemic compression, followed by 90 s of the no-pain Strain-Counterstrain technique. The Lewit group underwent flat palpation for 1 min, accompanied by 40 s of intermittent compression and post-isometric relaxation. The Chaitow group received deep palpation for 1 min, followed by the pressure release position lasting 20 s to 1 min, concluding with the muscle energy technique. The Sham group received only flat palpation and a 3-min homolateral muscle shortening position.
Results
Effects for all three techniques (Chaitow/Lewit/Jones) when comparing them to sham were not significant on pain intensity (−0.96/−1.01/−0.63) or on pressure threshold (−0.5/−0.4/−0.19). No adverse events or undesirable effects were observed during the study.
Conclusion
Immediate effects on pain intensity and pressure threshold are not directly attributable to any of the three tested trigger techniques.
{"title":"Immediate effects of three different upper trapezius trigger point techniques on pain intensity and pressure threshold in students with cervical pain: a randomized clinical trial","authors":"Jasemin Todri, Orges Lena, Carolina Vázquez-Villa, Juan Martínez-Fuentes, Alberto Ciferri, María Antonia Murcia-González","doi":"10.1016/j.ijosm.2025.100777","DOIUrl":"10.1016/j.ijosm.2025.100777","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the effectiveness of three manual therapy protocols (Jones, Lewit, and Chaitow) with a sham group in terms of pain pressure threshold and intensity.</div></div><div><h3>Participants</h3><div>Fifty-two physiotherapy bachelor students with neck pain lasting more than 3 days were recruited.</div><div>Outcomes: Pain was assessed with Numerical Rating Scale and Pressure Algometer, while cervical range of motion was evaluated with the Baiobit Inertial sensor.</div></div><div><h3>Intervention</h3><div>An investigator, independent of the assessment and randomization, conducted all the interventions and sham procedures. Specifically, the Jones group received pincer palpation with a 1-min duration of ischemic compression, followed by 90 s of the no-pain Strain-Counterstrain technique. The Lewit group underwent flat palpation for 1 min, accompanied by 40 s of intermittent compression and post-isometric relaxation. The Chaitow group received deep palpation for 1 min, followed by the pressure release position lasting 20 s to 1 min, concluding with the muscle energy technique. The Sham group received only flat palpation and a 3-min homolateral muscle shortening position.</div></div><div><h3>Results</h3><div>Effects for all three techniques (Chaitow/Lewit/Jones) when comparing them to sham were not significant on pain intensity (−0.96/−1.01/−0.63) or on pressure threshold (−0.5/−0.4/−0.19). No adverse events or undesirable effects were observed during the study.</div></div><div><h3>Conclusion</h3><div>Immediate effects on pain intensity and pressure threshold are not directly attributable to any of the three tested trigger techniques.</div></div><div><h3>Clinical trial registration number id</h3><div>NCT05265468.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100777"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867310","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}
Pub Date : 2025-12-01Epub Date: 2025-09-28DOI: 10.1016/j.ijosm.2025.100789
Brian Tuckey
Since the publication of “Jones Strain and Counterstrain” in 1995, there have been few documented methodological advancements in Counterstrain. However, over the past 20 years, Strain and Counterstrain (SCS) has been systematically expanded from a primarily musculoskeletal technique to a novel, multisystem evaluation and treatment method called Fascial Counterstrain (FCS). This expanded version of Counterstrain targets dysfunction of both the peripheral and central nervous system, including somatic, visceral, vascular and neuromeningeal tissues. Its proposed mechanisms are supported by emerging clinical and pre-clinical research related to central sensitization, the proprioceptive/contractile properties of fascia, and the science of microvascular dysfunction. In addition to describing FCS's diagnostic and treatment processes, this manuscript also presents an updated theoretical mechanism of action for Counterstrain technique. Finally, for clinical context, a case report (with video documentation) is included of a post-surgical and complex regional pain syndrome patient who failed to respond to multiple medical interventions, yet demonstrated rapid subjective, objective, and functional improvement following FCS treatment.
自1995年出版“Jones Strain and Counterstrain”以来，Counterstrain在方法上的进展很少。然而，在过去的20年里，应变和反应变（SCS）已经系统地从主要的肌肉骨骼技术扩展到一种新的，多系统的评估和治疗方法，称为筋膜反应变（FCS）。这种扩展版的反张力针对外周和中枢神经系统的功能障碍，包括躯体、内脏、血管和神经脑膜组织。其提出的机制得到了与中枢致敏、筋膜本体感觉/收缩特性和微血管功能障碍科学相关的新兴临床和临床前研究的支持。除了描述FCS的诊断和治疗过程外，本文还提出了反应变技术的最新理论作用机制。最后，在临床背景下，一个病例报告（带视频文件）包括一个术后和复杂的局部疼痛综合征患者，该患者对多种医疗干预无效，但在FCS治疗后表现出快速的主观、客观和功能改善。
{"title":"Fascial Counterstrain: A methodological advancement in indirect osteopathic manipulation","authors":"Brian Tuckey","doi":"10.1016/j.ijosm.2025.100789","DOIUrl":"10.1016/j.ijosm.2025.100789","url":null,"abstract":"<div><div>Since the publication of “Jones Strain and Counterstrain” in 1995, there have been few documented methodological advancements in Counterstrain. However, over the past 20 years, Strain and Counterstrain (SCS) has been systematically expanded from a primarily musculoskeletal technique to a novel, multisystem evaluation and treatment method called <em>Fascial Counterstrain (FCS)</em>. This expanded version of Counterstrain targets dysfunction of both the peripheral and central nervous system, including somatic, visceral, vascular and neuromeningeal tissues. Its proposed mechanisms are supported by emerging clinical and pre-clinical research related to central sensitization, the proprioceptive/contractile properties of fascia, and the science of microvascular dysfunction. In addition to describing FCS's diagnostic and treatment processes, this manuscript also presents an updated theoretical mechanism of action for Counterstrain technique. Finally, for clinical context, a case report (with video documentation) is included of a post-surgical and complex regional pain syndrome patient who failed to respond to multiple medical interventions, yet demonstrated rapid subjective, objective, and functional improvement following FCS treatment.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100789"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519741","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}
Pub Date : 2025-12-01Epub Date: 2025-09-26DOI: 10.1016/j.ijosm.2025.100791
Rosalba Courtney , Zoe Steele , Imogen Collyer
Background
Long COVID continues to have health impacts globally. Dyspnoea, fatigue, exercise intolerance and musculoskeletal symptoms are common and have been linked to pathophysiological mechanisms such as dysfunctional breathing, dysautonomia and neurolymphatic dysfunction that might be assisted by breathing retraining and manual therapy.
Objective
This review sought to identify research describing breathing retraining and manual therapy protocols that might be beneficial for long COVID.
Methods
A literature review was undertaken to identify research describing treatment protocols that included either manual therapy or breathing retraining approaches for long COVID.
Results
There were 17 articles that fit the inclusion criteria; 9 randomised control trials, 4 case series, 3 uncontrolled studies, and one case report. Whilst methodologies varied, all implemented interventions and reported outcomes involving breathing re-training and/or manual therapy, in four broad categories: manual therapy, singing-based breathing protocols, respiratory muscle training – device assisted, and breathing techniques.
Conclusion
Clinical protocols integrating multimodal interventions and patient self-care should be refined through pilot studies targeting specific phenotypes. High-quality research is needed to compare intervention effectiveness and assess long-term outcomes.
{"title":"Breathing retraining and manual therapy for long COVID – A literature review","authors":"Rosalba Courtney , Zoe Steele , Imogen Collyer","doi":"10.1016/j.ijosm.2025.100791","DOIUrl":"10.1016/j.ijosm.2025.100791","url":null,"abstract":"<div><h3>Background</h3><div>Long COVID continues to have health impacts globally. Dyspnoea, fatigue, exercise intolerance and musculoskeletal symptoms are common and have been linked to pathophysiological mechanisms such as dysfunctional breathing, dysautonomia and neurolymphatic dysfunction that might be assisted by breathing retraining and manual therapy.</div></div><div><h3>Objective</h3><div>This review sought to identify research describing breathing retraining and manual therapy protocols that might be beneficial for long COVID.</div></div><div><h3>Methods</h3><div>A literature review was undertaken to identify research describing treatment protocols that included either manual therapy or breathing retraining approaches for long COVID.</div></div><div><h3>Results</h3><div>There were 17 articles that fit the inclusion criteria; 9 randomised control trials, 4 case series, 3 uncontrolled studies, and one case report. Whilst methodologies varied, all implemented interventions and reported outcomes involving breathing re-training and/or manual therapy, in four broad categories: manual therapy, singing-based breathing protocols, respiratory muscle training – device assisted, and breathing techniques.</div></div><div><h3>Conclusion</h3><div>Clinical protocols integrating multimodal interventions and patient self-care should be refined through pilot studies targeting specific phenotypes. High-quality research is needed to compare intervention effectiveness and assess long-term outcomes.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"58 ","pages":"Article 100791"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465542","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}
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