Posts by: Patrick van Dun

Evidence-based medicine (EBM) requires that patient management decisions include deliberations on the best available evidence. However, engagement with EBM appears to be inconsistent. This pilot study used a mixed-methods approach to evaluate clinical educator and learner engagement with evidence in the clinical learning environment (CLE) through the SNAPPS-Plus clinical supervision model … ABSTRACT

Visceral dysfunction (e.g., mobility or motility restriction) may be an underlying cause or contributing factor for some non-specific LBP and can be treated by osteopathic manipulative treatment (OMT). The aim of this registered systematic review (CRD42018100633) is to determine the effectiveness of visceral mobilization for non-specific LBP and explore associations between changes in range of motion of the viscera and LBP symptoms … ABSTRACT

Muscle energy techniques are applied to reduce pain and increase range of motion. These are applied to a variety of pathological conditions and on asymptomatic subjects. There is however limited knowledge on their effectiveness and which protocol may be the most beneficial. The aim of this review is to determine the efficacy of muscle energy techniques (MET) in symptomatic and asymptomatic subjects … MORE

At the crux of patient centred care is Shared Decision Making (SDM), which benefits patient and practitioner. Despite external pressures, studies indicate that SDM remains poorly practised across a variety of healthcare professions. The degree of SDM engagement within United Kingdom osteopathic undergraduate teaching clinics is currently unknown. The authors of this study used the reliable and validated OPTION-12 (O12) instrument to calculate a score that reflected the degree of SDM utility in one United Kingdom Osteopathic Educational Institute’s teaching clinic … MORE

Concussions have been increasingly reported over the past decade, but the reported incidence likely minimizes the actual numbers of people affected. Associated symptoms include emotional, somatic, and cognitive complaints, which may be prolonged in patients with certain risk factors. Neurologic examination is necessary to exclude upper motor neuron lesions and thus the need for brain imaging. Cervical conditions are often found concurrently with head injury and displays a similar presentation to concussions. Therefore, determining symptom origin can be problematic. Neuropsychological, oculomotor, and balance evaluations expose specific deficits that can be successfully managed with rehabilitation. Osteopathic assessment of the cranium, spine, sacrum, and thorax for somatic dysfunctions allows for prudent interventions. Patients involved in sports may begin an established graduated return-to-play protocol once cleared by their physician. Concurrently, a parallel return-to-learn program, with applicable academic accommodations, is recommended … MORE

Nonpharmacologic treatment, such as osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) may be a beneficial complementary treatment for tension-type headache. However, to the authors’ knowledge, the benefit of OMTh in the management of tension-type headache has not been explored, especially chronic tension-type headache (CTTH). The objective of this study was to investigate the effectiveness of OMTh compared with traditional treatment in reducing pain intensity, frequency, and duration of CTTH, and to evaluate the objective postural measurement of the forward head posture (FHP) as an integral parameter in the assessment of the effects of OMTh and traditional management of CTTH … MORE

An essential prerequisite for the survival of an organism is the ability to detect and respond to aversive stimuli. Current belief is that noxious stimuli directly activate nociceptive sensory nerve endings in the skin. We discovered a specialized cutaneous glial cell type with extensive processes forming a mesh-like network in the subepidermal border of the skin that conveys noxious thermal and mechanical sensitivity. We demonstrate a direct excitatory functional connection to sensory neurons and provide evidence of a previously unknown organ that has an essential physiological role in sensing noxious stimuli. Thus, these glial cells, which are intimately associated with unmyelinated nociceptive nerves, are inherently mechanosensitive and transmit nociceptive information to the nerve … ABSTRACT

Physician empathy influences rapport with patients and improves outcomes, but it is not well understood as an outcome of osteopathic medical education. The objective of this study was to determine how clerkship preceptors at Touro University College of Osteopathic Medicine-CA (TUCOM) in Vallejo define empathy and how they compare observed empathetic behavior of TUCOM students with that of other medical students … MORE

Comparisons of osteopathic physicians (ie, DOs) and allopathic physicians (ie, MDs) on interpersonal manner, including empathy and communication style, have been limited by such methodologic issues as self-assessment and a focus on medical students rather than practicing physicians. The objective of this study was to compare perceptions of the interpersonal manner, empathy, and communication style of DOs and MDs and corresponding clinical measures reported by their patients … MORE