Pub Date : 2025-01-28DOI: 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 , Andrew MacMillan , Jerry Draper-Rodi , Mathieu Ménard , 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}
Pub Date : 2025-01-20DOI: 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.
{"title":"Osteopathic manipulative treatment in cervical dystonia patients treated with IncobotulinumtoxinA","authors":"Pascale Décarie , Sylvain Chouinard , Gabriel Venne","doi":"10.1016/j.ijosm.2025.100745","DOIUrl":"10.1016/j.ijosm.2025.100745","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>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).</div></div><div><h3>Method</h3><div>This experimental research had a pretest-posttest design. The participants (<em>n</em> = 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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"57 ","pages":"Article 100745"},"PeriodicalIF":1.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242209","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 : 2025-01-08DOI: 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.
背景慢性肌肉骨骼（MSK）疼痛是一个迫切的全球公共卫生问题。疼痛教育（PE）是一种用于MSK疼痛管理的干预措施。传统上，体育课是面对面授课，对偏远地区的人来说可能是一项挑战。远程康复已成为提供疼痛管理支持的可行替代方案。尽管体育锻炼和远程康复对个体有好处，但没有系统的综述评估这些干预措施对慢性MSK疼痛的影响。目的系统回顾远程康复疼痛教育对慢性肌肉骨骼疼痛患者疼痛和残疾的影响。方法本系统评价方案将遵循系统评价和荟萃分析方案的首选报告项目（PRISMA-P）声明，并在前瞻性系统评价登记册（PROSPERO）注册。我们将系统地检索MEDLINE、PEDro、Cochrane Central Register of Controlled Trials、Scopus、Web of Science和EMBASE数据库，从它们成立至今。我们将只纳入随机对照试验，涉及成人慢性MSK疼痛，通过远程康复接受PE。主要结果将是疼痛和/或残疾，而次要结果将评估疼痛对日常生活、工作能力和心理健康的影响。两位作者将独立地选择研究，评估偏倚风险，提取数据，并使用推荐、评估、发展和评价分级（GRADE）来判断证据的总体确定性。数据分析将使用结构化的叙述综合。在可能的情况下，将对定量结果进行汇总并进行荟萃分析。本综述将全面检查现有文献，以确定研究空白，并提供证据，帮助临床医生做出明智的、基于证据的慢性肌肉骨骼疼痛管理决策。回顾registrationCRD42024534188。
{"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, Francisco Xavier de Araujo, Carlos Vicente da Silva, Jodelle Chagas Machado, Fabiana Cristina da Silva, Morten Sebastian Hoegh, 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}
Pub Date : 2025-01-07DOI: 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.
目的系统回顾手疗（MT）对头顶运动员疼痛强度、残疾、内旋（IR）、外旋（ER）和水平内收（HA）活动度（ROM）的影响。数据源数据库（Medline， EMBASE, SPORTDiscus， CINAHL， CENTRAL， Web of Science和SCOPUS）从成立到2023年5月进行了检索。研究选择选择将MT与非治疗组或其他治疗组进行比较的随机对照试验（rct）。数据提取：两位研究者独立选择了调查MT对疼痛强度、残疾、IR、ER和HA rom影响的随机对照试验。数据综合计算了每个结果的平均差异或标准化平均差异，以及95%的置信区间。采用GRADE综合证据水平。结果共纳入12项随机对照试验，共纳入401名运动员。MT并不优越(p >；在改善疼痛、残疾、IR ROM和ER ROM方面优于不治疗，但在改善HA方面优于不治疗。MT并不优越(p >；在改善ER ROM和HA ROM方面优于其他治疗，但在改善IR ROM和残疾方面优于其他治疗。这些发现是基于非常低的证据确定性。结论：MT可能不能有效改善疼痛和ER ROM。关于MT对残疾和IR的影响的证据质量非常低，研究结果相互矛盾，并且对HA的影响很小，可能与临床无关，因此不能为MT治疗头顶运动员有效性的明确推荐提供足够的支持。实践意义-手工疗法可能不能有效改善疼痛强度和肩关节外旋活动范围。-手工疗法对残疾和肩关节内旋活动范围的影响相互矛盾。-手工治疗对水平内收活动范围的影响很小，且与临床无关。不同手法治疗方法间无显著差异。
{"title":"Does manual therapy improve pain, disability, and glenohumeral motion in overhead athletes? Systematic review and meta-analysis","authors":"Sávio Douglas Ferreira Santana , Vander Gava , Valéria Mayaly Alves de Oliveira , Gabriel Alves dos Santos , Tássio Augusto Soares Lima , Danilo Harudy Kamonseki","doi":"10.1016/j.ijosm.2025.100747","DOIUrl":"10.1016/j.ijosm.2025.100747","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Data sources</h3><div>Databases (Medline, EMBASE, SPORTDiscus, CINAHL, CENTRAL, Web of Science, and SCOPUS) were searched from inception up to May 2023.</div></div><div><h3>Study selection</h3><div>Randomized controlled trials (RCTs) comparing MT to a non-treatment group or other treatment groups were selected.</div></div><div><h3>Data extraction</h3><div>Two reviewers independently selected RCTs that investigated the effects of MT on pain intensity, disability, IR, ER, and HA ROM.</div></div><div><h3>Data synthesis</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div><div><h3>Implications for practice</h3><div><ul><li><span>-</span><span><div>Manual therapy may not effectively improve pain intensity and glenohumeral external rotation range of motion.</div></span></li><li><span>-</span><span><div>Manual therapy showed conflicting effects on disability and glenohumeral internal rotation range of motion.</div></span></li><li><span>-</span><span><div>Manual therapy showed small and clinically irrelevant effects on horizontal adduction range of motion.</div></span></li><li><span>-</span><span><div>No significant difference was observed among different manual therapy techniques.</div></span></li></ul></div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"55 ","pages":"Article 100747"},"PeriodicalIF":1.1,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132039","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 : 2025-01-07DOI: 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 , Victoria E. Abraira , John Burns , Brian F. Degenhardt , Greg Kawchuk , Damian Keter , M. Terry Loghmani , William R. Reed , Beth A. Winkelstein , 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}
Pub Date : 2025-01-06DOI: 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.
{"title":"Efficacy of preoperative exercise rehabilitation for patients after total knee arthroplasty: An updated systematic review and meta-analysis","authors":"Yang Zhou, Shengying Wang","doi":"10.1016/j.ijosm.2025.100748","DOIUrl":"10.1016/j.ijosm.2025.100748","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"55 ","pages":"Article 100748"},"PeriodicalIF":1.1,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132632","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 : 2025-01-06DOI: 10.1016/j.ijosm.2025.100746
Luca Bianco Prevot , Vittorio Bolcato , Stefania Fozzato , Livio Pietro Tronconi , Giuseppe Basile
Background
People increasingly look for osteopathic practitioners due to musculoskeletal conditions, particularly for low back pain. Serious complications such as femur fractures are rare, and often depend on bone fragility due to osteoporosis or neoplastic involvement.
Case report
We present a 43-year-old woman who suffered a femur fracture following osteopath manipulation at the lumbar and right thigh for low back pain of recent onset. The osteopath did not document informed consent disclosure and personal clinical history collection. After hospitalisation, the patient underwent synthesis with femoral nailing. Further investigations found secondary pelvic and spinal bones lesions of a breast cancer, 12 years after the treatment and out of follow-up.
Discussion
In Italy, the osteopath is a health professional aimed at maintaining well-being through external manipulation. The osteopath must then document in writting the informative process concerning the osteopathic method and the related risks, as well as the subject's consent. Meanwhile, a preliminary pathological history collection and objective examination must be performed to exclude pathological conditions, otherwise to be referred to a physician for further assessment and management.
Conclusions
The osteopath, who usually works as a self-insured free-lance professional, is called to inform the patient of the risks associated with manipulation and of alternative options, and to plan the care pathway after proper clinical assessment of the subject, by anticipating the possibility of further investigation by a physician.
{"title":"Shaft femoral fracture secondary to osteopathic manipulation: Case report and medico-legal implication","authors":"Luca Bianco Prevot , Vittorio Bolcato , Stefania Fozzato , Livio Pietro Tronconi , Giuseppe Basile","doi":"10.1016/j.ijosm.2025.100746","DOIUrl":"10.1016/j.ijosm.2025.100746","url":null,"abstract":"<div><h3>Background</h3><div>People increasingly look for osteopathic practitioners due to musculoskeletal conditions, particularly for low back pain. Serious complications such as femur fractures are rare, and often depend on bone fragility due to osteoporosis or neoplastic involvement.</div></div><div><h3>Case report</h3><div>We present a 43-year-old woman who suffered a femur fracture following osteopath manipulation at the lumbar and right thigh for low back pain of recent onset. The osteopath did not document informed consent disclosure and personal clinical history collection. After hospitalisation, the patient underwent synthesis with femoral nailing. Further investigations found secondary pelvic and spinal bones lesions of a breast cancer, 12 years after the treatment and out of follow-up.</div></div><div><h3>Discussion</h3><div>In Italy, the osteopath is a health professional aimed at maintaining well-being through external manipulation. The osteopath must then document in writting the informative process concerning the osteopathic method and the related risks, as well as the subject's consent. Meanwhile, a preliminary pathological history collection and objective examination must be performed to exclude pathological conditions, otherwise to be referred to a physician for further assessment and management.</div></div><div><h3>Conclusions</h3><div>The osteopath, who usually works as a self-insured free-lance professional, is called to inform the patient of the risks associated with manipulation and of alternative options, and to plan the care pathway after proper clinical assessment of the subject, by anticipating the possibility of further investigation by a physician.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"56 ","pages":"Article 100746"},"PeriodicalIF":1.1,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090469","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 : 2025-01-03DOI: 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 , Jorge E. Esteves , M. Terry Loghmani , Giacomo Rossettini , 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}
Pub Date : 2024-12-28DOI: 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.
{"title":"Development of standardized osteopathic manipulative treatment tracking forms recording pain and functional outcomes to facilitate osteopathic research","authors":"Charles Joseph , Linda S. Mintle , Carl Hoegerl , David Asher , Kristen Adams , Patrick Fugler , Janell McKinney","doi":"10.1016/j.ijosm.2024.100743","DOIUrl":"10.1016/j.ijosm.2024.100743","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>Forms are open access for general use, without restriction, tracking effectiveness of OMT for pain management and encourages development of an international database.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"56 ","pages":"Article 100743"},"PeriodicalIF":1.1,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090468","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 : 2024-12-25DOI: 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.
{"title":"Integration of osteopathy in the Portuguese National Health Service: Perceptions and expectations of citizens and health professionals","authors":"Beatriz Maria , Sílvia Gomes , Ana Rita Goes","doi":"10.1016/j.ijosm.2024.100744","DOIUrl":"10.1016/j.ijosm.2024.100744","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>Explore citizen and healthcare professionals' perceptions and expectations regarding integrating osteopathy into the Portuguese National Health Service.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div><div><h3>Implication for practice</h3><div><ul><li><span>•</span><span><div>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.</div></span></li><li><span>•</span><span><div>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.</div></span></li><li><span>•</span><span><div>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.</div></span></li></ul></div></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":"55 ","pages":"Article 100744"},"PeriodicalIF":1.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号