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At least 19 recordsLinked to original sources
PubMed1996

Preliminary findings on the use of osteopathic manipulative treatment by osteopathic physicians.

The literature suggests that the extent to which osteopathic physicians actually use osteopathic manipulative treatment (OMT) and the factors that predict the use of OMT remain virtually unexplored. A mailed survey of practicing osteopathic physicians was used to query respondents about their use of OMT and about the effects of a number of factors on use of OMT. The survey showed that 71% of 100 practicing physicians used OMT with 5% or more of their patients, and 14% in 50% or more of their patients. Multivariate statistical procedures revealed that a physician's having learned a new OMT format since graduation from medical school was the primary predictor of the use of OMT, followed by interest in OMT during internship. The other predictor was whether the respondent had a family member who was also a DO. Physician's specialty, emphasis on OMT during graduate and postgraduate training, and the era during which DOs received their training were not significant predictors of OMT use. These results indicate a need for further research on OMT use and the variables examined in this study.

Adult↗
PubMed2005

Cost-effective osteopathic manipulative medicine: a literature review of cost-effectiveness analyses for osteopathic manipulative treatment.

Despite the value that osteopathic manipulative medicine (OMM) may offer to healthcare consumers in a managed care, evidence-based healthcare system, very little research has been published on the cost-effectiveness of osteopathic manipulative treatment compared with other treatment modalities. The authors searched MEDLINE and OSTMED for English-language articles published between January 1966 and June 2002 using the key terms cost-effectiveness, osteopathic medicine, workers' compensation, hospital length of stay, healthcare providers, and manipulative medicine. The authors then extended their search by reviewing the reference lists provided in the articles initially identified as relevant by these databases. The purpose, methods, findings, and conclusions of each study were evaluated for how the cost-effectiveness of OMM was analyzed. The authors conclude that the osteopathic medical profession needs to conduct and publish research that is consistent with current practices in the conventional medical literature.

Activities of Daily Living↗
PubMed2003

Use of osteopathic manipulative treatment by Ohio osteopathic physicians in various specialties.

The authors mailed a survey designed to determine the use of osteopathic manipulative treatment (OMT) to the 2,318 active osteopathic physicians registered with the Ohio Osteopathic Association; 871 responses were received, for a response rate of 38%. Approximately 75% of the respondents had not or had rarely used OMT: 44% of these respondents did not use any OMT and 31% reported treating fewer than 10 patients with OMT during the week before the survey. Approximately 25% of the surveyed osteopathic physicians treated more than 10 patients with OMT, and about 6% of these treated more than 30 patients with OMT. Respondents represented 40 specialty disciplines. All of the osteopathic physicians in 17 specialties reported no OMT use, osteopathic physicians in 9 specialties reported using OMT for fewer than 10 patients during the previous week, and osteopathic physicians in 9 specialties reported using OMT for more than 10 patients during the previous week. Of the somatic dysfunctions listed in the survey, low back disorders were treated with OMT most often. Few osteopathic specialists used OMT for patients with asthma or chronic obstructive pulmonary disease. The data suggest that a great opportunity exists to increase the use of OMT by osteopathic physicians, especially those who are specialists.

Data Collection↗
PubMed2000

Effects of a structured curriculum in osteopathic manipulative treatment (OMT) on osteopathic structural examinations and use of OMT for hospitalized patients.

Osteopathic manipulative treatment (OMT) is a defining feature of osteopathic medicine; however, use of OMT by osteopathic physicians is declining. Recent studies reveal that many osteopathic physicians are abandoning use of OMT as early as medical school. Current national efforts are aimed at reversing this trend by standardizing osteopathic medical records and clinical training in OMT. The authors found that a structured clinical curriculum in OMT taught to house staff significantly increased the percentage of patients who received osteopathic structural examinations and the percentage of patients who received OMT as part of their hospital care.

Curriculum↗
PubMed2003

Osteopathic manipulative treatment techniques preferred by contemporary osteopathic physicians.

Data presented in this study were gathered through a national mail survey of 3000 randomly selected osteopathic physicians. A total of 955 questionnaires were usable for analysis. Osteopathic physicians' likelihood of using eleven osteopathic manipulative treatment (OMT) techniques (articulatory, counterstrain, cranial, facilitated positional release, fascial ligamentous release, functional, high-velocity low-amplitude thrust, lymphatic, muscle energy, myofascial/integrated neuromuscular release, and soft tissue) was determined. The relative frequency of use from most (soft tissue) to least (cranial) used was also determined. Respondents were more likely to use direct techniques than indirect or direct-indirect techniques. Demographic variables of gender, age, and specialty training were found to be related to the techniques used most. Female osteopathic physicians and older osteopathic physicians were more likely to use indirect techniques, whereas male and younger physicians preferred direct techniques. Moreover, OMT specialists used a broader range of techniques than other osteopathic physicians, and family physicians were more apt to use high-velocity low-amplitude thrust than other primary care or non-primary care osteopathic physicians. These results not only have implications for curricular planning in all phases of osteopathic undergraduate medical education, graduate medical education, and continuing medical education programs, but also for research on the quality and effectiveness of various OMT techniques.

Adult↗
PubMed2004

Assessing the ability of medical students to perform osteopathic manipulative treatment techniques.

While osteopathic and allopathic medicine share many commonalities, there are key practice-based differences that uniquely characterize the two professions. For osteopathic medicine, one such defining feature is the use of osteopathic manipulative treatment (OMT). Unfortunately, while various treatment modalities are taught in osteopathic medical schools, there has been relatively little work done to establish standardized evaluation protocols. The purpose of this investigation was to explore the use of OMT assessment in the context of a multistation standardized patient examination. Analysis of performance data from 121 fourth-year osteopathic medical students indicated that the ability to do OMT can be reliably and validly assessed using a combination of simulated patient encounters, trained osteopathic physician raters, and an objective rating tool. Additional studies that incorporate a larger sample of students and focus on modifications to the assessment tool and rating protocols are warranted.

Clinical Competence↗
PubMed2002

Osteopathic manipulative treatment for postoperative pain.

Osteopathic manipulative treatment (OMT) is an important aspect of pain management and disease prevention. Advantages of OMT administered postoperatively include easy implementation and cost-effectiveness in terms of shortened hospital stays resulting from effective relief of acute pain. Patients who receive morphine preoperatively and OMT postoperatively tend to have less postoperative pain and require less intravenously administered morphine. In addition, OMT and relief of pain lead to decreased postoperative morbidity and mortality and increased patient satisfaction. Also, soft tissue manipulative techniques and thoracic pump techniques help to promote early ambulation and body movement.

Humans↗
PubMed2003

Osteopathic manipulative treatment for chronic low back pain: a randomized controlled trial.

STUDY DESIGN: A randomized controlled trial was conducted. OBJECTIVE: To determine the efficacy of osteopathic manipulative treatment as a complementary treatment for chronic nonspecific low back pain. SUMMARY OF BACKGROUND DATA: Osteopathic manipulative treatment may be useful for acute or subacute low back pain. However, its role in chronic low back pain is unclear. METHODS: This trial was conducted in a university-based clinic from 2000 through 2001. Of the 199 subjects who responded to recruitment procedures, 91 met the eligibility criteria. They were randomized, with 82 patients completing the 1-month follow-up evaluation, 71 completing the 3-month evaluation, and 66 completing the 6-month evaluation. The subjects were randomized to osteopathic manipulative treatment, sham manipulation, or a no-intervention control group, and they were allowed to continue their usual care for low back pain. The main outcomes included the SF-36 Health Survey, a 10-cm visual analog scale for overall back pain, the Roland-Morris Disability Questionnaire, lost work or school days because of back pain, and satisfaction with back care. RESULTS: As compared with the no-intervention control subjects, the patients who received osteopathic manipulative treatment reported greater improvements in back pain, greater satisfaction with back care throughout the trial, better physical functioning and mental health at 1 month, and fewer cotreatments at 6 months. The subjects who received sham manipulation also reported greater improvements in back pain and physical functioning and greater satisfaction than the no-intervention control subjects. There were no significant benefits with osteopathic manipulative treatment, as compared with sham manipulation. CONCLUSIONS: Osteopathic manipulative treatment and sham manipulation both appear to provide some benefits when used in addition to usual care for the treatment of chronic nonspecific low back pain. It remains unclear whether the benefits of osteopathic manipulative treatment can be attributed to the manipulative techniques themselves or whether they are related to other aspects of osteopathic manipulative treatment, such as range of motion activities or time spent interacting with patients, which may represent placebo effects.

Chronic Disease↗
PubMed2000

The effectiveness of osteopathic manipulative treatment as complementary therapy following surgery: a prospective, match-controlled outcome study.

CONTEXT: Osteopathic manipulative treatment has been reported to relieve a variety of conditions, but no studies have examined the outcome effects of osteopathic manipulative treatment as a complementary modality for treating musculoskeletal problems during postoperative recovery. OBJECTIVE: To assess osteopathic manipulative treatment as a complementary therapy for patients undergoing elective knee or hip arthroplasty. DESIGN: Prospective, single-blinded, 2-group, match-controlled outcome study. SETTING: Osteopathic teaching hospital. PATIENTS: Of 166 eligible patients, 38 were assigned to a treatment group and matched with 38 control subjects. INTERVENTION: The treatment group received osteopathic manipulative treatment on postoperative days 2 through 5. MAIN OUTCOME MEASURES: Days to independent negotiation of stairs, distance ambulated, supplemental intramuscular analgesic use, length of hospital stay, and patients' perceptions of treatment. RESULTS: Compared to control subjects, the intervention group negotiated stairs 20% earlier (mean = 4.3 postoperative days, SD = 1.2; control subjects 5.4, SD = 1.6, P = .006) and ambulated 43% farther on the third postoperative day (mean = 24.3 m, SD = 18.3; controls = 13.9, SD = 14.4, P = .008). The intervention group also required less analgesia, had shorter hospital stays, and ambulated farther on postoperative days 1, 2, and 4. CONCLUSIONS: Patients receiving osteopathic manipulative treatment in the early postoperative period negotiated stairs earlier and ambulated greater distances than did control group patients.

Aged↗
PubMed2004

Osteopathic emergency physician training and use of osteopathic manipulative treatment.

Previous studies of osteopathic manipulative treatment (OMT) have examined its use in several clinical settings, but no study to date has been specific to emergency medicine. This article examines the use of OMT in the practice of emergency medicine by osteopathic physicians. Osteopathic physicians who identified their practice as emergency medicine were surveyed to determine OMT use, including techniques used, graduate medical education, and factors affecting usage. Use of OMT was common (55%), with a large minority (28%) of osteopathic physicians reporting daily or weekly usage. Techniques most often used include soft tissue treatment, high velocity/low amplitude treatment, and muscle energy treatment. Factors affecting usage include residency training, undergraduate medical experiences, and practice environment. These findings indicate that further investigation into the indications and efficacy of OMT in emergency medicine is warranted.

Adult↗
PubMed2005

Osteopathic manipulative medicine considerations in patients with chronic pain.

Osteopathic manipulative medicine (OMM) incorporates diagnostic and therapeutic strategies that address body unity, homeostatic mechanisms, and structure-function interrelationships. In regard to pain, osteopathic physicians take thorough histories guided by palpatory examination to determine the quality, duration, and origin of this condition, how it uniquely affects the individual, and whether segmental, reflex, or triggered pain phenomena coexist. Osteopathic manipulative medicine expands differential diagnoses by considering somatic dysfunction and treatment options by integrating specific aspects of complementary care into state-of-the-art pain management practices. Prescriptions formulated through an OMM algorithm integrate each osteopathic tenet with biopsychosocial and patient education models and medication, rehabilitation, and manual medicine techniques proportionate to individual needs.

Algorithms↗
PubMed1990

Quality assurance monitoring of osteopathic manipulative treatment.

The quality assurance review program of military medicine has implications for civilian osteopathic medicine. Clinical monitors need to be developed that are based on the principles of osteopathy. Components of a quality assurance screening checklist for osteopathic manipulative treatment include credentials of the osteopathic physician, the diagnosis, either somatic dysfunction or other condition, the type of osteopathic manipulative treatment applied, and specific contraindications. A checklist applicable to osteopathic manipulative treatment that could be used by military and civilian sectors is suggested.

Clinical Protocols↗
PubMed2005

Community-based osteopathic manipulative medicine student clinic: changes in curriculum and student confidence levels.

The West Virginia School of Osteopathic Medicine in Lewisburg instituted a free, community-based medical clinic in spring 1995 as part of an institution-wide Osteopathic Principles and Practices Integration Project. Under this initiative, osteopathic medical students are provided with 26 hours of supervised experience in osteopathic palpatory diagnosis and osteopathic manipulative treatment. The educational goal of the clinic is to increase the confidence of osteopathic medical students in their technical abilities in using osteopathic manipulative medicine to diagnose and treat community patients. Based on a variety of results from student-completed surveys, the authors conclude that the osteopathic manipulative medicine student clinic at West Virginia School of Osteopathic Medicine has met its goal of increasing student confidence in the application of these skills.

Ambulatory Care Facilities↗
PubMed2001

Diminished use of osteopathic manipulative treatment and its impact on the uniqueness of the osteopathic profession.

PURPOSE: To determine whether osteopathic manipulative treatment (OMT), a key identifiable feature of osteopathic medicine, is becoming a "lost art" in the profession, and whether the long-term evolution of osteopathic medicine into mainstream medicine and particularly specialization has had a similar impact on the use of OMT by family practitioners and specialists. METHOD: In April 1998, a two-page questionnaire was mailed to 3,000 randomly selected osteopathic physicians in the United States to assess factors affecting their use of OMT. Descriptive statistics, linear regression analyses, and analysis of variance techniques were used to test for differences. RESULTS: The response rate was 33.2%. Over 50% of the responding osteopathic physicians used OMT on less than 5% of their patients, and analysis of variance revealed OMT use was significantly affected by practice type, graduation date, and family physicians versus specialists. For specialists, 58% of the variance regression was attributed to barriers to use, practice protocol, attitudes, and training, whereas for family physicians, 43% of the variance regression was attributed to barriers to use, practice protocol, and attitudes. More important, the eventual level of OMT use was related to whether postgraduate training had been undertaken in osteopathic, allopathic, or mixed staff facilities, particularly for osteopathic specialists. CONCLUSIONS: The evidence supports the assertion that OMT is becoming a lost art among osteopathic practitioners. Osteopathic as well as allopathic medical educators and policymakers should address the impact of the diminished use of OMT on both U.S. health care and the unique identifying practices associated with the osteopathic profession.

Adult↗
PubMed2006

Incidence of iatrogenesis associated with osteopathic manipulative treatment of pediatric patients.

CONTEXT: Although studies have been published documenting the safety and efficacy of osteopathic manipulative treatment (OMT) in adults, no studies exist documenting the safety of OMT in pediatric patients. OBJECTIVE: To determine the incidence of iatrogenesis (ie, aggravations and complications) derived from OMT in the pediatric patient population. DESIGN: A retrospective review of medical records was conducted looking for documentation of aggravations or complications subsequent to OMT. Treatment-associated aggravations were defined as worsening of symptoms or complaints after treatment. Treatment complications were defined as cerebrovascular accidents, dislocation, fracture, pneumothorax, sprains and strains, or death as a treatment outcome. The authors documented all occurrences of treatment-associated aggravations or complications recorded at each office visit, as well as the timing of an aggravation between office visits. SETTING: Medical records of pediatric patients receiving OMT and being seen more than twice at osteopathic manipulative medicine offices in Pennsylvania and Virginia were reviewed. PATIENTS: Of 502 pediatric patients' medical records reviewed, 346 met the inclusion criteria of two or more office visits for which adequate follow-up data were available. RESULTS: No treatment-associated complications were documented. Thirty-one (9%) patients had documented treatment-associated aggravations. There was no significant difference between the proportion of male and female patients considered in the study, relative to a 50/50 distribution (females, 48%; males, 52%). CONCLUSIONS: Osteopathic manipulative treatment appears to be a safe treatment modality in the pediatric population when administered by physicians with expertise in OMT. Future studies should be prospective and include larger numbers of patients to document the safety of OMT in this clinical application.

Adolescent↗
PubMed2006

In vitro biophysical strain model for understanding mechanisms of osteopathic manipulative treatment.

CONTEXT: Normal physiologic movement, pathologic conditions, and osteopathic manipulative treatment (OMT) are believed to produce effects on the shape and proliferation of human fibroblasts. Studies of biophysically strained fibroblasts would be useful in producing a model of the cellular mechanisms underlying OMT. OBJECTIVE: To investigate the effects of acyclic in vitro biophysical strain on normal human dermal fibroblasts and observe potential changes in cellular shape and proliferation, as well as potential changes in cellular production of nitric oxide, interleukin (IL) 1beta, and IL-6. DESIGN AND METHODS: Randomized controlled trial. Human fibroblasts were subjected in vitro to control conditions (no strain) or biophysical strain of various magnitudes (10%-30% beyond resting length) and durations (12-72 hours). After control or strain stimuli, fibroblasts were analyzed for potential changes in cell shape, proliferative capacity, nitric oxide secretion, and cytokine (IL-1beta, IL-6) secretion. RESULTS: Low strain magnitudes (<20%) induced mild cellular rounding and pseudopodia truncation. High strain magnitudes (>20%) decreased overall cell viability and the mitogenic response, and induced cell membrane decomposition and pseudopodia loss. No basal or strain-induced secretion of IL-1beta was observed. Interleukin 6 concentrations increased two-fold, while nitric oxide levels increased three-fold, in cells strained at 10% magnitude for 72 hours (P<.05). CONCLUSION: Human fibroblasts respond to in vitro strain by secreting inflammatory cytokines, undergoing hyperplasia, and altering cell shape and alignment. The in vitro biophysical strain model developed by the authors is useful for simulating a variety of injuries, determining in vivo mediators of somatic dysfunction, and investigating the underlying mechanisms of OMT.

Biomechanical Phenomena↗