Posts by: Patrick van Dun

Treating Complex Regional Pain Syndrome Using Counterstrain: A Novel Approach

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Complex regional pain syndrome (CRPS) is a challenging disease to treat and requires a multidisciplinary and multimodal approach. We discuss the use of a novel approach to counterstrain using irritants – as identified by the patient – to induce symptoms of neuropathy and paresthesia and treat these symptoms as if they were counterstrain tender points. This treatment approach to CRPS has not previously been described in osteopathic manipulative treatment (OMT) literature, including Foundations of Osteopathic Medicine … MORE

An Osteopathic Modular Approach to Asthma: A Narrative Review

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Asthma is among of the first ailments documented in the existing academic literature as being successfully managed with osteopathic manipulative treatment (OMT) techniques. Time-efficient and well-tolerated OMT techniques have been gradually added to the literature to manage this increasingly prevalent disease. In this narrative review, the authors discuss previously-published literature describing the history, diagnosis, and management of asthma related to osteopathic principles and practices and OMT application. They also present current and newly-approved medical managements, including biologics and inhaled corticosteroids. This article also includes supplemental videos showcasing OMT techniques for asthma management, which were developed by the authors based on recommendations indicated in the literature … ABSTRACT

Cerebral tissue oxygenation during cranial osteopathic CV4 procedure in newborns

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The cranial osteopathic manipulative medicine has been shown to alter regional cerebral tissue oxygenation (cStO2) in adult patients; however, there are no reports regarding the neonatal population. The objective of this study is to assess the influence of compression of the 4th ventricle (CV4) osteopathic procedure on cStO2 in neonates … MORE

Osteopathic Manual Treatment for Pain Severity, Functional Improvement, and Return to Work in Patients With Chronic Pain

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Chronic non-cancer pain (CNCP) is associated with disability, poor quality of life (QOL), and failure to return to work (RTW). Osteopathic manipulative treatment (OMT) or osteopathic manual therapy (OMTh) are increasingly offered to patients with CNCP; however, the existing systematic reviews and meta-analyses in the literature that explore the effectiveness of OMTh have major limitations. The objective of this study was to systematically evaluate the quality of evidence documenting the effectiveness of OMTh for patients with CNCP using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, and to evaluate the efficacy of OMTh in patients with CNCP through a meta-analysis of pooled data from previous studies … ABSTRACT

Health Sciences—Evidence Based Practice Questionnaire (HS-EBP): Normative Data and Differential Profiles in Spanish Osteopathic Professionals

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The main goal of this study was to obtain normative data of the scores of the Health-Sciences Evidence Based Practice (HS-EBP) questionnaire, and to analyse evidence-based practice (EBP) among potential clusters of osteopathy professionals in Spain. An online descriptive cross-sectional study has been applied. A total number of 443 Spanish practicing osteopaths answered a survey including the 5 dimensions of the HS-EBP questionnaire and sociodemographic, training, and practice variables using the “LimeSurvey” online platform. Results point out that the median scores for each five HS-EBP questionnaire dimensions were 95.00, 86.00, 78.00, 84.00 and 62.00 considering that the range of possible scores in each of the dimensions was: from 12 to 120 in dimensions 1, 4 and 5; from 14–140 in dimension 2; and from 10–100 in dimension 3. A clustering algorithm extracted 6 different profiles across the five HS-EBP latent dimensions: low scores in all dimensions (cluster 1); low scores in all dimensions but with medium scores in dimension 1 (cluster 2); mixed pattern of scores, low in dimensions 2 and 5 and medium in the rest of the dimensions; medium scores in all dimensions (cluster 4); high scores in all dimensions and low scores in dimension 5 (cluster 5); and high scores in all dimensions (cluster 6). Significant relationship was found among the response patterns in the clusters and: academic degree level, EBP training and training level, and work time invested in healthcare activity, research and teaching activity. These results allow a description of the actual level of EBP and differential profiles of Osteopathy care practice in Spain. Knowledge of normative scores of the HS-EBP questionnaire and identification of different predictors of Spanish osteopaths’ EBP, e.g., academic degree, EBP training and training level, work time invested in healthcare activity, research, and teaching activity, and having a working relationship with an accredited educational centre, enable a comprehensive evaluation of the EBP of osteopathic professionals and can also be useful for developing and implementing formative intervention programs for improving EBP practice in osteopathic practice … MORE

Evidence-based assessment of potential therapeutic effects of adjunct osteopathic medicine for multidisciplinary care of acute and convalescent COVID-19 patients. Review article

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Although the COVID-19 pandemic affects predominantly the respiratory function, epidemiological studies show that multiple systems can be affected. The severe complications of SARS-CoV-2 infection seem to be induced by an inflammatory dysregulation (“cytokine storm”), which can also induce an immunodepression. Several studies highlight beneficial effects of osteopathic medicine on inflammation and immune regulation. A careful review of evidence-based literature brings to the fore significant improvements of osteopathic manipulative treatment (OMT) in adjunction to conventional care. OMT can improve the condition of infected patients by decreasing symptoms and boosting the efficiency of conventional care. OMT might also benefit surviving patients by reducing the long-lasting consequences of the infection as well as improving their quality of life during convalescence. This review should constitute an argument in favor of multidisciplinary care, although further biological and clinical research is essential to better assess the potential beneficial contributions of adjunct osteopathic medicine to conventional care in the fight against pandemics such as COVID-19 … ABSTRACT

Developing a psychologically-informed pain management course for use in osteopathic practice: The OsteoMAP cohort study

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Multidisciplinary healthcare programmes which include psychosocial interventions for persistent musculoskeletal pain demonstrate better patient outcomes than separate physical therapies. This paper reports outcomes from the OsteoMAP study, which combined psychological and mindfulness-informed interventions from Acceptance and Commitment Therapy (ACT) with manual treatment to create a multimodal pain self-management course for delivery by osteopaths working with patients with long-term musculoskeletal conditions … ABSTRACT

What Makes an Osteopathic Treatment Effective From a Patient’s Perspective: A Descriptive Phenomenological Study

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This study aimed to describe patients’ perspectives on their experience in osteopathic treatment, to contribute toward developing interpretative models on effectiveness … ABSTRACT

Patient expectations of manual and non-manual therapy within an osteopathic consultation: A cross sectional study

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Patient expectations of an osteopathic consultation can influence their evaluation of the effectiveness of osteopathic management. Throughout an osteopathic consultation practitioners’ may use manual therapy (MT) and/or non-manual therapy (NMT). Currently, little is known regarding patient’s expectations and preferences of osteopathic management. The aim of this study was to identify patients’ expectations of their management within an osteopathic consultation, specifically in terms of the ratio of MT and NMT … ABSTRACT

Mechanical stimulation of human dermal fibroblasts regulates pro-inflammatory cytokines: potential insight into soft tissue manual therapies

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Soft tissue manual therapies are commonly utilized by osteopathic physicians, chiropractors, physical therapists and massage therapists. These techniques are predicated on subjecting tissues to biophysical mechanical stimulation but the cellular and molecular mechanism(s) mediating these effects are poorly understood. Previous studies established an in vitro model system for examining mechanical stimulation of dermal fibroblasts and established that cyclical strain, intended to mimic overuse injury, induces secretion of numerous pro-inflammatory cytokines. Moreover, mechanical strain intended to mimic soft tissue manual therapy reduces strain-induced secretion of pro-inflammatory cytokines. Here, we sought to partially confirm and extend these reports and provide independent corroboration of prior results … MORE

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