Tensegrity and manual therapy practice: a qualitative study

Retention of tissue texture change after cervical muscle energy and high velocity low amplitude intervention: implications for treatment intervals

CONTEXT

When choosing to incorporate osteopathic manipulative treatment (OMT) into a patient's care, the risk-to-benefit ratio, the choice of treatment technique, as well as the frequency of treatments are always taken into consideration. This has been even more important during the COVID-19 pandemic, in which social distancing has been the best preventative measure to decrease exposure. By increasing treatment intervals, one could not only limit possible exposure/spread of viruses but also decrease the overall cost to the system as well as to the individual. This is an expansion of a previous study in which quantifiable changes in cervical hysteresis characteristics post-OMT were documented utilizing a durometer (Ultralign SA201^®; Sigma Instruments; Cranberry, PA USA). This study compared two treatment modalities, muscle energy (ME) and high-velocity low-amplitude (HVLA) postcervical treatment. Subjects in this study were allowed to re-enroll, provided that they could be treated utilizing the alternate treatment modality. By allowing repeat subjects, analysis of the data for lasting effects of OMT could be observed.

OBJECTIVES

To determine whether a significant change in cervical hysteresis would be observed after each treatment regardless of a short treatment interval.

METHODS

A total of 34 subjects were retrospectively noted to be repeat subjects from a larger, 213-subject study. These 34 subjects were repeat participants who were treated with two different direct-treatment modalities 7-10 days apart. Each subject was randomly assigned to receive a single-segmental ME or HVLA treatment technique directed toward a cervical (C) segment (C3-C5 only). Subjects were objectively measured pretreatment in all cervical segments utilizing the Ultralign SA201^®, then treated with cervical OMT to a single segment, and finally reassessed at all cervical levels with the Ultralign SA201^® posttreatment to assess for change in cervical hysteresis.

RESULTS

Statistically significant or suggestive changes (p-values 0.01-0.08) with good clinical effect size (0.30 or greater) were noted in all four components of the Ultralign SA201^® at multiple cervical levels after the first treatment, but only one component (frequency) had a statistically significant change after the second treatment (AA cervical level, p-value 0.01) with good clinical effect size (0.45). However, when comparing the post-first-treatment values to the pre-second-treatment values, no statistically significant differences (p-value 0.10 or higher) were observed between them.

CONCLUSIONS

Statistically significant changes were noted after the first treatment; however, when comparing cervical hysteresis changes after the first treatment to the cervical hysteresis values prior to the second treatment delivered 7-10 days later, there were no statistically significant or suggestive changes. This data suggest that several post-OMT changes noted after the first treatment were still in effect and may indicate that follow-up visits for direct manipulation may be deferred for a least two weeks.

The role of touch in osteopathic practice: A narrative review and integrative hypothesis

INTRODUCTION

Osteopathy relies on a touch-based approach to promote health. This narrative review aims to analyze the role of touch in clinical osteopathic practice.

METHODS

A database search was conducted using MEDLINE, EMBASE, PEDro and Google Scholar. Peer-reviewed papers without specifying limits on dates and design were included.

RESULTS

47 articles met the inclusion criteria and were used to elucidate two main themes: Biological and psychological effects of touch; Touch in the context of osteopathic clinical reasoning.

DISCUSSION

Touch is one of the tools to achieve a collaborative interaction with the patient, to substantiate clinical information, and to detect somatic dysfunctions: neuro-myofascial active areas that might act as an osteopath-patient interface to transmit the biological and physiological effects of touch.

CONCLUSION

The findings of the review support a shared decision-making process, in which touch is one of the osteopath-patient dyad 's leading communication tools to develop a tailor-made osteopathic approach.

The Hypothesis of Biotensegrity and D. D. Palmer's Hypothesis on Tone: A Discussion of Their Alignment

OBJECTIVE

The purpose of this article is to compare D. D. Palmer's hypothesis of tone with the modern hypothesis of biotensegrity.

DISCUSSION

Although researchers have been using the hypothesis of biotensegrity for over 40 years to explain the mechanics of movement within biological systems, it has experienced revived support in the last 25 years. Biotensegrity as a concept is applied at the molecular, cellular, tissue, and organ levels, revealing a different understanding of the architecture of biological organisms. Biotensegrity offers a way of exploring the human body in the field of functional anatomy. The model has become popular among bodywork and movement practitioners, as it recognizes the wholeness of the human body. D. D. Palmer used tone to explain the origin of disease; biotensegrity, instead, explains why certain diseases may develop.

CONCLUSION

The concept of tone hypothesized by D. D. Palmer is different from the modern concept of biotensegrity. Although biotensegrity offers a different way of seeing how the human body functions, using it as a theoretical framework to explain the effects of manual therapies such as chiropractic may be premature. The use of the biotensegrity hypothesis requires further research and investigation before application in clinical settings.

Tone as a health concept: An analysis

STUDY DESIGN

Concept analysis.

INTRODUCTION

This paper is a report on the analysis of the concept of tone in chiropractic.

PURPOSE

The purpose of this paper is to clarify the concept of tone as originally understood by Daniel David Palmer from 1895 to 1914 and to monitor its evolution over time.

METHODS

Data was sourced from Palmer's original work, published between 1895 and 1914. A literature search from 1980 to 2016 was also performed on the online databases CINHAL, PubMed and Scopus with key terms including 'tone', 'chiropractic', 'Palmer', 'vitalism', 'health', 'homeostasis', 'holism' and 'wellness'. Finally hand-searches were conducted through chiropractic books and professional literature from 1906 to 1980 for any references to 'tone'. Rodgers' evolutionary method of analysis was used to categorise the data in relation to the surrogates, attributes, references, antecedents and consequences of tone.

RESULTS

A total of 49 references were found: five from publications by Palmer; three from the database searches, and; the remaining 41 from professional books, trade journals and websites.

MAJOR CONCLUSIONS

There is no clear interpretation of tone in the contemporary chiropractic literature. Tone is closely aligned with functional neurology and can be understood as an interface between the metaphysical and the biomedical. Using the concept of tone as a foundation for practice could strengthen the identity of the chiropractic profession.