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Rören A, Yagappa DM, Zegarra-Parodi R, Fabre L, Krief G, Daste C, Lefèvre-Colau MM, Rannou F, Nguyen C. Responsiveness to osteopathic manipulative treatments in people with non-specific low back pain: A secondary analysis of the LCOSTEO trial. Ann Phys Rehabil Med 2024; 67:101831. [PMID: 38518521 DOI: 10.1016/j.rehab.2024.101831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 01/17/2024] [Accepted: 02/12/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Alexandra Rören
- AP-HP.Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 75014 Paris, France; INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique, ECaMO Team, 75014 Paris, France; Fédération pour la Recherche sur le Handicap et l'Autonomie, 75013 Paris, France.
| | - Didier Marie Yagappa
- AP-HP.Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 75014 Paris, France
| | - Rafael Zegarra-Parodi
- A.T. Still Research Institute, A.T. Still University, Kirksville, MO, USA; HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences Fribourg, Switzerland
| | - Laurent Fabre
- HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences Fribourg, Switzerland
| | - Guillaume Krief
- HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences Fribourg, Switzerland
| | - Camille Daste
- AP-HP.Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 75014 Paris, France; Université Paris Cité, Faculté de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMRS-1153, Centre de Recherche Épidémiologie et Statistique, METHODS Team, 75004 Paris, France
| | - Marie-Martine Lefèvre-Colau
- AP-HP.Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 75014 Paris, France; INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique, ECaMO Team, 75014 Paris, France; Fédération pour la Recherche sur le Handicap et l'Autonomie, 75013 Paris, France; Université Paris Cité, Faculté de Santé, UFR de Médecine, 75006 Paris, France
| | - François Rannou
- AP-HP.Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 75014 Paris, France; Fédération pour la Recherche sur le Handicap et l'Autonomie, 75013 Paris, France; Université Paris Cité, Faculté de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMRS-1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France
| | - Christelle Nguyen
- AP-HP.Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 75014 Paris, France; Université Paris Cité, Faculté de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMRS-1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France
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Tuscano SC, Haxton J, Ciardo A, Ciullo L, Zegarra-Parodi R. The Revisions of the First Autobiography of AT Still, the Founder of Osteopathy, as a Step towards Integration in the American Healthcare System: A Comparative and Historiographic Review. Healthcare (Basel) 2024; 12:130. [PMID: 38255019 PMCID: PMC10815194 DOI: 10.3390/healthcare12020130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION Osteopathy was originally introduced in rural America in 1874 as a comprehensive therapeutic approach aimed at promoting health. This approach was distinct and often conflicting with conventional/allopathic therapeutic methods available at that time to fight disease. We argue that, in struggling to achieve recognition within the American healthcare system and within the educational academic field that was about to be structured, the American osteopathic profession tried to protect itself from the charges of sectarism by starting to embrace principles of the biomedical paradigm. METHODS A comparative and historiographic review of the second version of the autobiography of AT Still (1908), the founder of osteopathy, against the first (1897) was chosen as an example of the adaptation of the American osteopathic profession to its evolving academic environment. RESULTS Although there were only a few substantial variations, we argue that they aimed to dampen the non-biological components of osteopathy, namely, its philosophical, spiritual, religious, emotional, and Native American roots, in an effort to gain respect and recognition within the emerging gold standard of the Western medical system. The shift towards a distinct, fully integrated profession within regulated Western healthcare systems was perceived by many professionals as a threat to AT Still's original ideas, and the trend started when he was alive. CONCLUSION Our findings suggest that a crucial conversation regarding the future of the professional identity must take place within the osteopathic community.
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Affiliation(s)
- Silvia Clara Tuscano
- Istituto Europeo per la Medicina Osteopatica (IEMO), 16122 Genova, Italy; (S.C.T.); (L.C.)
| | - Jason Haxton
- Museum of the Osteopathic Medicine, Kirksville, MO 63501, USA;
| | - Antonio Ciardo
- Grupo Thuban-Fundación Europea de Medicina Tradicional Complementaria e Integrativa (FEMTCI), 28028 Madrid, Spain;
- Facultad de Ciencias de la Salud, Universidad Europea del Atlántico, 39011 Santander, Spain
| | - Luigi Ciullo
- Istituto Europeo per la Medicina Osteopatica (IEMO), 16122 Genova, Italy; (S.C.T.); (L.C.)
| | - Rafael Zegarra-Parodi
- BMS Formation, 75116 Paris, France
- A.T. Still Research Institute, Kirksville, MO 63501, USA
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Baroni F, Schleip R, Arcuri L, Consorti G, D’Alessandro G, Zegarra-Parodi R, Vitali AM, Tramontano M, Lunghi C. Functional Neuromyofascial Activity: Interprofessional Assessment to Inform Person-Centered Participative Care-An Osteopathic Perspective. Healthcare (Basel) 2023; 11:2886. [PMID: 37958030 PMCID: PMC10667998 DOI: 10.3390/healthcare11212886] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Introduction: Health professionals and bodyworkers may be pivotal in promoting prevention programs, providing tailored advice and guidance to patients' adherence to self-care strategies, such as physical activity. Contemporary evidence encourages manual therapists to involve patients in decision-making and treatment procedures integrating passive and active approaches in treatment planning. This manuscript provides a definition and applications of neuromyofascial movement patterns, discusses the significance of functional assessment, and gives an example of clinical applications in the osteopathic field to highlight how this assessment can promote interdisciplinarity. Methods: The reporting framework used in the current manuscript followed guidelines for writing a commentary. Results: The manuscript highlights the crucial role that the neuromyofascial system plays in human movement and overall well-being and the importance of a functional neuromyofascial activity assessment in the context of person-centered participative care. Conclusions: Understanding individual neuromyofascial patterns could help healthcare practitioners, movement specialists, and bodyworkers in tailoring treatment plans, meeting patients' unique needs, and promoting a more effective personalized approach to care. The current perspective could spark debates within the professional community and provide a research roadmap for developing an evidence-informed interprofessional framework.
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Affiliation(s)
- Francesca Baroni
- BMS Formation, 75116 Paris, France; (F.B.); (C.L.)
- Osteopatia Lunghi-Baroni Private Practice, 00146 Rome, Italy
| | - Robert Schleip
- Department of Sport and Health Sciences, Conservative and Rehabilitative Orthopedics, Technical University of Munich, 80333 Munich, Germany;
| | - Lorenzo Arcuri
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65121 Pescara, Italy
| | - Giacomo Consorti
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
| | - Giandomenico D’Alessandro
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65121 Pescara, Italy
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy
| | | | | | - Marco Tramontano
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40126 Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40126 Bologna, Italy
| | - Christian Lunghi
- BMS Formation, 75116 Paris, France; (F.B.); (C.L.)
- Osteopatia Lunghi-Baroni Private Practice, 00146 Rome, Italy
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Zegarra-Parodi R, Baroni F, Lunghi C, Dupuis D. Historical Osteopathic Principles and Practices in Contemporary Care: An Anthropological Perspective to Foster Evidence-Informed and Culturally Sensitive Patient-Centered Care: A Commentary. Healthcare (Basel) 2022; 11:healthcare11010010. [PMID: 36611470 PMCID: PMC9818574 DOI: 10.3390/healthcare11010010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Historical osteopathic principles and practices (OPP)-considering the patient as a dynamic interaction of the body, mind, and spirit and incorporating the body's self-healing ability into care-are inherited from traditional/complementary and alternative (CAM) principles. Both concepts are familiar to contemporary osteopathic practitioners, but their incorporation into healthcare for evidence-informed, patient-centered care (PCC) remains unclear. Further, a polarity exists in the osteopathic profession between a 'traditional-minded' group following historical OPP despite evidence against those models and an 'evidence-minded' group following the current available evidence for common patient complaints. By shifting professional practices towards evidence-based practices for manual therapy in line with the Western dominant biomedical paradigm, the latter group is challenging the osteopathic professional identity. To alleviate this polarity, we would like to refocus on patient values and expectations, highlighting cultural diversity from an anthropological perspective. Increasing an awareness of diverse sociocultural health assumptions may foster culturally sensitive PCC, especially when including non-Western sociocultural belief systems of health into that person-centered care. Therefore, the current medical anthropological perspective on the legacy of traditional/CAM principles in historical OPP is offered to advance the osteopathic profession by promoting ethical, culturally sensitive, and evidence-informed PCC in a Western secular environment. Such inclusive approaches are likely to meet patients' values and expectations, whether informed by Western or non-Western sociocultural beliefs, and improve their satisfaction and clinical outcomes.
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Affiliation(s)
- Rafael Zegarra-Parodi
- A.T. Still Research Institute, A.T. Still University, Kirksville, MO 63501, USA
- BMS Formation, 75116 Paris, France
- Centre Européen d’Enseignement Supérieur de l’Ostéopathie (CEESO) Paris, 93200 Saint-Denis, France
- Correspondence:
| | - Francesca Baroni
- BMS Formation, 75116 Paris, France
- Centre Européen d’Enseignement Supérieur de l’Ostéopathie (CEESO) Paris, 93200 Saint-Denis, France
- Osteopatia Lunghi-Baroni Private Practice, 00146 Rome, Italy
| | - Christian Lunghi
- BMS Formation, 75116 Paris, France
- Centre Européen d’Enseignement Supérieur de l’Ostéopathie (CEESO) Paris, 93200 Saint-Denis, France
- Osteopatia Lunghi-Baroni Private Practice, 00146 Rome, Italy
| | - David Dupuis
- Institut National de la Santé et de la Recherche Médicale, Institut de Recherche Interdisciplinaire sur les Enjeux Sociaux (INSERM/IRIS), 93300 Aubervilliers, France
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Vogel S, Zegarra-Parodi R. Relevance of Historical Osteopathic Principles and Practices in Contemporary Care: Another Perspective from Traditional/Complementary and Alternative Medicine. INT J OSTEOPATH MED 2022. [DOI: 10.1016/j.ijosm.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Nguyen C, Zegarra-Parodi R, Boutron I. Osteopathic Manipulative Treatment for Chronic Low Back Pain-Reply. JAMA Intern Med 2021; 181:1143-1144. [PMID: 34180942 DOI: 10.1001/jamainternmed.2021.3186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Christelle Nguyen
- UFR de Médecine, Faculté de Santé, Université de Paris, Paris, France.,AP-HP, Centre-Université de Paris, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Paris, France.,INSERM UMRS-1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, Paris, France
| | - Rafael Zegarra-Parodi
- A.T. Still Research Institute, A.T. Still University, Kirksville, Missouri.,COME Collaboration, Pescara, Italy.,School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Isabelle Boutron
- UFR de Médecine, Faculté de Santé, Université de Paris, Paris, France.,AP-HP, Centre-Université de Paris, Hôpital Hôtel-Dieu, Centre d'Épidémiologie Clinique, Paris, France.,INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique, ECaMO Team, Paris, France
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Alvarez G, Zegarra-Parodi R, Esteves JE. Person-centered versus body-centered approaches in osteopathic care for chronic pain conditions. Ther Adv Musculoskelet Dis 2021; 13:1759720X211029417. [PMID: 34290833 PMCID: PMC8274118 DOI: 10.1177/1759720x211029417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Gerard Alvarez
- Spain National Centre, Foundation Centre for Osteopathic Medicine Collaboration, Barcelona, Spain
| | | | - Jorge E Esteves
- Foundation Centre for Osteopathic Medicine Collaboration, Italy National Centre, Pescara, Italy
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Nguyen C, Boutron I, Zegarra-Parodi R, Baron G, Alami S, Sanchez K, Daste C, Boisson M, Fabre L, Krief P, Krief G, Lefèvre-Colau MM, Rannou F. Effect of Osteopathic Manipulative Treatment vs Sham Treatment on Activity Limitations in Patients With Nonspecific Subacute and Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Intern Med 2021; 181:620-630. [PMID: 33720272 PMCID: PMC7961471 DOI: 10.1001/jamainternmed.2021.0005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE Osteopathic manipulative treatment (OMT) is frequently offered to people with nonspecific low back pain (LBP) but never compared with sham OMT for reducing LBP-specific activity limitations. OBJECTIVE To compare the efficacy of standard OMT vs sham OMT for reducing LBP-specific activity limitations at 3 months in persons with nonspecific subacute or chronic LBP. DESIGN, SETTING, AND PARTICIPANTS This prospective, parallel-group, single-blind, single-center, sham-controlled randomized clinical trial recruited participants with nonspecific subacute or chronic LBP from a tertiary care center in France starting February 17, 2014, with follow-up completed on October 23, 2017. Participants were randomly allocated to interventions in a 1:1 ratio. Data were analyzed from March 22, 2018, to December 5, 2018. INTERVENTIONS Six sessions (1 every 2 weeks) of standard OMT or sham OMT delivered by nonphysician, nonphysiotherapist osteopathic practitioners. MAIN OUTCOMES AND MEASURES The primary end point was mean reduction in LBP-specific activity limitations at 3 months as measured by the self-administered Quebec Back Pain Disability Index (score range, 0-100). Secondary outcomes were mean reduction in LBP-specific activity limitations; mean changes in pain and health-related quality of life; number and duration of sick leaves, as well as number of LBP episodes at 12 months; and consumption of analgesics and nonsteroidal anti-inflammatory drugs at 3 and 12 months. Adverse events were self-reported at 3, 6, and 12 months. RESULTS Overall, 200 participants were randomly allocated to standard OMT and 200 to sham OMT, with 197 analyzed in each group; the median (range) age at inclusion was 49.8 (40.7-55.8) years, 235 of 394 (59.6%) participants were women, and 359 of 393 (91.3%) were currently working. The mean (SD) duration of the current LBP episode was 7.5 (14.2) months. Overall, 164 (83.2%) patients in the standard OMT group and 159 (80.7%) patients in the sham OMT group had the primary outcome data available at 3 months. The mean (SD) Quebec Back Pain Disability Index scores for the standard OMT group were 31.5 (14.1) at baseline and 25.3 (15.3) at 3 months, and in the sham OMT group were 27.2 (14.8) at baseline and 26.1 (15.1) at 3 months. The mean reduction in LBP-specific activity limitations at 3 months was -4.7 (95% CI, -6.6 to -2.8) and -1.3 (95% CI, -3.3 to 0.6) for the standard OMT and sham OMT groups, respectively (mean difference, -3.4; 95% CI, -6.0 to -0.7; P = .01). At 12 months, the mean difference in mean reduction in LBP-specific activity limitations was -4.3 (95% CI, -7.6 to -1.0; P = .01), and at 3 and 12 months, the mean difference in mean reduction in pain was -1.0 (95% CI, -5.5 to 3.5; P = .66) and -2.0 (95% CI, -7.2 to 3.3; P = .47), respectively. There were no statistically significant differences in other secondary outcomes. Four and 8 serious adverse events were self-reported in the standard OMT and sham OMT groups, respectively, though none was considered related to OMT. CONCLUSIONS AND RELEVANCE In this randomized clinical trial of patients with nonspecific subacute or chronic LBP, standard OMT had a small effect on LBP-specific activity limitations vs sham OMT. However, the clinical relevance of this effect is questionable. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02034864.
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Affiliation(s)
- Christelle Nguyen
- UFR de Médecine, Faculté de Santé, Université de Paris, Paris, France.,AP-HP.Centre-Université de Paris, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Paris, France.,INSERM UMRS-1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, Paris, France
| | - Isabelle Boutron
- UFR de Médecine, Faculté de Santé, Université de Paris, Paris, France.,AP-HP.Centre-Université de Paris, Hôpital Hôtel-Dieu, Centre d'Épidémiologie Clinique, Paris, France.,INSERM UMRS-1153, Centre de Recherche Épidémiologie et Statistique, METHODS Team, Paris, France
| | - Rafael Zegarra-Parodi
- A.T. Still Research Institute, A.T. Still University, Kirksville, Missouri.,COME Collaboration, Pescara, Italy.,School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Gabriel Baron
- AP-HP.Centre-Université de Paris, Hôpital Hôtel-Dieu, Centre d'Épidémiologie Clinique, Paris, France.,INSERM UMRS-1153, Centre de Recherche Épidémiologie et Statistique, METHODS Team, Paris, France
| | - Sophie Alami
- Cabinet d'Études Sociologiques Interlis, Paris, France
| | - Katherine Sanchez
- AP-HP.Centre-Université de Paris, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Paris, France
| | - Camille Daste
- UFR de Médecine, Faculté de Santé, Université de Paris, Paris, France.,AP-HP.Centre-Université de Paris, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Paris, France.,INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique, ECaMO Team, Paris, France
| | - Margaux Boisson
- AP-HP.Centre-Université de Paris, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Paris, France
| | | | - Peggy Krief
- Department Health Work Environment, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Epalinges-Lausanne, Switzerland
| | - Guillaume Krief
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Marie-Martine Lefèvre-Colau
- UFR de Médecine, Faculté de Santé, Université de Paris, Paris, France.,AP-HP.Centre-Université de Paris, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Paris, France.,INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique, ECaMO Team, Paris, France.,Institut Fédératif de Recherche sur le Handicap, Paris, France
| | - François Rannou
- UFR de Médecine, Faculté de Santé, Université de Paris, Paris, France.,AP-HP.Centre-Université de Paris, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Paris, France.,INSERM UMRS-1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, Paris, France
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Zegarra-Parodi R, Draper-Rodi J, Haxton J, Cerritelli F. The Native American heritage of the body-mind-spirit paradigm in osteopathic principles and practices. INT J OSTEOPATH MED 2019. [DOI: 10.1016/j.ijosm.2019.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Zegarra-Parodi R, Pazdernik VK, Roustit M, Park PYS, Degenhardt BF. Effects of pressure applied during standardized spinal mobilizations on peripheral skin blood flow: A randomised cross-over study. ACTA ACUST UNITED AC 2016; 21:220-6. [DOI: 10.1016/j.math.2015.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 08/02/2015] [Accepted: 08/18/2015] [Indexed: 12/12/2022]
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Abstract
Abstract
Laser Doppler flowmetry (LDF) is commonly used in combination with reactivity tests to noninvasively evaluate skin sympathetic nerve activity and skin microvascular function. In manual medicine research, LDF has been used as a marker for global peripheral sympathetic nervous system function, but these results should be considered with caution because skin sympathetic nerve activity physiology is often overlooked. Another limitation of LDF in manual medicine research is the processing of LDF recordings. Two methods have been suggested: the time-domain analysis and the frequency-domain analysis. Standardization is required for data collection and processing in either domain to accurately interpret these changes in skin blood flow that occur after manual procedures. For physiologic studies using LDF, the authors recommend the use of noninvasive reactivity tests (positive controls) to evaluate the different mechanisms involved in overall skin blood flow changes and to compare the magnitude of these changes with those specifically elicited by manual procedures.
J Am Osteopath Assoc.2014;114(12):908-917 doi:10.7556/jaoa.2014.178
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Affiliation(s)
- Rafael Zegarra-Parodi
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Mr Zegarra-Parodi and Drs Snider and Degenhardt) , and the Department of Neurobehavorial Sciences (Dr Snider) at the A.T. Still University–Kirksville College of Osteopathic Medicine in Missouri (ATSU-KCOM). Student Doctor Park is a third-year osteopathic medical student at ATSU-KCOM
| | - Eric J. Snider
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Mr Zegarra-Parodi and Drs Snider and Degenhardt) , and the Department of Neurobehavorial Sciences (Dr Snider) at the A.T. Still University–Kirksville College of Osteopathic Medicine in Missouri (ATSU-KCOM). Student Doctor Park is a third-year osteopathic medical student at ATSU-KCOM
| | - Peter Yong Soo Park
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Mr Zegarra-Parodi and Drs Snider and Degenhardt) , and the Department of Neurobehavorial Sciences (Dr Snider) at the A.T. Still University–Kirksville College of Osteopathic Medicine in Missouri (ATSU-KCOM). Student Doctor Park is a third-year osteopathic medical student at ATSU-KCOM
| | - Brian F. Degenhardt
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Mr Zegarra-Parodi and Drs Snider and Degenhardt) , and the Department of Neurobehavorial Sciences (Dr Snider) at the A.T. Still University–Kirksville College of Osteopathic Medicine in Missouri (ATSU-KCOM). Student Doctor Park is a third-year osteopathic medical student at ATSU-KCOM
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Hubert D, Soubeiran L, Gourmelon F, Grenet D, Serreau R, Perrodeau E, Zegarra-Parodi R, Boutron I. Impact of osteopathic treatment on pain in adult patients with cystic fibrosis--a pilot randomized controlled study. PLoS One 2014; 9:e102465. [PMID: 25029347 PMCID: PMC4100932 DOI: 10.1371/journal.pone.0102465] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 06/16/2014] [Indexed: 12/04/2022] Open
Abstract
Background Pain is a common complication in patients with cystic fibrosis (CF) and is associated with shorter survival. We evaluated the impact of osteopathic manipulative treatment (OMT) on pain in adults with CF. Methods A pilot multicenter randomized controlled trial was conducted with three parallel arms: OMT (group A, 16 patients), sham OMT (sham treatment, group B, 8 patients) and no treatment (group C, 8 patients). Medical investigators and patients were double-blind to treatment for groups A and B, who received OMT or sham OMT monthly for 6 months. Pain was rated as a composite of its intensity and duration over the previous month. The evolution of chest/back pain after 6 months was compared between group A and groups B+C combined (control group). The evolution of cervical pain, headache and quality of life (QOL) were similarly evaluated. Results There was no statistically significant difference between the treatment and control groups in the decrease of chest/back pain (difference = −2.20 IC95% [−4.81; 0.42], p = 0.098); also, group A did not differ from group B. However, chest/back pain decreased more in groups A (p = 0.002) and B (p = 0.006) than in group C. Cervical pain, headache and QOL scores did not differ between the treatment and control groups. Conclusion This pilot study demonstrated the feasibility of evaluating the efficacy of OMT to treat the pain of patients with CF. The lack of difference between the group treated with OMT and the control group may be due to the small number of patients included in this trial, which also precludes any definitive conclusion about the greater decrease of pain in patients receiving OMT or sham OMT than in those with no intervention. Trial Registration ClinicalTrials.gov NCT01293019
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Affiliation(s)
- Dominique Hubert
- Adult CF Center and Pulmonology Department, Hôpital Cochin APHP, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- * E-mail:
| | - Lucile Soubeiran
- Clinical Research Department, Hôpital Cochin APHP, Paris, France
| | | | - Dominique Grenet
- Adult CF Center and Pulmonology Department, Hôpital Foch, Suresnes, France
| | - Raphaël Serreau
- Clinical Research Department, Hôpital Cochin APHP, Paris, France
| | - Elodie Perrodeau
- Clinical Epidemiology Center, Hôpital Hôtel Dieu APHP, Paris, France
| | - Rafael Zegarra-Parodi
- A.T. Still Research Institute, A.T. Still University, Kirksville, Missouri, United States of America
| | - Isabelle Boutron
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Clinical Epidemiology Center, Hôpital Hôtel Dieu APHP, Paris, France
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Luciani E, Cerritelli F, Waters M, Zegarra-Parodi R. Osteopathic student satisfaction and preparedness to practice: A comparative study. INT J OSTEOPATH MED 2014. [DOI: 10.1016/j.ijosm.2013.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hubert D, Soubeiran L, Gourmelon F, Grenet D, Serreau R, Perrodeau E, Aissat F, Zegarra-Parodi R, Boutron I. WS10.2 Impact of osteopathic manipulative treatment on pain of adult patients with cystic fibrosis – a pilot randomized study. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60070-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Zegarra-Parodi R, de Chauvigny de Blot P, Rickards LD, Renard EO. Cranial palpation pressures used by osteopathy students: effects of standardized protocol training. J Am Osteopath Assoc 2009; 109:79-85. [PMID: 19269938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
CONTEXT Descriptions of subtle palpatory perceptions in osteopathic cranial palpation can be misperceived by students. Thus, adequate dissemination and replication of cranial palpatory techniques is challenging for osteopathy students. OBJECTIVE To evaluate the effects of standardized protocol training on cranial palpation of the frontomalar suture. METHODS Fourth-year osteopathy students from the European Center for Osteopathic Higher Education in Paris, France, were recruited and randomly divided into three groups. Students in the study group received instruction in a standardized protocol for palpatory assessment of the frontomalar suture; students in the control group did not receive instruction; and the remaining students acted as subjects. A specialized force sensor was placed on the skin covering the left frontomalar suture of each subject. Student practitioners were instructed to palpate subjects' left frontomalar suture using the customary pressure described for evaluation and treatment of somatic dysfunction of the cranium. Pressure measurements were exported to a laptop computer. RESULTS Twelve students were in each group. Student practitioners' palpation pressures ranged from 0.19 to 1.12 N/cm(2), while mean palpation pressures for each test ranged from 0.27 to 0.98 N/cm(2). The mean (SD) palpation pressure in the study group and control group was 0.55 N/cm(2) (0.16 N/cm(2)) and 0.53 N/cm(2) (0.15 N/cm(2)), respectively. There was no statistically significant difference in mean palpation pressures used by the two groups. Substantial variation in test performance was noted in both groups. CONCLUSION Palpatory training was ineffective in improving student practitioners' precision of cranial palpation performance. Quantitative feedback of palpation pressures during training may improve outcomes. To our knowledge, data on palpation pressures used during osteopathic cranial manipulation have not been reported previously in the medical literature.
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Affiliation(s)
- Rafael Zegarra-Parodi
- Research Department, Centre Européen d'Enseignement Supérieur de l'Ostéopathie, Paris, France.
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Zegarra-Parodi R. 442 WIDE-DYNAMIC RANGE NEURONS SENSITIZATION AND SPINAL MANIPULATIVE THERAPY: A RATIONALE FOR OSTEOPATHIC MANAGEMENT OF NEUROPATHIC PAIN? Eur J Pain 2007. [DOI: 10.1016/j.ejpain.2007.03.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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