Does the inter-osseous membrane fascial dysfunction exist ? An observational study comparing palpation to ultrasound measurements

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4 June 2022

Does the inter-osseous membrane fascial dysfunction exist ? An observational study comparing palpation to ultrasound measurements

There is a lack of evidence to support a correspondence between osteopathic palpation and anatomical findings. The concept of dysfunction could be defined using more accurate words when describing palpatory findings if they could be explained by objective measurements. The forearm Interosseous Membrane (IOM) is a fascia often evaluated by osteopaths, searching for Fascial Dysfunction (FD). We measured IOM physical characteristics, such as elasticity and thickness, with ultrasound (US) and then compared it with osteopaths’ FD assessment … ABSTRACT

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Chronic Pain, Insomnia and their Mutual Maintenance: A Call for Cognitive Bias Research

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4 June 2022

Chronic Pain, Insomnia and their Mutual Maintenance: A Call for Cognitive Bias Research

Chronic pain and insomnia are highly comorbid: Approximately 50% of those with chronic pain experience insomnia or clinically significant sleep disturbances, and 50% of those with insomnia experience chronic pain. Further, these conditions can be extremely disabling, particularly when they co-occur. There is increasing recognition of the need to tackle both chronic pain and insomnia together, as evidenced by growing empirical research in this area. Cognitive processing biases have been independently implicated in both chronic pain and in insomnia. Given their trans-diagnostic status, cognitive biases may therefore have a role in explaining the co-occurrence and mutual maintenance of these conditions. These biases also represent novel, potentially modifiable targets for treatment. However, the role of cognitive biases has not been adequately explored in comorbid chronic pain and insomnia. Here, we describe the state of cognitive bias research in chronic pain and insomnia, considering evidence for the roles of attentional bias, interpretation bias, expectancy bias, and memory bias. In reviewing the literature, it is apparent that similar cognitive biases operate in insomnia and chronic pain, with preliminary, albeit sparse, evidence of pain-related cognitive biases influencing sleep-related outcomes. On the basis of current findings and separate theoretical models, we present a novel, testable cognitive model of comorbid chronic pain and insomnia, to guide future research in this area. Key recommendations for the future of this relatively new field are provided … ABSTRACT

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Association of sleep quality and chronification of musculoskeletal pain in an older adult: A case report

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4 June 2022

Association of sleep quality and chronification of musculoskeletal pain in an older adult: A case report

Sleep disorders and chronic musculoskeletal pain are highly prevalent conditions that are often comorbid clinically. The role of sleep disorder on the chronification of musculoskeletal pain is well documented, although the mechanisms have not yet been fully established. The authors present a case study demonstrating the clinical comorbidity of sleep disorder with chronification of musculoskeletal pain in an older adult with clinical history of hypothyroidism. The aim of this case is to highlight important risk factors of age, gender and hypothyroidism, which the clinician should be aware of for their potential contributory role in the development of sleep disorder and chronification of musculoskeletal pain … ABSTRACT
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4 M’s to make sense of evidence – Avoiding the propagation of mistakes, misinterpretation, misrepresentation and misinformation

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4 June 2022

4 M’s to make sense of evidence – Avoiding the propagation of mistakes, misinterpretation, misrepresentation and misinformation

Osteopaths are expected to keep up to date with research evidence relevant to their clinical practice and to integrate this knowledge with their own experience and their patients’ values and preferences. One of the potential challenges when engaging with research is to make sense of it, to decide if it is trustworthy, and if it is applicable to the complex and context-sensitive nature of clinical practice and the care of individual people. Clinicians are increasingly exposed to (deliberate and undeliberate) misinformation and overstatements which propagate easily, including via social media. This masterclass aims to facilitate critical thinking and engagement in research for clinicians to make better-informed decisions with their patients. It was developed to support osteopaths facing these questions with the aim of empowering them to judge research themselves, detect common fallacies in the conduct and reporting of different research designs, and to increase researchers’ accountability. Ultimately, we hope that by reading and considering the guidance and examples in this paper, clinicians will be better equipped to optimise the use of their (and their patients’) time when facing potential sources of evidence.
Mistakes, misinterpretation, misrepresentation and misinformation are discussed for each of these methods/methodologies: case reports, clinical trials, qualitative research, and reviews … MORE
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Pre-manipulative cervical spine testing and sustained rotation do not influence intracranial hemodynamics: an observational study with transcranial Doppler ultrasound

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4 June 2022

Pre-manipulative cervical spine testing and sustained rotation do not influence intracranial hemodynamics: an observational study with transcranial Doppler ultrasound

Manual joint mobilization and manipulation are recommended therapeutic interventions for people with neck pain. High-velocity thrust and sustained techniques have an uncertain association with serious arterial trauma. The validity of pre-manipulative tests of the cervical spine is often questioned, and the understanding of the effect of head/neck position on blood flow is still incomplete. Most of the evidence concerning hemodynamics in this area relates to extracranial flow (vertebral and carotid artery). Less is understood about the effects on intracranial flow while performing pre-manipulative tests and sustained positions like end of range cervical rotation mobilization. The aim of the study was to assess the influence of commonly used evaluation and treatment positions on intracranial hemodynamic parameters … ABSTRACT

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Impact of contextual factors on patient outcomes following conservative low back pain treatment: systematic review

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4 June 2022

Impact of contextual factors on patient outcomes following conservative low back pain treatment: systematic review

Chronic low back pain is pervasive, societally impactful, and current treatments only provide moderate relief. Exploring whether therapeutic elements, either unrecognised or perceived as implicit within clinical encounters, are acknowledged and deliberately targeted may improve treatment efficacy. Contextual factors (specifically, patient’s and practitioner’s beliefs/characteristics; patient-practitioner relationships; the therapeutic setting/environment; and treatment characteristics) could be important, but there is limited evidence regarding their influence. This research aims to review the impact of interventions modifying contextual factors during conservative care on patient’s pain and physical functioning … MORE

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Results of a feasibility randomised controlled trial of osteopathy on neck-shoulder pain in computer users

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4 June 2022

Results of a feasibility randomised controlled trial of osteopathy on neck-shoulder pain in computer users

Computer use is a well-known source of chronic pain, leading to absenteeism and reduced productivity and well-being. This study evaluated the feasibility of conducting a full-scale randomised controlled trial. Several methodological variables defined trial feasibility … MORE

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Efficacy and safety of osteopathic manipulative treatment: an overview of systematic reviews

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14 April 2022

Efficacy and safety of osteopathic manipulative treatment: an overview of systematic reviews

The objective of this overview was to summarise the available clinical evidence on the efficacy and safety of osteopathic manipulative treatment (OMT) for different conditions … MORE

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Effectiveness of osteopathic manipulative treatment for pediatric conditions: A systematic review

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7 April 2022

Effectiveness of osteopathic manipulative treatment for pediatric conditions: A systematic review

Osteopathic manipulative treatment (OMT) is commonly used by osteopaths and osteopathic physicians to manage a large variety of pediatric complaints. This current study reviewed the literature to determine the effectiveness of OMT for all pediatric complaints … ABSTRACT

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The Portuguese Osteopathic Practitioners Estimates and RAtes (OPERA): A cross-sectional survey

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7 April 2022

The Portuguese Osteopathic Practitioners Estimates and RAtes (OPERA): A cross-sectional survey

Osteopathy is regulated as an independent healthcare profession in Portugal. The Osteopathic Practitioners Estimates and RAtes (OPERA) project was developed as a survey to profile the osteopathic profession. This study aimed to describe the characteristics of Portuguese osteopathic practitioners … ABSTRACT

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