A modern way to teach and practice manual therapy

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25 May 2024

A modern way to teach and practice manual therapy

Musculoskeletal conditions are the leading contributor to global disability and health burden. Manual therapy (MT) interventions are commonly recommended in clinical guidelines and used in the management of musculoskeletal conditions. Traditional systems of manual therapy (TMT), including physiotherapy, osteopathy, chiropractic, and soft tissue therapy have been built on principles such as clinician-centred assessment, patho-anatomical reasoning, and technique specificity. These historical principles are not supported by current evidence. However, data from clinical trials support the clinical and cost effectiveness of manual therapy as an intervention for musculoskeletal conditions, when used as part of a package of care. The purpose of this paper is to propose a modern evidence-guided framework for the teaching and practice of MT which avoids reference to and reliance on the outdated principles of TMT. This framework is based on three fundamental humanistic dimensions common in all aspects of healthcare: safety, comfort, and efficiency. These practical elements are contextualised by positive communication, a collaborative context, and person-centred care. The framework facilitates best-practice, reasoning, and communication and is exemplified here with two case studies … MORE

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Primary and secondary prevention of musculoskeletal pain and disability in Chiropractic, Osteopathy, and Physiotherapy: a scoping review

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19 May 2024

Primary and secondary prevention of musculoskeletal pain and disability in Chiropractic, Osteopathy, and Physiotherapy: a scoping review

Musculoskeletal prevention is a key priority in public health and for national health systems due to the increasing number of people living with persistent conditions, including musculoskeletal (MSK) complaints. There is no robust review of the evidence on COP interventions and MSK prevention, such as what the current state of conceptual debate is about a possible role of COP interventions in prevention, where and how this has been studied, and what the evidence for effectiveness is. This scoping review was conducted to chart and appraise the available evidence regarding primary and secondary prevention in MSK care in the chiropractic, osteopathic and physiotherapy (COP) professions … MORE
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CHRONIC PAIN, COMPLEXITY AND A SUGGESTED ROLE FOR THE OSTEOPATHIC PROFESSION

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9 May 2024

CHRONIC PAIN, COMPLEXITY AND A SUGGESTED ROLE FOR THE OSTEOPATHIC PROFESSION

Chronic pain is common and has a substantial impact on individuals’ lives and the society in which they live. However, current strategies for managing chronic pain have low to moderate efficacy. We present a complexity informed model of managing chronic pain.

The authors propose that the biological, psychological and social factors influencing the experience of chronic pain can be framed as elements of a complex system (when ‘system’ is understood as a mental model of a set of relationships in the world) and discuss the advantages of this approach.

The ‘Learning Cycles’ framework of Human Learning Systems is suggested as an appropriate approach to managing chronic pain. There are five elements of the Learning Cycle; ‘understanding the system’, ‘co-design’, ‘experimentation exploration’, ‘embedding and influencing’ and ‘system stewardship’. The authors describe how this could be implemented in osteopathic practice.

The implications of a complexity approach with respect to evidence-informed as opposed to evidence-based practice is briefly discussed. Further, the opportunity for osteopathy to be at the vanguard of broader movement for change in public service and healthcare is highlighted.

Applying Learning Cycles to the context of managing chronic pain requires further research to explore its utility. Learning Cycles provide an action-research model that would supply the rich data by which to understand the efficacy of chronic pain management … ABSTRACT

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The effects of osteopathic manipulative treatment on pain and disability in patients with chronic low back pain: a single-blinded randomized controlled trial

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9 May 2024

The effects of osteopathic manipulative treatment on pain and disability in patients with chronic low back pain: a single-blinded randomized controlled trial

The evidence for the efficacy of osteopathic manipulative treatment (OMT) in the management of low back pain (LBP) is considered weak by systematic reviews, because it is generally based on low-quality studies. Consequently, there is a need for more randomized controlled trials (RCTs) with a low risk of bias. The objective of this study is to evaluate the efficacy of an OMT intervention for reducing pain and disability in patients with chronic LBP … MORE

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Reported biological effects following Osteopathic Manipulative Treatment: A comprehensive mapping review

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9 May 2024

Reported biological effects following Osteopathic Manipulative Treatment: A comprehensive mapping review

Osteopathic Manipulative Treatment (OMT) is a therapeutic whole-body approach mainly focused on correcting somatic dysfunctions. The aim of this scoping review is to systematically map the literature regarding the documented biological effects observed following OMT … MORE

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Investigating the safety and feasibility of osteopathic manipulative medicine in hospitalized children and adolescent young adults with cancer

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9 May 2024

Investigating the safety and feasibility of osteopathic manipulative medicine in hospitalized children and adolescent young adults with cancer

Children and adolescents young adults (AYAs) undergoing treatment for oncologic diagnoses are frequently hospitalized and experience unwanted therapy-induced side effects that diminish quality of life. Osteopathic manipulative treatment (OMT) is a medical intervention that utilizes manual techniques to diagnose and treat body structures. Few studies have investigated the implementation of OMT in the pediatric oncology outpatient setting. To date, no studies have investigated the safety and feasibility of OMT in the pediatric oncology inpatient setting. The objective of this study is to investigate the safety and feasibility of OMT in the pediatric oncology inpatient setting … MORE
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A superficial dissection approach to the sphenopalatine (pterygopalatine) ganglion to emphasize osteopathic clinical relevance

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9 May 2024

A superficial dissection approach to the sphenopalatine (pterygopalatine) ganglion to emphasize osteopathic clinical relevance

The sphenopalatine (pterygopalatine) ganglion (SPG) is the most superficial ganglia to manipulate from the oral cavity. It has parasympathetic and sensory fibers directly affecting the paranasal sinuses as well as the palatine, nasal, pharyngeal, and lacrimal glands. The SPG can be manipulated intraorally by students and physicians utilizing osteopathic manipulative treatment (OMT) to relieve congestion associated with sinusitis, allergies, headaches, and upper respiratory infections. Within osteopathic medical education programs, students have anecdotally had difficulty identifying this ganglion due to its deep anatomic location and lack of direct visualization. In this article, we discuss that cadaveric dissection with a superficial to deep approach to the SPG has the ability to allow medical students and physicians to better understand the three-dimensional location and osteopathic clinical relevance of this ganglion … MORE

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A framework for the interpretation of heart rate variability applied to transcutaneous auricular vagus nerve stimulation and osteopathic manipulation

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9 May 2024

A framework for the interpretation of heart rate variability applied to transcutaneous auricular vagus nerve stimulation and osteopathic manipulation

Reports on autonomic responses to transcutaneous auricular vagus nerve stimulation (taVNS) and osteopathic manipulative techniques have been equivocal, partly due to inconsistent interpretation of heart rate variability (HRV). We developed a mechanistic framework for the interpretation of HRV based on a model of sinus node automaticity that considers autonomic effects on Phase 3 repolarization and Phase 4 depolarization of the sinoatrial action potential. The model was applied to HRV parameters calculated from ECG recordings (healthy adult humans, both genders) before (30 min), during (15 min), and after (30 min) a time control intervention (rest, n = 23), taVNS (10 Hz, 300 μs, 1–2 mA, cymba concha, left ear, n = 12), or occipitoatlantal decompression (OA‐D, n = 14). The experimental protocol was repeated on 3 consecutive days. The model simulation revealed that low frequency (LF) HRV best predicts sympathetic tone when calculated from heart rate time series, while high frequency (HF) HRV best predicts parasympathetic tone when calculated from heart period time series. Applying our model to the HRV responses to taVNS and OA‐D, revealed that taVNS increases cardiac parasympathetic tone, while OA‐D elicits a mild decrease in cardiac sympathetic tone … MORE

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How do Australian osteopaths manage migraines? Outcomes from a national practice-based research network

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9 May 2024

How do Australian osteopaths manage migraines? Outcomes from a national practice-based research network

Individuals who experience migraines often seek out a variety of treatment options including manual or physical therapy. Evidence suggests that manual therapy, including osteopathy, can play a role in the management of migraines. Whilst there is some literature on the role osteopathy therapy plays in migraine management, none describes the treatment approaches used by practitioners.
The objective of this study is to explore the demographic, practice and clinical management characteristics of Australian osteopaths who report treating migraine ‘often’ in clinical practice … MORE
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The short- and long-term effect of osteopathic manipulative treatment on pain, and psychosocial factors in adults with chronic low back pain

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9 May 2024

The short- and long-term effect of osteopathic manipulative treatment on pain, and psychosocial factors in adults with chronic low back pain

Chronic low back pain (CLBP) has long plagued mankind, but little progress has been made in finding a rational and effective treatment, let alone a common cause. This study is an attempt to fill that void by measuring short- and long-term effects of osteopathic manipulative treatment (OMT), including psychosocial and pain reduction in CLBP patients. The objectives of this study were to investigate the effectiveness of neuromusculoskeletal medicine/osteopathic manipulative medicine (OMM) in treating CLBP, with a focus on biopsychosocial (pain sensitivity questionnaire [PSQ]) and pain control in chronic conditions … MORE

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