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The fascial system and exercise intolerance in patients with chronic heart failure: hypothesis of osteopathic treatment

The fascial system and exercise intolerance in patients with chronic heart failure: hypothesis of osteopathic treatment

functions of the fascial system: the rationale is to encourage research to see if, by combining the usual cardiovascular physiotherapy approach with a manual therapy, the symptoms of fatigue and exercise intolerance in patients with CHF can be improved. We will also propose a possible process of osteopathic treatment, based on each of the author’s 20 years of clinical experience. The aim of the proposed osteopathic techniques is to release the fascial restrictions and alter the mechanical properties of the fascia in, eg, its density, the hardness of the tissue, and its viscosity, so that the fascia may adapt more quickly to the physical stimulus it receives. 12
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A study into Osteopathic treatment of pregnant women in NSW and Queensland.

A study into Osteopathic treatment of pregnant women in NSW and Queensland.

activity and decrease the need for drugs. 43 A decrease in medical inductions and caesarean sections has been reported in literature where pregnant patients were treated via acupuncture prior to their delivery date. 44 Acupuncture was used by only 6% of the current survey respondents in conjunction with Osteopathic treatment, which supports recent research that shows physical therapy with acupuncture provide the best results when compared with only physical therapy or only acupuncture. 1 Acupuncture has been reported in the literature to be safe and affective for treatment and the current survey results show a small amount of respondents use the modality, which relates to only a small amount of the surveyed osteopaths having completed an acupuncture degree (6%).
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General Osteopathic Treatment is Associated with Postural Changes

General Osteopathic Treatment is Associated with Postural Changes

Material and Methods: One hundred thirteen persons, 72 females and 41 males, either symptom- free volunteers or patients with mild idiopathic back pain, were investigated using the DIERS formetric® system, before and immediately after a single session of general osteopathic treatment. Variables of static assessment of the thoraco-lumbar vertebral column and of the pelvis were compared before and after treatment, using paired statistics.

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Osteopathy and Emergency: A Model of Osteopathic Treatment Aimed at Managing the Post Traumatic Stress—Part 1

Osteopathy and Emergency: A Model of Osteopathic Treatment Aimed at Managing the Post Traumatic Stress—Part 1

J.M. Littlejohn, former student of Andrew Taylor Still, devised a system of dis- ease prevention and treatment through mechanical manipulation known as General Osteopathic Treatment (GOT). J.M. Littlejohn studied particularly the relationships between the different levels of the spine and the organs of the body, as well as the adaptation of the human being to the verticality. The GOT aims to support the physiological processes, reducing the allostatic load and thus increasing the individual’s ability to respond and adapt to the various internal and external stress factors. This result is obtained using the biomechanical and postural model, the neurological, respiratory and circulatory model as forms of treatment. The goal is to improve the distribution of forces through the continuity of the connective tissue, to reduce energy expenditure during the activities of daily life, to improve respiration and circulatory dynamics, the integrated somato-motor function and the function of the neuro-immune-endocrine system, by relating the different levels of the vertebral column and the organs of the body, as well as the adaptation of the human being to the verticality [13] [14] [15].
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Effects of osteopathic treatment on pulmonary function and chronic thoracic pain after coronary artery bypass graft surgery (OstinCaRe): study protocol for a randomised controlled trial

Effects of osteopathic treatment on pulmonary function and chronic thoracic pain after coronary artery bypass graft surgery (OstinCaRe): study protocol for a randomised controlled trial

Background: Coronary artery bypass graft surgery (CABG) is an effective and widespread coronary revascularisation technique, nevertheless there are a number of long-term postoperative complications from which patients can suffer. One year after CABG surgery pulmonary function is decreased by 12% and 30% of the patients suffer from chronic thoracic pain. To date and to our knowledge there are no effective treatments for these conditions. The aim of the present clinical trial is to explore the effectiveness of osteopathic treatment on these conditions. Methods: The study is designed as a randomised controlled trial with two parallel groups. Group A will receive a standard cardiac rehabilitation programme during 12 weeks and group B will receive the same standard cardiac rehabilitation programme supplemented with four osteopathic treatments (OT). OT will be performed at week 4, 5, 8 and 12 after surgery. Three hundred and eight patients (Group A: n = 154, Group B: n = 154) will be enrolled from the cardiothoracic surgery department of the Jessa Hospital Hasselt. Blinding will be assured for the staff of the cardiac rehabilitation centre and outcome assessors. Primary outcome measure will be the mean difference in change from baseline in slow vital capacity (SVC) at 12 weeks after surgery between groups. Secondary outcome measures will be the change from baseline in quality of life, pain, thoracic stiffness and maximal aerobic capacity at 12 weeks after surgery. A follow-up is planned 52 weeks after surgery for SVC, quality of life, pain and thoracic stiffness. Intention to treat analysis will be executed.
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Effects of osteopathic treatment on people with psoriatic arthritis. A pilot study.

Effects of osteopathic treatment on people with psoriatic arthritis. A pilot study.

This study is a pilot study because, to date, the effect of osteopathic treatment on people with PsA has not been investigated in a published research investigation. A single-subject experimental design of a small group of participants (n=4) was utilised. Each participant was individually assessed and treated by an osteopath according to the examination findings. This study design with its client centred focus is ideally suited for researching human behaviour in the rehabilitation environment. Most rehabilitation practice settings have too few clients with similar characteristics to enable evaluation of treatment outcomes using randomised clinical trials. 32 The procedure for single subject research involves systematic, repeated measurement of treatment outcome. 33 The outcomes of osteopathic treatment on the participants was assessed using the BASDAI (Appendix A) and the SF-36 (Appendix B). The Victoria University Faculty of Human Research Ethics Committee granted ethical approval for the study.
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The Effect of Osteopathic Treatment on the Irritable Bowel Syndrome: A Case Series

The Effect of Osteopathic Treatment on the Irritable Bowel Syndrome: A Case Series

Irritable bowel syndrome is a common condition, where there has been extensive research performed, but still treatment remains unsatisfactory. IBS has a high morbidity resulting from the profound impact on the person’s quality of life. The preliminary data of two patients in this study indicates that osteopathic treatment may help. However, the results are inconclusive due to an insufficient patient population and inadequate study design. In the profession of osteopathy we are constantly challenged to justify and provide evidence of efficacious and cost-effective care for a range of conditions. At the present time there is very little research that explores the potential benefits of osteopathic treatment of IBS. Future research would require a larger scale, longer-term, randomised, controlled study in order to show the benefits osteopathic treatment and management of IBS.
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Conclusion: Perceived intensity of neck pain, and perceived disability significantly reduced following four weeks of osteopathic management. This pilot study suggests that osteopathic treatment is effective for the management of chronic and sub-chronic ne

Conclusion: Perceived intensity of neck pain, and perceived disability significantly reduced following four weeks of osteopathic management. This pilot study suggests that osteopathic treatment is effective for the management of chronic and sub-chronic neck pain

Osteopathic treatment consists of a combination of a wide range of manual techniques, including soft tissue technique, passive mobilisation (articulatory) technique, high velocity technique (HVLA), functional (indirect) technique, myofascial release technique, craniosacral technique and muscle energy technique. 14 Although several studies have investigated the effect of specific treatment techniques on neck pain, there has been little investigation of the effect of osteopathic management, incorporating many of the above mentioned techniques. The aim of this pilot study was to examine the effect of osteopathic management on patients with subchronic or chronic neck pain.
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Effectiveness of an osteopathic treatment on the autonomic nervous system: a systematic review of the literature

Effectiveness of an osteopathic treatment on the autonomic nervous system: a systematic review of the literature

Results: 23 published studies (10 RCT, 1 clinic multi-centre study, 1 CCT, 5 randomized cross-over studies, 5 rand- omized pilot studies and 1 single case study) are included in this review. The studies were evaluated with the assess- ment tools according to their quality. 3 studies are graded as high quality, 11 as moderate and 8 as low-quality studies. Conclusion: The included published studies represent a good level of evidence. Due to a small number of subjects and no follow-ups, the methodological quality is rated as moderate. A significant change on the ANS was shown in studies including High-Velocity Low-Amplitude Techniques (HVLAT). No statement could be drawn in studies in which they used cranial osteopathic techniques due to the lack of methodological quality. A significant change on the ANS is shown in the treatment of the suboccipital region. In studies which evaluated the effectiveness of mobi- lization in the cervical and thoracic region, no statement could be displayed due to a low level of evidence. None of the findings in these studies have given statements if ANS activation takes place in the sympathetic or parasympa- thetic system.
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OSTEOPATHIC TREATMENT FOR THE SYMPTOMATIC RELIEF OF MÉNIÈRE’S DISEASE.

OSTEOPATHIC TREATMENT FOR THE SYMPTOMATIC RELIEF OF MÉNIÈRE’S DISEASE.

Participants reported that vertigo could be elicited through neck movements (especially extension). Bjorne 9 also recorded this observation. The term “Cervical Vertigo” represents a link between neck disorders and the provocation of vertigo 20 . Suboccipital muscular activity has also been linked to neck movements and triggering vertigo 21 , as the vestibular and neck proprioceptive systems contribute to postural and eye movement control. The aetiological factor of cervical vertigo is thought to be proprioceptive input from the suboccipital muscles, ligaments and sternocleidomastoid (SCM) 22 . Stretching of the posterior cervical muscles has been shown to relieve vertigo symptoms within Ménière’s patietns 15 , and was implemented within the OT protocol. OT addressed these regions and when treatment was removed Ménière’s symptoms deteriorated.
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Osteopathic manipulative treatment and pain in preterms: study protocol for a randomised controlled trial

Osteopathic manipulative treatment and pain in preterms: study protocol for a randomised controlled trial

Background: Recent evidence proved the necessity to improve health care and pain management in newborns. Osteopathic manipulative treatment (OMT) has been largely used to treat painful syndromes as well as term and preterm newborns. Recent studies have demonstrated positive results of osteopathy in reducing length of stay and costs. However, no trials were carried out on pain in newborns. The aim of the present clinical trial is to explore the effectiveness of osteopathic treatment in reducing pain in a sample of preterms.

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General Movements in preterm infants undergoing craniosacral therapy: a randomised controlled pilot trial

General Movements in preterm infants undergoing craniosacral therapy: a randomised controlled pilot trial

However, the effects of OMT and craniosacral therapy in preterm infants are not fully understood [8, 10, 37, 38]. There are several hypotheses including i) anti-inflammatory effects, ii) increases in the opioid reac- tions, or iii) effect on the autonomic nervous system. Narendran et al reported higher level of cortisol, al- bumin, IL-8 and IL-1β in preterm infants [37, 44], suggesting an increased level of systemic inflamma- tion. A recent study demonstrated that osteopathic treatment could reduce the inflammatory process act- ing mainly on anti-inflammatory factors [37, 45]. In addition, Degenhardt et al suggested that OMT could have a role in increasing the opioid reaction [37, 46]. However, this hypothesis has some intrinsic limita- tions in terms of the sample used, i.e. no infants were osteopathically treated, and in translating in vitro findings into in vivo mechanisms. Longin et al [37, 47] re- ported that the gestational age of newborn infants is cor- related with changes in heart rate variability (HRV). From the osteopathic perspective, changes in the HRV were re- corded after the application of myofascial release tech- niques [37, 48, 49]. For this reason, the application of OMT could balance the sympathetic and parasympathetic inputs, creating an improvement of newborns clinical con- dition [8, 10].
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<p>Osteopathic approach with a patient undergoing cardiac transplantation: the five diaphragms</p>

<p>Osteopathic approach with a patient undergoing cardiac transplantation: the five diaphragms</p>

Abstract: The case report presents a patient with a possible neuropathic sternal pain associated with a recent heart transplant procedure. The patient could not breathe deeply and move the upper limbs, with a trunk torsion, feeling a sharp pain under and around the left breastbone. A fascial osteopathic approach in the treatment of the pelvic fl oor, the respiratory diaphragm, the thoracic outlet, the tongue and the tentorium cerebelli allowed the patient to access to a cardiovascular rehabilitation program. In osteopathic medicine, these anatomical parts of the body are called the fi ve diaphragms. To our best knowledge, this is the fi rst case report that uses osteopathic treatment in a patient with sternal pain associated with an undergoing cardiac transplantation. The clinical importance of the case report is added to other osteopathic research with patients undergoing cardiac surgery (coronary artery bypass graft) and with multiple bene fi ts, without side effects. One of the main goals of osteopathic treatment is to provide the patient with well-being, from many clinical points of view, allowing the person to be discharged from the hospital more quickly and/or with less pain. Keywords: diaphragm, osteopathic, fascia, cardiac transplantation, pain, heart, case report
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Physiological Responses In Patients Receiving Osteopathic Interventions

Physiological Responses In Patients Receiving Osteopathic Interventions

A recent, unpublished, study conducted by Sherriff, (2002) focused on State anxiety and self perceived tension levels on Osteopathic students. These students listen to three different relaxation compact discs but did not receive any Osteopathic treatment. A significant difference was found between post-test group means for both State anxiety and self- perceived tension. The instrumental style of relaxation music followed by Natural “Ocean sounds” were found to be the most successful in decreasing State anxiety and self-perceived tension. This data however was collected from healthy subjects, further research is required to investigate the effects of relaxation music on symptomatic patients as they often suffer from a higher level of anxiety than Osteopathic students due to pain or chronic illness (Mulooly, Levin & Feldman, 1988; Pilowsky & Spence, 1975).
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Reflections on osteopathic fascia treatment in the peripheral nervous system

Reflections on osteopathic fascia treatment in the peripheral nervous system

The peripheral nerves are composed of several layers of fas- cial tissue, which can become a source of pain if they fail in their ability to slide. It is only recently that fascial osteopathy research has been aimed at understanding what happens to the fascia following treatment and, as a result of the first studies, it has been possible to highlight some of the benefits, including a reduction in local pain and inflammation. The osteopathic approach to the fascial system of the peripheral nerve does not have a grounding in scientific research, being based only on the clinical experience of individual operators, despite the use of peripheral nerve palpation as a method for the evalu- ation and testing of the nerve’s function. The authors wish to encourage the initiation of new research in the fields of academic and clinical osteopathy that is aimed at quantifying the possible benefits a patient may derive from osteopathic treatment of the peripheral nerve.
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Effect of osteopathic manipulative treatment on length of stay in a population of preterm infants: a randomized controlled trial

Effect of osteopathic manipulative treatment on length of stay in a population of preterm infants: a randomized controlled trial

According to costs computation, the application of OMT can theoretically save almost 3,000€ per preterm per LOS, putting the NICU in a more favorable economic position. The latter is due to the ISS reim- bursement procedures which establish a payment method based on DRG mean cost estimates [18] rather than on the duration of a single hospital admission. The net saving could be considered a “moneybox” that NICU managers can use to improve efficiency in pro- cedures, implementing diagnostic tools or optimizing turnovers. The cost analysis is highly dependent upon the relationship of the cost-reimbursement of the OMT to the cost-reimbursement of the DRG. Consid- ering the cost for OMT session equal to the cost of a standard physical care in a public domain (25€) [18], the net saving is approximately 2,700€ per LOS per newborn, confirming the osteopathic treatment a valu- able intervention.
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Osteopathic intervention in chronic non specific low back pain: a systematic review

Osteopathic intervention in chronic non specific low back pain: a systematic review

There is a need to evaluate the effectiveness of this service to these patients using rigorous research that can be applied to practice. A comparative review of the clin- ical trial literature of SMT or massage or osteopathy in the treatment of low back pain reveals an evidence base for SMT and massage, both modalities in use by osteo- paths, but a lack of research into whole osteopathic practice as demonstrated in the survey data mentioned. A Cochrane review of SMT in low back pain concluded that despite over 800 publications addressing this issue, evidence for the effect on low back pain is equivocal [8]. The Cochrane review of 13 clinical trials of massage found that there is evidence that it may be beneficial for subacute and chronic low back pain in conjunction with exercise [12]. A systematic review and meta-analysis of osteopathic clinical trials up to 2003 [9] concluded that patients had significant improvements from osteopathic intervention, but that many of the results are from trials with small numbers and the intervention is often a sin- gle modality or technique.
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Fryer G. Abbreviations for use in osteopathic case notes. Journal of Osteopathic Medicine. 2001;4(1):21-24. Gary Fryer

Fryer G. Abbreviations for use in osteopathic case notes. Journal of Osteopathic Medicine. 2001;4(1):21-24. Gary Fryer

A list of terms and phrases believed by the author to be useful or in common use, along with a list of suggested abbreviations for the terms, was presented to either Heads of Course or Heads of Clinic in various osteopathic teaching institutions. Questionnaires were sent to the Royal Melbourne Institute of Technology, Melbourne (RMIT), Victoria University, Melbourne (VU), University of Western Sydney,

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Shared decision making by United Kingdom osteopathic students: an observational study using the OPTION-12 instrument

Shared decision making by United Kingdom osteopathic students: an observational study using the OPTION-12 instrument

Self-determined United Kingdom patients do select- ively seek complementary care outside of the National Health Service, with osteopaths being one of the regu- lated healthcare professionals who are sought out; some of whom are contracted to work within the National Health Service [23]. The 5000 United Kingdom osteo- paths carry out approximately seven million encounters a year and are statutory regulated by the General Osteo- pathic Council [24]. The General Osteopathic Council are responsible for setting the professional standards and codes of practice for the United Kingdom osteopathic profession. The current Osteopathic Practice Standards came into force in September 2012 and is nearly identi- cal to General Medical Council’s guidance on good med- ical practice. Within the Osteopathic Practice Standards, the concept of SDM is explicitly referred to; standard A5 states that osteopaths must “work in partnership with patients to find the best treatment for them”; guidance note 1 states, “You should encourage patients to ask questions about their treatment and to take an active part in the treatment plan and any decisions that need to be made [24]”. This obligation remains within draft revised guidelines (relisted as A3.2) that are scheduled for publication in September 2019.
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Osteopathic manipulative treatment for low back pain: a systematic review and meta analysis of randomized controlled trials

Osteopathic manipulative treatment for low back pain: a systematic review and meta analysis of randomized controlled trials

Historically, low back pain has been the most common reason for visits to osteopathic physicians [1]. More recent data from the Osteopathic Survey of Health Care in Amer- ica has confirmed that a majority of patients visiting oste- opathic physicians continue to seek treatment for musculoskeletal conditions [2,3]. A distinctive element of low back care provided by osteopathic physicians is oste- opathic manipulative treatment (OMT). A comprehensive evaluation of spinal manipulation for low back pain undertaken by the Agency for Health Care Policy and Research in the United States concluded that spinal manipulation can be helpful for patients with acute low back problems without radiculopathy when used within the first month of symptoms [4]. Nevertheless, because most studies of spinal manipulation involve chiropractic or physical therapy [5], it is unclear if such studies ade- quately reflect the efficacy of OMT for low back pain. Although the professional associations that represent osteopaths, chiropractors, and physiotherapists in the United Kingdom developed a spinal manipulation pack- age consisting of three common manual elements for use in the UK Back pain Exercise and Manipulation (UK BEAM) trial [6], there are no between-profession compar- isons of clinical outcomes [7,8]. It is well known that OMT comprises a diversity of techniques [9] that are not adequately represented by the UK BEAM trial package. Professional differences in spinal manipulation are more pronounced in research studies, where chiropractors have focused almost exclusively on high-velocity-low-ampli- tude techniques [10]. For example, a major trial of chiro- practic manipulation as adjunctive treatment for childhood asthma used a high-velocity-low-amplitude thrust as the active treatment [11]. The simulated treat- ment provided in the sham manipulation arm of this chi- ropractic trial, which ostensibly was thought to have no therapeutic effect, had a marked similarity to OMT [10,12]. Further, because differences in professional back- ground and training lend themselves to diverse manipula- tion approaches, clinicians have been warned about generalizing the findings of systematic reviews to practice [13].
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