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Results for “Manipulation, Osteopathic”

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PubMed1997

Variables influencing the use of osteopathic manipulative treatment in family practice.

A questionnaire was mailed to 2000 randomly selected osteopathic physicians to assess use of osteopathic manipulative treatment (OMT). In all, 1055 responses were summarized for the study. The contention is supported that OMT is being used less and less by practicing physicians. Only 6% of the respondents treated more than 50% of their patients with OMT, and nearly one third used OMT on less than 5% of their patients. A progressive de-emphasis of OMT use correlated with more recent graduation from osteopathic medical colleges. Thirty-eight percent of the variance regarding OMT use was attributed to two factors: barriers to use, and OMT protocol used. Perceptions by physicians of insufficient OMT training were not predictive of decreased use of OMT. Significantly more OMT was used in solo practice as opposed to other settings. The results present a wake-up call for the osteopathic medical profession. The profession must strive to remove barriers that preclude OMT use by justifying to policymakers, health professionals, and the public the cost-benefits of OMT in holistic healthcare.

Adult↗

PubMedDate not supplied

Osteopathic manipulative medicine in the treatment of hypertension: an alternative, conventional approach.

The branch of medicine known as osteopathy was founded by Andrew Taylor Still in the mid to late 19th century. Osteopathy is a philosophy of medicine. Osteopathic physicians use techniques collectively referred to as osteopathic manipulative medicine (OMM). One of the most common diseases suffered by those residing in westernized nations is hypertension. Although osteopathic physicians are taught to incorporate OMM into the management of medical disorders, the usefulness of OMM in treating hypertension is less clear. This review reflects on the past 90 years of biomedical literature and attempts to address the utility of OMM used alone, or in combination with other treatments including antihypertensive medication, for the effective management of hypertension. Preliminary evidence may suggest a role for OMM in treating hypertension within the context of a multifaceted and long-lasting treatment regimen that may include traditional pharmacotherapeutics. To have universal acceptance, controlled and blinded outcome studies are needed to determine the effectiveness of OMM for the routine treatment of hypertension.

Autonomic Nervous System↗

PubMed1997

Osteopathic manipulative treatment: student attitudes before and after intensive clinical exposure.

It is widely known that family practice osteopathic physicians actively use osteopathic manipulative treatment (OMT) as a part of their everyday practices, but many DOs in other specialty areas fail to use OMT at all. Physicians who use this modality often limit its use to musculoskeletal complaints. This pattern likely begins during undergraduate training at the time that OMT is taught. To warm student attitudes to OMT and provide a more integrated OMT training background, the University of North Texas Health Science Center at Fort Worth/Texas College of Osteopathic Medicine has added to the clinical curriculum a required 1-month rotation in manipulative medicine. With the rotation in place for a full academic year, it was important to determine the efficacy of the rotation curriculum. This assessment has been accomplished using a specialized protocol designed to gauge student attitudes and opinions regarding OMT, osteopathic medicine, and their own OMT skills.

Education, Medical↗

PubMedDate not supplied

Allopathic family medicine residents can learn osteopathic manipulation techniques in a 1-month elective.

BACKGROUND: Graduating family medicine residents report a relative lack of confidence in managing musculoskeletal problems, and many primary care physicians desire more instruction in manual medicine. METHODS: We conducted a 1-month osteopathic manipulative treatment elective with five allopathic family medicine residents, utilizing multiple teaching and assessment strategies. RESULTS: Residents averaged 30 patient encounters each. Faculty graded their attainment of the knowledge and skills objectives at 3.9 and 3.8 on a 5-point scale, respectively. Residents reported unanimously that the course had reasonable expectations and fostered independent decision making and that they achieved the educational goals. CONCLUSIONS: After a 1-month elective, allopathic residents demonstrated competency in a defined set of osteopathic principles and skills.

Curriculum↗

PubMed1990

An open controlled assessment of osteopathic manipulation in nonspecific low-back pain.

An open controlled pilot trial on nonspecific low-back pain sufferers demonstrated responsiveness to osteopathic manipulation of some patients presenting with pain durations of 14 to 28 days. No response was demonstrated in those with shorter episodes at presentation. The advantage to manipulated patients was maximal between 1 and 2 weeks after commencing treatment, but was not discernable after 4 weeks. The demonstration of a similar responsive stratum by other investigators, with both teams totally unaware of each other's work during data collection, suggests a high degree of reliability for this finding.

Activities of Daily Living↗

PubMed1994

Effects of adding sacral base leveling to osteopathic manipulative treatment of back pain: a pilot study.

A selected group of patients with sacral base unleveling greater than 2 mm were studied to determine the effects of osteopathic manipulative treatment (OMT) and heel lifting on chronic low-back pain. The McGill-Melzack Pain Questionnaire administered by trained personnel was used to assess the patient's pain before and after treatments. Five patients with no experience with manual treatment were treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and OMT for restrictions in spinal motion. Their improvement was statistically significant. Seven patients who had been treated previously with OMT and NSAIDs received heel lifts of graduated thickness until the sacral base was within 2 mm of being level. Attaining a "level" sacral base with heel lifts also provided a statistically significant relief from low-back pain.

Adolescent↗

PubMed1995

Nerve compression syndromes as models for research on osteopathic manipulative treatment.

Experimental and clinical studies of nerve compression syndromes show that ischemia or edema, singly or combined, causes responses in nerves that lead to alterations in impulse conduction and to commonly observed clinical signs. Because osteopathic manipulative treatment (OMT) is thought to affect microcirculation and anatomic positioning of structures, nerve compression syndromes appear ideal as models for studying how OMT accomplishes results. We recommend that researchers develop experimental protocols or clinical studies of nerve compression syndromes that will use anatomic, histologic, and physiologic criteria to monitor the effects of OMT. Techniques such as soft tissue, muscle energy, counterstrain, or myofascial release are appropriate for study in nerve compression syndromes. Such studies are necessary to understand the biologic basis of OMT.

Animals↗

PubMed2003

Randomized osteopathic manipulation study (ROMANS): pragmatic trial for spinal pain in primary care.

BACKGROUND: Spinal pain is common and frequently disabling. Management guidelines have encouraged referral from primary care for spinal manipulation. However, the evidence base for these recommendations is weak. More pragmatic trials and economic evaluations have been recommended. OBJECTIVES: Our aim was to assess the effectiveness and health care costs of a practice-based osteopathy clinic for subacute spinal pain. METHODS: A pragmatic randomized controlled trial was carried out in a primary care osteopathy clinic accepting referrals from 14 neighbouring practices in North West Wales. A total of 201 patients with neck or back pain of 2-12 weeks duration were allocated at random between usual GP care and an additional three sessions of osteopathic spinal manipulation. The primary outcome measure was the Extended Aberdeen Spine Pain Scale (EASPS). Secondary measures included SF-12, EuroQol and Short-form McGill Pain Questionnaire. Health care costs were estimated from the records of referring GPs. RESULTS: Outcomes improved more in the osteopathy group than the usual care group. At 2 months, this improvement was significantly greater in EASPS [95% confidence interval (CI) 0.7-9.8] and SF-12 mental score (95% CI 2.7-10.7). At 6 months, this difference was no longer significant for EASPS (95% CI -1.5 to 10.4), but remained significant for SF-12 mental score (95% CI 1.0-9.9). Mean health care costs attributed to spinal pain were significantly greater by 65 UK pounds in the osteopathy group (95% CI 32-155 UK pounds). Though osteopathy also cost 22 UK pounds more in mean total health care cost, this was not significant (95% CI - 159 to 142 UK pounds). CONCLUSION: A primary care osteopathy clinic improved short-term physical and longer term psychological outcomes, at little extra cost. Rigorous multicentre studies are now needed to assess the generalizability of this approach.

Back Pain↗

PubMed1985