Healthcare

2024

Jump to: 2023, 2022

20 pages, 2196 KiB

Open AccessArticle

Does Osteopathic Heart-Focused Palpation Modify Heart Rate Variability in Stressed Participants with Musculoskeletal Pain? A Randomised Controlled Pilot Study

by Torsten Liem, Lucas Bohlen, Anna-Moyra Jung, Samira Hitsch and Tobias Schmidt

Healthcare 2024, 12(2), 138; https://doi.org/10.3390/healthcare12020138 - 08 Jan 2024

Cited by 1 | Viewed by 2408

Abstract

Heart rate variability (HRV) describes fluctuations in time intervals between heartbeats and reflects autonomic activity. HRV is reduced in stressed patients with musculoskeletal pain and improved after osteopathic manipulative treatment and mind–body interventions. Heart-focused palpation (HFP) combines manual and mind–body approaches to facilitate [...] Read more.

Heart rate variability (HRV) describes fluctuations in time intervals between heartbeats and reflects autonomic activity. HRV is reduced in stressed patients with musculoskeletal pain and improved after osteopathic manipulative treatment and mind–body interventions. Heart-focused palpation (HFP) combines manual and mind–body approaches to facilitate relaxation. This randomised controlled pilot study investigated the feasibility and sample size for a future randomised controlled trial and the effect of a single treatment with HFP or sham HFP (SHAM) on short-term HRV. A total of Thirty-three adults (47.7 ± 13.5 years old) with stress and musculoskeletal pain completed the trial with acceptable rates of recruitment (8.25 subjects per site/month), retention (100%), adherence (100%), and adverse events (0%). HFP (n = 18), but not SHAM (n = 15), significantly increased the root mean square of successive RR interval differences (p = 0.036), standard deviation of the NN intervals (p = 0.009), and ratio of the low-frequency to high-frequency power band (p = 0.026). HFP and SHAM significantly decreased the heart rate (p < 0.001, p = 0.009) but not the stress index and ratio of the Poincaré plot standard deviation along and perpendicular to the line of identity (p > 0.05). A power analysis calculated 72 participants. Taken together, the study was feasible and HFP improved HRV in stressed subjects with musculoskeletal pain, suggesting a parasympathetic effect. Full article

► Show Figures

Figure 1

22 pages, 1358 KiB

Open AccessReview

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

by Silvia Clara Tuscano, Jason Haxton, Antonio Ciardo, Luigi Ciullo and Rafael Zegarra-Parodi

Healthcare 2024, 12(2), 130; https://doi.org/10.3390/healthcare12020130 - 06 Jan 2024

Viewed by 2670

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 [...] Read more.

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. Full article

► Show Figures

Graphical abstract

2023

Jump to: 2024, 2022

23 pages, 418 KiB

Open AccessPerspective

Neurophysiology, Neuro-Immune Interactions, and Mechanobiology in Osteopathy in the Cranial Field: An Evidence-Informed Perspective for a Scientific Rationale

by Nicola Barsotti, Alessandro Casini, Marco Chiera, Christian Lunghi and Mauro Fornari

Healthcare 2023, 11(23), 3058; https://doi.org/10.3390/healthcare11233058 - 28 Nov 2023

Viewed by 6130

Abstract

(1) Background: Osteopathy in the cranial field (OCF) is a distinctive approach within osteopathy, focusing on the cranial region’s manual manipulation. Nevertheless, OCF fosters doubt in the scientific community because it refers to out-of-date models. This perspective paper critically analyzes the current knowledge [...] Read more.

(1) Background: Osteopathy in the cranial field (OCF) is a distinctive approach within osteopathy, focusing on the cranial region’s manual manipulation. Nevertheless, OCF fosters doubt in the scientific community because it refers to out-of-date models. This perspective paper critically analyzes the current knowledge in the fields of neurophysiology and mechanobiology to propose an evidence-informed rationale for OCF. (2) Methods: The reporting framework used in the current perspective article obeyed the guidelines for writing a commentary. (3) Results: The article’s main findings focus on the tactile stimulation of exocranial receptors and their implications in the management of craniofacial algic-dysfunctional syndromes implementing OCF. (4) Conclusions: By establishing an evidence-based rationale for OCF, this research aims to guide future directions in OCF and contribute to a more patient-centered and effective approach to health and wellbeing. Full article

19 pages, 2004 KiB

Open AccessEditor’s ChoiceSystematic Review

Effectiveness of Osteopathic Manipulative Treatment in Adults with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

by Francesca Buffone, Andrea Gianmaria Tarantino, Federico Belloni, Andrea Spadafora, Giorgio Bolzoni, Irene Bruini, Andrea Bergna and Luca Vismara

Healthcare 2023, 11(17), 2442; https://doi.org/10.3390/healthcare11172442 - 31 Aug 2023

Cited by 1 | Viewed by 2113

Abstract

The aim of this systematic review and meta-analysis was to evaluate the effectiveness of the osteopathic manipulative treatment (OMT) in adults with irritable bowel syndrome (IBS). A literature resview was carried out on the following databases: PubMed, Embase, Cochrane, Cinahl, Scopus, PEDro and [...] Read more.

The aim of this systematic review and meta-analysis was to evaluate the effectiveness of the osteopathic manipulative treatment (OMT) in adults with irritable bowel syndrome (IBS). A literature resview was carried out on the following databases: PubMed, Embase, Cochrane, Cinahl, Scopus, PEDro and ClinicalTrials.gov. 350 articles were recovered. Eligibility criteria were evaluated by two independent reviewers, including randomized controlled trials (RCTs), quasi-RCTs, or ongoing RCTs with OMT compared to any kind of control in patients diagnosed with IBS. Six studies (five RCTs and one ongoing RCT) were considered eligible. Four RCTs were classified as some concerns and one as high risk of bias. In the meta-analysis, OMT compared to sham/no intervention showed statistically significant results for abdominal pain (effect size ES = −1.14 [−1.66, −0.62]; p < 0.0001) and constipation (ES = −0.66 [−1.12, −0.20]; p = 0.005). Instead, OMT was not superior to the control for the IBS symptoms measured with the IBS Severity Score and the Likert scale (ES = −0.34 [−0.83, 0.16]; p = 0.19), and diarrhea (ES = −1.20 [−2.84, 0.43]; p = 0.15). The quality of evidence was “low” for IBS symptoms in general for abdominal pain and constipation, while it was judged as “very low” for diarrhea. OMT turns out to be safe in the treatment of IBS without major adverse effects. OMT may be effective in IBS patients, however the results must be interpreted carefully due to the low methodological quality of the studies. Full article

► Show Figures

Figure 1

26 pages, 3373 KiB

Open AccessPerspective

Reconceptualizing Somatic Dysfunction in the Light of a Neuroaesthetic Enactive Paradigm

by Giacomo Consorti, Carmine Castagna, Marco Tramontano, Mauro Longobardi, Paolo Castagna, Daniele Di Lernia and Christian Lunghi

Healthcare 2023, 11(4), 479; https://doi.org/10.3390/healthcare11040479 - 07 Feb 2023

Cited by 4 | Viewed by 5585

Abstract

Background: Palpatory findings are considered a central element of osteopathic practice, especially when associated with a patient’s altered regulative functions than with named somatic dysfunctions. Although osteopathic theories for somatic dysfunction could be plausible, the clinical applicability of the concept is debated, especially [...] Read more.

Background: Palpatory findings are considered a central element of osteopathic practice, especially when associated with a patient’s altered regulative functions than with named somatic dysfunctions. Although osteopathic theories for somatic dysfunction could be plausible, the clinical applicability of the concept is debated, especially because it is largely related to simple cause–effect models of osteopathic care. In contrast to a linear kind of diagnosis of a “tissue as a producer of symptoms”, this perspective article aims to provide a conceptual and operational framework in which the somatic dysfunction evaluation process is seen as a neuroaesthetic (en)active encounter between osteopath and patient. Subsections relevant to the subject: To summarize all concepts of the hypothesis, the enactive neuroaesthetics principles are proposed as a critical foundation for the osteopathic assessment and treatment of the person, specifically addressing a new paradigm for somatic dysfunction. Conclusions, and future directions: The present perspective article represents a proposition to blend technical rationality informed by neurocognitive and social sciences, and professional artistry clinical experience informed by traditional tenets, to overcome the controversy around somatic dysfunction, rather than dismissing the concept. Full article

► Show Figures

Figure 1

2022

Jump to: 2024, 2023

23 pages, 867 KiB

Open AccessEditor’s ChoiceEssay

Historical Osteopathic Principles and Practices in Contemporary Care: An Anthropological Perspective to Foster Evidence-Informed and Culturally Sensitive Patient-Centered Care: A Commentary

by Rafael Zegarra-Parodi, Francesca Baroni, Christian Lunghi and David Dupuis

Healthcare 2023, 11(1), 10; https://doi.org/10.3390/healthcare11010010 - 21 Dec 2022

Cited by 7 | Viewed by 6512

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 [...] Read more.

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. Full article

► Show Figures

Graphical abstract

14 pages, 665 KiB

Open AccessReview

A Systematic Review on Spinal Asymmetries in Case Studies of Unilateral Nephroptosis from a Viscerosomatic Point of View

by Ángel Oliva-Pascual-Vaca, María José Castillo-Cañuelo, Jesús Oliva-Pascual-Vaca, María Pérez-Montalbán, Francisco Javier Ordonez and José Antonio Martínez-Fernández

Healthcare 2022, 10(12), 2422; https://doi.org/10.3390/healthcare10122422 - 30 Nov 2022

Viewed by 1733

Abstract

The assessment of posture and asymmetries is common in musculoskeletal clinical practice, and correction is a frequent goal. In this setting, posture and asymmetries are usually interpreted in terms of musculoskeletal issues. This study aimed to evaluate spinal asymmetries in case studies of [...] Read more.

The assessment of posture and asymmetries is common in musculoskeletal clinical practice, and correction is a frequent goal. In this setting, posture and asymmetries are usually interpreted in terms of musculoskeletal issues. This study aimed to evaluate spinal asymmetries in case studies of unilateral nephroptosis. A systematic review was performed using PubMed, CINAHL, Scopus and Web of Science. We included case reports and case series of nephroptotic patients which showed diagnostic imaging that allowed us to assess the presence of spinal asymmetries in the frontal plane. The methodological quality of the selected studies was assessed by using Case Report (CARE) checklist. Nineteen studies were included, with a total number of 78 reported patients (69 women) ranging 22 to 44 years old (mean: 29). Only one patient presented with medial nephroptosis, while the rest presented with caudal migration. Ninety-one percent of the cases affected to the right kidney. All cases but two showed homolateral flank closure (lower rib descent, iliac crest raise and/or homolateral side-bending). The correction of nephroptosis, either by supine position or surgical treatment, removed asymmetries in some cases while other cases improved only partly. Manual therapists must consider visceral implications while assessing body posture. Further, since the most common symptom of nephroptosis is loin pain, and it has been claimed that loin pain is underdiagnosed, manual therapists should consider its potential presence during clinical practice. Finally, being that nephroptosis shares several features with idiopathic lumbar scoliosis (type of patient, postural adaptation), more research is needed regarding any possible relation between them. Full article

► Show Figures

Figure 1

11 pages, 869 KiB

Open AccessArticle

Model-Base Estimation of Non-Invasive Ventilation Weaning of Preterm Infants Exposed to Osteopathic Manipulative Treatment: A Propensity-Score-Matched Cohort Study

by Andrea Gianmaria Tarantino, Luca Vismara, Francesca Buffone, Giuliana Bianchi, Andrea Bergna, Monica Vanoni, Claudia Tabbi, Ilia Bresesti and Massimo Agosti

Healthcare 2022, 10(12), 2379; https://doi.org/10.3390/healthcare10122379 - 27 Nov 2022

Cited by 2 | Viewed by 2528

Abstract

Ventilation weaning is a key intensive care event influencing preterm infants’ discharge from a neonatal intensive care unit (NICU). Osteopathic manipulative treatment (OMT) has been recently introduced in some Italian NICUs. This retrospective cohort study tested if OMT is associated with faster non-invasive [...] Read more.

Ventilation weaning is a key intensive care event influencing preterm infants’ discharge from a neonatal intensive care unit (NICU). Osteopathic manipulative treatment (OMT) has been recently introduced in some Italian NICUs. This retrospective cohort study tested if OMT is associated with faster non-invasive ventilation (NIV) weaning. The time to NIV weaning was assessed in very preterm and very low birth weight infants who either received or did not receive OMT. The propensity score model included gender, antenatal steroids, gestational age (GA), birth weight (BW), and Apgar score 5′. Out of 93 infants, 40 were included in the multilevel survival analysis, showing a reduction of time to NIV weaning for GA (HR: 2.58, 95%CI: 3.91 to 1.71, p < 0.001) and OMT (HR: 3.62, 95%CI: 8.13 to 1.61, p = 0.002). Time to independent ventilation (TIV) was modeled with GA and BW as dependent variables and OMT as the factor. A negative linear effect of GA and BW on TIV was shown. OMT exposure studied as the factor of GA had effects on TIV in infants born up to the 32nd gestational week. Preterm infants exposed to OMT were associated with earlier achievement of NIV weaning. This result, together with the demonstrated OMT safety, suggests the conduct of clinical trials in preterm infants younger than 32 weeks of GA. Full article

► Show Figures

Figure 1

16 pages, 1242 KiB

Open AccessArticle

The Profile of Belgian Osteopaths: A Cross-Sectional Survey

by Patrick L.S. van Dun, Johan Verbeeck, Lorenzo Arcuri, Jorge E. Esteves and Francesco Cerritelli

Healthcare 2022, 10(11), 2136; https://doi.org/10.3390/healthcare10112136 - 27 Oct 2022

Cited by 5 | Viewed by 1679

Abstract

Background: This study gives an update on the characteristics of Belgian osteopaths five years after the Benelux Osteosurvey. Additional new data were collected on their professional identity and views on the profession. Methods: All Belgian osteopaths who could be contacted (n = [...] Read more.

Background: This study gives an update on the characteristics of Belgian osteopaths five years after the Benelux Osteosurvey. Additional new data were collected on their professional identity and views on the profession. Methods: All Belgian osteopaths who could be contacted (n = 1473) were invited to complete a voluntary, online-based, closed-ended survey distributed between May and September 2018. The survey, composed of 52 questions and seven sections, was formally translated from English to Dutch and French and adapted from the original version. Adult, self-defined osteopaths working in Belgium were eligible. Recruitment of participants was performed through all professional associations and the InterMutualistic Agency. Descriptive statistics were used to analyse the data. Results: The survey was completed by 332 osteopaths. Thirty-one per cent of the respondents were female. Almost all the respondents were self-employed (99.4%); half of them worked as part of a team (47.6%). Most respondents had a 5-year part-time training, and the majority had a previous academic degree, mainly in physical therapy (65.8%). According to respondents, most patients seek care for lumbar non-specific low back, pelvis and neck pain. Most respondents strongly define themselves as osteopaths and advertise themselves exclusively as osteopaths. Conclusions: This survey provided an update of the current characteristics of Belgian osteopathic practitioners and added new information on their professional identity and views on the profession. The information provided could contribute to the body of evidence used by stakeholders and policymakers in the future regulation of the profession in Belgium. Full article

► Show Figures

Figure 1

25 pages, 2701 KiB

Open AccessArticle

Beliefs and Use of Palpatory Findings in Osteopathic Clinical Practice: A Qualitative Descriptive Study among Italian Osteopaths

by Andrea Bergna, Matteo Galli, Francesco Todisco and Francesca Berti

Healthcare 2022, 10(9), 1647; https://doi.org/10.3390/healthcare10091647 - 29 Aug 2022

Cited by 1 | Viewed by 2914

Abstract

The Italian government has started the regulatory process of osteopathy to include it among the healthcare professions mentioning terms, such as “perceptual palpation” and “somatic dysfunction” within the professional profile. ‘Palpatory findings’ are one of the multidimensional aspects that can inform osteopathic clinical [...] Read more.

The Italian government has started the regulatory process of osteopathy to include it among the healthcare professions mentioning terms, such as “perceptual palpation” and “somatic dysfunction” within the professional profile. ‘Palpatory findings’ are one of the multidimensional aspects that can inform osteopathic clinical reasoning. The non-regulated educational system has led to heterogenic professionals working in Italy, thus, the aim of this study was to investigate how Italian experts use palpatory findings in their clinical practice. A total of 12 experts were selected to participate in four virtual focus groups. A qualitative inductive approach with a constructivist paradigm was chosen to describe the results. The themes that emerged were: osteopathic identity; evaluation; osteopathic diagnosis; and sharing with different recipients. Participants agreed on the peculiarity and distinctiveness of osteopathic palpation, but there was some disagreement on the clinical significance of the findings, highlighting a complex multidimensional approach to diagnosis and treatment. The results seem to reflect the history of the profession in Italy, which has evolved quickly, leading professionals to seek new paradigms blending tradition and scientific evidence. The authors suggest further investigation to verify the state of art among osteopaths not involved in research or a broader consensus of the results. Full article

► Show Figures

Figure 1

16 pages, 1217 KiB

Open AccessReview

The Role of Osteopathic Care in Gynaecology and Obstetrics: An Updated Systematic Review

by Nuria Ruffini, Giandomenico D’Alessandro, Annalisa Pimpinella, Matteo Galli, Tiziana Galeotti, Francesco Cerritelli and Marco Tramontano

Healthcare 2022, 10(8), 1566; https://doi.org/10.3390/healthcare10081566 - 18 Aug 2022

Cited by 4 | Viewed by 5257

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 [...] Read more.

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. Full article

► Show Figures

Figure 1

18 pages, 1661 KiB

Open AccessReview

Osteopathic Treatment for Gastrointestinal Disorders in Term and Preterm Infants: A Systematic Review and Meta-Analysis

by Francesca Buffone, Domenico Monacis, Andrea Gianmaria Tarantino, Fulvio Dal Farra, Andrea Bergna, Massimo Agosti and Luca Vismara

Healthcare 2022, 10(8), 1525; https://doi.org/10.3390/healthcare10081525 - 12 Aug 2022

Cited by 3 | Viewed by 3307

Abstract

The aim of this systematic review and meta-analysis is to evaluate the effectiveness of osteopathic manipulative treatment (OMT) for gastrointestinal disorders in term and preterm infants. Eligible studies were searched on PubMed, Scopus, Embase, Cochrane, Cinahl, and PEDro. Two reviewers independently assessed if [...] Read more.

The aim of this systematic review and meta-analysis is to evaluate the effectiveness of osteopathic manipulative treatment (OMT) for gastrointestinal disorders in term and preterm infants. Eligible studies were searched on PubMed, Scopus, Embase, Cochrane, Cinahl, and PEDro. Two reviewers independently assessed if the studies were randomized controlled trials (RCTs) and retrospective studies with OMT compared with any kind of control in term or preterm infants to improve gastrointestinal disorders. Nine articles met the eligibility criteria, investigating OMT compared with no intervention, five involving term infants, and the remaining treating preterm infants. Five studies showed low risk of bias. In the meta-analysis, two studies were included to analyze the hours of crying due to infantile colic, showing statistically significant results (ES = −2.46 [−3.05, −1.87]; p < 0.00001). The quality of evidence was “moderate”. The other outcomes, such as time to oral feeding, meconium excretion, weight gain, and sucking, were presented in a qualitative synthesis. OMT was substantially safe, and showed efficacy in some cases, but the conflicting evidence and lack of high-quality replication studies prevent generalization. High-quality RCTs are recommended to produce better-quality evidence. Full article

► Show Figures

Figure 1

12 pages, 1047 KiB

Open AccessCommunication

An Enactive–Ecological Model to Guide Patient-Centered Osteopathic Care

by Francesco Cerritelli and Jorge E. Esteves

Healthcare 2022, 10(6), 1092; https://doi.org/10.3390/healthcare10061092 - 12 Jun 2022

Cited by 8 | Viewed by 3857

Abstract

Osteopaths commonly face complexity and clinical uncertainty in their daily professional practice as primary contact practitioners. In order to effectively deal with complex clinical presentations, osteopaths need to possess well-developed clinical reasoning to understand the individual patient’s lived experience of pain and other [...] Read more.

Osteopaths commonly face complexity and clinical uncertainty in their daily professional practice as primary contact practitioners. In order to effectively deal with complex clinical presentations, osteopaths need to possess well-developed clinical reasoning to understand the individual patient’s lived experience of pain and other symptoms and how their problem impacts their personhood and ability to engage with their world. We have recently proposed (En)active inference as an integrative framework for osteopathic care. The enactivist and active inference frameworks underpin our integrative hypothesis. Here, we present a clinically based interpretation of our integrative hypothesis by considering the ecological niche in which osteopathic care occurs. Active inference enables patients and practitioners to disambiguate each other’s mental states. The patients’ mental states are unobservable and must be inferred based on perceptual cues such as posture, body language, gaze direction and response to touch and hands-on care. A robust therapeutic alliance centred on cooperative communication and shared narratives and the appropriate and effective use of touch and hands-on care enable patients to contextualize their lived experiences. Touch and hands-on care enhance the therapeutic alliance, mental state alignment, and biobehavioural synchrony between patient and practitioner. Therefore, the osteopath–patient dyad provides mental state alignment and opportunities for ecological niche construction. Arguably, this can produce therapeutic experiences which reduce the prominence given to high-level prediction errors—and consequently, the top-down attentional focus on bottom-up sensory prediction errors, thus minimizing free energy. This commentary paper primarily aims to enable osteopaths to critically consider the value of this proposed framework in appreciating the complexities of delivering person-centred care. Full article

► Show Figures

Figure 1

16 pages, 956 KiB

Open AccessReview

Tissutal and Fluidic Aspects in Osteopathic Manual Therapy: A Narrative Review

by Marco Verzella, Erika Affede, Luca Di Pietrantonio, Vincenzo Cozzolino and Luca Cicchitti

Healthcare 2022, 10(6), 1014; https://doi.org/10.3390/healthcare10061014 - 31 May 2022

Cited by 5 | Viewed by 3701

Abstract

Over the years, several authors have discussed the possibility of considering somatic dysfunction (SD) as a “nosological element” detectable on palpation. There are many aspects to consider regarding the etiology and diagnosis of SD, and the literature on osteopathic issues provides details on [...] Read more.

Over the years, several authors have discussed the possibility of considering somatic dysfunction (SD) as a “nosological element” detectable on palpation. There are many aspects to consider regarding the etiology and diagnosis of SD, and the literature on osteopathic issues provides details on physiological signs that characterize it, including tissue texture changes. Recent knowledge suggests that how tissue and, in particular, connective tissue, responds to osteopathic treatment may depend on the modulation of the inflammation degree. Low-grade inflammation (LGI) may act on the extracellular matrix (ECM) and on cellular elements; and these mechanisms may be mediated by biological water. With its molecules organized in structures called exclusion zones (EZ), water could explain the functioning of both healthy and injured tissues, and how they can respond to osteopathic treatment with possible EZ normalization as a result. The relationship between inflammation and DS and the mechanisms involved are described by several authors; however, this review suggests a new model relating to the characteristics of DS and to its clinical implications by linking to LGI. Tissue alterations detectable by osteopathic palpation would be mediated by body fluids and in particular by biological water which has well-defined biophysical characteristics. Research in this area is certainly still to be explored, but our suggestion seems plausible to explain many dynamics related to osteopathic treatment. We believe that this could open up a fascinating scenario of therapeutic possibilities and knowledge in the future. Full article

► Show Figures

Figure 1

16 pages, 564 KiB

Open AccessArticle

Osteopathic Manipulative Treatment Regulates Autonomic Markers in Preterm Infants: A Randomized Clinical Trial

by Andrea Manzotti, Francesco Cerritelli, Erica Lombardi, Elena Monzani, Luca Savioli, Jorge E. Esteves, Matteo Galli, Simona La Rocca, Pamela Biasi, Marco Chiera and Gianluca Lista

Healthcare 2022, 10(5), 813; https://doi.org/10.3390/healthcare10050813 - 27 Apr 2022

Cited by 2 | Viewed by 4732

Abstract

Osteopathic manipulative treatment (OMT) has been found to be effective in the context of premature infants. Nonetheless, no studies have investigated the immediate effects of OMT on heart rate variability (HRV). As altered HRV reflects poor or worsening newborn’s clinical conditions and neurodevelopment, [...] Read more.

Osteopathic manipulative treatment (OMT) has been found to be effective in the context of premature infants. Nonetheless, no studies have investigated the immediate effects of OMT on heart rate variability (HRV). As altered HRV reflects poor or worsening newborn’s clinical conditions and neurodevelopment, should OMT improve HRV fluctuations, it could become a relevant intervention for improving the care of preterm newborns. Therefore, this study aimed to evaluate whether OMT could affect HRV. The study was carried out at the Buzzi Hospital in Milan. From the neonatal intensive care unit, ninety-six preterm infants (41 males) were enrolled and were randomly assigned to one of two treatment groups: OMT or Static Touch. The infants were born at 33.5 weeks (±4.3) and had a mean birth weight of 2067 g (±929). The study had as primary outcome the change in the beat-to-beat variance in heart rate measured through root mean square of consecutive RR interval differences (RMSSD); other metrics were used as secondary and exploratory analyses. Despite the lack of statistically significant results regarding the primary outcomeand some study limitations, compared to static touch, OMT seemed to favor a parasympathetic modulation and improved HRV, which could reflect improvement in newborn’s clinical conditions and development. Full article

► Show Figures

Figure 1

19 pages, 1091 KiB

Open AccessArticle

A Content Analysis of Osteopaths’ Attitudes for a More Inclusive Clinical Practice towards Transgender People

by Irene Baldin, Jorge E. Esteves, Marco Tramontano, Mia Macdonald, Francesca Baroni and Christian Lunghi

Healthcare 2022, 10(3), 562; https://doi.org/10.3390/healthcare10030562 - 17 Mar 2022

Viewed by 3772

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 [...] Read more.

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. Full article

► Show Figures

Graphical abstract

9 pages, 470 KiB

Open AccessEditor’s ChoiceReview

Patient Active Approaches in Osteopathic Practice: A Scoping Review

by Christian Lunghi, Francesca Baroni, Andrea Amodio, Giacomo Consorti, Marco Tramontano and Torsten Liem

Healthcare 2022, 10(3), 524; https://doi.org/10.3390/healthcare10030524 - 14 Mar 2022

Cited by 6 | Viewed by 6059

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 [...] Read more.

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. Full article

► Show Figures

Graphical abstract

Journal Menu

Journal Browser

Osteopathic and Manual Therapy Healthcare Reconceptualization: Health Needs and New Evidence

Share This Topical Collection

Editor

Topical Collection Information

Keywords

Published Papers (17 papers)

2024

Jump to: 2023, 2022

2023

Jump to: 2024, 2022

2022

Jump to: 2024, 2023

Further Information

Guidelines

MDPI Initiatives

Follow MDPI