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PubMed1998

Manipulative treatment of carpal tunnel syndrome: biomechanical and osteopathic intervention to increase the length of the transverse carpal ligament.

To quantify the amount of transverse carpal ligament (TCL) elongation in response to osteopathic manipulation or sustained load bearing (or both), a study involving seven cadaver limbs was conducted. Distances from the trapezium to the hamate (distance A) and from the scaphoid to the pisiform (distance B) were measured in five mounted cadaver limbs during and after the limbs bore the weight (2 newtons [N] to 4 N) for 2 several-hour periods. A several-hour period occurred between the weight bearing to assess recoil. Distances A and B were measured before and after the limbs were manipulated, according to previously described techniques, as well as with a new maneuver, termed the "guywire" technique. Two dissected limbs also were subjected to further weight bearing, this time increased to 8 N. Greater weight loads produced greater lengthening of the TCL, and recoil after removal of weight loads was slower than recoil after manipulation. Manipulation was more effective than weight loading for increasing distance A (distal canal), but weight loading generally was more effective than manipulation for increasing distance B (proximal canal). The guywire manipulation combined with direct transverse extension appeared to have the greatest impact on lengthening the TCL distally. These results show promise for the effective use of manipulation and load bearing for TCL elongation and nonsurgical relief of pressure on the median nerve in patients with carpal tunnel syndrome.

Biomechanical Phenomena↗
PubMed2000

Progressive inhibition of neuromuscular structures (PINS) technique.

Progressive inhibition of neuromuscular structures (PINS) is a technique that can be included in the osteopathic manipulative treatment repertoire. It relies on knowledge of anatomy and neuromuscular physiologic features as well as on standard forms of osteopathic palpatory diagnosis and treatment. It is a variant of the inhibition technique that has been taught as an osteopathic manipulative technique for many years, and it bears some resemblance to other manual medicine techniques. The emphasis of the approach is the determination of the alteration of the tissues due to dysfunction, delivering treatment based on palpatory evaluation and patient feedback. Two related points are initially chosen, followed by a progression from one to the other. Relationships to similar techniques are also discussed. Theoretical as well as selected practical applications are presented.

Adult↗
PubMed2001

Osteopathic philosophy and emergent treatment in acute respiratory failure.

Osteopathic manipulation has been used to treat a wide range of diseases in largely outpatient settings. The authors describe the emergent use of osteopathic manipulative treatment to improve respiratory mechanics in a critically ill patient with acute respiratory failure. High-velocity mobilization of cervical and thoracic dysfunctions resulted in a decreased work of breathing, improved arterial oxygenation, resolution of tachycardia, and an overall improvement in the patient's clinical condition.

Acute Disease↗
PubMed2001

Manual medicine diversity: research pitfalls and the emerging medical paradigm.

Recent studies published in leading medical journals have concluded that chiropractic treatment is not particularly helpful for relieving asthma and migraine symptoms because even though study participants showed notable improvement in symptoms, those subjects who received sham manual medicine treatments also showed improvement. Yet the sham treatment received by control groups in these studies is reminiscent in many ways of traditional osteopathic manipulation. This seems to represent not only a failure to recognize the value of many manual medicine techniques but also an ignorance of the broad spectrum of manual medicine techniques used by various practitioners, from osteopathic physicians to chiropractors to physical therapists. Such blind spots compromise research methodology with regard to manual medicine studies, which could, in turn, diminish the role of manual medicine in clinical practice. Osteopathic manipulative treatment provides an excellent model for recognizing and integrating the full range of manual medicine techniques into research and clinical applications because of the wide range of techniques employed. The potential exists for these techniques to contribute much to medical research and clinical practice--provided that osteopathic physicians and other manual medicine practitioners work to alleviate ignorance about the efficacy of various forms of manipulation.

Asthma↗
PubMed1992

Effect of osteopathic medical management on neurologic development in children.

For 3 years, children between 18 months and 12 years of age with and without recognized neurologic deficits were studied at the Osteopathic Center for Children. Their response to 6 to 12 osteopathic manipulative treatments directed to all areas of impaired inherent physiologic motion was estimated from changes in three sensory and three motor areas of performance. Houle's Profile of Development was used to compare neurologic with chronologic age and rate of development, and scores were age-adjusted. Results in children after treatment were compared with those following a waiting period without treatment. Neurologic performance significantly improved after treatment in children with diagnosed neurologic problems and to a lesser degree in children with medical or structural diagnoses. The advances in neurologic development continued over a several months' interval. The results support the use of osteopathic manipulative treatment as part of pediatric healthcare based on osteopathic medical philosophy and principles.

Child↗
PubMed1991

Osteopathic vs. chiropractic education: a student perspective.

This study compares nationwide survey results from 506 second year students of 11 osteopathic schools and 881 students from the first and second academic year (third term/fourth quarter) of eight chiropractic colleges. Each student was given a questionnaire regarding his/her perspective on the education he/she was receiving. Both populations were questioned about whether or not they came from an osteopathic/chiropractic family, their application process, the efficacy of osteopathic manipulative therapy (OMT)/chiropractic adjustments, their first year attitude concerning the efficacy of OMT/chiropractic adjustments, the integration of osteopathic/chiropractic principles into the curriculum and the justification for separate health care professions. Osteopathic and chiropractic students entered their respective professions from nonosteopathic/non-chiropractic families. Although both populations selected their profession as a first and primary choice, chiropractic students were more substantially represented. Upon entering their program, osteopathic students were not convinced, but had an open mind concerning the effectiveness of osteopathic manipulative therapy (OMT), and were divided as to whether there is enough of a distinction between DOs and MDs to justify separate professions. Chiropractic students, on the other hand, entered their program convinced that chiropractic adjustments are effective, and saw a clear distinction between the roles of chiropractic physicians and medical doctors.

Attitude↗
PubMedDate not supplied

Biological significance of piezoelectricity in relation to acupuncture, Hatha Yoga, osteopathic medicine and action of air ions.

Piezoelectric properties of biological macromolecules such as proteins, nucleic acids and mucopolysaccharides are reviewed in this paper. It is indicated that the structural elements of the human body composed of these piezoelectric substances are capable of transducing a mechanical energy into an electric current. Such a transduction may be brought about by movements of an acupuncture needle, osteopathic manipulations; Hatha Yoga postures or action of negatively charged air irons. It is postulated that electric current induced by stimulation of the specific sites on the surface of human body flows towards the internal organs along the semiconductive channels of biologic macromolecules. Electric current induced either by the piezoelectric transduction or directly applied from an external source may in turn stimulate individual cells in the target organ. Involvement of electrical phenomena in regulatory mechanisms on cellular and molecular levels is discussed.

Acupuncture Therapy↗
PubMed1999

An osteopathic approach to asthma.

Asthma has become a serious challenge to clinical medicine today, with an increase in incidence, morbidity, and mortality over the past two decades. Asthma continues to be a problem despite increased knowledge of the pathophysiology of asthma coupled with the development of a variety of new and innovative medications that can be used to treat asthma. Five areas involving asthma management are reviewed and involve a failure to do the following: (1) identify disease instability and progression; (2) adopt an optimal pharmacologic treatment plan; (3) identify and help the patient avoid environmental triggers; (4) evaluate and treat certain disruptive psychodynamic issues; and (5) use essential non-pharmacologic modes of therapy such as osteopathic manipulation, nutritional considerations, physical training, and controlled breathing techniques that may help to favorably modify the asthma disease process.

Adolescent↗
PubMed2002

A retrospective study of cranial strain patterns in patients with idiopathic Parkinson's disease.

While providing osteopathic manipulative treatment to patients with Parkinson's disease at the clinic of the New York College of Osteopathic Medicine of New York Institute of Technology, physicians noted that these patients may exhibit particular cranial findings as a result of the disease. The purpose of this study was to compare the recorded observations of cranial strain patterns of patients with Parkinson's disease for the detection of common cranial findings. Records of cranial strain patterns from physician-recorded observations of 30 patients with idiopathic Parkinson's disease and 20 age-matched normal controls were compiled. This information was used to determine whether different physicians observed particular strain patterns in greater frequency between Parkinson's patients and controls. Patients with Parkinson's disease had a significantly higher frequency of bilateral occipitoatlantal compression (87% vs. 50%; P < .02) and bilateral occipitomastoid compression (40% vs. 10%; P < .05) compared with normal controls. Over subsequent visits and treatments, the frequency of both strain patterns were reduced significantly (occipitoatlantal compression, P < .01; occipitomastoid compression, P < .05) to levels found in the control group.

Aged↗
PubMed2006

A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic.

In this open, controlled, prospective study, 28 infants with colic were randomized to either cranial osteopathic manipulation or no treatment; all were seen once weekly for 4 weeks. Treatment was according to individual findings, and administered by the same practitioner. Parents recorded time spent crying, sleeping and being held/rocked on a 24-hour diary. A progressive, highly significant reduction between weeks 1 and 4 in crying (hours/24h) was detected (P<0.001) in treated infants; similarly, there was a significant improvement in time spent sleeping (P<0.002). By contrast, no significant differences were detected in these variables for the control group. Overall decline in crying was 63% and 23%, respectively, for treated and controls; improvement in sleeping was 11% and 2%. Treated infants also required less parental attention than the untreated group. In conclusion, this preliminary study suggests that cranial osteopathic treatment can benefit infants with colic; a larger, double-blind study is warranted.

Attitude to Health↗
PubMed1993

Integrate osteopathic principles and practices in postgraduate medical education--now.

We issue a call for an "osteopathic medical renaissance" in teaching osteopathic principles and osteopathic manipulative techniques. This article describes a seminar series in the postdoctoral training program at the College of Osteopathic Medicine of the Pacific. We ask osteopathic physicians to enhance their manual dexterity skills to better serve as role models for physicians-in-training. We challenge osteopathic physicians to stimulate a renewed emphasis in teaching distinctive osteopathic medical care.

Clinical Competence↗
PubMed1996

The safety of manipulative treatment: review of the literature from 1925 to 1993.

Many osteopathic medical students and physicians have an inherent fear of injuring patients when they perform osteopathic manipulative treatment (OMT). Based on the estimated several hundred million treatments performed each year in the United States as well as a review of the literature over the past six decades, only 185 reports of injury were found. However, besides good training in these techniques, the key to the safety of OMT is the taking of a thorough patient history and performing a thorough physical examination before the application of any manipulative procedure.

Adult↗
PubMed1993

The osteopathic distinction: fact or fancy?

Since osteopathic medicine's inception its distinction has been proclaimed steadfastly in the osteopathic literature. The uniqueness has been claimed to reside in: (1) rigid adherence to A.T. Still's tenets; (2) osteopathic manipulative treatment (OMT); (3) claims of "holism"; (4) "osteopathic principles", (5) esoteric definitions; and (6) other suggested differences. None of these claims can be successfully defended. An aspect of the osteopathic distinction may lie in the didactic of OMT per se. Certain experiences in medical school contribute to the "reconstruction" of the student's view of the patient. Touch, through OMT, may be a quality that affects this change and helps make the osteopathic physician different. When blended with traditional medical modalities this may result in a unique medical perspective. The ideal approach for the osteopathic profession would be an honest evaluation of its function in society and its uniqueness in medicine. The profession may discover a uniqueness with touch as an integral part.

History, 19th Century↗
PubMed2000

The Comprehensive Osteopathic Medical Licensing Examination, COMLEX-USA: a new paradigm in testing and evaluation.

Medical licensure in the United States demands a dynamic and current means to evaluate the competency of physicians seeking to practice medicine. A systematic measuring tool is required--one that is based on actual patient encounters and how physicians should apply their knowledge and skills to the clinical setting according to their level of training and professional development. Osteopathic physicians have a distinctive approach to healthcare, applying the biopsychosocial model with emphasis on the neuromusculoskeletal system. A component of this distinctive approach is a high level of knowledge and skill in the application of osteopathic manipulative treatment. Developed by the National Board of Osteopathic Medical Examiners, COMPLEX-USA is the new sequential three-level examination process for osteopathic medical licensure in the United States. The examination process is interdisciplinary and highly clinical, with even basic science components tested within a clinical context. Examination content is based on wide expert consensus and data consistent with osteopathic medical education, training, and practice. Its design is a novel multidimensional structure that emphasizes clinical problem-solving skills and osteopathic principles and practice within the context of life cycle, gender, ethnicity, and points of service. Design schemata and blueprints are included along with descriptions of strategic research and development. COMPLEX-USA represents the most appropriate pathway for initial licensure for a distinctive and unique professional: the osteopathic physician in the United States.

Educational Measurement↗
PubMed1996

A manipulative technique of Andrew Taylor Still as reported by Charles Hazzard, DO, in 1905.

This article presents rediscovered osteopathic manipulative techniques described by Charles Hazzard in 1905 and ascribed by him to Andrew Taylor Still, the founder of osteopathic medicine. Still refrained from writing about his manipulative techniques in any significant detail, apparently intentionally. The techniques published by Hazzard have both internal consistency and similarity to those less well described by Still, suggesting that the attribution is accurate. The techniques are analyzed and presented as a variant of a direct articulatory technique with axial compression. In honour of their originator, they are being termed the Still techniques.

Humans↗