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Delgadillo BE, Bui A, Debski AM, Miller B, Wu DO SS. Efficacy of Osteopathic Manipulative Treatment for Pain Reduction in Patients With Patellofemoral Pain Syndrome: A Meta-Analysis of Randomized Controlled Trials. Cureus 2024; 16:e59439. [PMID: 38826947 PMCID: PMC11140634 DOI: 10.7759/cureus.59439] [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: 04/15/2024] [Accepted: 04/30/2024] [Indexed: 06/04/2024] Open
Abstract
Patellofemoral pain syndrome (PFPS) is among the most common causes of musculoskeletal pain in the United States. It is defined as retropatellar or peripatellar pain that is reproduced with functional activities that load the patellofemoral joint in a flexed position, such as stair climbing or squatting. While it presents in both adolescents and adults, it is commonly found in physically active individuals, such as athletes and military recruits. Exploring the role of osteopathic manipulative treatment (OMT) in PFPS is of particular interest given the absence of a definitive treatment and the poor long-term prognosis associated with PFPS. This meta-analysis includes three studies exploring the use of OMT to reduce pain in patients suffering from PFPS and exploring the efficacy of OMT as a primary intervention. In these studies, pain assessments, pre-treatment, and post-treatment follow-up of at least 30 days were performed using a 10-cm visual analog scale (VAS). The mean difference in pain between OMT and no treatment (NT) groups using the random effects model was -3.95 (-6.39; -1.50) with a p<0.01, suggesting OMT resulted in significant knee pain reduction in those with PFPS. A measure of heterogeneity, known as I2, was found to be high at 97%, which suggests caution should be taken when interpreting the overall results. Given the lack of definitive treatment and the poor long-term prognosis for PFPS, the authors suggest OMT provides an effective option for pain relief in patients with PFPS. Further research is needed to provide results that may be more clinically applicable or valuably interpreted.
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Affiliation(s)
- Blake E Delgadillo
- Orthopaedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Audrey Bui
- Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Alyssa M Debski
- Anatomy, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Brooke Miller
- Urology, Lake Erie College of Osteopathic Medicine, Bradenton, USA
| | - Shan Shan Wu DO
- Allergy/Immunology, Allergy/Immunology Associates, Inc., Mayfield Heights, USA
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Stoll V, Jost JM, Jack A, Johnson T, Klein S, Darbhanga J, Hurwitz A, Mehra RS, Waters HB. Non-steroidal Anti-inflammatory Drugs and Osteopathic Manipulative Treatment for Pain Management in Patients With Osteoarthritis: A Literature Review. Cureus 2023; 15:e44168. [PMID: 37753003 PMCID: PMC10519647 DOI: 10.7759/cureus.44168] [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: 05/18/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
The pathophysiology of osteoarthritis (OA) involves the destruction of articular cartilage and the overgrowth of bone with lipping and spur formation. Nerve endings in the joint capsule and adjacent tissues play a major role in the pain mechanisms of osteoarthritis. This often requires patients to seek pain control measures beyond over-the-counter drugs, such as local anesthetics. Osteopathic manipulation treatment (OMT) is a conservative, non-pharmacological treatment that can be used to help treat chronic pain associated with OA. Other non-pharmacologic therapies include weight loss, exercise, physical therapy (PT), and assistive devices. However, pharmacologic management may be added synergistically to control flares and maintain baseline activities of daily living. While oral non-steroidal anti-inflammatory drugs (NSAIDs) have been the mainstay of treatment for pain and inflammation associated with OA, they have a non-selective inhibitory action that often results in negative side effects when used chronically. The possibility of minimizing these complications through alternate treatments such as topical NSAIDs provides an opportunity for patients to receive adequate pain relief from OA without suffering unnecessary consequences. This literature review seeks to assess the state of research regarding topical NSAIDs and OMT as alternatives to the current gold-standard treatment of OA. The significant inclusion criteria consisted of articles that described the effects of OMT on OA or the use of topical NSAIDs such as Voltaren on OA. Due to the limited articles found, a qualitative analysis was performed, and the salient conclusions are outlined. Alternative pharmacological and non-pharmacological treatments, such as topical diclofenac gel and OMT, have shown promising results in the treatment of pain in OA. It is seen that a majority of patients achieve pain management using NSAIDs, acetaminophen, or topical analgesics. Both diclofenac sodium and OMT have individually been shown to be effective treatments of OA when compared to the use of oral NSAIDs. A holistic treatment approach that utilizes both topical diclofenac sodium and OMT may provide OA patients with an effective option to reduce their moderate to severe chronic pain with limited side effects. Further, high-quality randomized controlled trials are needed to identify whether synergistic effects occur when combining diclofenac sodium gel and OMT for pain relief in patients with OA.
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Affiliation(s)
- Veenah Stoll
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Jennifer M Jost
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Allyson Jack
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Timothy Johnson
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Sarah Klein
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Jake Darbhanga
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Adam Hurwitz
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Rohit S Mehra
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Holly B Waters
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
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Arcuri L, Consorti G, Tramontano M, Petracca M, Esteves JE, Lunghi C. “What you feel under your hands”: exploring professionals’ perspective of somatic dysfunction in osteopathic clinical practice—a qualitative study. Chiropr Man Therap 2022; 30:32. [PMID: 36045398 PMCID: PMC9429724 DOI: 10.1186/s12998-022-00444-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background Despite controversy regarding its validity and clinical usefulness, manual examination findings still have an important role for manipulative therapies. As an example, somatic dysfunction (SD) remains central to osteopathic practice.This study aims to explore the experienced osteopaths' attitudes concerning SD and its role in osteopathic practice. This qualitative research could contribute to building a consistent paradigm for manual intervention in all musculoskeletal manipulations. Methods A thematic analysis with grounded theory elements was used. Data were collected through semi-structured interviews carried out between February and April 2021. A purposive sample of twenty professional osteopaths with past experience in osteopathic care was chosen to reflect the phenomenon's variety. The data analysis was done inductively and in tandem with the recruiting to keep track of data saturation. Results Eleven osteopaths participated in the study. Three main themes emerged from the data analysis: (1) SD as a safe tissue-touch-based communication tool between operator and person complex adaptive health system; (2) The treatment of SD is shareable between osteopaths, other health professionals, and the patients involved in the therapeutic pathway improving body awareness and health; (3) The development of the SD concept in research and practice to better clarify osteopathic profession identity and definition. Conclusions A panel of expert osteopaths consider the concept of SD as a valuable tool integrated into the osteopathic evaluation and treatment process. The shared concept and clinical application of SD is informed by person-centered care concepts and from the fields of neuroscience, cognitive and complexity science. Our study reports a common need among osteopaths to develop an evidence-based framework of SD to allow the best development of the osteopathic profession. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-022-00444-2.
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Ruffini N, D’Alessandro G, Pimpinella A, Galli M, Galeotti T, Cerritelli F, Tramontano M. The Role of Osteopathic Care in Gynaecology and Obstetrics: An Updated Systematic Review. Healthcare (Basel) 2022; 10:healthcare10081566. [PMID: 36011223 PMCID: PMC9408311 DOI: 10.3390/healthcare10081566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/30/2022] [Accepted: 08/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Many efforts are made to find safer and more feasible therapeutic strategies to improve gynaecological care. Non-pharmacological treatments, such as osteopathic interventions, could be used as complementary strategies to better manage different gynaecological conditions. This review aims to report the effectiveness of osteopathic treatment in the gynaecology and obstetrics field, updating the previous review published in 2016. The secondary aim was to elucidate the role of somatic dysfunction (SD) in osteopathic assessment and treatment procedures, as well as their health and economic implications. Methods: An electronic search was conducted in the following databases: Embase, MEDLINE (PubMed), and Science direct. All types of clinical studies published between May 2014 and December 2021 have been included: randomised controlled trial (RCT), controlled before/after, interrupted time series quasi RCT, case controls, case reports, case series, observational, clinical studies involving any type of osteopathic treatment, (standardised, semi-standardised or patients’ need-based treatment) performed alone or in combination with other treatments, were included). Results: A total of 76,750 were identified through database searching and other sources. After the removal of duplicates, 47,655 papers were screened based on title and abstract. A total of 131 full-text articles were consequently assessed for eligibility. Twenty-one new articles were included in the synthesis. A total of 2632 participants with a mean age of 28.9 ± 10.5 years were included in the review. Conclusions: Results showed an effectiveness of osteopathic care in gynaecology and obstetrics, but the studies were too heterogeneous to perform quantitative analysis and make clinical recommendations. Nevertheless, osteopathic care could be considered a safe complementary approach to traditional gynaecological care.
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Affiliation(s)
- Nuria Ruffini
- National Centre Germany, Foundation COME Collaboration, 10825 Berlin, Germany
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy
| | - Giandomenico D’Alessandro
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65121 Pescara, Italy
| | - Annalisa Pimpinella
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy
| | - Matteo Galli
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65121 Pescara, Italy
- Research Department, SOMA, Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Tiziana Galeotti
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy
| | - Francesco Cerritelli
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65121 Pescara, Italy
- Correspondence:
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A Content Analysis of Osteopaths’ Attitudes for a More Inclusive Clinical Practice towards Transgender People. Healthcare (Basel) 2022; 10:healthcare10030562. [PMID: 35327040 PMCID: PMC8953530 DOI: 10.3390/healthcare10030562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/21/2022] [Accepted: 03/15/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives. The aim of this qualitative study was to explore the attitudes, beliefs, and preferences of Italian osteopaths regarding the management of transgender patients through a content analysis of emergent data from semi-structured interviews. Methods. This study was a content analysis based on the Standards for Reporting Qualitative Research guidelines. Purposive sampling of 10 Italian osteopaths was applied. Data were collected through semi-structured interviews, from March to April 2021, and subsequently transcribed verbatim with the content analysis carried out as an iterative process. Results. One participant was excluded during the first interview due to them being unsuitable for this study. Data saturation was reached after two interviews with the remaining nine participants. Data analysis revealed four main themes: microaggressions, acceptance and non-judgement, person-centered treatment, and education implementation. Conclusions. This study presents cisgender Italian osteopaths’ attitudes in the care of transgender people, revealing the desire to embrace and apply osteopathic tenets regardless of the patient’s gender identity.
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Lunghi C, Baroni F, Amodio A, Consorti G, Tramontano M, Liem T. Patient Active Approaches in Osteopathic Practice: A Scoping Review. Healthcare (Basel) 2022; 10:healthcare10030524. [PMID: 35327002 PMCID: PMC8955940 DOI: 10.3390/healthcare10030524] [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: 01/24/2022] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 12/20/2022] Open
Abstract
Background: In the field of manual therapies there is a growing interest in moving from passive hands-on approaches to patient active approaches. In the osteopathic field there are both active and passive methods described as integrated in the process of care. However, this prospective linkage has not been formally explored and is not well shared in the community of practice. The present review aims to appraise the relevant literature on the functioning and principles of Patient active osteopathic approaches (PAOAs) and explore a prospective model for selecting the different types of PAOA, highlighting their integration into patient management strategies. Methods: A scoping review was conducted to analyze the relevant literature on the functioning and the different principles of PAOA and to obtain a comprehensive perspective on the phenomenon. Results: The eligible articles provide insights into the mechanisms of functioning and principles of application of active approaches to be integrated with hands-on approaches. These results provide new insights into the relevance of PAOA to clinical practice. Conclusions: The proposal, emerging from the review, may promote discussions in the community of practice and provide a road map for research towards achieving an evidence-based structure for PAOA.
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Affiliation(s)
- Christian Lunghi
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65100 Pescara, Italy; (C.L.); (G.C.)
- Research Department, Osteopathie Schule Deutschland, 22297 Hamburg, Germany;
| | - Francesca Baroni
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65100 Pescara, Italy; (C.L.); (G.C.)
- Correspondence:
| | | | - Giacomo Consorti
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65100 Pescara, Italy; (C.L.); (G.C.)
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
| | - Marco Tramontano
- Centre Pour l’Etude, la Recherche et la Diffusion Osteopathiques, 00199 Rome, Italy;
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Torsten Liem
- Research Department, Osteopathie Schule Deutschland, 22297 Hamburg, Germany;
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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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Neurogenic Bowel Dysfunction Changes after Osteopathic Care in Individuals with Spinal Cord Injuries: A Preliminary Randomized Controlled Trial. Healthcare (Basel) 2022; 10:healthcare10020210. [PMID: 35206825 PMCID: PMC8871877 DOI: 10.3390/healthcare10020210] [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: 12/09/2021] [Revised: 01/14/2022] [Accepted: 01/20/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Neurogenic bowel dysfunction (NBD) indicates bowel dysfunction due to a lack of nervous control after a central nervous system lesion. Bowel symptoms, such as difficulties with evacuation, constipation, abdominal pain and swelling, are experienced commonly among individuals with spinal cord injury (SCI). Consequentially, individuals with SCI experience a general dissatisfaction with the lower perceived quality of life (QoL). Several studies have demonstrated the positive effects of manual therapies on NBD, including Osteopathic Manipulative Treatment (OMT). This study aimed to explore OMT effects on NBD in individuals with SCI compared with Manual Placebo Treatment (MPT). Methods: The study was a double-blind randomized controlled trial composed of three phases, each one lasting 30 days (i: NBD/drugs monitoring; ii: four OMT/MPT sessions; iii: NBD/drug monitoring and follow-up evaluation). Results: the NBD scale, the QoL on worries and concerns sub-questionnaire, and the perception of abdominal swelling and constipation significantly improved after treatments compared to baseline only for individuals who underwent OMT. Conclusion: These preliminary results showed positive effects of OMT on bowel function and QoL in individuals with SCI, but further studies are needed to confirm our results.
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Tramontano M, Tamburella F, Dal Farra F, Bergna A, Lunghi C, Innocenti M, Cavera F, Savini F, Manzo V, D’Alessandro G. International Overview of Somatic Dysfunction Assessment and Treatment in Osteopathic Research: A Scoping Review. Healthcare (Basel) 2021; 10:28. [PMID: 35052192 PMCID: PMC8775713 DOI: 10.3390/healthcare10010028] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/13/2021] [Accepted: 12/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Osteopathic manipulative treatment (OMT) is a patient-centred, whole-body intervention aimed at enhance the person's self-regulation. OMT interventions are focused on somatic dysfunctions (SD) that can be defined as an altered regulative function associated with inflammatory signs palpable in the body framework in different body regions. The conceptual model that sustains SD, as well as its usefulness for the osteopathic profession, is still being discussed by the osteopathic community. Understanding the role and the application of SD is the aim of this scoping review. METHODS A literature search was carried out through the main biomedical databases: Pubmed (Medline), Cochrane, Central (Cochrane), Embase, PEDro and Scopus. Grey literature was considered via Google Scholar and the Osteopathic Research Web. The review was prepared by referring to the "Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews" (PRISMA-ScR). RESULTS A total of 37,279 records were identified through database searching and other sources. After the duplicates were removed, 27,023 titles and abstracts were screened. A total of 1495 full-text articles were assessed for eligibility. The qualitative synthesis included 280 studies. CONCLUSIONS Treating SD is an important part of osteopathic practice that varies from country to country. SD should be considered as a clinical value that assists in the clinical assessment and guides the decision-making process of osteopathic practitioners. Further studies should be designed to better understand why and how to choose the different assessment and intervention modalities to approach SD and to evaluate new osteopathic models.
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Affiliation(s)
| | | | - Fulvio Dal Farra
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.D.F.); (A.B.)
| | - Andrea Bergna
- Research Department, SOMA Istituto Osteopatia Milano, 20126 Milan, Italy; (F.D.F.); (A.B.)
- AISO-Associazione Italiana Scuole di Osteopatia, 65125 Pescara, Italy
| | - Christian Lunghi
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, 65121 Pescara, Italy; (C.L.); (G.D.)
| | - Mattia Innocenti
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
| | - Fabio Cavera
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
| | - Federica Savini
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
| | - Vincenzo Manzo
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
| | - Giandomenico D’Alessandro
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, 65121 Pescara, Italy; (C.L.); (G.D.)
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy; (M.I.); (F.C.); (F.S.); (V.M.)
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Baroni F, Tramontano M, Barsotti N, Chiera M, Lanaro D, Lunghi C. Osteopathic structure/function models renovation for a person-centered approach: a narrative review and integrative hypothesis. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 0:jcim-2021-0430. [PMID: 34758518 DOI: 10.1515/jcim-2021-0430] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES The construct of the osteopathic structure-function models is reported as a cornerstone of clinical reasoning and treatment processes. Nevertheless, there are no shared procedures described for their use in clinical practice. The present narrative review aims to analyze a more comprehensive perspective on the phenomenon. METHODS A structured narrative review was conducted. A database search was conducted using Pubmed, ScienceDirect, and Google Scholar. Peer-reviewed papers without specifying limits on dates and design were included. RESULTS Twenty-five findings were reported and grouped into two main themes: 1) Debate on models and theoretical frameworks for osteopathic care; 2) Clinical reasoning and decision-making process in the osteopathic field. CONCLUSIONS An integrated osteopathic care approach based on the structure/function models represents a starting point to establish a shared osteopathic diagnostic and clinical reasoning and an evidence-informed practice promoting health in an interdisciplinary person-centered care process. The present review highlights the limited amount of literature on using osteopathic conceptual models in decision-making and treatment strategies. A research plan is required to develop a common framework for an evidence-based osteopathic practice that promotes well-being in an interdisciplinary person-centered care process.
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Affiliation(s)
- Francesca Baroni
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, Pescara, Italy
| | | | - Nicola Barsotti
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, Pescara, Italy
- Research Commission on Manual Therapies and Mind-Body Disciplines, Società Italiana di Psico Neuro Endocrino Immunologia, Rome, Italy
| | - Marco Chiera
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, Pescara, Italy
- Research Commission on Manual Therapies and Mind-Body Disciplines, Società Italiana di Psico Neuro Endocrino Immunologia, Rome, Italy
| | - Diego Lanaro
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, Pescara, Italy
- Research Commission on Manual Therapies and Mind-Body Disciplines, Società Italiana di Psico Neuro Endocrino Immunologia, Rome, Italy
| | - Christian Lunghi
- Clinical-Based Human Research Department, Research Division, Foundation COME Collaboration, Pescara, Italy
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Hohenschurz-Schmidt D, Vollert J, Vogel S, Rice ASC, Draper-Rodi J. Performing and interpreting randomized clinical trials. J Osteopath Med 2021; 121:443-445. [PMID: 33694340 DOI: 10.1515/jom-2020-0320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 12/29/2020] [Indexed: 01/10/2023]
Affiliation(s)
| | - Jan Vollert
- Dept. of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Steven Vogel
- Research Centre, University College of Osteopathy, London, UK
| | - Andrew S C Rice
- Dept. of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
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Tramontano M, Lunghi C, Pagnotta S, Manzo C, Manzo F, Consolo S, Manzo V. Response to a letter to editor from Hohenschurz-Schmidt et al. J Osteopath Med 2021; 121:447-448. [PMID: 33694355 DOI: 10.1515/jom-2021-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/10/2021] [Indexed: 11/15/2022]
Affiliation(s)
| | | | - Simone Pagnotta
- Centre Pour l'Etude, la Recherche et la Diffusion Osteopathiques, Rome, Italy
| | - Camilla Manzo
- Centre Pour l'Etude, la Recherche et la Diffusion Osteopathiques, Rome, Italy
| | - Francesca Manzo
- Centre Pour l'Etude, la Recherche et la Diffusion Osteopathiques, Rome, Italy
| | - Stefano Consolo
- Centre Pour l'Etude, la Recherche et la Diffusion Osteopathiques, Rome, Italy
| | - Vincenzo Manzo
- Centre Pour l'Etude, la Recherche et la Diffusion Osteopathiques, Rome, Italy
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Shi W, Li Y, Xiong B, Du M. Diagnosis of Patellofemoral Pain Syndrome Based on a Multi-Input Convolutional Neural Network With Data Augmentation. Front Public Health 2021; 9:643191. [PMID: 33643997 PMCID: PMC7902860 DOI: 10.3389/fpubh.2021.643191] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/19/2021] [Indexed: 01/10/2023] Open
Abstract
Patellofemoral pain syndrome (PFPS) is a common disease of the knee. Despite its high incidence rate, its specific cause remains unclear. The artificial neural network model can be used for computer-aided diagnosis. Traditional diagnostic methods usually only consider a single factor. However, PFPS involves different biomechanical characteristics of the lower limbs. Thus, multiple biomechanical characteristics must be considered in the neural network model. The data distribution between different characteristic dimensions is different. Thus, preprocessing is necessary to make the different characteristic dimensions comparable. However, a general rule to follow in the selection of biomechanical data preprocessing methods is lacking, and different preprocessing methods have their own advantages and disadvantages. Therefore, this paper proposes a multi-input convolutional neural network (MI-CNN) method that uses two input channels to mine the information of lower limb biomechanical data from two mainstream data preprocessing methods (standardization and normalization) to diagnose PFPS. Data were augmented by horizontally flipping the multi-dimensional time-series signal to prevent network overfitting and improve model accuracy. The proposed method was tested on the walking and running datasets of 41 subjects (26 patients with PFPS and 15 pain-free controls). Three joint angles of the lower limbs and surface electromyography signals of seven muscles around the knee joint were used as input. MI-CNN was used to automatically extract features to classify patients with PFPS and pain-free controls. Compared with the traditional single-input convolutional neural network (SI-CNN) model and previous methods, the proposed MI-CNN method achieved a higher detection sensitivity of 97.6%, a specificity of 76.0%, and an accuracy of 89.0% on the running dataset. The accuracy of SI-CNN in the running dataset was about 82.5%. The results prove that combining the appropriate neural network model and biomechanical analysis can establish an accurate, convenient, and real-time auxiliary diagnosis system for PFPS to prevent misdiagnosis.
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Affiliation(s)
- Wuxiang Shi
- College of Physics and Information Engineering, Fuzhou University, Fuzhou, China.,Fujian Key Laboratory of Medical Instrumentation & Pharmaceutical Technology, Fuzhou University, Fuzhou, China
| | - Yurong Li
- Fujian Key Laboratory of Medical Instrumentation & Pharmaceutical Technology, Fuzhou University, Fuzhou, China
| | - Baoping Xiong
- Fujian Key Laboratory of Medical Instrumentation & Pharmaceutical Technology, Fuzhou University, Fuzhou, China.,Department of Mathematics and Physics, Fujian University of Technology, Fuzhou, China
| | - Min Du
- College of Physics and Information Engineering, Fuzhou University, Fuzhou, China.,Fujian Key Laboratory of Medical Instrumentation & Pharmaceutical Technology, Fuzhou University, Fuzhou, China.,Fujian Provincial Key Laboratory of Eco-Industrial Green Technology, Wuyi University, Wuyishan, China
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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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Tramontano M, Consorti G, Morone G, Lunghi C. Vertigo and Balance Disorders - The Role of Osteopathic Manipulative Treatment: A Systematic Review. Complement Med Res 2020; 28:368-377. [PMID: 33361695 DOI: 10.1159/000512673] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/28/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Balance disorders are among the most frequent reasons for consultation and referral to specialist care. Osteopathic Manipulative Treatment (OMT) can influence the proprioceptive system by inducing alterations in the proprioceptive stimuli, hence affecting postural control. OBJECTIVE The present systematic review aimed to explore the effects of OMT in managing patients with vertigo and balance disorders. METHODS MEDLINE (PubMed), ScienceDirect, and Google Scholar were searched. Clinical trials and prospective observational studies were considered. Only studies that considered OMT as the main intervention, provided alone or combined with other interventions, were included. The methodological quality of the evidence was assessed with a modified version of the Newcastle-Ottawa Scale. RESULTS Five studies that enrolled a total of 114 subjects met our inclusion criteria. Overall, it has been observed that there is a positive effect on balance disorders through different outcomes in all of the included studies. Only two studies (9 subjects) mentioned low to moderate adverse events after OMT. CONCLUSIONS OMT showed weak positive effects on balance function, encouraging the connection of conventional medicine and evidence-based complementary medicine for integrative clinical practice and interprofessional work. However, full-sized adequately powered randomized trials are required to determine the effectiveness of OMT for vertigo and balance disorders.
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Affiliation(s)
| | - Giacomo Consorti
- Clinical-Based Human Research Department, Centre for Osteopathic Medicine Collaboration, Pescara, Italy.,Educational Department of Osteopathy, Istituto Superiore Osteopatia, Milan, Italy
| | | | - Christian Lunghi
- Clinical-Based Human Research Department, Centre for Osteopathic Medicine Collaboration, Pescara, Italy
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Brain Connectivity Changes after Osteopathic Manipulative Treatment: A Randomized Manual Placebo-Controlled Trial. Brain Sci 2020; 10:brainsci10120969. [PMID: 33322255 PMCID: PMC7764238 DOI: 10.3390/brainsci10120969] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/01/2020] [Accepted: 12/07/2020] [Indexed: 11/21/2022] Open
Abstract
The effects of osteopathic manipulative treatment (OMT) on functional brain connectivity in healthy adults is missing in the literature. To make up for this lack, we applied advanced network analysis methods to analyze resting state functional magnetic resonance imaging (fMRI) data, after OMT and Placebo treatment (P) in 30 healthy asymptomatic young participants randomized into OMT and placebo groups (OMTg; Pg). fMRI brain activity measures, performed before (T0), immediately after (T1) and three days after (T2) OMT or P were used for inferring treatment effects on brain circuit functional organization. Repeated measures ANOVA and post-hoc analysis demonstrated that Right Precentral Gyrus (F (2, 32) = 5.995, p < 0.005) was more influential over the information flow immediately after the OMT, while decreased betweenness centrality in Left Caudate (F (2, 32) = 6.496, p < 0.005) was observable three days after. Clustering coefficient showed a distinct time-point and group effect. At T1, reduced neighborhood connectivity was observed after OMT in the Left Amygdala (L-Amyg) (F (2, 32) = 7.269, p < 0.005) and Left Middle Temporal Gyrus (F (2, 32) = 6.452, p < 0.005), whereas at T2 the L-Amyg and Vermis-III (F (2, 32) = 6.772, p < 0.005) increased functional interactions. Data demonstrated functional connectivity re-arrangement after OMT.
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Dal Farra F, Risio RG, Vismara L, Bergna A. Effectiveness of osteopathic interventions in chronic non-specific low back pain: A systematic review and meta-analysis. Complement Ther Med 2020; 56:102616. [PMID: 33197571 DOI: 10.1016/j.ctim.2020.102616] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Chronic low back pain (CLBP) is a frequent cause of disability and it represents a medical, social and economic burden globally. Therefore, we assessed effectiveness of osteopathic interventions in the management of NS-CLBP for pain and functional status. METHODS A systematic review and meta-analysis were conducted. Findings were reported following the PRISMA statement. Six databases were searched for RCTs. Studies were independently assessed using a standardized form. Each article was assessed using the Cochrane risk of bias (RoB) tool. Effect size (ES) were calculated at post-treatment and at 12 weeks' follow up. We used GRADE to assess quality of evidence. RESULTS 10 articles were included. Studies investigated osteopathic manipulative treatment (OMT, n = 6), myofascial release (MFR, n = 2), craniosacral treatment (CST, n = 1) and osteopathic visceral manipulation (OVM, n = 1). None of the study was completely judged at low RoB. Osteopathy revealed to be more effective than control interventions in pain reduction (ES: -0.59; 95% CI: -0.81, -0.36; P < 0.00,001) and in improving functional status (ES: -0.42; 95% 95% CI: -0.68, -0.15; P = 0.002). Moderate-quality evidence suggested that MFR is more effective than control treatments in pain reduction (ES: -0.69; 95% CI: -1.05, -0.33; P = 0.0002), even at follow-up (ES: -0.73; 95% CI: -1.09, -0.37; P < 0.0001). Low-quality evidence suggested superiority of OMT in pain reduction (ES: -0.57; 95% CI: -0.90, -0.25; P = 0.001) and in changing functional status (ES: -0.34; 95% CI: -0.65, -0.03; P = 0.001). Very low-quality evidence suggested that MFR is more effective than control interventions in functional improvements (ES: -0.73; 95% CI: -1.25, -0.21; P = 0.006). CONCLUSION Results strengthen evidence that osteopathy is effective in pain levels and functional status improvements in NS-CLBP patients. MFR reported better level of evidence for pain reduction if compared to other interventions. Further high-quality RCTs, comparing different osteopathic modalities, are recommended to produce better-quality evidence.
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Affiliation(s)
- Fulvio Dal Farra
- SOMA - Istituto Osteopatia Milano, Viale Sarca 336 F, 20126 Milan, Italy.
| | | | - Luca Vismara
- SOMA - Istituto Osteopatia Milano, Viale Sarca 336 F, 20126 Milan, Italy; Division of Neurology and Neurorehabilitation, IRCCS Institute Auxologico Italiano 28824, Piancavallo-Verbania, Italy; Department of Neurosciences "Rita Levi Montalcini", University of Torino, 10126 Torino, Italy.
| | - Andrea Bergna
- SOMA - Istituto Osteopatia Milano, Viale Sarca 336 F, 20126 Milan, Italy.
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