Bone Healing After Tooth Extraction in a Patient on Oral Bisphosphonates: A Case Report
Antonello Falco, Lorenzo Vittorini Orgeas, Roberta Di Pietro
et al.
<b>Background</b>: The present case report study aims to describe, from both clinical and histological aspects, the bone healing pattern in a patient under oral bisphosphonates therapy. <b>Case Presentation</b>: an 82-year-old female patient has been under oral nitrogen bisphosphonates therapy for two years. She underwent a tooth extraction. After four months, two bone biopsies were harvested, during standard implant drilling procedures. The first one corresponded to the healed alveolar socket of the previously extracted tooth (specimen A), while the second one corresponded to the bone ridge that was edentulous before starting the bisphosphonates therapy (specimen B). Morphometric and histologic analyses were performed. <b>Results</b>: In both, the bone resulted vital and no evidence of empty lacunae was detected. A reduction in the haversian canal diameter was observed in specimen B. The present case report highlights histological findings suggesting that patients undergoing oral bisphosphonates therapy may be eligible for surgical therapy. A pre-operative careful anamnesis and the observance of international guidelines for treating patients taking bisphosphonates are mandatory. <b>Conclusions</b>: These preliminary results will be used to plan a large clinical study in order to better understand the influence of bisphosphonates on the bone healing process.
Telerehabilitation During Disaster: Insights from the 2023 Türkiye Earthquake: A Retrospective Study
Esra DOGRU HUZMELI, Eren LEKESİZ, Yasemin KARAASLAN
et al.
Introduction: Access to physiotherapy and rehabilitation (PTR) services was very difficult
during the February 6, 2023 earthquakes in Türkiye. A telerehabilitation (TR) team was
established to help disaster victims by recognizing their urgent health needs. This study
aimed to determine whether TR could be used as a viable solution in situations where it is
difficult to provide traditional face-to-face PTR services during an earthquake. Materials and
Methods: Within the TR team, volunteer physiotherapists reached out to disaster victims
and planned weekly treatments. The diagnoses of the disaster victims include cerebral palsy,
peroneal nerve injury, drop foot, hand extensor tendon injury, muscle contusion, soft tissue
injury, left wrist fracture, disc herniation, hemiparesis, facial paralysis, temporomandibular
joint dysfunction, severe back pain, and asthma. PTR services were provided with TR.
Patients' satisfaction with TR was evaluated on a scale of 0-10. Results: A total of 25
earthquake victims contacted the TR team to receive rehabilitation. Fifteen patients
successfully completed the TR process. The average number of TR sessions received by the
patients was 4±3.48 days. The satisfaction level of 14 patients with the treatment was 9.5±1.02 out of 10. Conclusions: Accessing rehabilitation services during a disaster is a
challenging task. When hospitals face challenges in providing healthcare services, leveraging
technology through TR can be a viable solution. This study demonstrates that PTR services
can be successfully delivered online during disasters.
Therapeutics. Psychotherapy
Labor Induction with Synthetic Oxytocin and Infantile Colic: A Case–Control Study
Cristina Suárez-Fraga, Óscar Rodríguez-Nogueira, Arrate Pinto-Carral
et al.
<i>Background and Objectives</i>: Infantile colic affects 15–40% of infants ≤ 5 months, burdening families and health systems. While the effects of intrapartum oxytocin on neonatal outcomes have been widely investigated, its potential link with infantile colic remains poorly understood. We evaluated whether synthetic oxytocin is associated with infantile colic during the first five months of life and explored neonatal head circumference, feeding type and epidural anesthesia as additional factors. <i>Materials and Methods</i>: Prospective 1:1 matched case–control study in three Spanish pediatric outpatient clinics. Parents of 76 term infants aged 0–5 months (38 cases, 38 controls) completed face-to-face structured interviews documenting synthetic oxytocin and epidural use, infant anthropometry and feeding pattern. Infantile colic was diagnosed by Rome IV criteria. Associations were estimated with conditional logistic regression, producing adjusted odds ratios and 95% confidence intervals. <i>Results</i>: Synthetic oxytocin was used in 57.9% of deliveries and epidural anesthesia in 81.6%. Synthetic oxytocin showed no association with infantile colic (aOR 1.24; 95% CI 0.50–3.09). Epidural strongly predicted synthetic oxytocin exposure (aOR 4.55; 95% CI 1.28–16.20) but had no independent link to infantile colic. Infants with colic had a smaller mean head circumference at birth, although this difference did not remain significant after adjusting for gestational age, likely reflecting limited sample size. Synthetic oxytocin was not associated with breastfeeding status. <i>Conclusions</i>: In this cohort, intrapartum synthetic oxytocin was not related to infantile colic or to feeding difficulties. Smaller head circumference among colic cases may warrant further investigation as a potential risk marker. The high co-use of synthetic oxytocin and epidural underscores the need for larger longitudinal studies to clarify their peripartum–neonatal interactions.
New triple therapy for the diagnosis of CKD-MBD: a cross-sectional study in Shanxi province
Yun Zhou, Li Feng, Bo Huang
et al.
Objectives To seek a triple combination of biomarkers for early diagnosis of chronic kidney disease-mineral and bone metabolic disorder and to explore the diagnostic efficacy of β2-microglobulin, parathyroid hormone and blood urea nitrogen in chronic kidney disease-mineral and bone metabolic disorder.Participants We collected medical records of 864 patients with chronic kidney disease (without direct contact with patients) and divided them into two groups based on the renal bone disease manifestations of all patients.Primary and secondary outcome measures There were 148 and 716 subjects in the Chronic kidney disease-mineral and bone metabolic disorder and the control groups, respectively. The aggregated data included basic information and various clinical laboratory indicators, such as blood lipid profile, antibody and electrolyte levels, along with renal function-related indicators.Results It was observed that most renal osteopathy occurs in the later stages of chronic kidney disease. In the comparison of two clinical laboratory indicators, 16 factors were selected for curve analysis and compared. We discovered that factors with high diagnostic values were β2-microglobulin, parathyroid hormone and blood urea nitrogen.Conclusions The triple combination of β2-microglobulin+parathyroid hormone+blood urea nitrogen indicators can play the crucial role of a sensitive indicator for the early diagnosis of chronic kidney disease-mineral and bone metabolic disorder and in preventing or delaying the progress of chronic kidney disease-mineral and bone metabolic disorder.
Osteopathy in rural and remote Australia: analysis of demographic, practice and clinical management characteristics from a nationally representative sample of 992 osteopaths
Brett Vaughan, Amie Steel, Michael Fleischmann
et al.
Introduction: There is significant interest in allied health and the role it plays in health care for rural and remote populations. In Australia, osteopaths are allied health professionals who manage predominantly musculoskeletal complaints using manual therapy, exercise and patient education. Workforce distribution is a significant issue for osteopathy in Australia with most practitioners centred in the metropolitan regions of Victoria and New South Wales. There is limited evidence about the role osteopathy plays in the musculoskeletal health of Australian rural and remote populations. This research sought to profile the characteristics of Australian osteopaths who practise in rural and remote settings.
Methods: A secondary analysis of the Osteopathy Research and Innovation Network (ORION) data was undertaken to identify the demographic, practice and clinical management characteristics of Australian osteopaths in rural and remote settings. ORION is a practice-based research network for the Australian osteopathy profession. The ORION questionnaire comprised 27 items regarding osteopaths' characteristics. Inferential statistics were used to identify characteristics that were significantly different between Australian osteopaths practising in rural and remote settings compared to those practising in urban settings. Logistic regression was used to calculate adjusted odds ratios (AOR) relating to characteristics significantly associated with practising in a rural and remote setting.
Results: Of 992 osteopaths who responded to the ORION questionnaire, 18.3% (n=172) indicated practising in a rural and remote setting. Australian osteopaths in rural and remote settings were more likely to report receiving referrals from massage therapists (AOR 2.17), send referrals to other osteopaths (AOR 1.64), and often treat patients over the age of 65 years (AOR 2.25) compared to their urban counterparts. Osteopaths in rural and remote setting were less likely to report using private health insurance claim systems (AOR 0.36) and to treat non-English-speaking patients (AOR 0.09).
Conclusion: This secondary analysis identified several practitioner and practice characteristics that differ between osteopaths practising in rural and remote settings and those practising in urban settings. These findings contribute to the emerging picture of the practice of rural and remote Australian osteopaths. Further research is required to understand the role osteopaths play in rural and remote health care, and how the current data can inform workforce and health policy development.
Special situations and conditions, Public aspects of medicine
25-OH-vitamina D y reversión de comorbilidades metabólicas asociadas a la obesidad tras la cirugía bariátrica
León S, Alcántara Laguna M, Molina Puerta MJ
et al.
Introducción: La obesidad es un problema de salud pública en el que se producen defectos en el sistema endocrino generando en consecuencia enfermedades metabólicas. La cirugía bariátrica (CB) ha demostrado mayor eficacia en la pérdida de peso y reversión de las comorbilidades (especialmente inflamatorio y metabólico). Los mecanismos subyacentes relacionados con la reversión de comorbilidades son aún poco conocidos. Los pacientes sometidos a CB reciben de forma rutinaria suplementos de vitamina D, por lo que su papel en la reversión de comorbilidades puede ser relevante.
Objetivos: Determinar la relación entre los niveles de 25-OH-vitamina D, la prevalencia de comorbilidades metabólicas antes de la CB y 6 meses tras la misma.
Resultados: Se evaluaron 328 pacientes, los cuales mostraron pérdida significativa de peso y masa magra a los 6 meses de la CB. Los niveles séricos de 25-OH-vitamina D se incrementaron de forma paralela a un aumento en la suplementación, sin embargo, no se observaron correlaciones con la presencia de comorbilidades metabólicas basales ni a los 6 meses de la CB. Los niveles séricos de 25-OH-vitamina D se correlacionaron con algunos parámetros de la composición corporal de forma independiente a la reversión de las comorbilidades.
Conclusiones: La CB se asoció a mejoría significativa de comorbilidades metabólicas en los pacientes estudiados de forma independiente a los niveles séricos de 25-OH-vitamina D.
Effect of osteopathic manipulation on gait asymmetry
C. Hill, M. Romero, M. Rogers
et al.
Abstract Context Movement and loading asymmetry are associated with an increased risk of musculoskeletal injury, disease progression, and suboptimal recovery. Osteopathic structural screening can be utilized to determine areas of somatic dysfunction that could contribute to movement and loading asymmetry. Osteopathic manipulation treatments (OMTs) targeting identified somatic dysfunctions can correct structural asymmetries and malalignment, restoring the ability for proper compensation of stresses throughout the body. Little is currently known about the ability for OMTs to reduce gait asymmetries, thereby reducing the risk of injury, accelerated disease progression, and suboptimal recovery. Objectives To demonstrate whether osteopathic screening and treatment could alter movement and loading asymmetry during treadmill walking. Methods Forty-two healthy adults (20 males, 22 females) between the ages of 18 and 35 were recruited for this prospective intervention. Standardized osteopathic screening exams were completed by a single physician for each participant, and osteopathic manipulation was performed targeting somatic dysfunctions identified in the screening exam. Three-dimensional (3-D) biomechanical assessments, including the collection of motion capture and force plate data, were performed prior to and following osteopathic manipulation to quantify gait mechanics. Motion capture and loading data were processed utilizing Qualisys Track Manager and Visual 3D software, respectively. Asymmetry in the following temporal, kinetic, and kinematic measures was quantified utilizing a limb symmetry index (LSI): peak vertical ground reaction force, the impulse of the vertical ground reaction force, peak knee flexion angle, step length, stride length, and stance time. A 2-way repeated-measures analysis of variance model was utilized to evaluate the effects of time (pre/post manipulation) and sex (male/female) on each measure of gait asymmetry. Results Gait asymmetry in the peak vertical ground reaction force (−0.6%, p=0.025) and the impulse of the vertical ground reaction force (−0.3%, p=0.026) was reduced in males following osteopathic manipulation. There was no difference in gait asymmetry between time points in females. Osteopathic manipulation did not impact asymmetry in peak knee flexion angle, step length, stride length, or stance time. Among the participants, 59.5% (25) followed the common compensatory pattern, whereas 40.5% (17) followed the uncommon compensatory pattern. One third (33.3%, 14) of the participants showed decompensation at the occipitoatlantal (OA) junction, whereas 26.2% (11), one third (33.3%, 14), and 26.2% (11) showed decompensation at the cervicothoracic (CT), thoracolumbar (TL), and lumbosacral (LS) junctions, respectively. Somatic dysfunction at the sacrum, L5, right innominate, and left innominate occurred in 88.1% (37), 69.0% (29), 97.6% (41), and 97.6% (41) of the participants, respectively. Conclusions Correcting somatic dysfunction can influence gait asymmetry in males; the sex-specificity of the observed effects of osteopathic manipulation on gait asymmetry is worthy of further investigation. Osteopathic structural examinations and treatment of somatic dysfunctions may improve gait symmetry even in asymptomatic individuals. These findings encourage larger-scale investigations on the use of OMT to optimize gait, prevent injury and the progression of disease, and aid in recovery after surgery.
Medical Student Perception of Lifestyle Medicine and Willingness to Engage in Lifestyle Counseling: A Pilot Study of Allopathic and Osteopathic Medical Students
J. Lee, Imam M. Xierali, P. Jaini
et al.
Introduction. This study assessed medical students’ perception of lifestyle medicine and readiness to engage in lifestyle counseling. Methods. All medical students in one allopathic and one osteopathic medical school received a survey involving items designed to measure their awareness and interest in lifestyle medicine, perception of physicians serving as lifestyle role models for patients, and intent to practice lifestyle counseling. Results. Two hundred and eight-nine subjects (145 allopathic and 144 osteopathic students) responded to the survey. A total of 24.1% of responding allopathic students had heard about lifestyle medicine compared with 53.9% of responding osteopathic students (P < .01). A total of 90.5% of allopathic students rated their current knowledge of lifestyle medicine as inadequate or poor compared with 78.7% of osteopathic students (P < .01). Ninety-two percent of all respondents wanted to learn more about lifestyle medicine, while 95.2% believed they would provide more effective counseling if they were trained sufficiently to serve as a healthy lifestyle role model for their patients. Conclusions. Both cohorts favored learning more about lifestyle medicine and believed physicians should provide lifestyle counseling to patients with chronic diseases. Given these findings, and the demonstrated benefits of lifestyle medicine–based health care, the authors suggest that training in lifestyle medicine be increased in undergraduate medical education.
Osteopathic manipulative treatment and the Spanish flu: a historical literature review
Francesca Baroni, Damiana Mancini, Silvia Clara Tuscano
et al.
Abstract Context The Spanish flu pandemic of 1918 was approached with a variety of management techniques available at that time, including osteopathic care in addition to standard medical care. Objective To analyze the osteopathic manipulative treatment (OMT) techniques used for the management of patients affected by the Spanish flu according to four themes: the principles and procedures used, frequency and length of OMT, reported side effects, and advice for patients. Methods A structured review of the literature was performed by hand-searching texts at the Museum of Osteopathic Medicine International Center for Osteopathic History in Kirksville, Missouri, and online via PubMed (National Library of Medicine), ScienceDirect (Elsevier), and Google Scholar (Google, Inc). The literature search was carried out between February and March 2020. Three keywords were selected from the medical subject headings database of the National Library of Medicine: manipulation, osteopathic; influenza pandemic, 1918–1919; epidemics. Articles were then reviewed for relevance by screening for articles published between 1900 and 1940 that contained at least 1 of the following keywords in their title: Spanish influenza, flu, epidemic, grippe, pneumonia, or osteopathic management/treatment. All articles that provided information about OMT and advice met the inclusion criteria. Articles that did not report descriptions of manipulative intervention were excluded. Results Our search yielded 63 articles: 23 from the hand-search and 40 from the electronic search. No electronic source was selected for the review because none met inclusion criteria. A total of 16 articles from the hand-searched set met inclusion criteria and were analyzed according to the four main themes stated in the objective. The range of OMT approaches reported to be administered to patients with Spanish flu suggests that early osteopathic physicians treated patients with this disease using OMT in addition to offering advice on healthy lifestyle behaviors. Conclusion Conclusions from this study are limited by the historical and descriptive nature of the data gathered, which lacked the rigor of modern-day scientific studies. However, this review could lead to future research inquiries on the effectiveness of these approaches. Osteopathic physicians and osteopaths should embrace their historical osteopathic heritage by continuing the work of our predecessors and combining their hands-on experience and osteopathic principles with modern medical treatment and rigorous scientific standards.
Fisiopatología de la osteoporosis en las enfermedades articulares inflamatorias crónicas
Castañeda S, Garcés-Puentes MV, Bernad Pineda M
El sistema inmune y el hueso comparten con frecuencia los mismos nichos y espacios anatómicos, existiendo una estrecha relación funcional entre ambos. Esto hace que haya una interacción constante entre ellos, con un flujo bidireccional de información entre las células inmunes y las del tejido óseo (osteoclastos, osteoblastos y osteocitos), muchas veces desconocida, en la que intervienen múltiples mediadores inflamatorios y diversos factores de crecimiento y diferenciación celular. Ello conduce a una interacción muy estrecha entre inflamación y pérdida ósea. De hecho, la osteoporosis (OP) es una de las complicaciones sistémicas más frecuentes en las enfermedades inflamatorias crónicas (EIC). La prevalencia de OP en las EIC es variable y depende de cada escenario patológico. La artritis reumatoide (AR) es una de las enfermedades paradigmáticas de inflamación crónica, donde la presencia de OP es frecuente, apareciendo incluso antes de que aparezcan los primeros síntomas de la enfermedad. La patogenia de la OP asociada a la AR es compleja e incluye la colaboración de múltiples citoquinas proinflamatorias que favorecen la osteoclastogénesis e inhiben la formación ósea. Entre todas destacan el factor de necrosis tumoral alfa (conocido en inglés como TNF-α) y diversas interleuquinas (IL) como IL-1, IL-6 e IL-17. De todas, IL-6 tiene un papel jerárquico relevante. En esta revisión se repasa el papel de las citoquinas proinflamatorias en la destrucción ósea y articular en diferentes EIC, con especial énfasis en la AR, planteándose las bases de posibles vías que abran nuevos horizontes terapéuticos en el marco de las EIC.
The programme of comprehensive rehabilitation after LUMIC post-resection with the reconstruction of a proximal part of femur with MUTARS system resulting from the treatment of pelvis chondrosarcoma.
Anna Sachaj, Karina Szczypiór-Piasecka, Alicja Mińko
et al.
Abstract
Introduction: Malignant neoplasms of bone originating from the supporting tissues of the body of mesinchymal origin are heterogeneous in clinical and histological terms. In most cases, the etiology of these tumors is unknown. Histologically, sarcomas are classified into three main types. Chondrosarcoma (31% of sarcomas), osteosarcoma - originating from bone tissue (also accounts for 31% of sarcomas), Ewing sarcoma - originating from neuroectodermal tissue (accounts for 14% of sarcomas). The aim of this study was to present a program of comprehensive rehabilitation after LUMIC resection arthroplasty with reconstruction of the proximal part of the femur using the Mutars system as a result of pelvic chondrosarcoma treatment.
Materials and methods: The paper describes a case of a patient diagnosed with left pelvic chondrosarcoma with a pathological fracture and destruction of the left hip joint.
Results: In the rehabilitation program, both inpatient and outpatient, many methods of therapy have been used in order to restore the patient to the highest possible fitness as quickly as possible. The therapy was based on such exercises and methods as: PNF method, methods of visceral therapy, active exercises and methods of osteopathy.
Conclusion: Rehabilitation is an indispensable element of the treatment of cancer patients. The introduction of modern techniques, such as manual therapy and osteopathy to rehabilitation, has a positive effect on the effectiveness of therapy.
Osteopathic treatment of patients with shoulder pain. A pragmatic randomized controlled trial.
F. Schwerla, Torsten Hinse, Markus Klosterkamp
et al.
BACKGROUND Shoulder complaints are common in the general population. Typically, the diagnosis of a specific pathology is lacking. The objective of this trial was to evaluate the effectiveness of an osteopathic treatment in patients suffering from shoulder pain. METHODS A pragmatic randomized controlled trial was conducted in patients with a history of shoulder pain of 6 weeks to 12 months, and a pain intensity level of at least 40% on the visual analogue scale (VAS). Participants were identified from the general population in Germany and allocated by means of external randomization to an intervention group or a control group. Patients in the intervention group received five osteopathic treatments at intervals of two weeks. Treatment was custom tailored and based on osteopathic principles. Controls received their osteopathic treatment after an 8-week untreated waiting period. Primary outcome parameters were pain intensity and frequency, measured by VAS and Likert Scales. Secondary outcome parameters were shoulder specific pain and disability (Shoulder Pain and Disability Index, SPADI), and quality of life (SF-36). RESULTS A total of 70 patients aged 25-70 years (average age 45.6 ± 13.4 years) were included, 36 in the intervention group and 34 in the control group. The inter-group comparison of changes revealed clinically relevant improvements in favor of the intervention group for the main outcome parameters maximal pain intensity (VAS: between group difference of means 41.5; 95% CI: 34.6 to 48.3; p < 0.005) and average pain intensity (VAS: between group difference of means 40.4; 95% CI: 33.2 to 47.5; p < 0.005). The proportion of participants with a low frequency of pain increased in the osteopathic group only (from 7 to 34 vs. 9 to 6 in the control group, p = 0.006), and the number of patients with a high frequency decreased in the osteopathic group only (from 29 to 2 vs. 25 to 28, p < 0.0005). Shoulder specific pain and disability also improved. The follow-up assessment in the intervention group showed further improvements. CONCLUSIONS Five osteopathic treatments over a period of eight weeks led to statistically significant and clinically relevant positive changes of pain and disability in patients suffering from shoulder pain.
What families in the UK use to manage attention-deficit/hyperactivity disorder (ADHD): a survey of resource use
Clare Relton, Philippa Fibert
Objective To identify interventions being used to manage attention-deficit/hyperactivity disorder (ADHD) in the UK.Design A survey within the Sheffield Treatments for ADHD Research project. A convenience sample of participants in the UK who consented to join an observational cohort were asked closed questions about medication, behavioural change programmes and service use, and an open-ended question about what else they used.Setting A broad variety of non-National Health Service, non-treatment seeking settings throughout the UK, including local authority organisations, schools, ADHD and autism spectrum condition support groups and social media.Participants Families of children aged 5–18 with carer reported ADHD and Conners Global Index (CGI) T scores of 55+.Results Responses from 175 families were analysed. The mean age of the children was 10.21 (2.44), and two-thirds (n=114) had additional diagnoses. The majority used medications to manage ADHD (n=120) and had participated in a parenting class (n=130). Just over a quarter (28%, n=49) did not use ADHD medications, and used sleep medications. Just under half had consulted psychologists (n=83), and 32 had participated in other talking therapies such as psychotherapy, counselling and cognitive–behavioural therapy. A few used aids such as reward charts or fiddle toys (n=17) and participated in activities (mostly physical) (n=14). A substantial minority (78/175) had used non-mainstream treatments, the most popular being homoeopathy (n=32), nutritional interventions (n=21) and bodywork such as massage or cranial osteopathy (n=9).Conclusions Families reported use of a wide variety of treatments to help with management of their children with ADHD in addition to their use of mainstream treatments.
Specifics of Translating Osteopathic Terminology from English into Latvian
Irina Kaļiņina
The present article explores the complex issue of translation in the field of biodynamic osteopathic terminology. Due to the status of this discipline in Latvia, terms in the source language (English) still need to be transposed into Latvian, implementing the process of secondary term creation. The research examines community-generated translation practices and provides an overview of the resulting situation. The principles of terminological work are based on the communicative and frame-based theories of terminology, with the grounding principles of the General Theory of Terminology (GTT). The methodology includes qualitative and quantitative analysis of term translations obtained from 7 respondents, based on a corpus of 229 terms extracted from course books and didactic CDs in the field of biodynamics in osteopathy. The resulting data on user-generated translation practices can serve as a basis for further exploration of the given terminology in a more prescriptive key.
Literature (General), Philology. Linguistics
Shared decision making by United Kingdom osteopathic students: an observational study using the OPTION-12 instrument
Dévan Rajendran, Jane Beazley, Philip Bright
Abstract Background At the crux of patient centred care is Shared Decision Making (SDM), which benefits patient and practitioner. Despite external pressures, studies indicate that SDM remains poorly practised across a variety of healthcare professions. The degree of SDM engagement within United Kingdom osteopathic undergraduate teaching clinics is currently unknown. Methods In 2014 we used the reliable and validated OPTION-12 (O12) instrument to calculate a score that reflected the degree of SDM utility in one United Kingdom Osteopathic Educational Institute’s teaching clinic. We also aimed to compare these scores with those previously obtained for physiotherapists working within the United Kingdom’s National Health Service. Student-patient initial and follow-up encounters were audio recorded, transcribed and scored using the O12. Comparisons between the following O12 scores were performed: the Osteopathic Educational Institute’s 4th and 3rd year students; the Osteopathic Educational Institute’s student’s initial and follow-up patient encounters; the Osteopathic Educational Institute’s students and National Health Service physiotherapists. Results We analysed 35.5 h of transcribed data from 30 student-patient encounters (7 initial: 23 follow-up). An O12 score of 0.6% (range 0–10.4%) was calculated. No significant differences were found between year groups or encounter types. Significant differences were found compared to National Health Service physiotherapist (score = 24.4%): (U = 144, z = 4.25, p < 0.0005); although both scores are below the 60% threshold for competent SDM behaviour. Conclusions Undergraduate osteopaths did not appear to engage in competent SDM behaviours, implying traditional and paternalistic styles of decision making that align with results from other manual therapy professions. Students in this study did not practise competent SDM behaviours. Effective educational strategies are required to ensure SDM behaviours reach competent levels.
Chiropractic, Diseases of the musculoskeletal system
Osteopathic Manipulative Therapy Potentiates Motor Cortical Plasticity
V. Ponzo, A. M. Cinnera, F. Mommo
et al.
Abstract Context Osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) is effective in managing pain caused by a variety of clinical conditions. Nevertheless, the physiologic mechanisms at the basis of the clinical improvement are poorly understood. Objective To investigate the effects of OMTh, muscle stretching, and soft touch interventions on motor cortical excitability through a rapid-rate paired associative stimulation (PAS) protocol. Methods In this crossover study, participants underwent OMTh, muscle stretching, and soft touch interventions. A rapid-rate PAS transcranial magnetic stimulation protocol was performed immediately after each intervention session, which consisted of 600 pairs of stimuli continuously delivered to the left primary motor cortex and to the right median nerve at a rate of 5 Hz for 2 minutes. The interstimulus intervals between the peripheral stimulus and the transcranial magnetic stimulation was set at 25 milliseconds. Before and after rapid-rate PAS (immediately after and 15 minutes after), changes in the amplitude of the motor evoked potentials were measured in the right abductor pollicis brevis and the right first dorsal interosseous. Results Of the potential 15 participants initially recruited, 12 fit the inclusion criteria. Two of the 12 participants were excluded from the final analysis because of excessive artifact movements. Rapid-rate PAS induced a more pronounced, longer-lasting increase in cortical excitability in the abductor pollicis brevis muscle in patients 15 minutes after the OMTh intervention than after the muscle stretching or sham interventions (P=.016). Conclusion Results of the current study provide support for the effects of OMTh on cortical plasticity.
Medical Infrared Thermography in back pain osteopathic management.
G. Polidori, M. Kinne, Tracy Mereu
et al.
OBJECTIVES The objective of this study was to provide proof-of-concept for the use of Medical Infrared Thermography to verify both diagnosis and osteopathic management accuracy in back pain. METHODS A 50-year-old woman with acute back pain syndrome volunteered to participate in this study. RESULTS Prior the treatment, thermal image reveals that in a sagittal plane, the inflammation extends from vertebra D8 to L3 with a maximum inflammation between vertebrae D10 to L1. Post-treatment, Medical Infrared Thermography only shows a slight inflammation along the lumbar furrow that does not induce pain in the patient. CONCLUSION Medical Infrared Thermography has made it possible to scientifically support the osteopathic approach to back pain, both in the initial diagnostic phase and in the validation phase of treatment effectivess.
[The use of the osteopathic correction for the combined treatment and rehabilitation of the patients presenting with the vertebral artery syndrome].
V. Belash, D. Mokhov, E. Tregubova
Osteopathic Manipulative Treatment Effect on Pain Relief and Quality of Life in Oncology Geriatric Patients: A Nonrandomized Controlled Clinical Trial
C. Arienti, Teresa Bosisio, Silvia Ratti
et al.
Purpose: The aim of present study was to study the effect of osteopathic manipulation on pain relief and quality of life improvement in hospitalized oncology geriatric patients. Methods: A nonrandomized controlled clinical trial was performed in the Oncology Rehabilitation Unit, Milan, Italy, from September 2015 to March 2016. Twenty-three older cancer patients were enrolled and allocated in 2 experimental groups: the study group (OMT group, N = 12) underwent osteopathic manipulative treatment in addition to physiotherapy, and the control group (PT group, N = 12) underwent only physiotherapy. At enrollment (T0), 24 recruited oncology patients completed the sociodemographic forms and were evaluated for pain intensity and quality of life by an external examiner. All patients were revaluated every week (T1, T2, T3, and T4) for pain intensity and at the end of the study treatment (T4) for quality of life. A standard level of significance was set at α < .05. Results: The 2 groups did not significantly differ in age (P = .682), body mass index (P = .413), or gender (P = 1). The osteopathic manipulative treatment added to physiotherapy produced a significant reduction in Numeric Rating Scale (NRS) scores both at T2 (P = .004) and T4 (P = .002). The difference in quality of life improvements between T0 and T4 was not statistically significant. NRS improved in the PT group at T4. Between-group analysis of NRS and quality of life with the Mann-Whitney test did not show any significant difference between the 2 treatments. Conclusions: Our study showed a significant improvement in pain relief and a nonsignificant improvement in quality of life in hospitalized geriatric oncology patients during osteopathic manipulative treatment. Trial Registration: Protocol registered on Clinicaltrials.gov (NCT03142386).
Post-sternotomy pain syndrome following cardiac surgery: case report
B. Bordoni, F. Marelli, B. Morabito
et al.
Over 2 million people undergo sternotomy worldwide for heart surgery each year, and many develop post-sternotomy pain syndrome (PSPS) which persists in the anterior thorax. In some patients, PSPS lasts for many years or suddenly reappears a long time after the sternotomy. The exact etiology of PSPS is unknown. This article presents a case report of a patient with a diagnosis of PSPS (after cardiac surgery 4 years prior) for whom an osteopathic approach was used, which successfully eliminated the pain. In a previous study, we demonstrated that this osteopathic procedure could reduce sternal pain associated with a recent surgical wound. Further efforts are needed to understand the reasons for PSPS. In light of new scientific data, these osteopathic techniques could contribute to a multidisciplinary approach to solve the problem.