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Bonanno M, Papa GA, Ruffoni P, Catalioto E, De Luca R, Maggio MG, Calabrò RS. The Effects of Osteopathic Manipulative Treatment on Brain Activity: A Scoping Review of MRI and EEG Studies. Healthcare (Basel) 2024; 12:1353. [PMID: 38998887 PMCID: PMC11241316 DOI: 10.3390/healthcare12131353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/01/2024] [Accepted: 07/04/2024] [Indexed: 07/14/2024] Open
Abstract
Osteopathic manipulative treatment (OMT) is a hands-on therapy aiming to achieve the global homeostasis of the patient. OMT focuses on treating the somatic dysfunctions characterized by tissue modifications, body asymmetry, and range-of-motion restrictions. The benefits related to OMT are thought to be associated with the interconnectedness of the body's systems and the inherent capacity for self-healing. However, whether OMT can influence brain activity, and, consequently, neurophysiological responses is an open research question. Our research investigates the literature to identify the effects of OMT on brain activity. The main purpose of the research question is: can OMT influence brain activity and consequently neurophysiological responses? A scoping review was conducted, searching the following databases: PubMed, Google Scholar, and OSTEOMED.DR (Osteopathic Medical Digital Repository), Scopus, Web of Science (WoS), and Science Direct. The initial search returned 114 articles, and after removing duplicates, 69 were considered eligible to be included in the final sample. In the end, eight studies (six randomized controlled trials, one pilot study, and one cross-over study) were finally included and analyzed in this review. In conclusion, OMT seems to have a role in influencing functional changes in brain activity in healthy individuals and even more in patients with chronic musculoskeletal pain. However, further RCT studies are needed to confirm these findings. Registration protocol: CRD42024525390.
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Affiliation(s)
- Mirjam Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy
| | | | - Paola Ruffoni
- International College of Osteopathic Medicine, 20092 Milan, Italy
| | | | - Rosaria De Luca
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy
| | - Maria Grazia Maggio
- IRCCS Centro Neurolesi Bonino-Pulejo, Cda Casazza, SS 113, 98124 Messina, Italy
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Dal Farra F, Bergna A, Lunghi C, Bruini I, Galli M, Vismara L, Tramontano M. Reported biological effects following Osteopathic Manipulative Treatment: A comprehensive mapping review. Complement Ther Med 2024; 82:103043. [PMID: 38685285 DOI: 10.1016/j.ctim.2024.103043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/13/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND AND PURPOSE Osteopathic Manipulative Treatment (OMT) is a therapeutic whole-body approach mainly focused on correcting somatic dysfunctions. The aim of this scoping review is to systematically map the literature regarding the documented biological effects observed following OMT. METHODS The 2020 JBIRM version and the PRISMA-ScR were followed for the conceptualization and reporting of this review. The protocol was registered on the "Open Science Framework Registry" (https://doi.org/10.17605/OSF.IO/MFAUP). We searched for original articles published on Medline, Embase, and Scopus, from inception to the present. RESULTS Overall, 10,419 records were identified. After duplicate removal, screening for title and abstract, and specific exclusions with reasons, a total of 146 studies were included. Wide differences were detected among studies in their geographical localization, study design, temporal distribution, participants' condition, OMT protocols, and documented biological effects. Such variety in frequency distribution was properly described through descriptive statistics. CONCLUSIONS Biological modifications that appear to be induced by OMT have been detected in several body systems, but mostly in neurophysiological correlates and musculoskeletal changes. Results suggest a growing interest over the years on this topic, especially in the last two decades. More efforts in research are recommended to highlight whether such changes specifically depend on OMT, and to demonstrate its specific contribution to clinical practice.
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Affiliation(s)
- Fulvio Dal Farra
- Department Information Engineering, University of Brescia, Via Branze 38, 25123 Brescia, Italy
| | - Andrea Bergna
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; AISO - Associazione Italiana Scuole di Osteopatia, 65125 Pescara, Italy.
| | | | - Irene Bruini
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Matteo Galli
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Luca Vismara
- Division of Neurology and Neurorehabilitation - IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Verbania, Italy
| | - Marco Tramontano
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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De Marchi I, Buffone F, Mauro A, Bruini I, Vismara L. Manual Therapy of Dysphagia in a Patient with Amyotrophic Lateral Sclerosis: A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:845. [PMID: 38929462 PMCID: PMC11205607 DOI: 10.3390/medicina60060845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/12/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
Amyotrophic lateral sclerosis (ALS) is an incurable rare neurodegenerative condition, with 45% of cases showing the symptom of dysphagia; its clinical signs are atrophy, weakness, and fasciculations of the facial muscles, tongue, and pharynx. Furthermore, dysphagia is the main cause of aspiration pneumonia. The traditional treatment for dysphagia varies based on the patient's difficulty of swallowing. The initial phase consists of dietary consistency adjustments, progressing to alternatives like nasogastric tubes or percutaneous endoscopic gastrostomy (PEG) in advanced stages. Osteopathic manipulative treatment (OMT) is a complementary 'hands-on' approach that has already shown positive results as an add-on therapy in various health conditions. This study is a case report of a man diagnosed with ALS with initial dysphagia, managed with a protocol that extraordinarily included OMT. The patient showed somatic dysfunctions in the mediastinal region, upper cervical region, and occipital area which are all anatomically related to the nervous system, especially the glossopharyngeal reflex. At the end of the rehabilitation protocol, there was a reduction in the swallowing problems measured with Strand Scale and swallowing tests, and the patient reported an improved psycho-physical well-being assessed with the Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ-40). Instead, the neurological function measured with ALSFRS-S remained stable. Although the nature of this study design prevents any causal assumption, the positive results should lead to future randomized controlled trials to assess the effectiveness of OMT as an adjunctive therapeutic proposal to improve the health of ALS patients.
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Affiliation(s)
- Ilaria De Marchi
- Department of Neurology and ALS Centre, Traslational Medicine, University of Piemonte Orientale, Maggiore della Carità Hospital, 28100 Novara, Italy;
| | - Francesca Buffone
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy;
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy
- Principles and Practice of Clinical Research (PPCR), Harvard T.H. Chan School of Public Health–ECPE, Boston, MA 02115, USA
| | - Alessandro Mauro
- Division of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo-Verbania, Italy; (A.M.); (L.V.)
- Department of Neurosciences “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy
| | - Irene Bruini
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy;
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Luca Vismara
- Division of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo-Verbania, Italy; (A.M.); (L.V.)
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Vismara L, Bergna A, Tarantino AG, Dal Farra F, Buffone F, Vendramin D, Cimolin V, Cerfoglio S, Pradotto LG, Mauro A. Reliability and Validity of the Variability Model Testing Procedure for Somatic Dysfunction Assessment: A Comparison with Gait Analysis Parameters in Healthy Subjects. Healthcare (Basel) 2024; 12:175. [PMID: 38255064 PMCID: PMC10815658 DOI: 10.3390/healthcare12020175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/28/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Somatic dysfunction (SD) is an altered body function involving the musculoskeletal system. However, its clinical signs-tissue texture abnormalities, positional asymmetry, restricted range of motion, and tissue tenderness-did not achieve satisfactory results for reliability. A recent theoretical model proposed a revision assessing the movement variability around the joint rest position. The asymmetry and restriction of motion may characterize functional assessment in osteopathic clinical practice, demonstrating the reliability required. Hence, this study investigated the reliability of the new variability model (VM) with gait analysis (GA). Three blind examiners tested 27 young healthy subjects for asymmetry of motion around rest position and the SD grade on six body regions. The results were compared to the VICON procedure for 3D-GA. The inter-rater agreement for the detection of reduced movement variability ranged from 0.78 to 0.54, whereas for SD, grade ranged from 0.64 to 0.47. VM had a sensitivity and specificity of 0.62 and 0.53, respectively, in SD detection compared to step length normality. Global severity grade of SD demonstrated moderate to good correlation with spatial-temporal parameters. The VM showed palpatory reliability and validity with spatial-temporal parameters in GA. Those findings contribute to the innovation for SD examination with implications for the clinical practice.
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Affiliation(s)
- Luca Vismara
- Division of Neurology and Neurorehabilitation—IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo-Verbania, Italy; (L.V.); (V.C.); (S.C.); (L.G.P.); (A.M.)
| | - Andrea Bergna
- Department of Research, SOMA Istituto Osteopatia Milano—Institute Osteopathy Milan, 20126 Milan, Italy; (A.B.); (A.G.T.); (F.D.F.)
| | - Andrea Gianmaria Tarantino
- Department of Research, SOMA Istituto Osteopatia Milano—Institute Osteopathy Milan, 20126 Milan, Italy; (A.B.); (A.G.T.); (F.D.F.)
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy;
| | - Fulvio Dal Farra
- Department of Research, SOMA Istituto Osteopatia Milano—Institute Osteopathy Milan, 20126 Milan, Italy; (A.B.); (A.G.T.); (F.D.F.)
- Department of Information Engineering, University of Brescia, 25123 Brescia, Italy
| | - Francesca Buffone
- Department of Research, SOMA Istituto Osteopatia Milano—Institute Osteopathy Milan, 20126 Milan, Italy; (A.B.); (A.G.T.); (F.D.F.)
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy;
- Principles and Practice of Clinical Research (PPCR), Harvard T.H. Chan School of Public Health–ECPE, Boston, MA 02115, USA
| | - Davide Vendramin
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy;
| | - Veronica Cimolin
- Division of Neurology and Neurorehabilitation—IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo-Verbania, Italy; (L.V.); (V.C.); (S.C.); (L.G.P.); (A.M.)
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Serena Cerfoglio
- Division of Neurology and Neurorehabilitation—IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo-Verbania, Italy; (L.V.); (V.C.); (S.C.); (L.G.P.); (A.M.)
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Luca Guglielmo Pradotto
- Division of Neurology and Neurorehabilitation—IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo-Verbania, Italy; (L.V.); (V.C.); (S.C.); (L.G.P.); (A.M.)
- Department of Neurosciences “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy
| | - Alessandro Mauro
- Division of Neurology and Neurorehabilitation—IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo-Verbania, Italy; (L.V.); (V.C.); (S.C.); (L.G.P.); (A.M.)
- Department of Neurosciences “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy
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Tran A, Ngo T, Roberts T, Ko E, Holmgren JG, Edwards C, Coleman M, Gao J. Quantitative ultrasound to assess efficacy of treatment for neck somatic dysfunctions: a feasibility study. J Osteopath Med 2023; 123:443-450. [PMID: 37285456 DOI: 10.1515/jom-2022-0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/19/2023] [Indexed: 06/09/2023]
Abstract
CONTEXT Neck pain is a common complaint in healthcare clinics. Although the pathogenesis of neck pain is often multifactorial, trapezius muscle dysfunction has been commonly linked to neck pain. Osteopathic manipulative treatment (OMT) has been demonstrated to be an effective treatment modality in treating trapezius muscle dysfunction and neck pain. However, there is a current lack of objective, quantitative measures to assess the effectiveness of OMT. Through previous research, ultrasound technology has been shown to be promising in its ability to quantify tissue changes both pre- and post-OMT. OBJECTIVES The objectives of this study are to evaluate the feasibility of shear wave elastography (SWE) in assessing upper trapezius muscles with pain and hypertonicity, as well as the changes in these muscles post-OMT for cervical somatic dysfunctions. METHODS After obtaining approval from the Rocky Vista University Institutional Review Board and written informed consent from participants, SWE and osteopathic assessments were performed on 22 adult participants with and without cervical spine somatic dysfunction. Participants with positive osteopathic assessments of tissue texture, asymmetry, restricted motion, and/or tenderness (TART) were treated utilizing OMT. Shear wave velocity (SWV, m/s) and shear wave velocity rate [SWVR = (SWV contraction - SWV relaxation)/ SWV relaxation] of the upper trapezius muscles with and without pain and hypertonicity, and before and after OMT, were examined utilizing a two-tailed t-test. RESULTS SWV in muscle contraction and SWVR were significantly lower in muscles with pain compared to muscles without pain (p≤0.01). SWV in muscle contraction was also significantly lower in hypertonic muscles compared to normotonic muscles (p<0.01). Following OMT, SWV in muscle contraction and SWVR in muscles with pain and hypertonic increased significantly (p≤0.01). Overall TART score of all muscles with somatic dysfunction (SD) after OMT significantly decreased (p<0.01). SWV in muscle contraction and SWVR in hypertonic muscles were also significantly increased (p≤0.03), with an improvement index of 0.11 and 0.20. CONCLUSIONS This study's results demonstrate the feasibility of utilizing SWE to evaluate somatic dysfunctions of the upper trapezius musculature and the efficacy of OMT for neck somatic dysfunctions.
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Affiliation(s)
- Anthony Tran
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
| | - Thien Ngo
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
| | - Tanner Roberts
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
| | - Eric Ko
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
| | | | - Chris Edwards
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
| | - Michele Coleman
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
| | - Jing Gao
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA
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Buffone F, Tarantino AG, Belloni F, Spadafora A, Bolzoni G, Bruini I, Bergna A, Vismara L. Effectiveness of Osteopathic Manipulative Treatment in Adults with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:2442. [PMID: 37685480 PMCID: PMC10487478 DOI: 10.3390/healthcare11172442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
The aim of this systematic review and meta-analysis was to evaluate the effectiveness of the osteopathic manipulative treatment (OMT) in adults with irritable bowel syndrome (IBS). A literature resview was carried out on the following databases: PubMed, Embase, Cochrane, Cinahl, Scopus, PEDro and ClinicalTrials.gov. 350 articles were recovered. Eligibility criteria were evaluated by two independent reviewers, including randomized controlled trials (RCTs), quasi-RCTs, or ongoing RCTs with OMT compared to any kind of control in patients diagnosed with IBS. Six studies (five RCTs and one ongoing RCT) were considered eligible. Four RCTs were classified as some concerns and one as high risk of bias. In the meta-analysis, OMT compared to sham/no intervention showed statistically significant results for abdominal pain (effect size ES = -1.14 [-1.66, -0.62]; p < 0.0001) and constipation (ES = -0.66 [-1.12, -0.20]; p = 0.005). Instead, OMT was not superior to the control for the IBS symptoms measured with the IBS Severity Score and the Likert scale (ES = -0.34 [-0.83, 0.16]; p = 0.19), and diarrhea (ES = -1.20 [-2.84, 0.43]; p = 0.15). The quality of evidence was "low" for IBS symptoms in general for abdominal pain and constipation, while it was judged as "very low" for diarrhea. OMT turns out to be safe in the treatment of IBS without major adverse effects. OMT may be effective in IBS patients, however the results must be interpreted carefully due to the low methodological quality of the studies.
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Affiliation(s)
- Francesca Buffone
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy; (F.B.); (A.G.T.)
- Principles and Practice of Clinical Research (PPCR), Harvard T.H. Chan School of Public Health–ECPE, Boston, MA 02115, USA
| | - Andrea Gianmaria Tarantino
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy; (F.B.); (A.G.T.)
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.B.); (A.S.); (G.B.); (A.B.)
| | - Federico Belloni
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.B.); (A.S.); (G.B.); (A.B.)
| | - Andrea Spadafora
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.B.); (A.S.); (G.B.); (A.B.)
- Intermediate Care Department, Caimi Hospital Foundation, 26019 Vailate, Italy
| | - Giorgio Bolzoni
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.B.); (A.S.); (G.B.); (A.B.)
| | - Irene Bruini
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy; (F.B.); (A.G.T.)
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.B.); (A.S.); (G.B.); (A.B.)
| | - Andrea Bergna
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.B.); (A.S.); (G.B.); (A.B.)
| | - Luca Vismara
- Division of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo-Verbania, Italy;
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Origo D, Dal Farra F, Bruni MF, Catalano A, Marzagalli L, Bruini I. Are fascial strains involved in chronic pelvic pain syndrome? An exploratory matched case-control study. Int Urol Nephrol 2023; 55:511-518. [PMID: 36522568 DOI: 10.1007/s11255-022-03448-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Chronic pelvic pain (CPP) and chronic pelvic pain syndrome (CPPS) do not have a definite cause, even if their impact on quality of life was demonstrated. Furthermore, there is evidence of myofascial dysfunctions in a large number of CPP/CPPS, so that the role of fascia can be hypothesized. METHODS The aim of this exploratory matched case-control study was to assess whether fascial strains (FS) represent a factor associated with CPP/CPPS. The study followed the "Strengthening the Reporting of Observational Studies in Epidemiology" (STROBE) statement. We collected data from 189 subjects (cases: 58; controls: 131) who attended the clinic. The participants were managed through a 2:1 enrollment ratio. A standardized booklet requested for clinical information, previous FS and the following questionnaires: "National Institutes of Health Chronic Prostatitis Symptom Index" (NIH-CPSI), "Hospital Anxiety and Depression Scale" (HADS), "Fear Avoidance Belief Questionnaire" (FABQ). Each subject underwent a palpatory assessment to detect abnormal palpatory findings in the pelvic area. RESULTS The analyses showed that episiotomy, genito-urinary infections and surgery had a significantly increased odds ratio (OR) of 4.13, 3.1 and 3.08, respectively. FS as a whole had a significantly raised OR: 2.22 (1.14 to 4.33). The analysis was adjusted for physical activity and for type of job and OR decreased to 1.94 (0.82 to 4.61), losing its significance (p = 0.129). A strong correlation between symptoms' impact and CPP/CPPS was detected (rpbs = 0.710; p < 0.001) and a moderate one (0.3 < rpbs < 0.7; p < 0.001) was found considering anxiety, depression and abnormal palpatory findings. CONCLUSION This exploratory study suggests that FS could represent an etiological factor for developing CPP/CPPS. However, further research on fascial dysfunctions and relative implications in CPP/CPPS is needed for confirmation.
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Affiliation(s)
- Daniele Origo
- Research Department, SOMA Osteopathic Institute Milan, Viale Sarca 336 F, 20126, Milan, Italy
| | - Fulvio Dal Farra
- Research Department, SOMA Osteopathic Institute Milan, Viale Sarca 336 F, 20126, Milan, Italy. .,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Maria Federica Bruni
- Research Department, SOMA Osteopathic Institute Milan, Viale Sarca 336 F, 20126, Milan, Italy
| | - Andrea Catalano
- Research Department, SOMA Osteopathic Institute Milan, Viale Sarca 336 F, 20126, Milan, Italy
| | - Lorenzo Marzagalli
- Research Department, SOMA Osteopathic Institute Milan, Viale Sarca 336 F, 20126, Milan, Italy
| | - Irene Bruini
- Research Department, SOMA Osteopathic Institute Milan, Viale Sarca 336 F, 20126, Milan, Italy
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Consorti G, Castagna C, Tramontano M, Longobardi M, Castagna P, Di Lernia D, Lunghi C. Reconceptualizing Somatic Dysfunction in the Light of a Neuroaesthetic Enactive Paradigm. Healthcare (Basel) 2023; 11:healthcare11040479. [PMID: 36833014 PMCID: PMC9957393 DOI: 10.3390/healthcare11040479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/27/2022] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Background: Palpatory findings are considered a central element of osteopathic practice, especially when associated with a patient's altered regulative functions than with named somatic dysfunctions. Although osteopathic theories for somatic dysfunction could be plausible, the clinical applicability of the concept is debated, especially because it is largely related to simple cause-effect models of osteopathic care. In contrast to a linear kind of diagnosis of a "tissue as a producer of symptoms", this perspective article aims to provide a conceptual and operational framework in which the somatic dysfunction evaluation process is seen as a neuroaesthetic (en)active encounter between osteopath and patient. Subsections relevant to the subject: To summarize all concepts of the hypothesis, the enactive neuroaesthetics principles are proposed as a critical foundation for the osteopathic assessment and treatment of the person, specifically addressing a new paradigm for somatic dysfunction. Conclusions, and future directions: The present perspective article represents a proposition to blend technical rationality informed by neurocognitive and social sciences, and professional artistry clinical experience informed by traditional tenets, to overcome the controversy around somatic dysfunction, rather than dismissing the concept.
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Affiliation(s)
- Giacomo Consorti
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
- Correspondence:
| | - Carmine Castagna
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
| | - Marco Tramontano
- Fondazione Santa Lucia Istituto di Ricovero e Cura a Carattere Scientifico, 00179 Rome, Italy
- Centre Pour l’Etude, la Recherche et la Diffusion Osteopathiques, 00199 Rome, Italy
| | | | - Paolo Castagna
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
| | - Daniele Di Lernia
- Human Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100 Milan, Italy
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He Z, Hu J, Wang Y, Cong J, Han L, Su M. Sample entropy based prescribed performance control for tailless aircraft. ISA TRANSACTIONS 2022; 131:349-366. [PMID: 35581025 DOI: 10.1016/j.isatra.2022.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 04/23/2022] [Accepted: 04/24/2022] [Indexed: 06/15/2023]
Abstract
This paper proposes a sample entropy (SampEn) based prescribed performance controller (SPPC) for the longitudinal control of a supersonic tailless aircraft subject to model uncertainty and nonlinearity. Considering that SampEn can evaluate the system's stability, a SampEn-based feedback adjust system (SFAS) is developed in this paper. With the help of SFAS, the SPPC could identify the dangerous chattering in the status signal that may lead the aircraft to lose control and make appropriate adjustments to feedback. Besides, the SPPC does not require any accurate model information and only needs to know the rough trend of dynamic functions. Although no adaptive or robust control mechanisms are introduced, the SPPC shows robustness against model uncertainty utilizing the nonlinear error feedback. Compared with traditional prescribed performance control (TPPC), the SPPC achieves better performance and safer flight. The whole control structure is developed through the backstepping technique, and the closed-loop stability is proved. At last, the advance of SPPC is verified via simulation using a high-fidelity tailless aircraft model, and the inner mechanisms of SPPC are further discussed.
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Affiliation(s)
- Zihou He
- Equipment Management and Unmanned Aerial Vehicle Engineering College, Air Force Engineering University, Xi'an, 710051, China.
| | - Jianbo Hu
- Equipment Management and Unmanned Aerial Vehicle Engineering College, Air Force Engineering University, Xi'an, 710051, China
| | - Yingyang Wang
- Equipment Management and Unmanned Aerial Vehicle Engineering College, Air Force Engineering University, Xi'an, 710051, China.
| | - Jiping Cong
- Equipment Management and Unmanned Aerial Vehicle Engineering College, Air Force Engineering University, Xi'an, 710051, China
| | - Linxiao Han
- Equipment Management and Unmanned Aerial Vehicle Engineering College, Air Force Engineering University, Xi'an, 710051, China
| | - Maoyu Su
- Equipment Management and Unmanned Aerial Vehicle Engineering College, Air Force Engineering University, Xi'an, 710051, China
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Model-Base Estimation of Non-Invasive Ventilation Weaning of Preterm Infants Exposed to Osteopathic Manipulative Treatment: A Propensity-Score-Matched Cohort Study. Healthcare (Basel) 2022; 10:healthcare10122379. [PMID: 36553903 PMCID: PMC9777985 DOI: 10.3390/healthcare10122379] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
Ventilation weaning is a key intensive care event influencing preterm infants’ discharge from a neonatal intensive care unit (NICU). Osteopathic manipulative treatment (OMT) has been recently introduced in some Italian NICUs. This retrospective cohort study tested if OMT is associated with faster non-invasive ventilation (NIV) weaning. The time to NIV weaning was assessed in very preterm and very low birth weight infants who either received or did not receive OMT. The propensity score model included gender, antenatal steroids, gestational age (GA), birth weight (BW), and Apgar score 5′. Out of 93 infants, 40 were included in the multilevel survival analysis, showing a reduction of time to NIV weaning for GA (HR: 2.58, 95%CI: 3.91 to 1.71, p < 0.001) and OMT (HR: 3.62, 95%CI: 8.13 to 1.61, p = 0.002). Time to independent ventilation (TIV) was modeled with GA and BW as dependent variables and OMT as the factor. A negative linear effect of GA and BW on TIV was shown. OMT exposure studied as the factor of GA had effects on TIV in infants born up to the 32nd gestational week. Preterm infants exposed to OMT were associated with earlier achievement of NIV weaning. This result, together with the demonstrated OMT safety, suggests the conduct of clinical trials in preterm infants younger than 32 weeks of GA.
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Postoperative Osteopathic Manipulative Treatment in Children with Esophageal Atresia: Potential Benefits on the Anthropometric Parameters. Pediatr Rep 2022; 14:434-443. [PMID: 36278555 PMCID: PMC9590049 DOI: 10.3390/pediatric14040051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 10/09/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
Esophageal atresia (EA) is a congenital malformation that affects the normal esophageal development. Surgical treatment, although restoring the integrity of the alimentary tract, may lead to long-term sequelae-like developmental abnormalities and musculoskeletal deformities. We evaluated the effects of osteopathic manipulative treatment (OMT) on the recovery of the range of the right upper limb movement and on the rise of the auxological parameters. A case series of five children affected by type C EA were described. Six OMT sessions were performed over a 4-month period. At each treatment, height, weight, body mass index (BMI) and range of motion (ROM) in elevation of the right upper limb were assessed. OMT was applied to improve scar, larynx, rib cage, and sternum mobility. An average change of 2.3 cm in height and an average increase of 8° in the ROM of the upper limb in the period of study were detected. Additionally, OMT could improve the anthropometric data and the mobility of the right upper limb of children surgically treated for EA. Further studies that evaluate the effectiveness of OMT in post surgical treatment of congenital malformations of the thorax can be considered in the future.
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Vismara L, Gianmaria Tarantino A, Bergna A, Bianchi G, Bragalini C, Billò E, Dal Farra F, Buffone F, Agosti M. Correlation between diminished vagal tone and somatic dysfunction severity in very and extremely low birth weight preterm infants assessed with frequency spectrum heart rate variability and salivary cortisol. Medicine (Baltimore) 2022; 101:e30565. [PMID: 36197184 PMCID: PMC9509086 DOI: 10.1097/md.0000000000030565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Osteopathic manipulative treatment (OMT) is evolving in the neonatal intensive care unit (NICU) setting. Studies showed its efficacy in length of stay and hospitalization costs reduction. Moreover, it was suggested that OMT has a modulatory effect on the preterm infants' autonomic nervous system (ANS), influencing saturation and heart rate. Even if OMT is based on the palpatory examination of the somatic dysfunctions (SD), there are controversies about its identification and clinical relevance. The objective of this study was to evaluate the inter-rater reliability, clinical characteristics, and functional correlation of the SD Grade score with the heart rate variability (HRV) and the salivary cortisol (sCor) using a multivariate linear model approach. To evaluate those features, we implemented an ad hoc SD examination for preterm infants that was performed by 2 trained osteopaths. It was based on the new variability model of SD that includes an SD Grade assessment procedure. The ANS features were assessed by frequency parameters of HRV studying high frequency (HF), low frequency (LF), and HF/LF, whereas sCor was tested with a radioimmunoassay. The ANS assessment was standardized and performed before SD testing. Sixty-nine premature infants were eligible. SD Grade showed excellent concordance between the blinded raters. Using SD Grade as a grouping variable, the infants presented differences in GA, Apgar, pathological findings, length of stay, and ventilatory assistance. In our multivariate model, HF, LF, and LF/HF resulted linearly correlated with SD Grade. Instead, sCor presented a linear correlation with 5' Apgar and respiratory distress syndrome but not with SD Grade. SD Grade was in line with the natural history of the underdevelopment due to prematurity. Our models indicate that the cardiac vagal tone is linearly related with SD Grade. This finding may improve the multidisciplinary decision making inside NICU and the management of modifiable factors, like SD, for cardiac vagal tone regulation.
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Affiliation(s)
- Luca Vismara
- Division of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, Piancavallo-Verbania, Italy
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy
- Department of Research, SOMA – Istituto Osteopatia Milano, Milan, Italy
- *Correspondence: Luca Vismara, Division of Neurology and Neurorehabilitation, IRCCS IstitutoAuxologico Italiano, Piancavallo-Verbania, Italy (e-mail: )
| | - Andrea Gianmaria Tarantino
- Department of Research, SOMA – Istituto Osteopatia Milano, Milan, Italy
- Woman and Child Department, Varese Hospital, Insubria University, via Ravasi 2 21100 Varese, Italy
| | - Andrea Bergna
- Woman and Child Department, Varese Hospital, Insubria University, via Ravasi 2 21100 Varese, Italy
| | - Giuliana Bianchi
- PPCR, Harvard T.H. Chan School of Public Health - ECPE, Boston, MA, USA
| | | | - Elisa Billò
- Department of Research, SOMA – Istituto Osteopatia Milano, Milan, Italy
| | - Fulvio Dal Farra
- Woman and Child Department, Varese Hospital, Insubria University, via Ravasi 2 21100 Varese, Italy
| | - Francesca Buffone
- Department of Research, SOMA – Istituto Osteopatia Milano, Milan, Italy
- Woman and Child Department, Varese Hospital, Insubria University, via Ravasi 2 21100 Varese, Italy
| | - Massimo Agosti
- PPCR, Harvard T.H. Chan School of Public Health - ECPE, Boston, MA, USA
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Arcuri L, Consorti G, Tramontano M, Petracca M, Esteves JE, Lunghi C. “What you feel under your hands”: exploring professionals’ perspective of somatic dysfunction in osteopathic clinical practice—a qualitative study. Chiropr Man Therap 2022; 30:32. [PMID: 36045398 PMCID: PMC9429724 DOI: 10.1186/s12998-022-00444-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background Despite controversy regarding its validity and clinical usefulness, manual examination findings still have an important role for manipulative therapies. As an example, somatic dysfunction (SD) remains central to osteopathic practice.This study aims to explore the experienced osteopaths' attitudes concerning SD and its role in osteopathic practice. This qualitative research could contribute to building a consistent paradigm for manual intervention in all musculoskeletal manipulations. Methods A thematic analysis with grounded theory elements was used. Data were collected through semi-structured interviews carried out between February and April 2021. A purposive sample of twenty professional osteopaths with past experience in osteopathic care was chosen to reflect the phenomenon's variety. The data analysis was done inductively and in tandem with the recruiting to keep track of data saturation. Results Eleven osteopaths participated in the study. Three main themes emerged from the data analysis: (1) SD as a safe tissue-touch-based communication tool between operator and person complex adaptive health system; (2) The treatment of SD is shareable between osteopaths, other health professionals, and the patients involved in the therapeutic pathway improving body awareness and health; (3) The development of the SD concept in research and practice to better clarify osteopathic profession identity and definition. Conclusions A panel of expert osteopaths consider the concept of SD as a valuable tool integrated into the osteopathic evaluation and treatment process. The shared concept and clinical application of SD is informed by person-centered care concepts and from the fields of neuroscience, cognitive and complexity science. Our study reports a common need among osteopaths to develop an evidence-based framework of SD to allow the best development of the osteopathic profession. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-022-00444-2.
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Beliefs and Use of Palpatory Findings in Osteopathic Clinical Practice: A Qualitative Descriptive Study among Italian Osteopaths. Healthcare (Basel) 2022; 10:healthcare10091647. [PMID: 36141259 PMCID: PMC9498689 DOI: 10.3390/healthcare10091647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
The Italian government has started the regulatory process of osteopathy to include it among the healthcare professions mentioning terms, such as “perceptual palpation” and “somatic dysfunction” within the professional profile. ‘Palpatory findings’ are one of the multidimensional aspects that can inform osteopathic clinical reasoning. The non-regulated educational system has led to heterogenic professionals working in Italy, thus, the aim of this study was to investigate how Italian experts use palpatory findings in their clinical practice. A total of 12 experts were selected to participate in four virtual focus groups. A qualitative inductive approach with a constructivist paradigm was chosen to describe the results. The themes that emerged were: osteopathic identity; evaluation; osteopathic diagnosis; and sharing with different recipients. Participants agreed on the peculiarity and distinctiveness of osteopathic palpation, but there was some disagreement on the clinical significance of the findings, highlighting a complex multidimensional approach to diagnosis and treatment. The results seem to reflect the history of the profession in Italy, which has evolved quickly, leading professionals to seek new paradigms blending tradition and scientific evidence. The authors suggest further investigation to verify the state of art among osteopaths not involved in research or a broader consensus of the results.
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Colati R, Pagano A. Effectiveness of Osteopathic Treatment on the Spinal Column as Measured by the Spinal Mouse®: A Case Series. Cureus 2022; 14:e28074. [PMID: 36127955 PMCID: PMC9477510 DOI: 10.7759/cureus.28074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction This case series aims to compare changes in spinal column mobility using the Spinal Mouse® (Idiag, Volketswil, Switzerland), a device providing a spatial survey of a single vertebra's position. The measurements have been made before and after an osteopathic treatment with different spinal column positions on healthy subjects. We presumed that osteopathic treatment is able to improve spinal column mobility. Methods The measurement was carried out with the naked spinal column in the following positions: standing, static bending, dynamic bending, and conducting the static Matthiass test, which consists of maintaining the standing position with outstretched arms, with a 1 kg weight. We evaluated the vertebral tilt degrees and changes in height (expressed in mm) in the mentioned positions before and after the osteopathic treatment. Results We observed improvements in spinal column tilt (expressed in degrees) and in vertebral metameres length (expressed in mm) in a standing position (T<0.04 and T<0.04). We also noted a global increase in tilt (expressed in degrees) during the static bending position (T<0.05) and in the thoracic tract during the Matthiass test (T<0.02). Conclusions The present study highlighted that osteopathic treatment was able to increase vertebral mobility, concerning tilt (expressed in degrees) and length (expressed in mm), evaluated in different positions.
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Buffone F, Monacis D, Tarantino AG, Dal Farra F, Bergna A, Agosti M, Vismara L. Osteopathic Treatment for Gastrointestinal Disorders in Term and Preterm Infants: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:1525. [PMID: 36011182 PMCID: PMC9408562 DOI: 10.3390/healthcare10081525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022] Open
Abstract
The aim of this systematic review and meta-analysis is to evaluate the effectiveness of osteopathic manipulative treatment (OMT) for gastrointestinal disorders in term and preterm infants. Eligible studies were searched on PubMed, Scopus, Embase, Cochrane, Cinahl, and PEDro. Two reviewers independently assessed if the studies were randomized controlled trials (RCTs) and retrospective studies with OMT compared with any kind of control in term or preterm infants to improve gastrointestinal disorders. Nine articles met the eligibility criteria, investigating OMT compared with no intervention, five involving term infants, and the remaining treating preterm infants. Five studies showed low risk of bias. In the meta-analysis, two studies were included to analyze the hours of crying due to infantile colic, showing statistically significant results (ES = −2.46 [−3.05, −1.87]; p < 0.00001). The quality of evidence was “moderate”. The other outcomes, such as time to oral feeding, meconium excretion, weight gain, and sucking, were presented in a qualitative synthesis. OMT was substantially safe, and showed efficacy in some cases, but the conflicting evidence and lack of high-quality replication studies prevent generalization. High-quality RCTs are recommended to produce better-quality evidence.
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Affiliation(s)
- Francesca Buffone
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy
- Department of Research, SOMA—Istituto Osteopatia Milano, 20126 Milan, Italy
- PPCR, Harvard T.H. Chan School of Public Health—ECPE, Boston, MA 02115, USA
| | - Domenico Monacis
- Department of Research, SOMA—Istituto Osteopatia Milano, 20126 Milan, Italy
- Department of Humanities, Literature, Cultural Heritage, Education Sciences, University of Foggia, 71122 Foggia, Italy
| | - Andrea Gianmaria Tarantino
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy
- Department of Research, SOMA—Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Fulvio Dal Farra
- Department of Research, SOMA—Istituto Osteopatia Milano, 20126 Milan, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Andrea Bergna
- Department of Research, SOMA—Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Massimo Agosti
- Woman and Child Department, Varese Hospital, Insubria University, 21100 Varese, Italy
| | - Luca Vismara
- Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, 20125 Milan, Italy
- Department of Research, SOMA—Istituto Osteopatia Milano, 20126 Milan, Italy
- Division of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy
- Department of Neurosciences, University of Torino, 10126 Torino, Italy
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Dal Farra F, Buffone F, Risio RG, Tarantino AG, Vismara L, Bergna A. Effectiveness of osteopathic interventions in patients with non-specific neck pain: A systematic review and meta-analysis. Complement Ther Clin Pract 2022; 49:101655. [PMID: 35986986 DOI: 10.1016/j.ctcp.2022.101655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/13/2022] [Accepted: 08/01/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis is to evaluate whether osteopathic manipulative interventions can reduce pain levels and enhance the functional status in patients with non-specific neck pain (NS-NP). METHODS A systematic review and meta-analysis was conducted following the 2020 PRISMA statement. Randomized controlled trials (RCTs) were searched in five databases, assessed through a standardized form, and evaluated using the "13 items Cochrane risk of bias (RoB) tool". Effect sizes (ES) were calculated post-treatment, and the quality of evidence was assessed through GRADE criteria. RESULTS Five articles were included in the review, and none of these was completely judged at low RoB. Four of these were included in the meta-analysis. Osteopathic interventions compared to no intervention/sham treatment showed statistically significant results for pain levels (ES = -1.57 [-2.50, -0.65]; P = 0.0008) and functional status (ES = -1.71 [-3.12, -0.31]; P = 0.02). The quality of evidence was "very low" for all the assessed outcomes. Other results were presented in a qualitative synthesis. CONCLUSIONS Osteopathic interventions could be effective for pain levels and functional status improvements in adults with NS-NP. However, these findings are affected by a very low quality of evidence. Therefore, further high-quality RCTs are necessary to improve the quality of evidence and generalize the results.
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Affiliation(s)
- Fulvio Dal Farra
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Francesca Buffone
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy; PPCR, Harvard T.H. Chan School of Public Health - ECPE, Boston, USA.
| | | | - Andrea Gianmaria Tarantino
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy.
| | - Luca Vismara
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy; Division of Paediatric, Manima Non-Profit Organization Social Assistance and Healthcare, Milan, Italy; Division of Neurology and Neurorehabilitation, IRCCS Istituto Auxologico Italiano, Piancavallo-Verbania, Italy; Department of Neurosciences "Rita Levi Montalcini", University of Turin, 10126, Turin, Italy.
| | - Andrea Bergna
- Department of Research, SOMA - Istituto Osteopatia Milano, Milan, Italy.
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Tissutal and Fluidic Aspects in Osteopathic Manual Therapy: A Narrative Review. Healthcare (Basel) 2022; 10:healthcare10061014. [PMID: 35742064 PMCID: PMC9222872 DOI: 10.3390/healthcare10061014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/25/2022] [Accepted: 05/29/2022] [Indexed: 12/20/2022] Open
Abstract
Over the years, several authors have discussed the possibility of considering somatic dysfunction (SD) as a “nosological element” detectable on palpation. There are many aspects to consider regarding the etiology and diagnosis of SD, and the literature on osteopathic issues provides details on physiological signs that characterize it, including tissue texture changes. Recent knowledge suggests that how tissue and, in particular, connective tissue, responds to osteopathic treatment may depend on the modulation of the inflammation degree. Low-grade inflammation (LGI) may act on the extracellular matrix (ECM) and on cellular elements; and these mechanisms may be mediated by biological water. With its molecules organized in structures called exclusion zones (EZ), water could explain the functioning of both healthy and injured tissues, and how they can respond to osteopathic treatment with possible EZ normalization as a result. The relationship between inflammation and DS and the mechanisms involved are described by several authors; however, this review suggests a new model relating to the characteristics of DS and to its clinical implications by linking to LGI. Tissue alterations detectable by osteopathic palpation would be mediated by body fluids and in particular by biological water which has well-defined biophysical characteristics. Research in this area is certainly still to be explored, but our suggestion seems plausible to explain many dynamics related to osteopathic treatment. We believe that this could open up a fascinating scenario of therapeutic possibilities and knowledge in the future.
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Effectiveness of Myofascial Manual Therapies in Chronic Pelvic Pain Syndrome: A Systematic Review and Meta-Analysis. Int Urogynecol J 2022; 33:2963-2976. [PMID: 35389057 DOI: 10.1007/s00192-022-05173-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/20/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Chronic pelvic pain syndrome (CPPS) is defined as the occurrence of chronic pelvic pain (CPP) in the absence of a specific cause. People typically refer to pain associated with urological, gynaecological, and sexual dysfunction, affecting the quality of life. Therefore, we assessed the effectiveness of myofascial manual therapies (MMT) for pain and symptom impact. METHODS A systematic review and meta-analysis were conducted. Findings were reported following the 2020 PRISMA statement. Five databases were searched for RCTs. Studies were independently assessed through a standardized form, and their internal validity was evaluated using the Cochrane risk of bias (RoB) tool. Effect sizes (ES) were calculated post-treatment, and the quality of evidence was assessed through GRADE criteria. RESULTS Seven articles were included in the review, five of these in the meta-analysis. None of these studies were completely judged at low RoB. MMT was revealed to be not significantly superior for pain reduction [ES: -0.54 (-1.16; 0.08); p = 0.09], for symptom impact [ES: -0.37 (-0.87; 0.13); p = 0.15], and for quality of life [ES: -0.44 (-1.22, 0.33), p = 0.26] compared to standard care. The quality of evidence was "very low". Other results were presented in a qualitative synthesis. CONCLUSIONS In patients with CPP/CPPS, MMT is not considered superior to other interventions for pain reduction and symptom impact improvements. However, a positive trend was detected, and we should find confirmation in the future. Further high-quality, double-blinded, sham-controlled RCTs are first necessary to confirm these positive effects and to improve the quality of evidence.
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Tramontano M, Tamburella F, Dal Farra F, Bergna A, Lunghi C, Innocenti M, Cavera F, Savini F, Manzo V, D’Alessandro G. International Overview of Somatic Dysfunction Assessment and Treatment in Osteopathic Research: A Scoping Review. Healthcare (Basel) 2021; 10:28. [PMID: 35052192 PMCID: PMC8775713 DOI: 10.3390/healthcare10010028] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/13/2021] [Accepted: 12/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Osteopathic manipulative treatment (OMT) is a patient-centred, whole-body intervention aimed at enhance the person's self-regulation. OMT interventions are focused on somatic dysfunctions (SD) that can be defined as an altered regulative function associated with inflammatory signs palpable in the body framework in different body regions. The conceptual model that sustains SD, as well as its usefulness for the osteopathic profession, is still being discussed by the osteopathic community. Understanding the role and the application of SD is the aim of this scoping review. METHODS A literature search was carried out through the main biomedical databases: Pubmed (Medline), Cochrane, Central (Cochrane), Embase, PEDro and Scopus. Grey literature was considered via Google Scholar and the Osteopathic Research Web. The review was prepared by referring to the "Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews" (PRISMA-ScR). RESULTS A total of 37,279 records were identified through database searching and other sources. After the duplicates were removed, 27,023 titles and abstracts were screened. A total of 1495 full-text articles were assessed for eligibility. The qualitative synthesis included 280 studies. CONCLUSIONS Treating SD is an important part of osteopathic practice that varies from country to country. SD should be considered as a clinical value that assists in the clinical assessment and guides the decision-making process of osteopathic practitioners. Further studies should be designed to better understand why and how to choose the different assessment and intervention modalities to approach SD and to evaluate new osteopathic models.
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Affiliation(s)
| | | | - Fulvio Dal Farra
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.D.F.); (A.B.)
| | - Andrea Bergna
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.D.F.); (A.B.)
- AISO-Associazione Italiana Scuole di Osteopatia, 65125 Pescara, Italy
| | - Christian Lunghi
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, 65121 Pescara, Italy; (C.L.); (G.D.)
| | - Mattia Innocenti
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
| | - Fabio Cavera
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
| | - Federica Savini
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
| | - Vincenzo Manzo
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
| | - Giandomenico D’Alessandro
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, 65121 Pescara, Italy; (C.L.); (G.D.)
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
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Bohlen L, Shaw R, Cerritelli F, Esteves JE. Osteopathy and Mental Health: An Embodied, Predictive, and Interoceptive Framework. Front Psychol 2021; 12:767005. [PMID: 34777176 PMCID: PMC8578726 DOI: 10.3389/fpsyg.2021.767005] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
Globally, mental and musculoskeletal disorders present with high prevalence, disease burden, and comorbidity. In order to improve the quality of care for patients with persistent physical and comorbid mental health conditions, person-centered care approaches addressing psychosocial factors are currently advocated. Central to successful person-centered care is a multidisciplinary collaboration between mental health and musculoskeletal specialists underpinned by a robust therapeutic alliance. Such a collaborative approach might be found in osteopathy, which is typically utilized to treat patients with musculoskeletal disorders but may arguably also benefit mental health outcomes. However, research and practice exploring the reputed effect of osteopathy on patients with mental health problems lack a robust framework. In this hypothesis and theory article, we build upon research from embodied cognition, predictive coding, interoception, and osteopathy to propose an embodied, predictive and interoceptive framework that underpins osteopathic person-centered care for individuals with persistent physical and comorbid mental health problems. Based on the premise that, for example, chronic pain and comorbid depression are underlined by overly precise predictions or imprecise sensory information, we hypothesize that osteopathic treatment may generate strong interoceptive prediction errors that update the generative model underpinning the experience of pain and depression. Thus, physical and mental symptoms may be reduced through active and perceptual inference. We discuss how these theoretical perspectives can inform future research into osteopathy and mental health to reduce the burden of comorbid psychological factors in patients with persistent physical symptoms and support person-centered multidisciplinary care in mental health.
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Affiliation(s)
- Lucas Bohlen
- Osteopathic Research Institute, Osteopathie Schule Deutschland, Hamburg, Germany
| | - Robert Shaw
- Scandinavian College of Osteopathy, Gothenburg, Sweden
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Ultimo, NSW, Australia
| | - Francesco Cerritelli
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Ultimo, NSW, Australia
- Clinical-based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | - Jorge E. Esteves
- Clinical-based Human Research Department, Foundation COME Collaboration, Pescara, Italy
- Research Department, University College of Osteopathy, London, United Kingdom
- International College of Osteopathic Medicine, Malta, Italy
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Bettelli L, Pisa V, Formica A. “I do it my way” - Italian osteopaths’ beliefs and attitudes about five osteopathic models: A qualitative study. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2020.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Dal Farra F, Risio RG, Vismara L, Bergna A. Effectiveness of osteopathic interventions in chronic non-specific low back pain: A systematic review and meta-analysis. Complement Ther Med 2020; 56:102616. [PMID: 33197571 DOI: 10.1016/j.ctim.2020.102616] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Chronic low back pain (CLBP) is a frequent cause of disability and it represents a medical, social and economic burden globally. Therefore, we assessed effectiveness of osteopathic interventions in the management of NS-CLBP for pain and functional status. METHODS A systematic review and meta-analysis were conducted. Findings were reported following the PRISMA statement. Six databases were searched for RCTs. Studies were independently assessed using a standardized form. Each article was assessed using the Cochrane risk of bias (RoB) tool. Effect size (ES) were calculated at post-treatment and at 12 weeks' follow up. We used GRADE to assess quality of evidence. RESULTS 10 articles were included. Studies investigated osteopathic manipulative treatment (OMT, n = 6), myofascial release (MFR, n = 2), craniosacral treatment (CST, n = 1) and osteopathic visceral manipulation (OVM, n = 1). None of the study was completely judged at low RoB. Osteopathy revealed to be more effective than control interventions in pain reduction (ES: -0.59; 95% CI: -0.81, -0.36; P < 0.00,001) and in improving functional status (ES: -0.42; 95% 95% CI: -0.68, -0.15; P = 0.002). Moderate-quality evidence suggested that MFR is more effective than control treatments in pain reduction (ES: -0.69; 95% CI: -1.05, -0.33; P = 0.0002), even at follow-up (ES: -0.73; 95% CI: -1.09, -0.37; P < 0.0001). Low-quality evidence suggested superiority of OMT in pain reduction (ES: -0.57; 95% CI: -0.90, -0.25; P = 0.001) and in changing functional status (ES: -0.34; 95% CI: -0.65, -0.03; P = 0.001). Very low-quality evidence suggested that MFR is more effective than control interventions in functional improvements (ES: -0.73; 95% CI: -1.25, -0.21; P = 0.006). CONCLUSION Results strengthen evidence that osteopathy is effective in pain levels and functional status improvements in NS-CLBP patients. MFR reported better level of evidence for pain reduction if compared to other interventions. Further high-quality RCTs, comparing different osteopathic modalities, are recommended to produce better-quality evidence.
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Affiliation(s)
- Fulvio Dal Farra
- SOMA - Istituto Osteopatia Milano, Viale Sarca 336 F, 20126 Milan, Italy.
| | | | - Luca Vismara
- SOMA - Istituto Osteopatia Milano, Viale Sarca 336 F, 20126 Milan, Italy; Division of Neurology and Neurorehabilitation, IRCCS Institute Auxologico Italiano 28824, Piancavallo-Verbania, Italy; Department of Neurosciences "Rita Levi Montalcini", University of Torino, 10126 Torino, Italy.
| | - Andrea Bergna
- SOMA - Istituto Osteopatia Milano, Viale Sarca 336 F, 20126 Milan, Italy.
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