Perspectives on tissue adaptation related to allostatic load: scoping review and integrative hypothesis with a focus on osteopathic palpation

Full Paper

Authors:

Lunghi C, Consorti G, Tramontano M, Esteves J.E, Cerritelli F.

Journal: JBMT
Abstract:

Introduction
Osteopathic care may support an individual’s adaptive capacity, including allostatic regulation and tissue changes in both health and disease. The palpatory findings which osteopaths claim are related to tissue changes may be linked to allostatic load. However, this putative link has not been formally investigated.

Methods
We conducted a scoping review to critically appraise the relevant literature on the relationship between allostatic processes and tissue alterations. This review evaluates the use and relevance of palpatory findings in osteopathic care. We searched on PubMed, EMBASE, Cochrane library for research exploring the links between tissue adaptation, allostasis and osteopathic palpatory findings (OPF).

Results
Recent studies provide insights into the role of allostatic regulation on body systems’ responses related to tissue alterations. These results provide new insights into the relevance of OPF to clinical practice.

Discussion
We build upon the findings of our review to propose a putative model for OPF in clinical practice.

Conclusion
Although the clinical phenomena associated with OPF may be biologically plausible, it lacks the necessary underpinning research evidence. Arguably, the classical focus on the diagnosis of palpable tissue changes fails to integrate biological, social and neuropsychological aspects such as stress responses. Tissue alterations related to stress and allostatic load markers have been less studied. Tissue changes involved in the adaptive process may be useful to practitioners in the field of manual therapy, particularly in osteopathy. We propose that OPF are one of the multidimensional aspects that may inform osteopathic decision-making. However, they should be considered within a biopsychosocial perspective and taking into account concepts of allostatic load and regulation.