International Journal of Osteopathic Medicine最新文献

Background

Although low back pain (LBP) contributes to the global disease burden, literature on the scientometric analysis of low back pain is limited.

Objective

This study aimed to demonstrate the research state and capture developmental dynamics of low back pain utilizing scientometric analysis and visualization methods.

Methods

Literature on low back pain from 2011 to 2020 was retrieved from the Web of Science core collection. CiteSpace software was used to generate the relevant knowledge map and carry out scientometric analysis on the volume of literature, cooperation between countries/regions and research institutions, disciplines, journals, highly cited references, and keywords. Research hotspots and trends of the included literature were then stated.

Results

A total of 27,968 publications were obtained and the number of annual publications maintained growth continually. Australia and the University of Washington had the maximum centrality. The USA and the University of Sydney were the most prolific country and institution respectively, thus indicating that they are important in this field. Publications were devoted to the disciplines of neurology, orthopedics and rehabilitation. The highest cited journal is Spine (18478), followed by European Spine Journal (11344) and Pain (11097). The systematic review, disease burden, epidemiology, clinical practice recommendations, and primary care management are the key subjects covered by highly cited papers. The keywords were primarily concerned with pain etiology, disease type, clinical treatment, and trials. Burst keywords in LBP were controlled trial, practice guideline, stability, adolescent, individual, activation and expression, which can be regarded as research hotspots and frontiers.

Conclusion

In conclusion, the data clearly shows a consistent increase in LBP studies. The historical review provides insight into LBP as well as valuable information for researchers to identify new perspectives on potential cooperative institutions, hot topics, and a strong foundation for future research.

Objective

The objective of this scoping review is to chart and appraise the available evidence regarding osteopathic education.

Introduction

The extent and quality of the evidence regarding osteopathic education is not known. The available evidence mostly consists of small trials, qualitative interviews, cross-sectional surveys and conceptual commentaries, therefore a review to chart and appraise the available evidence is warranted.

Inclusion criteria

The review is intended to include papers related to undergraduate, postgraduate and preregistration osteopathic education. Qualitative, quantitative, mixed methods and opinion pieces and grey literature will be sought. This review will exclude papers regarding education as a treatment modality and will exclude papers regarding osteopathy as a medical profession, as is seen in a North American context.

Methods

The study will be conducted using OVID, PubMed, ERIC databases, and hand searches for key words will be conducted in key osteopathic journals. Reference lists of included papers will be screened for relevant papers, forwards and backwards citation tracking and key authors will be searched for similar publications which may be germane.

Papers not available in English, French, Spanish, German or Portuguese will be excluded. There will be no limit placed upon date of publication.

Implications for practice

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  This manuscript is the protocol for a systematic scoping review which is intended to answer the following questions:

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  What is the extent and nature of the existing evidence regarding osteopathic education?

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  Are there any elements of the literature which demonstrate good practice that can be adopted in wider osteopathic educational practice?

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  Are there any gaps within the evidence base which subsequent research can explore?

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  To date no systematic reviews have been conducted on this topic and this review will highlight the extent of the literature and guide future research priorities.

Objective

Clinical running analysis is commonly employed in the screening of running related injuries. Currently, there remains little research exploring the use of clinical running analysis within the osteopathic profession. Hence, the aim of this pilot study is to investigate the inter-rater reliability of sagittal plane visual gait observation amongst osteopathic practitioners.

Methods

Fourteen osteopaths were recruited through an online platform. Each participant completed five, 11-item gait analysis forms, with each form corresponding to a different running gait video recorded in the sagittal plane. Krippendorff's alpha (Kα) was calculated to determine the inter-rater reliability between all participants, and between groups based on years of clinical experience.

Results

Very low inter-rater reliability was found between all participants (Kα<0.67) across all questions. Strong reliability was found for two questions answered by the 5–10 years’ experience group (Kα<0.8155) with regard to foot strike in the runners.

Discussion

The poor inter-rater reliability found in this pilot study, is in disagreement with previous research that has identified high inter-rater reliability with practitioners of varied clinical experience on a similar gait analysis task. These discrepancies may be explained by a range of methodological differences and limitations, chiefly the sample size and the objective nature of the kinematic observation tasks.

Conclusion

The results of this pilot study indicate there is very low reliability between this group of clinicians interpretation of running gait. Building on from this, future research should investigate clinician inter-rater reliability using more objective gait analysis measures.

This paper is a critical conflict-based intersectional feminist analysis of professional training that requires students to undress and expose their bodies in order to acquire knowledge. A premise of this essay is that such training is exclusive, harmful and rooted in aesthetic values that tend to percolate osteopathic discourse in multiple ways. The dangerous side of aesthetically guided professional behaviour renders potential harm to people who sit on the margins of what is considered beautiful and normal in the Global North, subsequently contributing to the wider health inequities and social injustice. This paper proposes alternative ways of acquiring knowledge that could support the osteopathic profession and education in becoming more inclusive and socially just, by adopting intersectional feminist framework. At the core of the essay are following questions: Are there ethical costs in prioritising aesthetic and body-based values? In the age of profound socio-political conflicts, what values truly matter in osteopathy? Also, has the time finally come to leave the confines of anatomical aestheticism, and enter the anatomical realm of social justice and transformative action?

Objective

SARS-CoV-2 infection responsible for the COVID-19 pandemic has demonstrated a significant burden on the mental health of health care providers. The purpose of the study is to evaluate the mental health symptoms among osteopathic physicians from a single academic institution during the COVID-19 pandemic.

Methods

This was a cross-sectional, survey-based study conducted during the COVID-19 pandemic from January 2021 to March 2021. The survey was emailed to 4239 alumni physicians from the single medical school in California, USA. Burnout, anxiety, and depression were assessed by the single-item Mini-Z Burnout Assessment, 7-item Generalized Anxiety Disorder Scale, and 2-item Patient Health Questionnaire, respectively.

Results

A total of 104 survey responses were analyzed. Of them, 53 (51.0%) were attending physicians and 51 (49.0%) were residents or fellow physicians. Anxiety, burnout, and depression were reported in 29 (29.9%), 31 (32%), and 11 (11.3%), respectively. Females had increased anxiety (OR 1.66, CI 1.21–2.27; P = 0.002). Resident had higher burnout symptoms (OR 1.28, CI 1.06–1.53; p = 0.009) and depression symptoms (OR 1.15, CI 1.01–1.30; p = 0.032) compared to attending physicians. Physicians who encountered >50 COVID-19 patients had higher depression symptoms (OR 1.17, CI 1.02–1.35; p = 0.027).

Conclusion

Our survey study demonstrated that osteopathic physicians graduated from a single academic institution experienced symptoms of anxiety, burnout, and depression during the COVID-19 pandemic based on the validated questionnaires. A higher prevalence was shown in the lesser experienced group of residents and fellow physicians compared to more experienced attending physicians. In addition, adjustments to the pandemic have caused a financial burden among osteopathic physicians. Future studies are warranted to assess the long-term effects of the pandemic on mental health among osteopathic physicians.

Objective

Osteopathic manipulative treatment (OMT) in surgical patients aims at reducing postoperative pain and enhancing recovery. The effects of OMT have not been extensively studied in cardiac surgery patients, mostly owing to the fact that a limited number of osteopathic physicians are trained in thoracic surgery.

Methods

A systematic review of the literature was performed to identify all currently available data on postoperative OMT in cardiac surgery patients. Case reports and case series were excluded. Risk of bias of the eligible studies was assessed individually using specific protocols. Among the outcomes of interest were postoperative pain, hospital length of stay, changes in respiratory capacity, and changes in cardiac index and mixed oxygen venous saturation (SvO₂) measurements.

Results

We identified four eligible studies which were included in the quantitative analysis of the present review. There were three randomized controlled trials (RCTs) and one non-randomized controlled cohort study which investigated on outcomes of OMT in cardiac surgery patients. The most common cardiac operations performed were coronary artery bypass grafting, valve procedures, combined procedures, and aortic operations. Numerous OMT modalities were used on postoperative patients. The OMT group of patients showed improvement in pain management and respiratory capacity, and shorter hospital length of stay.

Conclusions

Osteopathic treatment might be helpful as an adjunct to current medical therapies in mitigating postoperative pain and improving the overall patient's functional status.

Objectives

Osteopathic healthcare has been shown to include a broad range of therapeutic interventions, however little is known about the clinical reasoning used by practitioners in their selection of these modalities. The aim of this research is to address this gap in the literature and explore what influences a practitioner's choice of therapeutic approach.

Methods

A sequential mixed methods design was used to explore the question. Quantitative data was obtained by an exploratory national survey and qualitative data was obtained by a practitioner focus group. Survey data was analysed by SPSS while the qualitative data was analysed using a thematic analysis. The results were then synthesised via triangulation.

Results

Findings showed that there are numerous variables involved in clinical reasoning. Quantitative data showed that practitioners look to include patient and practitioner-based factors as well as external influences. Four main themes emerged from the qualitative phase: (1) Patient/person Centred Care, (2) Practitioner Wellbeing, (3) Experiential Learning and (4) Integrating Evidence. Synthesised results revealed the complex nature of CR and how the numerous factors from both sets of data overlap.

Conclusion

This study revealed a diversity of factors influencing clinical reasoning in osteopathic practice in the choice of therapeutic approach.

This narrative review presents key concepts from neurophysiology, phenomenology, psychology, and narrative medicine which underpin a developing enactive-ecological framework for osteopathic practice. This framework aims to provide a coherent theoretical basis for understanding healthcare processes and outcomes, based on the neuroscience principles of active inference and enactivism. It offers insights into factors that influence patients' pain perception and behaviour and foster or inhibit the development of effective therapeutic relationships. Although this approach offers promising opportunities to increase the scope of care by harnessing potential in the unique embodied ecological niches created between patients and osteopaths, it raises challenges to traditional treatment agendas. Healthcare which frames the patient-as-a person, and acknowledges the multidimensional nature of the self, requires practitioners to be collaborative and self-aware, and be able to elicit patients' lived experiences and body stories. Phenomenological and psychological studies into enactivism emphasise the complex, dynamic nature of therapeutic relationships and the need to understand each person's unique lifeworld context. The new framework represents an important step forward, but further research is now needed to explore ways of integrating active and enactive inference into practice, of developing psychological or mindful self- and body-awareness, and narrative communication skills for shared sense-making.