Posts by: Patrick van Dun

Effect of osteopathic visceral manipulation for individuals with functional constipation and chronic nonspecific low back pain: Randomized controlled trial

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The objective of this study was to investigate the effect of osteopathic visceral manipulation (OVM) on disability and pain intensity in individuals with functional constipation and chronic nonspecific low back pain … ABSTRACT

Attitudes and underlying beliefs of French osteopathy students, educators, and practitioners toward non-specific low back pain

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Psychosocial factors play a critical role in the prognosis and management of patients with non-specific low back pain (NSLBP). Scientific evidence suggests that an individual’s beliefs about pain are associated with the attitudes and beliefs of the clinician they consult. This study explores the attitudes, beliefs, and clinical orientations of students, recent graduates, educators, and non-teaching practitioners from two French osteopathic educational institutes regarding the management of NSLBP … ABSTRACT French

OSCAR (Osteopathic Single CAse Research) – Assessing the effect of standard and biopsychosocial osteopathic management for patients with non-specific low back pain: Protocol for a Single Case Experimental Design (SCED)

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Osteopathy has been shown to be effective in the management of chronic low back pain (LBP). Guidelines recommend biopsychosocial care for chronic, complex musculoskeletal conditions, including non-specific LBP. This study has four aims: 1/to assess how patients with LBP improve after osteopathic treatment, both before and after an osteopath has completed a Biopsychosocial Pain Management course; 2/to assess if it is feasible and acceptable for osteopaths to receive weekly SCED data and use it to guide patient management; 3/to assess if it is acceptable for patients to submit daily data and discuss weekly summary with their osteopaths; and 4/to test feasibility for researchers in collecting, managing and storing large quantities of individual patient data … ABSTRACT

Effects of a Myofascial Technique on the Stiffness and Thickness of the Thoracolumbar Fascia and Lumbar Erector Spinae Muscles in Adults with Chronic Low Back Pain: A Randomized before-and-after Experimental Study

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The thoracolumbar fascia (TLF) may be a pain generator, given its rich innervation. Structural and biomechanical changes have also been documented in adults with chronic non-specific low back pain (LBP). Myofascial techniques (MFTs) are commonly used in manual therapy and are hypothesized to reduce tissue stiffness and pain. However, evidence for these effects is limited. The objective of this study was to evaluate the immediate effects of a standardized MFT compared to a simulated MFT on: (1) the stiffness of the TLF and erector spinae muscles (shear-wave sonoelastography), (2) the thickness of the TLF (B-mode ultrasound), and (3) pain intensity (numerical rating scale). Forty-nine participants with chronic non-specific LBP were included in a randomized before-and-after experimental study. Outcome measures were collected before (T0) and immediately after the intervention (T1). Pain intensity was also assessed on day two (T2) and seven (T7). The MFT group showed a significant decrease in left erector spinae muscle stiffness and left TLF thickness compared to the simulated group. In addition, there was a significant reduction in pain intensity in the MFT group compared to the simulated group at T1 and T2. The results of this study suggest that MFT results in immediate tissue changes and transient pain reduction in patients with LBP … MORE

Effectiveness of osteopathic treatment in patients with Lower Urinary Tract Symptoms (LUTS)

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International continence society mentions that more than 50 % of females suffer from lower urinary tract symptoms (LUTS) and more than 90% of them were not on any medication. LUTS is a term that covers symptoms resulting from conditions affecting the urinary bladder and urethra, prostate, other pelvic organs or any other part of the body which is related to the bladder and urethra anatomically. LUTS can be classified into 3 subcategories, i.e., storage symptoms (symptoms during storage of urine), voiding symptoms (symptoms during micturition), and post micturition symptoms (symptoms after completing micturition). Patients with LUTS may present with a combination of storage, voiding, and post micturition symptoms. The aim of this study is to assess the effectiveness of osteopathy treatment in patients with lower urinary tract symptoms … ABSTRACT

Osteopathic manipulative treatment of patients with chronic low back pain in the United States: a retrospective cohort study

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The practice of osteopathic manipulative treatment (OMT) varies substantially across nations. Much of this variability may be attributed to disparate international educational, licensing, and regulatory environments that govern the practice of osteopathy by nonphysicians. This is in contrast with the United States, where osteopathic physicians are trained to integrate OMT as part of comprehensive patient management. This study will analyze the factors associated with OMT use and its outcomes when integrated within the overall medical care for chronic low back pain (CLBP) provided by osteopathic physicians in the United States … MORE

Impact of osteopathic manipulative techniques on the management of dizziness caused by neuro-otologic disorders: systematic review and meta-analysis

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Osteopathic manipulative treatment (OMT) has been utilized by osteopathic clinicians as primary or adjunctive management for dizziness caused by neuro-otologic disorders. To our knowledge, no current systematic reviews provide pooled estimates that evaluate the impact of OMT on dizziness. This study aimed to systematically evaluate the effectiveness and safety of OMT and analogous techniques in the treatment of dizziness … MORE

“It’s all about the story”. Osteopaths’ experiences of exploring menopausal symptoms: A qualitative interview study

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The prevalence of natural menopause means that middle aged women seeking osteopathic treatment are likely to have symptoms, but it is unknown how osteopaths explore and give advice about it. The aim of this study was to explore osteopaths’ experiences of screening for symptoms of menopause and providing advice to climacteric patients … ABSTRACT

Enabling health potential: exploring nonlinear and complex results of osteopathic manual medicine through complex systems theory

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Osteopathic medicine is a holistic, patient-specific approach. Explaining the impact of osteopathic manipulative medicine (OMM) has been problematic because many of its effects are nonlinear. Complex systems theory (CST) is explored as a mechanism of understanding the interplay of the body’s anatomy and physiology, an illness process, and the effects of OMM. Tensegrity is discussed as an example of an emergent property of the body’s systems that affects not only biomechanics but also pathophysiology. Previous explanations of osteopathic philosophy are reviewed. The Host + Disease=Illness paradigm is a way to think through the impact of host and disease factors on an illness state, and how targeted interventions may affect the illness. The Osteopathic 5 Models are another way to view the body’s complexity. The area of greatest restriction (AGR) screen can be understood to direct OMM in a way that respects complexity and enables asymmetric and nonlocal results to realize health potential. The impact of this framework is in coherently explaining the impact of osteopathic philosophy and OMM and exploring new approaches to research … MORE

Revisiting chronic low back pain: evidence that it is not non-specific

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There is a common symptom pattern with most chronic low back pain (CLBP), suggesting that there is a common underlying etiology, belying the term “nonspecific.” Many studies of CLBP and its treatment have been conducted with the assumption of nonspecificity, and as a result, treatment has not been focused, thus there has not been a significant change in CLBP prevalence over the past several decades. It is the thesis of this study to show that there is an underlying, specific cause of CLBP and that the presumption that CLBP is nonspecific is misdirected. The lumbosacropelvic (LSP) region, including the sacroiliac joint (SIJ), is part of a neuromusculoskeletal (NMSK) feedback system, and it is proposed here that CLBP is the result of a change in the feedback (afferent) aspect in that system. The objectives of this study are to show that CLBP presents as a pattern of symptoms that actually represents the final common pathway for a dysfunctional LSP joint system. Rather than being “nonspecific,” the majority of CLBP has an underlying cause that is quite specific and predictable … MORE

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