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Roberts, Ashley, Kaylee Harris, Bethany Outen, Amar Bukvic, Ben Smith, Adam Schultz, Stephen Bergman, and Debasis Mondal. "Osteopathic Manipulative Medicine: A Brief Review of the Hands-On Treatment Approaches and Their Therapeutic Uses." Medicines 9, no. 5 (April 27, 2022): 33. http://dx.doi.org/10.3390/medicines9050033.
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Osteopathic manipulative medicine (OMM) is an emerging practice in the healthcare field with increasing popularity and evidence-based therapy. Osteopathic manipulative treatments (OMT) include hands-on manipulations of different body structures to increase systemic homeostasis and total patient well-being. Indeed, this new realm of the whole patient-based approach is being taught in osteopathic schools around the country, and the osteopathic principles of a mind-body-spirit-based treatment are being instilled in many new Doctor of Osteopathy (D.O.) students. However, despite their proven therapeutic value, there are still many individuals, both in and outside the medical profession, who are unaware (or misinformed) of the therapeutic uses and potential benefits of OMT. Here, we provide a brief introduction to this osteopathic therapeutic approach, focusing on the hands-on techniques that are regularly implemented in the clinical setting. It is becoming increasingly evident that different OMTs can be implemented to enhance patient recovery, both alone and in conjunction with the targeted therapies used in allopathic regimens. Therefore, it may be beneficial to inform the general medical community and educate the public and those associated with the healthcare field about the benefits of using OMT as a treatment modality. OMT is lower-cost, noninvasive, and highly effective in promoting full-body healing by targeting the nervous, lymphatic, immune, and vascular systems. There is a growing body of literature related to osteopathic research and the possible molecular pathways involved in the healing process, and this burgeoning field of medicine is expected to increase in value in the healthcare field. This brief review article explains the frequently utilized OMT modalities and their recognized therapeutic benefits, which underscore the need to understand the possible molecular mechanisms and circulating biomarkers linked to the systemic benefits of osteopathic medicine.
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Grolaux, Pascal J., Timothy J. Sparrow, and François Lalonde. "Traditional Osteopathy and the General Osteopathic Treatment: A Historical Concept and a Modern Application." AAO Journal 31, no. 4 (December 1, 2021): 39–46. http://dx.doi.org/10.53702/2375-5717-31.4.39.
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Abstract Historically, Andrew Taylor Still, MD, DO, differentiated osteopathic medicine from allopathic medicine with its unique approach to treatment using manual therapy. Those treatments, known as osteopathic manipulative treatment (OMT), are currently used to treat somatic dysfunction. The Educational Council on Osteopathic Principles (ECOP) includes different treatment methods, such as muscle energy, high-velocity, low-amplitude, Still techniques, myofascial release, and counterstrain, amongst others, under the category of OMT. Conversely, osteopathic practitioners outside the USA, mostly from Europe, use some techniques that are not necessarily documented as OMT by the ECOP. This is the case of the General Osteopathic Treatment (GOT). The GOT found its origin with Dr. Still and was promoted, amongst his contemporaries, by Dr. John Martin Littlejohn, DO, who founded the British School of Osteopathy in London. The general treatment, based on a strong biomechanical background, was further spread in Europe by John Wernham, DO, a British osteopath and one of Littlejohn’s students. Wernham developed and taught the GOT in its original form based on the principles and philosophy of osteopathic medicine. The goals of this article are to give an historical perspective of the GOT, to describe the foundation and concepts behind it, and to provide a review of the scientific literature of this treatment approach. The GOT can be used to diagnose and directly treat somatic dysfunction using the TART principle in a clinical setting. Besides the recognized contra-indications of treating somatic dysfunction, there are no clear scientifically published findings of contraindications for the use of the GOT. Like other OMTs, the GOT needs more scientific evidence to better understand its clinical applications.
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Li, Raymond, Ann Jose, Jessica Poon, Cindy Zou, Maria Istafanos, and Sheldon C. Yao. "Efficacy of osteopathic manipulative treatment in patients with Parkinson’s disease: a narrative review." Journal of Osteopathic Medicine 121, no. 12 (September 22, 2021): 891–98. http://dx.doi.org/10.1515/jom-2021-0081.
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Abstract Context Parkinson’s disease (PD) is a neurodegenerative disease that leads to impaired motor and non-motor function in patients. PD is non-curative and gradually reduces quality of life, leading patients to seek treatment for symptom management. Osteopathic manipulative treatment (OMT) applies the biomechanical, neurologic, circulatory, metabolic, and psychosocial models in approaching and treating the major symptomatology of PD patients. Objectives This article evaluates the literature published in the past 10 years analyzing evidence on OMT and its functional application on gait, balance, motor function, bradykinesia, and autonomic dysfunctions, and to identify promising avenues for further investigation. Methods The authors obtained studies from the research databases MEDLINE/PubMed, ScienceDaily, and EBSCO, as well as the Journal of American Osteopathic Association’s published archives. Searches were conducted in December 2020 utilizing the search phrases “OMM” (osteopathic manipulative medicine), “OMT,” “osteopathic,” “Parkinson Disease,” “manual therapy,” “physical therapy,” “training,” “autonomics,” “gait,” and “balance.” Articles published between 2010 and 2021 including subjects with Parkinson’s disease and the use of OMT or any other form of manual therapy were included. Five authors independently performed literature searches and methodically resolved any disagreements over article selection together. Results There were a total of 10,064 hits, from which 53 articles were considered, and five articles were selected based on the criteria. Conclusions The progressive nature of PD places symptom management on the forefront of maintaining patients’ quality of life. OMT has demonstrated the greatest efficacy on managing motor-related and neurologic symptoms and assists in treating the greater prevalence of somatic dysfunctions that arise from the disease. Research in this field remains limited and should be the target of future research.
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Gordon, Samantha, and Stefan Hagopian. "Osteopathic Manipulative Treatment for Optic Pathway Glioma." AAO Journal 32, no. 3 (September 1, 2022): 37–41. http://dx.doi.org/10.53702/2375-5717-32.3.37.
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Abstract Optic gliomas are a known complication of neurofibromatosis type 1 (NF1) and can result in significant impairment. This case report centers around a 3-year-old girl with NF1 and optic glioma diagnosed by MRI, whose optic glioma has not increased in size since commencing treatment with osteopathic manipulative treatment (OMT) at regular intervals. We cover the rationale behind treating these patients with OMT with a thorough review of the relevant anatomy. We suggest a basis of treatment that could benefit patients with a number of intracranial and extracranial pathologies.
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Lloyd, Caroline A., Brianne L. Wehner, and Regina K. Fleming. "Conductive Hearing Loss: A Case Report." AAO Journal 31, no. 3 (September 1, 2021): 27–31. http://dx.doi.org/10.53702/2375-5717-31.3.27.
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Abstract In this case report, osteopathic manipulative treatment restored hearing to an 8-year-old female suffering from conductive hearing loss. Numerous factors can result in hearing loss. In children and adolescents, mild or greater hearing loss occurs with a prevalence of 3.1%.1 Current osteopathic literature focuses on conductive hearing loss due to middle ear effusion (MEE).This case report examines an 8-year-old female presumed to have permanent conductive hearing loss without MEE after a traumatic ATV accident. The use of osteopathic manipulative treatment (OMT) resulted in complete resolution of the patient’s conductive hearing loss. To the authors’ knowledge, this is the first case report documenting the successful use of OMT to treat conductive hearing loss without MEE. Being able to recognize and understand the connection between the primary respiratory mechanism (PRM), which includes the cranial bones and nerves, allows an osteopathic physician to provide a unique approach to patient care and the use of OMT as a treatment modality for conductive hearing loss should be considered.
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Bagagiolo, Donatella, Alessia Didio, Marco Sbarbaro, Claudio Priolo, Tiziana Borro, and Daniele Farina. "Osteopathic Manipulative Treatment in Pediatric and Neonatal Patients and Disorders: Clinical Considerations and Updated Review of the Existing Literature." American Journal of Perinatology 33, no. 11 (September 2016): 1050–54. http://dx.doi.org/10.1055/s-0036-1586113.
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Osteopathic medicine is a form of complementary and alternative medicine. Osteopathic practitioners treat patients of all ages: according to the Osteopathic International Alliance's 2012 survey, about one-third of all treated patients are aged between 31 and 50 years and nearly a quarter (23.4%) are pediatric patients, with 8.7% of them being younger than 2 years. In 2013 a systematic review evaluated the effectiveness of osteopathic manipulative treatment (OMT) in pediatric patients with different underlying disorders, but due to the paucity and low methodological quality of the primary studies the results were inconclusive. The aim of this review is therefore to update the evidence concerning OMT in perinatal and pediatric disorders and to assess its clinical impact. Most published studies favor OMT, but the generally small sample sizes in these studies cannot support ultimate conclusions about the efficacy of osteopathic therapy in pediatric age. In turn, clinical trials of OMT in premature infants might represent an important step in the osteopathic research because they can address both cost-effectiveness issues, and an innovative, multidisciplinary approach to the management of specific pediatric diseases cared for by the same, common health care system. The available studies in neonatal settings provide evidence that OMT is effective in reducing the hospital length of stay of the treated infants, therefore, suggesting that robust cost-effectiveness analyses should be included in the future clinical trials' design to establish new possible OMT-shared strategies within the health care services provided to newborns.
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Ball, Kyrstin T., Daniel E. Kraft, and Karen T. Snider. "Effects of Osteopathic Manipulation and Other Manual Manipulative Treatments on Cystic Fibrosis." AAO Journal 31, no. 3 (September 1, 2021): 17–22. http://dx.doi.org/10.53702/2375-5717-31.3.17.
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Abstract Context: Cystic fibrosis (CF) is a genetic disease that affects multiple organ systems, and symptoms include chronic cough, gastrointestinal (GI) malabsorption, exercise intolerance, and chronic pain. Examples of standard treatments are nebulizers, supplementary enzymes, chest percussive therapy, respiratory therapy, and lifestyle modifications. Objective: The purpose of the current review was to determine whether manual therapies, such as osteopathic manipulative treatment (OMT), in conjunction with standard treatments, provide symptom relief for patients with CF. Methods: PubMed was searched to identify studies investigating the role of manual medicine in the care of CF patients. Search terms included chiropractic, physical therapy, physiotherapy, osteopathic, manipulation, massage, and manual medicine. All terms were searched in combination with cystic fibrosis. Studies investigating only exercise or chest percussive therapy as adjunctive treatments were excluded. Results: Eight studies were found that investigated manual therapies alone or in conjunction with exercise for treatment of CF symptoms. All studies reported improvement after manual therapy in 1 or more symptoms, such as posture, GI symptoms, peak airflow, anxiety, back or chest pain, or breathing. Study types included a case study, prospective observational studies, and randomized controlled trials. Most studies were small and statistically underpowered. In an inpatient/outpatient observational study of adults with CF, patients reported a significant reduction in pain after a single physiotherapy treatment, and inpatients also reported significantly improved breathing after treatment. In a randomized controlled trial involving adult CF outpatients, there was a significant improvement in chest and back pain scores between the OMT and control groups. Conclusions: Results of the current review suggested patients with CF can experience symptom relief after OMT and similar manual therapies. Patients subjectively reported improvement with manual therapies, and studies found statistically significant decreases in pain after a single treatment. However, larger studies with sufficient statistical power are needed to further define the role of manual therapies as adjunctive treatment for symptom relief in CF patients.
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Vismara, Luca, Vincenzo Cozzolino, Luca Guglielmo Pradotto, Riccardo Gentile, and Andrea Gianmaria Tarantino. "Severe Postoperative Chronic Constipation Related to Anorectal Malformation Managed with Osteopathic Manipulative Treatment." Case Reports in Gastroenterology 14, no. 1 (April 27, 2020): 220–25. http://dx.doi.org/10.1159/000506937.
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Constipation is frequent amongst infants who have undergone surgery for anorectal malformation (ARM). Faecal retention, due to a dysfunctional enteric reflex of defaecation, can cause abdominal cramps, pseudoincontinence and, in the worst cases, megacolon. Prokinetic protocols are used to stimulate at least 1 bowel movement per day, including laxatives, enema, stools softeners and dietary schedules. While osteopathic manipulative treatment is adopted in adults for functional constipation, it has not been described for infants. Herein, we report the case of an infant undergoing anorectoplasty for a low ARM who was referred to the osteopath 2 years after the onset of severe constipation associated with pseudoincontinence and abdominal cramps and was refractory to the prokinetic protocol. In a child with a good ARM prognosis, autonomous daily bowel movements should be achieved. In this child, the imbalanced tension of the pelvic floor and immaturity of the parasympathetic plexus led to a functional alteration of the defaecation reflex. After adjunction of osteopathic manipulative treatment (OMT) to the therapeutic panel, the constipation showed gradual remission, with acquisition of autonomous defaecation 4 months after the therapy began. This suggests the importance of investigating the efficacy of OMT inclusion in the postsurgical prokinetic protocols for ARM patients with a good prognosis.
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Esterov, Dmitry, Alphonsa Thomas, and Kyle Weiss. "Osteopathic manipulative medicine in the management of headaches associated with postconcussion syndrome." Journal of Osteopathic Medicine 121, no. 7 (April 9, 2021): 651–56. http://dx.doi.org/10.1515/jom-2020-0035.
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Abstract Context Previous studies have demonstrated the effectiveness of osteopathic manipulative treatment (OMT) for various headache types, with limited evidence of its use for headaches related to mild traumatic brain injury (MTBI). No studies prior studies were found regarding OMT for headaches in patients with postconcussion syndrome (PCS), defined as symptom persistence for longer than 3 months after MTBI. Objectives To evaluate OMT for headaches in patients with PCS. Methods A controlled pilot study was conducted of patients with PCS who presented to an outpatient interdisciplinary rehabilitation clinic; patients with symptoms lasting longer than 3 months were enrolled and randomly assigned to an OMT treatment group or a control group. Primary outcome measures were immediate change in headache scores according to a Visual Analog Scale (VAS) and change in the six item Headache Impact Test (HIT-6) between baseline and follow up visits. The participants in the control group completed the HIT-6 between baseline and follow up visits but did not receive OMT and did not complete the VAS. Mean immediate VAS score change for the treatment group and mean improvement in HIT-6 scores for both groups between baseline and follow up were analyzed for statistical significance. Results A total of 26 patients were included in this study: 13 (50%) in the treatment group and 13 (50%) in the control group. Six patients (23.1%), three from each group, did not complete the study, so 10 subjects in each group were included in the final analysis. Statistically significant improvement in VAS scores was seen immediately after OMT in the treatment group (mean change, 2.1;p=0.002). Mean HIT-6 scores showed improvement in the treatment group compared with the control group, although the change was not statistically significant (p=0.15) from baseline to follow up visit. No adverse effects from treatments were noted. Conclusions Patients with headaches secondary to PCS showed immediate benefit in headache pain intensity after OMT. However, no sustained benefit was found on the follow up visit compared with the control group.
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Jansen, Jonathan W., and Sandra Snyder. "Is osteopathic manipulative therapy (OMT) effective for pregnancy-related musculoligamentous pain?" Evidence-Based Practice 17, no. 5 (May 2014): E10—E11. http://dx.doi.org/10.1097/01.ebp.0000540659.23729.3e.
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Cooley, Danielle, James Bailey, and Richard Jermyn. "Cost comparison of osteopathic manipulative treatment for patients with chronic low back pain." Journal of Osteopathic Medicine 121, no. 7 (April 15, 2021): 635–42. http://dx.doi.org/10.1515/jom-2020-0238.
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Abstract Context Chronic low back pain (cLBP) is the second leading cause of disability in the United States, with significant physical and financial implications. Development of a multifaceted treatment plan that is cost effective and optimizes patients’ ability to function on a daily basis is critical. To date, there have been no published prospective studies comparing the cost of osteopathic manipulative treatment to that of standard care for patients with cLBP. Objectives To contrast the cost for standard of care treatment (SCT) for cLBP with standard of care plus osteopathic manipulative treatment (SCT + OMT). Methods This prospective, observational study was conducted over the course of 4 months with two groups of patients with a diagnosis of cLBP. Once consent was obtained, patients were assigned to the SCT or the SCT + OMT group based on the specialty practice of their physician. At enrollment and after 4 months of treatment, all patients in both groups completed two questionnaires: the 11 point pain intensity numerical scale (PI-NRS) and the Roland Morris Disability Questionnaire (RMDQ). Cost data was collected from the electronic medical record of each patient enrolled in the study. Chi-square (χ 2 Yates) tests for independence using Yates’ correction for continuity were performed to compare the results for each group. Results There was a total of 146 patients: 71 (48.6%) in the SCT + OMT group and 75 (51.4%) in the SCT group. The results showed no significant differences between the mean total costs for the SCT + OMT ($831.48 ± $553.59) and SCT ($997.90 ± $1,053.22) groups. However, the utilization of interventional therapies (2; 2.8%) and radiology (4; 5.6%) services were significantly less for the SCT + OMT group than the utilization of interventional (31; 41.3%) and radiology (17; 22.7%) therapies were for the SCT group (p<0.001). Additionally, the patients in the SCT + OMT group were prescribed fewer opioid medications (15; 21.1) than the SCT (37; 49.3%) patients (p.001). Patients in the SCT group were approximately 14.7 times more likely to have received interventional therapies than patients in the SCT + OMT group. Likewise, the patients in the SCT group were approximately four times more likely to have received radiological services. Paired t tests comparing the mean pre- and 4 month self reported pain severity scores on the RMDQ for 68 SCT + OMT patients (9.91 ± 5.88 vs. 6.40 ± 5.24) and 66 SCT patients (11.44 ± 6.10 vs. 8.52 ± 6.14) found highly significant decreases in pain for both group (<0.001). Conclusions The mean total costs for the SCT and SCT + OMT patients were statistically comparable across 4 months of treatment. SCT + OMT was comparable to SCT alone in reducing pain and improving function in patients with chronic low back pain; however, there was less utilization of opioid analgesics, physical therapy, interventional therapies, radiologic, and diagnostic services for patients in the SCT + OMT group.
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Jones, LaQuita M., Christopher Regan, Kimberly Wolf, Jenifer Bryant, Alexander Rakowsky, Melissa Pe, and Dane A. Snyder. "Effect of osteopathic manipulative treatment on pulmonary function testing in children with asthma." Journal of Osteopathic Medicine 121, no. 6 (May 7, 2021): 589–96. http://dx.doi.org/10.1515/jom-2020-0040.
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Abstract Context Asthma is a leading cause of pediatric chronic illness, and poor disease control can lead to decreased quality of life and impaired academic performance. Although osteopathic manipulative treatment (OMT) has been shown to have positive effects on pulmonary function in adult patient populations, less is known about its impact in children. Objectives To evaluate changes in pulmonary function testing (PFT) in pediatric patients on the same day they received OMT compared with PFT in those who received usual care. Methods We recruited patients between the ages of 7–18 years with a diagnosis of asthma who were receiving routine care at a primary care asthma clinic and had undergone baseline spirometry. Patients were excluded if they met any of the following criteria: clinical indication for pre- and postbronchodilator spirometry on the day of their visit, albuterol use in the last 8 hours, oral steroid use in the previous 2 weeks, or diagnosis of asthma exacerbation in the previous 4 weeks. Eligible patients were then randomized to either an OMT or a control group. Patients in the OMT group were treated with rib raising and suboccipital release in addition to standard asthma care, while control group patients received standard care only. A second PFT was performed for patients in both groups at the end of the visit. OMT was performed by multiple osteopathic pediatric residents specifically trained for this study. Change in spirometry results (forced vital capacity [FVC], forced expiration volume in 1 second [FEV1], FVC/FEV1, and forced expiratory flow 25–75%) were then compared. Results The study population included 58 patients: 31 (53.4%) were assigned to the OMT group and 27 (46.6%) were assigned to the standard of care group. Patients who received OMT had greater improvement in all spirometry values compared to the usual group; however, these changes were not statistically significant. Conclusions The benefits of OMT on short term spirometry results in pediatric asthma patients remain unclear.
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Auger, Kyle, Gregory Shedlock, Kasey Coutinho, Nicole E. Myers, and Santiago Lorenzo. "Effects of osteopathic manipulative treatment and bio-electromagnetic energy regulation therapy on lower back pain." Journal of Osteopathic Medicine 121, no. 6 (March 2, 2021): 561–69. http://dx.doi.org/10.1515/jom-2020-0132.
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Abstract Context Lower back pain (LBP) is prevalent and is a leading contributor to disease burden worldwide. Osteopathic manipulative treatment (OMT) can alleviate alterations in the body that leads to musculoskeletal disorders such as LBP. Bio-electromagnetic Energy Regulation (BEMER; BEMER International AG), which has also been shown to relieve musculoskeletal pain, is a therapeutic modality that deploys a biorhythmically defined stimulus through a pulsed electromagnetic field (PEMF). Therefore, it is possible that combined OMT and BEMER therapy could reduce low back pain in adults more than the effect of either treatment modality alone. Objectives To investigate the individual and combined effects of OMT and BEMER therapy on LBP in adults. Methods Employees and students at a medical college were recruited to this study by email. Participants were included if they self-reported chronic LBP of 3 months’ duration or longer; participants were excluded if they were experiencing acute LBP of 2 weeks’ duration or less, were currently being treated for LBP, were pregnant, or had a known medical history of several conditions. Ultimately, 40 participants were randomly assigned to four treatment groups: an OMT only, BEMER only, OMT+BEMER, or control (light touch and sham). Treatments were given regularly over a 3 week period. Data on LBP and quality of life were gathered through the Visual Analog Scale (VAS), Short Form 12 item (SF-12) health survey, and Oswestry Low Back Pain Questionnaire/Oswestry Disability Index prior to treatment and immediately after the 3 week intervention protocol. One-way analysis of variance (ANOVA) was performed retrospectively and absolute changes for each participant were calculated. Normal distribution and equal variances were confirmed by Shapiro–Wilk test (p>0.05) and Brown-Forsythe, respectively. Significance was set at p<0.05. Results Despite a lack of statistical significance between groups, subjective reports of pain reported on the VAS showed a substantial mean percentage decrease (50.8%) from baseline in the OMT+BEMER group, compared with a 10.2% decrease in the OMT-only and 9.8% in BEMER-only groups when comparing the difference in VAS ratings from preintervention to postintervention. Participants also reported in quality of life assessed on the Oswestry Low Back Pain Questionnaire/Oswestry Disability Index, with the OMT+BEMER group showing a decrease of 30.3% in score, the most among all groups. The OMT+BEMER group also reported the greatest improvement in score in the physical component of the SF-12, with an increase of 21.8%. Conclusions The initial data from this study shows a potential additive effect of combination therapy (OMT and BEMER) for management of LBP, though the results did not achieve statistical significance.
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Hess, Nicklaus J. "Osteopathic Manipulative Treatment for Nausea and Vomiting Following Fine Needle Aspiration of the Neck." AAO Journal 27, no. 1 (March 1, 2017): 12–25. http://dx.doi.org/10.53702/2375-5717-27.1.12.
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Abstract A 47-year-old woman underwent ultrasound-guided fine needle aspiration of an enlarged lymph node located in the right side of her neck. During this procedure, she began to experience nausea with vomiting, and later, she was hospitalized for intractable symptoms. Upon discharge, the patient required scopolamine to control her symptoms. She followed up with her primary care provider in an outpatient family medicine clinic, and somatic dysfunction was appreciated on her osteopathic structural exam. It was postulated that the patient’s symptoms had originated from vagal irritation sustained during the biopsy. Following osteopathic manipulative treatment (OMT), her nausea and vomiting resolved 4 days later, and she no longer required pharmacologic therapy for symptom management. This case report suggests a potential role for somatic dysfunction and the application of OMT in suspected vagally mediated nausea and vomiting.
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Montrose, Stephanie, Mark Vogel, and Kimberly R. Barber. "Use of osteopathic manipulative treatment for low back pain patients with and without pain medication history." Journal of Osteopathic Medicine 121, no. 1 (January 1, 2021): 63–69. http://dx.doi.org/10.1515/jom-2019-0193.
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Abstract Context Low back pain is one of the most frequent diagnoses in primary care, and prescription pain medication is commonly used for management. Osteopathic physicians may use osteopathic manipulative treatment (OMT) as an additional tool to help alleviate pain. Objective To determine if nonpharmacological options can improve back pain with the use of OMT. Methods Two groups were studied: patients receiving OMT but not using prescribed pain medications (OMT-only group) and patients who received prescribed pain medication and began receiving OMT after three months of pharmacologic therapy (OMT + medication group). All patients were enrolled in the study for one year. The amount of time between treatments was determined by the physician performing the OMT and the patient’s pain improvement. The Keele STarT survey and Oswestry Disability Index tool were used at each appointment to assess the patient’s functionality and pain. Results Thirty-six patients enrolled in the study: 26 in the OMT-only group and 10 in the OMT + medication group. Each group reported improvement in low back pain (LBP) according to both scales used. The OMT-only group reported improvement according to the Keele STarT survey (30% relative decrease in the mean score) and the Oswestry Disability Index tool (18% relative decrease in disability index), while patients in the OMT + medication group also reported improvement according to the Keele STarT survey (29.5% relative decrease in the mean score) and the Oswestry Disability Index tool (18% relative decrease in disability index). A decrease in Cyclobenzaprine usage was also observed in the OMT + medication group. Conclusion Both groups showed significant decreases in overall pain, and this similar effect in each group may indicate a lack of need for medications when OMT is used. Additional research on efficacy of OMT in this patient population is needed with larger, multicenter, randomized trials.
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Heineman, Katherine. "An Osteopathic Manipulative Treatment (OMT) Evaluation and Treatment Protocol to Improve Gastrointestinal Function." AAO Journal 32, no. 2 (June 1, 2022): 34–44. http://dx.doi.org/10.53702/2375-5717-32.2.34.
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Abstract As a hands-on approach to patient care diagnosis and management, osteopathic manipulative medicine (OMM) can be utilized to modulate the autonomic input to the gastrointestinal system. Palpatory findings of tissue texture changes at predictable body regions may correspond to visceral dysfunction related to the gastrointestinal (GI) system.1 Osteopathic manipulative treatment (OMT) of the viscero-somatic segment or viscero-visceral reflex can remove the feedback related to the somatic or visceral component, thereby affecting nociceptive facilitation at the spinal or visceral level and helping to restore autonomic balance.1,2 The purpose of this thesis is to describe an evaluation and treatment protocol to address somatic and visceral dysfunction found in many patients with impaired gastrointestinal function. A retrospective analysis of 5 patients will be outlined using the evaluation and treatment protocol. The safety of an OMT evaluation and treatment protocol as applied to address gastrointestinal function and as outlined in the current literature will also be addressed.
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Hoffman, Patricia, Dimitry Belogorodsky, and Lauren Noto-Bell. "Single Osteopathic Manipulative Treatment Session Eliminates Percutaneous Coronary Intervention-Induced Upper Thoracic Pain in Elderly Male." AAO Journal 31, no. 3 (September 1, 2021): 5–8. http://dx.doi.org/10.53702/2375-5717-31.3.5.
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Abstract Restoration of blood flow is critical to a blocked coronary blood vessel. With respect to the heart, two main procedures, coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) revascularize the area to prevent future blockages. Post-procedurally, bed rest iatrogenically produces non-life-threatening back pain.1,2 No exact guideline for the duration of post-procedural bed rest exists but recommendations range from 2 to 24 hours.1 However, research has shown that bed rest beyond 4 hours significantly increased the presence of post-procedural back pain.1,2 Osteopathic manipulative treatment (OMT) is the term ascribed to a number of categories of manual techniques used by osteopathic physicians to treat somatic dysfunctions, to complement conventional management in patient care. In this case report, we discuss a patient with post-procedural upper thoracic pain that resolves with OMT, demonstrating that OMT may play a useful post-PCI role in the care of patients who undergo stent procedures.
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Huzij, Teodor. "The Touch Taboo: Origins for the Prohibition of Touch in Psychiatry and a Rational Osteopathic Approach." AAO Journal 32, no. 4 (November 30, 2022): 19–32. http://dx.doi.org/10.53702/2375-5717-32.4.19.
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Abstract The prohibition of touch in psychiatry has multiple origins. The most prominent advocate for an interdiction on touch has been Sigmund Freud and the legacy of psychoanalysis. Scientism, dualism, and medicolegal concerns have also promoted a touch taboo in psychiatry. However, it is evident that non-sexual physical touch is vital for human health; studies of touch in children and adults have shown numerous health benefits physically and psychologically. A discussion of ethical principles in light of the use of touch in psychiatry is provided. Several theoretical paradigms do utilize touch in treating patients and are reviewed including the medical model, body-psychotherapies, and osteopathic medicine. The osteopathic philosophy provides a lens through which the osteopathic physician both assesses and provides rational treatment to the patient. In addition to this philosophy, osteopathic physicians are extensively trained in osteopathic manipulative treatment (OMT). Osteopathic physicians have treated patients with psychiatric disorders with OMT and other treatments for nearly 150 years. The unique osteopathic model of care contrasts with the long-standing prohibition of touch with psychiatric patients and thereby provides a rational approach to the use of touch in psychiatry. The reasoned recommendations for osteopathic psychiatrists using touch clinically include consent, context, and competency considerations.
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Belsky, Jennifer A., Joseph Stanek, Micah A. Skeens, Cynthia A. Gerhardt, and Melissa J. Rose. "Supportive care and osteopathic medicine in pediatric oncology: perspectives of current oncology clinicians, caregivers, and patients." Supportive Care in Cancer 29, no. 2 (July 9, 2020): 1121–28. http://dx.doi.org/10.1007/s00520-020-05612-9.
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Abstract Background and objective Many children receiving chemotherapy struggle with therapy-induced side effects. To date, there has been no literature investigating the needs, knowledge, or implementation of osteopathic manipulative treatments (OMT) as a supportive care option in pediatric oncology. We hypothesized that pediatric oncology clinicians, caregivers, and patients have (a) limited knowledge of OMT and (b) dissatisfaction with current supportive care options and (c) would be interested in having OMT available during chemotherapy, once educated. Methods Participants included three cohorts: (1) children aged ≥ 9 years, diagnosed with cancer and actively receiving chemotherapy; (2) their caregivers; and (3) oncology clinicians at Nationwide Children’s Hospital. Participants completed 1:1 semi-structured interviews, which were audio-recorded, transcribed, and analyzed for thematic content regarding their perception of supportive care measures and views on OMT. Quantitative data was summarized descriptively. Results A total of 60 participants completed the interview. Participants demonstrated limited awareness of osteopathic medicine; no participant had more than “some” knowledge of OMT. After education about OMT using a brief video, all clinicians, caregivers, and 95% of patients were receptive to OMT as a supportive care option. Major themes included the following: (a) patients have uncontrolled chemotherapy side effects, (b) improved supportive care options are desired, and (c) osteopathic medicine is a favorable supportive care adjunct. Conclusions Pediatric oncology clinicians, caregivers, and patients reported a need for better management of chemotherapy-associated side effects and an interest in utilizing OMT. These findings support further investigation into the safety, feasibility, and efficacy of implementing OMT in the pediatric oncology clinical setting.
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Nourani, Bobby, Ross Gilbert, and David Rabago. "The Treatment of Coccydynia and Headache with Transrectal OMT: A Case Report." Scholar: Pilot and Validation Studies 1, no. 1 (January 1, 2020): 14–18. http://dx.doi.org/10.32778/spvs.71366.2020.4.
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Abstract Coccydynia is debilitating pain of the coccyx that substantially impacts quality of life. Although most cases resolve with conservative therapy, pain can become chronic and involve other anatomical areas. Treatment options include physical therapy, manual medicine, injection, and surgery with mixed results. Manual medicine options vary depending on provider and physical exam findings. Little is known about transrectal therapy. We present a case of a 21-year-old female with coccydynia and subsequent headaches that failed conventional work-up and conservative therapy but resolved with osteopathic manipulative treatment (OMT).
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Franke, Helge, and Klaus Hoesele. "Osteopathic manipulative treatment (OMT) for lower urinary tract symptoms (LUTS) in women." Journal of Bodywork and Movement Therapies 17, no. 1 (January 2013): 11–18. http://dx.doi.org/10.1016/j.jbmt.2012.05.001.
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Marshall, Sylvia, Sara Winter, and John D. Capobianco. "Lymphatic osteopathic manipulative treatment reduces duration of deltoid soreness after Pfizer/BioNTech COVID-19 vaccine." Journal of Osteopathic Medicine 122, no. 3 (January 12, 2022): 153–57. http://dx.doi.org/10.1515/jom-2021-0189.
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Abstract Pfizer-BioNTech BNT162b2 is one of the three U.S. Food and Drug Administration (FDA)-approved vaccines for the prevention of COVID-19. Its most common side effect, injection site pain, occurs because of locally recruited inflammatory mediators and is mitigated by the lymphatic system. Side effects may discourage individuals from receiving vaccines; therefore, reducing the duration of injection site pain can promote vaccination compliance. Osteopathic manipulative treatments (OMT) can directly affect the physiology underlying muscle soreness; however, there is currently no literature that supports the use of OMT in this scenario. In this case report, an otherwise healthy male presented with acute left deltoid soreness after receiving the Pfizer COVID-19 vaccine. The pain began 5 h prior to the visit. Three hours after being treated with lymphatic OMT, the severity of the pain was significantly reduced and was alleviated 8h after onset in comparison to the median duration of 24–48 h. He received his second dose 3 weeks later. This case report can provide future studies with the groundwork for further investigating the role of OMT in treating postvaccination muscle soreness, which can improve patient satisfaction and potentially promote vaccination compliance.
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Licciardone, John C. "Preventing progression from chronic to widespread pain and its impact on health-related quality of life: a historical cohort study of osteopathic medical care." Journal of Osteopathic Medicine 122, no. 1 (September 23, 2021): 21–29. http://dx.doi.org/10.1515/jom-2021-0105.
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Abstract Context It is generally acknowledged that osteopathic physicians take a holistic approach to patient care. This style may help prevent the progression of painful musculoskeletal conditions, particularly if combined with osteopathic manipulative treatment (OMT). Objectives The study aimed to determine if osteopathic medical care lowers the risk of progression from localized chronic low back pain to widespread pain and lessens the impact of pain on health-related quality of life. Methods A historical cohort study was conducted within the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation (PRECISION Pain Research Registry) using data acquired from April 2016 through March 2021. Registry participants aged 21–79 years with chronic low back pain at the baseline encounter were potentially eligible for inclusion if they had a treating physician, completed all four quarterly follow-up encounters, and did not report physician crossover at the final 12-month encounter. Eligible participants were classified according to the type of physician provider at baseline and thereby into osteopathic or allopathic medical care groups. Participants were also classified according to prior use of OMT at the final encounter. Widespread pain was measured at baseline and each quarterly encounter to determine the period prevalence rate of widespread pain and its severity over 12 months using the Minimum Dataset for Chronic Low Back Pain recommended by the National Institutes of Health. Participants who reported “not being bothered at all” by widespread pain during each encounter were classified as not having widespread pain, whereas those who were bothered “a little” or “a lot” at any quarterly encounter were classified as having widespread pain. The severity of widespread pain was measured by summing participant responses at each encounter. The Patient-Reported Outcomes Measurement Information System was used at each encounter to measure health-related quality-of-life (HRQOL) scores for physical function, anxiety, depression, fatigue, sleep disturbance, participation in social roles and activities, and pain interference with activities. Results A total of 462 participants were studied, including 101 (21.9%) in the osteopathic medical care group and 73 (15.8%) who used OMT. The mean age of participants at baseline was 52.7 ± 13.2 years (range, 22–79 years) and 336 (72.7%) were female. A lower period prevalence rate of widespread pain was observed in the osteopathic medical care group (OR, 0.47; 95% CI, 0.27–0.81; p=0.006) and in the OMT group (OR, 0.40; 95% CI, 0.21–0.75; p=0.004), although the latter finding did not persist after adjustment for potential confounders. The osteopathic medical care and OMT groups both reported lower widespread pain severity. The osteopathic medical care group also reported better age- and sex-adjusted outcomes for each of the seven HRQOL dimensions throughout the study. The OMT group reported better outcomes in five of the HRQOL dimensions. Conclusions This study supports the view that osteopathic physicians practice a holistic approach to medical care that manifests itself through a lower risk of progression from chronic low back pain to widespread pain, lower widespread pain severity, and lesser deficits in HRQOL. Similar findings were generally associated with OMT use.
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Miranda, Eneida, Jennifer Giza, Eleonora Feketeova, Cristian Castro-Nunez, Ulrick Vieux, and Minh-Duc Huynh. "Osteopathic Manipulative Treatment in Patients with Anxiety and Depression: A Pilot Study." AAO Journal 31, no. 3 (September 1, 2021): 9–16. http://dx.doi.org/10.53702/2375-5717-31.3.9.
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Abstract Background & Aims: The role of touch in managing psychiatric patients is controversial. The purpose of this pilot study was to determine the effectiveness of osteopathic manipulative treatment (OMT) in patients with anxiety and or depression. Methods: This was an 8-week pilot study comparing a treatment to a control group, each consisting of 10 randomly assigned adult participants with anxiety and or depression on psychotropics. No significant difference existed between groups for age or severity of disease. Participant responses for anxiety and depression were recorded weekly via a modified Generalized Anxiety Disorder 7 item (GAD-7) and Harvard National Depression Screening Day (HANDS) scales. From the initial cohort (n=20) a complete database was achieved for 16 of the patients. Statistical analysis was performed using RStudio. Results: Of the 16 patients who successfully participated in the study, 6 received OMT, and 10 were part of the control group. For statistical purposes, the data gathered from both groups were subdivided into two categories: depression and anxiety subgroups. The depression treatment group had a week 1 mean of 24.4 ± 11.2 (n=5) with a paired t-test showing significance at week 7 of 18.0 ± 10.9 (n=5), P = .00767 and week 8 of 15.2 ± 12.5 (n=5), P = .041.The anxiety treatment group had a week 1 mean of 26.0 ± 8.7 (n=5) with paired t-test significant at week 7 of 20.2 ± 10.7 (n=5), P = .019 and week 8 of 19.2 ± 11.1 (n=5), P = .00815.All patients in the treatment group showed significant improvements in their anxiety and depression levels compared to those in the control group, which worsened by week 8. Conclusions: Findings in this study indicate that OMT may be an effective adjunctive treatment modality for depression and anxiety.
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Lewis, Drew D., and Jonathan Pickos. "Restoring Full Squat Range of Motion by Applying OMT to Superior Innominate Shear: A Case Report." AAO Journal 29, no. 2 (June 1, 2019): 7–12. http://dx.doi.org/10.53702/2375-5717-29.2.7.
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Abstract Hamstring injuries in sports are common and often require rest or more active rehabilitative efforts before returning to sport-specific participation. This case report provides a potential framework of osteopathic manipulative treatment (OMT) for an acute traumatic superior innominate shear where traditional medical treatment, including physical therapy sessions, failed to provide significant and/or complete resolution. In the present case report, a 17-year-old male high-school athlete presented with hamstring strain and proximal hamstring and low back pain, following a hurdle injury with fall on extended knee. He was found to have significant somatic dysfunctions related to his condition. An OMT approach was utilized to provide relief, restore his full squat range of motion, and ultimately return to non-restricted football and basketball participation.
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Kasten, Kody M., Samantha K. Tyler, Anna R. Johnson, Erika R. Kolakowski, Jonathan Pickos, Katherine Heineman, and Chunfa Jie. "The Immediate, Intermediate, and Long-Term Effects of Osteopathic Manipulative Treatment on Pulmonary Function in Adults with Asthma." AAO Journal 30, no. 3 (September 1, 2020): 29–35. http://dx.doi.org/10.53702/2375-5717-30.3.29.
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Abstract Context Asthma is a common chronic obstructive lung disease with increasing prevalence and economic burden. The effect of osteopathic manipulative treatment (OMT) has been studied in patients with several lung diseases, including asthma; however, no clinical trials have studied effects beyond the immediate time period in adults with asthma using spirometry. Objective To examine the immediate, intermediate, and long-term effects of OMT on objective pulmonary function and subjective quality of life in asthmatic adults. Methods Twenty-five adults with asthma were recruited from the Des Moines University community. Standardized Asthma Quality of Life Questionnaire (AQLQ(S)) surveys and spirometry measures including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), the FEV1/FVC ratio, and peak expiratory flow (PEF) were collected at baseline. Spirometry testing was performed immediately after and 3 days after each of 3 weekly standardized OMT sessions. Spirometry and AQLQ(S) surveys were collected again 4 weeks after the final OMT session. Spirometry results were analyzed using a repeated measure, linear mixed-effect model, and survey results were analyzed using paired t-tests. Results The study demonstrated statistically significant changes to the spirometry results, including the PEF and FEV1/FVC ratio. The PEF measurements increased 3 days after the first treatment and remained elevated through the completion of the study. The FEV1/FVC ratio decreased by 0.01 at 4 weeks post-OMT compared to baseline. There were no significant differences observed in the immediate, intermediate or long-term FEV1 and FVC measurements post-OMT. However, there was a significant increase in the overall score and all 4 domains of the AQLQ(S), including Symptoms, Activity Limitations, Emotional Function, and Environmental Stimuli. Conclusion The results of this pilot study suggest that OMT may improve the quality of life in adults with asthma. Spirometry testing revealed a significant change in some measures of pulmonary function and participants reported an improvement in asthma-specific quality of life. The authors suggest that, in combination with preventive measures and pharmacologic therapy, OMT may offer additional benefit in the treatment of adults with asthma. The results also suggest a need for further study of the effects of OMT on respiratory function in asthmatic adults.
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Paoli, Daniela, Leonardo Michelin, Fabrizio Vassallo, Luigi Ciullo, Paolo Brusini, and Lucio Torelli. "The Glymphatic System and New Etiopathogenic Hypotheses Concerning Glaucoma Based on Pilot Study on Glaucoma Patients Who Underwent Osteopathic Manipulative Treatment (OMT)." BOHR International Journal of Current Research in Optometry and Ophthalmology 1, no. 1 (2022): 19–25. http://dx.doi.org/10.54646/bijcroo.007.
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Purpose Malfunction of the lymphatic or glymphatic system recently shown in the brain, seems to play an important role in central neurodegenerative pathologies through a build-up of neurotoxins. Recent studies have shown functional links between aqueous humour and cerebrospinal fluid via the glymphatic system, offering new perspectives and unifying theories on the vascular, biomechanical and biochemical causes of chronic and open angle glaucoma (POAG). The aim of this randomized pilot study is to compare the variations in intraocular pressure between 20 cases of compensated POAG under pharmacological therapy and 20 glaucoma patients undergoing osteopathic treatment, hypothesizing that this manipulation can influence intraocular pressure. Materials and Methods The 40 patients under study, all covered by the Helsinki convention, were randomly divided into 2 groups (treated group or TG and control group or CG). The 40 patients were chosen from compensated glaucoma sufferers, who required neither changes in therapy nor operations which would affect their eye pressure which was measured both before and after manipulative osteopathic treatment scheduled into 4 sessions at intervals of 7.3 and 150 days, then compared with the control group (20 patients) who were undergoing pharmacological treatment only. Results The average IOP in the TG was compared with the CG throughout the entire treatment cycle showing a statistically inconclusive reduction in the right eye RE P-value (0.0561), while for the left eye a significant effect was shown LE (0.0073). The difference between the reduction in IOP between TG and CG was observable 10 months after the first session or rather 5 months after the last, and demonstrable during a check-up 13 months after the beginning of the study, or rather 8 months in absence of treatment with a highly significant statistical p-value (0.000434). Conclusions This study has shown that manipulative osteopathic treatment can affect intraocular pressure after each session and that the pressure is significantly lower even months after the last treatment session.
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Deol, Navneet, Victor Nuño, Molly Schuman, and Cristian Contreras. "An Osteopathic Approach to Complex Regional Pain Syndrome (CRPS)." AAO Journal 31, no. 4 (December 1, 2021): 47–54. http://dx.doi.org/10.53702/2375-5717-31.4.47.
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Abstract Complex Regional Pain Syndrome (CRPS) is a chronic neuropathic pain condition in a region of the body where the pain experienced by the patient is disproportionate to the stimuli preceding the pain. In this case, a 52-year-old post-menopausal woman presents with chronic distal limb pain due to a left ankle contusion from a work injury. Previous treatments that focused on specific symptoms failed. However, the patient was then evaluated and treated comprehensively by an osteopathic physician. Treatment was tailored to individual patient needs based on the five models of osteopathic care. Within a 1.5 years period of integrative osteopathic treatment that utilized osteopathic manipulative treatment (OMT) in addition to medications and supplements, the patient was able to start walking again with only mild discomfort. This individualized approach seemed to improve her quality of life, and overall satisfaction with her health, psyche, and well-being. The patient is now discharged from the practice, has resumed normal daily activities, and is working full-time as a cashier.
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Ellis, Megan M., and Drew D. Lewis. "Osteopathic Approach to Treatment of Radial Head Dysfunction: The Radial Head Range of Motion Technique." AAO Journal 32, no. 1 (February 28, 2022): 32–33. http://dx.doi.org/10.53702/2375-5717-32.1.32.
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Abstract Falls on an outstretched hand, overuse, and restriction of motion at the wrist can all contribute to the formation of a radial head somatic dysfunction. Radial head somatic dysfunctions may contribute to or cause painful conditions of the forearm, elbow, and wrist and impact the proper balance of muscular, neural, and circulatory influences. The radial head range of motion technique is a simple and effective osteopathic manipulative treatment (OMT) that can be utilized to address discomfort of the lateral elbow, proximal forearm, and wrist.
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Berenbeim, Gabriel, and Jose Figueroa. "The Role of Osteopathic Manipulative Medicine in the Rehabilitation of a Competitive Dancer after a Major Abdominal Surgery." AAO Journal 32, no. 4 (November 30, 2022): 11–18. http://dx.doi.org/10.53702/2375-5717-32.4.11.
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Abstract Transmural inflammation in Crohn’s disease can lead to stricturing of the bowel which may result in an obstruction and perforation of the intestines. Emergent surgery is indicated to amend a perforation but complications, such as edema, can limit a surgeon’s ability to close the abdominal wall. In such a case, the open wounds may heal by secondary intent where new tissue is laid down from the base upwards. This case report describes a 23-year-old woman completing her Bachelor of Arts in dance with a past medical history of stricturing and inflammatory ileocolonic Crohn’s disease who presented to the osteopathic manipulative medicine (OMM)/Physical Medicine and Rehabilitation (PM&R) clinic for multiple open abdominal wounds and weakness. To the authors’ knowledge, this is the first case report detailing the benefits of osteopathic manipulative treatment (OMT) to healing open abdominal wounds, increasing flexibility and physical fitness, and improving the mental health of an individual who required prompt rehabilitation to return to the high-level of fitness required to pursue a career as a professional dancer.
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Price, James W. "A mixed treatment comparison of selected osteopathic techniques used to treat acute nonspecific low back pain: a proof of concept and plan for further research." Journal of Osteopathic Medicine 121, no. 6 (February 24, 2021): 571–82. http://dx.doi.org/10.1515/jom-2020-0268.
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Abstract Context Back injuries have a high prevalence in the United States and can be costly for both patients and the healthcare system at large. While previous guidelines from the American College of Physicians for the management of acute nonspecific low back pain (ANLBP) have encouraged nonpharmacologic management, those treatment recommendations involved only superficial heat, massage, acupuncture, and spinal manipulation. Investigation about the efficacy of spinal manipulation in the management of ANLBP is warranted. Objectives To compare the results in previously-published literature documenting the outcomes of osteopathic manipulative treatment (OMT) techniques used to treat ANLBP. The secondary objective of this study was to demonstrate the utility of using Bayesian network meta-analysis (NMA) to perform a mixed treatment comparison (MTC) of a variety of osteopathic techniques. Methods A literature search for randomized controlled trials (RCTs) of ANLBP treatments was performed in April 2020 according to PRISMA guidelines by searching MEDLINE/PubMed, OVID, Cochrane Central, PEDro, and OSTMED.Dr databases; scanning the reference lists of articles; and using the Canadian Agency for Drugs and Technologies in Health grey literature checklist. Each database was searched from inception to April 1, 2020. The following search terms were used: acute low back pain, acute low back pain plus physical therapy, acute low back pain plus spinal manipulation, and acute low back pain plus osteopathic manipulation. The validity of eligible trials was assessed by the single author using an adapted National Institute for Health and Care Excellence methodology checklist for randomized, controlled trials and an extraction form based on that checklist. The outcome measure chosen for this NMA was the Visual Analogue Scale of pain. The NMA were performed using the GeMTC user interface for automated NMA utilizing a Bayesian hierarchical model of random effects. Results The literature search initially found 483 unduplicated records. After screening and full text assessment, five RCTs were eligible for the MTC, yielding a total of 430 participants. Results of the MTC model suggested that there was no statistically significant decrease in reported pain when exercise, high-velocity low-amplitude (HVLA), counterstrain, muscle energy technique, or a mix of techniques were added to conventional treatment to treat ANLBP. However, the rank probabilities assessment determined that HVLA and the OMT mixed treatment protocol plus conventional care were ranked superior to conventional care alone for improving ANLBP. Conclusions While this study failed to provide definitive evidence upon which clinical recommendations can be based, it does demonstrate the utility of performing NMA for MTCs of osteopathic modalities used to treat ANLBP. However, to take full advantage of this statistical technique, future studies should be designed with consideration for the methodological shortcomings found in past osteopathic research.
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Balyakina, Elizabeth S., Malinda M. Hansen, and David Mason. "Development of Osteopathic Neuromusculoskeletal Medicine (ONMM) residency curriculum guidelines to meet Accreditation Council for Graduate Medical Education (ACGME) milestones." Journal of Osteopathic Medicine 122, no. 4 (January 24, 2022): 175–85. http://dx.doi.org/10.1515/jom-2021-0122.
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Abstract Context A memorandum of understanding was reached between the Accreditation Council for Graduate Medical Education (ACGME), the American Osteopathic Association (AOA), and the American Association of Colleges of Osteopathic Medicine (AACOM) in 2014 outlining the course for a single accreditation system for graduate medical education. This process was completed in 2020 and has included the transition of AOA-accredited neuromusculoskeletal and Osteopathic Manipulative Medicine (OMM) programs into programs now termed “Osteopathic Neuromusculoskeletal Medicine” (ONMM) under the single accreditation system. Progress through ONMM residency is evaluated on the basis of 15 ACGME milestones that encompass six core competencies. However, there are no curricular guidelines to help guide the achievement of these milestones. Objectives The primary purpose of this study was to develop a proposed structure and content for an ONMM residency curriculum that is based on (1) the alignment of residency curriculum with ACGME milestones in one ACGME-accredited ONMM residency program, and (2) the perceived needs of residents and faculty for an ONMM residency curriculum. Methods A mixed-methods exploratory sequential approach with embedded design was utilized. Qualitative analysis of didactics curriculum content for the past 2 years was coded according to themes identified in the residency curriculum content, which were further coded according to ACGME milestones. Curriculum topics identified in qualitative analysis were utilized to create a questionnaire that was administered to residents and faculty (n=24) in the ONMM residency program to examine the perceived importance of each curriculum topic based on a five-point Likert scale. Open-ended questions were embedded in the questionnaire that asked how faculty and residents define ONMM and what they believe should be the purpose of an ONMM residency curriculum. Results Five themes were identified in qualitative analysis of curriculum: (1) OMM laboratory topics; (2) faculty-led activities and lecture topics; (3) resident-led activities and lecture topics; (4) research; and (5) training courses and volunteer activities. The most important perceived curriculum topics for faculty and residents were osteopathic structural examination, orthopedic exam, direct and indirect methods, osteopathic cranial manipulative medicine, pediatric OMT, common upper and lower extremity injuries, and low back pain. Each of these topics aligned well with ACGME milestones. Residents reported that integrative medicine topics such as acupuncture were a significantly more important OMM laboratory topic (mean=3.58, SD=0.996) compared to faculty (mean=2.33, SD=0.985), t (22)=−3.091, p=0.005. Study participants most commonly described ONMM in terms of the specialized knowledge required for the discipline (n=19, 79.2%) and the Tenets of Osteopathy (n=17, 70.8%), and they felt that the purpose of an ONMM residency curriculum should be to gain knowledge (n=20, 83.3%) and become a competent physician (n=19, 79.2%). Conclusions The present findings were applied to the development of proposed ONMM residency curriculum guidelines and submitted to the American Academy of Osteopathy (AAO) for consideration. They are presented here as a resource for ONMM residencies to develop a program curriculum in alignment with individual program needs.
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Fraser, Kristina A., Harvard Nguyen, Suhhyun Kim, Flora Park, Joshua Bernal, Alexa D. Westberg, and Alan Podawiltz. "Perceptions of nonopioid treatment for pain in a homeless population." Journal of Osteopathic Medicine 121, no. 7 (April 5, 2021): 643–49. http://dx.doi.org/10.1515/jom-2020-0239.
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Abstract Context Opioid abuse has developed into a public health emergency within the last decade because opioid medications, while addictive, are effective and commonly used for pain management. In 2016, over 42,000 deaths were attributed to opioids. Chronic pain affects about 50% of people experiencing homelessness in the US, and they have a higher overall rate of chronic pain than the general population; opioids are among the methods they might use to manage that pain. Complementary and alternative therapies for pain management have largely gone unexplored in the homeless population. Objectives To determine, among people experiencing homelessness, the willingness to use and current use of complementary and alternative treatments (physical and massage therapy, chiropractic treatments). A secondary objective was to investigate awareness and perception of osteopathic manipulative treatment (OMT) as a complementary treatment for chronic pain among the homeless population. Methods A 32 question survey was administered verbally to guests of True Worth Place Homeless Shelter in Fort Worth, Texas in three 4 hour sessions from February 2019 to April 2019. If participants gave verbal consent, a researcher read the questionnaire, one question at a time, and recorded the participant’s responses. The survey included queries for opioid and nonopioid treatment modalities (physical and massage therapy, chiropractic, and OMT) to assess the perception of and current use of each among the population. Appropriate nonparametric statistical analysis was conducted to assess significance and correlations among the treatment groups. Results Of the 200 survey participants, 126 (91.3%) reported a history of opiate use for pain, but 136 (68.0%) believed that a nondrug pain intervention could better treat their pain. Additionally, 150 participants (75.0%) believed that regular manipulation, including OMT, would decrease their need for pain medications. Participants with a history of opioid use for pain were more likely to believe that the availability of regular manipulation, including OMT, at True Worth Place could decrease their need for pain medication (odds ratio=3.7143; 95% confidence interval=1.6122–8.5572; p=0.0009). Moreover, some participants (141; 70.5%) were already pursuing nondrug pain management modalities such as PT, massage therapy, and chiropractic care. The greatest barriers to receiving OMT were transportation and cost. Conclusions This survey study was conducted to determine whether a homeless population would be willing to use nonopioid treatment, particularly OMT, for chronic pain management. Results revealed both a willingness to use and a previous use of nonopioid treatments for pain, along with a high prevalence of opiate use. Despite limited exposure to OMT, this population reported being potentially willing to pursue manipulation, including OMT, as a complementary treatment for pain relief alongside opioids if readily available.
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Berenbeim, Gabriel, Isaac Metzler, Drew Lewis, and Chunfa Jie. "Student Perception of an OMM Virtual Practical Examination: In the Setting of Social Distancing." AAO Journal 32, no. 1 (February 28, 2022): 13–17. http://dx.doi.org/10.53702/2375-5717-32.1.13.
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Abstract Introduction: Osteopathic manipulative medicine (OMM) practical examinations (PEs) are important for assessing osteopathic medical students’ cognitive knowledge and psychomotor skills required for osteopathic manipulative treatment (OMT). In the response to the COVID-19 pandemic, first-year medical students at Des Moines University (DMU) were no longer allowed to participate in a standard in-person PE (sPE) in December 2020. A novel virtual PE (vPE) over Zoom was developed to assess the students’ understanding of OMM learned in lab to replace the sPE. Objective: To determine if the vPE was perceived by the students as a successful and efficacious alternative to the sPE. Method: After the graduating class of 2024 completed their vPE, an administrative email from the DMU OMM department was sent to gather anonymous, voluntary student feedback evaluating their perception and experience of the vPE. The survey consisted of 5 Likert scale questions that asked students to determine the extent they agree to 5 distinct statements and the survey contained a free-text response question asking for suggestions to improve the vPE experience. A Chi-square test of goodness-of-fit was used to assess for equal distributions of responses. Simultaneous 95% confidence intervals (CI) for multinomial proportions were created. The free text was qualitatively analyzed based on themes. Results: Of the 224 first-year osteopathic students, 207 students responded to the Likert scale questions and 113 responded to the free text. Students strongly agree or somewhat agree that the vPE was a fair assessment of their knowledge of OMM lab material (90.82%) and optimally assessed their procedural OMM skills (86.96%). Students strongly agree that the vPE better assessed their OMM lab knowledge than a written multiple-choice examination (73.91%) and they received helpful feedback during the vPE (77.78%). Conclusion: Survey results support that the vPE was perceived by students to be an effective and fair alternative to the sPE. The creative use of a pair of pants and a prop sacrum was validated, as students confirmed that the vPE optimally assessed their procedural skills given the practical’s limitations.
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Paiva, Alexander, and Hans C. Bruntmyer. "Effectiveness of Osteopathic Manipulation Treatment in the Rehabilitation of Post-External Immobilization for a Supracondylar Fracture of the Distal Humerus: A Case Report." AAO Journal 32, no. 3 (September 1, 2022): 42–47. http://dx.doi.org/10.53702/2375-5717-32.3.42.
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Abstract Pediatric bone fractures are a common occurrence, particularly among youth sports participants. Supracondylar humeral fractures are the most common pediatric elbow fracture, accounting for approximately 60% of all pediatric elbow fractures for children less than 10 years of age. For nondisplaced supracondylar humeral fractures, the standard of care is to immobilize the affected arm with an above the elbow-long cast for 3 weeks. Following cast removal, the recommendations for rehabilitation are conflicting, between doing some physical therapy as part of recovery or no therapy and letting the arm heal on its own for upwards of 12 weeks. The purpose of this case report was to observe if the addition of osteopathic manipulation treatment (OMT) could improve the somatic dysfunctions associated with post-immobilization elbow stiffness and reduce the amount of recovery time. Various OMT techniques were utilized over a span of 8 sessions across 4 weeks. The use of OMT provided relief of stiffness and return to full range of motion of the affected upper extremity joints. The incorporation of OMT as a part of a recovery regimen could be considered for future utilization, research, and evaluation.
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Tyner, Trevor J., Chase Cavayero, Anthony Philips, Brooke Johnson, and Thomas Quinn. "Poster 290 Evaluating Osteopathic Manipulative Therapy (OMT) as a Treatment Modality for the Reduction of Chronic Stress in Medical Students." PM&R 7 (September 2015): S186. http://dx.doi.org/10.1016/j.pmrj.2015.06.326.
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Franke, Helge, and Klaus Hoesele. "Corrigendum to “Osteopathic Manipulative Treatment (OMT) for Lower Urinary Tract Symptoms (LUTS) in women” [J. Bodyw. Mov. Ther. 17 (2013) 11–18]." Journal of Bodywork and Movement Therapies 18, no. 1 (January 2014): 92. http://dx.doi.org/10.1016/j.jbmt.2013.10.005.
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Hill, Cherice N., M’Lindsey Romero, Mark Rogers, Robin M. Queen, and Per Gunnar Brolinson. "Effect of osteopathic manipulation on gait asymmetry." Journal of Osteopathic Medicine 122, no. 2 (November 18, 2021): 85–94. http://dx.doi.org/10.1515/jom-2021-0046.
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Abstract Context Movement and loading asymmetry are associated with an increased risk of musculoskeletal injury, disease progression, and suboptimal recovery. Osteopathic structural screening can be utilized to determine areas of somatic dysfunction that could contribute to movement and loading asymmetry. Osteopathic manipulation treatments (OMTs) targeting identified somatic dysfunctions can correct structural asymmetries and malalignment, restoring the ability for proper compensation of stresses throughout the body. Little is currently known about the ability for OMTs to reduce gait asymmetries, thereby reducing the risk of injury, accelerated disease progression, and suboptimal recovery. Objectives To demonstrate whether osteopathic screening and treatment could alter movement and loading asymmetry during treadmill walking. Methods Forty-two healthy adults (20 males, 22 females) between the ages of 18 and 35 were recruited for this prospective intervention. Standardized osteopathic screening exams were completed by a single physician for each participant, and osteopathic manipulation was performed targeting somatic dysfunctions identified in the screening exam. Three-dimensional (3-D) biomechanical assessments, including the collection of motion capture and force plate data, were performed prior to and following osteopathic manipulation to quantify gait mechanics. Motion capture and loading data were processed utilizing Qualisys Track Manager and Visual 3D software, respectively. Asymmetry in the following temporal, kinetic, and kinematic measures was quantified utilizing a limb symmetry index (LSI): peak vertical ground reaction force, the impulse of the vertical ground reaction force, peak knee flexion angle, step length, stride length, and stance time. A 2-way repeated-measures analysis of variance model was utilized to evaluate the effects of time (pre/post manipulation) and sex (male/female) on each measure of gait asymmetry. Results Gait asymmetry in the peak vertical ground reaction force (−0.6%, p=0.025) and the impulse of the vertical ground reaction force (−0.3%, p=0.026) was reduced in males following osteopathic manipulation. There was no difference in gait asymmetry between time points in females. Osteopathic manipulation did not impact asymmetry in peak knee flexion angle, step length, stride length, or stance time. Among the participants, 59.5% (25) followed the common compensatory pattern, whereas 40.5% (17) followed the uncommon compensatory pattern. One third (33.3%, 14) of the participants showed decompensation at the occipitoatlantal (OA) junction, whereas 26.2% (11), one third (33.3%, 14), and 26.2% (11) showed decompensation at the cervicothoracic (CT), thoracolumbar (TL), and lumbosacral (LS) junctions, respectively. Somatic dysfunction at the sacrum, L5, right innominate, and left innominate occurred in 88.1% (37), 69.0% (29), 97.6% (41), and 97.6% (41) of the participants, respectively. Conclusions Correcting somatic dysfunction can influence gait asymmetry in males; the sex-specificity of the observed effects of osteopathic manipulation on gait asymmetry is worthy of further investigation. Osteopathic structural examinations and treatment of somatic dysfunctions may improve gait symmetry even in asymptomatic individuals. These findings encourage larger-scale investigations on the use of OMT to optimize gait, prevent injury and the progression of disease, and aid in recovery after surgery.
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Barnes, Precious L., Frank J. Casella, Hilda Lai, Olavi Airaksinen, and Michael L. Kuchera. "Retention of tissue texture change after cervical muscle energy and high velocity low amplitude intervention: implications for treatment intervals." Journal of Osteopathic Medicine 122, no. 4 (January 24, 2022): 203–9. http://dx.doi.org/10.1515/jom-2021-0187.
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Abstract Context When choosing to incorporate osteopathic manipulative treatment (OMT) into a patient’s care, the risk-to-benefit ratio, the choice of treatment technique, as well as the frequency of treatments are always taken into consideration. This has been even more important during the COVID-19 pandemic, in which social distancing has been the best preventative measure to decrease exposure. By increasing treatment intervals, one could not only limit possible exposure/spread of viruses but also decrease the overall cost to the system as well as to the individual. This is an expansion of a previous study in which quantifiable changes in cervical hysteresis characteristics post-OMT were documented utilizing a durometer (Ultralign SA201®; Sigma Instruments; Cranberry, PA USA). This study compared two treatment modalities, muscle energy (ME) and high-velocity low-amplitude (HVLA) postcervical treatment. Subjects in this study were allowed to re-enroll, provided that they could be treated utilizing the alternate treatment modality. By allowing repeat subjects, analysis of the data for lasting effects of OMT could be observed. Objectives To determine whether a significant change in cervical hysteresis would be observed after each treatment regardless of a short treatment interval. Methods A total of 34 subjects were retrospectively noted to be repeat subjects from a larger, 213-subject study. These 34 subjects were repeat participants who were treated with two different direct-treatment modalities 7–10 days apart. Each subject was randomly assigned to receive a single-segmental ME or HVLA treatment technique directed toward a cervical (C) segment (C3–C5 only). Subjects were objectively measured pretreatment in all cervical segments utilizing the Ultralign SA201®, then treated with cervical OMT to a single segment, and finally reassessed at all cervical levels with the Ultralign SA201® posttreatment to assess for change in cervical hysteresis. Results Statistically significant or suggestive changes (p-values 0.01–0.08) with good clinical effect size (0.30 or greater) were noted in all four components of the Ultralign SA201® at multiple cervical levels after the first treatment, but only one component (frequency) had a statistically significant change after the second treatment (AA cervical level, p-value 0.01) with good clinical effect size (0.45). However, when comparing the post–first-treatment values to the pre–second-treatment values, no statistically significant differences (p-value 0.10 or higher) were observed between them. Conclusions Statistically significant changes were noted after the first treatment; however, when comparing cervical hysteresis changes after the first treatment to the cervical hysteresis values prior to the second treatment delivered 7–10 days later, there were no statistically significant or suggestive changes. This data suggest that several post-OMT changes noted after the first treatment were still in effect and may indicate that follow-up visits for direct manipulation may be deferred for a least two weeks.
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Andrews, M. A. W. "An initial investigation into the possible influence of reactive oxygen species (ROS) in chronic nerve compression injuries and the effects of osteopathic manipulative therapy (OMT)." International Journal of Osteopathic Medicine 9, no. 1 (March 2006): 38. http://dx.doi.org/10.1016/j.ijosm.2006.01.016.
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Danieli, Dulce Marieli, Fabíola De Almeida Gomes, Bruna Eibel, and William Dhein. "Aplicabilidade clínica das técnicas de liberação manual diafragmática: uma revisão sistemática." Caderno de Educação Física e Esporte 18, no. 3 (October 27, 2020): 111–16. http://dx.doi.org/10.36453/2318-5104.2020.v18.n3.p111.
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INTRODUÇÃO: O diafragma é o principal músculo respiratório e desempenha um papel importante na respiração e na regulação fisiológica. Uma terapia que visa melhorar essas condições referentes ao diafragma, é a técnica de liberação manual diafragmática. OBJETIVO: O objetivo deste estudo foi verificar a aplicabilidade clínica das técnicas manuais de liberação diafragmática e identificar as principais técnicas, populações investigadas, variáveis avaliadas e seus desfechos. MÉTODOS: Foram pesquisadas as seguintes bases de dados: PubMed, Scielo e Science Direct, com os descritores “Diaphragm [Mesh]” e “Musculoskeletal Manipulations [Mesh]” com seus correspondentes no mesmo idioma. Foram incluídos ensaios clínicos randomizados, não randomizados, estudos semi, quase-experimentais e estudos pilotos ou de caso, que abordaram técnicas de liberação manuais diafragmáticas.RESULTADOS: Há variadas técnicas de liberação diafragmática, sendo as mais mencionadas: normalização dos pilares do diafragma, alongamento e estiramento do diafragma, relaxamento dos pilares do diafragma. Além disso, as técnicas de liberação diafragmática vêm sendo associadas a protocolos de terapia manipulativa osteopática (TMO). As principais populações estudadas foram de pacientes saudáveis, com lombalgia, cervicalgia, osteoartrite, asmáticos, doença pulmonar obstrutiva crônica, constipados, cardiopatas e com refluxo gastroesofágico. Os principais desfechos avaliados são variáveis musculoesqueléticas (dor, flexibilidade, amplitude, espessura diafragmática), variáveis cardiorrespiratórias (pressão inspiratória/expiratória máxima (PImax e Pemax), mobilidade torácica, frequência cardíaca e respiratória), qualidade de vida e disfunções gastrointestinais/gastroesofágicas. CONCLUSÃO: A aplicabilidade clínica das técnicas de liberação diagramática está sendo investigada associado com outras técnicas osteopáticas, em protocolos de TMO em pacientes saudáveis, pneumopatas, cardiopatas, gestantes, em cicatriz pós-cirúrgica, constipados, com refluxo gastroesofágico, osteoartrite, cervicalgia e com lombalgia. Evidencia-se: diminuição ou eliminação das dores musculoesqueléticas, aumento da flexibilidade, ADM, Pimáx e Pemáx, aumento da mobilidade torácica, aumento da qualidade de vida, diminuição do inchaço e dor abdominal e sem efeito em cardiopatas.ABSTRACT. Clinical applicability of manual diaphragmatic release techniques: a systematic review.BACKGROUND: The diaphragm is the main respiratory muscle and plays an important role in breathing and physiological regulation. A therapy that aims to improve these conditions regarding the diaphragm, is the manual diaphragmatic release technique.OBJECTIVE: The aim of this study was to verify the clinical applicability of manual diaphragmatic release techniques and searching the main techniques, population, evaluated variables, and outcomes. METHODS: The following electronic databases were searched: PubMed, Scielo, and Science Direct, with the descriptors “Diaphragm [Mesh]” and “Musculoskeletal Manipulations [Mesh]” with their correspondents in the same language. There were included randomized clinical trial, non-randomized clinical trials, semi, and quasi-experimental studies, and pilot or case studies, which addressed manual diaphragmatic release techniques.RESULTS: There are various diaphragmatic release techniques, the most mentioned are: normalization of the diaphragm pillars, stretching of the diaphragm, relaxation of the diaphragm pillars, and protocols for osteopathic manipulative therapy (OMT) for the diaphragm. The main populations studied were healthy patients, with low back pain, asthmatics, chronic pulmonary obstructive disease, constipated, cardiac patients, and gastroesophageal reflux. The main outcomes assessed are musculoskeletal variables (pain, flexibility, range of motion, diaphragmatic thickness), cardiorespiratory variables (maximal inspiratory/expiratory pressure (MIP and MEP), chest mobility, heart, and respiratory rate), quality of life, and gastrointestinal/ gastroesophageal disorders.CONCLUSION: The clinical applicability of diagrammatic release techniques is being investigated in association with other osteopathic techniques, in protocols of OMT in healthy subjects, patients with lung diseases, heart disease, pregnant women, scar tissue, constipated, with gastroesophageal reflux, osteoarthritis, cervicalgia and with low back pain. There is evidence of reduction and elimination of musculoskeletal pain, increased MIP, increased chest mobility, an increase in health quality, a decrease of bloating and abdominal pain related to constipation, and a decrease of reflux symptoms.
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Rehman, Yasir, Hannah Ferguson, Adelina Bozek, Joshua Blair, Ashley Allison, and Robert Johnston. "Dropout associated with osteopathic manual treatment for chronic noncancerous pain in randomized controlled trials." Journal of Osteopathic Medicine 121, no. 4 (March 16, 2021): 417–28. http://dx.doi.org/10.1515/jom-2020-0240.
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Abstract Context Reviews exploring harm outcomes such as adverse effects (AE), all cause dropouts (ACD), dropouts due to inefficacy, and dropouts due to AE associated with osteopathic manipulative treatment (OMT) or osteopathic manual therapy (OMTh) are scant. Objectives To explore the overall AE, ACD, dropouts due to inefficacy, and AE in chronic noncancerous pain (CNCP) patients receiving OMTh through a systematic review of previous literature. Methods For this systematic review and meta-analysis, the authors searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), EMCare, and Allied and Complementary Medicine Database (AMED), and Ostmed.Dr, as well as the bibliographical references of previous systematic reviews evaluating OMTh for pain severity, disability, quality of life, and return to work outcomes. Randomized controlled trials with CNCP patients 18 years or older with OMTh as an active or combination intervention and the presence of a control or combination group were eligible for inclusion. In this sub-study of a previous, larger systematic review, 11 studies (n=1,015) reported data that allowed the authors to perform meta-analyses on ACD and dropouts due to AE. The risk of bias (ROB) was assessed with the Cochrane ROB tool and the quality of evidence was determined with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results The pooled analysis showed that ACD was not significantly different for visceral OMTh (vOMTh) vs. OMTh control (odds ratio [OR]=2.66 [95% confidence interval [[CI]], 0.28, 24.93]) or for OMTh vs. standard care (OR=1.26 [95% CI, 0.84, 1.89]; I2=0%). Single study analysis showed that OMTh results were nonsignificant in comparison with chemonucleolysis, gabapentin, and exercise. OMTh in combination with gabapentin (vs. gabapentin alone) and OMTh in combination with exercise (vs. exercise alone) showed nonsignificant ACD. Dropouts due to AE were not significantly different, but the results could not be pooled due to an insufficient number of studies. Conclusions Most articles did not explicitly report AEs, ACD rates, or dropouts due to AEs and inefficacy. The limited data available on dropouts showed that OMTh was well tolerated compared with control interventions, and that the ACD and dropouts due to AEs were not significantly different than comparators. Future trials should focus on explicit reporting of dropouts along with beneficial outcomes to provide a better understanding of OMTh efficacy.
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Novikov, Yu O., D. E. Mokhov, J. P. Amigues, G. M. Musina, and A. R. Shaiakhmetov. "Randomized controlled study of the effectiveness of osteopathic manipulative correction for muscular torticollis due to birth injury." Russian Osteopathic Journal, no. 1-2 (July 23, 2019): 6–18. http://dx.doi.org/10.32885/2220-0975-2019-1-2-6-18.
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Introduction. Muscular torticollis (MT) is the most common lesion of the musculoskeletal system in children, ranking third in pediatric practice. There are references in the literature confi rming high effi cacy of manipulative therapy, but in Cochrane′s 2015 Annual Review, experts did not fi nd evidence of the effectiveness of the manipulations. We carried out research in order to determine the effectiveness of osteopathic manipulative correction (OMC) in children with muscular torticollis (MT) due to birth injury (code for ICD X: P 15.8).Goal of research — to study the gradual effectiveness of OMC on the basis of clinical and instrumental studies and ultrasound examination of the relationship between the bone structures and the cervical muscles.Materials and methods. 57 children aged 0–7 years with muscular torticollis due to birth injury were examined. All patients were randomly divided into 2 groups. Patients of the main group (32 children) received osteopathic treatment. Each child received from 3 to 5 sessions, depending on the severity of the birth injury and the duration of postural disorders. The time gap between the sessions was 2–3 weeks. Patients of the control group (25 children) received physiotherapy, massage and orthosis every day for 2 weeks. Along with the neurological examination the study of the effectiveness of treatment included assessment of the pain syndrome with the use of the behavioral numerical scale FLACC, and the assessment of the muscle tone with the help of the kinesthetic examination. Angle of rotation in the cervical spine was measured with the use of the goniometer. Moreover, all children underwent sonography of the cervical spine in order to determine the position of the tooth axis, with the calculation of the coeffi cient of asymmetry. The state of the musculus rectus capitis major (MRCM) and musculus sterno cleido mastoideus (MSCM) was also assessed.Results. It was observed that after OMC the clinically signifi cant improvement started earlier in patients of the main group. This improvement manifested by complete elimination or signifi cant reduction of biomechanical and tone disorders in the neck. Pain syndrome, measured with the help of the FLACC scale, signifi cantly decreased both after treatment and in catamnesis after 6 months (p0,05). When intercomparing left and right muscles in the groups, signifi cant differences were revealed (p0,05).Conclusion. The use of OMC (3 to 5 treatment sessions with the intervals of 2–3 weeks) in patients with MT is more effective than the treatment with the use of physiotherapy, massage and orthotics, which was received by patients every day for 2 weeks. This allows to recommend OMC for wider clinical use in this category of patients.
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Healy, Colson J., Matthew D. Brockway, and Benjamin B. Wilde. "Osteopathic manipulative treatment (OMT) use among osteopathic physicians in the United States." Journal of Osteopathic Medicine 121, no. 1 (January 1, 2021): 57–61. http://dx.doi.org/10.1515/jom-2020-0013.
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Abstract Context Updated data on the use of Osteopathic Manipulative Treatments (OMT) by osteopathic physicians in the United States is overdue. This data would provide an up-to-date point of reference for evaluating the current use of OMT as a distinguishing feature of the osteopathic profession. Objective To determine the prevalence of OMT use, barriers to its use, and factors that correlate with increased use. Methods The American Osteopathic Association (AOA) distributed its triannual survey on professional practices and preferences of osteopathic physicians, including questions on OMT, to a random sample of 10,000 osteopathic physicians in August 2018 through Survey Monkey (San Mateo, CA). Follow-up efforts included a paper survey mailed to nonrespondents one month after initial distribution and three subsequent email reminders. The survey was available from August 15, 2018 to November 5, 2018. The OMT questions focused on frequency of OMT use, perceived barriers, and basic demographic information of osteopathic physician respondents. Statistical analysis (including a one sample test of proportion, chi-square, and Spearman’s rho) was performed to identify significant factors influencing OMT use. Results Of 10,000 surveyed osteopathic physicians, 1,683 (16.83%) responded. Of those respondents, 1,308 (77.74%) reported using OMT on less than 5% of their patients, while 958 (56.95%) did not use OMT on any of their patients. Impactful barriers to OMT use included lack of time, lack of reimbursement, lack of institutional/practice support, and lack of confidence/proficiency. Factors positively correlated with OMT use included female gender, being full owner of a practice, and practicing in an office-based setting. Conclusion Our data suggest that OMT use among osteopathic physicians in the US continues to decline. Barriers to its use appear to be related to the difficulty that most physicians have with successfully integrating OMT into the country’s insurance-based system of healthcare delivery. Follow-up investigations on this subject in subsequent years will be imperative in the ongoing effort to monitor and preserve the distinctiveness of the osteopathic profession.
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Herring, Joshua A., Gabriela N. Soto, and Sabrina Silver. "Crochet the Pain Away: A Case Study of Osteopathic Manipulation for Cervical Rib Induced Thoracic Outlet Syndrome." AAO Journal 31, no. 2 (June 1, 2021): 51–54. http://dx.doi.org/10.53702/2375-5717-31.2.51.
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Abstract Background: Many people experience symptoms of thoracic outlet syndrome each year; one cause of these symptoms is the presence of cervical ribs. Cervical ribs have an estimated prevalence of 2% in the general population and 8.3% of those with thoracic outlet syndrome symptoms.1 Current treatment for thoracic outlet syndrome includes physical therapy and surgical resection. Techniques have been described for the treatment of thoracic outlet syndrome with osteopathic manipulation, but no specific treatment for cervical ribs was noted on a literature review. Case Presentation: 25-year-old healthy female presents with intermittent hand numbness and tingling along the C8 distribution that worsened with crocheting. She had also noted for many years the presence of a hard-supraclavicular mass on her left side. Palpation of this mass showed a bony protrusion that stopped 2 cm posterior to the clavicle on the left, but no mass noted on the right. Records review revealed an x-ray confirming cervical rib on the left. Results: After the treatment of surrounding dysfunctions without improvement in symptoms, the cervical rib was identified, manually isolated, and treated with direct myofascial release with respiratory assistance. This treatment provided immediate resolution of her symptoms. She remained asymptomatic for 10 days after treatment. A repeat treatment at two weeks resulted in resolution of her symptoms as far out as three months. Discussion: Cervical ribs are common in patients with thoracic outlet syndrome, and treatment for these patients typically includes physical therapy followed by surgical intervention for non-responders. We propose that OMT, with a focus on direct myofascial release, may be effective in alleviating symptoms for patients with cervical ribs. A limitation of this study is that it is a case report of one young active female. A larger study that includes various ages, activity levels, and both sexes would be more generalizable. Conclusion: Direct myofascial release is an effective technique for treatment of cervical rib induced thoracic outlet syndrome when myofascial restrictions are present.
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Rogers, Amy E., Joshua Baker, Anthony Beutler, Catherine Witkop, and Jeffrey C. Leggit. "Injury and Illness Surveillance During the 2016 Department of Defense Warrior Games: Review of Methods and Results." Military Medicine 184, no. 11-12 (April 3, 2019): e616-e621. http://dx.doi.org/10.1093/milmed/usz063.
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ABSTRACT Introduction Surveillance systems have become a valuable tool to capture epidemiological data at multi-sport events, with findings serving to predict and prevent injury, reduce illness, and guide efficient utilization of medical resources. In 2016, the first injury and illness surveillance tool for the Department of Defense (DoD) Warrior Games was established to inform the required medical footprint. The purpose of this paper is to describe the methods and findings from the 2016 DoD Warrior Games surveillance system, which included a database of injuries and illness. Materials and Methods A total of 245 wounded warrior (WW) athletes were followed over 19 days, to include train-up and competition periods, as they competed for their respective teams of Army, Navy, Air Force, Marines, Special Operations, and United Kingdom. Medical personnel recorded injuries and illnesses treated utilizing a standardized surveillance form and data were entered into a daily tracker to examine patterns or areas for prevention. Reports included sex, age, event discipline, previous injury or illness, reason for presentation, and treatment provided. Results From June 3 to June 21, 2016, 114 individual encounters were recorded on the standard form and entered into the surveillance database. Athletes accounted for 67% of all encounters. Illness accounted for 30.7% of all visits, while injuries accounted for 69.2%. The incident proportion of injuries in athletes was 23.3 injuries per 100 athletes (95% CI 17.6, 30.1) and incident rate of 12.2 injuries per 1000 athlete days. Integrative medicine treatments including acupuncture, osteopathic manipulative treatment (OMT), massage therapy, and gua sha accounted for the largest forms of treatment (31%). Conclusions From the surveillance data, staff levels and treatment supplies can be adjusted. In addition an improved surveillance tool can be created. Continuous surveillance is required to provide information on trends in injury and illness to support prevention strategies.
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Ofei-Dodoo, Samuel, Julia Black, Michael Kirkover, Colin Lisenby, Andrew Porter, and Paul Cleland. "Collegiate Athletes’ Perceptions of Osteopathic Manipulative Treatment." Kansas Journal of Medicine 13 (June 25, 2020): 147–51. http://dx.doi.org/10.17161/kjm.v13i.13819.
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Introduction. Many published studies have examined the effects of osteopathic manipulative treatment (OMT), but none has evaluated its role in treating collegiate athletes. The authors examined collegiate athletes’ perception of OMT.
Methods. A cross-sectional survey of a convenience sample of 592 collegiate athletes was conducted from two universities in the midwestern United States during August-September 2019. The athletes completed a 12-item survey during pre-participation physical evaluations at their respective institutions. Main outcome measures included pain, need for pain medication, stress and anxiety associated with injuries, and overall satisfaction with the OMT in recovery and return to sports. Fisher’s exact test was used to evaluate association between the variables.
Results. The participation rate was 80.6% (477/592). Slightly fewer than 7% (31/477) of the athletes were familiar with OMT. Eighteen of the 31 athletes (58.1%) had received osteopathic manipulation as part of a treatment plan for injury. Of these athletes, 94.4% (17/18) reported a decreased need for pain medication and 83.3% (15/18) had reduced stress and anxiety related to their injury. One in three of them expressed interest in receiving osteopathic manipulation as a treatment option for an injury. The athletes reported general satisfaction with OMT in their recovery and return to sports.
Conclusion. The findings demonstrated the interest and benefits of OMT among collegiate athletes. This evidence supported previous findings about perceived efficacy of OMT in treating patients regardless of injury and diagnosis. Future studies need to establish causal relationship among OMT, stress and anxiety, pain, and use of pain medications.
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Sposato, Niklas S., and Kristofer Bjerså. "Osteopathic Manipulative Treatment in Surgical Care." Journal of Evidence-Based Integrative Medicine 23 (January 1, 2018): 2515690X1876767. http://dx.doi.org/10.1177/2515690x18767671.
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Background. A growing trend in surgical care is the investigation and incorporation of multimodal interventions into standardized programs. Additionally, manual therapies such as osteopathic manipulative treatment (OMT) are being used with patients in surgical care. Yet the scientific dialogue and the use of OMT in surgical care are currently insubstantial. Objective. The aim of this study was to present an overview of published research articles within the subject field of OMT in surgical care. Method. Summative review of peer-reviewed research articles published in osteopathic journals during the period 1990 to 2017. In total, 10 articles were identified. Result. Previous research has been conducted within the areas of abdominal, thoracic, gynecological, and/or orthopedic surgery with measured outcomes such as pain, analgesia consumption, length of hospital stay, and range of motion. Heterogeneity was identified in usage of osteopathic techniques, treatment duration, and occurrence, as well as in the treating osteopath’s experience. Conclusion. Despite the small number of research articles within this field, both positive measured effects as well as the absence of such effects were identified. Overall, there was a heterogeneity concerning surgical contexts, diagnoses, signs and symptoms, as well as surgical phases in current interprofessional osteopathic publications. In this era of multimodal surgical care, we argue that there is an urgent need to evaluate OMT in this context of care and with a proper research approach.
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Cicchitti, Luca, Alessandra Di Lelio, Gina Barlafante, Vincenzo Cozzolino, Susanna Di Valerio, Paola Fusilli, Giuseppe Lucisano, Cinzia Renzetti, Marco Verzella, and Maria Chiara Rossi. "Osteopathic Manipulative Treatment in Neonatal Intensive Care Units." Medical Sciences 8, no. 2 (June 24, 2020): 24. http://dx.doi.org/10.3390/medsci8020024.
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The aim of this study was to assess the impact of osteopathic manipulative treatment (OMT) on newborn babies admitted at a neonatal intensive care unit (NICU). This was an observational, longitudinal, retrospective study. All consecutive admitted babies were analyzed by treatment (OMT vs. usual care). Treatment group was randomly assigned. Between-group differences in weekly weight change and length of stay (LOS) were evaluated in the overall and preterm populations. Among 1249 babies (48.9% preterm) recorded, 652 received usual care and 597 received OMT. Weight increase was more marked in the OMT group than in the control group (weekly change: +83 g vs. +35 g; p < 0.001). Similar trends were found in the subgroup of preterm babies. A shorter LOS was found in the OMT group vs. the usual care group both in overall population (average mean difference: −7.9 days, p = 0.15) and in preterm babies (−12.3 days; p = 0.04). In severe preterm babies, mean LOS was more than halved as compared to the control group. OMT was associated with a more marked weekly weight increase and, especially in preterm babies, to a relevant LOS reduction: OMT may represent an efficient support to usual care in newborn babies admitted at a NICU.
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Dubey, Jared, Sarah James, and Larissa Zakletskaia. "Osteopathic manipulative treatment for allopathic physicians: piloting a longitudinal curriculum." Journal of Osteopathic Medicine 121, no. 4 (February 15, 2021): 371–76. http://dx.doi.org/10.1515/jom-2020-0038.
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Abstract Context Under the Accreditation for Graduate Medical Education (ACGME) single accreditation system, there is likely to be increasing interest and opportunity for teaching osteopathic manipulative treatment (OMT) to allopathic residents and residency faculty. When learning OMT, allopathic physicians (MDs) have distinct needs compared with osteopathic medical students. For example, MDs already have a foundation in anatomy and medical vocabulary, but incorporating an osteopathic approach to patient care may require a paradigm shift. Thus, a unique approach to osteopathic education for MDs in residency programs with osteopathic recognition (OR) is needed. Objectives To create a longitudinal OMT elective for allopathic residents and residency faculty and assess its impact on attitudes and confidence regarding osteopathic principles and treatment. Methods Drawing from standard texts used during preclinical osteopathic education, a blended online and in-person laboratory modular curriculum for the OMT elective course was developed by osteopathic residents and faculty within the Department of Family Medicine and Community Health at the University of Wisconsin in Madison. The modalities of muscle energy, counterstrain, myofascial release, and soft tissue were included; the curriculum also reviewed autonomic physiology, somatovisceral, and viscerosomatic reflexes. A quality improvement study of the course was conducted via pre- and postcourse surveys to assess its impact on perceptions and confidence regarding the theory and practice, referral, and use of OMT. A precourse survey was distributed before the first module to obtain background information and assess participants’ prior OMT exposure, among other things. Nine months after the course ended, a corresponding postcourse survey was distributed. Pre- and postcourse surveys were individually matched to improve statistical analysis, using unique identifiers. Also, following each laboratory, a postlaboratory survey was collected about the participant’s experience for that lecture and for laboratory-specific quality improvement purposes. Two years after course completion, graduates were reached via phone or email for informal interviews to assess the perceived long-term impact from the elective. Results Eleven MDs from a total potential pool of 26 residents and approximately 120 attending physicians enrolled in the course; eight (72.7%) completed all modules and pre- and postcourse evaluations. Participants reported statistically significant gains in attitudes and confidence regarding OMT (“knowledgeable regarding OMT principles”: precourse mean, 2.50 [0.76], vs. postcourse mean, 3.37 [0.52]; p=0.021; “know how to treat using OMT”: precourse mean, 2.25 [1.39], vs. postcourse mean, 3.12 [1.25]; p=0.041). Several participants (five; 62.5%) had completed prior OMT training. There was an increase, albeit nonsignificant, in the use of OMT, with more providers using OMT (precourse mean, five, vs. postcourse mean, six; p=0.171), and providers using OMT more often (precourse OMT use monthly or more often, three, vs. postcourse OMT use monthly or more often, six; p=0.131). Conclusions Implementing a longitudinal elective curriculum is a feasible way to improve attitudes and confidence in OMT for MDs involved in a family medicine residency. Whether our elective leads to competency in OMT for allopathic residents and faculty remains to be formally evaluated. Our pilot established the feasibility and led to a revision of our curriculum; the elective continues to occur yearly. Future analyses will focus on competency assessment.