Hasil untuk "Osteopathy"

Alex Kane Miller, Matthew Stewart Easthardt, Christopher Ryan Michel et al.

Study Design Cross-sectional social media content analysis. Purpose Patients increasingly rely on social media for education and perspectives regarding surgical care. Given the growing interest in endoscopic spine surgery, there is a need to critically evaluate related content available on social media. Overview of Literature While patient and surgeon engagement with spine surgery topics on social media has been explored, no previous study has specifically examined endoscopic spine surgery content on Twitter/X. Methods The Twitter/X website’s user-facing search functionality was used to compile tweets containing hashtags related to endoscopic spine surgery. The search spanned from the website’s inception to December 31, 2024. Tweets were categorized by authorship and location. Each tweet was independently analyzed by two reviewers to identify themes and contextual nature (educational vs. promotional). Results A total of 890 tweets from 199 accounts were analyzed. The majority of content (76.0%) originated from outside the United States. Medical doctors, doctors of osteopathy, and other healthcare providers authored 44.4% of the content. Patient-facing advertisements accounted for 24.5% of tweets. Approximately 22.1% of tweets contained content intended for healthcare professionals already familiar with endoscopic spine surgery, primarily highlighting conference/educational activities, research projects, or noteworthy cases. Conclusions A growing body of information related to endoscopic spine surgery is available on Twitter/X, though a large portion of this content consists of healthcare providers advertising to potential patients. Future research should prioritize identifying and analyzing patient perspectives on endoscopic spine surgery portrayed on social media platforms.

Jerry Draper-Rodi, Hilary Abbey, John Hammond et al.

Abstract Background Individuals from minority groups have historically faced social injustices. Those from underrepresented groups have been less likely to access both healthcare services and higher education. Little is known about the experiences of underrepresented students during their undergraduate studies in osteopathy in the UK. The aim of this project was to explore awareness of cultural diversity and beliefs about patients from underrepresented groups in current osteopathic educational environments and evaluate students’ preparedness to manage patients from diverse groups. The project also aimed to investigate the educational experiences of students from underrepresented backgrounds during their training and their opinions on changes that could support better levels of recruitment and achievement. The findings were discussed with stakeholders in interactive workshops with the aim to develop recommendations for action and change. Methods A transformative action research paradigm informed this mixed methods project. It included: 1/ a survey of students from all seven osteopathic educational providers in the UK using the Multidimensional Cultural Humility Scale (MCHS); 2/ a series of focus groups with students from underrepresented groups (women, students with disabilities, students from minority ethnic backgrounds, and students identifying as LGBTQIA+); and 3/ a workshop forum to discuss findings. Results A total of 202 participants completed the MCHS and demographic questionnaire and seven focus groups were conducted. A model was developed to describe participants’ training experiences comprising two main themes: institutional contextual obstacles (with four sub-themes) and underrepresented students’ conceptual understanding of Equity, Diversity and Inclusion (EDI). Recommendations for change identified in the workshops were based on three topics: institutions, staff, and students. Conclusion Our findings confirm conclusions from other institutions that staff education is urgently needed to create and maintain equitable, inclusive environments in osteopathic educational institutions in the UK to support all students, particularly those from underrepresented groups. Institutional EDI processes and policies also need to be clarified or modified to ensure their usefulness, accessibility, and implementation.

G. Rotter, Moritz W Ahnert, Anne V Geue et al.

Patients with atopic dermatitis (AD) frequently use acupuncture (ACU) and osteopathic medicine (OM), although their therapeutic benefits are unclear.

D. Mokhov, Y. Potekhina, A. A. Gurichev

The article presents the main osteopathic tests that allow identifying and differentiating biomechanical, hydrodynamic and neurodynamic components of somatic dysfunctions and choosing adequate techniques for osteopathic correction. For each test, an anatomical and physiological justifi cation is given and the principle of its implementation is described.

M. Verzella, Erika Affede, Luca Di Pietrantonio et al.

Over the years, several authors have discussed the possibility of considering somatic dysfunction (SD) as a “nosological element” detectable on palpation. There are many aspects to consider regarding the etiology and diagnosis of SD, and the literature on osteopathic issues provides details on physiological signs that characterize it, including tissue texture changes. Recent knowledge suggests that how tissue and, in particular, connective tissue, responds to osteopathic treatment may depend on the modulation of the inflammation degree. Low-grade inflammation (LGI) may act on the extracellular matrix (ECM) and on cellular elements; and these mechanisms may be mediated by biological water. With its molecules organized in structures called exclusion zones (EZ), water could explain the functioning of both healthy and injured tissues, and how they can respond to osteopathic treatment with possible EZ normalization as a result. The relationship between inflammation and DS and the mechanisms involved are described by several authors; however, this review suggests a new model relating to the characteristics of DS and to its clinical implications by linking to LGI. Tissue alterations detectable by osteopathic palpation would be mediated by body fluids and in particular by biological water which has well-defined biophysical characteristics. Research in this area is certainly still to be explored, but our suggestion seems plausible to explain many dynamics related to osteopathic treatment. We believe that this could open up a fascinating scenario of therapeutic possibilities and knowledge in the future.

M. Cummings

In August 2014, the American Osteopathic Association (AOA) and the American Association of Colleges of Osteopathic Medicine (AACOM) signed a memorandum of understanding with the Accreditation Council for Graduate Medical Education (ACGME) to create the Single Accreditation System (SAS) for graduate medical education (GME) in the United States. The AOA made the decision that it would close its GME accreditation system in response to dramatic growth in colleges of osteopathic medicine, a shortfall in osteopathic GME positions with increasing dependence on the ACGME system, ACGME policy decisions that adversely impacted osteopathic students, and declining osteopathic student interest in primary care. Osteopathic teaching institutions bore responsibility for meeting ACGME accreditation standards between 2015-2020, including determining institutional sponsorship, which program applications to submit, program size, educational leadership, and whether to pursue Osteopathic Recognition. Approximately 692 of 954 (72.5%) eligible osteopathic GME programs in 2014-2015 obtained ACGME accreditation by June 1, 2020. There were sharp reductions in surgical and subspecialty programs and a significant drop of DOs in educational leadership positions. A low percentage of ACGME-accredited programs applied for Osteopathic Recognition. In closing its GME accreditation system and joining the ACGME, the AOA gave up control of its direct relationship with osteopathic residents, fellows, and teaching institutions to gain critical GME opportunities. In this article, the author considers whether this gain will offset the risks taken by the AOA, including decreased DO leadership opportunities and role models, lower than expected interest in Osteopathic Recognition, and possible decreased DO interest in osteopathic organizations and osteopathic specialty board certification. Time and the choices of current and future DO trainees in ACGME programs will determine the future of the osteopathic profession-and whether these risks were worth taking.

Carmine Castagna, Giacomo Consorti, Matteo Turinetto et al.

Objective The purpose of this article is to propose a tool to assist with clinical reasoning to select and integrate different osteopathic models and evidence-based actions into clinical practice. Discussion The authors adopted the guidelines for writing a commentary as a reporting framework for the present article. The proposed Osteopathic Models Integration Radar Plot has potential for integration into clinical practice and the educational environment. This framework may enable clinicians to manage complex clinical phenomena, such as musculoskeletal disorders related to allostatic load. Conclusion This proposed framework may be helpful to communicate the outcome of osteopathic evaluations to other healthcare professionals. This proposed model will need to be tested to determine feasibility.

García-Fontana B, Avilés-Pérez MD, González-Salvatierrra S et al.

Introducción: La mayoría de estudios han puesto de manifiesto una disminución de la función y fuerza muscular en pacientes con diabetes mellitus tipo 2 (DM2). Sin embargo, la relación entre la función muscular y la salud ósea en los pacientes con DM2 no está bien definida. Objetivo: El objetivo del estudio fue analizar la relación entre la fuerza muscular y la fragilidad ósea en pacientes con DM2. Material y métodos: Estudio observacional transversal. Se incluyeron un total de 60 pacientes con DM2 (60% varones y 40% mujeres postmenopáusicas) con una edad entre 49-85 años. Se estudiaron variables demográficas, antropométricas, clínicas y bioquímicas. Se determinó la densidad mineral ósea (DMO) en columna lumbar (CL), cuello femoral y cadera total mediante DXA (Hologic QDR 4500), y los valores de TBS (TBS iNsight Software, versión 3.0.2.0, Medimaps, Merignac, France). La fuerza de la mano (kg/cm2) se midió con un dinamómetro hidráulico manual Jamar® (5030j1; jackson, MI). Para evaluar el nivel de movilidad y el riesgo de caídas, se realizó el test Time Up and Go. El análisis estadístico se realizó mediante el programa SPSS (SPSS, inc, v 25.0). Resultados: La edad media de los pacientes fue de 66,3±8,3 años. La HbA1c media fue de 7,7±1,1%, observándose un inadecuado control glucémico (HbA1c >7,5%) en el 73,3% de los pacientes. El 91,7% de las mujeres y el 77,8% de los varones presentaron baja fuerza muscular. El 41,7% de mujeres y el 25% de varones presentaron un riesgo elevado de caídas. Los sujetos con baja fuerza de prensión manual y los que tenían riesgo de caídas elevado presentaron valores significativamente menores de TBS que los que tenían mayor fuerza de la mano (0,99±0,17 vs 1,12±0,15; p=0,03) y bajo riesgo de caídas (0,94±0,13 vs 1,04±0,19; p=0,02). Los pacientes con TBS normal y parcialmente degradado tenían mayor fuerza de agarre manual que los sujetos con TBS degradado (p=0,031). La fuerza de la mano se asoció positivamente con TBS (p<0,05) independientemente de la edad, perímetro de cintura, niveles de 25OH vitamina D y DMO en CL. No hubo diferencias significativas en la fuerza de agarre manual en función de los valores de DMO. Conclusión: Nuestro estudio muestra que la reducción de la fuerza muscular puede estar relacionada con el deterioro de la microarquitectura ósea determinada por TBS en pacientes con DM2.

James Furness, Katherine McArthur, Debbie Remnant et al.

Background New Zealand (NZ) has nearly 14,000 km of coastline and a surfing population of approximately 315,000 surfers. Given its popularity, surfing has a high frequency of injury claims, however, there remains a lack of data on traumatic surfing-related injuries from large population studies. The primary purpose of this study was to examine traumatic surfing injuries in NZ specific to injury incidence, duration, location, type, mechanism of injury and associated risk factors. Methods A sample of self-identified surfers currently living in NZ participated in an online retrospective cross-sectional survey between December 2015 and July 2016. Demographic and surfing injury data were collected and analysed. Results The survey yielded 1,473 respondents (18.3% female); a total of 502 surfers reported 702 major traumatic injuries with an overall incidence proportion of 0.34 (95% CI [0.32–0.37]). When comparing the number of injured surfers who sustained an injury at various body locations, a significantly higher proportion of competitive surfers, compared to recreational surfers, had an injury at the neck (6.8% vs 4%, χ2 (1,1473) = 5.84, P = 0.019); shoulder (7.4% vs 4.3%, χ2 (1,1473) = 6.34, P = 0.017), upper back (1% vs 2.4%, χ2 (1,1473) = 4.77, P = 0.043), lower back (7% vs 3.1%, χ2 (1,1473) = 11.98, P = 0.001) and knee (7% vs 3.4%, χ2 (1,1473) = 9.67, P = 0.003). A significantly higher proportion of surfers who performed aerial manoeuvres compared to those who did not reported a higher proportion of knee injuries (9.7% vs 3.9%, χ2 (1,1473) = 13.00, P = 0.001). With respect to injury duration, the shoulder represented the largest proportion of chronic injuries (>3 months) (44.4%), and the head and face represented the largest proportion of acute injuries (≤3 months) (88%). Muscle and tendon injuries were reported most frequently (25.6%) and direct contact injuries accounted for 58.1% of all injury mechanisms. Key risk factors for traumatic injury included: competitive compared to recreational status (41.0% vs 30.1%, Relative Risk (RR) = 1.36, P < 0.001), ability to perform aerial manoeuvres (48.1% vs 31.8%, RR = 1.51, P < 0.001) and intermediate or above skill level surfers compared to beginner surfers (35.8% vs 22.7%, RR = 1.58, P < 0.001). Conclusion One third of recreational surfers sustained a major traumatic injury in the previous 12 months. For competitive or aerialist surfers the risk was greater, with this proportion approximately half. Overall, the head/face was the most common location of traumatic injury, with competitive surfers being more likely to sustain a neck, shoulder, lower back, and knee injury compared to recreational surfers. The shoulder was associated with the highest proportion of injuries of chronic duration. Future research should investigate injury mechanisms and causation using prospective injury monitoring to better underpin targeted injury prevention programs.

Cordoba A, García-Unzueta MT, Riancho-Zarrabeitia L et al.

Objetivo: Investigar la prevalencia de hipercalcemia en pacientes con artritis reumatoide (AR) y analizar las características clínicas y las causas de la hipercalcemia. Material y métodos: Estudio retrospectivo de revisión basado en casos que incluyó 500 pacientes con AR. Se identificaron los pacientes con niveles de calcio aumentados en al menos dos ocasiones. Resultados: La hipercalcemia estuvo presente en 24 de los 500 pacientes con AR (4,8%). La edad osciló entre 50 y 80 años, con una media de 68±10 años. La duración media de la enfermedad fue de 10±7 años. De los pacientes con hipercalcemia, 22 eran mujeres postmenopáusicas (92%) y solo dos eran hombres (8%). El hiperparatiroidismo se encontró en 9 pacientes de la serie; solo un paciente tenía una hipercalcemia maligna debido a un mieloma múltiple, y un caso fue consecuencia de una intoxicación por vitamina D. En un paciente la hipercalcemia parecía relacionada con el síndrome calcio-alcalino. En el resto de pacientes, la hipercalcemia fue idiopática (8/24) o el estudio fue incompleto (4/24). No se encontró una relación evidente entre la actividad de la enfermedad y la aparición de hipercalcemia. Conclusión: Al igual que sucede en la población general, el hiperparatiroidismo primario es la causa más común de hipercalcemia en pacientes con AR. En algunos pacientes no se identificaron otros trastornos causantes de hipercalcemia, lo que plantea la posibilidad de una relación causal entre la AR y la hipercalcemia.

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.

F. Cerritelli, Patrick L S van Dun, J. Esteves et al.

The prevalence of osteopathic practitioners, their professional profile and features of their clinical practice, particularly where statutory regulation does not yet exist, are still significantly underreported. The Osteopathic Practitioners Estimates and RAtes (OPERA) project was developed as an European-based census dedicated to profiling the osteopathic profession across Europe. The present study aimed to describe the osteopathic practitioners and the profession in Italy. A voluntary, online based, closed-ended survey was distributed across Italy in the period between February and June 2017. An e-based campaign was set up to reach the Italian osteopathic professionals. Participants were asked to complete the forms by filling in the information regarding the demographics, working status and professional activities, education, consultation fees, patient complaints, treatment and management. The survey was completed by 4816 individuals. 196 people started the survey but did not finish, which corresponds to a 4% attrition rate. The majority of respondents were males (66.7%). The modal age group was 30–39 (40.0%). 73.8% of respondents had a previous academic degree, mainly in the fields of sports science (36.4%) and physiotherapy (25.3%). 25.6% declared not to have a previous academic degree. The majority of respondents declared to work alone (58.4%), while the remaining declared to work in association with other professionals. The osteopaths /citizens ratio was 8.0 osteopaths/100,000 citizens. The profile of osteopaths in Italy seems to be characterised by a self-employed young adult male working mostly as a sole practitioner, who has been trained as osteopath through a part-time curriculum and had a previous degree mostly in the fields of sports science or physiotherapy. These results provide important insights into the osteopathic profession in Italy. The varied professional educational backgrounds need to be considered with regard to the implementation of a professional licensing process and future pre-registration education in the country. The number of respondents is an estimate of the actual number of Italian osteopaths. Only the completion of the regulatory process and the creation of the mandatory official register will allow to know the number of Italy based osteopaths.

Reidar P. Lystad, Benjamin T. Brown, Michael S. Swain et al.

Abstract Background Better understanding of the dynamics and temporal changes in manual therapy service utilisation may assist with healthcare planning and resource allocation. The objectives of this study were to quantify, describe, and compare service utilisation trends in the manual therapy professions within the Australian private healthcare setting between 2008 and 2017. Methods Data regarding the number of services, total cost, and benefits paid were extracted for each manual therapy profession (i.e. chiropractic, osteopathy, and physiotherapy) for the period 2008–2017 from the Australian Prudential Regulation Authority. The number of registered providers for each profession were obtained from the Australian Health Practitioner Regulation Agency. Descriptive statistics were produced for two time periods (i.e. 2008–2012 and 2013–2017) for each manual therapy profession. Annual percentage change during each time period was estimated by fitting Poisson regression models. Test for the equality of regression coefficients was used to compare the trends in the two time periods within each profession, and to compare the trends across professions within a time period. Results A cumulative total of 198.6 million manual therapy services with a total cost of $12.8 billion was provided within the Australian private healthcare setting between 2008 and 2017. Although service utilisation and total cost increased throughout the ten-year period, the annual growth was significantly lower during 2013–2017 than 2008–2012. Whereas osteopathy and physiotherapy experienced significant annual growth in the number of services and total cost during 2013–2017, negative growth in the number of services was observed for chiropractic during the same period. The annual number of services per provider declined significantly for chiropractic and physiotherapy between 2013 and 2017. Conclusion Service provision under private health insurance general treatment cover constitute a major source of revenue for manual therapy professions in Australia. Although manual therapy service utilisation increased throughout the ten-year period from 2008 to 2017, the annual growth declined. There were diverging trends across the three professions, including significantly greater decline in annual growth for chiropractic than for osteopathy and physiotherapy.

Kaveh Haddadi, Saeed Kargar Soleiman Abad, Seiied Mohammad Hashemie Amir et al.

Background and Aim: Neurofibromatosis-1 (NF1) is a common genetic condition in children. It is becoming increasingly recognized that in neurofibromatosis, there might be anomalous development of bone with or without any local anomaly of neuroectodermal basis. This review was conducted to highlight the different features of spinal disorders in this congenital disease. Methods and Materials: Different search engines were used in this research. After going through the results and discarding the repeated ones, 2 reviewers began to inspect the studies independent of one another. In case of any disagreements between the reviewers over the inclusion of certain research material into the study, the final decision was made by the senior author. In the end, accepted research materials were used as needed in categorizing different types of spinal injuries. Results: Skeletal defects are among the most effective complications on the quality of life of patients. Bone deformities, osteoporosis, osteopenia, reduction of bone mass density, and spinal osteopathy such as scoliosis among such defects. Although the relative prevalence of spinal defects in neurofibromatosis type 1 is not clear, scoliosis can be considered the most common type of spinal deformity in this illness to the point it is present in 10 to 71% of cases. Thus, spine surgeons may face numerous common challenging conditions in NF1 patients like scoliosis, spondylolisthesis, and dural ectasia. Conclusion: As NF1 distresses several organ systems, radiologic spine screening is important in patients with NF1 and patients are likely to profit most from a multidisciplinary treatment policy.

Machelle Linsenmeyer, L. Wimsatt, Mark R. Speicher et al.

Brian M. Schmidt, Crystal Holmes

D. Cooper, Jungsoo Kim, K. Duderstadt et al.

Dental caries is the most prevalent chronic childhood disease in the United States. Dental caries affects the health of 60–90% of school-aged children worldwide. The prevalence of untreated early childhood dental caries is 19% for children 2–5 years of age in the U.S. Some factors that contribute to the progression of dental caries include socioeconomic status, access to dental care, and lack of anticipatory guidance. The prevalence of dental caries remains highest for children from specific ethnic or racial groups, especially those living in underserved areas where there may be limited access to a dentist. Although researchers have acknowledged the various links between oral health and overall systemic health, oral health care is not usually a component of pediatric primary health care. To address this public health crisis and oral health disparity in children, new collaborative efforts among health professionals is critical for dental disease prevention and optimal oral health. This evaluation study focused on a 10-week interprofessional practice and education (IPE) course on children’s oral health involving dental, osteopathic medical, and nurse practitioner students at the University of California, San Francisco. This study’s objective was to evaluate changes in knowledge, confidence, attitude, and clinical practice in children’s oral health of the students completed the course. Thirty-one students participated in the IPE and completed demographic questionnaires and four questionnaires before and after the IPE course: (1) course content knowledge, (2) confidence, (3) attitudes, and (4) clinical practice. Results showed a statistically significant improvement in the overall knowledge of children’s oral health topics, confidence in their ability to provide oral health services, and clinical practice. There was no statistically significant difference in attitude, but there was an upward trend toward positivity. To conclude, this IPE evaluation showed that offering an interprofessional course on children’s oral health to graduate students in dentistry, nursing, and osteopathic medicine can improve their knowledge, confidence, and practice toward children’s oral health and expand their professional goals to include caring for underserved, minority children.

G. Fryer

Abstract The biopsychosocial mechanisms for therapeutic effect in an osteopathic treatment encounter for people with somatic pain were reviewed and discussed in Part 1 of this article. The author argued that both biological and psychosocial therapeutic mechanisms are potentially important in clinical practice, although the relative importance of these mechanisms differs depending on the person's presentation and the nature and chronicity of the involved pain. In Part 2, clinical implications of the differing processes of pain and therapeutic mechanisms of osteopathic techniques are discussed. A rationale is presented for osteopathic management based on an understanding of the likely biological and psychological factors present and for the complementary actions of manual therapy with a cognitive behavioural approach to pain and disability. Appropriate communication, reassurance, education, and empowerment can result in positive attitudes and behaviours to pain and complement the specific biological effects of osteopathic manipulative treatment. This article will aid the clinical reasoning process and provide guidance to osteopaths for treatment selection based on patient presentation and the likely biological and psychological factors involved in pain and disability.

G. Fryer

Abstract This article reviews and discusses the biological and psychological mechanisms that may be responsible for therapeutic effect in an osteopathic therapeutic encounter. Although many of the reviewed mechanisms require additional high-quality evidence, osteopathic treatment may reduce pain and improve movement and function from a ‘bottom-up' influence on tissues and tissue receptors and from a ‘top-down' influence on cognitive and psychological states. Osteopathic models and manipulative technique have traditionally emphasized tissue and biomechanical mechanisms, but this emphasis is misplaced given the paucity of clinical evidence for these effects. In recent decades, growing evidence supports the importance of neurological and psychosocial factors in musculoskeletal pain, making the ‘biopsychosocial' model of pain management a mainstream consideration for the management of pain. This article proposes that both biological and psychosocial therapeutic mechanisms may contribute to therapeutic effect and that tissue and neurological effects on pain and motion, albeit small and temporary, may complement cognitive reassurance and education to promote improved confidence and control in movement. Judgement of the dominating factors will help determine the clinical approach. Part 2 will explore the clinical approaches that arise from an understanding of the mechanisms likely involved in manual therapy.

F. Cerritelli, Nuria Ruffini, E. Lacorte et al.