Defining the landscape of patient harm after osteopathic manipulative treatment: synthesis of an adverse event model

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2 December 2023

Defining the landscape of patient harm after osteopathic manipulative treatment: synthesis of an adverse event model

In the United States, osteopathic manipulative treatment (OMT), is a popular complementary physical health approach for the treatment of neuromusculoskeletal disorders. However, post-OMT adverse events (AEs) are poorly defined in terms of frequency, severity, and temporal evolution. To date, no benchmark for patient safety exists. To improve understanding in this field, we set out to model the landscape of patient harm after OMT … MORE

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A Randomized, Clinical Trial Comparing the Efficacy of a Fascia Release Technique for the Treatment of Acute Ankle Sprains

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2 December 2023

A Randomized, Clinical Trial Comparing the Efficacy of a Fascia Release Technique for the Treatment of Acute Ankle Sprains

Acute ankle sprains are treated with ice, elevation, immobilization, and non-steroidal anti-inflammatory drugs. Resolution typically takes days. Osteopathic physicians utilize manipulation for a variety of joint disorders and injuries. Few have been studied in randomized controlled trials and many allopathic physicians are unaware of their utility. One manipulation, a modified muscle energy release technique, appears to offer promise for the treatment of acute ankle injuries, potentially returning patients to function more quickly than standard treatment alone. This study involved a comparison of a modified muscle energy release technique with standard treatment to standard treatment alone in the emergency department (ED) setting for patients with acute ankle injuries … MORE

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The association between cervical artery dissection and spinal manipulation among US adults

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19 October 2023

The association between cervical artery dissection and spinal manipulation among US adults

Cervical artery dissection (CeAD), which includes both vertebral artery dissection (VAD) and carotid artery dissection (CAD), is the most serious safety concern associated with cervical spinal manipulation (CSM). The authors of this study evaluated the association between CSM and CeAD among US adults … ABSTRACT

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Integrating osteopathic manipulative treatment into prenatal care visits in a family medicine resident clinic

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19 October 2023

Integrating osteopathic manipulative treatment into prenatal care visits in a family medicine resident clinic

Literature describing the integration of osteopathic manipulative treatment (OMT) during prenatal care visits in a resident clinic setting are scarce. Concise and readily accessible resources reviewing OMT in pregnancy are limited. We sought to integrate OMT into routine prenatal care appointments in a family medicine resident clinic setting and create a concise resource for those performing OMT in pregnancy. Musculoskeletal (MSK) pain in pregnancy is common. Specifically, low back pain (LBP) often accompanies pregnancy and may negatively impact sleep, the ability to work, and the ability to complete daily tasks. Treatment options for LBP in pregnancy are limited due to the concern for fetal or maternal harm associated with pharmacologic options or invasive procedures. OMT is a low-risk intervention that has been demonstrated to improve back pain and reduce deterioration of back-specific function in pregnancy. Over a 12-month period, one resident physician offered OMT during routine prenatal care visits in a family medicine resident clinic. During the study period, we identified barriers to integrating OMT along with solutions … MORE

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An international consensus on gaps in mechanisms of forced-based manipulation research: findings from a nominal group technique

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16 October 2023

An international consensus on gaps in mechanisms of forced-based manipulation research: findings from a nominal group technique

Force-Based Manipulation (FBM) including light touch, pressure, massage, mobilization, thrust manipulation, and needling techniques are utilized across several disciplines to provide clinical analgesia. These commonly used techniques demonstrate the ability to improve pain-related outcomes; however, mechanisms behind why analgesia occurs with these hands-on interventions has been understudied. Neurological, neuroimmune, biomechanical, neurovascular, neurotransmitter, and contextual factor interactions have been proposed to influence response; however, the specific relationships to clinical pain outcomes has not been well established. The purpose of this study was to identify gaps present within mechanism-based research as it relates to FBM. An international multidisciplinary nominal group technique (NGT) was performed and identified 37 proposed gaps across eight domains. Twenty-three of these gaps met consensus across domains supporting the complex multisystem mechanistic response to FBM. The strength of support for gaps within the biomechanical domain had less overall support than the others. Gaps assessing the influence of contextual factors had strong support as did those associating mechanisms with clinical outcomes (translational studies). The importance of literature investigating how FBM differs with individuals of different pain phenotypes (pain mechanism phenotypes and clinical phenotypes) was also presented aligning with other analgesic techniques trending toward patient-specific pain management (precision medicine) through the use of pain phenotyping … ABSTRACT

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Integrating osteopathic manipulative treatment into prenatal care visits in a family medicine resident clinic

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7 October 2023

Integrating osteopathic manipulative treatment into prenatal care visits in a family medicine resident clinic

Literature describing the integration of osteopathic manipulative treatment (OMT) during prenatal care visits in a resident clinic setting are scarce. Concise and readily accessible resources reviewing OMT in pregnancy are limited. We sought to integrate OMT into routine prenatal care appointments in a family medicine resident clinic setting and create a concise resource for those performing OMT in pregnancy. Musculoskeletal (MSK) pain in pregnancy is common. Specifically, low back pain (LBP) often accompanies pregnancy and may negatively impact sleep, the ability to work, and the ability to complete daily tasks. Treatment options for LBP in pregnancy are limited due to the concern for fetal or maternal harm associated with pharmacologic options or invasive procedures. OMT is a low-risk intervention that has been demonstrated to improve back pain and reduce deterioration of back-specific function in pregnancy. Over a 12-month period, one resident physician offered OMT during routine prenatal care visits in a family medicine resident clinic. During the study period, we identified barriers to integrating OMT along with solutions. Barriers to integrating OMT were noted in three areas: clinic setup and logistics, attending physician awareness of OMT in pregnancy, and treating physician knowledge of OMT in pregnancy. OMT provides pregnant patients with additional treatment options and relief from MSK pain. This may reduce the number of patients with untreated MSK pain and benefit those who are unable to attend additional appointments outside of prenatal care due to financial or logistic barriers. OMT can be integrated into routine prenatal care visits in a training setting by providing complaint-specific OMT and determining how treatments can be performed for each unique examination room and table. Reviewing OMT in pregnancy with the attending physician prior to treatment, contraindications to OMT in pregnancy, and visualizing how treatments will be altered in pregnancy allows for smooth integration … MORE

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The osteopath-parent-child triad in osteopathic care in the first 2 years of life: a qualitative study

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2 October 2023

The osteopath-parent-child triad in osteopathic care in the first 2 years of life: a qualitative study

Enactivism and active inference are two important concepts in the field of osteopathy. While enactivism emphasizes the role of the body and the environment in shaping our experiences and understanding of the world, active inference emphasizes the role of action and perception in shaping our experiences and understanding of the world. Together, these frameworks provide a unique perspective on the practice of osteopathy, and how it can be used to facilitate positive change in patients. Since the neonatal period is a crucial time for development, osteopaths should aim to create a therapeutic relationship. Arguably, through participatory sense-making, osteopaths can help the baby build a generative model (with positive priors) to deal with stress and needs throughout their life. Since the literature considers that interactions with the environment, which enact the patients’ experiences, depending on contextual factors and communication between patient and caregiver, this research explored whether there is a correspondence between the indications in the literature and clinical practice in the management of the mother/parent–child dyad during osteopathic care on children aged 0 to 2 years old … MORE

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Effectiveness of Osteopathic Manipulative Treatment in Adults with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

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15 September 2023

Effectiveness of Osteopathic Manipulative Treatment in Adults with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

The aim of this systematic review and meta-analysis was to evaluate the effectiveness of the osteopathic manipulative treatment (OMT) in adults with irritable bowel syndrome (IBS) … MORE

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Influence of Osteopathic Manipulative Treatment on the Quality of Life and the Intensity of Lumbopelvic Pain in Pregnant Women in the Third Trimester: A Prospective Observational Study

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14 September 2023

Influence of Osteopathic Manipulative Treatment on the Quality of Life and the Intensity of Lumbopelvic Pain in Pregnant Women in the Third Trimester: A Prospective Observational Study

During pregnancy, the various changes women undergo can affect their health status. Manual therapies are important aids because they do not use medication. This study aimed to evaluate the influence of osteopathic manipulative treatment on the intensity of lumbar and pelvic pain and changes in quality of life. This prospective study included women over 18 years old and between 27 and 41 weeks pregnant, and excluded women with fetal malformations, multiple fetuses, premature rupture of membranes, and in labor … MORE

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Using medical storytelling to communicate problems and solutions in the low back pain conundrum: an evidence-based tale of twins

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17 August 2023

Using medical storytelling to communicate problems and solutions in the low back pain conundrum: an evidence-based tale of twins

Low back pain (LBP) is the number one cause of disability world-wide. It is also the most expensive area in healthcare. Patient-centered innovations are needed. This paper uses medical storytelling to illustrate the common problems that often lead to unnecessary suffering for patients, and costs to society. The authors present innovative solutions, including narrative interventions … MORE

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