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Talebi-Talghian T, Schulz P, Huzij T. Neuropsychiatric considerations in treating anorexia nervosa patients with osteopathic manipulative medicine: a narrative review. J Osteopath Med 2024; 0:jom-2023-0242. [PMID: 39066999 DOI: 10.1515/jom-2023-0242] [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: 11/29/2023] [Accepted: 06/28/2024] [Indexed: 07/30/2024]
Abstract
Osteopathic manipulative medicine (OMM) has a growing recognition in serving as an effective treatment to promote adaptation and homeostasis of the body by addressing musculoskeletal, neural, vascular, and lymphatic structures to promote self-healing and regulation. OMM can treat the musculoskeletal tension and sympathetic hyperactivity resulting from the increased cortisol response and hypersensitivity found in varying psychiatric illnesses, including anorexia nervosa (AN). This paper addresses the considerations necessary for treating AN patients with OMM, emphasizing the need to evaluate their abnormal high-level neuronal processing of sensory information, including differences in touch perception compared to the general population. Current literature was gathered utilizing a combination of the following keywords: anorexia nervosa, perception of touch, and osteopathic manipulative medicine/treatment. No literature was found addressing the effects of OMM on treating AN patients. Eight studies addressed the change in perception of touch found in AN patients. Results of the literature review reveal that the perceptions of touch in AN patients are distorted and can lead to reduced perceived pleasantness encountered in social interactions and touch. Specific changes have been found in C-tactile (CT) afferents responsible for the positive effects of touch, thus influencing emotional regulation. The significance of addressing this topic is to provide insight into the pathophysiological processes of AN and to inform physicians of unconventional stimuli that may exacerbate AN symptoms and behaviors. Further study is required to elucidate the role and mechanism of OMM in patients with AN and whether manual therapy could worsen pathological behavior and thinking patterns seen in AN patients. Such studies could include, but are not limited to, examining biological factors such as cortisol levels in AN patients receiving OMM and collecting data about AN patients' thinking patterns and behavior during OMM treatment.
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Affiliation(s)
- Tara Talebi-Talghian
- 149991 College of Osteopathic Medicine, Rocky Vista University , Englewood, CO, USA
| | - Paulyna Schulz
- 149991 College of Osteopathic Medicine, Rocky Vista University , Englewood, CO, USA
| | - Teodor Huzij
- Department of Osteopathic Principles and Practice, Idaho College of Osteopathic Medicine, Meridian, ID, USA
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Kerry R, Young KJ, Evans DW, Lee E, Georgopoulos V, Meakins A, McCarthy C, Cook C, Ridehalgh C, Vogel S, Banton A, Bergström C, Mazzieri AM, Mourad F, Hutting N. A modern way to teach and practice manual therapy. Chiropr Man Therap 2024; 32:17. [PMID: 38773515 PMCID: PMC11110311 DOI: 10.1186/s12998-024-00537-0] [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: 10/18/2023] [Accepted: 04/17/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Musculoskeletal conditions are the leading contributor to global disability and health burden. Manual therapy (MT) interventions are commonly recommended in clinical guidelines and used in the management of musculoskeletal conditions. Traditional systems of manual therapy (TMT), including physiotherapy, osteopathy, chiropractic, and soft tissue therapy have been built on principles such as clinician-centred assessment, patho-anatomical reasoning, and technique specificity. These historical principles are not supported by current evidence. However, data from clinical trials support the clinical and cost effectiveness of manual therapy as an intervention for musculoskeletal conditions, when used as part of a package of care. PURPOSE The purpose of this paper is to propose a modern evidence-guided framework for the teaching and practice of MT which avoids reference to and reliance on the outdated principles of TMT. This framework is based on three fundamental humanistic dimensions common in all aspects of healthcare: safety, comfort, and efficiency. These practical elements are contextualised by positive communication, a collaborative context, and person-centred care. The framework facilitates best-practice, reasoning, and communication and is exemplified here with two case studies. METHODS A literature review stimulated by a new method of teaching manual therapy, reflecting contemporary evidence, being trialled at a United Kingdom education institute. A group of experienced, internationally-based academics, clinicians, and researchers from across the spectrum of manual therapy was convened. Perspectives were elicited through reviews of contemporary literature and discussions in an iterative process. Public presentations were made to multidisciplinary groups and feedback was incorporated. Consensus was achieved through repeated discussion of relevant elements. CONCLUSIONS Manual therapy interventions should include both passive and active, person-empowering interventions such as exercise, education, and lifestyle adaptations. These should be delivered in a contextualised healing environment with a well-developed person-practitioner therapeutic alliance. Teaching manual therapy should follow this model.
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Affiliation(s)
- Roger Kerry
- School of Health Sciences, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2HA, UK
| | - Kenneth J Young
- Allied Health Research Unit, University of Central Lancashire, Preston, PR1 2HE, UK.
| | - David W Evans
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Edward Lee
- School of Health Sciences, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2HA, UK
- Nottingham CityCare Partnership, Bennerley Rd, Nottingham, NG6 8WR, UK
| | - Vasileios Georgopoulos
- School of Health Sciences, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2HA, UK
- School of Medicine, University of Nottingham, Queens Medical Centre, Nottingham, NG7 2HA, UK
| | - Adam Meakins
- Department of Orthopaedics, West Herts Hospitals Trust, Watford, WD18 0HB, UK
| | - Chris McCarthy
- School of Physiotherapy, Manchester Metropolitan University, Manchester, M15 6GX, UK
| | - Chad Cook
- Department of Orthopaedics, Duke University, 200 Morris Street, Durham, NC, 27701, USA
| | - Colette Ridehalgh
- School of Sport and Health Sciences, University of Brighton, Darley Rd, Eastbourne, BN20 7UR, UK
- Clinical Neuroscience, Trafford Building, Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX, UK
| | - Steven Vogel
- University College of Osteopathy, 275 Borough High St, London, SE1 1JE, UK
| | - Amanda Banton
- University College of Osteopathy, 275 Borough High St, London, SE1 1JE, UK
| | - Cecilia Bergström
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, S-90187, Umeå, Sweden
| | | | - Firas Mourad
- Department of health, LUNEX, Differdange, 4671, Luxembourg
- Luxembourg Health & Sport Sciences Research Institute A.s.b.l., 50, Avenue du Parc des Sports, Differdange, 4671, Luxembourg
| | - Nathan Hutting
- Department of Occupation and Health, School of Organization and Development, HAN University of Applied Sciences, Nijmegen, the Netherlands
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Hohenschurz-Schmidt D, Phalip J, Chan J, Gauhe G, Soliman N, Vollert J, Lunde SJ, Vase L. Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Eur J Pain 2024; 28:513-531. [PMID: 37985188 DOI: 10.1002/ejp.2205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/18/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND The magnitude of placebo effects from physical and psychological 'sham' is unknown but could impact efficacy trials and treatment understanding. To quantify placebo effects, this systematic review of three-armed randomised controlled trials (RCTs) of physical and psychological interventions for pain compared outcomes in 'sham' control intervention and non-exposure arms. METHODS RCTs with treatment, 'sham' control intervention, and non-exposure groups were included, enrolling adults with any pain. A protocol was pre-registered (PROSPERO: CRD42023413324), and twelve databases searched from 2008 to July 2023. Trial methods and blinding were analysed descriptively and risk of bias assessed. Meta-analysis of pain measures at short-, medium- and long-term was performed with random-effects models of standardised mean differences (SMD).Studies were sub-grouped according to control intervention type. RESULTS Seventeen RCTs were included. The average short-term placebo effect was small (0.21 SMD, 0.1-0.33 95% CI, p = 0.0002, 1440 participants). It showed no heterogeneity (Tau2 = 0.1, I2 = 11%, p = 0.3), preventing meta-regression analyses of effect modifiers. However, sub-group analyses revealed larger placebo effects in manual control interventions compared to disabled devices and miscellaneous control interventions. Overall, placebo analgesia accounted for 39% of treatments' short-term effectiveness. No placebo effects were found at medium-term (7 RCTs, 381 participants) or long-term follow-up (3 RCTs, 173 participants). CONCLUSIONS The observed placebo analgesia has mechanistic and methodological implications, though its clinical importance may be limited. Control intervention design affects placebo effects, highlighting the importance of considering methodology in RCT interpretation. Review limitations include a small number of long-term studies and sample heterogeneity. SIGNIFICANCE This systematic review directly quantifies placebo effects from physical and psychological 'sham' control interventions and compares them to treatments' overall effectiveness. By doing so, the review enhances our understanding of placebo effects, their relative contribution in clinical trials, and their susceptibly to trial design. It poses further questions regarding the influence of blinding, participant expectations, and features of the therapeutic context. Overall, the insights provided by this review carry methodological significance and are important for the interpretation and synthesis of efficacy trials in this field.
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Affiliation(s)
- David Hohenschurz-Schmidt
- Pain Research, Department of Surgery and Cancer, Imperial College London, London, UK
- Research Department, University College of Osteopathy, London, UK
| | - Jules Phalip
- Institut ANALGESIA, Faculté de Médecine, Université Clermont Auvergne, Clermont-Ferrand, France
- CHU Clermont-Ferrand, Inserm 1107 Neuro-Dol, Service de pharmacologie médicale, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jessica Chan
- Faculty of Medicine, Imperial College London, London, UK
| | - Greta Gauhe
- Centre for Dance Research, Coventry University, Coventry, UK
| | - Nadia Soliman
- Pain Research, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Jan Vollert
- Pain Research, Department of Surgery and Cancer, Imperial College London, London, UK
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Kiel, Germany
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Münster, Germany
- Neurophysiology, Mannheim Center of Translational Neuroscience (MCTN), Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Sigrid Juhl Lunde
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Lene Vase
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
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Manzotti A, Panisi C, Pivotto M, Vinciguerra F, Benedet M, Brazzoli F, Zanni S, Comassi A, Caputo S, Cerritelli F, Chiera M. An in-depth analysis of the polyvagal theory in light of current findings in neuroscience and clinical research. Dev Psychobiol 2024; 66:e22450. [PMID: 38388187 DOI: 10.1002/dev.22450] [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: 03/04/2023] [Revised: 09/04/2023] [Accepted: 12/01/2023] [Indexed: 02/24/2024]
Abstract
The polyvagal theory has led to the understanding of the functions of the autonomic nervous system in biological development in humans, since the vagal system, a key structure within the polyvagal theory, plays a significant role in addressing challenges of the mother-child dyad. This article aims to summarize the neurobiological aspects of the polyvagal theory, highlighting some of its strengths and limitations through the lens of new evidence emerging in several research fields-including comparative anatomy, embryology, epigenetics, psychology, and neuroscience-in the 25 years since the theory's inception. Rereading and incorporating the polyvagal idea in light of modern scientific findings helps to interpret the role of the vagus nerve through the temporal dimension (beginning with intrauterine life) and spatial dimension (due to the numerous connections of the vagus with various structures and systems) in the achievement and maintenance of biopsychosocial well-being, from the uterus to adulthood.
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Affiliation(s)
- Andrea Manzotti
- Division of Neonatology, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
- Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | - Cristina Panisi
- Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Micol Pivotto
- Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | | | - Matteo Benedet
- Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | | | - Silvia Zanni
- Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | - Alberto Comassi
- Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | - Sara Caputo
- Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | - Francesco Cerritelli
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | - Marco Chiera
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
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Accardi C, Cerritelli F, Bovo L, Esteves JE. The osteopath-parent-child triad in osteopathic care in the first 2 years of life: a qualitative study. Front Psychol 2023; 14:1253355. [PMID: 37849480 PMCID: PMC10577191 DOI: 10.3389/fpsyg.2023.1253355] [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: 07/05/2023] [Accepted: 09/12/2023] [Indexed: 10/19/2023] Open
Abstract
Background Enactivism and active inference are two important concepts in the field of osteopathy. While enactivism emphasizes the role of the body and the environment in shaping our experiences and understanding of the world, active inference emphasizes the role of action and perception in shaping our experiences and understanding of the world. Together, these frameworks provide a unique perspective on the practice of osteopathy, and how it can be used to facilitate positive change in patients. Since the neonatal period is a crucial time for development, osteopaths should aim to create a therapeutic relationship. Arguably, through participatory sense-making, osteopaths can help the baby build a generative model (with positive priors) to deal with stress and needs throughout their life. Aim Since the literature considers that interactions with the environment, which enact the patients' experiences, depending on contextual factors and communication between patient and caregiver, this research explored whether there is a correspondence between the indications in the literature and clinical practice in the management of the mother/parent-child dyad during osteopathic care on children aged 0 to 2 years old. Methods Semi-structured interviews were conducted with a purposive sample of nine osteopaths with experience in the field of pediatrics. Interviews were transcribed verbatim, and constructivist grounded theory was used to conceptualize, collect and analyze data. Codes and categories were actively constructed through an interpretive/constructionist paradigm. Results The core category was the idea of the pediatric osteopath as a support for the family, not only for the child. Four additional categories were identified: (1) Preparing a safe environment for both children and parents, (2) Communication, (3) Attachment and synchrony, and (4) Synchronization. Conclusion Through participatory sense-making, osteopaths manage contextual factors to establish an effective therapeutic alliance through the osteopath-parent-child triad to facilitate the construction of the child's internal generative model to promote healthy development. The therapeutic encounter is considered an encounter between embodied subjects, occurring within a field of affordances (ecological niche) that allows the interlocutors to actively participate in creating new meanings through interpersonal synchronization. Participatory sense-making and the establishment of a therapeutic alliance through the osteopath-parent-child triad are crucial to promote healthy development in the child.
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Affiliation(s)
- Caterina Accardi
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
- Malta ICOM Educational Ltd., Gzira, Malta
| | - Francesco Cerritelli
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
| | - Lorenza Bovo
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
- Malta ICOM Educational Ltd., Gzira, Malta
| | - Jorge E. Esteves
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
- Malta ICOM Educational Ltd., Gzira, Malta
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6
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Landsman ZT, Kao AR, Gerling GJ. Human-Delivered Brushstroke Characterization using an Instrumented Brush Focused on Torque. WORLD HAPTICS CONFERENCE. WORLD HAPTICS CONFERENCE 2023; 2023:85-92. [PMID: 38618516 PMCID: PMC11015477 DOI: 10.1109/whc56415.2023.10224489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Pleasant brush therapies may benefit those with autism, trauma, and anxiety. While studies monitor brushing velocity, hand-delivery of brush strokes introduces variability. Detailed measurements of human-delivered brushing physics may help understand such variability and subsequent impact on receivers' perceived pleasantness. Herein, we instrument a brush with multi-axis force and displacement sensors to measure their physics as 12 participants pleasantly stroke a receiver's forearm. Algorithmic procedures identify skin contact, and define four stages of arrival, stroke, departure, and airtime between strokes. Torque magnitude, rather than force, is evaluated as a metric to minimize inertial noise, as it registers brush bend and orientation. Overall, the results of the naturally delivered brushing experiments indicate force and velocity values in the range of 0.4 N and 3-10 cm/s, in alignment with prior work. However, we observe significant variance between brushers across velocity, force, torque, and brushstroke length. Upon further analysis, torque and force measures are correlated, yet torque provides distinct information from velocity. In evaluating the receiver's response to individual differences between brushers of the preliminary case study, higher pleasantness is tied to lower mean torque, and lower instantaneous variance over the stroke duration. Torque magnitude appears to complement velocity's influence on perceived pleasantness.
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Affiliation(s)
| | - Anika R Kao
- University of Virginia, Charlottesville, USA
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Hohenschurz-Schmidt D, Draper-Rodi J, Vase L, Scott W, McGregor A, Soliman N, MacMillan A, Olivier A, Cherian CA, Corcoran D, Abbey H, Freigang S, Chan J, Phalip J, Nørgaard Sørensen L, Delafin M, Baptista M, Medforth NR, Ruffini N, Skøtt Andresen S, Ytier S, Ali D, Hobday H, Santosa AANAA, Vollert J, Rice AS. Blinding and sham control methods in trials of physical, psychological, and self-management interventions for pain (article I): a systematic review and description of methods. Pain 2023; 164:469-484. [PMID: 36265391 PMCID: PMC9916059 DOI: 10.1097/j.pain.0000000000002723] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 05/17/2022] [Accepted: 06/12/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT Blinding is challenging in randomised controlled trials of physical, psychological, and self-management therapies for pain, mainly because of their complex and participatory nature. To develop standards for the design, implementation, and reporting of control interventions in efficacy and mechanistic trials, a systematic overview of currently used sham interventions and other blinding methods was required. Twelve databases were searched for placebo or sham-controlled randomised clinical trials of physical, psychological, and self-management treatments in a clinical pain population. Screening and data extraction were performed in duplicate, and trial features, description of control methods, and their similarity to the active intervention under investigation were extracted (protocol registration ID: CRD42020206590). The review included 198 unique control interventions, published between 2008 and December 2021. Most trials studied people with chronic pain, and more than half were manual therapy trials. The described control interventions ranged from clearly modelled based on the active treatment to largely dissimilar control interventions. Similarity between control and active interventions was more frequent for certain aspects (eg, duration and frequency of treatments) than others (eg, physical treatment procedures and patient sensory experiences). We also provide an overview of additional, potentially useful methods to enhance blinding, as well as the reporting of processes involved in developing control interventions. A comprehensive picture of prevalent blinding methods is provided, including a detailed assessment of the resemblance between active and control interventions. These findings can inform future developments of control interventions in efficacy and mechanistic trials and best-practice recommendations.
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Affiliation(s)
- David Hohenschurz-Schmidt
- Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College, Chelsea, London, United Kingdom
| | - Jerry Draper-Rodi
- Research Centre, University College of Osteopathy, London, United Kingdom
| | - Lene Vase
- Section for Psychology and Neuroscience, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus C, Denmark
| | - Whitney Scott
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- INPUT Pain Management Unit, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Alison McGregor
- Human Performance Group, Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Nadia Soliman
- Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College, Chelsea, London, United Kingdom
| | - Andrew MacMillan
- Research Centre, University College of Osteopathy, London, United Kingdom
| | - Axel Olivier
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Cybill Ann Cherian
- Chemical Engineering Department, Khalifa University, Abu Dhabi, United Arab Emirates
| | | | - Hilary Abbey
- Research Centre, University College of Osteopathy, London, United Kingdom
| | - Sascha Freigang
- Department of Neurosurgery, Medical University Graz, Graz, Austria
| | - Jessica Chan
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | | | - Lea Nørgaard Sørensen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Maite Delafin
- The Penn Clinic, Hertfordshire, Hatfield, United Kingdom
| | - Margarida Baptista
- Department of Psychology, Wolfson Centre for Age Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | - Nuria Ruffini
- National Centre Germany, Foundation C.O.M.E. Collaboration, Berlin, Germany
| | | | | | - Dorota Ali
- Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Harriet Hobday
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | - Jan Vollert
- Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College, Chelsea, London, United Kingdom
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Kiel, Germany
- Neurophysiology, Mannheim Center of Translational Neuroscience (MCTN), Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany
| | - Andrew S.C. Rice
- Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College, Chelsea, London, United Kingdom
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8
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McParlin Z, Cerritelli F, Manzotti A, Friston KJ, Esteves JE. Therapeutic touch and therapeutic alliance in pediatric care and neonatology: An active inference framework. Front Pediatr 2023; 11:961075. [PMID: 36923275 PMCID: PMC10009260 DOI: 10.3389/fped.2023.961075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 02/07/2023] [Indexed: 03/03/2023] Open
Abstract
Therapeutic affective touch has been recognized as essential for survival, nurturing supportive interpersonal interactions, accelerating recovery-including reducing hospitalisations, and promoting overall health and building robust therapeutic alliances. Through the lens of active inference, we present an integrative model, combining therapeutic touch and communication, to achieve biobehavioural synchrony. This model speaks to how the brain develops a generative model required for recovery, developing successful therapeutic alliances, and regulating allostasis within paediatric manual therapy. We apply active inference to explain the neurophysiological and behavioural mechanisms that underwrite the development and maintenance of synchronous relationships through touch. This paper foregrounds the crucial role of therapeutic touch in developing a solid therapeutic alliance, the clinical effectiveness of paediatric care, and triadic synchrony between health care practitioner, caregiver, and infant in a variety of clinical situations. We start by providing a brief overview of the significance and clinical role of touch in the development of social interactions in infants; facilitating a positive therapeutic alliance and restoring homeostasis through touch to allow a more efficient process of allostatic regulation. Moreover, we explain the role of CT tactile afferents in achieving positive clinical outcomes and updating prior beliefs. We then discuss how touch is implemented in treatment sessions to promote cooperative interactions in the clinic and facilitate theory of mind. This underwrites biobehavioural synchrony, epistemic trust, empathy, and the resolution of uncertainty. The ensuing framework is underpinned by a critical application of the active inference framework to the fields of pediatrics and neonatology.
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Affiliation(s)
- Zoe McParlin
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
| | - Francesco Cerritelli
- Division of Neonatology, “V. Buzzi” Children's Hospital, ASST-FBF-Sacco, Milan, Italy
| | - Andrea Manzotti
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
- Division of Neonatology, “V. Buzzi” Children's Hospital, ASST-FBF-Sacco, Milan, Italy
- Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Karl J Friston
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, Queen Square, London, United Kingdom
| | - Jorge E Esteves
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
- Malta ICOM Educational, Malta, Finland
- Research Department, University College of Osteopathy, Research Department, London, United Kingdom
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9
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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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10
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Dynamic touch induces autonomic changes in preterm infants as measured by changes in heart rate variability. Brain Res 2023; 1799:148169. [PMID: 36410429 DOI: 10.1016/j.brainres.2022.148169] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 08/29/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022]
Abstract
Preterm birth significantly increases the risk of developing various long-term health problems and developmental disabilities. While touch is a crucial component of many perinatal care strategies, the neurobiological underpinnings are rarely considered. C-tactile fibers (CTs) are unmyelinated nerve fibers that are activated by low-force, dynamic touch. Touch directed specifically at CTs activates the posterior insular cortex, consistent with an interoceptive function, and has been shown to reduce heart rate and increase oxygen saturation. The current research compared the effect of five minutes of CT optimal velocity stroking touch versus five minutes of static touch on autonomic markers of preterm infants between 28 and 37 weeks gestational age. CT touch induces a higher increase in heart rate variability metrics related to the parasympathetic system, which persisted for a 5-minute post-touch period. Conversely, there was no such increase in infants receiving static touch. The present findings confirmed that CTs signal the affective quality of nurturing touch, thereby arguing an additional neurobiological substrate for the evident valuable impacts of neonatal tactile interventions and improving the effectiveness of such interventions.
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11
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Kidd T, Dferevine SL, Walker SC. Affective Touch and Regulation of Stress Responses. Health Psychol Rev 2022; 17:60-77. [PMID: 36346350 DOI: 10.1080/17437199.2022.2143854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Much has been documented on the association between stress and health. Both direct and indirect pathways have been identified and explored extensively, helping us understand trajectories from healthy individuals to reductions in well-being, and development of preclinical and disease states. Some of these pathways are well established within the field; physiology, affect regulation, and social relationships. The purpose of this review is to push beyond what is known separately about these pathways and provide a means to integrate them using one common mechanism. We propose that social touch, specifically affective touch, may be the missing active ingredient fundamental to our understanding of how close relationships contribute to stress and health. We provide empirical evidence detailing how affective touch is fundamental to the development of our stress systems, critical to the development of attachment bonds and subsequent social relationships across the life course. We will also explore how we can use this in applied contexts and incorporate it into existing interventions.
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Affiliation(s)
- Tara Kidd
- School of Psychology, Liverpool John Moore University, Liverpool, U.K
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12
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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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13
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Giandomenico D, Nuria R, Alessandro A, Matteo G, Mattia I, Marco T, Francesco C. Differences between experimental and placebo arms in manual therapy trials: a methodological review. BMC Med Res Methodol 2022; 22:219. [PMID: 35941533 PMCID: PMC9358888 DOI: 10.1186/s12874-022-01704-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/04/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND To measure the specific effectiveness of a given treatment in a randomised controlled trial, the intervention and control groups have to be similar in all factors not distinctive to the experimental treatment. The similarity of these non-specific factors can be defined as an equality assumption. The purpose of this review was to evaluate the equality assumptions in manual therapy trials. METHODS Relevant studies were identified through the following databases: EMBASE, MEDLINE, SCOPUS, WEB OF SCIENCE, Scholar Google, clinicaltrial.gov, the Cochrane Library, chiloras/MANTIS, PubMed Europe, Allied and Complementary Medicine (AMED), Physiotherapy Evidence Database (PEDro) and Sciencedirect. Studies investigating the effect of any manual intervention compared to at least one type of manual control were included. Data extraction and qualitative assessment were carried out independently by four reviewers, and the summary of results was reported following the PRISMA statement. RESULT Out of 108,903 retrieved studies, 311, enrolling a total of 17,308 patients, were included and divided into eight manual therapy trials categories. Equality assumption elements were grouped in three macro areas: patient-related, context-related and practitioner-related items. Results showed good quality in the reporting of context-related equality assumption items, potentially because largely included in pre-existent guidelines. There was a general lack of attention to the patient- and practitioner-related equality assumption items. CONCLUSION Our results showed that the similarity between experimental and sham interventions is limited, affecting, therefore, the strength of the evidence. Based on the results, methodological aspects for planning future trials were discussed and recommendations to control for equality assumption were provided.
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Affiliation(s)
- D.’Alessandro Giandomenico
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy ,Centre Pour L’Etude, La Recherche Et La Diffusion Ostéopathiques “C.E.R.D.O”, 00199 Rome, Italy
| | - Ruffini Nuria
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy ,Foundation C.O.ME. Collaboration, National Centre Germany, 10825 Berlin, Germany
| | - Aquino Alessandro
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy ,grid.4708.b0000 0004 1757 2822Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Galli Matteo
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy ,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Innocenti Mattia
- Centre Pour L’Etude, La Recherche Et La Diffusion Ostéopathiques “C.E.R.D.O”, 00199 Rome, Italy
| | - Tramontano Marco
- grid.417778.a0000 0001 0692 3437Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Cerritelli Francesco
- Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, 65121 Pescara, Italy
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14
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McParlin Z, Cerritelli F, Rossettini G, Friston KJ, Esteves JE. Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Biobehavioural Synchrony in Musculoskeletal Care. Front Behav Neurosci 2022; 16:897247. [PMID: 35846789 PMCID: PMC9280207 DOI: 10.3389/fnbeh.2022.897247] [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: 03/15/2022] [Accepted: 05/24/2022] [Indexed: 12/05/2022] Open
Abstract
Touch is recognised as crucial for survival, fostering cooperative communication, accelerating recovery, reducing hospital stays, and promoting overall wellness and the therapeutic alliance. In this hypothesis and theory paper, we present an entwined model that combines touch for alignment and active inference to explain how the brain develops "priors" necessary for the health care provider to engage with the patient effectively. We appeal to active inference to explain the empirically integrative neurophysiological and behavioural mechanisms that underwrite synchronous relationships through touch. Specifically, we offer a formal framework for understanding - and explaining - the role of therapeutic touch and hands-on care in developing a therapeutic alliance and synchrony between health care providers and their patients in musculoskeletal care. We first review the crucial importance of therapeutic touch and its clinical role in facilitating the formation of a solid therapeutic alliance and in regulating allostasis. We then consider how touch is used clinically - to promote cooperative communication, demonstrate empathy, overcome uncertainty, and infer the mental states of others - through the lens of active inference. We conclude that touch plays a crucial role in achieving successful clinical outcomes and adapting previous priors to create intertwined beliefs. The ensuing framework may help healthcare providers in the field of musculoskeletal care to use hands-on care to strengthen the therapeutic alliance, minimise prediction errors (a.k.a., free energy), and thereby promote recovery from physical and psychological impairments.
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Affiliation(s)
- Zoe McParlin
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | - Francesco Cerritelli
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | | | - Karl J. Friston
- Institute of Neurology, Wellcome Centre for Human Neuroimaging, London, United Kingdom
| | - Jorge E. Esteves
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
- Malta ICOM Educational, Gzira, Malta
- University College of Osteopathy, London, United Kingdom
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15
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Osteopathic Manipulative Treatment Regulates Autonomic Markers in Preterm Infants: A Randomized Clinical Trial. Healthcare (Basel) 2022; 10:healthcare10050813. [PMID: 35627950 PMCID: PMC9141319 DOI: 10.3390/healthcare10050813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 11/24/2022] Open
Abstract
Osteopathic manipulative treatment (OMT) has been found to be effective in the context of premature infants. Nonetheless, no studies have investigated the immediate effects of OMT on heart rate variability (HRV). As altered HRV reflects poor or worsening newborn’s clinical conditions and neurodevelopment, should OMT improve HRV fluctuations, it could become a relevant intervention for improving the care of preterm newborns. Therefore, this study aimed to evaluate whether OMT could affect HRV. The study was carried out at the Buzzi Hospital in Milan. From the neonatal intensive care unit, ninety-six preterm infants (41 males) were enrolled and were randomly assigned to one of two treatment groups: OMT or Static Touch. The infants were born at 33.5 weeks (±4.3) and had a mean birth weight of 2067 g (±929). The study had as primary outcome the change in the beat-to-beat variance in heart rate measured through root mean square of consecutive RR interval differences (RMSSD); other metrics were used as secondary and exploratory analyses. Despite the lack of statistically significant results regarding the primary outcomeand some study limitations, compared to static touch, OMT seemed to favor a parasympathetic modulation and improved HRV, which could reflect improvement in newborn’s clinical conditions and development.
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16
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Esteves JE, Cerritelli F, Kim J, Friston KJ. Osteopathic Care as (En)active Inference: A Theoretical Framework for Developing an Integrative Hypothesis in Osteopathy. Front Psychol 2022; 13:812926. [PMID: 35250743 PMCID: PMC8894811 DOI: 10.3389/fpsyg.2022.812926] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/11/2022] [Indexed: 12/11/2022] Open
Abstract
Osteopathy is a person-centred healthcare discipline that emphasizes the body’s structure-function interrelationship—and its self-regulatory mechanisms—to inform a whole-person approach to health and wellbeing. This paper aims to provide a theoretical framework for developing an integrative hypothesis in osteopathy, which is based on the enactivist and active inference accounts. We propose that osteopathic care can be reconceptualised under (En)active inference as a unifying framework. Active inference suggests that action-perception cycles operate to minimize uncertainty and optimize an individual’s internal model of the lived world and, crucially, the consequences of their behaviour. We argue that (En)active inference offers an integrative framework for osteopathy, which can evince the mechanisms underlying dyadic and triadic (e.g., in paediatric care) exchanges and osteopathic care outcomes. We propose that this theoretical framework can underpin osteopathic care across the lifespan, from preterm infants to the elderly and those with persistent pain and other physical symptoms. In situations of chronicity, as an ecological niche, the patient-practitioner dyad provides the osteopath and the patient with a set of affordances, i.e., possibilities for action provided by the environment, that through shared intentionally, can promote adaptations and restoration of productive agency. Through a dyadic therapeutic relationship, as they engage with their ecological niche’s affordances—a structured set of affordances shared by agents—osteopath and patient actively construct a shared sense-making narrative and realise a shared generative model of their relation to the niche. In general, touch plays a critical role in developing a robust therapeutic alliance, mental state alignment, and biobehavioural synchrony between patient and practitioner. However, its role is particularly crucial in the fields of neonatology and paediatrics, where it becomes central in regulating allostasis and restoring homeostasis. We argue that from an active inference standpoint, the dyadic shared ecological niche underwrites a robust therapeutic alliance, which is crucial to the effectiveness of osteopathic care. Considerations and implications of this model—to clinical practice and research, both within- and outside osteopathy—are critically discussed.
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Affiliation(s)
- Jorge E. Esteves
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
- Malta ICOM Educational, Gżira, Malta
- Research Department, University College of Osteopathy, London, United Kingdom
- *Correspondence: Jorge E. Esteves,
| | - Francesco Cerritelli
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | - Joohan Kim
- Department of Communication, Yonsei University, Seoul, South Korea
| | - Karl J. Friston
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, London, United Kingdom
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17
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McParlin Z, Cerritelli F, Friston KJ, Esteves JE. Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Synchrony. Front Psychol 2022; 13:783694. [PMID: 35250723 PMCID: PMC8892201 DOI: 10.3389/fpsyg.2022.783694] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 01/19/2022] [Indexed: 12/15/2022] Open
Abstract
Recognizing and aligning individuals' unique adaptive beliefs or "priors" through cooperative communication is critical to establishing a therapeutic relationship and alliance. Using active inference, we present an empirical integrative account of the biobehavioral mechanisms that underwrite therapeutic relationships. A significant mode of establishing cooperative alliances-and potential synchrony relationships-is through ostensive cues generated by repetitive coupling during dynamic touch. Established models speak to the unique role of affectionate touch in developing communication, interpersonal interactions, and a wide variety of therapeutic benefits for patients of all ages; both neurophysiologically and behaviorally. The purpose of this article is to argue for the importance of therapeutic touch in establishing a therapeutic alliance and, ultimately, synchrony between practitioner and patient. We briefly overview the importance and role of therapeutic alliance in prosocial and clinical interactions. We then discuss how cooperative communication and mental state alignment-in intentional communication-are accomplished using active inference. We argue that alignment through active inference facilitates synchrony and communication. The ensuing account is extended to include the role of (C-) tactile afferents in realizing the beneficial effect of therapeutic synchrony. We conclude by proposing a method for synchronizing the effects of touch using the concept of active inference.
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Affiliation(s)
- Zoe McParlin
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
| | - Francesco Cerritelli
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
| | - Karl J. Friston
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, London, United Kingdom
| | - Jorge E. Esteves
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
- Malta ICOM Educational Ltd., Gzira, Malta
- Research Department, University College of Osteopathy, London, United Kingdom
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18
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Manzotti A, Cerritelli F, Lombardi E, La Rocca S, Biasi P, Chiera M, Galli M, Lista G. Newborns' clinical conditions are correlated with the neonatal assessment manual scorE (NAME). Front Pediatr 2022; 10:967301. [PMID: 36160780 PMCID: PMC9500432 DOI: 10.3389/fped.2022.967301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the relationship between the Neonatal Assessment Manual scorE (NAME) and newborns' clinical condition on a large number of infants. The NAME model was developed as an instrument to assess the infant's general conditions, especially in NICUs, by evaluating how the infant's body responds to an external stressor such as static touch. Previous studies, employing experienced assessors, showed good validity indices as well as high inter-rater reliability. STUDY DESIGN Newborns were recruited at the "Vittore Buzzi" Pediatric Hospital NICU ward in Milan and their clinical conditions were collected through a standardized form-the complexity index. Two manual practitioners assessed all eligible newborns using the NAME scores. Data was analyzed using Kendall's τ correlation and odds ratio (OR) to assess the relationship between the NAME scores and the complexity index. RESULTS Two hundred two newborns (46% female; 34.1 w ± 4.3; birth weight of 2,093.4 gr ± 879.8) entered the study. The Kendall's correlation between the clinical conditions (complexity index) and the NAME score was -0.206 [95% CI: (-0.292, -0.116), p-value < 0.001], corresponding to an OR of 0.838 [95% CI: (0.757, 0.924), p-value < 0.001]. Further exploratory analyses showed significant correlation between gestational age, birth weight and NAME scores. CONCLUSION The present paper adds evidence to the NAME model validity by demonstrating its applicability in the clinical neonatological context.
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Affiliation(s)
- Andrea Manzotti
- Research and Assistance for Infants to Support Experience (RAISE) Lab, Foundation Centre for Osteopathic Medicine (COME) Collaboration, Pescara, Italy.,Division of Neonatology, "V. Buzzi" Children's Hospital ASST-FBF-Sacco, Milan, Italy.,Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | - Francesco Cerritelli
- Research and Assistance for Infants to Support Experience (RAISE) Lab, Foundation Centre for Osteopathic Medicine (COME) Collaboration, Pescara, Italy
| | - Erica Lombardi
- Research and Assistance for Infants to Support Experience (RAISE) Lab, Foundation Centre for Osteopathic Medicine (COME) Collaboration, Pescara, Italy.,Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | - Simona La Rocca
- Research and Assistance for Infants to Support Experience (RAISE) Lab, Foundation Centre for Osteopathic Medicine (COME) Collaboration, Pescara, Italy.,Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | - Pamela Biasi
- Research and Assistance for Infants to Support Experience (RAISE) Lab, Foundation Centre for Osteopathic Medicine (COME) Collaboration, Pescara, Italy.,Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | - Marco Chiera
- Research and Assistance for Infants to Support Experience (RAISE) Lab, Foundation Centre for Osteopathic Medicine (COME) Collaboration, Pescara, Italy
| | - Matteo Galli
- Research and Assistance for Infants to Support Experience (RAISE) Lab, Foundation Centre for Osteopathic Medicine (COME) Collaboration, Pescara, Italy.,Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | - Gianluca Lista
- Division of Neonatology, "V. Buzzi" Children's Hospital ASST-FBF-Sacco, Milan, Italy
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19
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Roura S, Álvarez G, Solà I, Cerritelli F. Do manual therapies have a specific autonomic effect? An overview of systematic reviews. PLoS One 2021; 16:e0260642. [PMID: 34855830 PMCID: PMC8638932 DOI: 10.1371/journal.pone.0260642] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Background The impact of manual therapy interventions on the autonomic nervous system have been largely assessed, but with heterogeneous findings regarding the direction of these effects. We conducted an overview of systematic reviews to describe if there is a specific autonomic effect elicited by manual therapy interventions, its relation with the type of technique used and the body region where the intervention was applied. Methods We conducted an overview according to a publicly registered protocol. We searched the Cochrane Database of Systematic Reviews, MEDLINE, EPISTEMONIKOS and SCOPUS, from their inception to march 2021. We included systematic reviews for which the primary aim of the intervention was to assess the autonomic effect elicited by a manual therapy intervention in either healthy or symptomatic individuals. Two authors independently applied the selection criteria, assessed risk of bias from the included reviews and extracted data. An established model of generalisation guided the data analysis and interpretation. Results We included 12 reviews (5 rated as low risk of bias according the ROBIS tool). The findings showed that manual therapies may have an effect on both sympathetic and parasympathetic systems. However, the results from included reviews were inconsistent due to differences in their methodological rigour and how the effects were measured. The reviews with a lower risk of bias could not discriminate the effects depending on the body region to which the technique was applied. Conclusion The magnitude of the specific autonomic effect elicited by manual therapies and its clinical relevance is uncertain. We point out some specific recommendations in order to improve the quality and relevance of future research in this field.
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Affiliation(s)
- Sonia Roura
- Spain National Center, Foundation COME Collaboration, Barcelona, Spain
- * E-mail:
| | - Gerard Álvarez
- Spain National Center, Foundation COME Collaboration, Barcelona, Spain
- Iberoamerican Cochrane Centre–Biomedical Research Institute Sant Pau, IIB Sant Pau, Barcelona, Spain
| | - Ivan Solà
- Iberoamerican Cochrane Centre–Biomedical Research Institute Sant Pau, IIB Sant Pau, Barcelona, Spain
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20
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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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21
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The legacy and implications of the body-mind-spirit osteopathic tenet: A discussion paper evaluating its clinical relevance in contemporary osteopathic care. INT J OSTEOPATH MED 2021. [DOI: 10.1016/j.ijosm.2021.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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22
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Parravicini G, Ghiringhelli M. Osteopathic Cranial Manipulation for a Patient With Whiplash-Associated Disorder: A Case Report. J Chiropr Med 2021; 20:163-169. [DOI: 10.1016/j.jcm.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/12/2021] [Accepted: 12/03/2021] [Indexed: 10/18/2022] Open
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23
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Xu M, Tachibana T, Suzuki N, Hoshino E, Terasawa Y, Miki N, Minagawa Y. The effect of haptic stimulation simulating heartbeats on the regulation of physiological responses and prosocial behavior under stress: The influence of interoceptive accuracy. Biol Psychol 2021; 164:108172. [PMID: 34407425 DOI: 10.1016/j.biopsycho.2021.108172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 12/19/2022]
Abstract
Research has discovered the modulatory effect of peripheral stimulation simulating altered bodily signals on emotion. Whether such an effect varies depending on one's interoceptive accuracy (IAc) remains unclear. Therefore, we provided haptic stimulation simulating participants' slowed-down heartbeats or no stimulation while they engaged in socially stressful tasks to examine whether participants reacted differently depending on their IAc. Results showed that haptic stimulation exhibited the opposite effect on participants with different levels of IAc for both heart rate and heart rate variability (HRV). When receiving the stimulation, participants with higher IAc showed less increased heart rate and more elevated HF than participants with lower IAc. In contrast, in the absence of stimulation, an opposite pattern of response depending on participants' IAc was observed. The modulatory effect of stimuli and IAc on prosocial behavior was not significant. Individual differences in IAc were shown to affect how one perceives/responds to altered bodily signals.
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Affiliation(s)
- Mingdi Xu
- Global Research Institute, Keio University, Tokyo, Japan; Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan
| | - Takeshi Tachibana
- Department of Mechanical Engineering, Faculty of Science and Technology, Keio University, Kanagawa, Japan
| | - Nana Suzuki
- Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan
| | - Eiichi Hoshino
- Global Research Institute, Keio University, Tokyo, Japan; Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan
| | - Yuri Terasawa
- Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan
| | - Norihisa Miki
- Department of Mechanical Engineering, Faculty of Science and Technology, Keio University, Kanagawa, Japan
| | - Yasuyo Minagawa
- Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan.
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24
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Pasin Neto H, Bicalho E, Bortolazzo G. Interoception and Emotion: A Potential Mechanism for Intervention With Manual Treatment. Cureus 2021; 13:e15923. [PMID: 34336427 PMCID: PMC8312802 DOI: 10.7759/cureus.15923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 11/05/2022] Open
Abstract
Interoception is considered a perception pathway as important as the exteroceptive pathways for determining responses to maintain homeostasis. There is evidence about the influence of the interoception on emotional responses as these expressions are considered to be a combination of physical, environmental and individual beliefs. A large percentage of afferent fibers in the body are related to free nerve endings which, when stimulated, reach the insular cortex that participates in the process of emotions. The viscera afferent fibers represent 5% to 15% of all these inputs. Evidence emerges that demonstrates the importance of visceral health as part of the treatment of patients with emotional imbalances. It can be postulated that manual treatment applied to visceral fasciae can assist in interoceptive balance and have a positive impact on emotions. Therefore, the objective of the present study is to discuss the concepts of interoception, central sensitization, emotional health and visceral manual treatment.
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Affiliation(s)
- Hugo Pasin Neto
- Osteopathy, Brazilian College of Osteopathy, Sorocaba, BRA.,Physiotherapy, University of Sorocaba, Sorocaba, BRA
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Abbey H, Nanke L, Brownhill K. Developing a psychologically-informed pain management course for use in osteopathic practice: The OsteoMAP cohort study. INT J OSTEOPATH MED 2021. [DOI: 10.1016/j.ijosm.2020.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Cerritelli F, Chiacchiaretta P, Gambi F, Saggini R, Perrucci MG, Ferretti A. Osteopathy modulates brain-heart interaction in chronic pain patients: an ASL study. Sci Rep 2021; 11:4556. [PMID: 33633195 PMCID: PMC7907192 DOI: 10.1038/s41598-021-83893-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/09/2021] [Indexed: 01/31/2023] Open
Abstract
In this study we used a combination of measures including regional cerebral blood flow (rCBF) and heart rate variability (HRV) to investigate brain-heart correlates of longitudinal baseline changes of chronic low back pain (cLBP) after osteopathic manipulative treatment (OMT). Thirty-two right-handed patients were randomised and divided into 4 weekly session of OMT (N = 16) or Sham (N = 16). Participants aged 42.3 ± 7.3 (M/F: 20/12) with cLBP (duration: 14.6 ± 8.0 m). At the end of the study, patients receiving OMT showed decreased baseline rCBF within several regions belonging to the pain matrix (left posterior insula, left anterior cingulate cortex, left thalamus), sensory regions (left superior parietal lobe), middle frontal lobe and left cuneus. Conversely, rCBF was increased in right anterior insula, bilateral striatum, left posterior cingulate cortex, right prefrontal cortex, left cerebellum and right ventroposterior lateral thalamus in the OMT group as compared with Sham. OMT showed a statistically significant negative correlation between baseline High Frequency HRV changes and rCBF changes at T2 in the left posterior insula and bilateral lentiform nucleus. The same brain regions showed a positive correlation between rCBF changes and Low Frequency HRV baseline changes at T2. These findings suggest that OMT can play a significant role in regulating brain-heart interaction mechanisms.
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Affiliation(s)
- Francesco Cerritelli
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, Pescara, Italy
| | - Piero Chiacchiaretta
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,grid.412451.70000 0001 2181 4941ITAB-Institute for Advanced Biomedical Technologies, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Francesco Gambi
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,grid.412451.70000 0001 2181 4941ITAB-Institute for Advanced Biomedical Technologies, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Raoul Saggini
- grid.412451.70000 0001 2181 4941School of Specialty in Physical and Rehabilitation Medicine, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Mauro Gianni Perrucci
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,grid.412451.70000 0001 2181 4941ITAB-Institute for Advanced Biomedical Technologies, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Antonio Ferretti
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,grid.412451.70000 0001 2181 4941ITAB-Institute for Advanced Biomedical Technologies, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
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Baroni F, Ruffini N, D'Alessandro G, Consorti G, Lunghi C. The role of touch in osteopathic practice: A narrative review and integrative hypothesis. Complement Ther Clin Pract 2021; 42:101277. [PMID: 33348305 DOI: 10.1016/j.ctcp.2020.101277] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/05/2020] [Accepted: 11/18/2020] [Indexed: 12/14/2022]
Abstract
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.
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Affiliation(s)
- Francesca Baroni
- Clinical-based Human Research Department, Research Division, COME Collaboration, Pescara, Italy; Malta ICOM Educational, Malta
| | - Nuria Ruffini
- Clinical-based Human Research Department, Research Division, COME Collaboration, Pescara, Italy; National Centre Germany, Foundation C.O.ME. Collaboration, Berlin, Germany
| | | | - Giacomo Consorti
- Clinical-based Human Research Department, Research Division, COME Collaboration, Pescara, Italy; Research Department of the Centre pour L'Etude, La Recherche et La Diffusion Osteopathiques (C.E.R.D.O.), Rome, Italy.
| | - Christian Lunghi
- Clinical-based Human Research Department, Research Division, COME Collaboration, Pescara, Italy; Malta ICOM Educational, Malta
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Lunghi C, Iacopini A, Baroni F, Consorti G, Cerritelli F. Thematic Analysis of Attitudes Held by a Group of Italian Osteopaths Toward Osteopathic Evaluation, Treatment, and Management in the Neonatal and Pediatric Field: A Qualitative Study. J Manipulative Physiol Ther 2021; 44:164-175. [PMID: 33431275 DOI: 10.1016/j.jmpt.2020.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 07/18/2020] [Accepted: 07/19/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the attitudes held by a group of Italian osteopaths toward osteopathic evaluation, treatment, and management in the neonatal and pediatric field. METHODS A thematic analysis with elements of grounded-theory approaches was used. Purposive sampling was used to recruit expert osteopaths in the neonatal and pediatric field. Data were gathered from July 2017 to January 2018 by individual semistructured interviews and transcribed verbatim. A thematic analysis of the data was then performed. The Consolidated Criteria for Reporting Qualitative Research checklist was used to structure the design of this qualitative study. RESULTS Eight osteopaths participated. Data analysis generated 3 main themes: the role of the osteopath in the collaborative process of care, osteopathic diagnostic-clinical reasoning in the neonatal and pediatric field, and osteopathic treatment in the neonatal and pediatric field. CONCLUSION The present study highlights that Italian osteopaths may prefer interprofessional and integrative activities aimed at supporting adaptive capacity and resilience for pediatric patients.
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Affiliation(s)
- Christian Lunghi
- Qualitative Research Division, COME Collaboration ONLUS, Pescara, Italy; Malta ICOM Educational, San Gilijan, Malta.
| | - Alessio Iacopini
- Qualitative Research Division, COME Collaboration ONLUS, Pescara, Italy
| | - Francesca Baroni
- Qualitative Research Division, COME Collaboration ONLUS, Pescara, Italy; Malta ICOM Educational, San Gilijan, Malta
| | - Giacomo Consorti
- Qualitative Research Division, COME Collaboration ONLUS, Pescara, Italy; Research Department of the Centre pour l'Etude, la Recherche et la Diffusion Osteopathiques, Rome, Italy
| | - Francesco Cerritelli
- Clinical-Based Human Research Department, COME Collaboration ONLUS, Pescara, Italy
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Manzotti A, Cerritelli F, Lombardi E, La Rocca S, Biasi P, Chiera M, Galli M, Lista G. The Neonatal Assessment Manual scorE: A Reliability Study on Hospitalized Neonates. Front Pediatr 2021; 9:715091. [PMID: 34631618 PMCID: PMC8492991 DOI: 10.3389/fped.2021.715091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/18/2021] [Indexed: 01/20/2023] Open
Abstract
Despite clinical improvements in neonatal intensive care units (NICUs), prematurity keeps causing several comorbidities. To enhance the management of such conditions, in previous studies we devised the Neonatal Assessment Manual scorE (NAME) model, a structured touch-based assessment that aims to evaluate how newborns respond to gentle touch-based stimuli. The present study aimed to begin assessing the NAME interrater reliability and specific agreements. At the "Vittore Buzzi" Pediatric Hospital NICU ward in Milan, Italy, we enrolled 144 newborns, 85 male and 59 female, with a mean age of 35.9 weeks (±4.1) and a weight of 2,055.3 g (±750.6). Two experienced manual professionals performed the NAME procedure on all the infants. Regarding the total sample and the analysis by sex, we found moderate and statistically significant results for the interrater reliability (p < 0.001) and the specific agreements (p < 0.05), in particular for the "Marginal" score. Furthermore, interrater reliability significantly (p < 0.05) increased as age and weight increased, whereas there was an almost constant moderate and significant (p < 0.05) agreement especially for the "Marginal" score. Therefore, we found preliminary results showing that the NAME could be a reliable diagnostic tool for assessing the newborns' general condition.
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Affiliation(s)
- Andrea Manzotti
- RAISE lab, Foundation COME Collaboration, Pescara, Italy.,Division of Neonatology, Department of Pediatrics, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy.,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | | | - Erica Lombardi
- RAISE lab, Foundation COME Collaboration, Pescara, Italy.,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Simona La Rocca
- RAISE lab, Foundation COME Collaboration, Pescara, Italy.,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Pamela Biasi
- RAISE lab, Foundation COME Collaboration, Pescara, Italy.,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Marco Chiera
- RAISE lab, Foundation COME Collaboration, Pescara, Italy
| | - Matteo Galli
- RAISE lab, Foundation COME Collaboration, Pescara, Italy.,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Gianluca Lista
- Division of Neonatology, Department of Pediatrics, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy
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"Babywearing" in the NICU: An Intervention for Infants With Neonatal Abstinence Syndrome. Adv Neonatal Care 2020; 20:440-449. [PMID: 33009160 DOI: 10.1097/anc.0000000000000788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The US opioid epidemic has resulted in an increase of infants at risk for developing neonatal abstinence syndrome (NAS). Traditionally, treatment has consisted of pharmacological interventions to reduce symptoms of withdrawal. However, nonpharmacological interventions (eg, skin-to-skin contact, holding) can also be effective in managing the distress associated with NAS. PURPOSE The purpose of this study was to examine whether infant carrying or "babywearing" (ie, holding an infant on one's body using cloth) can reduce distress associated with NAS among infants and caregivers. METHODS Heart rate was measured in infants and adults (parents vs other adults) in a neonatal intensive care unit (NICU) pre- (no touching), mid- (20 minutes into being worn in a carrier), and post-babywearing (5 minutes later). RESULTS Using a 3-level hierarchical linear model at 3 time points (pre, mid, and post), we found that babywearing decreased infant and caregiver heart rates. Across a 30-minute period, heart rates of infants worn by parents decreased by 15 beats per minute (bpm) compared with 5.5 bpm for infants worn by an unfamiliar adult, and those of adults decreased by 7 bpm (parents) and nearly 3 bpm (unfamiliar adult). IMPLICATIONS FOR PRACTICE Results from this study suggest that babywearing is a noninvasive and accessible intervention that can provide comfort for infants diagnosed with NAS. Babywearing can be inexpensive, support parenting, and be done by nonparent caregivers (eg, nurses, volunteers). IMPLICATIONS FOR RESEARCH Close physical contact, by way of babywearing, may improve outcomes in infants with NAS in NICUs and possibly reduce the need for pharmacological treatment.See the video abstract for a digital summary of the study. VIDEO ABSTRACT AVAILABLE AT:.
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Devine SL, Walker SC, Makdani A, Stockton ER, McFarquhar MJ, McGlone FP, Trotter PD. Childhood Adversity and Affective Touch Perception: A Comparison of United Kingdom Care Leavers and Non-care Leavers. Front Psychol 2020; 11:557171. [PMID: 33240148 PMCID: PMC7683385 DOI: 10.3389/fpsyg.2020.557171] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 09/29/2020] [Indexed: 11/21/2022] Open
Abstract
In the United Kingdom, the most common reasons for a child to come under the care of social services are neglect and abuse. Such early childhood adversity is a risk factor for social-isolation and poor mental health in adulthood. Touch is a key channel for nurturing interactions, and previous studies have shown links between early somatosensory input, experience dependent neural plasticity, and later life emotional functioning. The aim of the present study was to test the relationship between childhood neglect/abuse and later life experiences, attitudes, and hedonic ratings of affective touch. Here, affective touch is defined as low force, dynamic touch which C-Tactile afferents (CTs) respond optimally to. We hypothesized that a childhood lacking in early nurturing tactile stimulation would be associated with reduced sensitivity to socially relevant affective touch in adulthood. To test this, 19 care leavers (average 9.32 ± 3.70 years in foster care) and 32 non-care leavers were recruited through opportunity sampling (mean age = 21.25 ± 1.74 years). Participants completed a range of psychophysical somatosensory tests. First, they rated the pleasantness of CT-optimal (3 cm/s) and non-CT-optimal (0.3 and 30 cm/s) stroking touch applied to their forearm, both robotically and by an experimenter. They also made vicarious ratings of the anticipated pleasantness of social tactile interactions depicted in a series of videos. Finally, they filled in the Childhood Trauma Questionnaire (CTQ) and the Touch Experiences and Attitudes Questionnaire (TEAQ). As expected, care leavers reported significantly higher levels of childhood trauma than the control group. They also reported significantly lower levels of positive childhood touch compared to non-care leavers, but their attitudes and experiences of current intimate and affiliative touch did not differ. Across all psychophysical tests, care leavers showed specific reduction in sensitivity to the affective value of CT targeted 3 cm/s touch. The results of this study support the hypothesis that a lack of nurturing touch in early developmental periods leads to blunted sensitivity to the specific social value of affective touch. Future research should investigate the neural and physiological mechanisms underlying the observed effect.
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Affiliation(s)
- Shaunna L Devine
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, United Kingdom
| | - Susannah C Walker
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, United Kingdom
| | - Adarsh Makdani
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, United Kingdom
| | - Elizabeth R Stockton
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, United Kingdom
| | - Martyn J McFarquhar
- Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, United Kingdom
| | - Francis P McGlone
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, United Kingdom.,Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
| | - Paula D Trotter
- Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, United Kingdom
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INYBI: A New Tool for Self-Myofascial Release of the Suboccipital Muscles in Patients With Chronic Non-Specific Neck Pain: A Randomized Controlled Trial. Spine (Phila Pa 1976) 2020; 45:E1367-E1375. [PMID: 32796456 DOI: 10.1097/brs.0000000000003605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A randomized, single-blinded (the outcome assessor was unaware of participants' allocation group) controlled clinical trial. OBJECTIVE To investigate the effects of myofascial release therapy (MRT) over the suboccipital muscles, compared with self-MRT using a novel device, the INYBI tool, on pain-related outcomes, active cervical mobility, and vertical mouth opening, in adults with chronic non-specific neck pain (NSNP). SUMMARY OF BACKGROUND DATA MRT is used to manage chronic musculoskeletal pain conditions, with purported positive effects. The efficacy of self-MRT, compared with MRT, has been scarcely evaluated. METHODS Fifty-eight participants (mean age of 34.6 ± 4.7 yrs; range 21-40 yrs; 77.6% females, 22.4% males) with persistent NSNP agreed to participate, and were equally distributed into an INYBI (n = 29) or a control group (n = 29). Both groups underwent a single 5-minutes intervention session. For participants in the control group, MRT of the suboccipital muscles was performed using the suboccipital muscle inhibition technique, while those in the INYBI group underwent a self-MRT intervention using the INYBI device. Primary measurements were taken of pain intensity (visual analogue scale), local pressure pain sensitivity, as assessed with an algometer, and active cervical range-of-movement. Secondary outcomes included pain-free vertical mouth opening. Outcomes were collected at baseline, immediately after intervention and 45 minutes later. RESULTS The analysis of variance (ANOVAs) demonstrated no significant between-groups effect for any variable (all, P > 0.05). In the within-groups comparison, all participants significantly improved pain-related outcomes, and showed similar positive changes for mouth opening. Cervical range-of-movement- mainly increased after intervention for participants in the control group. CONCLUSION Both, MRT and self-MRT using the INYBI, are equally effective to enhance self-reported pain intensity, and local pressure pain sensitivity in chronic NSNP patients. For cervical mobility, MRT appears to be slighlty superior, compared with the INYBI, to achieve improvements in this population. LEVEL OF EVIDENCE 2.
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Carnevali L, Lombardi L, Fornari M, Sgoifo A. Exploring the Effects of Osteopathic Manipulative Treatment on Autonomic Function Through the Lens of Heart Rate Variability. Front Neurosci 2020; 14:579365. [PMID: 33117124 PMCID: PMC7575744 DOI: 10.3389/fnins.2020.579365] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/17/2020] [Indexed: 11/13/2022] Open
Abstract
The osteopathic community has long hypothesized that the autonomic nervous system (ANS) represents one of the putative substrates through which osteopathic manipulative treatment (OMT) can improve body functions that have been altered by musculoskeletal alterations. Heart rate variability (HRV) is an important physiological measure of cardiac ANS activity. Emerging evidence suggests that OMT is associated with HRV changes that (i) are indicative of a larger cardiac vagal modulation, (ii) are independent from the part of the body needing treatment, (iii) occur even in the absence of musculoskeletal alterations. Yet, many questions remain unanswered, the duration of these effects and the specificity of HRV responses to different OMT techniques being perhaps the most critical. Therefore, this paper discusses prospects for future applications of HRV for the study of the influence of OMT on ANS function. Moreover, based on existing studies and preliminary data on the effects of OMT on HRV in specific pathological (hypertension) and physiological (stress exposure and recovery from sport competition) conditions that are commonly associated with increased sympathetic and/or decreased vagal activity, we propose that HRV analysis could be exploited to evaluate the effectiveness of OMT as a preventive or complementary strategy in clinical and non-clinical conditions characterized by ANS imbalance.
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Affiliation(s)
- Luca Carnevali
- Stress Physiology Lab, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
- Stress Control Lab, Collegio Italiano di Osteopatia, Parma, Italy
| | - Luca Lombardi
- Stress Control Lab, Collegio Italiano di Osteopatia, Parma, Italy
| | - Mauro Fornari
- Stress Control Lab, Collegio Italiano di Osteopatia, Parma, Italy
| | - Andrea Sgoifo
- Stress Physiology Lab, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
- Stress Control Lab, Collegio Italiano di Osteopatia, Parma, Italy
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Abstract
The fascial system, due to its enormous capacity to connect all other body systems, is currently highlighted for a better understanding of human life and health. The evolutionary theory is the most accepted explanation today to describe the development of this enormous variety of life on our planet. The report presents phylogenesis through the eyes of the fascial system. The development of the fascial system and its adaptations have made it possible to increase Homo sapiens' survival and success. We present a historical contextualization of the evolutionary theory followed by the main changes in the movement fasciae, in the transverse diaphragms, visceral fasciae, dermis, subcutaneous tissue, and neural fasciae. The article presents the evolutionary perspective with the resulting increase in efficiency with less energy expenditure.
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Affiliation(s)
- Leonardo Vieira
- Osteopathy, Brazilian Academy of Fascias, Belo Horizonte, BRA
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Potekhina Y, Filatova A, Tregubova E, Mokhov D. Mechanosensitivity of Cells and Its Role in the Regulation of Physiological Functions and the Implementation of Physiotherapeutic Effects (Review). Sovrem Tekhnologii Med 2020; 12:77-89. [PMID: 34795996 PMCID: PMC8596276 DOI: 10.17691/stm2020.12.4.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Indexed: 01/11/2023] Open
Abstract
Regulatory signals in the body are not limited to chemical and electrical ones. There is another type of important signals for cells: those are mechanical signals (coming from the environment or arising from within the body), which have been less known in the literature. The review summarizes new information on the mechanosensitivity of various cells of connective tissue and nervous system. Participation of mechanical stimuli in the regulation of growth, development, differentiation, and functioning of tissues is described. The data focus on bone remodeling, wound healing, neurite growth, and the formation of neural networks. Mechanotransduction, cellular organelles, and mechanosensitive molecules involved in these processes are discussed as well as the role of the extracellular matrix. The importance of mechanical characteristics of cells in the pathogenesis of diseases is highlighted. Finally, the possible role of mechanosensitivity in mediating the physiotherapeutic effects is addressed.
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Affiliation(s)
- Yu.P. Potekhina
- Professor, Department of Normal Physiology named after N.Y. Belenkov; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - A.I. Filatova
- Student, Faculty of Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - E.S. Tregubova
- Professor, Department of Osteopathy; North-Western State Medical University named after I.I. Mechnikov, 41 Kirochnaya St., Saint Petersburg, 191015, Russia; Associate Professor, Institute of Osteopathy; Saint Petersburg State University, 7/9 Universitetskaya naberezhnaya, Saint Petersburg, 199034, Russia
| | - D.E. Mokhov
- Head of the Department of Osteopathy; North-Western State Medical University named after I.I. Mechnikov, 41 Kirochnaya St., Saint Petersburg, 191015, Russia; Director of the Institute of Osteopathy Saint Petersburg State University, 7/9 Universitetskaya naberezhnaya, Saint Petersburg, 199034, Russia
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Cerritelli F, Cardone D, Pirino A, Merla A, Scoppa F. Does Osteopathic Manipulative Treatment Induce Autonomic Changes in Healthy Participants? A Thermal Imaging Study. Front Neurosci 2020; 14:887. [PMID: 33013294 PMCID: PMC7461826 DOI: 10.3389/fnins.2020.00887] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 07/30/2020] [Indexed: 12/27/2022] Open
Abstract
Osteopathic manipulative treatment (OMT) has been demonstrated to be an effective therapy in several clinical conditions and age groups. Despite the clinical effectiveness, lack of robust data in terms of neurobiological, specifically autonomic, mechanisms of action is observed. Preliminary studies showed a parasympathetic effect leading to a trophotropic effect of OMT. However, these data are limited to heart rate variability (HRV) analysis. In order to study further the role of OMT on the autonomic nervous system, a cross-over randomized controlled trial RCT has been designed to test the effect of osteopathic treatment compared to sham therapy on a range of autonomic parameters. Thermal images, HRV and skin conductance data were collected on a sample of healthy adults. The study design consisted of two sessions (OMT and SHAM), 1 treatment per week, lasting 35 min each, composed of 5 min of baseline, 25 min of treatment, and 5 min of post-touch. During the baseline and the post-treatment, participants received no touch. Thirty-seven participants (aged 27 ± 5 years old, male ratio 40%) completed the study. Multivariate analysis showed a significant parasympathetic effect of group as well as of epoch on thermographic data of the nose (estimate 0.38; 95% CI 0.12–0.63; p < 0.01), left (0.17; 0.06–0.27; <0.001) and right (0.16; 0.07–0.24; <0.001) perioral as well as on the forehead (0.07; 0.01–0.12; <0.01) regions but not for the chin (0.08; −0.02 to 0.18; 0.13). Consistent with a parasympathetic effect, analyses demonstrated a difference between OMT and sham groups on the nuHF (p < 0.001) and DFA-a1 (p < 0.01) as well as on skin conductance (<0.01). The present research supports the hypothesis that a single session of OMT as compared to sham induces autonomic consequences in healthy non-symptomatic adults. Clinicaltrial.gov identifier: NCT03888456, https://clinicaltrials.gov/ct2/show/NCT03888456.
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Affiliation(s)
- Francesco Cerritelli
- Clinical-based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | - Daniela Cardone
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Alessio Pirino
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Arcangelo Merla
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Fabio Scoppa
- Faculty of Medicine and Dental Surgery, Sapienza University of Rome, Rome, Italy.,Chinesis I.F.O.P. Osteopathy School, Rome, Italy
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Manzotti A, Cerritelli F, Lombardi E, La Rocca S, Chiera M, Galli M, Lista G. Effects of osteopathic treatment versus static touch on heart rate and oxygen saturation in premature babies: A randomized controlled trial. Complement Ther Clin Pract 2020; 39:101116. [PMID: 32379655 DOI: 10.1016/j.ctcp.2020.101116] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Osteopathic manipulative treatment (OMT) has been successfully tested in the context of preterm infants. No studies, however, have been conducted to investigate the OMT immediate effects on physiological measurements, such as partial oxygen saturation (SpO2) and heart rate (HR). The purpose of the present study was to assess the effect of osteopathic treatment on SpO2 and HR values and to compare it with 10 min of static touch. MATERIALS AND METHODS Ninety-six preterm infants (41 male), aged 33.5 weeks (±4.3) with mean weight at birth of 2067gr (±929) were recruited from the neonatal intensive care unit (NICU) of the Buzzi Hospital in Milan, and randomly allocated to two groups: OMT and Static Touch. Each protocol session consisted of: a) 5-min Pre-touch baseline recording, b) 10-min touch procedure, c) 5-min post-touch recording. Primary and secondary outcomes were, respectively, the baseline changes of HR and SpO2. RESULTS The 2 × 2 repeated measure ANOVA for HR showed a statistically significant effect (F (1,94) = 5.34; p < 0.02), revealing that the OMT group decreases the HR value at T2 (p = 0.006). In contrast, SpO2 analysis showed an increase of SpO2 value where the OMT group demonstrated higher values at T2 (p = 0.04). CONCLUSION Results from the present study suggest that a single osteopathic intervention may induce beneficial effects on preterm physiological parameters. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03833635 - Date: February 7, 2019.
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Affiliation(s)
- Andrea Manzotti
- RAISE Lab, Foundation COME Collaboration, Pescara, Italy; Division of Neonatology, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy; Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | | | - Erica Lombardi
- RAISE Lab, Foundation COME Collaboration, Pescara, Italy; Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Simona La Rocca
- RAISE Lab, Foundation COME Collaboration, Pescara, Italy; Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Marco Chiera
- RAISE Lab, Foundation COME Collaboration, Pescara, Italy
| | - Matteo Galli
- RAISE Lab, Foundation COME Collaboration, Pescara, Italy; Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Gianluca Lista
- Division of Neonatology, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy
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Casals-Gutiérrez S, Abbey H. Interoception, mindfulness and touch: A meta-review of functional MRI studies. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2019.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Esteves JE, Zegarra-Parodi R, van Dun P, Cerritelli F, Vaucher P. Models and theoretical frameworks for osteopathic care – A critical view and call for updates and research. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2020.01.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Cerritelli F, Chiacchiaretta P, Gambi F, Perrucci MG, Barassi G, Visciano C, Bellomo RG, Saggini R, Ferretti A. Effect of manual approaches with osteopathic modality on brain correlates of interoception: an fMRI study. Sci Rep 2020; 10:3214. [PMID: 32081945 PMCID: PMC7035282 DOI: 10.1038/s41598-020-60253-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 02/10/2020] [Indexed: 01/17/2023] Open
Abstract
The present randomised placebo controlled trial explored the extent to which osteopathic manipulative treatment (OMT) affects brain activity, particularly the insula, during both an “interoceptive awareness” and “exteroceptive awareness” task in a sample of 32 right-handed adults with chronic Low Back Pain (CLBP) randomly assigned to either the OMT or sham group. Patients received 4 weekly sessions and fMRI was performed at enrolment (T0), immediately after the first session (T1) and at 1 month (T2). The results revealed that the OMT produced a distinct and specific reduction in BOLD response in specific brain areas related to interoception, i.e., bilateral insula, ACC, left striatum and rMFG. The observed trend across the three time points appears uncharacteristic. At T1, a marginal increase of the BOLD response was observed in all the above-mentioned areas except the rMFG, which showed a decrease in BOLD response. At T2, the response was the opposite: areas related to interoception (bilateral insula and ACC) as well as the rMFG and left striatum demonstrated significant decreased in BOLD response. The findings of this study provide an insight into the effects of manual therapies on brain activity and have implications for future research in the field.
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Affiliation(s)
- Francesco Cerritelli
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,ITAB-Institute for Advanced Biomedical Technologies, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Clinical-Based Human Research Department-C.O.M.E. Collaboration ONLUS, Pescara, Italy
| | - Piero Chiacchiaretta
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy. .,ITAB-Institute for Advanced Biomedical Technologies, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.
| | - Francesco Gambi
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,ITAB-Institute for Advanced Biomedical Technologies, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Mauro Gianni Perrucci
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,ITAB-Institute for Advanced Biomedical Technologies, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Giovanni Barassi
- Department of Medical Oral and Biotechnological Science, "Gabriele d'Annunzio" University, Chieti-Pescara, Italy
| | - Christian Visciano
- Department of Medical Oral and Biotechnological Science, "Gabriele d'Annunzio" University, Chieti-Pescara, Italy
| | | | - Raoul Saggini
- Department of Medical Oral and Biotechnological Science, "Gabriele d'Annunzio" University, Chieti-Pescara, Italy
| | - Antonio Ferretti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,ITAB-Institute for Advanced Biomedical Technologies, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
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Mothers’ and fathers’ early tactile contact behaviors during triadic and dyadic parent-infant interactions immediately after birth and at 3-months postpartum: Implications for early care behaviors and intervention. Infant Behav Dev 2019; 57:101347. [DOI: 10.1016/j.infbeh.2019.101347] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 02/02/2023]
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Effects of Osteopathic Visceral Treatment in Patients with Gastroesophageal Reflux: A Randomized Controlled Trial. J Clin Med 2019; 8:jcm8101738. [PMID: 31635110 PMCID: PMC6832476 DOI: 10.3390/jcm8101738] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 02/07/2023] Open
Abstract
Osteopathic manual treatment has been recommended as a non-pharmacological therapy for Gastroesophageal Reflux Disease (GERD). However, to date, no study has supported the effectiveness of this intervention with respect to the symptoms of the disease. Our goal was to assess the effect of an osteopathic manual technique for the lower esophageal sphincter on GERD symptoms, cervical mobility and on the C4 spinous process pressure pain threshold (PPTs). METHODS A randomized, double-blind placebo-controlled trial was performed. Sixty subjects suffering from GERD participated in this study and were randomly assigned to either an experimental group (EG) (n = 29), who received the osteopathic technique for the lower esophageal sphincter, or to a control group (CG) (n = 31), who received a manual contact, which mimicked the osteopathic technique without exerting any therapeutic force. Randomization was computer-generated, with allocation concealed by sequentially numbered, opaque, sealed envelopes. The GerdQ questionnaire was used to assess symptom changes the week after intervention. Cervical Range of Motion (CROM) and algometer were used to evaluate cervical mobility and PPTs before and after both treatments. Before-after between groups comparison (t-test) was used for statistical analysis of the outcome, with two measurement points (GerdQ), while repeated-measures ANOVA was used for those outcomes with four measurement points (CROM and PPT). RESULTS The application of the osteopathic manual treatment in subjects with GERD produced a significant improvement in symptoms one week after the intervention (p = 0.005) with a between-groups difference of 1.49 points in GerdQ score (95% CI: 0.47-2.49). PPT C4 improved in the EG after the treatment (p = 0.034; η2 = 0.048) (between-groups difference 8.78 Newton/cm2; 95% CI: 0.48-17.09). CROM also increased in the EG compared to the CG (p < 0.001; η2 = 0.108) (between-groups difference 33.89 degrees; 95% CI: 15.17-52.61). CONCLUSIONS The manual osteopathic technique produces an improvement in GERD symptoms one week after treatment, cervical mobility, and PPTs. This may mean that osteopathic treatment is useful for improving symptoms of GERD.
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Manzotti A, Cerritelli F, Esteves JE, Lista G, Lombardi E, La Rocca S, Gallace A, McGlone FP, Walker SC. Dynamic touch reduces physiological arousal in preterm infants: A role for c-tactile afferents? Dev Cogn Neurosci 2019; 39:100703. [PMID: 31487608 PMCID: PMC6969366 DOI: 10.1016/j.dcn.2019.100703] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/27/2019] [Accepted: 08/19/2019] [Indexed: 01/08/2023] Open
Abstract
Preterm birth is a significant risk factor for a range of long-term health problems and developmental disabilities. Though touch plays a central role in many perinatal care strategies, the neurobiological basis of these approaches is seldom considered. C-Tactile afferents (CTs) are a class of unmyelinated nerve fibre activated by low force, dynamic touch. Consistent with an interoceptive function, touch specifically targeted to activate CTs activates posterior insular cortex and has been reported to reduce autonomic arousal. The present study compared the effect of 5 min of CT optimal velocity stroking touch to 5 min of static touch on the heart-rate and oxygen saturation levels of preterm infants between 28- & 37-weeks gestational age. CT touch produced a significant decrease in infants' heart-rates and increase in their blood oxygenation levels, which sustained throughout a 5-min post-touch period. In contrast, there was no significant change in heart-rate or blood oxygenation levels of infants receiving static touch. These findings provide support for the hypothesis that CTs signal the affective quality of nurturing touch, providing a neurobiological substrate for the apparent beneficial effects of neonatal tactile interventions and offering insight for their optimisation.
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Affiliation(s)
- Andrea Manzotti
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy; Division of Neonatology, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy; Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Francesco Cerritelli
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy.
| | - Jorge E Esteves
- Gulf National Centre, Foundation COME Collaboration, Riyadh, Saudi Arabia; MYO Osteopathy, Riyadh, Saudi Arabia; University College of Osteopathy, London, UK; Instituto Piaget, Lisbon, Portugal
| | - Gianluca Lista
- Division of Neonatology, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy
| | - Erica Lombardi
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy; Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Simona La Rocca
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy; Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Alberto Gallace
- Department of Psychology and Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Milan, Italy
| | - Francis P McGlone
- Research Centre for Brain & Behaviour, School of Natural Sciences & Psychology, Liverpool John Moores University, UK; Institute of Psychology, Health & Society, University of Liverpool, UK
| | - Susannah C Walker
- Research Centre for Brain & Behaviour, School of Natural Sciences & Psychology, Liverpool John Moores University, UK
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Marinelli B, Pluchinotta F, Cozzolino V, Barlafante G, Strozzi MC, Marinelli E, Franchini S, Gazzolo D. Osteopathic Manipulation Treatment Improves Cerebro-splanchnic Oximetry in Late Preterm Infants. Molecules 2019; 24:molecules24183221. [PMID: 31487945 PMCID: PMC6767098 DOI: 10.3390/molecules24183221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/22/2019] [Accepted: 08/27/2019] [Indexed: 12/18/2022] Open
Abstract
Background: To evaluate the effectiveness/side-effects of osteopathic manipulation treatment (OMT) performed on the 7th post-natal day, on cerebro-splanchnic oximetry, tissue activation and hemodynamic redistribution in late preterm (LP) infants by using near infrared spectroscopy (NIRS). Methods: Observational pretest-test study consisting in a cohort of 18 LPs who received OMT on the 7th post-natal day. NIRS monitoring was performed at three different time-points: 30 min before (T0), (30 min during (T1) and 30 min after OMT (T2). We evaluated the effects of OMT on the following NIRS parameters: cerebral (c), splanchnic (s) regional oximetry (rSO2), cerebro-splanchnic fractional tissue oxygen extraction (FTOE) and hemodynamic redistribution (CSOR). Results: crSO2 and cFTOE significantly (P < 0.001) improved at T0-T2; srSO2 significantly (P < 0.001) decreased and sFTOE increased at T0-T1. Furthermore, srSO2 and sFTOE significantly improved at T1-T2. Finally, CSOR significantly (P < 0.05) increased at T0-T2. Conclusions: The present data show that OMT enhances cerebro-splanchnic oximetry, tissue activation and hemodynamic redistribution in the absence of any adverse clinical or laboratory pattern. The results indicate the usefulness of further randomized studies in wider populations comparing the effectiveness of OMT with standard rehabilitation programs.
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Affiliation(s)
- Benedetta Marinelli
- Department, Italian Academy of Traditional Osteopathy (AIOT), 65100 Pescara, Italy
| | - Francesca Pluchinotta
- Laboratory Research, Department of Paediatric Cardiovascular Surgery, San Donato Milanese University Hospital, 20097 San Donato, Italy
| | - Vincenzo Cozzolino
- Department, Italian Academy of Traditional Osteopathy (AIOT), 65100 Pescara, Italy
| | - Gina Barlafante
- Department, Italian Academy of Traditional Osteopathy (AIOT), 65100 Pescara, Italy
| | - Maria Chiara Strozzi
- Department of Maternal, Fetal and Neonatal Medicine, C. Arrigo Children's Hospital, 15121 Alessandria, Italy
| | - Eleonora Marinelli
- Department, Italian Academy of Traditional Osteopathy (AIOT), 65100 Pescara, Italy
| | - Simone Franchini
- Neonatal Intensive Care Unit G. D'Annunzio University of Chieti, 66100 Chieti, Italy
| | - Diego Gazzolo
- Department of Maternal, Fetal and Neonatal Medicine, C. Arrigo Children's Hospital, 15121 Alessandria, Italy.
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Multimodal Neurological Enhancement Intervention for Self-regulation in Premature Infants. Adv Neonatal Care 2019; 19:E3-E11. [PMID: 30946037 DOI: 10.1097/anc.0000000000000595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The neonatal intensive care unit is often a noisy, overstimulating environment that disrupts infants' regulation of physiological and behavioral states and interrupts caregiver bonding; however, infants benefit from early intervention, including the use of multimodal neurological enhancement (MMNE) intervention to provide appropriate neurodevelopmental stimulation. No one has investigated whether it assists infants in self-regulation. PURPOSE The purpose of this retrospective longitudinal analysis was to examine the effect of a music therapy intervention, MMNE, on self-regulation of premature infants as measured by changes in heart rate (HR). METHODS A convenience sample of 60 premature infants received 486 MMNE sessions provided by a board-certified music therapist (MT-BC). Documentation, taken during routine clinical services, involved recording infant's HRs from the standard monitor for 3 minutes at baseline, during, and after a 20-minute MMNE intervention. RESULTS Infants' mean HRs were decreased during and post-MMNE sessions compared with baseline (P < .004 and P < .001, respectively). Furthermore, infants with a baseline HR above 170 had significant decreases both during and after the MMNE session (P < .001 for both time periods). IMPLICATIONS FOR PRACTICE Results of this study support the existing body of evidence showing the benefits of MMNE with premature infants. Based on our results, MMNE may help infants develop and demonstrate self-regulation as indicated by maintained HRs during and after the intervention as well as a lowered HR for infants who had high HRs prior to MMNE. IMPLICATIONS FOR RESEARCH Further research needs to be done regarding how infants process MMNE and its potential to aid sensory processing.
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Are the antidepressive effects of massage therapy mediated by restoration of impaired interoceptive functioning? A novel hypothetical mechanism. Med Hypotheses 2019; 128:28-32. [DOI: 10.1016/j.mehy.2019.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/11/2019] [Accepted: 05/10/2019] [Indexed: 12/20/2022]
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48
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Edwards DJ, Young H, Cutis A, Johnston R. The Immediate Effect of Therapeutic Touch and Deep Touch Pressure on Range of Motion, Interoceptive Accuracy and Heart Rate Variability: A Randomized Controlled Trial With Moderation Analysis. Front Integr Neurosci 2018; 12:41. [PMID: 30297988 PMCID: PMC6160827 DOI: 10.3389/fnint.2018.00041] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 09/06/2018] [Indexed: 12/20/2022] Open
Abstract
Background: There is paucity in the literature regarding the role of the interoceptive pathway through the insular cortex (IC), as well as heart rate variability (HRV) in relation to Osteopathic Manipulative Therapy (OMT) and deep-touch. Aims: The present study investigated whether both OMT treatment and deep-touch (a newly hypothesized treatment option) was effective at altering the interoceptive pathway and HRV, whilst OMT was only expected to be effective for increasing Range of Motion (ROM). Methods: Thirty-five healthy volunteers were randomly allocated into three conditions in a repeated measures crossover design; a control (laying supine on a plinth); deep-touch (head cradling); and an osteopathic mobilization therapeutic technique on the temporomandibular joint (TMJ). Interoceptive accuracy (IAc), HRV, as well as range of motion (ROM) for the TMJ area as well as the cervical spine (Csp) right and left measures were taken pre and post each condition setting. Results: Significant condition effects emerged from the deep-touch and mobilization interventions for IAc where increases were identified through planned comparisons. For the HRV measure (RMSSD), a significant effect emerged in the deep-touch condition (increase) but not in the mobilization or control conditions. ROM did not increase for any condition. IAc correlated with post-ROM outcomes in many cases and HRV moderated some of these relations. Conclusion: These results are discussed in the context of clinical practice, where cranial deep-touch maybe an effective treatment and modulator of the parasympathetic nervous systems, as well as the interoceptive system.
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Affiliation(s)
- Darren J Edwards
- Department of Interprofessional Health Studies, Swansea University, Swansea, United Kingdom
| | - Hayley Young
- Department of Psychology, Swansea University, Swansea, United Kingdom
| | - Annabel Cutis
- Department of Interprofessional Health Studies, Swansea University, Swansea, United Kingdom
| | - Ross Johnston
- Department of Interprofessional Health Studies, Swansea University, Swansea, United Kingdom
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A Proposed Molecular Mechanism for Physical Analgesia in Chronic Pain. Neural Plast 2018; 2018:1260285. [PMID: 29887879 PMCID: PMC5985137 DOI: 10.1155/2018/1260285] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 03/22/2018] [Accepted: 03/27/2018] [Indexed: 12/20/2022] Open
Abstract
Although pain is indispensable for survival, chronic pain places a heavy burden on humans. As the efficacy of opioid treatment is limited, the development of alternative methods of pain relief without medication is desirable. Recently, we have developed a novel method of physical analgesia using an adhesive “pyramidal thorn patch.” When we apply about 3 trials of these patches on the skin of a pain region, the pain region moves toward the spinal cord like a “cutaneous rabbit,” and finally, the pain vanishes. In the present review, we propose a molecular mechanism for this analgesic method or pain relief following application of the pyramidal thorn patch where firstly the mechanoreceptors and their related nerves under the skin are activated in response to touch. Transient receptor potential (TRP) channels serve as mechanosensitive channels within these mechanoreceptors. We further propose that activation of the nerves connected with the mechanoreceptors releases oxytocin, which has an antinociceptive function and activates TRP channels to hyperpolarize the pain signal nerves. We believe that our system will pave the way for alternative pain treatment.
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Mantis I, Mercuri M, Stack DM, Field TM. Depressed and non-depressed mothers' touching during social interactions with their infants. Dev Cogn Neurosci 2018; 35:57-65. [PMID: 29422337 PMCID: PMC6968954 DOI: 10.1016/j.dcn.2018.01.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 12/03/2017] [Accepted: 01/22/2018] [Indexed: 12/02/2022] Open
Abstract
Depressed mothers engage in less touching that is playful and interactive in nature. Depressed mothers touch their infants less during face-to-face interactions. Nondepressed mothers maintain high levels of touch following a perturbation period. Depressed mothers decrease playful/stimulating touch after a perturbation period. Implications for intervention programs of early touch stimulation for at-risk dyads.
Touch is a critical channel of communication used by mothers to communicate and interact with their infants and to contribute to their infants’ socio-emotional development. The present study examined maternal touching in 41 mothers with and without depressive symptomatology. Mothers and their 4-month-old infants participated in the Still-Face (maternal emotional unavailability) and Separation (maternal physical unavailability) procedures. Maternal touching behaviours were video-recorded and coded using the Caregiver Infant Touch Scale (CITS). Results indicated that mothers with higher levels of depressive symptoms engaged in less touching following the perturbation period in the Still-Face procedure, whereas mothers with lower levels of depressive symptoms maintained stable levels of touching across both interaction periods. Mothers with higher levels of depressive symptoms displayed less playful/stimulating types of touching. Taken together, these results underscore the importance of touch and suggest key differences in touching behaviour between dyads with maternal depressive symptomatology and those without.
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Affiliation(s)
- Irene Mantis
- Department of Psychology, Concordia University, Centre for Research in Human Development, Canada.
| | - Marisa Mercuri
- Department of Psychology, Concordia University, Centre for Research in Human Development, Canada
| | - Dale M Stack
- Department of Psychology, Concordia University, Centre for Research in Human Development, Canada.
| | - Tiffany M Field
- Touch Research Institute, University of Miami School of Medicine, United States
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