Posts by: Patrick van Dun

Touch is the process by which one person physically contacts another individual and as such plays an integral role in osteopathic practice. Osteopathic practitioners use touch in almost every aspect of care including examination, diagnosis and treatment. Although touch is intrinsic to osteopathic practice, there has been no published research to date that qualifies the experience of osteopathic touch within a treatment session. The aim of this phenomenological study was to examine and describe the patient’s experience of touch during a consultation with an osteopathic practitioner … ABSTRACT

Clinical reasoning has been described as a process that draws heavily on the knowledge, skills and attributes that are particular to each health profession. However, the clinical reasoning processes of practitioners of different disciplines demonstrate many similarities, including hypothesis generation and reflective practice. The aim of this study was to understand clinical reasoning in osteopathy from the perspective of osteopathic clinical educators and the extent to which it was similar or different from clinical reasoning in other health professions … MORE

Somatic dysfunction is considered a central concept for the theory and practice of osteopathy, but its relevance to the modern profession is questionable due to its unclear pathophysiology and poor reliability of detection. This article will explore the factors that may produce clinical signs attributed to somatic dysfunction and discuss the plausibility of the concept … ABSTRACT

Medically unexplained symptoms (MUS) are a considerable presenting problem in general practice. Alexithymia and difficulties with mental elaboration of bodily arousal are hypothesized as a key mechanism in MUS. In turn, this inability influences the embodied being and participating of these patients in the world, which is coined as ‘the lived body’ and underlies what is mostly referred to as body awareness (BA). The present article explores a more innovative hypothesis how hands-on bodywork can influence BA and serve as a rationale for a body integrated psychotherapeutic approach of MUS … MORE

Osteopathic manipulative treatment (OMT) is often used to treat patients with low back pain (LBP). The objective of this study was 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 … MORE

Little is known about recovery after spinal manipulation in patients with low back pain (LBP). The objective of this study was 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 … MORE

However, the percentage of osteopathic physicians who use OMT in older patients, the differences in conditions for which OMT is used, and the OMT techniques used in older patients compared with younger patients are unknown. The objective of this study was to determine the use of OMT by osteopathic physicians in older patients compared with younger patients … ABSTRACT

Numerous articles have been published describing the scientific discovery of the lymphatic system, but few of these articles have focused on the origin and development of manual techniques addressing this complex system of vessels, valves, nodes, and organs. These manual techniques—like knowledge about the lymphatic system itself—evolved late in the history of medicine. MORE

The brain has long been thought to lack a lymphatic drainage system. Recent studies, however, show the presence of a brain-wide paravascular system appropriately named the glymphatic system based on its similarity to the lymphatic system in function and its dependence on astroglial water flux. Besides the clearance of cerebrospinal fluid and interstitial fluid, the glymphatic system also facilitates the clearance of interstitial solutes such as amyloid-β and tau from the brain. As cerebrospinal fluid and interstitial fluid are cleared through the glymphatic system, eventually draining into the lymphatic vessels of the neck, this continuous fluid circuit offers a paradigm shift in osteopathic manipulative medicine. For instance, manipulation of the glymphatic-lymphatic continuum could be used to promote experimental initiatives for nonpharmacologic, noninvasive management of neurologic disorders. In the present review, the authors describe what is known about the glymphatic system and identify several osteopathic experimental strategies rooted in a mechanistic understanding of the lymphatic-lymphatic continuum … ABSTRACT