Facilitated oscillatory release—a dynamic method of neuromuscular and ligamentous/articular assessment and treatment

Patient Active Approaches in Osteopathic Practice: A Scoping Review

Background: In the field of manual therapies there is a growing interest in moving from passive hands-on approaches to patient active approaches. In the osteopathic field there are both active and passive methods described as integrated in the process of care. However, this prospective linkage has not been formally explored and is not well shared in the community of practice. The present review aims to appraise the relevant literature on the functioning and principles of Patient active osteopathic approaches (PAOAs) and explore a prospective model for selecting the different types of PAOA, highlighting their integration into patient management strategies. Methods: A scoping review was conducted to analyze the relevant literature on the functioning and the different principles of PAOA and to obtain a comprehensive perspective on the phenomenon. Results: The eligible articles provide insights into the mechanisms of functioning and principles of application of active approaches to be integrated with hands-on approaches. These results provide new insights into the relevance of PAOA to clinical practice. Conclusions: The proposal, emerging from the review, may promote discussions in the community of practice and provide a road map for research towards achieving an evidence-based structure for PAOA.

Evaluation of viscoelastic parameters of the skeletal muscles in junior triathletes

Five male triathletes of the Estonian national junior team were observed during a seven-week competition period. The Myoton-2 equipment was used to describe the viscoelastic parameters of the skeletal muscles. The frequency of damped mechanical oscillation of the muscle tissue (Hz - indicating the tension in the muscle), logarithmic decrement of the oscillations (Theta - indicating the elasticity of the muscle) and stiffness (N m(-1)) of the muscle tissue were registered bilaterally in eight muscles in both the relaxed and the contracted states: BB - biceps brachii (caput longum); TB - triceps brachii (caput longum); BF - biceps femoris (caput longum); RF - rectus femoris; TA - tibialis anterior; GC - gastrocnemius (caput mediale); LD - latissimus dorsi; PM - pectoralis major (pars sternocostalis). A portable massage table was used for the subject to rest on during the measuring. For the measurement of the anterior muscles, the subject lay supine; for the posterior muscles the prone position was used. The (isometric) contraction was standardized simply by the same measuring position of the limb-the subject raised his arm or leg to an angle of 45 degrees from the horizontal level, using a 2.3 kg dumb-bell as an additional weight for the upper limb. The tarsal dorsiflexion and plantarflexion was performed against a fixed table to contract the crural muscles. The elasticity of the skeletal muscle is higher for the contracted state with respect to the relaxed one (p < 0.0001) and is described by decline of the value of logarithmic decrement, the stiffness and the tension in the muscle increases (p < 0.0001 for both parameters). The measured skeletal muscles differ significantly (p < 0.0018) by the viscoelastic properties in the relaxed state. In the relaxed state, TA was the most elastic (mean +/- SD; Theta-0.74 +/- 0.13), stiff (mean +/- SD; 346.68 +/- 60.34 N m(-1)) and tense muscle (mean +/- SD; 18.72 +/- 1.55 Hz). In the contracted state, the elasticity of TA did not change (0.76 +/- 0.14) while the stiffness and the tension in this muscle rose significantly (93% and 38%, accordingly). Personal differences (p < 0.005) exist if pooled data from the muscles are compared between the subjects.