International Journal of Osteopathic Medicine最新文献_第5页

A retrospective analysis of osteopathic manipulative treatment techniques used by 3rd and 4th year medical students 回顾性分析三、四年级医学生使用的整骨手法治疗技术

IF 1.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Osteopathic Medicine

Pub Date : 2025-09-01 Epub Date: 2025-05-24 DOI: 10.1016/j.ijosm.2025.100768

Heidi R. Bowman , Brian D. Schwartz , Mark E. Payton , Christopher M. LaFontano

Objective

To determine whether there is a correlation between the frequency with which osteopathic manipulative techniques are taught in preclinical osteopathic medical school years one and two and the prevalence of student use during years three and four. The secondary objective was to determine the students’ reported comfort and perception of ease and safety when using osteopathic manipulative treatment (OMT).

Methods

Third- and fourth-year OMT patient encounter logs for the classes of 2020–2022 were retrospectively reviewed for the students' technique of choice. These techniques were compared to how frequently that technique was taught in the preclinical curriculum. Survey data was collected from the class of 2025 third-year students upon completion of their family medicine rotation evaluating factors that influence students’ use of certain OMT techniques while on third- and fourth-year rotations.

Results

Final analysis included 20,149 OMT logs and ninety-six student surveys. The logs indicated that Muscle Energy (ME) was the most used technique among the classes. Muscle energy is also the most frequently taught in the preclinical curriculum. The data show ease of use and confidence were significantly correlated to students’ use of osteopathic techniques during clinical rotations. There was a strong correlation of consistency (0.72-0.98) among the different classes and all pairwise correlations were statistically significant.

Conclusion

The use of osteopathic techniques during third and fourth-year clinical rotations is directly related to their confidence and ease of performing the technique. Correlations exist between curricular frequency and students’ confidence, indicating the importance of preclinical curriculum and hands-on lab time.

目的确定临床前骨科医学院1、2年级教授整骨手法的频率与3、4年级学生使用整骨手法的频率之间是否存在相关性。次要目的是确定学生在使用整骨手法治疗（OMT）时报告的舒适度和对易用性和安全性的感知。方法回顾性分析2020-2022年第三和第四年OMT患者遭遇日志，以了解学生选择的技术。将这些技术与临床前课程中教授该技术的频率进行比较。调查数据收集自2025名完成家庭医学轮转的三年级学生，评估影响学生在三年级和四年级轮转时使用某些OMT技术的因素。最终分析包括20,149份OMT日志和96份学生调查。日志显示，肌肉能量（ME）是班级中使用最多的技术。肌肉能量也是临床前课程中最常教授的内容。数据显示，易用性和信心与学生在临床轮转期间使用整骨疗法技术显著相关。不同类别间一致性相关性较强（0.72-0.98），两两相关均有统计学意义。结论在第三和第四年的临床轮转中，骨科技术的使用与他们的信心和实施技术的容易程度直接相关。课程频率与学生信心之间存在相关性，表明临床前课程和动手实验时间的重要性。

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引用次数: 0

Osteopathic manipulative treatment in cervical dystonia patients treated with IncobotulinumtoxinA 肉毒杆菌毒素治疗颈肌张力障碍的整骨手法治疗

IF 1.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Osteopathic Medicine

Pub Date : 2025-09-01 Epub Date: 2025-01-20 DOI: 10.1016/j.ijosm.2025.100745

Pascale Décarie , Sylvain Chouinard , Gabriel Venne

Background

Cervical dystonia (CD) is a neurological syndrome characterized by involuntary contractions in the cervical region, leading to abnormal head and shoulders postures, neck pain and tremors.

Objective

The objectives of this pilot study were to observe the impact of osteopathic manual Therapy (OMT) as an adjunct intervention on symptoms associated with CD in patients treated with injections of BotulinumtoxinA (BoNTA).

Method

This experimental research had a pretest-posttest design. The participants (n = 10) were randomly divided into 2 equal groups: experimental and control. Three questionnaires were used: TWSTRS (severity, disability and pain), CDIP-58 (quality of life) and CGI (evolution). Each patient had six visits over a BoNTA treatment cycle. Overall, three OMT or Sham treatments were administered.

Results

Overall, the percentage differences between groups were: 32.0 % better in the experimental group for the TWSTRS global score; 38.3 % for severity and 51.6 % for the pain subscore. The quality-of-life CDIP-58 score was 12.2 % better in the experimental group. As for the global evolution CGI score, the experimental group showed a 57.1 % of improvement compared to the control group. No adverse events associated with OMT were reported.

Conclusion

Results suggest that OMT could improve symptomology associated with CD, when administered as an adjunct therapy to BoNTA treatment; consequently, suggesting this care as an adjunct therapy. A larger-scale study would be required to validate findings.

背景：颈肌张力障碍（CD）是一种以颈部不自主收缩为特征的神经系统综合征，可导致头部和肩部姿势异常、颈部疼痛和震颤。目的：本初步研究的目的是观察骨疗法（OMT）作为一种辅助干预对注射肉毒杆菌毒素（BoNTA）治疗的患者与CD相关症状的影响。方法采用前测后测设计。10名受试者随机分为实验组和对照组。采用三份调查问卷：TWSTRS（严重程度、残疾和疼痛）、CDIP-58（生活质量）和CGI（进化）。在BoNTA治疗周期中，每位患者有六次就诊。总的来说，进行了三次OMT或Sham治疗。结果两组间比较，实验组TWSTRS总分优于对照组32.0%；严重程度为38.3%，疼痛评分为51.6%。实验组生活质量CDIP-58评分提高12.2%。在全球进化CGI评分方面，实验组比对照组提高了57.1%。没有与OMT相关的不良事件的报道。结论：OMT作为BoNTA治疗的辅助治疗可改善CD相关症状；因此，建议将此护理作为辅助治疗。需要更大规模的研究来验证这些发现。

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引用次数: 0

Employment characteristics of individuals who received osteopathic care: a retrospective cross-sectional observational study 接受整骨疗法治疗的个体的就业特征：一项回顾性横断面观察研究

IF 1.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Osteopathic Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-04 DOI: 10.1016/j.ijosm.2025.100772

N. Verhaeghe , P.L.S. van Dun , L. Annemans

Objective

The profile and clinical presentation of people consulting osteopaths in Belgium has been studied and reported before. Information on employment aspects of such individuals is lacking. The aim was to contribute to filling this gap.

Methods

The study had a retrospective cross-sectional observational design. The study population included employed Dutch-speaking members, aged 18–65, of a large Health Insurance Fund in Belgium who had visited an osteopath at least once in the period January 1, 2019 and December 31, 2019. Data collection occurred through a digital self-reported instrument to be filled out once. Participation in the study was entirely voluntary. Descriptive, between-group and a multivariate logistic regression analyses were performed.

Results

The study population included 955 individuals with 70 % being female. Thirty-one per cent reported work absence (mean: 37.5 ± 62.5 days) in a 12 months’ time period due to the complaint for which they consulted an osteopath. The main reason for work absence included non-specific low back pain (21.9 %). Respondents indicating the osteopath as the first care professional they consulted had significantly fewer work absence days compared to those who first consulted another health care professional (27.9 ± 52.2 vs. 41.5 ± 66.1 days, p < .01).

Conclusion

This is the first study examining employment-related characteristics of individuals seeking osteopathic care. The findings must be cautiously interpreted, but they give a first impression of what the effect of osteopathic care on employment may be. This impact needs to be further examined applying study designs that allow conclusions about the causal or non-causal relationship between osteopathic care and employment outcomes.

目的对比利时骨科患者的临床表现进行了研究和报道。缺乏关于这些人就业方面的资料。其目的是为填补这一空白作出贡献。方法采用回顾性横断面观察设计。研究人群包括比利时一家大型健康保险基金的雇佣荷兰语成员，年龄在18-65岁之间，他们在2019年1月1日至2019年12月31日期间至少看过一次整骨医生。数据收集通过数字自我报告仪器进行，填写一次。参与这项研究完全是自愿的。进行了描述性、组间和多变量逻辑回归分析。结果研究人群共955人，其中女性占70%。31%的人在12个月内因向整骨医生投诉而缺勤（平均：37.5±62.5天）。缺勤的主要原因包括非特异性腰痛（21.9%）。与首次咨询其他医疗保健专业人员的受访者相比，首次咨询整骨医生的受访者缺勤天数明显减少(27.9±52.2天对41.5±66.1天，p <；. 01)。结论：本研究首次探讨了寻求整骨疗法的个体的就业相关特征。研究结果必须谨慎地解释，但它们给人的第一印象是骨科护理对就业的影响。这种影响需要应用研究设计来进一步检验，从而得出关于整骨疗法治疗与就业结果之间因果关系或非因果关系的结论。

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引用次数: 0

Understanding specific, contextual and non-specific effects in osteopathy 了解骨病的特异性、情境性和非特异性效应

IF 1.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Osteopathic Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-13 DOI: 10.1016/j.ijosm.2025.100773

Nicholas Tripodi , Amy Lawton , Daniel Corcoran , Jack Feehan

Osteopathic care has been a part of the healthcare landscape for many years, and whilst diverse in its practice, in many world regions it has a predominant focus on musculoskeletal care. Despite the extensive history of osteopathy, the paradigms, principles and modes of effect that occur within its delivery lack consensus. Of the proposed modes of effect, many are based on specific and local phenomena that lack robust evidence supporting their proposed mechanisms. Recent research has promoted a shift away from exclusively explaining clinical outcomes through specific effects but rather, conceptualising these outcomes through the interplay of specific, non-specific and contextual effects. An improved understanding of this interplay is critical for osteopathy and, indeed, all other professions involved in musculoskeletal care. Reconceptualising the effects involved in clinical interventions will contribute to improved health outcomes through the facilitation of person-centred care and the adoption of the biopsychosocial model of healthcare.

多年来，整骨疗法一直是医疗保健领域的一部分，虽然其实践多种多样，但在世界许多地区，它主要侧重于肌肉骨骼护理。尽管整骨疗法有着广泛的历史，但在其治疗过程中所发生的范式、原则和效果模式缺乏共识。在提出的效应模式中，许多是基于特定和局部现象，缺乏强有力的证据支持其提出的机制。最近的研究促进了一种转变，即不再仅仅通过特定效应来解释临床结果，而是通过特异性、非特异性和背景效应的相互作用来概念化这些结果。提高对这种相互作用的理解对于整骨病和所有其他涉及肌肉骨骼护理的专业都是至关重要的。重新定义临床干预所涉及的影响将有助于通过促进以人为本的护理和采用医疗保健的生物心理社会模式来改善健康结果。

引用次数: 0

Repositioning menstrual pain management: Multidisciplinary collaboration and cultural sensitivity as key priorities 重新定位经痛管理：多学科合作和文化敏感性作为关键优先事项

IF 1.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Osteopathic Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-03 DOI: 10.1016/j.ijosm.2025.100771

Erma Pratiwi Nufi

引用次数: 0

A review of osteopathic and related manipulative treatments for improving symptoms of gastrointestinal distress in neurological disorders 整骨疗法及相关手法治疗改善神经系统疾病患者胃肠窘迫症状的综述

IF 1.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Osteopathic Medicine

Pub Date : 2025-09-01 Epub Date: 2025-05-08 DOI: 10.1016/j.ijosm.2025.100766

Joseph Peters , Grant Runnels , Alexa Lauinger , Tanner Murphy , Abbey Griffith , Turner Slicho

Objective

To determine the clinical utility of osteopathic manipulative treatments (OMT) and related manual therapies for improving gastrointestinal distress in patients with neurological disorders (ND).

Methods

A database search through PubMed, Embase, Scopus, and Ovid was conducted to identify randomized and non-randomized clinical trials that analyzed the effects of OMT and related manual therapies on gut health in patients with ND. Two independent reviewers screened articles for inclusion and extracted information related to participant characteristics, intervention details, outcome measures, and significant outcomes. Methodological quality of eligible studies was assessed using the Standard Quality Assessment Criteria.

Results

Twelve studies (nine randomized controlled trials, two pre-post trials, and one non-randomized controlled trial) with a total of 516 individuals with ND were analyzed. All twelve studies showed improvements in symptoms of gastrointestinal distress following OMT and related treatments. Findings may be limited by methodological variability (i.e., heterogenous disability types, treatment modalities) and language exclusions.

Conclusion

Evidence suggests that OMT and related treatments are effective interventions for improving symptoms of gastrointestinal distress like constipation and abdominal pain. Future randomized controlled trials should examine the dose-response of OMT and microbiome changes associated with these treatments.

目的探讨骨科手法治疗（OMT）及相关手法治疗在改善神经性疾病（ND）患者胃肠不适中的临床应用价值。方法通过PubMed、Embase、Scopus和Ovid检索数据库，确定随机和非随机临床试验，分析OMT和相关手工治疗对ND患者肠道健康的影响。两名独立审稿人筛选了纳入的文章，并提取了与参与者特征、干预细节、结果测量和重要结果相关的信息。采用标准质量评价标准对合格研究的方法学质量进行评价。结果共分析了12项研究（9项随机对照试验、2项前后试验和1项非随机对照试验）共516例ND患者。所有12项研究均显示OMT及相关治疗后胃肠道窘迫症状有所改善。研究结果可能受到方法可变性（即异质残疾类型、治疗方式）和语言排除的限制。结论OMT及相关治疗是改善便秘、腹痛等胃肠道不适症状的有效干预措施。未来的随机对照试验应该检查OMT的剂量反应和与这些治疗相关的微生物组变化。

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引用次数: 0

Potential impact of an osteopathic intervention for internationally adopted children with fetal alcohol spectrum disorder (FASD); a prospective case series 骨科干预对国际收养的胎儿酒精谱系障碍（FASD）儿童的潜在影响前瞻性病例系列

IF 1.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Osteopathic Medicine

Pub Date : 2025-09-01 Epub Date: 2025-05-14 DOI: 10.1016/j.ijosm.2025.100763

Ramon Cases-Solé , David Varillas-Delgado , Marta Astals-Vizcaino , Victoria Aldecoa-Bilbao , Óscar García-Algar

Objective

To explore the potential impact of Osteopathic Manipulative Treatment (OMT) on Health-Related Quality of Life (HRQoL) on internationally adopted children with fetal alcohol spectrum disorder (FASD).

Methods

Twelve children with FASD adopted from Eastern European countries were recruited in this prospective observational study. HRQoL was collected using the Kidscreen-52 questionnaire. The participants followed a six-month intervention plan that included 4 bi-weekly OMT sessions and 4 monthly OMT sessions.

Results

Significant differences were detected in the pre-post intervention values (p = 0.001), interaction by group (p = 0.048), in the results of four dimensions (Moods & Emotions, p = 0.008, Self-Perception, p = 0.016, School Environment, p = 0.008 and Social Acceptance, p = 0.017) and in the overall assessment for parents’ version (p = 0.002). A mild adverse effect (pain/discomfort) was reported by one participant (8.3 % of the total sample) after one session.

Conclusion

This study shows that a six-month OMT intervention is a feasible personalized intervention for children and adolescents with FASD coming from international adoption. The study suggests that measuring instruments can detect changes in HRQoL over time, pointing out the need to develop a specific HRQoL assessment instrument for children with FASD to be applied in future studies. Even though promising significant changes were observed, these were most likely not only due to OMT, and further studies are required before assuming these could be due to osteopathic care.

目的探讨骨科手法治疗（OMT）对国际收养胎儿酒精谱系障碍（FASD）患儿健康相关生活质量（HRQoL）的潜在影响。方法从东欧国家收养的12名FASD儿童进行前瞻性观察研究。HRQoL采用Kidscreen-52问卷收集。参与者遵循六个月的干预计划，包括4次每两周一次的OMT治疗和4次每月的OMT治疗。结果在干预前后值（p = 0.001）、组间交互作用（p = 0.048）、四个维度(情绪和情绪；情绪（p = 0.008）、自我知觉（p = 0.016）、学校环境（p = 0.008）和社会接受（p = 0.017）以及家长的整体评估（p = 0.002）。一名参与者（占总样本的8.3%）在一次疗程后报告了轻微的不良反应（疼痛/不适）。结论对国际收养的FASD儿童和青少年进行为期6个月的OMT干预是一种可行的个性化干预。研究表明，测量仪器可以检测HRQoL随时间的变化，并指出有必要为FASD儿童开发一种专门的HRQoL评估工具，以便在未来的研究中应用。尽管观察到有希望的显著变化，但这些变化很可能不仅仅是由于OMT，在假设这些变化可能是由于整骨疗法治疗之前，还需要进一步的研究。

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引用次数: 0

Development of standardized osteopathic manipulative treatment tracking forms recording pain and functional outcomes to facilitate osteopathic research 开发标准化的整骨手法治疗跟踪表格，记录疼痛和功能结果，以促进整骨疗法研究

IF 1.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Osteopathic Medicine

Pub Date : 2025-06-01 Epub Date: 2024-12-28 DOI: 10.1016/j.ijosm.2024.100743

Charles Joseph , Linda S. Mintle , Carl Hoegerl , David Asher , Kristen Adams , Patrick Fugler , Janell McKinney

Objectives

Osteopathic physicians are well positioned to provide needed non-pharmacological pain management using osteopathic manipulative treatment (OMT) in the holistic treatment of pain. Reflecting on years of often ineffective and potentially harmful traditional pharmacological management of musculoskeletal (MSK) pain, OMT as an alternative method is underutilized and under-recognized option. There is a need for standardized data collection to support the use of OMT as an evidence-based complement to pain management. This project developed efficient and standardized intake and follow-up forms to assess short and long term OMT treatment outcomes.

Methods

Addressing the need, standardized, mineable research instruments that capture the specifics of patient presentation, clinical findings, treatment modalities including outcomes for OMT pain management were created. Including background health information, the intake includes active medications, quantitating analgesics, pain location charts, pain severity/location (ICD) 10th revision diagnostic codes (ICD-11 codes unavailable in US), functional capacity score/location, and OMT implemented/body location. Follow-up form documents prior treatments outcome, pain, and functional status outcome scores, quantitates analgesics.

Results

Forms are open access for general use, without restriction, tracking effectiveness of OMT for pain management and encourages development of an international database.

Conclusion

Developing these OMT intake and follow-up forms creates clinically useable and research mineable instruments for documentation of OMT procedures and outcomes in the overall treatment of MSK pain. OMT will gain better worldwide recognition as a validated alternative to pharmacologic treatments.

目的整骨疗法医师能够在疼痛的整体治疗中使用整骨手法治疗（OMT）提供所需的非药物疼痛管理。考虑到多年来肌肉骨骼（MSK）疼痛的传统药理学治疗往往无效且可能有害，OMT作为一种替代方法未得到充分利用和认可。需要标准化的数据收集，以支持使用OMT作为疼痛管理的循证补充。该项目制定了有效和标准化的摄入和随访表格，以评估短期和长期OMT治疗结果。方法：为了满足需求，我们创建了标准化的、可挖掘的研究工具，以捕捉患者的具体表现、临床发现、治疗方式，包括OMT疼痛管理的结果。包括背景健康信息，摄入包括活性药物、定量镇痛药、疼痛定位图、疼痛严重程度/位置（ICD）第10版诊断代码（ICD-11代码在美国不可用）、功能能力评分/位置和实施的OMT /身体位置。随访表记录了之前的治疗结果，疼痛和功能状态结果评分，量化镇痛药。结果表格开放供一般使用，不受限制，追踪OMT治疗疼痛的有效性，并鼓励建立国际数据库。结论：制定这些OMT的摄入和随访表格，为记录OMT的过程和MSK疼痛的整体治疗结果创造了临床可用和可研究的工具。作为一种有效的替代药物治疗方法，OMT将在世界范围内获得更好的认可。

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引用次数: 0

Is regression in lumbar disk herniation possible by spinal mobilization? A single-blind randomized controlled clinical study 腰椎间盘突出症可以通过脊柱活动恢复吗？一项单盲随机对照临床研究

IF 1.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Osteopathic Medicine

Pub Date : 2025-06-01 Epub Date: 2025-04-05 DOI: 10.1016/j.ijosm.2025.100760

Burhan Taşkaya , İsmail Taşkent , Mahmut Çakıllı , Öznur Tunca

Aims

This study aims to examine the impacts of spinal mobilization practices on herniation distance, disc height, and facet joint distance, as well as functional status, pain, range of motion (ROM), and flexibility in lumbar disc herniation (LDH) patients.

Methods

Thirty-two participants participated in the study, divided into an Intervention and Control Group. Radiological findings were evaluated by magnetic resonance imaging before and after the study. The Back Performance Scale, Visual Analogue Scale, The S, and The Sit and Reach Test were assessed before, after, and at three months. The control group received ten sessions of stabilization exercises for five weeks, two sessions per week. In the intervention group, spinal mobilization applications were applied in addition to stabilization exercises

Results

Intra-group analysis revealed significant reductions in herniation distance, increases in facet joint distance, pain alleviation, functional improvement, enhanced flexibility, and extended ROM in both groups (p < 0.05). Notably, a significant increase in disc height was observed exclusively in the Intervention Group (p < 0.05). Inter-group analysis revealed no significant differences between the groups post-intervention (p > 0.05).

Conclusion

Mobilization applications applied in LDH patients may have a positive effect on radiological findings, functional status, pain, ROM, and flexibility.

ClinicalTrials.gov Identifier

NCT05753579 (03.02.2023)

目的：本研究旨在探讨脊柱活动训练对腰椎间盘突出症（LDH）患者的突出距离、椎间盘高度、关节突关节距离以及功能状态、疼痛、活动范围（ROM）和柔韧性的影响。方法32例被试分为干预组和对照组。在研究前后通过磁共振成像评估放射学表现。在三个月前、三个月后和三个月时分别对背部表现量表、视觉模拟量表、S量表和坐伸测试进行评估。对照组接受10次稳定训练，为期5周，每周2次。结果组间分析显示，两组患者的突出距离显著减少，关节突关节距离增加，疼痛减轻，功能改善，柔韧性增强，关节活动范围延长(p <；0.05)。值得注意的是，仅在干预组观察到椎间盘高度显著增加(p <；0.05)。组间分析显示干预后各组间无显著差异(p >；0.05)。结论在LDH患者中应用活动应用可能对放射学表现、功能状态、疼痛、ROM和柔韧性有积极影响。

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引用次数: 0

Placebo effects in osteopathy and other manual therapies – What they are and why they matter to clinical practice, education, and research 整骨疗法和其他手工疗法中的安慰剂效应-它们是什么以及为什么它们对临床实践、教育和研究很重要

IF 1.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Osteopathic Medicine

Pub Date : 2025-06-01 Epub Date: 2025-04-17 DOI: 10.1016/j.ijosm.2025.100762

David Hohenschurz-Schmidt , Torsten Liem

Placebo effects are measurable changes in health outcomes arising from treatment context, driven by learning and expectancy mechanisms. While increasingly well documented and understood, their role in osteopathic and other manual therapies remains underexplored. Given the inherently complex and interpersonal nature of these interventions, understanding placebo and nocebo effects is essential for refining clinical practice, education, and research.

This narrative review synthesises current research on placebo mechanisms and their implications for osteopathic practice, education, and research. A non-systematic literature search was conducted using Google Scholar, structured by pre-defined learning outcomes, and prioritising high-quality studies and systematic reviews where available. Contradictory findings were sought and critically appraised to provide a balanced perspective.

Beginning with a historical overview and up-to-date summary of placebo-related concepts and mechanisms, the review highlights how expectancy, contextual factors, and psychobiological processes contribute to treatment effects in manual therapy. On this basis, the article advocates for a person-centred, biopsychosocial approach that leverages positive expectations while minimising nocebo effects. It also underscores the need for education models that incorporate placebo science to enhance clinical practice. Future research should prioritise well-designed efficacy trials, while also advancing knowledge of how expectancy and learning mechanisms influence treatment outcomes in manual therapies.

安慰剂效应是在学习和预期机制的驱动下，由治疗环境引起的可测量的健康结果变化。虽然越来越多的文献和理解，它们在整骨疗法和其他手工疗法中的作用仍未被充分探索。鉴于这些干预措施固有的复杂性和人际关系性质，了解安慰剂和反安慰剂效应对于改进临床实践、教育和研究至关重要。这篇叙述性综述综合了目前关于安慰剂机制的研究及其对整骨疗法实践、教育和研究的影响。使用谷歌Scholar进行非系统文献检索，该检索由预定义的学习成果构成，并优先考虑可用的高质量研究和系统综述。为了提供一个平衡的观点，我们寻求并批判性地评估了相互矛盾的发现。本文首先回顾了安慰剂相关概念和机制的历史概况和最新总结，重点介绍了预期、环境因素和心理生物学过程如何影响手工疗法的治疗效果。在此基础上，文章提倡以人为本的生物心理社会方法，利用积极的期望，同时最大限度地减少反安慰剂效应。它还强调了需要将安慰剂科学纳入教育模式，以加强临床实践。未来的研究应该优先考虑设计良好的疗效试验，同时也要推进关于期望和学习机制如何影响手工疗法治疗结果的知识。

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引用次数: 0