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The Glymphatic-Lymphatic Continuum: Opportunities for Osteopathic Manipulative Medicine

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5 March 2016

The Glymphatic-Lymphatic Continuum: Opportunities for Osteopathic Manipulative Medicine

The brain has long been thought to lack a lymphatic drainage system. Recent studies, however, show the presence of a brain-wide paravascular system appropriately named the glymphatic system based on its similarity to the lymphatic system in function and its dependence on astroglial water flux. Besides the clearance of cerebrospinal fluid and interstitial fluid, the glymphatic system also facilitates the clearance of interstitial solutes such as amyloid-β and tau from the brain. As cerebrospinal fluid and interstitial fluid are cleared through the glymphatic system, eventually draining into the lymphatic vessels of the neck, this continuous fluid circuit offers a paradigm shift in osteopathic manipulative medicine. For instance, manipulation of the glymphatic-lymphatic continuum could be used to promote experimental initiatives for nonpharmacologic, noninvasive management of neurologic disorders. In the present review, the authors describe what is known about the glymphatic system and identify several osteopathic experimental strategies rooted in a mechanistic understanding of the lymphatic-lymphatic continuum … ABSTRACT

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Osteopaths’ clinical reasoning during consultation with patients experiencing acute low back pain: A qualitative case study approach

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5 March 2016

Osteopaths’ clinical reasoning during consultation with patients experiencing acute low back pain: A qualitative case study approach

The clinical reasoning strategies employed in healthcare have been well established in a wide range of health professions. Currently, there is little literature pertaining to the diagnostic process of osteopaths and the clinical reasoning strategies utilised in osteopathy. The aim of this study was to investigate the processes of clinical reasoning utilised by osteopaths in the diagnostic hypothesis generation for patients with acute low back pain … ABSTRACT

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Beliefs about back pain: The confluence of client, clinician and community

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18 February 2016

Beliefs about back pain: The confluence of client, clinician and community

Patient beliefs play an important role in the development of back pain and disability, as well as subsequent recovery. Community beliefs about the back and back pain which are inconsistent with current research evidence have been found in a number of developed countries. These beliefs negatively influence people’s back-related behaviour in general, and these effects may be amplified when someone experiences an episode of back pain … ABSTRACT

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Manual therapy and cervical artery dysfunction: identification of potential risk factors in clinical encounters

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18 February 2016

Manual therapy and cervical artery dysfunction: identification of potential risk factors in clinical encounters

Cervical artery dysfunction is a reported potential risk associated with manual therapy applied to the cervical and cervicothoracic spine. While a variety of physical examination tests have been advocated to screen patients who may be at risk of adverse events during or after manipulation, their clinical utility is limited. This paper provides an overview of the literature and current thinking with regard to risk assessment and clinical action related to the application of manual and exercise therapy for the cervical and upper thoracic spine … ABSTRACT

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Burnout Among Osteopathic Residents: A Cross-sectional Analysis

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17 February 2016

Burnout Among Osteopathic Residents: A Cross-sectional Analysis

Burnout is a known problem among physicians in training but has not been extensively studied in osteopathic residents. The objective of this study was to evaluate the relationship of burnout to sex, age, marital status, and residency program type (surgical vs nonsurgical) and length (3, 4, 5, or 6 years) across 12 residency programs at Doctors Hospital in Columbus, Ohio … ABSTRACT

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Attenuation Effect of Spinal Manipulation on Neuropathic and Postoperative Pain Through Activating Endogenous Anti-Inflammatory Cytokine Interleukin 10 in Rat Spinal Cord

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17 February 2016

Attenuation Effect of Spinal Manipulation on Neuropathic and Postoperative Pain Through Activating Endogenous Anti-Inflammatory Cytokine Interleukin 10 in Rat Spinal Cord

The purpose of this study was to investigate roles of the anti-inflammatory cytokine interleukin (IL) 10 and the proinflammatory cytokines IL-1β and tumor necrosis factor α (TNF-α) in spinal manipulation–induced analgesic effects of neuropathic and postoperative pain … ABSTRACT

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The biomechanical model in manual therapy: is there an ongoing crisis or just the need to revise the underlying concept and application?

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17 February 2016

The biomechanical model in manual therapy: is there an ongoing crisis or just the need to revise the underlying concept and application?

Different approaches to body biomechanics are based on the classical concept of “ideal posture” which is regarded as the state where body mass is distributed in such a way that ligamentous tensions neutralize the force of gravity and muscles retain their normal tone, as result of the integration of somatic components related to posture and balance mechanisms. When compromised, optimal posture can be restored through the balanced and effective use of musculoskeletal components; however, various research findings and the opinion of experts in this field suggest a move away from the dogmas that have characterized the idea of health dependent on ideal posture, to promote instead dynamic approaches based on the interdependency of the body systems as well as on the full participation of the person in the healing process. Following these concepts, this article proposes a revised biomechanical model that sees posture as the temporary result of the individual’s current ability to adapt to the existing allostatic load through the dynamic interaction of extero-proprio-interoceptive information integrated at a neuromyofascial level … ABSTRACT

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Muscle energy technique for non-specific low-back pain. A Cochrane systematic review

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17 February 2016

Muscle energy technique for non-specific low-back pain. A Cochrane systematic review

Low back pain (LBP) is responsible for considerable personal suffering due to pain and reduced function, as well as being a societal burden due to costs of health care and lost work productivity. Muscle energy technique (MET) is a manual therapy treatment technique used predominantly by osteopaths, physiotherapists and chiropractors which involves alternating periods of resisted muscle contractions and assisted stretching. It is unclear whether MET is effective in reducing pain and improving function in people with LBP. The objectives of this research were to examine the effectiveness of MET in the treatment of people with non-specific LBP compared with control interventions, with particular emphasis on subjective pain and disability outcomes … ABSTRACT

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Internal Carotid Artery Strains During High-Speed, Low-Amplitude Spinal Manipulations of the Neck

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17 February 2016

Internal Carotid Artery Strains During High-Speed, Low-Amplitude Spinal Manipulations of the Neck

The primary objective of this study was to quantify the strains applied to the internal carotid artery (ICA) during neck spinal manipulative treatments and range of motion (ROM)/diagnostic testing of the head and neck … ABSTRACT

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Repeat-measures longitudinal study evaluating behavioural and gastrointestinal symptoms in children with autism before, during and after visceral osteopathic technique (VOT)

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17 February 2016

Repeat-measures longitudinal study evaluating behavioural and gastrointestinal symptoms in children with autism before, during and after visceral osteopathic technique (VOT)

This study investigated the influence of visceral osteopathic technique (VOT) on the behaviour and gastrointestinal (GI) symptoms of children with autism using a validated questionnaire to measure outcome … ABSTRACT

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