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PubMed2005

Survey of osteopathic and allopathic residents' attitudes toward osteopathic manipulative treatment.

More than 50% of new osteopathic physicians receive their residency training in programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) rather than in programs approved by the American Osteopathic Association (AOA). To examine the implications of this training pattern for trends in the practice of osteopathic manipulative treatment (OMT), the authors surveyed attitudes toward OMT with questionnaires targeted to osteopathic and allopathic residents in family medicine residency programs. Osteopathic residents in specialties other than family medicine were also surveyed. Differences in views between osteopathic residents in AOA-approved and ACGME-accredited programs--as well as the views of the allopathic residents--were analyzed using chi(2) tests. Fewer osteopathic residents in ACGME-accredited family medicine programs (39.5%) reported frequent use of OMT than did osteopathic residents in AOA-approved family medicine programs (67.9%). This difference appears to result more from experiences during residency training than from expectations formed before residency training. Ninety percent of the allopathic residents who responded to the survey said they believed that OMT is effective for treating somatic dysfunction. Moreover, 70.9% of allopathic physicians indicated they had at least some interest in learning OMT. To the authors' knowledge, this study was the first to quantify a change in attitude of allopathic residents toward a more positive view of osteopathic medicine.

Attitude of Health Personnel↗

PubMed2002

Evaluation of osteopathic manipulative treatment training by practicing physicians in Ohio.

The authors mailed a survey designed to evaluate beliefs about osteopathic manipulative treatment (OMT) training to the 2318 osteopathic physicians registered with the Ohio Osteopathic Association. Responses were received from 871 osteopathic physicians (response rate, 38%). Fifty-three percent of the respondents had used OMT with patients at least once during the week before the survey. With regard to OMT training, 60% rated their experience during medical school as acceptable; during postgraduate training the acceptable rating dropped to 9%. Osteopathic manipulative treatment training through continuing medical education programs was rated as acceptable by 26% who had participated in these programs. Forty percent of the respondents reported that they were practicing less OMT now than when they originally entered practice, while 20% reported using OMT procedures more often. No significant correlation was observed between OMT training satisfaction during medical school and current use of OMT. However, a strong negative correlation was observed between satisfaction with postgraduate OMT training and OMT use. This survey did not detect any association between year of graduation and use of OMT.

Attitude of Health Personnel↗

PubMed1999

Adjunctive osteopathic manipulative treatment in the elderly hospitalized with pneumonia: a pilot study.

To evaluate the benefit of osteopathic manipulative treatment in the elderly with pneumonia, the authors recruited 21 individuals older than 60 years who were hospitalized with acute pneumonia. Eleven patients were randomly assigned to the treatment group and ten to the control group. The treatment group received specific osteopathic manipulative treatment for somatic dysfunction and a standardized treatment protocol. Both groups received conventional therapy, and the attending physician was blind to group assignments. No significant difference existed between groups for age, sex, or severity of illness. Although the mean duration of leukocytosis, intravenous antibiotic treatment, and length of stay were shorter for the treatment group, these measures did not reach statistical significance. However, the mean duration of oral antibiotic use did reach statistical significance at 3.1 days for the treatment group and 0.8 day for the control group. Osteopathic manipulative treatment may reduce antibiotic use and length of stay; however, a larger study is needed to clarify this outcome.

Aged↗

PubMed1994

Effects of osteopathic manipulative treatment in patients with cervicothoracic pain: pilot study using thermography.

To provide information on how cervicothoracic pain responds to osteopathic manipulative treatment, five subjects with acute or chronic pain received appropriate medication and three osteopathic manipulative treatments by the principal investigator using thrust and nonthrust techniques. The mean number of findings by both investigators on structural examination decreased considerably immediately after each of the three treatments. The number of findings increased in week 2 and decreased in week 3. The principal investigator observed a further decrease by the final session, but the coinvestigator reported an increase. The pain scale score improved an average of nearly 30%. Thermography showed cooling of the cervicothoracic region in all subjects and conversion to a normal pattern in four. Osteopathic manipulative treatment should be considered for patients with acute or chronic cervicothoracic pain. The use of thermographic analysis in clinical osteopathic research seems warranted.

Adult↗

PubMed2003

The use of osteopathic manipulative treatment as adjuvant therapy in children with recurrent acute otitis media.

OBJECTIVE: To study effects of osteopathic manipulative treatment as an adjuvant therapy to routine pediatric care in children with recurrent acute otitis media (AOM). STUDY DESIGN: Patients 6 months to 6 years old with 3 episodes of AOM in the previous 6 months, or 4 in the previous year, who were not already surgical candidates were placed randomly into 2 groups: one receiving routine pediatric care, the other receiving routine care plus osteopathic manipulative treatment. Both groups received an equal number of study encounters to monitor behavior and obtain tympanograms. Clinical status was monitored with review of pediatric records. The pediatrician was blinded to patient group and study outcomes, and the osteopathic physician was blinded to patient clinical course. MAIN OUTCOME MEASURES: We monitored frequency of episodes of AOM, antibiotic use, surgical interventions, various behaviors, and tympanometric and audiometric performance. RESULTS: A total of 57 patients, 25 intervention patients and 32 control patients, met criteria and completed the study. Adjusting for the baseline frequency before study entry, intervention patients had fewer episodes of AOM (mean group difference per month, -0.14 [95% confidence interval, -0.27 to 0.00]; P =.04), fewer surgical procedures (intervention patients, 1; control patients, 8; P =.03), and more mean surgery-free months (intervention patients, 6.00; control patients, 5.25; P =.01). Baseline and final tympanograms obtained by the audiologist showed an increased frequency of more normal tympanogram types in the intervention group, with an adjusted mean group difference of 0.55 (95% confidence interval, 0.08 to 1.02; P =.02). No adverse reactions were reported. CONCLUSIONS: The results of this study suggest a potential benefit of osteopathic manipulative treatment as adjuvant therapy in children with recurrent AOM; it may prevent or decrease surgical intervention or antibiotic overuse.

Acute Disease↗

PubMed2002

Quality of life in referred patients presenting to a specialty clinic for osteopathic manipulative treatment.

Previous research has found that patients of osteopathic physicians tend to report poorer general health perceptions than persons in the general population or than patients of allopathic physicians. Quality of life and level of healthcare satisfaction in patients referred to a specialty clinic for osteopathic manipulative treatment (OMT) at a college of osteopathic medicine were measured in 1997. Data from the Medical Outcomes Study 36-Item Short Form (SF-36) were used to compute standardized scores in the following eight health scales: physical functioning, role limitations because of physical problems, bodily pain, general health perceptions, vitality, social functioning, role limitations because of emotional problems, and mental health. There were 185 patients who returned the survey (mean response rate, 90%), including 22 new and 163 established patients. Patients reported poorer health than the general population on all eight scales (P < .001). Patients frequently reported poorer quality of life than referents with hypertension, congestive heart failure, type 2 diabetes mellitus, recent acute myocardial infarction, or clinical depression. More than 97% of established patients were satisfied or very satisfied with the healthcare received at the clinic. This study suggests that referred patients presenting to osteopathic physicians for OMT may have poorer quality of life than is generally recognized when relying only on traditional diagnostic approaches. Early detection and treatment of musculoskeletal conditions may be important factors in preventing chronicity and its impact on quality of life.

Adult↗

PubMed2003

Implementation of an osteopathic manipulative medicine clinic at an allopathic teaching hospital: a research-based experience.

Mastery of osteopathic palpatory skills and the skilled delivery of osteopathic manipulative treatment is a life-long venture that demands from practitioners increasingly sophisticated manual skills. Specific receptors and neural networks within the brain allow for the gradual development of refined manual skills that parallel responsive alterations and refinements that develop with repeated experience. During clinical training, most graduates of colleges of osteopathic medicine are not given opportunities to hone their palpatory skills. This is unfortunate because there is an increasing public demand for the nonpharmacologic treatment modalities osteopathic physicians could supply. At Berkshire Medical Center in Pittsfield, Mass, a major teaching affiliate of the University of Massachusetts Medical School in Worcester, the authors assembled a team of osteopathic and allopathic physicians to found an osteopathic manipulative medicine clinic. In this article, the authors share their experience in the creation of this research-based osteopathic medical clinic.

Clinical Competence↗

PubMed2002

Quantifiable effects of osteopathic manipulative techniques on patients with chronic asthma.

In this pilot study, the authors evaluated the immediate effects of osteopathic manipulative procedures compared with sham procedures on 10 subjects who were diagnosed with chronic asthma. The research followed a pretest-posttest crossover design wherein each subject served as her own control. Blinded examiners recorded respiratory excursion, peak expiratory flow rates, and subjective measures of asthma symptoms. Measurements of both upper thoracic and lower thoracic forced respiratory excursion statistically increased after osteopathic manipulative procedures compared with sham procedures. Changes in peak expiratory flow rates and asthma symptoms were not statistically significant.

Adult↗

PubMed2006