PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Manipulation, Osteopathic”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources
PubMed2000

Galbreath technique: a manipulative treatment for otitis media revisited.

Otitis media is a common disorder that results in numerous visits to the physician each year. Antimicrobials, antihistamines, steroids, and surgery have all been used to treat otitis media; however, the literature makes little mention of osteopathic manipulative treatment in this regard. This article describes a technique that was first described in 1929 by William Otis Galbreath, DO. By simple mandibular manipulation, the eustachian tube is made to open and close in a "pumping action" that allows the ear to drain accumulated fluid more effectively. Physicians can easily teach this procedure to parents for use at home.

Anti-Bacterial Agents↗
PubMed2003

Awareness and use of osteopathic physicians in the United States: results of the Second Osteopathic Survey of Health Care in America (OSTEOSURV-II).

The Second Osteopathic Survey of Health Care in America (OSTEOSURV-II), a national telephone survey conducted during 2000 using random-digit dialing, was used to address questions about public awareness of the osteopathic medical profession and use of osteopathic physicians. A total of 499 adult, noninstitutionalized, household respondents were surveyed. The main outcomes included prevalence of and multivariate factors associated with awareness and use of osteopathic physicians. The overall response rate was 64%. The prevalence of awareness, lifetime use, and current use of osteopathic physicians among unscreened respondents was 46%, 16%, and 7%, respectively. Among lifetime users, 84% received primary care; 52%, osteopathic manipulative treatment; and 25%, specialty care. The multivariate factors most strongly associated with awareness of osteopathic physicians were college education (rate ratio [RR], 1.86; 95% confidence interval [CI], 1.43-2.40), 60 or more years of age (RR, 1.52; 95% CI, 1.15-2.01), and Midwest residence (RR, 1.39; 95% CI, 1.05-1.84). Nonwhites, including Hispanics, were less likely to be aware of osteopathic physicians (RR, 0.54; 95% CI, 0.38-0.76). Respondents with college education (RR, 2.34; 95% CI, 1.44-3.79), respondents of intermediate age (RR, 1.71; 95% CI, 1.12-2.61), and women (RR, 1.68; 95% CI, 1.12-2.52) were more likely to report lifetime use of osteopathic physicians. Nonwhites were less likely to report lifetime use (RR, 0.25; 95% CI, 0.11-0.57). Greater promotional efforts are needed to increase awareness of osteopathic medicine and to remove barriers to using osteopathic physicians, particularly among nonwhites.

Awareness↗
PubMed2001

Characteristics, satisfaction, and perceptions of patients receiving ambulatory healthcare from osteopathic physicians: a comparative national survey.

A national telephone survey was conducted in 1998 using random-digit dialing and the first Osteopathic Survey of Healthcare in America (OSTEOSURV-I) instrument to determine patients' satisfaction with their healthcare, as well as their perceptions of osteopathic medicine. Of the 1106 respondents, 243 (22.0%) had received medical care from an osteopathic physician, and another 307 (27.8%) claimed to be aware of osteopathic physicians. Patients of osteopathic physicians reported the highest levels of satisfaction in 8 of the 11 elements studied when compared with patients of allopathic physicians, chiropractors, and nonphysician clinicians other than chiropractors. Respondents perceived osteopathic manipulative treatment (OMT) to be beneficial for musculoskeletal disorders (P < .001). In addition, respondents perceived that healthcare services provided by osteopathic physicians were similar to those provided by allopathic physicians (P < .001), but not to those provided by chiropractors (P = .01). A total of 97.9% of current patients of osteopathic physicians agreed with the statement that osteopathic physicians practiced in their local community, compared with 80.6% of former patients of osteopathic physicians and 67.8% of patients who had never visited osteopathic physicians (P < .001). In general, the most favorable perceptions of osteopathic medicine were reported by current patients of osteopathic physicians, followed by former patients of such physicians. The least favorable perceptions came from patients who had never been patients of osteopathic physicians. The perception that OMT should be covered by health insurance was significantly associated with the use of osteopathic physicians (odds ratio, 3.2; 95% confidence interval, 1.5 to 6.7, among patients who had ever been to an osteopathic physician). The results of our survey suggest that greater access to osteopathic services, including OMT, is desirable and that promotional efforts aimed at encouraging the use of osteopathic medical services among the general population are warranted.

Chiropractic↗
PubMed1999

Standardized medical record: a new outpatient osteopathic SOAP note form: validation of a standardized office form against physician's progress notes.

The accuracy and efficiency of recording information on a one-page standardized Outpatient Osteopathic SOAP Note Form (SNF) was compared with that obtained using the physician's progress notes (PPN). Use of the SNF in lieu of the PPN would assure the physician that proper clinical data were recorded to ensure proof of need and care in any instances of refused reimbursement. Moreover, standardized SNFs could be used to document and analyze present treatment protocols, enabling medical advances. Ten osteopathic physicians, who were skilled in osteopathic manipulative treatment (OMT), enrolled 300 patients. Initial and follow-up examinations totaled 959 visits (statistical cases); 76 statistical variables were compared. Essentially all information recorded in the PPN was recorded on the SNF. A significant difference (P < .05) was found between the PPN data set and the SNF data set in all but 17 of the 76 variables. Greater content of information almost always was found with the SNF data set. In addition, the SNF contained information not found in the PPN, most notably the severity and response to treatment of detected somatic dysfunctions. Participating physicians stated that the SNF takes about the same amount of time to fill in as the PPN. This makes the SNF a practical instrument for accurately and efficiently obtaining patient data in all physicians' offices. The validation study conducted demonstrated that the Outpatient Osteopathic SOAP Note Form easily and accurately reflected information recorded in the PPN and that data recorded may be used by physicians in their individual practices or for the conduct of osteopathic research.

Data Collection↗
PubMedDate not supplied

Osteopathic medicine.

Osteopathic physicians are licensed physicians practicing in all 50 states. This article describes the philosophy of Osteopathic Medicine and reviews the objective support for it. Special emphasis is placed on somatic, visceral, and psychologic interaction. Specific examples of Osteopathic Manipulative Therapy (OMT) are also described.

Humans↗
PubMed1994

Palpatory diagnosis and manipulative management of carpal tunnel syndrome.

Carpal tunnel syndrome was studied by use of supplemental palpatory diagnosis in 20 abnormal wrists. Restriction in motion at the carpal tunnel was quantified with a rating system. All wrists with carpal tunnel syndrome revealed at least moderate restriction to motion, as compared with only mild or no restriction in 20 wrists in normal, symptom-free subjects. Several participants (16 abnormal wrists) underwent osteopathic manipulative treatment, including a new "opponens roll" maneuver, and self-stretching, or a similar treatment accomplished by use of a self-treatment accomplished by use of a self-treatment appliance. In those treated, palpatory restriction decreased into the normal range, often before symptoms decreased. Improvement in nerve conduction studies usually followed within 1 to 3 months. Palpatory diagnosis is a useful adjunctive method of assessing patient status in carpal tunnel syndrome and helpful in prognosticating outcome. The modified manipulative technique described for the treatment of mild to moderate carpal tunnel syndrome may be effective in more severe cases.

Adult↗
PubMed1987

The dilemma of osteopathic physicians and the rationalization of medical practice.

Years ago, Peter New observed that osteopathic medical students faced a dilemma concerning their identity. On the one hand, they wished to be considered complete medical practitioners. On the other hand, they wished to be seen as different from MDs. There is evidence that osteopathic physicians continue to face that dilemma. I hypothesize that in part this stems from a conflict between classical 'lifestyle commitments' of the osteopathic community (e.g. toward general practice, osteopathic manipulative therapy, holism) and the rationalized model of medicine practiced by MDs (characterized by specialization and scientific elitism). Results of a survey of a local population of osteopathic physicians generally confirm this. Specific findings are that (1) classical elements of osteopathic commitment are not tied to commitment to the profession in general, (2) there appears to be a waning of commitment to general practice, (3) an increasing number of osteopathic physicians used the DO degree as a 'back door' into medicine and are less likely to identify with classical osteopathic norms, and (4) DOs from socially conservative backgrounds are more likely than others to maintain commitment to the classical elements of osteopathic practice.

Attitude of Health Personnel↗
PubMed2005

American Osteopathic Association commitment to quality and lifelong learning.

The American Osteopathic Association (AOA) initiated programs to enhance quality for 54,000 doctors of osteopathic medicine (DOs) practicing in the United States. Seven core competencies are required in undergraduate and graduate medical education standards. They include osteopathic philosophy and osteopathic manipulative medicine, medical knowledge, patient care, professionalism, interpersonal or communication skills, practice-based learning, and systems-based practice. The AOA Clinical Assessment Program (AOA-CAP) is a quality improvement tool for physicians to evaluate the safety of patient care. Osteopathic residents and practicing physicians measure the quality and safety of patient care using evidence-based standards through an AOA-supported, Web-based architecture. Alternative models for recertification, including a Maintenance of Certification process, are under review by the AOA, the Bureau of Osteopathic Specialists (BOS), and osteopathic certifying boards. The BOS establishes and maintains standards for the various osteopathic certifying boards and oversees matters of policy, jurisdiction, and standards review. The American Osteopathic Board of Emergency Medicine is the first osteopathic board to adopt a Maintenance of Certification process. The goals of the AOA's continuing medical education (CME) program are continued excellence of patient care and improvement of health and well-being of individual patients and the public. The AOA agrees that CME will play a critical role in recertification and continual assessment of physician competence. The AOA believes that proposed activities of the Conjoint Committee on CME and quality initiatives of the osteopathic profession are in tandem with goals and quality initiatives of the AOA.

Education, Medical, Continuing↗
PubMed2005

American osteopathic association commitment to quality and lifelong learning.

The American Osteopathic Association (AOA) initiated programs to enhance quality for 54,000 doctors of osteopathic medicine (DOs) practicing in the United States. Seven core competencies are required in undergraduate and graduate medical education standards. They include osteopathic philosophy and osteopathic manipulative medicine, medical knowledge, patient care, professionalism, interpersonal or communication skills, practice-based learning, and systems-based practice. The AOA Clinical Assessment Program (AOA-CAP) is a quality-improvement tool for physicians to evaluate the safety of patient care. Osteopathic residents and practicing physicians measure the quality and safety of patient care using evidence-based standards through an AOA-supported, Web-based architecture. Alternative models for recertification, including a Maintenance of Certification (MOC) process, are under review by the AOA, the Bureau of Osteopathic Specialists (BOS), and osteopathic certifying boards. The BOS establishes and maintains standards for the various osteopathic certifying boards and oversees matters of policy, jurisdiction, and standards review. The American Osteopathic Board of Emergency Medicine is the first osteopathic board to adopt a MOC process. The goals of the AOA's continuing medical education (CME) program are continued excellence of patient care and improvement of health and well-being of individual patients and the public. The AOA agrees that CME will play a critical role in recertification and continual assessment of physician competence. The AOA believes that proposed activities of the Conjoint Committee on CME and quality initiatives of the osteopathic profession are in tandem with goals and quality initiatives of the AOA.

Attitude of Health Personnel↗
PubMed1995

Palpatory diagnosis and manipulative management of carpal tunnel syndrome: Part 2. 'Double crush' and thoracic outlet syndrome.

The physician treating carpal tunnel syndrome needs to be aware of the possible concomitant occurrence of thoracic outlet syndrome, the so-called double crush syndrome. Palpation is used to differentiate carpal tunnel syndrome from thoracic outlet syndrome. Such palpatory examination assists the physician in planning the initial treatment, including osteopathic manipulation and self-stretching maneuvers, targeted specifically at the most clinically significant pathologic region. Supplemental physical medicine modalities such as ultrasound may enhance the treatment response. Some illustrative cases are reported.

Adult↗
PubMed2003

Evaluating the clinical skills of osteopathic medical students.

Because clinical skills play an important role in health services, many medical credentialing organizations are making performance-based assessments part of the board-certification and licensure processes. While clinical skills are taught and evaluated at colleges of osteopathic medicine, the development and validation of standardized assessment methodologies is far from complete. The purpose of this study was to gather data to support the use of a performance-based assessment of osteopathic clinical skills. A sample of 121 fourth-year osteopathic medical students was tested using the Comprehensive Osteopathic Medical Licensing Examination-USA performance-based clinical skills examination (COMLEX-USA-PE) prototype, a standardized patient performance evaluation that involves a series of 12 simulated encounters. Students were evaluated in a number of domains that included history taking, physical examination, osteopathic manipulative treatment techniques, written communication and clinical problem solving, and physician-patient communication. The analysis of data from 1452 standardized patient encounters suggests that reliable and valid scores can be obtained using the current prototype. The use of COMLEX-USA-PE to assess the readiness of osteopathic medical students to provide patient care in supervised graduate medical education training programs is supported.

Clinical Competence↗
PubMed2003

Development of the Attitudes Toward Osteopathic Principles and Practice Scale (ATOPPS): preliminary results.

Little empirical work has been done to examine how osteopathic medical students' attitudes toward osteopathic principles and practice (OPP) develop and evolve over the course of their medical education. A major obstacle to conducting this research is the absence of reliable and sensitive instruments to measure students' attitudes toward OPP. The purpose of this project is to develop a sensitive and reliable instrument to measure students' attitudes toward OPP. Face-to-face and telephone interviews were conducted with osteopathic medical students, osteopathic manipulative medicine (OMM) residents, OMM undergraduate fellows, and three board-certified OMM specialists. These interviews were summarized in a 39-item instrument administered to 127 students at the completion of their core OMM rotation at the University of North Texas Health Science Center at Fort Worth-Texas College of Osteopathic Medicine. Factor analysis of student responses to the 39 candidate items yielded two interpretable factors. Factor 1 contained 24 items and accounted for 33% of the item response variance, and factor 2 contained four items and accounted for 5.6% of the item response variance. Based on these results, 14 of the original 39 statements were eliminated and the smaller second factor was dropped. Factor 1 contained items reflecting both positive and negative attitudes toward the application of OPP in patient care, the importance of OPP in medical education, and professional distinctiveness. One of the original 39 candidate items was returned to factor 1 because it was judged by the investigators to be consistent with the underlying construct of the scale and helped balance the number of forward-scored and reversed-scored items in the final instrument. Two internal consistency estimates of reliability were computed for the revised 25-item Attitudes Toward Osteopathic Principles and Practice Scale (ATOPPS): the Spearman-Brown unequal-length corrected coefficient alpha and the split-half reliability coefficients. Estimates for the split-half coefficients were .89 for part 1 and .87 for part 2. The Spearman-Brown coefficient alpha was .93, indicating substantial internal consistency. The 25-item ATOPPS seems to reflect a continuum of positive and negative attitudes toward OPP. This preliminary report documents reliability for the 25-item ATOPPS. With continued support for its construct validity, ATOPPS provides investigators with a reliable tool to assess the development of attitudes toward OPP.

Attitude of Health Personnel↗
PubMed2006

Palpatory diagnosis of plagiocephaly.

INTRODUCTION: The term plagiocephaly, from the Greek plagios (oblique) and kephalê (head), means distortion of the head, and refers clinically to cranial asymmetry. Cranial Osteopathy, since it was first proposed, has focussed upon the diagnosis and treatment of birth trauma and cranial asymmetries, and consequently specific therapy for plagiocephalic deformities has been described. Osteopathic manipulation also has been proposed as a treatment for torticollis, a condition associated with plagiocephaly. For these reasons, we decided to look at the mechanics of the occipital bone and the adjacent atlas and bones of the cranial base, in relation to functional plagiocephaly. METHODS: The records of 649 children seen in an osteopathic practice in Lyon, France, were reviewed retrospectively, in compliance with the legal requirements of the Commission Nationale de l'Informatique et des Libertés (CRIL) and the Helsinki accord, for gender, age at presentation, birth history, obstetrical data (breech presentation, vacuum extraction, forceps delivery or Caesarean section), presenting complaint, side of posterior plagiocephaly, side of frontal plagiocephaly, torticollis, motion pattern of the occipital bone upon the atlas, and motion pattern of the spheno-occipital synchondrosis. RESULTS: We found significant correlations between plagiocephaly (right/left) and primipara (P=0.024), use of forceps (P=0.055) and extractor suction (P=0.055). Correlations were also found between flattening of the occiput (right/left) and lateral strain of the spheno-occipital synchondrosis (P=0.002) and between plagiocephaly (right/left) and occipito-atlantal motion (P=0.000). CONCLUSION: We found a significant correlation between the lateral strain pattern of the spheno-occipital synchondrosis and plagiocephaly and between rotational dysfunction of the occiput upon the atlas and the side of posterior plagiocephaly. We suggest that thorough neonatal osteopathic examination can identify individuals predisposed to develop posterior plagiocephaly.

Atlanto-Occipital Joint↗
PubMed2004

Musculoskeletal disorders: does the osteopathic medical profession demonstrate its unique and distinctive characteristics?

The authors used the National Ambulatory Medical Care Survey: 1999 Summary to compare the practice patterns of osteopathic and allopathic physicians in the management of musculoskeletal disorders in family practice settings. Patient and physician characteristics, diagnostic test ordering patterns, treatments, and amount of time spent with patients during visits were compared. Patients who visited osteopathic physicians were more likely to be middle-aged and referred, with injury-related visits that were self-paid. Osteopathic physicians spent more time with patients, ordered a greater number of nontraditional diagnostic tests, and provided more manual and complementary modes of therapy. In contrast, although most of the patients seen by both osteopathic and allopathic physicians were white, allopathic physicians had a greater percentage of patients who were of an ethnic minority or under Medicaid or Medicare. Allopathic physicians ordered a greater number of traditional diagnostic tests and prescribed more medications. Based on the nationally representative data, osteopathic physicians used physiotherapy (including osteopathic manipulative treatment and physical modes of therapy) and complementary treatments to a greater degree in their physician-patient contacts. In contrast, allopathic physicians spent more resources on diagnosis versus treatment (eg, physiotherapy) and seemed to focus on the search for a nonstructural medical cause.

Adolescent↗
PubMed2005

Management of osteoarthritic knee pain.

Osteoarthritis (OA) is one of the most common forms of arthritis seen in primary care practice. The pain associated with this condition is the chief complaint of most patients, prompting them to seek medical attention. Pain can originate from the synovial membrane, joint capsule, periarticular muscles and ligaments, and periosteum and subchondral bone, among other sources. Osteoarthritis is traditionally thought of as a noninflammatory type of arthritis; however, inflammatory mechanisms can be present. Therefore, the management of osteoarthritic pain involves nonpharmacologic modes of therapy as well as pharmacologic agents. Nonpharmacologic therapeutic modalities include osteopathic manipulative treatment, physical therapy, exercise, use of assistive devices, and weight reduction. Pharmacologic options, categorized as topical, intra-articular, or oral, include acetaminophen, nonsteroidal anti-inflammatory agents, and cyclooxygenase type 2 inhibitors. Patients often benefit from use of a combination of these therapeutic modalities. Although pain relief is a chief motivator for patients with OA to seek medical attention, a secondary benefit of successful treatment is to delay the decreased quality of life associated with osteoarthritic pain.

Algorithms↗
PubMed2001

Sinusitis in children: the importance of diagnosis and treatment.

The complications from untreated sinusitis in a 10-month-old male infant, though at the more severe end of the spectrum, brings to light the importance of diagnosis and treatment even in the very young patient. Acute sinusitis should be diagnosed using established guidelines. Appropriate pharmacologic and osteopathic manipulative treatment should be initiated on diagnosis. Initial antibiotic therapy is a 14-day course of amoxicillin. If the sinusitis fails to resolve, a trial of a second-line antibiotic should be considered. The use of adjunctive medications such as antihistamines, decongestants, and nasal steroids remains controversial. If the patient fails maximal medical therapy, a computed tomography scan and referral to an otolaryngologist for possible surgical intervention should be considered.

Acute Disease↗
PubMed2005

Involvement of the cannabimimetic compound, N-palmitoyl-ethanolamine, in inflammatory and neuropathic conditions: review of the available pre-clinical data, and first human studies.

The endogenous cannabimimetic compound, and anandamide analogue, N-palmitoyl-ethanolamine (PEA), was shown to exert potent anti-inflammatory and analgesic effects in experimental models of visceral, neuropathic and inflammatory pain by acting via several possible mechanisms. However, only scant data have been reported on the regulation of PEA levels during pathological conditions in animals or, particularly, humans. We review the current literature on PEA and report the results of three separate studies indicating that its concentrations are significantly increased during three different inflammatory and neuropathic conditions, two of which have been assessed in humans, and one in a mouse model. In patients affected with chronic low back pain, blood PEA levels were not significantly different from those of healthy volunteers, but were significantly and differentially increased (1.6-fold, P<0.01, N=10 per group) 30 min following an osteopathic manipulative treatment. In the second study, the paw skin levels of PEA in mice with streptozotocin-induced diabetic neuropathic pain were found to be significantly higher (1.5-fold, P<0.005, N=5) than those of control mice. In the third study, colonic PEA levels in biopsies from patients with ulcerative colitis were found to be 1.8-fold higher (P<0.05, N=8-10) than those in healthy subjects. These heterogeneous data, together with previous findings reviewed here, substantiate the hypothesis that PEA is an endogenous mediator whose levels are increased following neuroinflammatory or neuropathic conditions in both animals and humans, possibly to exert a local anti-inflammatory and analgesic action.

Amides↗