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Galeazzi Y, Houel N, Gouaux L, Rohan A, Le Heiget H, Jung C, Housset B, Stubbe L. Effect of osteopathic manipulative treatment on pain in palliative care patients: a randomized placebo-controlled clinical trial. Pain Rep 2025; 10:e1239. [PMID: 39917323 PMCID: PMC11801812 DOI: 10.1097/pr9.0000000000001239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 10/27/2024] [Accepted: 11/20/2024] [Indexed: 02/09/2025] Open
Abstract
Introduction Standard osteopathic manipulative therapy (OMT) is used as a supportive care for pain management in cancer patients. Objectives The present study aimed to compare the efficacy of OMT with that of a sham treatment to attenuate pain in cancer patients in a palliative care unit. Methods This randomized clinical trial was a simple blind, monocentric, placebo-controlled study. Seventy-five patients were randomly distributed between standard and sham OMT sessions at a 1:1 ratio, receiving standard or sham treatment every 2 days for the 7 days of the study. Patients were assessed using a self-administered visual analog scale (VAS)-ranging from 0 to 100, recorded in the morning and evening. They also completed the QLQ-C15-PAL quality-of-life questionnaire on the first and last day of the study. For participants with controlled analgesia pumps, the number of analgesic doses was recorded. Results The OMT group demonstrated a significant effect of days, circadian period, and group on VAS pain decrease (P < 0.05). The VAS pain score for the OMT group exhibited a notable decline from the third day (D3 pm) (P = 0.03) to D6 pm (P = 1.28 × 10-05) with 43.2% improvement by the conclusion of the study. On D6, the quality-of-life score exhibited a tendency towards improvement. Patients with analgesia pumps showed a 31.58% reduction in their demand for analgesics (P = 0.016). No significant results were observed between D0 and D3. Conclusion It is hypothesized that OMT could prove an efficacious method of pain management in cancer patients receiving palliative care, in addition to conventional cancer treatment.
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Affiliation(s)
- Yann Galeazzi
- ESO-Paris Recherche, Ecole Supérieure d’Ostéopathie—Paris, Champs Sur Marne, France
| | - Nicolas Houel
- ESO-Paris Recherche, Ecole Supérieure d’Ostéopathie—Paris, Champs Sur Marne, France
- PSMS EA 7507, Université de Reims Champagne-Ardenne, Reims, France
| | - Léa Gouaux
- ESO-Paris Recherche, Ecole Supérieure d’Ostéopathie—Paris, Champs Sur Marne, France
| | - Anne Rohan
- Centre Hospitalier Intercommunal Créteil (CHIC), Créteil, France
| | - Hélène Le Heiget
- Centre Hospitalier Intercommunal Créteil (CHIC), Créteil, France
| | - Camille Jung
- Centre Hospitalier Intercommunal Créteil (CHIC), Créteil, France
- Clinical Research Center, CHIC, Créteil, France
- Université Paris-Est, Créteil, France
| | - Bruno Housset
- Centre Hospitalier Intercommunal Créteil (CHIC), Créteil, France
| | - Laurent Stubbe
- ESO-Paris Recherche, Ecole Supérieure d’Ostéopathie—Paris, Champs Sur Marne, France
- CIAMS EA 4532, Université Paris Sud, Université Paris-Saclay, Orsay, France
- CIAMS EA 4532, Université d’Orléans, Orléans, France
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Ceballos-Laita L, Jiménez-del-Barrio S, Carrasco-Uribarren A, Medrano-de-la-Fuente R, Robles-Pérez R, Ernst E. Is Osteopathic Manipulative Treatment Clinically Superior to Sham or Placebo for Patients with Neck or Low-Back Pain? A Systematic Review with Meta-Analysis. Diseases 2024; 12:287. [PMID: 39589961 PMCID: PMC11593019 DOI: 10.3390/diseases12110287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Revised: 11/02/2024] [Accepted: 11/07/2024] [Indexed: 11/28/2024] Open
Abstract
Objectives: The aim of this systematic review and meta-analysis was to compare whether osteopathic manipulative treatment (OMT) for somatic dysfunctions was more effective than sham or placebo interventions in improving pain intensity, disability, and quality of life for patients with neck pain (NP) or low-back pain (LBP). Methods: A systematic review and meta-analysis was carried out. Searches were conducted in PubMed, Physiotherapy Evidence Database, Cochrane Library, and Web of Science from inception to September 2024. Studies applying a pragmatic intervention based on the diagnosis of somatic dysfunctions in patients with NP or LBP were included. The methodological quality was assessed with the PEDro scale. The quantitative synthesis was performed using random-effect meta-analysis calculating the standardized mean difference (SMD) with RevMan 5.4. The certainty of evidence was evaluated using GRADEPro. Results: Nine studies were included in the qualitative synthesis, and most of them showed no superior effect of OMTs compared to sham or placebo in any clinical outcome. The quantitative synthesis reported no statistically significant differences for pain intensity (SMD = -0.15; -0.38, 0.08; seven studies; 1173 patients) or disability (SMD = -0.09; -0.25, 0.08; six studies; 1153 patients). The certainty of evidence was downgraded to moderate, low, or very low. Conclusions: The findings of this study reveal that OMT is not superior to sham or placebo for improving pain, disability, and quality of life in patients with NP or LBP.
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Affiliation(s)
- Luis Ceballos-Laita
- Grupo de Investigación Clínica en Ciencias de la Salud, Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Universidad de Valladolid, Campus Duques de Soria, 42004 Soria, Spain; (L.C.-L.)
| | - Sandra Jiménez-del-Barrio
- Grupo de Investigación Clínica en Ciencias de la Salud, Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Universidad de Valladolid, Campus Duques de Soria, 42004 Soria, Spain; (L.C.-L.)
| | - Andoni Carrasco-Uribarren
- Departamento de Fisioterapia, Universidad Internacional de Cataluña, 08195 Sant Cugat del Valles, Spain
| | - Ricardo Medrano-de-la-Fuente
- Grupo de Investigación Clínica en Ciencias de la Salud, Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Universidad de Valladolid, Campus Duques de Soria, 42004 Soria, Spain; (L.C.-L.)
| | - Román Robles-Pérez
- Grupo de Investigación Clínica en Ciencias de la Salud, Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Universidad de Valladolid, Campus Duques de Soria, 42004 Soria, Spain; (L.C.-L.)
| | - Edzard Ernst
- Emeritus Professor, University of Exeter, Exeter EX4 4PY, UK;
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Pelletier J, Capistrant T, Nordt SP. Osteopathic manipulation and its applicability in the emergency department: A narrative review. Am J Emerg Med 2024; 84:74-80. [PMID: 39096712 DOI: 10.1016/j.ajem.2024.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 07/25/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND Osteopathic manipulative treatment (OMT), also known as osteopathic manipulative medicine (OMM), is a set of manual techniques, developed by Dr. Andrew Taylor Still, founder of osteopathic medicine, initially limited to osteopathic medicine, for the treatment of painful conditions. This toolset is now used by allopathic physicians, international osteopaths, physical therapists, chiropractors, and other healthcare workers for the treatment of musculoskeletal pain. OMT can be used in the emergency department (ED) for the treatment of musculoskeletal complaints as an adjunct to pharmacologic agents (e.g., NSAIDs), or an alternative to opioids. OBJECTIVE This narrative review provides emergency clinicians with an understanding of OMT, including a broad overview of the basis, development, and common subtypes of OMT; data on OMT efficacy and on the use of conditions commonly encountered in the ED setting; and information on how to implement the use of OMT in emergency medicine and urgent care settings. DISCUSSION OMT can be used for a wide variety of acute and chronic pain conditions, particularly back pain, headaches, neck pain, and extremity pain (assuming that life-threatening conditions have been excluded). There are small studies and case series demonstrating both efficacy and subjective improvement with OMT, including in the ED. However, limitations to the current body of literature include: small numbers of patients, challenges with blinding and standardization, limited adverse event reporting, and most research has been outside of the ED setting. There is great opportunity for future studies and application of OMT in the ED. There are an increasing number of emergency clinicians incorporating OMT in their practice and despite the perception of OMT requiring extended periods of time to perform, current data suggests OMT does not prolong ED visits or cost to patients. OMT is a procedure with billing codes, and courses and training in OMT are available for both osteopathic and allopathic physicians. CONCLUSION OMT is being used and has great potential in the management of acute and chronic musculoskeletal pain in the ED in addition to, or instead of pharmacologic agents, in particular as an opioid-sparing option.
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Affiliation(s)
- J Pelletier
- Assistant Professor of Emergency Medicine, Assistant Residency Program Director, University of Missouri-Columbia, 1 Hospital Dr # M562, Columbia, MO 65201, United States of America.
| | - T Capistrant
- Osteopathic Manipulative Medicine, Tanana Valley Clinic, 1001 Noble Street, Fairbanks, Alaska 99701, United States of America.
| | - S P Nordt
- Professor of Emergency Medicine, Loma Linda University, School of Medicine, Department of Emergency Medicine, 11234, Anderson St Loma Linda, CA 92354, United States of America.
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Delgadillo BE, Bui A, Debski AM, Miller B, Wu DO SS. Efficacy of Osteopathic Manipulative Treatment for Pain Reduction in Patients With Patellofemoral Pain Syndrome: A Meta-Analysis of Randomized Controlled Trials. Cureus 2024; 16:e59439. [PMID: 38826947 PMCID: PMC11140634 DOI: 10.7759/cureus.59439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 04/30/2024] [Indexed: 06/04/2024] Open
Abstract
Patellofemoral pain syndrome (PFPS) is among the most common causes of musculoskeletal pain in the United States. It is defined as retropatellar or peripatellar pain that is reproduced with functional activities that load the patellofemoral joint in a flexed position, such as stair climbing or squatting. While it presents in both adolescents and adults, it is commonly found in physically active individuals, such as athletes and military recruits. Exploring the role of osteopathic manipulative treatment (OMT) in PFPS is of particular interest given the absence of a definitive treatment and the poor long-term prognosis associated with PFPS. This meta-analysis includes three studies exploring the use of OMT to reduce pain in patients suffering from PFPS and exploring the efficacy of OMT as a primary intervention. In these studies, pain assessments, pre-treatment, and post-treatment follow-up of at least 30 days were performed using a 10-cm visual analog scale (VAS). The mean difference in pain between OMT and no treatment (NT) groups using the random effects model was -3.95 (-6.39; -1.50) with a p<0.01, suggesting OMT resulted in significant knee pain reduction in those with PFPS. A measure of heterogeneity, known as I2, was found to be high at 97%, which suggests caution should be taken when interpreting the overall results. Given the lack of definitive treatment and the poor long-term prognosis for PFPS, the authors suggest OMT provides an effective option for pain relief in patients with PFPS. Further research is needed to provide results that may be more clinically applicable or valuably interpreted.
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Affiliation(s)
- Blake E Delgadillo
- Orthopaedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Audrey Bui
- Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Alyssa M Debski
- Anatomy, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Brooke Miller
- Urology, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Shan Shan Wu DO
- Allergy/Immunology, Allergy/Immunology Associates, Inc., Mayfield Heights, USA
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5
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Gillan R, Bachtel G, Webber K, Ezzair Y, Myers NE, Bishayee A. Osteopathic manipulative treatment for chronic inflammatory diseases. J Evid Based Med 2024; 17:172-186. [PMID: 38488211 DOI: 10.1111/jebm.12590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/25/2024] [Indexed: 04/02/2024]
Abstract
Chronic inflammatory diseases (CIDs) are debilitating and potentially lethal illnesses that affect a large proportion of the global population. Osteopathic manipulative treatment (OMT) is a manual therapy technique developed and performed by osteopathic physicians that facilitates the body's innate healing processes. Therefore, OMT may prove a beneficial anti-inflammatory modality useful in the management and treatment of CIDs. This work aims to objectively evaluate the therapeutic benefits of OMT in patients with various CIDs. In this review, a structured literature search was performed. The included studies involving asthma, chronic obstructive pulmonary disease, irritable bowel syndrome, ankylosing spondylitis, and peripheral arterial disease were selected for this work. Various OMT modalities, including lymphatic, still, counterstain, and muscle energy techniques, were utilized. Control treatments included sham techniques, routine care, or no treatment. OMT utilization led to variable patient outcomes in individuals with pathologies linked to CID.
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Affiliation(s)
- Ross Gillan
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Gabrielle Bachtel
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Kassidy Webber
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Yasmine Ezzair
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Nicole E Myers
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Anupam Bishayee
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
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6
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Tran A, Ngo T, Roberts T, Ko E, Holmgren JG, Edwards C, Coleman M, Gao J. Quantitative ultrasound to assess efficacy of treatment for neck somatic dysfunctions: a feasibility study. J Osteopath Med 2023; 123:443-450. [PMID: 37285456 DOI: 10.1515/jom-2022-0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/19/2023] [Indexed: 06/09/2023]
Abstract
CONTEXT Neck pain is a common complaint in healthcare clinics. Although the pathogenesis of neck pain is often multifactorial, trapezius muscle dysfunction has been commonly linked to neck pain. Osteopathic manipulative treatment (OMT) has been demonstrated to be an effective treatment modality in treating trapezius muscle dysfunction and neck pain. However, there is a current lack of objective, quantitative measures to assess the effectiveness of OMT. Through previous research, ultrasound technology has been shown to be promising in its ability to quantify tissue changes both pre- and post-OMT. OBJECTIVES The objectives of this study are to evaluate the feasibility of shear wave elastography (SWE) in assessing upper trapezius muscles with pain and hypertonicity, as well as the changes in these muscles post-OMT for cervical somatic dysfunctions. METHODS After obtaining approval from the Rocky Vista University Institutional Review Board and written informed consent from participants, SWE and osteopathic assessments were performed on 22 adult participants with and without cervical spine somatic dysfunction. Participants with positive osteopathic assessments of tissue texture, asymmetry, restricted motion, and/or tenderness (TART) were treated utilizing OMT. Shear wave velocity (SWV, m/s) and shear wave velocity rate [SWVR = (SWV contraction - SWV relaxation)/ SWV relaxation] of the upper trapezius muscles with and without pain and hypertonicity, and before and after OMT, were examined utilizing a two-tailed t-test. RESULTS SWV in muscle contraction and SWVR were significantly lower in muscles with pain compared to muscles without pain (p≤0.01). SWV in muscle contraction was also significantly lower in hypertonic muscles compared to normotonic muscles (p<0.01). Following OMT, SWV in muscle contraction and SWVR in muscles with pain and hypertonic increased significantly (p≤0.01). Overall TART score of all muscles with somatic dysfunction (SD) after OMT significantly decreased (p<0.01). SWV in muscle contraction and SWVR in hypertonic muscles were also significantly increased (p≤0.03), with an improvement index of 0.11 and 0.20. CONCLUSIONS This study's results demonstrate the feasibility of utilizing SWE to evaluate somatic dysfunctions of the upper trapezius musculature and the efficacy of OMT for neck somatic dysfunctions.
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Affiliation(s)
- Anthony Tran
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
| | - Thien Ngo
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
| | - Tanner Roberts
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
| | - Eric Ko
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
| | | | - Chris Edwards
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
| | - Michele Coleman
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
| | - Jing Gao
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
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Dal Farra F, Buffone F, Risio RG, Tarantino AG, Vismara L, Bergna A. Effectiveness of osteopathic interventions in patients with non-specific neck pain: A systematic review and meta-analysis. Complement Ther Clin Pract 2022; 49:101655. [PMID: 35986986 DOI: 10.1016/j.ctcp.2022.101655] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/13/2022] [Accepted: 08/01/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis is to evaluate whether osteopathic manipulative interventions can reduce pain levels and enhance the functional status in patients with non-specific neck pain (NS-NP). METHODS A systematic review and meta-analysis was conducted following the 2020 PRISMA statement. Randomized controlled trials (RCTs) were searched in five databases, assessed through a standardized form, and evaluated using the "13 items Cochrane risk of bias (RoB) tool". Effect sizes (ES) were calculated post-treatment, and the quality of evidence was assessed through GRADE criteria. RESULTS Five articles were included in the review, and none of these was completely judged at low RoB. Four of these were included in the meta-analysis. Osteopathic interventions compared to no intervention/sham treatment showed statistically significant results for pain levels (ES = -1.57 [-2.50, -0.65]; P = 0.0008) and functional status (ES = -1.71 [-3.12, -0.31]; P = 0.02). The quality of evidence was "very low" for all the assessed outcomes. Other results were presented in a qualitative synthesis. CONCLUSIONS Osteopathic interventions could be effective for pain levels and functional status improvements in adults with NS-NP. However, these findings are affected by a very low quality of evidence. Therefore, further high-quality RCTs are necessary to improve the quality of evidence and generalize the results.
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Affiliation(s)
- Fulvio Dal Farra
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Francesca Buffone
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy; PPCR, Harvard T.H. Chan School of Public Health - ECPE, Boston, USA.
| | | | - Andrea Gianmaria Tarantino
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy.
| | - Luca Vismara
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy; Division of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, Piancavallo-Verbania, Italy; Department of Neurosciences "Rita Levi Montalcini", University of Turin, 10126, Turin, Italy.
| | - Andrea Bergna
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy.
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Damian K, Chad C, Kenneth L, David G. Time to evolve: the applicability of pain phenotyping in manual therapy. J Man Manip Ther 2022; 30:61-67. [PMID: 35344468 PMCID: PMC8967203 DOI: 10.1080/10669817.2022.2052560] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Keter Damian
- Department of Veterans Affairs Medical Center, Cleveland, Ohio, USA
- Department of Graduate Studies in Health and Rehabilitation Sciences, Youngstown State University, Youngstown, Ohio, USA
| | - Cook Chad
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Department of Population Health Sciences, Duke University, Durham, NC, USA
- Duke Clinical Research Institution, Duke University, Durham, NC, USA
| | - Learman Kenneth
- Department of Graduate Studies in Health and Rehabilitation Sciences, Youngstown State University, Youngstown, Ohio, USA
| | - Griswold David
- Department of Graduate Studies in Health and Rehabilitation Sciences, Youngstown State University, Youngstown, Ohio, USA
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Schmid GL, Kluge J, Deutsch T, Geier AK, Bleckwenn M, Unverzagt S, Frese T. Osteopathy in Germany: attitudes, beliefs and handling among general practitioners - results of a nationwide cross-sectional questionnaire survey. BMC FAMILY PRACTICE 2021; 22:197. [PMID: 34620110 PMCID: PMC8499418 DOI: 10.1186/s12875-021-01545-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/17/2021] [Indexed: 11/23/2022]
Abstract
Background Osteopathy is a type of complementary medicine based on specific manual techniques. In many countries, including Germany, the profession is not officially regulated, and evidence for the effectiveness of osteopathy is insufficient for most diseases. Nevertheless, many health insurances in Germany offer reimbursement for therapy costs, if osteopathy is recommended by a physician. This cross-sectional survey of German general practitioners (GPs) explored beliefs and attitudes towards osteopathic medicine and described their daily interactions with it. Methods A random sample of 1000 GPs from all federal states was surveyed by mail using a self-designed questionnaire. We collected data on sociodemographics, personal experiences with osteopathy, and attitudes and expectations towards osteopathy. In particular, participants were asked about indications for osteopathic treatment and their beliefs about its effectiveness for different patient groups and diagnoses. A self-designed score was used to estimate general attitudes towards osteopathy and identify factors correlated with greater openness. Additionally, we performed logistic regression to reveal factors associated with the frequency of recommending osteopathy to patients. Results Response rate was 34.4%. 46.5% of participants were women, and the median age was 56.0 years. 91.3% of GPs had referred patients to an osteopath, and 88.0% had recommended osteopathy to their patients. However, 57.5% acknowledged having little or no knowledge about osteopathy. Most frequent reasons for a recommendation were spinal column disorders (46.2%), other complaints of the musculoskeletal system (18.2%) and headaches (9.8%). GPs estimated the highest benefit for chronically ill and middle-aged adults. Female gender (OR 2.09; 95%CI 1.29–3.38) and personal treatment experiences (OR 5.14; 95%CI 2.72–9.72) were independently positively associated with more frequent treatment recommendation. Conclusion GPs in Germany have frequent contact with osteopathy, and the vast majority have recommended osteopathic treatment to some extent in their practice, with foci and opinions comparable to other Western countries. The discrepancy between GPs making frequent referrals for osteopathic treatment while self-assessing to have little knowledge about it demonstrates need for intensified research on the collaboration with osteopaths and how to best integrate osteopathic treatments. Our results may help to focus future effectiveness studies on most relevant clinical conditions in general practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01545-2.
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Affiliation(s)
- Gordian L Schmid
- Department of General Practice, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany.
| | - Jeremias Kluge
- Department of General Practice, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Tobias Deutsch
- Department of General Practice, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Anne-Kathrin Geier
- Department of General Practice, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Markus Bleckwenn
- Department of General Practice, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Susanne Unverzagt
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany
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10
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Winter J, Kimber A, Montenegro S, Gao J. Ultrasonography to Assess the Efficacy of Osteopathic Manipulative Treatment for Lumbar Spine Asymmetry. J Osteopath Med 2021; 120:761-769. [PMID: 33021624 DOI: 10.7556/jaoa.2020.127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Context The effectiveness of osteopathic manipulative treatment (OMT) on the lumbar spine has been studied qualitatively, but quantitative measurement of the effects of OMT has not been thoroughly investigated. Objective To quantitatively measure the palpated improvements of OMT on the lumbar spine using ultrasonography (US) and correlate palpatory diagnosis with US measurements of lumbar asymmetry. Methods From September to November 2018, we recruited 20 adult participants 18 years of age or older. Lumbar somatic dysfunction (SD) was identified via osteopathic palpation. US was then performed on all participants with standard machine settings (frequency, 7 MHz; depth, 7 cm; dynamic range, 60; tissue harmonic imaging; and single-image focus). Longitudinal images of each lumbar transverse process were recorded and saved bilaterally by an experienced radiologist and a medical student. The participant's SD was then managed using OMT, including Still technique, myofascial release, muscle energy technique, high-velocity low-amplitude technique, functional positional release, balanced ligamentous tension, and counterstrain. Following OMT, US was performed again in the same method. Measurements of the saved US images were reviewed using a Digital Imaging and Communications in Medicine viewer. These measurements were obtained by 3 separate observers (J.W., A.K., S.M.), using the same computer software. Statistical analysis included a 2-tailed paired t-test to analyze rotational asymmetry pre- and posttreatment, an intraclass correlation coefficient (ICC) to test intra- and interobserver reliability, and a Pearson correlation coefficient (PCC) to analyze the correlation between US findings and OMT. Results The difference in soft tissue thickness before and after OMT was significant (P=.014), indicating improvements in rotational asymmetry. Side-bending asymmetry did not demonstrate statistically significant improvement. US findings correlated with the physician's palpatory rotational diagnosis (PCC=0.62, P=.004). ICC was greater than 0.9 for intra- and interobserver reliability tests of both US operation and offline image processing. Conclusion The results of this study demonstrate that US is a feasible method of evaluating the efficacy of OMT. These results show good intra- and interobserver reliability of US acquisition and landmark measurement. Our study suggests that US assessment correlated closely with palpatory diagnosis. Our results also suggest that OMT can significantly improve lumbar rotational asymmetry, but did not improve side-bending asymmetry.
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Nicol R, Yu H, Selb M, Prodinger B, Hartvigsen J, Côté P. How Does the Measurement of Disability in Low Back Pain Map Unto the International Classification of Functioning, Disability and Health?: A Scoping Review of the Manual Medicine Literature. Am J Phys Med Rehabil 2021; 100:367-395. [PMID: 33141774 DOI: 10.1097/phm.0000000000001636] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT The objective of this study was to catalog items from instruments used to measure functioning, disability, and contextual factors in patients with low back pain treated with manual medicine (manipulation and mobilization) according to the International Classification of Functioning, Disability and Health. This catalog will be used to inform the development of an International Classification of Functioning, Disability and Health-based assessment schedule for low back pain patients treated with manual medicine. In this scoping review, we systematically searched MEDLINE, Embase, PsycINFO, and CINAHL. We identified instruments (questionnaires, clinical tests, single questions) used to measure functioning, disability, and contextual factors, extracted the relevant items, and then linked these items to the International Classification of Functioning, Disability and Health. We included 95 articles and identified 1510 meaningful concepts. All but 70 items were linked to the International Classification of Functioning, Disability and Health. Of the concepts linked to the International Classification of Functioning, Disability and Health, body functions accounted for 34.7%, body structures accounted for 0%, activities and participation accounted for 41%, environmental factors accounted for 3.6%, and personal factors accounted for 16%. Most items used to measure functioning and disability in low back pain patient treated with manual medicine focus on body functions, as well as activities and participation. The lack of measures that address environmental factors warrants further investigation.
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Affiliation(s)
- Richard Nicol
- From the ELiB (et liv i bevegelse), Oslo, Norway (RN); UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology, Oshawa, Ontario, Canada (HY, PC); ICF Research Branch, Nottwil, Switzerland (MS); Swiss Paraplegic Research, Nottwil, Switzerland (MS); Department of Applied Health and Social Sciences, University of Applied Sciences Rosenheim, Rosenheim, Germany (BP); Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark (JH); Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark (JH); and Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada (PC)
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Lo Basso F, Pilzer A, Ferrero G, Fiz F, Fabbro E, Oliva D, Cazzarolli C, Turrina A. Manual treatment for kidney mobility and symptoms in women with nonspecific low back pain and urinary infections. J Osteopath Med 2021; 121:489-497. [PMID: 33705610 DOI: 10.1515/jom-2020-0288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 11/20/2020] [Indexed: 11/15/2022]
Abstract
CONTEXT Recent studies have suggested a connection between low back pain (LBP) and urinary tract infections (UTI). These disturbances could be triggered via visceral-somatic pathways, and there is evidence that kidney mobility is reduced in patients suffering from nonspecific LBP. Manual treatment of the perinephric fascia could improve both kidney mobility and LBP related symptoms. OBJECTIVES To assess whether manual treatment relieves UTI and reduces pain in patients with nonspecific LBP through improvement in kidney mobility. METHODS Records from all patients treated at a single physical therapy center in 2019 were retrospectively reviewed. Patients were included if they were 18 years of age or older, had nonspecific LBP, and experienced at least one UTI episode in the 3 months before presentation. Patients were excluded if they had undergone manipulative treatment in the 6 months before presentation, if they had one of several medical conditions, if they had a history of chronic pain medication use, and more. Patient records were divided into two groups for analysis: those who were treated with manipulative techniques of the fascia with thrust movement (Group A) vs those who were treated without thrust movement (Group B). Kidney Mobility Scores (KMS) were analyzed using high resolution ultrasound. Symptoms as reported at patients' 1 month follow up visits were also used to assess outcomes; these included UTI relapse, lumbar spine mobility assessed with a modified Schober test, and lumbar spine pain. RESULTS Of 126 available records, 20 patients were included in this retrospective study (10 in Group A and 10 in Group B), all of whom who completed treatment and attended their 1 month follow up visit. Treatments took place in a single session for all patients and all underwent ultrasound of the right kidney before and after treatment. The mean (± standard deviation) KMS (1.9 ± 1.1), mobility when bending (22.7 ± 1.2), and LBP scores (1.2 ± 2.6) of the patients in Group A improved significantly in comparison with the patients in Group B (mean KMS, 1.1 ± 0.8; mobility when bending, 21.9 ± 1.1; and LBP, 3.9 ± 2.7) KMS, p<0.001; mobility when bending, p=0.003; and LBP, p=0.007). At the 1 month follow up visit, no significant statistical changes were observed in UTI recurrence (secondary outcome) in Group A (-16.5 ± 4.3) compared with Group B (-20.4 ± 7) (p=0.152). CONCLUSIONS Manual treatments for nonspecific LBP associated with UTI resulted in improved mobility and symptoms for patients in this retrospective study, including a significant increase in kidney mobility.
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Affiliation(s)
| | | | - Giulio Ferrero
- Diagnostic and Interventional Radiology Unit, Ospedale Santa Corona, Pietra Ligure, Italy
| | - Francesco Fiz
- Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | | | - Daniele Oliva
- Private Practice, Studio Fisioterapico Loano, Loano, Italy
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Franzetti M, Dries E, Stevens B, Berkowitz L, Yao SC. Support for osteopathic manipulative treatment inclusion in chronic pain management guidelines: a narrative review. J Osteopath Med 2021; 121:307-317. [PMID: 33635954 DOI: 10.1515/jom-2019-0284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Context Osteopathic manipulative treatment (OMT) is used to treat chronic pain conditions. However, few guidelines focusing on chronic pain management include recommendations for OMT. Objectives To evaluate previous literature on the use of OMT for improving chronic pain. Methods A literature search was conducted on MEDLINE/PubMed and ScienceDirect on August 26-27, 2019, using the terms "osteopathic," "chronic," and "pain," yielding a total of 312 MEDLINE/PubMed articles and 515 ScienceDirect articles. Eligibility criteria required that studies investigate pain, functional status, or medication usage through an experimental design, focusing on human subjects with chronic pain who had various forms of OMT administered by osteopathically trained individuals in which the comparator group received no intervention, a sham or placebo, or conventional care. Three authors independently performed literature searches and methodically settled disagreements over article selection. Results In the 22 articles included in our study that examined OMT use in chronic pain conditions, we evaluated primary outcomes of pain (22; 100%) and functional status (20; 90.9%), and the secondary outcome of medication usage (3; 13.6%). The majority of articles showed that OMT resulted in a significant decrease in pain levels as compared to baseline pain levels or the control group (20; 90.9%) and that OMT resulted in an improvement in functional status (17; 77.3%). In articles that did not find a significant difference in pain (2; 9.1%) or functional status (3; 13.6%), there were overall outcomes improvements noted. All articles that investigated medication usage (3; 13.6%) showed that OMT was effective in decreasing patients' medication usage. Our study was limited by its small sample size and multimodal comparator group exclusion. Conclusions OMT provides an evidence-based management option to reduce pain levels, improve functional status, and decrease medication usage in chronic pain conditions, especially low back pain (LBP). Pain management guidelines should include OMT as a resource to alleviate chronic pain.
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Affiliation(s)
- Megan Franzetti
- College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Emily Dries
- College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Brady Stevens
- College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Lisa Berkowitz
- College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Sheldon C Yao
- Department of Osteopathic Manipulative Medicine, New York Institute of Technology, Old Westbury, NY, USA
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Cerritelli F, Chiacchiaretta P, Gambi F, Saggini R, Perrucci MG, Ferretti A. Osteopathy modulates brain-heart interaction in chronic pain patients: an ASL study. Sci Rep 2021; 11:4556. [PMID: 33633195 PMCID: PMC7907192 DOI: 10.1038/s41598-021-83893-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/09/2021] [Indexed: 01/31/2023] Open
Abstract
In this study we used a combination of measures including regional cerebral blood flow (rCBF) and heart rate variability (HRV) to investigate brain-heart correlates of longitudinal baseline changes of chronic low back pain (cLBP) after osteopathic manipulative treatment (OMT). Thirty-two right-handed patients were randomised and divided into 4 weekly session of OMT (N = 16) or Sham (N = 16). Participants aged 42.3 ± 7.3 (M/F: 20/12) with cLBP (duration: 14.6 ± 8.0 m). At the end of the study, patients receiving OMT showed decreased baseline rCBF within several regions belonging to the pain matrix (left posterior insula, left anterior cingulate cortex, left thalamus), sensory regions (left superior parietal lobe), middle frontal lobe and left cuneus. Conversely, rCBF was increased in right anterior insula, bilateral striatum, left posterior cingulate cortex, right prefrontal cortex, left cerebellum and right ventroposterior lateral thalamus in the OMT group as compared with Sham. OMT showed a statistically significant negative correlation between baseline High Frequency HRV changes and rCBF changes at T2 in the left posterior insula and bilateral lentiform nucleus. The same brain regions showed a positive correlation between rCBF changes and Low Frequency HRV baseline changes at T2. These findings suggest that OMT can play a significant role in regulating brain-heart interaction mechanisms.
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Affiliation(s)
- Francesco Cerritelli
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, Pescara, Italy
| | - Piero Chiacchiaretta
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,grid.412451.70000 0001 2181 4941ITAB-Institute for Advanced Biomedical Technologies, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Francesco Gambi
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,grid.412451.70000 0001 2181 4941ITAB-Institute for Advanced Biomedical Technologies, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Raoul Saggini
- grid.412451.70000 0001 2181 4941School of Specialty in Physical and Rehabilitation Medicine, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Mauro Gianni Perrucci
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,grid.412451.70000 0001 2181 4941ITAB-Institute for Advanced Biomedical Technologies, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Antonio Ferretti
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,grid.412451.70000 0001 2181 4941ITAB-Institute for Advanced Biomedical Technologies, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
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Montrose S, Vogel M, Barber KR. Use of osteopathic manipulative treatment for low back pain patients with and without pain medication history. J Osteopath Med 2021; 121:63-69. [PMID: 33512387 DOI: 10.1515/jom-2019-0193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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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Affiliation(s)
- Stephanie Montrose
- Department of Family Medicine , Ascension Genesys Hospital , Grand Blanc , MI , USA
| | - Mark Vogel
- Department of Family Medicine , Ascension Genesys Hospital , Grand Blanc , MI , USA
| | - Kimberly R Barber
- Department of Research , Ascension Genesys Hospital , Grand Blanc , MI , USA
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de Oliveira Meirelles F, de Oliveira Muniz Cunha JC, da Silva EB. Osteopathic manipulation treatment versus therapeutic exercises in patients with chronic nonspecific low back pain: A randomized, controlled and double-blind study. J Back Musculoskelet Rehabil 2020; 33:367-377. [PMID: 31658037 DOI: 10.3233/bmr-181355] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Osteopathic manipulation treatment is widely used in the clinical practice in the care of patients with chronic nonspecific low back pain, however, its benefits still seem uncertain. OBJECTIVE This study aimed to verify the efficacy of osteopathic manipulation for chronic nonspecific low back pain. MATERIALS AND METHODS Forty-two participants with chronic nonspecific low back pain were selected and randomized into two groups: active control group (ACG - n= 19) and osteopathic manipulation treatment group (OMTG - n= 23). Therapeutic exercises were performed with the ACG and osteopathic manipulation techniques with the OMTG. The interventions were carried out over 5 weeks of treatment, totaling 10 treatments for the ACG and 5 for the OMTG.The visual analogue scale (VAS) was used to measure chronic nonspecific low back pain and the Oswestry Disability Index 2.0, Tampa Scale of Kinesiophobia and Beck Depression Inventory were used to measure disability, kinesiophobia and depression, respectively. RESULTS The final chronic nonspecific low back pain in both groups was significantly lower than the initial low back pain (p⩽ 0.01) and the final chronic nonspecific low back pain of the OMTG was significantly lower than that of the ACG (p= 0.001). CONCLUSION This study demonstrated that the treatments were effective in both groups. However, the efficacy of the osteopathic manipulation treatment was greater than that of the therapeutic exercises.
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Affiliation(s)
- Frederico de Oliveira Meirelles
- Estacio de Sá University, Rio de Janeiro, Brazil.,Instituto de Educação Física e Desportos, Rio de Janeiro State University, Brazil, Rio de Janeiro
| | | | - Elirez Bezerra da Silva
- Instituto de Educação Física e Desportos, Rio de Janeiro State University, Brazil, Rio de Janeiro
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Shafer D, Gooing J, Lee V, Seffinger MA. Musculoskeletal Conditions in Patients With Diabetes: A Narrative Review. J Osteopath Med 2020; 120:660-664. [PMID: 32877927 DOI: 10.7556/jaoa.2020.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Diabetes mellitus (DM) is a multisystem disease that affects millions of people worldwide. The vascular and cardiac effects of DM have been well-studied, but little is known about the prevalence of musculoskeletal (MSK) conditions in patients with DM. This review provides an in-depth analysis of a cross-sectional study investigating the presence of several common MSK disorders in patients with DM. This review also analyzes current literature to update health care professionals about the MSK conditions associated with DM.
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Asahi MG, Briganti D, Cam E, Seffinger MA. The Role of Musculoskeletal Disorders in Chronic Disease: A Narrative Review. J Osteopath Med 2020; 120:665-670. [PMID: 32936865 DOI: 10.7556/jaoa.2020.134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Chronic diseases and musculoskeletal conditions are responsible for a significant portion of the global disease burden and are frequently comorbid, such as with low back pain in patients who also have chronic organ disease. Low back pain is the leading cause of long-term disability and is the most common reason adults seek adjunctive treatment, including osteopathic manipulative treatment (OMT). OMT has been shown to be effective in relieving low back pain and improving back-specific functioning. In this narrative review, the authors summarize literature published in the last decade and analyze the relationship between musculoskeletal disorders and systemic medical conditions such as diabetes mellitus; they also discuss the efficacy and cost-effectiveness of OMT in managing somatic dysfunction in patients with chronic diseases.
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Ponna V, Talsma J, Pierce-Talsma S. Osteopathic Manipulative Treatment for Low Back Pain. J Osteopath Med 2020; 120:e84-e85. [PMID: 32451545 DOI: 10.7556/jaoa.2020.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bill AS, Dubois J, Pasquier J, Burnand B, Rodondi PY. Osteopathy in the French-speaking part of Switzerland: Practitioners' profile and scope of back pain management. PLoS One 2020; 15:e0232607. [PMID: 32357175 PMCID: PMC7194435 DOI: 10.1371/journal.pone.0232607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/18/2020] [Indexed: 12/29/2022] Open
Abstract
Background Osteopathy is commonly used for spinal pain, but knowledge about back pain management by osteopaths is scarce. Objective The aim of this study was to survey osteopaths across the French-speaking part of Switzerland about the scope of their practice and their management of patients with back pain. Design This cross-sectional observational study was based on an online survey conducted from March to June 2017. Setting and participants: All registered osteopaths of the French-speaking part of Switzerland were asked to complete the survey. Outcome measures: In addition to descriptive statistics (practice characteristics, patients’ profiles, scope of treatment modalities, health promotion, research, and osteopathic practice), we explored variables associated with osteopaths’ practice, such as age and gender. Results A total of 241 osteopaths completed the questionnaire (response rate: 28.8%). Almost two thirds of osteopaths were female. Ages ranged from 25 to 72 years with an overall mean of 42.0 (SD 10.7) years. Male osteopaths reported more weekly working hours than female osteopaths did (38.2 [SD 11.0] vs 31.6 [SD 8.9], respectively, p<0.001). Almost a third (27.8%,) of osteopaths could arrange an appointment for acute conditions on the same day and 62.0% within a week. Acute or subacute spinal conditions, mainly low back and neck pain, were the most frequent conditions seen by our respondents. For 94.4% of osteopaths, one to three consultations were required for the management of such conditions. Conclusion Osteopaths play a role in the management of spinal conditions, especially for acute problems. These findings, combined with short waiting times for consultations for acute conditions, as well as prompt management capabilities for acute low back and acute neck pain, support the view that the osteopathic profession constitutes an added value to primary care.
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Affiliation(s)
- Anne-Sylvie Bill
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
- * E-mail:
| | - Julie Dubois
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
| | - Jérôme Pasquier
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Bernard Burnand
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Pierre-Yves Rodondi
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
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Tramontano M, Pagnotta S, Lunghi C, Manzo C, Manzo F, Consolo S, Manzo V. Assessment and Management of Somatic Dysfunctions in Patients With Patellofemoral Pain Syndrome. J Osteopath Med 2020; 120:165-173. [DOI: 10.7556/jaoa.2020.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Abstract
Context
Patellofemoral pain syndrome (PFPS) is one of the most common determinants of knee pain. The causes of PFPS are multifactorial, and most treatment approaches are conservative. There are many kinds of therapy for this syndrome, which are based on building strength, flexibility, proprioception, and endurance. Training is functional and progression is gradual. Our hypothesis is that total-body osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) focused on the management of somatic dysfunctions could be useful for managing the pain of patients with PFPS.
Objective
To investigate the effect of OMTh on pain reduction in patients with PFPS.
Methods
This pilot study was randomized, controlled, and single-blinded with 2 months of follow-up. Qualified participants were randomly assigned to 1 of 2 groups: OMTh group or placebo group. Each participant received either 4 sessions of OMTh or 4 sessions of manual placebo intervention that consisted of passive touching without joint mobilization in a protocolled order. A visual analogue scale (VAS) was used to assess general knee pain, peripatellar pain, pain after prolonged sitting, pain during the patellar compression test, and pain during stair ascent and descent. Pain assessment was performed before the baseline (T0), second (T1), third (T2), and fourth (T3) sessions, and follow-up (T4) was performed 8 weeks after T3.
Results
Thirty-five participants were enrolled the study. The VAS score was significantly reduced and clinically relevant in the OMTh group after each treatment and after 2 months of follow-up. The change in the VAS score before each treatment indicates that the most improved areas at T1 compared with T0 were lumbar and sacral with improvements in 83% and 40% of patients, respectively. At T2 compared with T1, the most improved areas were cervical and sacral with improvements found in 58% and 36% of patients, respectively. The number of dysfunctions that were diagnosed decreased during the baseline to T3 period (40% change). The correlation analysis showed significant results for the dysfunction and the compression test at T2 (P=.01, ρ=0.543).
Conclusion
Significant differences in VAS scores were found between the OMTh and placebo groups. These findings underline how OMTh can lead to reduced pain in patients with PFPS.
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Steel A, Peng W, Sibbritt D, Adams J. Introducing national osteopathy practice-based research networks in Australia and New Zealand: an overview to inform future osteopathic research. Sci Rep 2020; 10:846. [PMID: 31964999 PMCID: PMC6972961 DOI: 10.1038/s41598-020-57918-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 12/17/2019] [Indexed: 11/09/2022] Open
Abstract
Both the Osteopathic Research Innovation Network (ORION) and the Osteopathy Research Connect-New Zealand (ORC-NZ) are practice-based research networks (PBRNs) recently established in Australia and New Zealand. This paper highlights the profile of the osteopaths participating in each PBRN in order to encourage and facilitate further related research in osteopathy. All registered osteopaths in Australia and New Zealand were invited to participate in the ORION and ORC-NZ PBRNs, respectively. This paper presents practice and sociodemographic characteristics of the osteopaths that elected to join the PBRN in their country. A total of 253 registered osteopaths in New Zealand (48.7%) agreed to join ORC-NZ while 992 registered osteopaths in Australia (44.5%) joined ORION. Membership of both PBRNs reflect national geographical spread, and diverse personal and practice characteristics. Combined membership of both PBRNs represents 45.3% of all registered osteopaths in Australasia and 7.7% of the global osteopathic profession. The PBRNs, independently and in combination, hold much potential to advance the evidence-base and capacity of osteopathy research. Both ORION and ORC-NZ PBRNs are powerful, innovative resources available to other interested parties to help conduct further osteopathy research in Australia and New Zealand.
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Affiliation(s)
- Amie Steel
- University of Technology Sydney, Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, Ultimo, NSW, 2006, Australia.
| | - Wenbo Peng
- University of Technology Sydney, Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, Ultimo, NSW, 2006, Australia
| | - David Sibbritt
- University of Technology Sydney, Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, Ultimo, NSW, 2006, Australia
| | - Jon Adams
- University of Technology Sydney, Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, Ultimo, NSW, 2006, Australia
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Relating the Diers formetric measurements with the subjective severity of acute and chronic low back pain. Med Hypotheses 2019; 133:109390. [DOI: 10.1016/j.mehy.2019.109390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/23/2019] [Accepted: 09/02/2019] [Indexed: 10/26/2022]
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Andrews MAW. Stretch Receptor and Somatic Dysfunction: A Narrative Review. J Osteopath Med 2019; 119:511-519. [PMID: 31355890 DOI: 10.7556/jaoa.2019.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
From its founding by Andrew Taylor Still, MD, DO, through the work of many contributors, one of the cornerstones of osteopathic medicine has been its ability to aid health by promoting neuromuscular homeostasis. As part of the understanding of osteopathic medicine since the time of Still, the proper functioning of stretch receptor organs (SROs) of skeletal muscle have been recognized as having a central role in this homeostasis. In doing so, the complexities of these numerous and vital sensors are described, including recent findings regarding their structure, function, and the nature of their neural connections. In their homeostatic role, SROs conduct information centrally for integration in proprioceptive and autonomic reflexes. By virtue of their integral role in muscle reflexes, they are putatively involved in somatic dysfunction and segmental facilitation. In reviewing some well-established knowledge regarding the SRO and introducing more recent scientific findings, an attempt is made to offer insights on how this knowledge may be applied to better understand somatic dysfunction.
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The beliefs and attitudes of UK registered osteopaths towards chronic pain and the management of chronic pain sufferers - A cross-sectional questionnaire based survey. INT J OSTEOPATH MED 2018. [DOI: 10.1016/j.ijosm.2018.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Iskra DA. [Comorbidity of type 2 diabetes mellitus and low back pain]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:126-130. [PMID: 30251990 DOI: 10.17116/jnevro2018118081126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Diabetes mellitus (DM) and back pain are widespread and often develop simultaneously. In patients with DM 2 type, the incidence of back pain is increased. The association of DM with the severity of pain and the frequency of its chronization and recurrence has been revealed. The most likely mechanism of such an association is the lesion of intervertebral discs mediated by the accumulation of advanced glycation end-products (EGP). In DM the concentration of EGP increases significantly; they initiate ectopic calcification, a decrease in cell density in the end plates, and changes in vertebras. Cells of the pulpous nuclei begin to produce pro-inflammatory cytokines and chemokines that trigger the processes of angio- and neurogenesis. Dorsopathies develop due to other etiological factors, but the mechanisms of systemic inflammation are similar. Thus, DM and back pain are comorbid pathologies with common elements in pathogenesis. To prevent the development of dorsopathy in DM 2 type it is considered promising to use drugs that reduce the intensity of accumulation of AGP and inhibitors of pro-inflammatory cytokines, for example, symptomatic slow acting drugs.
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Affiliation(s)
- D A Iskra
- Kirov Military Medical Academy, St-Petersburg, Russia
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Osteopathic Manipulative Treatment Including Specific Diaphragm Techniques Improves Pain and Disability in Chronic Nonspecific Low Back Pain: A Randomized Trial. Arch Phys Med Rehabil 2018; 99:1720-1729. [PMID: 29787734 DOI: 10.1016/j.apmr.2018.04.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/18/2018] [Accepted: 04/21/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the effects of an osteopathic manipulative treatment (OMT), which includes a diaphragm intervention compared to the same OMT with a sham diaphragm intervention in chronic nonspecific low back pain (NS-CLBP). DESIGN Parallel group randomized controlled trial. SETTING Private and institutional health centers. PARTICIPANTS Participants (N=66) (18-60y) with a diagnosis of NS-CLBP lasting at least 3 months. INTERVENTIONS Participants were randomized to receive either an OMT protocol including specific diaphragm techniques (n=33) or the same OMT protocol with a sham diaphragm intervention (n=33), conducted in 5 sessions provided during 4 weeks. MAIN OUTCOME MEASURES The primary outcomes were pain (evaluated with the Short-Form McGill Pain Questionnaire [SF-MPQ] and the visual analog scale [VAS]) and disability (assessed with the Roland-Morris Questionnaire [RMQ] and the Oswestry Disability Index [ODI]). Secondary outcomes were fear-avoidance beliefs, level of anxiety and depression, and pain catastrophization. All outcome measures were evaluated at baseline, at week 4, and at week 12. RESULTS A statistically significant reduction was observed in the experimental group compared to the sham group in all variables assessed at week 4 and at week 12 (SF-MPQ [mean difference -6.2; 95% confidence interval, -8.6 to -3.8]; VAS [mean difference -2.7; 95% confidence interval, -3.6 to -1.8]; RMQ [mean difference -3.8; 95% confidence interval, -5.4 to -2.2]; ODI [mean difference -10.6; 95% confidence interval, -14.9 to 6.3]). Moreover, improvements in pain and disability were clinically relevant. CONCLUSIONS An OMT protocol that includes diaphragm techniques produces significant and clinically relevant improvements in pain and disability in patients with NS-CLBP compared to the same OMT protocol using sham diaphragm techniques.
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Edwards DJ, Toutt C. An evaluation of osteopathic treatment on psychological outcomes with patients suffering from chronic pain: A prospective observational cohort study collected through a health and well-being academy. Health Psychol Open 2018; 5:2055102918774684. [PMID: 29780605 PMCID: PMC5952292 DOI: 10.1177/2055102918774684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Co-morbid mental health conditions such as anxiety, depression and fear avoidance are often associated with chronic pain. This novel study aimed to explore the impact of osteopathic treatment on several psychological outcome measures relating to anxiety, depression, mental health and fear avoidance for a chronic pain population receiving osteopathic treatment over a 2-week period. The findings show that there were significant reductions in anxiety, pain, mental health dysfunction and improvements in self-care. These results are promising, and it is suggested that now a full-scale randomised controlled trial should be conducted.
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Coulter ID, Crawford C, Hurwitz EL, Vernon H, Khorsan R, Suttorp Booth M, Herman PM. Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. Spine J 2018; 18:866-879. [PMID: 29371112 PMCID: PMC6020029 DOI: 10.1016/j.spinee.2018.01.013] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/07/2017] [Accepted: 01/11/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Mobilization and manipulation therapies are widely used to benefit patients with chronic low back pain. However, questions remain about their efficacy, dosing, safety, and how these approaches compare with other therapies. PURPOSE The present study aims to determine the efficacy, effectiveness, and safety of various mobilization and manipulation therapies for treatment of chronic low back pain. STUDY DESIGN/SETTING This is a systematic literature review and meta-analysis. OUTCOME MEASURES The present study measures self-reported pain, function, health-related quality of life, and adverse events. METHODS We identified studies by searching multiple electronic databases from January 2000 to March 2017, examining reference lists, and communicating with experts. We selected randomized controlled trials comparing manipulation or mobilization therapies with sham, no treatment, other active therapies, and multimodal therapeutic approaches. We assessed risk of bias using Scottish Intercollegiate Guidelines Network criteria. Where possible, we pooled data using random-effects meta-analysis. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was applied to determine the confidence in effect estimates. This project is funded by the National Center for Complementary and Integrative Health under Award Number U19AT007912. RESULTS Fifty-one trials were included in the systematic review. Nine trials (1,176 patients) provided sufficient data and were judged similar enough to be pooled for meta-analysis. The standardized mean difference for a reduction of pain was SMD=-0.28, 95% confidence interval (CI) -0.47 to -0.09, p=.004; I2=57% after treatment; within seven trials (923 patients), the reduction in disability was SMD=-0.33, 95% CI -0.63 to -0.03, p=.03; I2=78% for manipulation or mobilization compared with other active therapies. Subgroup analyses showed that manipulation significantly reduced pain and disability, compared with other active comparators including exercise and physical therapy (SMD=-0.43, 95% CI -0.86 to 0.00; p=.05, I2=79%; SMD=-0.86, 95% CI -1.27 to -0.45; p<.0001, I2=46%). Mobilization interventions, compared with other active comparators including exercise regimens, significantly reduced pain (SMD=-0.20, 95% CI -0.35 to -0.04; p=.01; I2=0%) but not disability (SMD=-0.10, 95% CI -0.28 to 0.07; p=.25; I2=21%). Studies comparing manipulation or mobilization with sham or no treatment were too few or too heterogeneous to allow for pooling as were studies examining relationships between dose and outcomes. Few studies assessed health-related quality of life. Twenty-six of 51 trials were multimodal studies and narratively described. CONCLUSION There is moderate-quality evidence that manipulation and mobilization are likely to reduce pain and improve function for patients with chronic low back pain; manipulation appears to produce a larger effect than mobilization. Both therapies appear safe. Multimodal programs may be a promising option.
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Affiliation(s)
- Ian D Coulter
- RAND Corporation, 1776 Main St, Santa Monica, CA 90407-2138, USA; UCLA School of Dentistry, Box 951668, Los Angeles, CA 90095-1668, USA; Southern California University of Health Sciences, 16200 Amber Valley Dr, Whittier, CA 90604, USA.
| | - Cindy Crawford
- RAND Corporation, 1776 Main St, Santa Monica, CA 90407-2138, USA
| | - Eric L Hurwitz
- RAND Corporation, 1776 Main St, Santa Monica, CA 90407-2138, USA; Office of Public Health Studies, University of Hawai'i, Mānoa, 1960 East-West Rd, Biomed D104AA, Honolulu, HI 96822, USA
| | - Howard Vernon
- RAND Corporation, 1776 Main St, Santa Monica, CA 90407-2138, USA; Division of Research, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON, Canada M2H 3J1
| | - Raheleh Khorsan
- UCI Department of Urban Planning and Public Policy, 300 Social Ecology I, Irvine, CA 92697-7075, USA
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Bussières AE, Stewart G, Al-Zoubi F, Decina P, Descarreaux M, Haskett D, Hincapié C, Pagé I, Passmore S, Srbely J, Stupar M, Weisberg J, Ornelas J. Spinal Manipulative Therapy and Other Conservative Treatments for Low Back Pain: A Guideline From the Canadian Chiropractic Guideline Initiative. J Manipulative Physiol Ther 2018; 41:265-293. [PMID: 29606335 DOI: 10.1016/j.jmpt.2017.12.004] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 12/18/2017] [Accepted: 12/23/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of this study was to develop a clinical practice guideline on the management of acute and chronic low back pain (LBP) in adults. The aim was to develop a guideline to provide best practice recommendations on the initial assessment and monitoring of people with low back pain and address the use of spinal manipulation therapy (SMT) compared with other commonly used conservative treatments. METHODS The topic areas were chosen based on an Agency for Healthcare Research and Quality comparative effectiveness review, specific to spinal manipulation as a nonpharmacological intervention. The panel updated the search strategies in Medline. We assessed admissible systematic reviews and randomized controlled trials for each question using A Measurement Tool to Assess Systematic Reviews and Cochrane Back Review Group criteria. Evidence profiles were used to summarize judgments of the evidence quality and link recommendations to the supporting evidence. Using the Evidence to Decision Framework, the guideline panel determined the certainty of evidence and strength of the recommendations. Consensus was achieved using a modified Delphi technique. The guideline was peer reviewed by an 8-member multidisciplinary external committee. RESULTS For patients with acute (0-3 months) back pain, we suggest offering advice (posture, staying active), reassurance, education and self-management strategies in addition to SMT, usual medical care when deemed beneficial, or a combination of SMT and usual medical care to improve pain and disability. For patients with chronic (>3 months) back pain, we suggest offering advice and education, SMT or SMT as part of a multimodal therapy (exercise, myofascial therapy or usual medical care when deemed beneficial). For patients with chronic back-related leg pain, we suggest offering advice and education along with SMT and home exercise (positioning and stabilization exercises). CONCLUSIONS A multimodal approach including SMT, other commonly used active interventions, self-management advice, and exercise is an effective treatment strategy for acute and chronic back pain, with or without leg pain.
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Affiliation(s)
- André E Bussières
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Québec, Canada.; Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada..
| | - Gregory Stewart
- Private Practice, Winnipeg, Manitoba, Canada; Immediate Past President, World Federation of Chiropractic, North American Region, Canada
| | - Fadi Al-Zoubi
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Québec, Canada
| | - Philip Decina
- Department of Clinical Education, Canadian Memorial Chiropractic College, North York, Ontario, Canada
| | - Martin Descarreaux
- Département des Sciences de l'Activité Physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Danielle Haskett
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Cesar Hincapié
- Epidemiologist, Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Isabelle Pagé
- Département d'anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Steven Passmore
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada
| | - John Srbely
- Human Health and Nutritional Science, University of Guelph, Guelph, Ontario, Canada
| | - Maja Stupar
- Department of Clinical Education, Canadian Memorial Chiropractic College, North York, Ontario, Canada
| | | | - Joseph Ornelas
- Health Systems Management, Rush University, Chicago, Illinois
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Saracutu M, Rance J, Davies H, Edwards DJ. The effects of osteopathic treatment on psychosocial factors in people with persistent pain: A systematic review. INT J OSTEOPATH MED 2018. [DOI: 10.1016/j.ijosm.2017.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Snider KT, Redman CL, Edwards CR, Bhatia S, Kondrashova T. Ultrasonographic Evaluation of the Effect of Osteopathic Manipulative Treatment on Sacral Base Asymmetry. J Osteopath Med 2018; 118:159-169. [DOI: 10.7556/jaoa.2018.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Abstract
Context
Patients with low back pain (LBP) may receive osteopathic manipulative treatment (OMT) to resolve or manage their pain. The indication for OMT for patients with LBP is the presence of somatic dysfunction, diagnosed using palpatory examination. Because palpatory findings commonly have poor interexaminer reliability, the current study used ultrasonography (US) to establish pre-OMT and post-OMT musculoskeletal measurements of relative asymmetry between pelvic and sacral bony landmarks.
Objective
To document objective musculoskeletal changes that occur in response to OMT using US and to compare palpatory assessment of landmark asymmetry with US assessment.
Methods
Sixty men and women aged 20 to 55 years with at least 1 episode of LBP in the past 2 weeks were assigned to a seated control, walking control, or OMT group (20 participants per group). Participants received an initial, bilateral US measurement of the skin to posterior superior iliac spine (SPSIS), skin to sacral base position (SBP), and sacral sulcus depth (SSD). Participants in seated control and OMT groups received a palpatory assessment of SBP and SSD prior to initial US assessment. After assessment, the seated control group sat in a waiting room for 30 minutes, the walking control group walked for 5 minutes, and the OMT group received OMT to address sacral base asymmetry using predominantly direct techniques for a maximum of 20 minutes. Participants then received a second US assessment of the same structures.
Results
Body mass index (BMI) was correlated with SPSIS (r=0.5, P=.001) and SBP (r=0.6, P<.001). More participants in seated control (75%) and OMT (65%) groups had an increase in asymmetry from first to second US assessment for SPSIS compared with participants in the walking control group (35%, P=.05). No significant differences were found between groups for absolute asymmetry or total change in asymmetry (all P>.10). The κ was −0.1 (95% CI, −0.2 to 0.03) for SBP and −0.01 (95% CI, −0.1 to 0.1) for SSD.
Conclusion
Musculoskeletal changes in SPSIS and SBP measurements related to OMT could not be readily identified using US. The SPSIS and SBP measurements were dependent on BMI, which may have affected the accuracy of US to detect small changes in asymmetry. Qualitative palpatory assessments did not correlate with US measurements. Further study is needed to identify US measurements that demonstrate change with OMT. (ClinicalTrials.gov number NCT02820701)
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Affiliation(s)
- John C Licciardone
- From University of North Texas Health Science Center, Fort Worth, and University of Texas at Arlington, Arlington, Texas
| | - Robert J Gatchel
- From University of North Texas Health Science Center, Fort Worth, and University of Texas at Arlington, Arlington, Texas
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Clearfield M. A Path to Osteopathic Distinction: The Touro California GROUPIE Program. J Osteopath Med 2017; 117:488-494. [DOI: 10.7556/jaoa.2017.098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Carnes D, Mars T, Plunkett A, Nanke L, Abbey H. A mixed methods evaluation of a third wave cognitive behavioural therapy and osteopathic treatment programme for chronic pain in primary care (OsteoMAP). INT J OSTEOPATH MED 2017. [DOI: 10.1016/j.ijosm.2017.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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36
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Steel A, Blaich R, Sundberg T, Adams J. The role of osteopathy in clinical care: Broadening the evidence-base. INT J OSTEOPATH MED 2017. [DOI: 10.1016/j.ijosm.2017.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Halimi M, Leder A, Mancini JD. Integration of Osteopathic Manual Treatments in Management of Cervical Dystonia with Tremor: A Case Series. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2017; 7:435. [PMID: 28119789 PMCID: PMC5243944 DOI: 10.7916/d8np24xb] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 12/07/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cervical dystonia, also known as spasmodic torticollis, is a chronic disorder in which patients exhibit involuntary repetitive contractions of neck muscles resulting in abnormal postures or movements. Occasionally, there is also a dystonic head tremor. The underlying mechanisms for cervical dystonia and dystonic tremor are not clear, and treatments are limited. CASE REPORT In the present cases, two females with head tremor starting in adolescence developed worsening symptoms of cervical dystonia with dystonic tremor in their 60s. On osteopathic physical examination, both had a vertical type strain to the sphenobasilar synchondrosis. DISCUSSION Vertical strains are more frequently found in patients after head trauma, congenital or later in life, than in healthy patients, and head trauma may have been a precipitating factor in these patients. There were improvements in cervical dystonia symptoms, including tremor, in both patients after osteopathic manual treatment.
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Affiliation(s)
- Miriam Halimi
- College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Adena Leder
- College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Jayme D Mancini
- College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
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Complementary and Alternative Medicine. Fam Med 2017. [DOI: 10.1007/978-3-319-04414-9_47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ruhlen RL, Singh VK, Pazdernik VK, Towns LC, Snider EJ, Sargentini NJ, Degenhardt BF. Changes in rat spinal cord gene expression after inflammatory hyperalgesia of the joint and manual therapy. J Osteopath Med 2016; 114:768-76. [PMID: 25288712 DOI: 10.7556/jaoa.2014.151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
CONTEXT Mobilization of a joint affects local tissue directly but may also have other effects that are mediated through the central nervous system. OBJECTIVE To identify differential gene expression in the spinal cords of rats with or without inflammatory joint injury after manual therapy or no treatment. METHODS Rats were randomly assigned to 1 of 4 treatment groups: no injury and no touch (NI/NT), injury and no touch (I/NT), no injury and manual therapy (NI/MT), and injury and manual therapy (I/MT). We induced acute inflammatory joint injury in the rats by injecting carrageenan into an ankle. Rats in the no-injury groups did not receive carrageenan injection. One day after injury, rats received manual therapy to the knee of the injured limb. Rats in the no-touch groups were anesthetized without receiving manual therapy. Spinal cords were harvested 30 minutes after therapy or no touch, and spinal cord gene expression was analyzed by microarray for 3 comparisons: NI/NT vs I/NT, I/MT vs I/NT, and NI/NT vs NI/MT. RESULTS Three rats were assigned to each group. Of 38,875 expressed sequence tags, 755 were differentially expressed in the NI/NT vs I/NT comparison. For the other comparisons, no expressed sequence tags were differentially expressed. Cluster analysis revealed that the differentially expressed sequence tags were over-represented in several categories, including ion homeostasis (enrichment score, 2.29), transmembrane (enrichment score, 1.55), and disulfide bond (enrichment score, 2.04). CONCLUSIONS An inflammatory injury to the ankle of rats caused differential expression of genes in the spinal cord. Consistent with other studies, genes involved in ion transport were among those affected. However, manual therapy to the knees of injured limbs or to rats without injury did not alter gene expression in the spinal cord. Thus, evidence for central nervous system mediation of manual therapy was not observed.
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Affiliation(s)
- Rachel L Ruhlen
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Drs Snider, Sargentini, and Degenhardt); the departments of microbiology /immunology (Drs Singh and Sargentini), anatomy (Dr Towns), and osteopathic manipulative medicine (Dr Snider) at A.T. Still University-Kirksville College of Osteopathic Medicine in Missouri; and Research Support at A.T. Still University in Mesa, Arizona (Ms Pazdernik). Dr Ruhlen was affiliated with the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri, at the time of this study
| | - Vineet K Singh
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Drs Snider, Sargentini, and Degenhardt); the departments of microbiology /immunology (Drs Singh and Sargentini), anatomy (Dr Towns), and osteopathic manipulative medicine (Dr Snider) at A.T. Still University-Kirksville College of Osteopathic Medicine in Missouri; and Research Support at A.T. Still University in Mesa, Arizona (Ms Pazdernik). Dr Ruhlen was affiliated with the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri, at the time of this study
| | - Vanessa K Pazdernik
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Drs Snider, Sargentini, and Degenhardt); the departments of microbiology /immunology (Drs Singh and Sargentini), anatomy (Dr Towns), and osteopathic manipulative medicine (Dr Snider) at A.T. Still University-Kirksville College of Osteopathic Medicine in Missouri; and Research Support at A.T. Still University in Mesa, Arizona (Ms Pazdernik). Dr Ruhlen was affiliated with the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri, at the time of this study
| | - Lex C Towns
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Drs Snider, Sargentini, and Degenhardt); the departments of microbiology /immunology (Drs Singh and Sargentini), anatomy (Dr Towns), and osteopathic manipulative medicine (Dr Snider) at A.T. Still University-Kirksville College of Osteopathic Medicine in Missouri; and Research Support at A.T. Still University in Mesa, Arizona (Ms Pazdernik). Dr Ruhlen was affiliated with the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri, at the time of this study
| | - Eric J Snider
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Drs Snider, Sargentini, and Degenhardt); the departments of microbiology /immunology (Drs Singh and Sargentini), anatomy (Dr Towns), and osteopathic manipulative medicine (Dr Snider) at A.T. Still University-Kirksville College of Osteopathic Medicine in Missouri; and Research Support at A.T. Still University in Mesa, Arizona (Ms Pazdernik). Dr Ruhlen was affiliated with the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri, at the time of this study
| | - Neil J Sargentini
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Drs Snider, Sargentini, and Degenhardt); the departments of microbiology /immunology (Drs Singh and Sargentini), anatomy (Dr Towns), and osteopathic manipulative medicine (Dr Snider) at A.T. Still University-Kirksville College of Osteopathic Medicine in Missouri; and Research Support at A.T. Still University in Mesa, Arizona (Ms Pazdernik). Dr Ruhlen was affiliated with the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri, at the time of this study
| | - Brian F Degenhardt
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Drs Snider, Sargentini, and Degenhardt); the departments of microbiology /immunology (Drs Singh and Sargentini), anatomy (Dr Towns), and osteopathic manipulative medicine (Dr Snider) at A.T. Still University-Kirksville College of Osteopathic Medicine in Missouri; and Research Support at A.T. Still University in Mesa, Arizona (Ms Pazdernik). Dr Ruhlen was affiliated with the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri, at the time of this study
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Sillem M, Juhasz-Böss I, Klausmeier I, Mechsner S, Siedentopf F, Solomayer E. Osteopathy for Endometriosis and Chronic Pelvic Pain - a Pilot Study. Geburtshilfe Frauenheilkd 2016; 76:960-963. [PMID: 27681520 DOI: 10.1055/s-0042-111010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Introduction: Pelvic pain is a common problem in gynaecological practice. It is often unclear whether definite causality exists between reported symptoms and objective clinical findings of the female genital tract, and medical or operative treatments do not always achieve long-term resolution of symptoms. Methods: This pilot study investigated 28 patients (age 20-65, median 36.5 years) from a gynaecology practice whose only clinical finding was painful pelvic floor muscle tightness. Following standardised gynaecological and physiotherapist examination, all patients received osteopathic treatment. Pain had been present for a median of 3 years (range 1 month to 20 years). 14 patients had previously confirmed endometriosis. Treatment success was evaluated on consultation with patients in person or in writing. Results: 22 of the 28 participants completed the treatment according to plan. Overall, 17 reported symptom improvement, while 10 of the 14 patients with endometriosis did. Conclusion: Osteopathy is well received by women with painful pelvic floor muscle tightness and appears to be an effective treatment option.
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Affiliation(s)
- M Sillem
- Praxisklinik am Rosengarten, Mannheim, Germany
| | - I Juhasz-Böss
- Frauenklinik Homburg, Uniklinikum Saarland, Homburg/Saar, Germany
| | - I Klausmeier
- DC Physiotherapie, Universitätsmedizin Mannheim, Mannheim, Germany
| | - S Mechsner
- Gynäkologie, Campus Benjamin Franklin, Charité, Berlin, Germany
| | - F Siedentopf
- Klinik für Gynäkologie und Geburtshilfe, Martin-Luther-Krankenhaus, Berlin, Germany
| | - E Solomayer
- Frauenklinik Homburg, Uniklinikum Saarland, Homburg/Saar, Germany
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Hanson GC, Jones B, Bacon CJ, Moran RW. Exploration of clinical changes following a novel mobilisation technique for treatment of chronic low back pain: A single cohort design. J Bodyw Mov Ther 2016; 20:571-8. [PMID: 27634080 DOI: 10.1016/j.jbmt.2015.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 11/02/2015] [Accepted: 12/09/2015] [Indexed: 12/21/2022]
Abstract
To explore clinical changes following a novel manual mobilisation technique, 24 participants who experienced 'moderate' to 'severe' chronic low back pain were recruited from new patients attending a suburban osteopathy clinic. The intervention was a previously undescribed side-lying mobilisation technique targeting the lumbosacral spine (median of 6 treatment sessions). After 8 weeks reductions were shown in Oswestry Disability Index of 15 points (95% CI: 9.3, 22.7; p < 0.0001 for overall ANOVA); Quadruple Visual Analogue Scale of 2.0 points (95% CI: 1.0, 3.0; p < 0.0001); and Patient Specific Functional Scale of 3.1 points (95% CI: 1.9, 4.3; p < 0.0001). The results indicate that pain intensity, disability and function improved in most participants following treatment. Further investigation is indicated using more robust research designs to compare this approach with other treatment approaches and usual care for the treatment of chronic low back pain.
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Affiliation(s)
| | | | - Catherine J Bacon
- Department of Community & Health Services (Osteopathy), Unitec Institute of Technology, Private Bag 92025, Auckland 1142, New Zealand
| | - Robert W Moran
- Department of Community & Health Services (Osteopathy), Unitec Institute of Technology, Private Bag 92025, Auckland 1142, New Zealand.
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Boulet S, Boudot E, Houel N. Relationships between each part of the spinal curves and upright posture using Multiple stepwise linear regression analysis. J Biomech 2016; 49:1149-1155. [PMID: 26970888 DOI: 10.1016/j.jbiomech.2016.02.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 02/27/2016] [Accepted: 02/29/2016] [Indexed: 01/06/2023]
Abstract
Back pain is a common reason for consultation in primary healthcare clinical practice, and has effects on daily activities and posture. Relationships between the whole spine and upright posture, however, remain unknown. The aim of this study was to identify the relationship between each spinal curve and centre of pressure position as well as velocity for healthy subjects. Twenty-one male subjects performed quiet stance in natural position. Each upright posture was then recorded using an optoelectronics system (Vicon Nexus) synchronized with two force plates. At each moment, polynomial interpolations of markers attached on the spine segment were used to compute cervical lordosis, thoracic kyphosis and lumbar lordosis angle curves. Mean of centre of pressure position and velocity was then computed. Multiple stepwise linear regression analysis showed that the position and velocity of centre of pressure associated with each part of the spinal curves were defined as best predictors of the lumbar lordosis angle (R(2)=0.45; p=1.65*10-10) and the thoracic kyphosis angle (R(2)=0.54; p=4.89*10-13) of healthy subjects in quiet stance. This study showed the relationships between each of cervical, thoracic, lumbar curvatures, and centre of pressure's fluctuation during free quiet standing using non-invasive full spinal curve exploration.
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Affiliation(s)
- Sebastien Boulet
- ESO Paris Research, Ecole Supérieure d'Ostéopathie, Cité Descartes - 8 Rue Alfred Nobel, 77420 Champs-sur-Marne, France.
| | - Elsa Boudot
- ESO Paris Research, Ecole Supérieure d'Ostéopathie, Cité Descartes - 8 Rue Alfred Nobel, 77420 Champs-sur-Marne, France
| | - Nicolas Houel
- ESO Paris Research, Ecole Supérieure d'Ostéopathie, Cité Descartes - 8 Rue Alfred Nobel, 77420 Champs-sur-Marne, France
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Licciardone JC, Gatchel RJ, Aryal S. Recovery From Chronic Low Back Pain After Osteopathic Manipulative Treatment: A Randomized Controlled Trial. J Osteopath Med 2016; 116:144-55. [DOI: 10.7556/jaoa.2016.031] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
Context: Little is known about recovery after spinal manipulation in patients with low back pain (LBP).
Objective: To assess recovery from chronic LBP after a short regimen of osteopathic manipulative treatment (OMT) in a responder analysis of the OSTEOPAThic Health outcomes In Chronic low back pain (OSTEOPATHIC) Trial.
Methods: A randomized double-blind, sham-controlled trial was conducted to determine the efficacy of 6 OMT sessions over 8 weeks. Recovery was assessed at week 12 using a composite measure of pain recovery (10 mm or less on a 100-mm visual analog scale) and functional recovery (2 or less on the Roland-Morris Disability Questionnaire for back-specific functioning). The RRs and numbers-needed-to-treat (NNTs) for recovery with OMT were measured, and corresponding cumulative distribution functions were plotted according to baseline LBP intensity and back-specific functioning. Multiple logistic regression was used to compute the OR for recovery with OMT while simultaneously controlling for potential confounders. Sensitivity analyses were performed to corroborate the primary results.
Results: There were 345 patients who met neither of the recovery criteria at baseline in the primary analyses and 433 patients who met neither or only 1 of these criteria in the sensitivity analyses. There was a large treatment effect for recovery with OMT (RR, 2.36; 95% CI, 1.31-4.24; P=.003), which was associated with a clinically relevant NNT (8.9; 95% CI, 5.4-25.5). This significant finding persisted after adjustment for potential confounders (OR, 2.92; 95% CI, 1.43-5.97; P=.003). There was also a significant interaction effect between OMT and comorbid depression (P=.02), indicating that patients without depression were more likely to recover from chronic LBP with OMT (RR, 3.21; 95% CI, 1.59-6.50; P<.001) (NNT, 6.5; 95% CI, 4.2-14.5). The cumulative distribution functions demonstrated optimal RR and NNT responses in patients with moderate to severe levels of LBP intensity and back-specific dysfunction at baseline. Similar results were observed in the sensitivity analyses.
Conclusions: The OMT regimen was associated with significant and clinically relevant measures for recovery from chronic LBP. A trial of OMT may be useful before progressing to other more costly or invasive interventions in the medical management of patients with chronic LBP. (ClinicalTrials.gov number NCT00315120)
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Licciardone JC, Gatchel RJ, Aryal S. Targeting Patient Subgroups With Chronic Low Back Pain for Osteopathic Manipulative Treatment: Responder Analyses From a Randomized Controlled Trial. J Osteopath Med 2016; 116:156-68. [DOI: 10.7556/jaoa.2016.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
Context: Osteopathic manipulative treatment (OMT) is often used to treat patients with low back pain (LBP).
Objective: To identify subgroups of patients with chronic LBP who achieve medium to large treatment effects with OMT based on responder analyses involving pain and functioning outcomes from the OSTEOPAThic Health outcomes In Chronic low back pain (OSTEOPATHIC) Trial.
Methods: This randomized, double-blind, sham-controlled trial involving 455 patients in Dallas-Fort Worth was conducted from 2006 to 2011. A 100-mm visual analog scale (VAS) for LBP intensity and the Roland-Morris Disability Questionnaire (RMDQ) for back-specific functioning were used to assess primary and secondary outcomes, respectively. Substantial improvement was defined as 50% or greater reduction at week 12 compared with baseline. Cumulative distribution functions for the RR and number-needed-to-treat (NNT) were used to assess response.
Results: Medium treatment effects for LBP intensity were observed overall (RR, 1.41; 95% CI, 1.13-1.76; P=.002; NNT, 6.9; 95% CI, 4.3-18.6). However, large treatment effects were observed in patients with baseline VAS scores of 35 mm or greater. Although OMT was not associated with overall substantial improvement in back-specific functioning, patients with baseline RMDQ scores of 7 or greater experienced medium effects, and patients with baseline scores 16 or greater experienced large effects that were significant. The OMT effects for LBP intensity and back-specific functioning were independent of baseline patient demographic characteristics, comorbid medical conditions, and medication use for LBP during the trial.
Conclusions: Subgrouping according to baseline levels of chronic LBP intensity and back-specific functioning appears to be a simple strategy for identifying sizeable numbers of patients who achieve substantial improvement with OMT and may thereby be less likely to use more costly and invasive interventions. (ClinicalTrials.gov number NCT00315120)
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Usage of Complementary Medicine in Switzerland: Results of the Swiss Health Survey 2012 and Development Since 2007. PLoS One 2015; 10:e0141985. [PMID: 26513370 PMCID: PMC4626041 DOI: 10.1371/journal.pone.0141985] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 10/15/2015] [Indexed: 01/21/2023] Open
Abstract
Background Complementary medicine (CM) is popular in Switzerland. Several CM methods (traditional Chinese medicine/acupuncture, homeopathy, anthroposophic medicine, neural therapy, and herbal medicine) are currently covered by the mandatory basic health insurance when performed by a certified physician. Treatments by non-medical therapists are partially covered by a supplemental and optional health insurance. In this study, we investigated the frequency of CM use including the evolvement over time, the most popular methods, and the user profile. Methods Data of the Swiss Health Surveys 2007 and 2012 were used. In 2007 and 2012, a population of 14,432 and 18,357, respectively, aged 15 years or older answered the written questionnaire. A set of questions queried about the frequency of use of various CM methods within the last 12 months before the survey. Proportions of usage and 95% confidence intervals were calculated for these methods and CM in general. Users and non-users of CM were compared using logistic regression models. Results The most popular methods in 2012 were homeopathy, naturopathy, osteopathy, herbal medicine, and acupuncture. The average number of treatments within the 12 months preceding the survey ranged from 3 for homeopathy to 6 for acupuncture. 25.0% of the population at the age of 15 and older had used at least one CM method in the previous 12 months. People with a chronic illness or a poor self-perceived health status were more likely to use CM. Similar to other countries, women, people of middle age, and those with higher education were more likely to use CM. 59.9% of the adult population had a supplemental health insurance that partly covered CM treatments. Conclusions Usage of CM in Switzerland remained unchanged between 2007 and 2012. The user profile in Switzerland was similar to other countries, such as Germany, United Kingdom, United States or Australia.
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Park SE, Wang JS. Effect of joint mobilization using KEOMT and PNF on a patient with CLBP and a lumbar transitional vertebra: a case study. J Phys Ther Sci 2015; 27:1629-32. [PMID: 26157278 PMCID: PMC4483456 DOI: 10.1589/jpts.27.1629] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 01/31/2015] [Indexed: 12/04/2022] Open
Abstract
[Purpose] The purpose of this case study was to identify the effects of joint mobilization using Kaltenborn-Evjenth orthopedic manual therapy (KEOMT) and proprioceptive neuromuscular facilitation (PNF) techniques on a patient with chronic low back pain (CLBP) and a lumbar transitional vertebra. [Methods] The intervention methods were joint mobilization using KEOMT and PNF techniques. The program consisted of 40-min sessions 3 days a week for 4 weeks. The spinal motion (thoracic and lumbar vertebrae), pain, and thickness of the multifidus were measured. [Results] The angle of spinal curvature increased, and the range of motions (ROMs) flexion and extension increased in the thoracic and lumbar vertebrae. The pain score as measured on a visual analogue scale (VAS) and the Oswestry disability index (ODI) score decreased. The thickness of the multifidus (L4) increased on the left and right sides. [Conclusion] These results suggest that joint mobilization using KEOMT and PNF techniques had a positive effect on the spinal motion, pain, and thickness of the multifidus of a patient with chronic low back pain and a lumbar transitional vertebra.
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Affiliation(s)
- Si-Eun Park
- Department of Physical Therapy, Yongin University, Republic
of Korea
| | - Joong-San Wang
- Department of Physical Therapy, Yeoju Institute of
Technology, Republic of Korea
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Devine M, Hayes M. Complementary and Alternative Medicine. Fam Med 2015. [DOI: 10.1007/978-1-4939-0779-3_47-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Romeyke T, Stummer H. Evidence-Based Complementary and Alternative Medicine in Inpatient Care. J Evid Based Complementary Altern Med 2014; 20:87-93. [DOI: 10.1177/2156587214555714] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The aim of this report is to provide the reader an overview of the complex therapy currently used within the German health system. Complex therapies in inpatient care in Germany establish the basis for an integrative and interdisciplinary provision of services. They define minimal criteria for the organization of a hospital, enable the integration of different therapeutic approaches, and therefore, lead to an intensive and holistic treatment by a specially trained team. The German model can be viewed as a pilot program for the introduction of integrative patient-centered care in other hospitals around the world.
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Affiliation(s)
- Tobias Romeyke
- University for Health Sciences, Medical Informatics and Technology, Vienna, Austria
- Waldhausklinik Deuringen, Stadtbergen, Germany
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Licciardone JC. Observational study fails to demonstrate the effectiveness of OMT in decreasing low back pain. J Osteopath Med 2014; 114:e119-20. [PMID: 25352411 DOI: 10.7556/jaoa.2014.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
The Journal of the American Osteopathic Association (JAOA) encourages osteopathic physicians, faculty members and students at colleges of osteopathic medicine, and others within the health care professions to submit comments related to articles published in the JAOA and the mission of the osteopathic medical profession. The JAOA's editors are particularly interested in letters that discuss recently published original research.
Letters must be submitted online at http://www.osteopathic.org/JAOAsubmit. Letters to the editor are considered for publication in the JAOA with the understanding that they have not been published elsewhere and are not simultaneously under consideration by any other publication. All accepted letters to the editor are subject to editing and abridgment.
Although the JAOA welcomes letters to the editor, these contributions have a lower publication priority than other submissions. As a consequence, letters are published only when space allows.
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Affiliation(s)
- John C Licciardone
- The Osteopathic Research Center, University of North Texas Health Science Center (UNTHSC), Fort Worth; Department of Medical Education, UNTHSC Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth
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Seffinger MA. OMT Is Efficacious for Patients With High Baseline Low Back Pain. J Osteopath Med 2014. [DOI: 10.7556/jaoa.2014.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Michael A. Seffinger
- Western University of Health Sciences College of Osteopathic Medicine of the Pacific, Pomona , California
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