News update – Page 13 – COME collaboration

Patient Active Approaches in Osteopathic Practice: A Scoping Review

15 March 2022 | By Patrick van Dun | 0 Comments

15 March 2022

Patient Active Approaches in Osteopathic Practice: A Scoping Review

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 … MORE

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Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Synchrony

21 February 2022 | By Patrick van Dun | 0 Comments

21 February 2022

Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Synchrony

Recognizing and aligning individuals’ unique adaptive beliefs or “priors” through cooperative communication is critical to establishing a therapeutic relationship and alliance. Using active inference, we present an empirical integrative account of the biobehavioral mechanisms that underwrite therapeutic relationships. A significant mode of establishing cooperative alliances—and potential synchrony relationships—is through ostensive cues generated by repetitive coupling during dynamic touch. Established models speak to the unique role of affectionate touch in developing communication, interpersonal interactions, and a wide variety of therapeutic benefits for patients of all ages; both neurophysiologically and behaviorally. The purpose of this article is to argue for the importance of therapeutic touch in establishing a therapeutic alliance and, ultimately, synchrony between practitioner and patient. We briefly overview the importance and role of therapeutic alliance in prosocial and clinical interactions. We then discuss how cooperative communication and mental state alignment—in intentional communication—are accomplished using active inference. We argue that alignment through active inference facilitates synchrony and communication. The ensuing account is extended to include the role of (C-) tactile afferents in realizing the beneficial effect of therapeutic synchrony. We conclude by proposing a method for synchronizing the effects of touch using the concept of active inference … MORE

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Osteopathic Care as (En)active Inference: A Theoretical Framework for Developing an Integrative Hypothesis in Osteopathy

19 February 2022 | By Patrick van Dun | 0 Comments

19 February 2022

Osteopathic Care as (En)active Inference: A Theoretical Framework for Developing an Integrative Hypothesis in Osteopathy

Osteopathy is a person-centred healthcare discipline that emphasizes the body’s structure-function interrelationship—and its self-regulatory mechanisms—to inform a whole-person approach to health and wellbeing. This paper aims to provide a theoretical framework for developing an integrative hypothesis in osteopathy, which is based on the enactivist and active inference accounts. We propose that osteopathic care can be reconceptualised under (En)active inference as a unifying framework. Active inference suggests that action-perception cycles operate to minimize uncertainty and optimize an individual’s internal model of the lived world and, crucially, the consequences of their behaviour. We argue that (En)active inference offers an integrative framework for osteopathy, which can evince the mechanisms underlying dyadic and triadic (e.g., in paediatric care) exchanges and osteopathic care outcomes. We propose that this theoretical framework can underpin osteopathic care across the lifespan, from preterm infants to the elderly and those with persistent pain and other physical symptoms. In situations of chronicity, as an ecological niche, the patient-practitioner dyad provides the osteopath and the patient with a set of affordances, i.e., possibilities for action provided by the environment, that through shared intentionally, can promote adaptations and restoration of productive agency. Through a dyadic therapeutic relationship, as they engage with their ecological niche’s affordances—a structured set of affordances shared by agents—osteopath and patient actively construct a shared sense-making narrative and realise a shared generative model of their relation to the niche. In general, touch plays a critical role in developing a robust therapeutic alliance, mental state alignment, and biobehavioural synchrony between patient and practitioner. However, its role is particularly crucial in the fields of neonatology and paediatrics, where it becomes central in regulating allostasis and restoring homeostasis. We argue that from an active inference standpoint, the dyadic shared ecological niche underwrites a robust therapeutic alliance, which is crucial to the effectiveness of osteopathic care. Considerations and implications of this model—to clinical practice and research, both within- and outside osteopathy—are critically discussed … MORE

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Effects of osteopathic manipulative treatment vs. osteopathic cranial manipulative medicine on Parkinsonian gait

19 February 2022 | By Patrick van Dun | 0 Comments

19 February 2022

Effects of osteopathic manipulative treatment vs. osteopathic cranial manipulative medicine on Parkinsonian gait

Sixty thousand people are diagnosed with Parkinson’s disease (PD) each year, making it the second most common neurodegenerative disorder. PD results in a variety of gait disturbances, including muscular rigidity and decreased range of motion (ROM), that increase the fall risk of those afflicted. Osteopathic manipulative treatment (OMT) emphasizes the central role of the musculoskeletal system, which could be ideal for addressing the somatic dysfunction associated with neurodegeneration in PD. The close anatomical relationship of structures implicated in PD within the skull and the increased frequency of strain patterns raise the question of whether osteopathic cranial manipulative medicine (OCMM) can improve gait performance by improving circulation to the affected nervous tissue. However, there have been few studies in recent years that explore the effects of a standardized OMT protocol on Parkinsonian gait characteristics, and there have been few studies that include OCMM techniques. This study aims to determine whether a single session of OMT or OMT + OCMM can improve the gait of individuals with PD by addressing joint restrictions in the sagittal plane and by increasing ROM in the lower limb … MORE

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Cranial manipulation affects cholinergic pathway gene expression in aged rats

15 February 2022 | By Patrick van Dun | 0 Comments

15 February 2022

Cranial manipulation affects cholinergic pathway gene expression in aged rats

Age-dependent dementia is a devastating disorder afflicting a growing older population. Although pharmacological agents improve symptoms of dementia, age-related comorbidities combined with adverse effects often outweigh their clinical benefits. Therefore, nonpharmacological therapies are being investigated as an alternative. In a previous pilot study, aged rats demonstrated improved spatial memory after osteopathic cranial manipulative medicine (OCMM) treatment. In this continuation of the pilot study, we examine the effect of OCMM on gene expression to elicit possible explanations for the improvement in spatial memory … MORE

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Lymphatic osteopathic manipulative treatment reduces duration of deltoid soreness after Pfizer/BioNTech COVID-19 vaccine

15 February 2022 | By Patrick van Dun | 0 Comments

15 February 2022

Lymphatic osteopathic manipulative treatment reduces duration of deltoid soreness after Pfizer/BioNTech COVID-19 vaccine

Pfizer-BioNTech BNT162b2 is one of the three U.S. Food and Drug Administration (FDA)-approved vaccines for the prevention of COVID-19. Its most common side effect, injection site pain, occurs because of locally recruited inflammatory mediators and is mitigated by the lymphatic system. Side effects may discourage individuals from receiving vaccines; therefore, reducing the duration of injection site pain can promote vaccination compliance. Osteopathic manipulative treatments (OMT) can directly affect the physiology underlying muscle soreness; however, there is currently no literature that supports the use of OMT in this scenario. In this case report, an otherwise healthy male presented with acute left deltoid soreness after receiving the Pfizer COVID-19 vaccine. The pain began 5 h prior to the visit. Three hours after being treated with lymphatic OMT, the severity of the pain was significantly reduced and was alleviated 8h after onset in comparison to the median duration of 24–48 h. He received his second dose 3 weeks later. This case report can provide future studies with the groundwork for further investigating the role of OMT in treating postvaccination muscle soreness, which can improve patient satisfaction and potentially promote vaccination compliance … MORE

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International Overview of Somatic Dysfunction Assessment and Treatment in Osteopathic Research: A Scoping Review

15 February 2022 | By Patrick van Dun | 0 Comments

15 February 2022

International Overview of Somatic Dysfunction Assessment and Treatment in Osteopathic Research: A Scoping Review

Osteopathic manipulative treatment (OMT) is a patient-centred, whole-body intervention aimed at enhance the person’s self-regulation. OMT interventions are focused on somatic dysfunctions (SD) that can be defined as an altered regulative function associated with inflammatory signs palpable in the body framework in different body regions. The conceptual model that sustains SD, as well as its usefulness for the osteopathic profession, is still being discussed by the osteopathic community. Understanding the role and the application of SD is the aim of this scoping review … MORE

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Immediate alteration of the lumbar intervertebral foramen during the so-called osteopathic locking technique: A preliminary analysis on healthy subjects

18 January 2022 | By Patrick van Dun | 0 Comments

18 January 2022

Immediate alteration of the lumbar intervertebral foramen during the so-called osteopathic locking technique: A preliminary analysis on healthy subjects

Degenerative processes in the lumbar spine can lead to a decrease of the disc height and an alteration of the foramen with potential compression of the nerve root. Several osteopathic manipulative techniques are designed to improve the intervertebral joints and the foraminal area. The objective of this study was intended to explore the effect of so-called osteopathic manipulative locking technique (OMLT) on the lumbar foramen … ABSTRACT

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Preventing progression from chronic to widespread pain and its impact on health-related quality of life: a historical cohort study of osteopathic medical care

5 January 2022 | By Patrick van Dun | 0 Comments

5 January 2022

Preventing progression from chronic to widespread pain and its impact on health-related quality of life: a historical cohort study of osteopathic medical care

This study aimed to determine if osteopathic medical care lowers the risk of progression from localized chronic low back pain to widespread pain and lessens the impact of pain on health-related quality of life … MORE

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Osteopathic structure/function models renovation for a person-centered approach: a narrative review and integrative hypothesis

5 January 2022 | By Patrick van Dun | 0 Comments

5 January 2022

Osteopathic structure/function models renovation for a person-centered approach: a narrative review and integrative hypothesis

The construct of the osteopathic structure-function models is reported as a cornerstone of clinical reasoning and treatment processes. Nevertheless, there are no shared procedures described for their use in clinical practice. The present narrative review aims to analyze a more comprehensive perspective on the phenomenon… ABSTRACT

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