MacMut Biblio N°1 osteopathic Manipulation V2

Transcription

Dossier bibliographique n°1
Osteopathic
Manipulations
dans PubMed et Medline
31 mars 2006
Pr Eddy TAMBOISE
avec l’aide de
Dr Jean Marie COHEN
Pr Pierre CORNILLOT
Isabelle DAVIAUD
et du groupe de travail MacMut
-1-
Sommaire
•
Résumé. Pr Pierre CORNILLOT
•
Matériel et méthodes
o Base de données utilisée : PubMed
o Thesaurus utilisé : le MESH 2006
o Mots clés utilisés : manipulation, osteopathic
•
Résultats
o Essais cliniques contrôlés et méta-analyses. Dr Jean-Marie Cohen
o Liste des articles publiés (classés par ordre chronologique inverse)
o Résumés des articles publiés (classés par ordre chronologique inverse)
o Répertoire des premiers signataires
o Liste des revues
-2-
Résumé
Pr Pierre CORNILLOT
-3-
Matériels et méthodes
Base de données utilisée : PubMed / Medline
En première approche, pour des raisons de commodité, nous n’avons utilisé qu’une base de
données bibliographiques, celle de la Bibliothèque Nationale de Médecine (National
Library of Medecine) et de l’Institut National de Santé (National Institute for Health)
des Etats Unis. Cette base est surnommée PubMed.
Cette base a l’inconvénient de satisfaire en priorité les besoins des chercheurs nordaméricains et d’être exclusivement anglophone. Cependant, elle a le mérite de référencer
des articles publiés dans des revues scientifiques à comité de lecture et d’être
accessible très facilement et gratuitement par internet à l’adresse suivante :
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
Cette simplicité d’accès électronique, rendue possible grâce au soutien du Centre
National pour l’Information Biotechnologique (National Center for Biotechnology
Information - NCBI), a fait de PubMed la base de données bibliographiques de
référence. D’autres bases moins américano-centrées peuvent être consultées. Nous les
interrogerons si des versions ultérieures de ce document sont mises en œuvre.
Thesaurus utilisé : le MESH 2006
Le MESH (Medical Subject Headings) est le dictionnaire des termes médicaux utilisé par
la Bibliothèque Nationale de Médecine des Etats Unis (National Library of Medicine). Le
MESH est mis à jour chaque année. Les nouvelles versions du MESH sont en général
mises en ligne à la mi-novembre chaque année.
Le MESH utilise des descripteurs et des mots-clés classés soit par ordre alphabétique
soit sous forme d’un « arbre hiérarchique » (MeSH Tree Structures).
Cette enquête bibliographique a utilisé la version 2006 du MESH mise en ligne en
novembre 2005.
Les explications sur le MESH sont accessibles à l’adresse suivante :
http://www.nlm.nih.gov/mesh/termscon.html
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Mots clés utilisés : manipulation, osteopathic
Après plusieurs tests, il s’est avéré que le mot-clé le plus pertinent est manipulation,
osteopathic, au sein de la rubrique Musculoskeletal Manipulations, dans le chapitre
Complementary Thérapies.
Extrait du thésaurus MESH 2006 (Medical Subject Headings)
Complementary Therapies;E02.190
Musculoskeletal Manipulations;E02.190.599
Kinesiology, Applied;E02.190.599.186
Manipulation, Chiropractic;E02.190.599.233
Manipulation, Osteopathic;E02.190.599.280
Manipulation, Spinal;E02.190.599.374
Manipulation, Chiropractic;E02.190.599.374.500
Massage;E02.190.599.500
Acupressure;E02.190.599.500.500
Myofunctional Therapy;E02.190.599.750
Relaxation Techniques;E02.190.599.875
Groupe de travail
Ce travail bibliographique a été effectué en grande partie par le Pr Eddy Tamboise.
La rédaction et la mise en forme ont été assurées par le Dr Jean Marie Cohen et
Isabelle Daviaud.
Le Pr Pierre Cornillot a dirigé ce groupe de travail bibliographique et présidé le Conseil
scientifique de MacMut, animé aussi par André Blanc-Rosset, le Dr Elie-Paul Cohen, Guy
Peyronnet, Jean-Claude Delavier, Dominique Siorat, Anne Moraud, Lucie Journé et
Mathieu Lapprand.
Laurent Stubbe et Robert Meslé (Académie d’Ostéopathie), Philippe Sterlingot (SFDO),
Pascal Javerliat (ROF), Thierry Le Men (UFOF), les Drs Bruno Burel et Marc Baillargeat
(Ostéos de France), Philippe Fleuriau et Jacques Guyot (AFC), membres du Conseil
scientifique de MacMut, ont joué un rôle très actif dans la définition des objectifs et
dans la mise au point de ce document.
Les praticiens ostéopathes (médecins et non médecins) associés aux recherches du
groupe de travail MacMut ainsi que les participants aux journées scientifiques MacMut
des 26 janvier et du 7 mars 2006 ont participé à la discussion et la relecture de ce
document.
Bui Tan Tai et l’équipe d’Open Rome assurent la mise en ligne de ce document sur le site
www.macmut.net et dans la Bibliothèque électronique d’Open Rome (BIBO) accessible à
l’adresse suivante : http://www.openrome.org/bibo/user/index.php
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Résultats
Essais cliniques contrôlés et méta-analyses
•
Dr Jean Marie Cohen
Bref rappel sur les « essais cliniques contrôlés »
Pour évaluer l’efficacité d’un traitement, médicamenteux ou non, il faut éliminer plusieurs
sources de biais, notamment :
- la subjectivité du médecin et du patient
- l’évolution spontanée de la maladie ou du problème de santé,
- le choix des patients à traiter.
Il est admis que pour éviter ces biais, il est nécessaire de
- comparer le traitement soit à un placebo, soit à un autre traitement dit « de
référence »
- définir précisément les critères d’inclusion et d’exclusion des malades traités
- tirer au sort les patients recevant le traitement et ceux recevant le placebo ou le
traitement de référence
- organiser des modalités de prescription et de délivrance des traitements de façon
à ce que ni le patient ni le médecin ne sachent si le traitement délivré est le
traitement étudié, le placebo ou le traitement de référence.
Quand ces conditions sont réalisées, on parle d’essais cliniques « contrôlés en double insu
versus placebo (ou versus traitement de référence) avec tirage au sort ».
Un nombre croissant d’experts soulignent actuellement que la subjectivité du statisticien
qui analyse les données peut également influencer sa façon de présenter les résultats.
Ces experts proposent d’organiser la saisie des données de façon à ce que le statisticien
ne puisse pas savoir quel groupe de patients a été traité par quoi. On parle alors de
« triple insu ».
Enfin, un des biais très pervers est celui de la non publication des essais dont les
résultats ne conviennent pas aux auteurs, soit parce que les résultats sont négatifs, soit
parce que le déroulement de l’essai a été perturbé par un manque de rigueur ou des
conditions expérimentales incompatibles avec les façons de pratiquer les soins.
La non-publication peut aussi être liée à un manque de moyens (publier les résultats
demande du temps et un savoir-faire particulier) ou au refus des responsables de revues
de publier des résultats qui les contrarient.
Ce « biais de publication » ne peut pas être détecté par l’interrogation des bases
bibliographiques, puisqu’elles ne contiennent que les articles publiés.
•
Essais cliniques contrôlés trouvés dans Pubmed
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Nous avons trouvé 20 essais cliniques contrôlés, dont le résumé contient l’expression
« manipulations, osteopathic ». 19 de ces articles ont été publiés entre 2000 et 2006. Un
seul est beaucoup plus ancien et date de 1990. Leur liste est présentée pages suivantes.
Philippi H, Faldum A, Schleupen A, Pabst B, Jung T, Bergmann H, Bieber I,
Related Articles, Links
1: Kaemmerer C, Dijs P, Reitter B.
Infantile postural asymmetry and osteopathic treatment: a randomized therapeutic trial.
Dev Med Child Neurol. 2006 Jan;48(1):5-9; discussion 4.
PMID: 16359587 [PubMed - indexed for MEDLINE]
2: O-Yurvati AH, Carnes MS, Clearfield MB, Stoll ST, McConathy WJ.
Hemodynamic effects of osteopathic manipulative treatment immediately after coronary artery
bypass graft surgery.
J Am Osteopath Assoc. 2005 Oct;105(10):475-81.
3: McPartland JM, Giuffrida A, King J, Skinner E, Scotter J, Musty RE.
Cannabimimetic effects of osteopathic manipulative treatment.
J Am Osteopath Assoc. 2005 Jun;105(6):283-91.
4: Goldstein FJ, Jeck S, Nicholas AS, Berman MJ, Lerario M.
Preoperative intravenous morphine sulfate with postoperative osteopathic manipulative
treatment reduces patient analgesic use after total abdominal hysterectomy.
5: Guiney PA, Chou R, Vianna A, Lovenheim J.
Effects of osteopathic manipulative treatment on pediatric patients with asthma: a randomized
controlled trial.
J Am Osteopath Assoc. 2005 Jan;105(1):7-12.
6: Noll DR, Degenhardt BF, Stuart MK, Werden S, McGovern RJ, Johnson JC.
The effect of osteopathic manipulative treatment on immune response to the influenza vaccine
in nursing homes residents: a pilot study.
Altern Ther Health Med. 2004 Jul-Aug;10(4):74-6. No abstract available.
7: Licciardone JC, Stoll ST, Cardarelli KM, Gamber RG, Swift JN Jr, Winn WB.
A randomized controlled trial of osteopathic manipulative treatment following knee or hip
arthroplasty.
J Am Osteopath Assoc. 2004 May;104(5):193-202.
8: Geldschlager S.
[Osteopathic versus orthopedic treatments for chronic epicondylopathia humeri radialis: a
randomized controlled trial]
Forsch Komplementarmed Klass Naturheilkd. 2004 Apr;11(2):93-7. German.
9: Duncan B, Barton L, Edmonds D, Blashill BM.
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Parental perceptions of the therapeutic effect from osteopathic manipulation or acupuncture in
children with spastic cerebral palsy.
Clin Pediatr (Phila). 2004 May;43(4):349-53.
10: Noll DR, Degenhardt BF, Stuart M, McGovern R, Matteson M.
Effectiveness of a sham protocol and adverse effects in a clinical trial of osteopathic
manipulative treatment in nursing home patients.
J Am Osteopath Assoc. 2004 Mar;104(3):107-13. No abstract available.
11: Williams NH, Wilkinson C, Russell I, Edwards RT, Hibbs R, Linck P, Muntz R.
Randomized osteopathic manipulation study (ROMANS): pragmatic trial for spinal pain in
primary care.
Fam Pract. 2003 Dec;20(6):662-9.
12: Eisenhart AW, Gaeta TJ, Yens DP.
Osteopathic manipulative treatment in the emergency department for patients with acute ankle
injuries.
J Am Osteopath Assoc. 2003 Sep;103(9):417-21.
13: Licciardone JC, Stoll ST, Fulda KG, Russo DP, Siu J, Winn W, Swift J Jr.
Osteopathic manipulative treatment for chronic low back pain: a randomized controlled trial.
Spine. 2003 Jul 1;28(13):1355-62.
14: Karason AB, Drysdale IP.
Somatovisceral response following osteopathic HVLAT: a pilot study on the effect of
unilateral lumbosacral high-velocity low-amplitude thrust technique on the cutaneous blood
flow in the lower limb.
J Manipulative Physiol Ther. 2003 May;26(4):220-5.
15: O' Leary S, Carroll M, Mellor R, Scott A, Vicenzino B.
The effect of soft tissue deloading tape on thoracic spine pressure pain thresholds in
asymptomatic subjects.
Man Ther. 2002 Aug;7(3):150-3.
16: Knebl JA, Shores JH, Gamber RG, Gray WT, Herron KM.
Improving functional ability in the elderly via the Spencer technique, an osteopathic
manipulative treatment: a randomized, controlled trial.
J Am Osteopath Assoc. 2002 Jul;102(7):387-96.
17: Bockenhauer SE, Julliard KN, Lo KS, Huang E, Sheth AM.
Quantifiable effects of osteopathic manipulative techniques on patients with chronic asthma.
J Am Osteopath Assoc. 2002 Jul;102(7):371-5; discussion 375.
18: Gamber RG, Shores JH, Russo DP, Jimenez C, Rubin BR.
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Osteopathic manipulative treatment in conjunction with medication relieves pain associated
with fibromyalgia syndrome: results of a randomized clinical pilot project.
19: Burton AK, Tillotson KM, Cleary J.
Single-blind randomised controlled trial of chemonucleolysis and manipulation in the
treatment of symptomatic lumbar disc herniation.
Eur Spine J. 2000 Jun;9(3):202-7.
20: MacDonald RS, Bell CM.
An open controlled assessment of osteopathic manipulation in nonspecific low-back pain.
Spine. 1990 May;15(5):364-70. Erratum in: Spine 1991 Jan;16(1):104.
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Description des 20 essais cliniques recensés
Publié
2006
2005
2005
2005
2005
2004
2004
2004
1er auteur
Philippi H
Pays
Allemagne
Patients
pathologie
Nourrissons
assymétrie
6–12 semaines
posturale
O-Urvati AH
USA
Adultes
pontage coronaire
(post op)
McPartland JM Nouv Zél.
Adultes
en bonne santé
18 – 80 ans
Goldstein FJ
USA
Femmes
hystérectomie
totale (post op)
Guiney PA
USA
Enfants
Asthme
Noll DR
USA
Personnes
post vaccination
âgées
anti-grippale
Licciardone JC
USA
adultes
Prothèse genou
hanche (post op)
Geldschlager S Allemagne
adultes
Tennis elbow
2004
Duncan B
USA
enfants
2004
Noll DR
USA
2003
Williams NH
2003
Eisenhart AW
Pays de
Galles
USA
Personnes
âgées
Adultes
2003
Licciardone JC
USA
adultes
2003
2002
2002
Karason AB
O’Leary S
Knebl JA
Angleterre
Australie
USA
2002
2002
Bockenhauer SF
Gamber RG
USA
USA
adultes
Adultes
Personnes
âgées
adultes
adultes
2000
Burton AK
Angleterre
adultes
1990
MacDonald RS
Angleterre
adultes
Adultes
OP : traitement ostéopathique
AG : anesthésie générale
- 10 -
Paralysie
spastique
?
Douleurs
rachidiennes
Trauma cheville
récent
lombalgies
OP comparée à
OP simulée
absence d’OP
(sous AG)
OP simulée
OP simulée
+/- opiacés
OP simulée
?
OP simulée
Traitement
orthopédique
Acupuncture
OP simulée
?
absence d’OP
absence d’OP
OP simulée
absence d’OP
en bonne santé
OP simulée
Douleurs rachis
Ceinture flanelle
Douleurs épaules
technique
chroniques
Spencer simulée
Asthme chronique
OP simulée
Syndrome fibroEducation
myalgique
Chaleur humide
médicaments
Hernie discale
Nucléolyse
chimique
lombalgies
?
Liste des articles publiés (classement par ordre chronologique inverse)
Sont présentées ici toutes les publications détectées dans PubMed classées par type
d’article puis par ordre chronologique inverse de parution. Sont mentionnées le nom des
auteurs, le titre et les références bibliographiques (revue, pages, etc.). Il est précisé si
« aucun résumé n’est disponible ». Dans le cas contraire, le résumé est présenté au
chapitre « Résumé des articles publiés ».
1: Leiber JD.
Allopathic Family Medicine Residents Can Learn Osteopathic Manipulation Techniques
in a 1-month Elective.
Fam Med. 2005 Nov;37(10):693-5.
PMID: 16273444 [PubMed - in process]
2: McPartland JM, Giuffrida A, King J, Skinner E, Scotter J, Musty RE.
3: Goldstein FJ, Jeck S, Nicholas AS, Berman MJ, Lerario M.
Preoperative intravenous morphine sulfate with postoperative osteopathic manipulative
treatment reduces patient analgesic use after total abdominal hysterectomy.
4: Licciardone JC, Brimhall AK, King LN.
Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis
of randomized controlled trials.
BMC Musculoskelet Disord. 2005 Aug 4;6:43.
5: Rogers FJ.
Advancing a traditional view of osteopathic medicine through clinical practice.
J Am Osteopath Assoc. 2005 May;105(5):255-9. Aucun résumé n'est disponible
6: Coston JL, McReynolds TM, Sheridan BJ.
IM ketorolac versus OMT: was agent at peak analgesic effect in JAOA study?
J Am Osteopath Assoc. 2005 May;105(5):237; author reply 237-8. Aucun résumé n'est disponible
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7: Canter PH, Ernst E.
Sources of bias in reviews of spinal manipulation for back pain.
Wien Klin Wochenschr. 2005 May;117(9-10):333-41.
8: Biondi DM.
Physical treatments for headache: a structured review.
Headache. 2005 Jun;45(6):738-46. Review.
9: Saedt E, van der Woude B, Theunissen P.
[Systematic review of the effects of therapy in infants with the KISS-syndrome
(kinetic imbalance due to suboccipital strain)]
Ned Tijdschr Geneeskd. 2005 May 28;149(22):1238-9; author reply 1239. Dutch.
Aucun résumé n'est disponible
10: Renckens CN.
Ned Tijdschr Geneeskd. 2005 May 28;149(22):1237; author reply 1237-8. Dutch.
Aucun résumé n'est disponible
11: Sucher BM, Hinrichs RN, Welcher RL, Quiroz LD, St Laurent BF, Morrison BJ.
Manipulative treatment of carpal tunnel syndrome: biomechanical and osteopathic intervention
to increase the length of the transverse carpal ligament: part 2. Effect of sex differences and
manipulative "priming".
J Am Osteopath Assoc. 2005 Mar;105(3):135-43. Erratum in: J Am Osteopath Assoc. 2005
May;105(5):238.
12: Rubinstein L.
Still keeping the faith.
J Am Osteopath Assoc. 2005 Mar;105(3):126. Aucun résumé n'est disponible
- 12 -
13: Hondras MA, Linde K, Jones AP.
Manual therapy for asthma.
Cochrane Database Syst Rev. 2005 Apr 18;(2):CD001002. Review.
14: Brand PL, Engelbert RH, Helders PJ, Offringa M.
Ned Tijdschr Geneeskd. 2005 Mar 26;149(13):703-7. Review. Dutch.
15: Cohen AM, Mertz J, Stewart P, Warner MJ, Kuchera ML.
Hysteresis as a measure of ankle dysfunction.
J Am Osteopath Assoc. 2005 Jan;105(1):22. Aucun résumé n'est disponible
16: Guiney PA, Chou R, Vianna A, Lovenheim J.
Effects of osteopathic manipulative treatment on pediatric patients with asthma:
a randomized controlled trial.
17: Taylor AJ, Kerry R.
Neck pain and headache as a result of internal carotid artery dissection: implications
for manual therapists.
Man Ther. 2005 Feb;10(1):73-7. Aucun résumé n'est disponible
18: Richards BS, Johnston CE, Wilson H.
Nonoperative clubfoot treatment using the French physical therapy method.
J Pediatr Orthop. 2005 Jan-Feb;25(1):98-102.
19: Licciardone JC.
The unique role of osteopathic physicians in treating patients with low back pain.
J Am Osteopath Assoc. 2004 Nov;104(11 Suppl 8):S13-8. Review.
- 13 -
20: Magoun HI Jr.
More about the use of OMT during influenza epidemics.
J Am Osteopath Assoc. 2004 Oct;104(10):406-7. Aucun résumé n'est disponible
21: Bledsoe BE.
The elephant in the room: does OMT have proved benefit?
J Am Osteopath Assoc. 2004 Oct;104(10):405-6; author reply 406. Aucun résumé n'est disponible
22: Williams NH, Edwards RT, Linck P, Muntz R, Hibbs R, Wilkinson C, Russell I, Russell D,
Hounsome B.
Cost-utility analysis of osteopathy in primary care: results from a pragmatic randomized
controlled trial.
Fam Pract. 2004 Dec;21(6):643-50. Epub 2004 Nov 5.
23: D'Alonzo GE Jr.
Influenza epidemic or pandemic? Time to roll up sleeves, vaccinate patients, and hone
osteopathic manipulative skills.
J Am Osteopath Assoc. 2004 Sep;104(9):370-1. Aucun résumé n'est disponible
24: Smith RM.
Conclusion of frequently used unsupported by data.
J Am Osteopath Assoc. 2004 Aug;104(8):315. Aucun résumé n'est disponible
25: Balon JW, Mior SA.
Chiropractic care in asthma and allergy.
Ann Allergy Asthma Immunol. 2004 Aug;93(2 Suppl 1):S55-60. Review.
26: Salamon E, Zhu W, Stefano GB.
Nitric oxide as a possible mechanism for understanding the therapeutic effects of
osteopathic manipulative medicine (Review).
Int J Mol Med. 2004 Sep;14(3):443-9. Review.
- 14 -
27: Noll DR, Degenhardt BF, Stuart MK, Werden S, McGovern RJ, Johnson JC.
The effect of osteopathic manipulative treatment on immune response
to the influenza vaccine in nursing homes residents: a pilot study.
Altern Ther Health Med. 2004 Jul-Aug;10(4):74-6. Aucun résumé n'est disponible
28: Boulet JR, Gimpel JR, Dowling DJ, Finley M.
Assessing the ability of medical students to perform
osteopathic manipulative treatment techniques.
29: Licciardone JC, Stoll ST, Cardarelli KM, Gamber RG, Swift JN Jr, Winn WB.
A randomized controlled trial of osteopathic manipulative treatment following knee or
hip arthroplasty.
30: Geldschlager S.
[Osteopathic versus orthopedic treatments for chronic epicondylopathia humeri radialis:
a randomized controlled trial]
31: Connolly TP.
DO relates positive experience with use of integrated neuromusculoskeletal release.
J Am Osteopath Assoc. 2004 Apr;104(4):146. Aucun résumé n'est disponible
32: Duncan B, Barton L, Edmonds D, Blashill BM.
Parental perceptions of the therapeutic effect from osteopathic manipulation or
acupuncture in children with spastic cerebral palsy.
33: Noll DR, Degenhardt BF, Stuart M, McGovern R, Matteson M.
Effectiveness of a sham protocol and adverse effects in a clinical trial of osteopathic
manipulative treatment in nursing home patients.
- 15 -
J Am Osteopath Assoc. 2004 Mar;104(3):107-13. Aucun résumé n'est disponible
34: Elliott JM, Zylstra ED, Centeno CJ.
The presence and utilization of psoas musculature despite congenital absence of the right hip.
Man Ther. 2004 May;9(2):109-13. Aucun résumé n'est disponible
35: Sleszynski SL, Glonek T, Kuchera WA.
Outpatient osteopathic single organ system musculoskeletal exam form: training and certification
J Am Osteopath Assoc. 2004 Feb;104(2):76-81.
36: Porcelli MJ.
Why are our patients still in pain? Finding a balance in treating patients for nonmalignant pain.
J Am Osteopath Assoc. 2004 Feb;104(2):73-5, 66. Erratum in: J Am Osteopath Assoc. 2004
Apr;104(4):147.
37: Richardson ME.
Let's learn from the influenza epidemic.
J Am Osteopath Assoc. 2004 Feb;104(2):71; author reply 71. Aucun résumé n'est disponible
38: Martin RB.
Osteopathic approach to sexual dysfunction: holistic care to improve patient satisfaction and
prevent mortality and morbidity.
J Am Osteopath Assoc. 2004 Jan;104(1 Suppl 1):S1-8. Review.
39: Ray AM, Cohen JE, Buser BR.
Osteopathic emergency physician training and use of osteopathic manipulative treatment.
40: Mahal J.
Discussion and literature review of primary respiration.
J Am Osteopath Assoc. 2004 Jan;104(1):8, 12. Aucun résumé n'est disponible
- 16 -
41: Crosby JB.
Bridging the gap between medical education and application of OPP/OMT.
J Am Osteopath Assoc. 2004 Jan;104(1):6-7. Aucun résumé n'est disponible
42: Danto JB.
Review of integrated neuromusculoskeletal release and the novel application of a segmental
anterior/posterior approach in the thoracic, lumbar, and sacral regions.
J Am Osteopath Assoc. 2003 Dec;103(12):583-96. Review.
43: King HH, Tettambel MA, Lockwood MD, Johnson KH, Arsenault DA, Quist R.
Osteopathic manipulative treatment in prenatal care: a retrospective case control design study.
J Am Osteopath Assoc. 2003 Dec;103(12):577-82.
44: Burton AK, McClune TD, Clarke RD, Main CJ.
Long-term follow-up of patients with low back pain attending for manipulative care: outcomes
and predictors.
Man Ther. 2004 Feb;9(1):30-5.
45: Sommerfeld P, Kaider A, Klein P.
Inter- and intraexaminer reliability in palpation of the "primary respiratory mechanism"
within the "cranial concept".
Man Ther. 2004 Feb;9(1):22-9.
46: Williams NH, Wilkinson C, Russell I, Edwards RT, Hibbs R, Linck P, Muntz R.
Randomized osteopathic manipulation study (ROMANS): pragmatic trial for spinal pain in
primary care.
Fam Pract. 2003 Dec;20(6):662-9.
47: Przekop PR Jr, Tulgan H, Przekop A, DeMarco WJ, Campbell N, Kisiel S.
Implementation of an osteopathic manipulative medicine clinic at an allopathic teaching hospital:
- 17 -
a research-based experience.
J Am Osteopath Assoc. 2003 Nov;103(11):543-9.
48: Millett PJ, Johnson B, Carlson J, Krishnan S, Steadman JR.
Rehabilitation of the arthrofibrotic knee.
Am J Orthop. 2003 Nov;32(11):531-8. Review.
49: Chamberlain NR, Yates HA.
A prospective study of osteopathic medical students' attitudes toward use of osteopathic
manipulative treatment in caring for patients.
50: Eisenhart AW, Gaeta TJ, Yens DP.
Osteopathic manipulative treatment in the emergency department for patients with acute ankle
injuries.
51: Sucher BM.
How I remember Bill.
52: Pichichero ME.
Osteopathic manipulation to prevent otitis media--does it work?
Arch Pediatr Adolesc Med. 2003 Sep;157(9):852-3. Aucun résumé n'est disponible
53: Boehm KM, Lawner BJ, McFee RB.
Study raises important issues about the potential benefit of osteopathy in the cranial field to
patients with Parkinson's disease.
J Am Osteopath Assoc. 2003 Aug;103(8):354-5; author reply 355-6. Aucun résumé n'est disponib
54: Rebain R, Baxter GD, McDonough S.
- 18 -
The passive straight leg raising test in the diagnosis and treatment of lumbar disc herniation:
a survey of United kingdom osteopathic opinion and clinical practice.
Spine. 2003 Aug 1;28(15):1717-24.
55: Spiegel AJ, Capobianco JD, Kruger A, Spinner WD.
Osteopathic manipulative medicine in the treatment of hypertension: an alternative, conventional
approach.
Heart Dis. 2003 Jul-Aug;5(4):272-8. Review.
56: Elliott JM, Jacobson EJ, Centeno CJ, Emerson PL.
Cranial manipulation with possible neurovascular contact injury at the cerebello-pontine angle:
a case report.
Altern Ther Health Med. 2003 Jul-Aug;9(4):112, 108-9. Aucun résumé n'est disponible
57: Murphy LS, Reinsch S, Najm WI, Dickerson VM, Seffinger MA, Adams A, Mishra SI.
Searching biomedical databases on complementary medicine: the use of controlled vocabulary
among authors, indexers and investigators.
BMC Complement Altern Med. 2003 Jul 7;3:3. Epub 2003 Jul 7.
58: Licciardone JC, Stoll ST, Fulda KG, Russo DP, Siu J, Winn W, Swift J Jr.
Osteopathic manipulative treatment for chronic low back pain: a randomized controlled trial.
Spine. 2003 Jul 1;28(13):1355-62.
59: Crow RM.
Osteopathic physicians provide quality care--with or without OMT.
J Am Osteopath Assoc. 2003 Jun;103(6):264; author reply 264-5. Aucun résumé n'est disponible
60: Tessien RM.
OMT's effectiveness already proven.
J Am Osteopath Assoc. 2003 Jun;103(6):262. Aucun résumé n'est disponible
- 19 -
61: Johnson SM, Kurtz ME.
Osteopathic manipulative treatment techniques preferred by contemporary osteopathic
physicians.
62: Karason AB, Drysdale IP.
Somatovisceral response following osteopathic HVLAT: a pilot study on the effect of unilateral
lumbosacral high-velocity low-amplitude thrust technique on the cutaneous blood flow in the
lower limb.
63: Bentley EM.
A proposal that benefits all.
64: Dupeyron A, Vautravers P, Lecocq J, Isner-Horobeti ME.
[Complications following vertebral manipulation-a survey of a French region physicians]
Ann Readapt Med Phys. 2003 Feb;46(1):33-40. French.
65: Harvey E, Burton AK, Moffett JK, Breen A; UK BEAM trial team.
Spinal manipulation for low-back pain: a treatment package agreed to by the UK chiropractic,
osteopathy and physiotherapy professional associations.
Man Ther. 2003 Feb;8(1):46-51. Review.
66: Hirayama F, Kageyama Y, Urabe N, Senjyu H.
The effect of postoperative ataralgesia by manual therapy after pulmonary resection.
Man Ther. 2003 Feb;8(1):42-5.
67: Hing WA, Reid DA, Monaghan M.
Manipulation of the cervical spine.
- 20 -
68: Brolinson PG.
Precompetition manipulation: placebo or performance enhancer?
Clin J Sport Med. 2003 Mar;13(2):69-70. Aucun résumé n'est disponible
69: Corbett RM.
Failure to convince osteopathic medical students of OMT's worth increases risk of
subspecialization.
J Am Osteopath Assoc. 2003 Feb;103(2):71. Aucun résumé n'est disponible
70: Spaeth DG, Pheley AM.
Use of osteopathic manipulative treatment by Ohio osteopathic physicians in various specialties.
71: Calder PR, Tennent TD, Allen PW.
Assessment of the efficacy of Proguard RR-2 radio-protective gloves during forearm
manipulation.
Injury. 2003 Feb;34(2):159-61.
Cochrane Database Syst Rev. 2002;(4):CD001002. Review. Update in: Cochrane Database Syst
Rev. 2005;(2):CD001002.
73: Cali GE.
Parameters of asthma and manipulation study questioned.
J Am Osteopath Assoc. 2002 Nov;102(11):573; author reply 573. Aucun résumé n'est disponible
- 21 -
74: Sergueef N, Nelson KE, Glonek T.
The effect of cranial manipulation on the Traube-Hering-Mayer oscillation as measured by
laser-Doppler flowmetry.
Altern Ther Health Med. 2002 Nov-Dec;8(6):74-6.
Perceptions of philosophic and practice differences between US osteopathic physicians and
their allopathic counterparts.
Soc Sci Med. 2002 Dec;55(12):2141-8.
Conditions and diagnoses for which osteopathic primary care physicians and specialists use
osteopathic manipulative treatment.
J Am Osteopath Assoc. 2002 Oct;102(10):527-32, 537-40.
77: O' Leary S, Carroll M, Mellor R, Scott A, Vicenzino B.
The effect of soft tissue deloading tape on thoracic spine pressure pain thresholds in
asymptomatic subjects.
Man Ther. 2002 Aug;7(3):150-3.
78: Nicholas AS, Oleski SL.
Osteopathic manipulative treatment for postoperative pain.
J Am Osteopath Assoc. 2002 Sep;102(9 Suppl 3):S5-8.
79: Rivera-Martinez S, Wells MR, Capobianco JD.
A retrospective study of cranial strain patterns in patients with idiopathic Parkinson's disease.
J Am Osteopath Assoc. 2002 Aug;102(8):417-22.
- 22 -
80: Knebl JA, Shores JH, Gamber RG, Gray WT, Herron KM.
Improving functional ability in the elderly via the Spencer technique, an osteopathic
manipulative treatment: a randomized, controlled trial.
81: Bockenhauer SE, Julliard KN, Lo KS, Huang E, Sheth AM.
Quantifiable effects of osteopathic manipulative techniques on patients with chronic asthma.
82: King HH.
Osteopathy in the cranial field: uncovering challenges and potential applications.
J Am Osteopath Assoc. 2002 Jul;102(7):367-9. Aucun résumé n'est disponible
83: Gamber RG, Shores JH, Russo DP, Jimenez C, Rubin BR.
Osteopathic manipulative treatment in conjunction with medication relieves pain associated with
fibromyalgia syndrome: results of a randomized clinical pilot project.
84: Protopapas MG, Cymet TC.
Joint cracking and popping: understanding noises that accompany articular release.
J Am Osteopath Assoc. 2002 May;102(5):283-7. Review. Erratum in: J Am Osteopath Assoc
2002 Jun;102(6):306. Protapapas Marina G [corrected to Protopapas Marina G].
85: Yates HA, Vardy TC, Kuchera ML, Ripley BD, Johnson JC.
Effects of osteopathic manipulative treatment and concentric and eccentric maximal-effort
exercise on women with multiple sclerosis: a pilot study.
- 23 -
86: Burns SB, Burns EA.
Women students at Kirksville Missouri, Circa 1909.
J Altern Complement Med. 2002 Apr;8(2):109-10. Aucun résumé n'est disponible
87: Oleski SL, Kim MD.
Need for objective measures to prove clinical outcome.
J Am Osteopath Assoc. 2002 Mar;102(3):120; author reply 120-1. Aucun résumé n'est disponible
88: Licciardone JC, Gamber RG, Russo DP.
Quality of life in referred patients presenting to a specialty clinic for osteopathic
manipulative treatment.
J Am Osteopath Assoc. 2002 Mar;102(3):151-5.
89: Spaeth DG, Pheley AM.
Evaluation of osteopathic manipulative treatment training by practicing physicians in Ohio.
90: Turney J.
Tackling birth trauma with cranio-sacral therapy.
Pract Midwife. 2002 Mar;5(3):17-9. Review. Aucun résumé n'est disponible
91: Maher CG, Latimer J, Starkey I.
An evaluation of Superthumb and the Kneeshaw device as manual therapy tools.
Aust J Physiother. 2002;48(1):25-30.
92: Licciardone J, Gamber R, Cardarelli K.
Patient satisfaction and clinical outcomes associated with osteopathic manipulative treatment.
- 24 -
93: Oleski SL, Smith GH, Crow WT.
Radiographic evidence of cranial bone mobility.
Cranio. 2002 Jan;20(1):34-8.
94: Fiechtner JJ, Brodeur RR.
Manual and manipulation techniques for rheumatic disease.
Med Clin North Am. 2002 Jan;86(1):91-103. Review.
95: Siehl D.
Andrew Taylor Still Memorial Lecture: the osteopathic difference--is it only manipulation? 1984.
96: Meacham WB.
Destiny of osteopathic profession. 1916.
97: Patterson MM.
The destiny of the osteopathic profession: the osteopathic difference.
J Am Osteopath Assoc. 2001 Oct;101(10):625. Aucun résumé n'est disponible
98: Rogers FJ.
The muscle hypothesis: a model of chronic heart failure appropriate for osteopathic medicine.
J Am Osteopath Assoc. 2001 Oct;101(10):576-83. Review.
99: Chiradejnant A, Maher CG, Latimer J.
Development of an instrumented couch to measure forces during manual physiotherapy treatment
Man Ther. 2001 Nov;6(4):229-34.
100: Plotkin BJ, Rodos JJ, Kappler R, Schrage M, Freydl K, Hasegawa S, Hennegan E,
Hilchie-Schmidt C, Hines D, Iwata J, Mok C, Raffaelli D.
- 25 -
Adjunctive osteopathic manipulative treatment in women with depression: a pilot study.
101: Bronfort G, Assendelft WJ, Evans R, Haas M, Bouter L.
Efficacy of spinal manipulation for chronic headache: a systematic review.
J Manipulative Physiol Ther. 2001 Sep;24(7):457-66.
102: Irvin RE.
The origin and relief of common pain.
J Back Musculoskeletal Rehabil. 1998;11(2):89-130.
103: Becker AD.
Osteopathic treatment of the common cold. 1937.
J Am Osteopath Assoc. 2001 Aug;101(8):461-3. Aucun résumé n'est disponible
104: Gibbons P, Tehan P.
Patient positioning and spinal locking for lumbar spine rotation manipulation.
Man Ther. 2001 Aug;6(3):130-8. Review.
105: Stretanski MF, Kaiser G.
Osteopathic philosophy and emergent treatment in acute respiratory failure.
106: Mein EA, Greenman PE, McMillin DL, Richards DG, Nelson CD.
Manual medicine diversity: research pitfalls and the emerging medical paradigm.
107: Bratzler DW.
Osteopathic manipulative treatment and outcomes for pneumonia.
- 26 -
108: Patterson MM.
Applications of manipulative techniques.
J Am Osteopath Assoc. 2001 Jul;101(7):402. Aucun résumé n'est disponible
Diminished use of osteopathic manipulative treatment and its impact on the uniqueness of
the osteopathic profession.
Acad Med. 2001 Aug;76(8):821-8.
110: Kimberly PE.
The application of the respiratory principle to osteopathic manipulative procedures. 1949.
111: Denslow JS.
Soft tissues in areas of osteopathic lesion. 1947.
112: Burns L.
Methods of applying manipulative technic. 1945.
113: Gamber RG, Gish EE, Herron KM.
Student perceptions of osteopathic manipulative treatment after completing a
manipulative medicine rotation.
114: Zorski KC, Woeller KN, Galin CM, Nani S, Myers GP, Greenfield JR, Sendzicki B, Haltof AH.
DOs question intent of challenge.
J Am Osteopath Assoc. 2001 Jun;101(6):329-30. Aucun résumé n'est disponible
- 27 -
115: Grimshaw DN.
Cervicogenic headache: manual and manipulative therapies.
Curr Pain Headache Rep. 2001 Aug;5(4):369-75. Review.
116: Jermyn RT.
A nonsurgical approach to low back pain.
J Am Osteopath Assoc. 2001 Apr;101(4 Suppl Pt 2):S6-11. Review.
117: Tettambel MA.
Osteopathic treatment considerations for rheumatic diseases.
118: Johnston WL, Golden WJ.
Segmental definition--Part IV. Updating the differential for somatic and visceral inputs.
J Am Osteopath Assoc. 2001 May;101(5):278-83. Review.
119: MacDonald RC.
Letter that questions OCF requires no response.
J Am Osteopath Assoc. 2001 May;101(5):268. Aucun résumé n'est disponible
120: Hoover HV.
Functional technic in osteopathic manipulative treatment. 1956.
- 28 -
Cochrane Database Syst Rev. 2001;(1):CD001002. Review. Update in: Cochrane Database Syst Rev
2002;(4):CD001002.
122: Denslow JS.
Analyzing the osteopathic lesion. 1940.
J Am Osteopath Assoc. 2001 Feb;101(2):99-100. Aucun résumé n'est disponible
123: Mills MV.
Wasn't A.T. still an MD, too?
124: Breithaupt T, Harris K, Ellis J, Purcell E, Weir J, Clothier M, Boesler D.
Thoracic lymphatic pumping and the efficacy of influenza vaccination in healthy young and elderly
populations.
125: Noll DR, Shores JH, Gamber RG, Herron KM, Swift J Jr.
Benefits of osteopathic manipulative treatment for hospitalized elderly patients with pneumonia.
126: Norton JM.
Questioning of OCF should rouse osteopathic response.
J Am Osteopath Assoc. 2000 Dec;100(12):763-4. Aucun résumé n'est disponible
- 29 -
127: Strassburg HM.
[Manual therapy from the viewpoint of the neuropediatrician]
Kinderkrankenschwester. 2000 Oct;19(10):408-11. German. Aucun résumé n'est disponible
128: Peckham FF.
The necessity for emphasizing and strengthening the manipulative service offered in osteopathic
hospitals. 1947.
J Am Osteopath Assoc. 2000 Nov;100(11):748-9. Aucun résumé n'est disponible
129: Waitley DD.
The autonomic nervous system in osteopathic therapy. 1948.
130: Pratt-Harrington D.
Galbreath technique: a manipulative treatment for otitis media revisited.
131: Lawlor TH.
Individualizing treatment plan and combining approaches key to pain management and holistic
care: a student's perspective.
132: Kimberly PE.
Osteopathic cranial lesions. 1948.
- 30 -
133: Shubrook JH Jr, Dooley J.
Effects of a structured curriculum in osteopathic manipulative treatment (OMT)
on osteopathic structural examinations and use of OMT for hospitalized patients.
134: Eck JC, Circolone NJ.
The use of spinal manipulation in the treatment of low back pain: a review of goals,
patient selection, techniques, and risks.
J Orthop Sci. 2000;5(4):411-7. Review.
135: Jarski RW, Loniewski EG, Williams J, Bahu A, Shafinia S, Gibbs K, Muller M.
The effectiveness of osteopathic manipulative treatment as complementary therapy
following surgery: a prospective, match-controlled outcome study.
Altern Ther Health Med. 2000 Sep;6(5):77-81.
136: Vautravers P, Maigne JY.
Cervical spine manipulation and the precautionary principle.
Joint Bone Spine. 2000;67(4):272-6. Review.
137: Bernard H.
The mechanism of anatomical structure in its relation to osteopathy. 1911.
138: Chamberlain NR, Yates HA.
Use of a computer-assisted clinical case (CACC) SOAP note exercise
to assess students' application of osteopathic principles and practice.
- 31 -
139: Burton AK, Tillotson KM, Cleary J.
Single-blind randomised controlled trial of chemonucleolysis and manipulation in
the treatment of symptomatic lumbar disc herniation.
Eur Spine J. 2000 Jun;9(3):202-7.
140: Zorski KC.
Another great article on osteopathic manipulative treatment.
141: Mann DD, Eland DC, Patriquin DA, Johnson DF.
Increasing osteopathic manipulative treatment skills and confidence through mastery learning.
J Am Osteopath Assoc. 2000 May;100(5):301-4, 309.
142: Dowling DJ.
Progressive inhibition of neuromuscular structures (PINS) technique.
J Am Osteopath Assoc. 2000 May;100(5):285-6, 289-98.
143: Breen A, Carrington M, Collier R, Vogel S.
Communication between general and manipulative practitioners: a survey.
Complement Ther Med. 2000 Mar;8(1):8-14.
144: Pittler MH, Abbot NC, Harkness EF, Ernst E.
Location bias in controlled clinical trials of complementary/alternative therapies.
J Clin Epidemiol. 2000 May;53(5):485-9.
145: Horan J.
National study of the impact of managed care on osteopathic physicians.
J Am Osteopath Assoc. 2000 Apr;100(4):218-24, 227.
- 32 -
Cochrane Database Syst Rev. 2000;(2):CD001002. Review. Update in:
Cochrane Database Syst Rev. 2001;(1):CD001002.
147: Kaprow MG, Sandhouse M.
Refractory torticollis after a fall.
148: Orlando C, Field L.
Osteopathic treatment of low back pain.
N Engl J Med. 2000 Mar 16;342(11):819; author reply 819-20. Aucun résumé n'est disponible
149: Sweetman BJ.
150: Rogers FJ.
151: Lyon DA.
152: Foster D, Johnson MD, Harrelson A.
N Engl J Med. 2000 Mar 16;342(11):817-8; author reply 819-20. Aucun résumé n'est disponible
153: Oppenheim JS.
- 33 -
154: Cherkin D.
155: Littlejohn JM.
Osteopathy an independent system co-extensive with the science and art of healing. 1901.
156: Fiechtner JJ, Brodeur RR.
Rheum Dis Clin North Am. 2000 Feb;26(1):83-96, ix. Review.
157: Abend DS.
Importance of OMT cannot be overemphasized.
158: Newswanger DL, Patel AT, Ogle A.
Osteopathic medicine in the treatment of low back pain.
Am Fam Physician. 2000 Dec 1;62(11):2414-5. Aucun résumé n'est disponible
159: Coughlin P, Kriebel R, Fogel R.
New England Journal of Medicine article may be misleading about OMT.
J Am Osteopath Assoc. 1999 Nov;99(11):561, 565. Aucun résumé n'est disponible
160: Ylinen J, Piispanen J, Silen K, Airaksinen O.
[Manual therapy, chiropractic, osteopathy. From alternative therapy to medicine]
Duodecim. 1996;112(14):1264-73. Review. Finnish. Aucun résumé n'est disponible
- 34 -
161: Sleszynski SL, Glonek T, Kuchera WA.
Standardized medical record: a new outpatient osteopathic SOAP note form:
validation of a standardized office form against physician's progress notes.
162: Lesho EP.
An overview of osteopathic medicine.
Arch Fam Med. 1999 Nov-Dec;8(6):477-84. Review.
163: Howell JD.
The paradox of osteopathy.
N Engl J Med. 1999 Nov 4;341(19):1465-8. Aucun résumé n'est disponible
164: Andersson GB, Lucente T, Davis AM, Kappler RE, Lipton JA, Leurgans S.
A comparison of osteopathic spinal manipulation with standard care for patients with
low back pain.
N Engl J Med. 1999 Nov 4;341(19):1426-31.
165: Hess JA, Mootz RD.
Comparison of work and time estimates by chiropractic physicians with those of medical and
osteopathic providers.
J Manipulative Physiol Ther. 1999 Jun;22(5):280-91.
166: Rowane WA, Rowane MP.
An osteopathic approach to asthma.
167: Gotfried R.
DOs' approach to patient is 'wholistic'--not holistic.
- 35 -
168: Levine HM.
Levine's 'osteopathic hug' for self-administered OPP and OMT.
J Am Osteopath Assoc. 1999 Apr;99(4):198. Aucun résumé n'est disponible
169: Danto JB, Kavieff TR.
Making a difference: the osteopathic approach lecture series.
170: Noll DR, Shores J, Bryman PN, Masterson EV.
Adjunctive osteopathic manipulative treatment in the elderly hospitalized with pneumonia:
a pilot study.
J Am Osteopath Assoc. 1999 Mar;99(3):143-6, 151-2.
171: Wells MR, Giantinoto S, D'Agate D, Areman RD, Fazzini EA, Dowling D, Bosak A.
Standard osteopathic manipulative treatment acutely improves gait performance in patients
with Parkinson's disease.
172: Abend DS.
Revisiting the role of osteopathic manipulation in primary care.
173: Hopp RJ.
Revisiting the role of osteopathic manipulation in primary care.
174: Sucher BM, Hinrichs RN.
Manipulative treatment of carpal tunnel syndrome: biomechanical and osteopathic intervention
to increase the length of the transverse carpal ligament.
- 36 -
175: Dudley G.
Sinusitus Supplement missing osteopathic component.
176: Klein P.
[Osteopathy and chiropractic]
Rev Med Brux. 1998 Sep;19(4):A283-9. Review. French.
177: Friedman HD.
Alternative therapies and complementary medicine: a mutiny in the making.
J Am Osteopath Assoc. 1998 Sep;98(9):476. Aucun résumé n'est disponible
178: Radjieski JM, Lumley MA, Cantieri MS.
Effect of osteopathic manipulative treatment of length of stay for pancreatitis:
a randomized pilot study.
J Am Osteopath Assoc. 1998 May;98(5):264-72. Erratum in: J Am Osteopath Assoc 1998 Jul;
98(7):408.
179: Gaines E, Chila AG.
Communication for osteopathic manipulative treatment (OMT): the language of lived experience
in OMT pedagogy.
- 37 -
180: Jackson KM, Steele TF, Dugan EP, Kukulka G, Blue W, Roberts A.
Effect of lymphatic and splenic pump techniques on the antibody response to hepatitis B vaccine:
a pilot study.
181: Hanten WP, Dawson DD, Iwata M, Seiden M, Whitten FG, Zink T.
Craniosacral rhythm: reliability and relationships with cardiac and respiratory rates.
J Orthop Sports Phys Ther. 1998 Mar;27(3):213-8.
182: Mesina J, Hampton D, Evans R, Ziegler T, Mikeska C, Thomas K, Ferretti J.
Transient basophilia following the application of lymphatic pump techniques: a pilot study.
183: Perrin RN, Edwards J, Hartley P.
An evaluation of the effectiveness of osteopathic treatment on symptoms associated
with myalgic encephalomyelitis. A preliminary report.
J Med Eng Technol. 1998 Jan-Feb;22(1):1-13. Aucun résumé n'est disponible
184: Peterson B.
A compilation of the thoughts of George W. Northup, DO, on the philosophy
of osteopathic medicine.
185: Williams N.
Managing back pain in general practice--is osteopathy the new paradigm?
Br J Gen Pract. 1997 Oct;47(423):653-5. Review.
- 38 -
186: Scheurmier N, Breen AC.
A pilot study of the purchase of manipulation services for acute low back pain
in the United Kingdom.
J Manipulative Physiol Ther. 1998 Jan;21(1):14-8.
187: Northup GW.
Osteopathic manifesto. I. Introduction. II. The roots. 1981.
188: Abend DS.
Lack of osteopathic component in anxiety supplement.
189: Fuller DB.
Osteopathic medical component missed in treating anterior hip pain.
190: Wax CM, Abend DS, Pearson PH.
Chest pain and the role of somatic dysfunction.
J Am Osteopath Assoc. 1997 Jun;97(6):347-52, 355.
191: Shekelle PG, Coulter I.
Cervical spine manipulation: summary report of a systematic review of the literature and
a multidisciplinary expert panel.
J Spinal Disord. 1997 Jun;10(3):223-8. Review. Aucun résumé n'est disponible
192: Nelson KE.
Osteopathic medical considerations of reflex sympathetic dystrophy.
- 39 -
193: Brooks JG, Abidin MR.
Repositioning maneuver for benign paroxysmal positional vertigo (BPPV).
194: Allen TW.
Will failure to use OMT be grounds for malpractice?
J Am Osteopath Assoc. 1997 May;97(5):268. Aucun résumé n'est disponible
195: Hallas B, Lehman S, Bosak A, Tierney S, Galler R, Jacovina P, Scandalis TA, Wells M.
Establishment of behavioral parameters for the evaluation of osteopathic treatment principles
in a rat model of arthritis.
J Am Osteopath Assoc. 1997 Apr;97(4):207-14.
196: Abend DS.
Osteopathic manipulation for low back pain.
Postgrad Med. 1997 Apr;101(4):56, 58. Aucun résumé n'est disponible
197: Magnus WW, Gamber RG.
Osteopathic manipulative treatment: student attitudes before and after intensive clinical
exposure.
198: Johnson SM, Kurtz ME, Kurtz JC.
Variables influencing the use of osteopathic manipulative treatment in family practice.
J Am Osteopath Assoc. 1997 Feb;97(2):80-7. Erratum in: J Am Osteopath Assoc 1997
Apr;97(4):202.
199: Fry LJ.
Can DOs still 'circle the wagons'? Reflections on the use of osteopathic manipulative treatment.
200: Van Buskirk RL.
- 40 -
A manipulative technique of Andrew Taylor Still as reported by Charles Hazzard, DO, in 1905.
201: Moskalenko IuE, Kravchenko TI, Vainshtein GB, Semernia VN, Chervotok AE, Mitrofanov VF.
[The role of the CSF dynamic component in forming the periodic fluctuations in the electric
impedance of the head]
Fiziol Zh Im I M Sechenova. 1996 Jul;82(7):36-45. Russian.
202: Paul FA, Buser BR.
Osteopathic manipulative treatment applications for the emergency department patient.
203: Holmes JA.
Be not content to "sleep and feed".
Phys Ther. 1996 Jun;76(6):664-6. Aucun résumé n'est disponibleErratum in: Phys Ther 1996
Aug;76(8):896.
204: Purdy WR, Frank JJ, Oliver B.
Suboccipital dermatomyotomic stimulation and digital blood flow.
205: Vick DA, McKay C, Zengerle CR.
The safety of manipulative treatment: review of the literature from 1925 to 1993.
J Am Osteopath Assoc. 1996 Feb;96(2):113-5. Review.
206: Degenhardt BF, Kuchera ML.
Update on osteopathic medical concepts and the lymphatic system.
207: Fry LJ.
- 41 -
Preliminary findings on the use of osteopathic manipulative treatment by osteopathic physicians.
208: Kasovac M.
When it comes to OMT, do we practice what we preach?
209: Weir JP, McDonough AL, Hill VJ.
The effects of joint angle on electromyographic indices of fatigue.
Eur J Appl Physiol Occup Physiol. 1996;73(3-4):387-92.
210: Atchison JW, Newman RL, Klim GV.
Interest in manual medicine among residents in physical medicine and rehabilitation.
The need for increased instruction.
Am J Phys Med Rehabil. 1995 Nov-Dec;74(6):439-43.
211: Feely RA.
Hospital guidelines for diagnosis-related groups/osteopathic manipulative treatment.
212: Stiles EG.
Proposed matrix could yield bountiful 'harvest'.
J Am Osteopath Assoc. 1995 Sep;95(9):522, 524. Aucun résumé n'est disponible
213: Sucher BM.
Palpatory diagnosis and manipulative management of carpal tunnel syndrome: Part 2.
'Double crush' and thoracic outlet syndrome.
214: Luckenbill-Edds L, Bechill GB.
- 42 -
Nerve compression syndromes as models for research on osteopathic manipulative treatment.
215: Reitman C, Esses SI.
Conservative options in the management of spinal disorders, Part II. Exercise, education,
and manual therapies.
Am J Orthop. 1995 Mar;24(3):241-50. Review.
216: Greenman PE, McPartland JM.
Cranial findings and iatrogenesis from craniosacral manipulation in patients with traumatic
brain syndrome.
J Am Osteopath Assoc. 1995 Mar;95(3):182-8; 191-2.
217: Sucher BM.
Palpatory diagnosis and manipulative management of carpal tunnel syndrome.
J Am Osteopath Assoc. 1994 Aug;94(8):647-63. Review.
218: Orman R.
Osteopathic manipulation and injection therapy for low back pain.
Am Fam Physician. 1994 Jul;50(1):54-5. Aucun résumé n'est disponible
219: Abend DS.
Am Fam Physician. 1994 Jul;50(1):51, 54; author reply 55. Aucun résumé n'est disponible
220: Mirman MJ.
Am Fam Physician. 1994 Jul;50(1):51. Aucun résumé n'est disponible
221: Abend DS.
- 43 -
You can be both conventional and nonconventional.
Arch Fam Med. 1994 Jun;3(6):487-9. Aucun résumé n'est disponible
222: Moncman MG.
Osteopathic principles underlie treatment of back pain.
223: Hoffman KS, Hoffman LL.
Effects of adding sacral base leveling to osteopathic manipulative treatment of back pain:
a pilot study.
224: Cisler TA.
Whiplash as a total-body injury.
225: Walko EJ, Janouschek C.
Effects of osteopathic manipulative treatment in patients with cervicothoracic pain:
pilot study using thermography.
226: O'Neill A.
Danger and safety in medicines.
Soc Sci Med. 1994 Feb;38(4):497-507. Review.
227: Peters D, Davies P, Pietroni P.
Musculoskeletal clinic in general practice: study of one year's referrals.
Br J Gen Pract. 1994 Jan;44(378):25-9.
228: Pearson RH.
- 44 -
Osteopathic manipulation for lumbar disk disease.
Am Fam Physician. 1994 Jan;49(1):63. Aucun résumé n'est disponible
229: Steiner C.
Osteopathic manipulative treatment: what does it really do?
230: Baird RE, Cullom S, Deedman R, Feeney J, Kellogg J, Simning P.
Osteopathic manipulation and tension-type headaches.
Am Fam Physician. 1993 Nov 1;48(6):1023-4. Aucun résumé n'est disponible
231: Friedman H.
Osteopathy vs chiropractic.
J Fam Pract. 1993 Sep;37(3):221-2. Aucun résumé n'est disponible
232: Wax CM.
Primary care DOs, specialists--and OMM--important to profession.
J Am Osteopath Assoc. 1993 Sep;93(9):888, 890. Aucun résumé n'est disponible
233: Keller JA.
OMT enhances any medical regimen.
J Am Osteopath Assoc. 1993 Sep;93(9):888. Aucun résumé n'est disponible
234: Ormos G.
[Trends in therapy by "manipulation", basic concepts of manual therapy]
Orv Hetil. 1993 Aug 29;134(35):1948-9. Hungarian. Aucun résumé n'est disponible
- 45 -
235: Geiser M.
[Forgotten expertise about chiropractic]
Schweiz Rundsch Med Prax. 1993 Aug 17;82(33):875-9. German.
236: Sleszynski SL, Kelso AF.
Comparison of thoracic manipulation with incentive spirometry
in preventing postoperative atelectasis.
J Am Osteopath Assoc. 1993 Aug;93(8):834-8, 843-5.
237: Allen TW, D'Alonzo GE.
Investigating the role of osteopathic manipulation in the treatment of asthma.
J Am Osteopath Assoc. 1993 Jun;93(6):654-6, 659. Aucun résumé n'est disponible
238: Morehouse M.
Osteopathy, chiropractic, and spinal manipulation.
Ann Intern Med. 1993 Apr 15;118(8):651-2; author reply 652-3. Aucun résumé n'est disponible
239: Abend DS.
Osteopathy, chiropractic, and spinal manipulation.
Ann Intern Med. 1993 Apr 15;118(8):651; author reply 652-3. Aucun résumé n'est disponible
240: Boesler D, Warner M, Alpers A, Finnerty EP, Kilmore MA.
Efficacy of high-velocity low-amplitude manipulative technique in subjects with low-back pain
during menstrual cramping.
J Am Osteopath Assoc. 1993 Feb;93(2):203-8, 213-4.
241: Chapman JD.
Progress in scientifically proving the benefits of OMT in treating symptoms of dysmenorrhea.
- 46 -
242: Pringle M, Tyreman S.
Study of 500 patients attending an osteopathic practice.
Br J Gen Pract. 1993 Jan;43(366):15-8.
243: Bergmann TF.
Manual force, mechanically assisted articular chiropractic technique using long and/or short level
contacts.
J Manipulative Physiol Ther. 1993 Jan;16(1):33-6. Review.
244: Sucher BM.
Myofascial release of carpal tunnel syndrome.
J Am Osteopath Assoc. 1993 Jan;93(1):92-4, 100-1.
245: Kasovac M, Jones JM 3rd.
Integrate osteopathic principles and practices in postgraduate medical education--now.
J Am Osteopath Assoc. 1993 Jan;93(1):118, 123-5.
246: Kponkton A, Hamonet C, Montagne A, Devailly JP.
[Complications of cervical spine manipulation. A case of "locked-in syndrome"]
Presse Med. 1992 Dec 5;21(42):2050-2. French.
247: Farrell JP, Jensen GM.
Manual therapy: a critical assessment of role in the profession of physical therapy.
Phys Ther. 1992 Dec;72(12):843-52. Review.
248: Bergmann TF.
Short lever, specific contact articular chiropractic technique.
J Manipulative Physiol Ther. 1992 Nov-Dec;15(9):591-5. Review.
249: Kissling RO, Hochstrasser R, Kubli D.
- 47 -
[Manual medicine of the spine--indication, diagnostic and therapeutic possibilities]
Schweiz Rundsch Med Prax. 1992 Sep 8;81(37):1087-91. German.
250: Greenman PE.
Manipulation with the patient under anesthesia.
J Am Osteopath Assoc. 1992 Sep;92(9):1159-60, 1167-70.
251: Patriquin DA.
The evolution of osteopathic manipulative technique: the Spencer technique.
252: Bailey M, Dick L.
Nociceptive considerations in treating with counterstrain.
J Am Osteopath Assoc. 1992 Mar;92(3):334, 337-41. Review.
253: Cooper GJ.
Incorporating OMT in hospital training.
J Am Osteopath Assoc. 1991 Nov;91(11):1054. Aucun résumé n'est disponible
254: Levine DZ.
Burning pain in an extremity. Breaking the destructive cycle of reflex sympathetic dystrophy.
Postgrad Med. 1991 Aug;90(2):175-8, 183-5. Review.
255: Woolbright JL.
An alternative method of teaching strain/counterstrain manipulation.
J Am Osteopath Assoc. 1991 Apr;91(4):370, 373-6.
256: Obarski TP.
Not every DO masters the art of manipulation.
J Am Osteopath Assoc. 1991 Mar;91(3):220. Aucun résumé n'est disponible
- 48 -
257: Padgett DK.
To manipulate or not to manipulate, that is the question.
J Am Osteopath Assoc. 1991 Mar;91(3):218, 220. Aucun résumé n'est disponible
258: Korr IM.
Osteopathic research: the needed paradigm shift.
J Am Osteopath Assoc. 1991 Feb;91(2):156, 161-8, 170-1. Review.
259: Kuchera WA.
Our osteopathic uniqueness needs nurturing.
J Am Osteopath Assoc. 1991 Feb;91(2):117, 121. Aucun résumé n'est disponible
260: Scheibel A, Debusschere M.
[Changes in posture induced by 2 osteopathic manipulations are coherent with the sagittal
or frontal orientation they involve]
Agressologie. 1991;32(2):134-6. French.
261: Cole TJ.
Do real DOs practice manipulation?
J Am Osteopath Assoc. 1990 Dec;90(12):1051. Aucun résumé n'est disponible
262: Sucher BM.
Thoracic outlet syndrome--a myofascial variant: Part 1. Pathology and diagnosis.
J Am Osteopath Assoc. 1990 Aug;90(8):686-96, 703-4. Review.
263: Samorukov AE.
[The prospects for the development of manual therapy in the USSR]
Vopr Kurortol Fizioter Lech Fiz Kult. 1990 Jul-Aug;(4):65-7. Russian. Aucun résumé n'est disponib
- 49 -
264: Locke RG, Salvia JV.
Pharmacologic manipulation of the respiratory control center in the infant.
J Am Osteopath Assoc. 1990 Jul;90(7):602-4, 607-12. Review.
265: Koss RW.
Quality assurance monitoring of osteopathic manipulative treatment.
266: MacDonald RS, Bell CM.
An open controlled assessment of osteopathic manipulation in nonspecific low-back pain.
267: Goldstein M.
War, politics, and osteopathic medicine.
268: Schiowitz S.
Facilitated positional release.
J Am Osteopath Assoc. 1990 Feb;90(2):145-6, 151-5. Review.
269: [No authors listed]
Readers' thoughts on treating low back pain with counterstrain technique.
J Am Osteopath Assoc. 1989 Nov;89(11):1379, 1384, 1387 passim. Aucun résumé n'est disponible
- 50 -
270: Dickey JL.
Postoperative osteopathic manipulative management of median sternotomy patients.
271: Norris SH.
A "closet DO" comes out for manipulation.
Hosp Pract (Off Ed). 1989 Sep 30;24(9A):12-4. Aucun résumé n'est disponible
272: Heath DM.
Manipulation for postop pain.
Hosp Pract (Off Ed). 1989 Sep 15;24(9):13. Aucun résumé n'est disponible
273: Pintal WJ, Kurtz ME.
An integrated osteopathic treatment approach in acute otitis media.
274: Dobrusin R.
An osteopathic approach to conservative management of thoracic outlet syndromes.
275: Kuchera WA.
Osteopathic manipulation: purposes and protocols.
Hosp Pract (Off Ed). 1989 Jul 15;24(7):17, 20. Aucun résumé n'est disponible
276: Beal MC, Vorro J, Johnston WL.
Chronic cervical dysfunction: correlation of myoelectric findings with clinical progress.
277: Lomakin PV.
- 51 -
[Our experience with organizing a department of manual therapy in an urban hospital]
Ortop Travmatol Protez. 1989 May;(5):55-8. Russian. Aucun résumé n'est disponible
278: Neame A.
Manipulative physiotherapy.
N Z Med J. 1989 Mar 8;102(863):112. Aucun résumé n'est disponible
279: Aboul-Ela N, Jacobson EL, Jacobson MK.
Labeling methods for the study of poly- and mono(ADP-ribose) metabolism in cultured cells.
Anal Biochem. 1988 Oct;174(1):239-50.
280: Ellestad SM, Nagle RV, Boesler DR, Kilmore MA.
Electromyographic and skin resistance responses to osteopathic manipulative treatment
for low-back pain.
281: Paterson JK.
Spinal manipulation: science or black art?
Practitioner. 1988 Mar 22;232(1445):289, 291. Aucun résumé n'est disponible
282: Allen LB, Kehoe MJ, Hsu SC, Barfield R, Holland CS, Dimitrijevich SD.
A simple method of drying virus on inanimate objects for virucidal testing.
J Virol Methods. 1988 Mar-Apr;19(3-4):239-47.
283: Klein BG, Renehan WE, Jacquin MF, Rhoades RW.
Anatomical consequences of neonatal infraorbital nerve transection upon the trigeminal
ganglion and vibrissa follicle nerves in the adult rat.
J Comp Neurol. 1988 Feb 22;268(4):469-88.
284: Johnston WL.
- 52 -
Segmental definition: Part II. Application of an indirect method in osteopathic manipulative
treatment.
285: Johnston WL.
Segmental definition: Part I. A focal point for diagnosis of somatic dysfunction.
286: Weiner LB, Grant LA, Grant AH.
Monitoring ocular changes that may accompany use of dental appliances and/or osteopathic
craniosacral manipulations in the treatment of TMJ and related problems.
Cranio. 1987 Jul;5(3):278-85. Aucun résumé n'est disponible
287: Higgins BE, Patriquin DA.
A low-velocity, high-amplitude procedure for demonstrating osteopathic principles and
concepts of technique.
288: Burton AK.
Osteopathy in back trouble.
Br Med J (Clin Res Ed). 1986 Dec 6;293(6560):1482-3. Aucun résumé n'est disponible
289: Gramer JH.
Osteopathic medicine today.
290: Brownson RJ, Zollinger WK, Madeira T, Fell D.
Sudden sensorineural hearing loss following manipulation of the cervical spine.
Laryngoscope. 1986 Feb;96(2):166-70.
291: Paul RT, Stomel RJ, Broniak FF, Williams BB Jr.
Interferon levels in human subjects throughout a 24-hour period following thoracic lymphatic
- 53 -
pump manipulation.
292: Davis C.
Osteopathic manipulation resulting in damage to spinal cord.
Br Med J (Clin Res Ed). 1986 Jan 18;292(6514):205. Aucun résumé n'est disponible
Osteopathic manipulation resulting in damage to the spinal cord.
Br Med J (Clin Res Ed). 1985 Dec 14;291(6510):1720-1. Aucun résumé n'est disponible
294: Davis C.
Osteopathic manipulation resulting in damage to spinal cord.
Br Med J (Clin Res Ed). 1985 Nov 30;291(6508):1540-1. Aucun résumé n'est disponible
295: Hruby RJ.
The total body approach to the osteopathic management of temporomandibular joint dysfunction.
296: Gibson T, Grahame R, Harkness J, Woo P, Blagrave P, Hills R.
Controlled comparison of short-wave diathermy treatment with osteopathic treatment in
non-specific low back pain.
Lancet. 1985 Jun 1;1(8440):1258-61.
297: Morgan JP, Dickey JL, Hunt HH, Hudgins PM.
A controlled trial of spinal manipulation in the management of hypertension.
298: Northup GW.
Louisa Burns Memorial Lecture: Re--search.
- 54 -
299: Payson SM, Holloway HS.
Possible complications of using naloxone as an internal opiate antagonist in the investigation of
the role of endorphins in osteopathic manipulative treatment.
J Am Osteopath Assoc. 1984 Sep;84(1 Suppl):152-6. Aucun résumé n'est disponible
300: Belcastro MR, Backes CR, Chila AG.
Bronchiolitis: a pilot study of osteopathic manipulative treatment, bronchodilators, and other
therapy.
301: Goodridge JP.
Thomas L. Northup Lecture--1983 American Academy of Osteopathy: AAO--yesterday, today
and tomorrow.
J Am Osteopath Assoc. 1984 Apr;83(8):593-600. Aucun résumé n'est disponible
302: Siehl D.
Andrew Taylor Still memorial lecture: the osteopathic difference--is it only manipulation?
303: Soutas-Little RW.
Louisa Burns memorial lecture: biomechanics and osteopathic manipulative treatment.
304: Reilly DT.
Young doctors' views on alternative medicine.
Br Med J (Clin Res Ed). 1983 Jul 30;287(6388):337-9.
305: Gunby P.
Study to evaluate manipulation therapy.
- 55 -
JAMA. 1983 Jun 17;249(23):3148-50. Aucun résumé n'est disponible
306: Guthrie RA, Martin RH.
Effect of pressure applied to the upper thoracic (placebo) versus lumbar areas
(osteopathic manipulative treatment) for inhibition of lumbar myalgia during labor.
307: Kelso AF, Grant RG, Johnston WL.
Use of thermograms to support assessment of somatic dysfunction or effects of osteopathic
manipulative treatment: preliminary report.
308: Llorens C.
[The osteopathic idea; its significance in dentistry]
Inf Dent. 1982 Oct 28;64(37):3583-615. Review. French. Aucun résumé n'est disponible
309: Beal MC.
Teaching of basic principles of osteopathic manipulative techniques.
310: Grieve GP.
Concepts of manipulative treatment.
Physiotherapy. 1982 Apr;68(4):104. Aucun résumé n'est disponible
311: Schmidt IC.
Osteopathic manipulative therapy as a primary factor in the management of upper, middle,
and pararespiratory infections.
312: Dinnar U, Beal MC, Goodridge JP, Johnston WL, Karni Z, Mitchell FL Jr, Upledger JE,
McConnell DG.
- 56 -
Description of fifty diagnostic tests used with osteopathic manipulation.
313: Burton AK.
Back pain in osteopathic practice.
Rheumatol Rehabil. 1981 Nov;20(4):239-46.
314: Siehl D.
Osteopathic manipulation for accident-prone patient.
315: Korzh AA, Khvisiuk NI, Prodan AI.
[Manual therapy of spinal osteochondrosis (an analytical review of the literature)]
Ortop Travmatol Protez. 1980 Oct;(10):69-76. Review. Russian. Aucun résumé n'est disponible
316: Isaacson PR.
Living anatomy: an anatomic basis for the osteopathic concept.
317: Kimberly PE.
Formulating a prescription for osteopathic manipulative treatment.
318: Kelso AF, Larson NJ, Kappler RE.
A clinical investigation of the osteopathic examination.
319: Beal MC.
Osteopathic basics.
- 57 -
320: Dinnar U, Beal MC, Goodridge JP, Johnston WL, Karni Z, Mitchell FL Jr, Upledger JE,
McConnell DG.
Classification of diagnostic tests used with osteopathic manipulation.
321: Allen TW, Kelso AF.
Osteopathic research and respiratory disease.
322: Dove CI.
Manipulation, osteopathy, and back pain.
Lancet. 1979 Jun 23;1(8130):1350. Aucun résumé n'est disponible
323: Hoyt WH, Shaffer F, Bard DA, Benesler JS, Blankenhorn GD, Gray JH, Hartman WT,
Hughes LC.
Osteopathic manipulation in the treatment of muscle-contraction headache.
324: Kirk CE.
Biodynamics of self-administered manipulation.
325: Lipinski B.
Biological significance of piezoelectricity in relation to acupuncture, Hatha Yoga, osteopathic
medicine and action of air ions.
Med Hypotheses. 1977 Jan-Feb;3(1):9-12.
326: Roppel RM, Mitchell FL Jr, Ch'an KC.
Musculoskeletal changes immediately following acupuncture.
Am J Chin Med (Gard City N Y). 1977 Spring;5(1):79-84.
- 58 -
327: Stiles EG.
Osteopathic manipulation in a hospital environment.
328: Lacey R.
Proceedings: The response to osteopathic manipulative treatment of a case of brachial
plexus neuritis.
329: Bailey HW.
Some problems in making osteopathic spinal manipulative therapy appropriate and specific.
330: Northup GW.
History of the development of osteopathic concepts, with notes on osteopathic terminology.
331: Hewitt D, Wood PH.
Heterodox practitioners and the availability of specialist advice.
Rheumatol Rehabil. 1975 Aug;14(3):191-9.
332: Harakal JH.
An osteopathically integrated approach to the whiplash complex.
Letter: Manipulation in treatment of low back pain.
Br Med J. 1975 May 10;2(5966):334. Aucun résumé n'est disponible
- 59 -
334: Howell RK, Allen TW, Kappler RE.
The influence of osteopathic manipulative therapy in the management of patients with chronic
obstructive lung disease.
335: Rumney IC.
The relevance of somatic dysfunction.
336: Hulse M, Partsch CJ, Wolff HD.
[The acute cervical vertigo under otologic and osteopathic view (author's transl)]
Laryngol Rhinol Otol (Stuttg). 1975 Mar;54(3):263-7. German.
337: Cipolla VT, Dubrow CM, Schuller EA Jr.
Preliminary study: an evaluation of the effects of osteopathic manipulative therapy on
intraocular pressure.
338: Lowenstein MB.
Osteopathic theories and practice.
Va Med Mon (1918). 1975 Jan;102(1):25-8. Aucun résumé n'est disponible
339: Lay EM.
The osteopathic management of trigeminal neuralgia.
340: Caviezel H.
[Evolution of basic theories in manual therapy (author's transl)]
Schweiz Rundsch Med Prax. 1974 Jul 9;63(27):829-36. German. Aucun résumé n'est disponible
- 60 -
341: Kolman S, Getson P, Levin F, Sculthorpe R.
Effects of osteopathic manipulation on several different physiologic functions. IV.
Absence of crossover effect.
Editorial: Osteopathic medicine: philosophy vs. manipulative therapy.
343: Mall R.
An evaluation of routine pulmonary function tests as indicators of responsiveness of
a patient with chronic obstructive lung disease to osteopathic health care.
344: Howell RK, Kappler RE.
The influence of osteopathic manipulative therapy on a patient with advanced cardiopulmonary
disease.
345: Wright RM.
The role of manipulation in the rehabilitation of the athlete.
346: Morey LW Jr.
Osteopathic manipulation under general anesthesia.
347: Jones LH.
Foot treatment without hand trauma.
- 61 -
348: Johnston WL.
Segmental behavior during motion. 3. Extending behavioral boundaries.
349: Johnston WL.
Segmental behavior during motion. 3. Extending behavioral boundaries.
350: Johnston WL.
Segmental behavior during motion. II. Somatic dysfunction--the clinical distortion.
351: Larson NJ.
Osteopathic manipulation for syndromes of the brachial plexus.
352: Gimlett DM.
Osteopathic and allopathic medicine.
J Occup Med. 1972 Dec;14(12):892. Aucun résumé n'est disponible
353: Gerber A.
The osteopathic orthopedic surgeon and industrial back problems.
J Occup Med. 1972 Nov;14(11):851-3. Aucun résumé n'est disponible
- 62 -
354: Clymer DH, Levin FL, Sculthorpe RH.
Effects of osteopathic manipulation on several different physiologic functions. 3.
Measurement of changes in several different physiologic parameters as a result of
osteopathic manipulation.
355: Cyriax JH.
Manipulation--doctor, layman or physiotherapist?
Nurs Mirror Midwives J. 1972 Feb 25;134(7):24-7. Aucun résumé n'est disponible
356: Eshleman J, Myers S, Pantle P.
Measurement of changes in blood volume as a result of osteopathic manipulation.
357: Siehl D, Olson DR, Ross HE, Rockwood EE.
Manipulation of the lumbar spine with the patient under general anesthesia: evaluation
by electromyography and clinical-neurologic examination of its use for lumbar nerve root
compression syndrome.
358: Moss L.
Subluxation of the sacroiliac joint.
Lancet. 1970 Feb 21;1(7643):412-3. Aucun résumé n'est disponible
359: Stoddard A.
Osteopathic techniques of manipulation.
Physiotherapy. 1970 Jan 10;56(1):29-30. Aucun résumé n'est disponible
- 63 -
The painful back.
Trans Soc Occup Med. 1970 Jan;20(1):1. Aucun résumé n'est disponible
361: Galewaler JE.
Motion, the lymphatics, and manipulation.
362: Stookey JR.
Manipulative therapy at the bedside.
363: Rumney IC.
Recording musculoskeletal findings in hospitals.
364: Hirschkoff S.
[Articular manipulation of the extremities. Methods of practice]
Rhumatologie. 1968 Dec;20(10):411-4. French. Aucun résumé n'est disponible
365: Le Corre F.
[History of vertebral manipulation. Development of ideas]
Cah Coll Med Hop Paris. 1968 Sep;9(10):861-6. French. Aucun résumé n'est disponible
366: Foellner RP, Taylor RM, Marjan G, Kelso AF.
Proposed study to evaluate the effect of osteopathic manipulative therapy in the
treatment of the emphysema patient.
- 64 -
367: Celander E, Koenig AJ, Celander DR.
Effect of osteopathic manipulative therapy on autonomic tone as evidenced by blood
pressure changes and activity of the fibrinolytic system.
368: Shuman D.
Ambulation, osteopathic manipulative therapy, and joint sclerotherapy in the management
of common low-back disorders.
369: Rumney IC.
Structural diagnosis and manipulative therapy.
370: Greenspan J, Melchior J.
The effect of osteopathic manipulative treatment on the resistance of rats to stressful
situations.
371: Purse FM.
Manipulative therapy of upper respiratory infections in children.
372: COLE WV.
A REFLEX BASIS FOR OSTEOPATHIC MEDICINE.
J Am Osteopath Assoc. 1963 Dec;63:343-50. Aucun résumé n'est disponible
PMID: 14121164 [PubMed - OLDMEDLINE for Pre1966]
373: KALTENBORN-BRUUN F.
[On the so-called osteopathic study method and manipulation technic for the spine.]
Nord Med. 1963 Jun 6;69:684-7. Norwegian. Aucun résumé n'est disponible
- 65 -
374: KALTENBORN-BRUUN F.
[On the so-called osteopathic study method and manipulation technic for the spine.]
Nord Med. 1963 Jun 6;69:684-7. Norwegian. Aucun résumé n'est disponible
375: PURSE FM.
Clinical evaluation of osteopathic manipulative therapy in measles.
J Am Osteopath Assoc. 1961 Dec;61:274-6. Aucun résumé n'est disponible
376: STODDARD A.
Manipulation; an explanation of osteopathic technique.
Br J Phys Med. 1952 Jul;15(7):160-2. Aucun résumé n'est disponible
377: WOOD LR.
Prenatal management including osteopathic manipulation.
378: CHANDLER LC.
The evaluation of specific manipulation in osteopathic therapy.
- 66 -
Résumés des articles publiés
Sont présentés ici tous les résumés disponibles des publications détectées dans PubMed
classées par ordre chronologique inverse de parution.
1: Fam Med. 2005 Nov;37(10):693-5.
Allopathic Family Medicine Residents Can Learn Osteopathic Manipulation
Techniques in a 1-month Elective.
Leiber JD.
Malcolm Grow Medical Center Family Medicine Residency, Andrews Air Force Base, Md.
BACKGROUND: Graduating family medicine residents report a relative lack of confidence in
managing musculoskeletal problems, and many primary care physicians desire more
instruction in manual medicine. METHODS: We conducted a 1-month osteopathic
manipulative treatment elective with five allopathic family medicine residents, utilizing
multiple teaching and assessment strategies. RESULTS: Residents averaged 30 patient
encounters each. Faculty graded their attainment of the knowledge and skills objectives at
3.9 and 3.8 on a 5-point scale, respectively. Residents reported unanimously that the course
had reasonable expectations and fostered independent decision making and that they
achieved the educational goals. CONCLUSIONS: After a 1-month elective, allopathic
residents demonstrated competency in a defined set of osteopathic principles and skills.
- 67 -
2: J Am Osteopath Assoc. 2005 Jun;105(6):283-91.
McPartland JM, Giuffrida A, King J, Skinner E, Scotter J, Musty RE.
Unitec Institute of Technology, Auckland, New Zealand. [email protected]
Endogenous cannabinoids activate cannabinoid receptors in the brain and elicit moodaltering effects. Parallel effects (eg, anxiolysis, analgesia, sedation) may be elicited by
osteopathic manipulative treatment (OMT), and previous research has shown that the
endorphin system is not responsible for OMT's mood-altering effects. The authors
investigate whether OMT generated cannabimimetic effects for 31 healthy subjects in a
dual-blind, randomized controlled trial that measured changes in subjects' scores on the
67-item Drug Reaction Scale (DRS). Chemical ionization gas chromatography and mass
spectrometry were also used to determine changes in serum levels of anandamide (AEA), 2arachidonoylglycerol (2-AG), and oleylethanolamide (OEA). In subjects receiving OMT,
posttreatment DRS scores increased significantly for the cannabimimetic descriptors good,
high, hungry, light-headed, and stoned, with significant score decreases for the descriptors
inhibited, sober, and uncomfortable. Mean posttreatment AEA levels (8.01 pmol/mL)
increased 168% over pretreatment levels (2.99 pmol/mL), mean OEA levels decreased 27%,
and no changes occurred in 2-AG levels in the group receiving OMT. Subjects in the sham
manipulative treatment group recorded mixed DRS responses, with both increases and
decreases in scores for cannabimimetic and noncannabimimetic descriptors and no changes
in sera levels. When changes in serum AEA were correlated with changes in subjects' DRS
scores, increased AEA correlated best with an increase for the descriptors cold and
rational, and decreased sensations for the descriptors bad, paranoid, and warm. The authors
propose that healing modalities popularly associated with changes in the endorphin system,
such as OMT, may actually be mediated by the endocannabinoid system.
Publication Types:
Clinical Trial
Randomized Controlled Trial
- 68 -
Preoperative intravenous morphine sulfate with postoperative osteopathic
manipulative treatment reduces patient analgesic use after total abdominal
hysterectomy.
Goldstein FJ, Jeck S, Nicholas AS, Berman MJ, Lerario M.
Philadelphia College of Osteopathic Medicine, 4170 City Avenue, Philadelphia, PA 19131-1610,
USA. [email protected]
CONTEXT: Administration of opioids for treatment of pain after total abdominal
hysterectomy (TAH) is a common postoperative procedure, providing an excellent parameter
for evaluating the efficacy of postsurgical osteopathic manipulative treatment (OMT).
OBJECTIVE: To determine whether a combination of preemptive morphine sulfate and
postoperative OMT could provide improved analgesic effects. DESIGN: Randomized doubleblind controlled trial. SETTING AND PATIENTS: Thirty-nine hospitalized patients assigned
to one of four treatment groups: (1) preoperative saline and postoperative sham
manipulative treatment; (2) preoperative saline and postoperative OMT; (3) preoperative
morphine and postoperative sham manipulative treatment; or (4), preoperative morphine and
postoperative OMT. INTERVENTION: Saline (control) or morphine, 10 mg, delivered
intravenously (IV) 10 minutes before surgical incision. All patients received a postoperative
patient-controlled IV analgesia pump containing morphine. At specified intervals following
preoperative IV injections, blood was drawn and analyzed for morphine concentrations.
Subjects were also asked to rate their postoperative levels of pain, nausea, and vomiting.
RESULTS: There were no differences in either pain, or nausea and vomiting scores among
the four study groups. Patients in Group 4 used less morphine than those in the Group 3 for
the first 24 hours (P=.02) and from 25-48 hours (P=.01) after elective TAH. Morphine blood
concentrations were lower after 24 hours in Group 4 compared with Group 2 (P=.04).
CONCLUSION: Administration of postoperative OMT enhanced pre- and postoperative
morphine analgesia in the immediate 48-hour period following elective TAH, demonstrating
that OMT can be a therapeutic adjunct in pain management following this procedure.
Publication Types:
Clinical Trial
- 69 -
4: BMC Musculoskelet Disord. 2005 Aug 4;6:43.
Osteopathic manipulative treatment for low back pain: a systematic review
and meta-analysis of randomized controlled trials.
Licciardone JC, Brimhall AK, King LN.
Osteopathic Research Center, University of North Texas Health Science Center, Fort
Worth, TX 76107, USA. [email protected]
BACKGROUND: Osteopathic manipulative treatment (OMT) is a distinctive modality
commonly used by osteopathic physicians to complement their conventional treatment of
musculoskeletal disorders. Previous reviews and meta-analyses of spinal manipulation for low
back pain have not specifically addressed OMT and generally have focused on spinal
manipulation as an alternative to conventional treatment. The purpose of this study was to
assess the efficacy of OMT as a complementary treatment for low back pain. METHODS:
Computerized bibliographic searches of MEDLINE, EMBASE, MANTIS, OSTMED, and the
Cochrane Central Register of Controlled Trials were supplemented with additional database
and manual searches of the literature. Six trials, involving eight OMT vs control treatment
comparisons, were included because they were randomized controlled trials of OMT that
involved blinded assessment of low back pain in ambulatory settings. Data on trial
methodology, OMT and control treatments, and low back pain outcomes were abstracted by
two independent reviewers. Effect sizes were computed using Cohen's d statistic and metaanalysis results were weighted by the inverse variance of individual comparisons. In addition
to the overall meta-analysis, stratified meta-analyses were performed according to control
treatment, country where the trial was conducted, and duration of follow-up. Sensitivity
analyses were performed for both the overall and stratified meta-analyses. RESULTS:
Overall, OMT significantly reduced low back pain (effect size, -0.30; 95% confidence
interval, -0.47 - -0.13; P = .001). Stratified analyses demonstrated significant pain
reductions in trials of OMT vs active treatment or placebo control and OMT vs no
treatment control. There were significant pain reductions with OMT regardless of whether
trials were performed in the United Kingdom or the United States. Significant pain
reductions were also observed during short-, intermediate-, and long-term follow-up.
CONCLUSION: OMT significantly reduces low back pain. The level of pain reduction is
greater than expected from placebo effects alone and persists for at least three months.
Additional research is warranted to elucidate mechanistically how OMT exerts its effects,
to determine if OMT benefits are long lasting, and to assess the cost-effectiveness of
OMT as a complementary treatment for low back pain.
7: Wien Klin Wochenschr. 2005 May;117(9-10):333-41.
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Sources of bias in reviews of spinal manipulation for back pain.
Canter PH, Ernst E.
Peninsula Medical School, Complementary Medicine, University of Plymouth, Exeter, UK.
[email protected]
The effectiveness of spinal manipulation as a treatment for back pain remains uncertain and
controversial. This is because of methodological weakness in many of the published clinical
trials and also because of markedly opposing interpretations of the primary data by
different reviewers. We have systematically assessed a representative sample of recent
reviews on this topic. Reviews were included in the analysis if they were published between
1993 and March 2004, were listed in PubMed with an abstract and categorised as a review
or meta-analysis, and were written in English. They were also required to present the
evidence from at least two referenced clinical trials of spinal manipulation for back pain and
to reach a conclusion about the effectiveness of the intervention. Each review was
evaluated for methodological quality. Twenty-nine reviews met the inclusion criteria.
Sixteen reached an overall positive conclusion, 7 a negative conclusion and 6 a neutral
conclusion regarding therapeutic effectiveness. There were statistically significant pairwise
correlations between each of the three factors: direction of conclusion, methodological
quality and authorship by osteopaths or chiropracters. This indicates an association between
authorship by osteopaths or chiropractors and low methodological quality and positive
conclusion. We conclude that the outcomes of reviews of this subject are strongly
influenced by both scientific rigour and profession of authors. The effectiveness of spinal
manipulation for back pain is less certain than many reviews suggest; most high quality
reviews reach negative conclusions.
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8: Headache. 2005 Jun;45(6):738-46.
Physical treatments for headache: a structured review.
Biondi DM.
Harvard Medical School, Boston, MA, USA.
BACKGROUND: Primary headache disorders, especially migraine, are commonly accompanied
by neck pain or other symptoms. Because of this, physical therapy (PT) and other physical
treatments are often prescribed. This review updates and synthesizes published clinical
trial evidence, systematic reviews, and case series regarding the efficacy of selected
physical modalities in the treatment of primary headache disorders. METHODS: The
National Library of Medicine (MEDLINE), The Cochrane Library, and other sources of
information were searched through June 2004 to identify clinical studies, systematic
reviews, case series, or other information published in English that assessed the treatment
of headache or migraine with chiropractic, osteopathic, PT, or massage interventions.
RESULTS: PT is more effective than massage therapy or acupuncture for the treatment of
TTH and appears to be most beneficial for patients with a high frequency of headache
episodes. PT is most effective for the treatment of migraine when combined with other
treatments such as thermal biofeedback, relaxation training, and exercise. Chiropractic
manipulation demonstrated a trend toward benefit in the treatment of TTH, but evidence is
weak. Chiropractic manipulation is probably more effective in the treatment of tension-type
headache (TTH) than it is in the treatment of migraine. Evidence is lacking regarding the
efficacy of these treatments in reducing headache frequency, intensity, duration, and
disability in many commonly encountered clinical situations. Many of the published case
series and controlled studies are of low quality. CONCLUSIONS AND
RECOMMENDATIONS: Further studies of improved quality are necessary to more firmly
establish the place of physical modalities in the treatment of primary headache disorders.
With the exception of high velocity chiropractic manipulation of the neck, the treatments
are unlikely to be physically dangerous, although the financial costs and lost treatment
opportunity by prescribing potentially ineffective treatment may not be insignificant. In the
absence of clear evidence regarding their role in treatment, physicians and patients are
advised to make cautious and individualized judgments about the utility of physical
treatments for headache management; in most cases, the use of these modalities should
complement rather than supplant better-validated forms of therapy.
Publication Types:
Review
Review, Tutorial
11: J Am Osteopath Assoc. 2005 Mar;105(3):135-43.
- 72 -
Erratum in:
J Am Osteopath Assoc. 2005 May;105(5):238.
Manipulative treatment of carpal tunnel syndrome: biomechanical and
osteopathic intervention to increase the length of the transverse carpal
ligament: part 2. Effect of sex differences and manipulative "priming".
Sucher BM, Hinrichs RN, Welcher RL, Quiroz LD, St Laurent BF, Morrison BJ.
Center for Carpal Tunnel Studies, 10585 N Tatum Blvd, Ste D135, Paradise Valley, AZ
85253-1073, USA. [email protected]
As a theoretical basis for treatment of carpal tunnel syndrome (CTS) and expanding upon
part 1 of this study, the authors investigated the effects of static loading (weights) and
dynamic loading (osteopathic manipulation [OM]) on 20 cadaver limbs (10 male, 10 female).
This larger study group allowed for comparative analysis of results by sex and reversal of
sequencing for testing protocols. In static loading, 10-newton loads were applied to metal
pins inserted into carpal bones. In dynamic loading, the OM maneuvers used were those
currently used in clinical settings to treat patients with CTS. Transverse carpal ligament
(TCL) response was observed by measuring changes in the width of the transverse carpal
arch (TCA) with three-dimensional video analysis and precision calipers. Results
demonstrated maximal TCL elongation of 13% (3.7 mm) with a residual elongation after
recovery of 9% (2.6 mm) from weight loads in the female cadaver limbs, compared to less
than 1 mm as noted in part 1, which used lower weight loads and combined results from both
sexes. Favorable responses to all interventions were more significant among female cadaver
limbs. Higher weight loads also caused more linear translatory motion through the metal
pins, resulting in TCA widening equal to 63% of the increases occurring at skin level,
compared to only 38% with lower loads. When OM was performed first, it led to greater
widening of the TCA and lengthening of the TCL during the weight loading that followed.
Both methods hold promise to favorably impact the course of management of CTS,
particularly in women.
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13: Cochrane Database Syst Rev. 2005 Apr 18;(2):CD001002.
Update of:
Cochrane Database Syst Rev. 2002;(4):CD001002.
Hondras MA, Linde K, Jones AP.
Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA 52803, USA.
[email protected]
BACKGROUND: A variety of manual therapies with similar postulated biologic mechanisms
of action are commonly used to treat patients with asthma. Manual therapy practitioners
are also varied, including physiotherapists, respiratory therapists, chiropractic and
osteopathic physicians. A systematic review across disciplines is warranted. OBJECTIVES:
To evaluate the evidence for the effects of manual therapies for treatment of patients
with bronchial asthma. SEARCH STRATEGY: We searched for trials in computerized
general (EMBASE, CINAHL and MEDLINE) and specialized databases (Cochrane
Complementary Medicine Field, Cochrane Rehabilitation Field, Index to Chiropractic
Literature (ICL), and Manual, Alternative and Natural Therapy (MANTIS)). In addition, we
assessed bibliographies from included studies, and contacted authors of known studies for
additional information about published and unpublished trials. Date of most recent search:
August 2004. SELECTION CRITERIA: Trials were included if they: (1) were randomised; (2)
included asthmatic children or adults; (3) examined one or more types of manual therapy;
and (4) included clinical outcomes with observation periods of at least two weeks. DATA
COLLECTION AND ANALYSIS: All three reviewers independently extracted data and
assessed trial quality using a standard form. MAIN RESULTS: From 473 unique citations,
68 full text articles were retrieved and evaluated, which resulted in nine citations to three
RCTs (156 patients) suitable for inclusion. Trials could not be pooled statistically because
studies that addressed similar interventions used disparate patient groups or outcomes. The
methodological quality of one of two trials examining chiropractic manipulation was good and
neither trial found significant differences between chiropractic spinal manipulation and a
sham manoeuvre on any of the outcomes measured. One small trial compared massage
therapy with a relaxation control group and found significant differences in many of the
lung function measures obtained. However, this trial had poor reporting characteristics and
the data have yet to be confirmed. AUTHORS' CONCLUSIONS: There is insufficient
evidence to support the use of manual therapies for patients with asthma. There is a need
to conduct adequately-sized RCTs that examine the effects of manual therapies on clinically
relevant outcomes. Future trials should maintain observer blinding for outcome assessments,
and report on the costs of care and adverse events. Currently, there is insufficient
evidence to support or refute the use of manual therapy for patients with asthma.
Publication Types:
Review
14: Ned Tijdschr Geneeskd. 2005 Mar 26;149(13):703-7.
- 74 -
Comment in:
Ned Tijdschr Geneeskd. 2005 May 28;149(22):1237; author reply 1237-8.
Ned Tijdschr Geneeskd. 2005 May 28;149(22):1238-9; author reply 1239.
[Systematic review of the effects of therapy in infants with the KISSsyndrome (kinetic imbalance due to suboccipital strain)]
[Article in Dutch]
Brand PL, Engelbert RH, Helders PJ, Offringa M.
Isala Klinieken, Amalia kinderafdeling, Postbus 10.500, 8000 GM Zwolle. [email protected]
OBJECTIVE: To establish the effects of manual therapy, chiropractic, or osteopathic
treatment of the KISS-syndrome (kinetic imbalance due to suboccipital strain) in infants
with positional preference, plagiocephaly, and colic. DESIGN: Systematic review of the
literature. METHOD: PubMed, Embase and the Cochrane Library were searched for articles
on the effects of manual therapy, chiropractic and osteopathy on the KISS-syndrome.
Experts in the field of manual medicine and osteopathy were asked to provide relevant
articles. The bibliography in a textbook of manual therapy for children was hand-searched
for additional references to the KISS-syndrome. RESULTS: No clinical trials were found
that evaluated the effects of manual therapy or osteopathy on either the KISS-syndrome
or its symptoms. Pooled analysis of two randomised clinical trials on the effects of
chiropractic in infantile colic showed no statistically significant difference between active
and control treatments. In addition, we found that 22% of infants showed short episodes of
apnoea during manual therapy of the spine, and that one case has been described in which
such apnoea resulted in death. CONCLUSION: Given the absence of evidence of beneficial
effects of spinal manipulation in infants and in view of its potential risks, manual therapy,
chiropractic and osteopathy should not be used in infants with the KISS-syndrome, except
within the context of randomised double-blind controlled trials.
Publication Types:
Meta-Analysis
Review
16: J Am Osteopath Assoc. 2005 Jan;105(1):7-12.
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Effects of osteopathic manipulative treatment on pediatric patients with
asthma: a randomized controlled trial.
Guiney PA, Chou R, Vianna A, Lovenheim J.
Family Practice Residency Program, Department of Family Practice, Peninsula Hospital
Center, 51-15 Beach Channel Dr, Far Rockaway, NY 11691-1042, USA.
[email protected]
Asthma is a common chronic condition that has long plagued the pediatric patient population.
Asthma in children can cause excessive school absenteeism, hospitalizations, and even
death. Osteopathic manipulative treatment (OMT) is an underutilized noninvasive treatment
method for patients with asthma. The use of OMT may help decrease mortality and
morbidity rates among this patient group. The authors conducted a randomized controlled
trial attempting to demonstrate the therapeutic relevance of OMT in the pediatric asthma
population. With a confidence level of 95%, results for the OMT group showed a
statistically significant improvement of 7 L per minute to 9 L per minute for peak
expiratory flow rates. These results suggest that OMT has a therapeutic effect among this
patient population. The authors suggest that more clinical trials are required to better
demonstrate the effectiveness of OMT in patients with asthma.
Publication Types:
Clinical Trial
- 76 -
18: J Pediatr Orthop. 2005 Jan-Feb;25(1):98-102.
Nonoperative clubfoot treatment using the French physical therapy
method.
Richards BS, Johnston CE, Wilson H.
Texas Scottish Rite Hospital for Children, Dallas, Texas, USA. [email protected]
Ninety-eight patients (142 clubfeet) treated nonoperatively by the French physical therapy
method were reviewed to determine the effectiveness of this technique. All were 3 months
old or less when treatment began and were rated for initial clubfoot severity using the
Dimeglio scale (moderate, severe, very severe). Follow-up averaged 35 months (range 20-62
months). Forty-two percent of the feet needed no surgery to achieve a plantigrade position,
9% needed heelcord tenotomies, 29% needed posterior releases, and 20% needed
comprehensive posteromedial releases. The Dimeglio scale was prognostic for outcomes,
with moderate feet having the best results and very severe feet having the worst results.
The French physical therapy method significantly reduced the need for operative
intervention at the authors' institution.
19: J Am Osteopath Assoc. 2004 Nov;104(11 Suppl 8):S13-8.
- 77 -
The unique role of osteopathic physicians in treating patients with low back
pain.
Licciardone JC.
Department of Family Medicine, University of North Texas Health Science Center at Fort
Worth-Texas College of Osteopathic Medicine, 3500 Camp Bowie Blvd, Fort Worth, TX
Low back pain is a common and costly condition in industrialized nations. Consequently, a
variety of treatment modalities and providers are available. A widely recognized clinical
practice guideline states that spinal manipulation, as potentially provided by various types of
practitioners, can be helpful for patients with acute low back problems without
radiculopathy when used within the first month of symptoms. The underlying principles of
osteopathic manipulative treatment (OMT) suggest the potential utility of OMT in both
acute and chronic low back pain. The author summarizes the methodologic characteristics
and results of the three major clinical trials of OMT for low back pain conducted in the
United States and discusses their implications for osteopathic medicine.
Publication Types:
Review
Review, Tutorial
- 78 -
22: Fam Pract. 2004 Dec;21(6):643-50. Epub 2004 Nov 5.
Cost-utility analysis of osteopathy in primary care: results from a
pragmatic randomized controlled trial.
Williams NH, Edwards RT, Linck P, Muntz R, Hibbs R, Wilkinson C, Russell I, Russell D,
Hounsome B.
Department of General Practice, University of Wales College of Medicine, Cardiff
University, Wescram, UK. [email protected]
BACKGROUND: Spinal pain is common and costly to health services and society. Management
guidelines have encouraged primary care referral for spinal manipulation, but the evidence
base is weak. More economic evaluations alongside pragmatic trials have been recommended.
OBJECTIVE: Our aim was to assess the cost-utility of a practice-based osteopathy clinic
for subacute spinal pain. METHODS: A cost-utility analysis was performed alongside a
pragmatic single-centre randomized controlled trial in a primary care osteopathy clinic
accepting referrals from 14 neighbouring practices in North West Wales. Patients with
back pain of 2-12 weeks duration were randomly allocated to treatment with osteopathy plus
usual GP care or usual GP care alone. Costs were measured from a National Health Service
(NHS) perspective. All primary and secondary health care interventions recorded in GP
notes were collected for the study period. We calculated quality adjusted life year (QALY)
gains based on EQ-5D responses from patients in the trial, and then cost per QALY ratios.
Confidence intervals (CIs) were estimated using non-parametric bootstrapping. RESULTS:
Osteopathy plus usual GP care was more effective but resulted in more health care costs
than usual GP care alone. The point estimate of the incremental cost per QALY ratio was
3560 pounds (80% CI 542 pounds-77,100 pounds). Sensitivity analysis examining spinerelated costs alone and total costs excluding outliers resulted in lower cost per QALY
ratios. CONCLUSION: A primary care osteopathy clinic may be a cost-effective addition to
usual GP care, but this conclusion was subject to considerable random error. Rigorous multicentre studies are needed to assess the generalizability of this approach.
Publication Types:
Clinical Trial
25: Ann Allergy Asthma Immunol. 2004 Aug;93(2 Suppl 1):S55-60.
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Chiropractic care in asthma and allergy.
Balon JW, Mior SA.
Department of Graduate Studies and Research, Canadian Memorial Chiropractic College,
Ottawa, Ontario. [email protected]
OBJECTIVE: To provide a brief overview of the current state of evidence for chiropractic
care, specifically in the management of asthma and to a lesser extent allergy. DATA
SOURCES: A search of MEDLINE for English-language articles published between January
1966 and July 2002 was conducted using the keywords asthma, allergy, manual therapy,
physical therapy techniques, chiropractic, physical therapy (specialty), physiotherapy,
massage, and massage therapy. A hand search of the primary chiropractic and osteopathic
literature on the treatment of asthma was performed, and proceedings from a recent
research symposium on spinal manipulation were included. STUDY SELECTION: Clinical
controlled studies and systematic reviews on spinal manipulative therapy (SMT) and asthma
were selected. There were no primary clinical trials on SMT and allergy found. RESULTS:
Many of the claims of chiropractic success in asthma have been primarily based on
anecdotal evidence or uncontrolled case studies. Three recently reported randomized
controlled studies showed benefit in subjective measures, such as quality of life, symptoms,
and bronchodilator use; however, the differences were not statistically significant between
controls and treated groups. There were no significant changes in any objective lung
function measures. The clinical issues emanating from these trials are discussed.
CONCLUSIONS: There is currently no evidence to support the use of chiropractic SMT as
a primary treatment for asthma or allergy. Based on reported subjective improvement in
patients receiving chiropractic care, certain clinical circumstances may warrant a
therapeutic trial in patients with asthma. Further properly designed, collaborative research
is needed to determine if there is a role for chiropractic SMT in the care of asthma or
allergy.
Publication Types:
Review
Review, Tutorial
26: Int J Mol Med. 2004 Sep;14(3):443-9.
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Nitric oxide as a possible mechanism for understanding the therapeutic
effects of osteopathic manipulative medicine (Review).
Salamon E, Zhu W, Stefano GB.
Neuroscience Research Institute, State University of New York, College at Old Westbury,
Old Westbury, NY 11568, USA.
Throughout the history of medicine we have seen the progression of medical therapies from
the empirical to the counter-intuitive, with much pressure being placed upon the scientific
community to distinguish the two. This exercise has proven the effectiveness of numerous
modern therapeutic techniques that have been adapted into modern medicine with
remarkable success. While it is certain that many of these techniques yield beneficial
results, the mechanisms by which these results are achieved have not been fully realized. In
the present report, we consider the case of osteopathic manipulative medicine (OMM),
which represents a therapeutic technique developed over a century ago as a means of noninvasive treatment for numerous ailments. Our intention is to use current findings from our
laboratory, as well as those of our colleagues in the area of nitric oxide (NO) research to
explain the mechanism through which osteopathic manipulations aid the patient. These
reports demonstrate that fluidic motions applied to vascular and nerve tissue in a manner
comparable to manipulations can cause a remarkable increase in NO concentration within the
blood and vasculature. These findings combined with the overwhelming amount of research
into the beneficial effects of constitutive NO provide a dynamic theoretical framework to
explain the therapeutic effects of OMM.
Publication Types:
Review
Review, Tutorial
- 81 -
28: J Am Osteopath Assoc. 2004 May;104(5):203-11.
Assessing the ability of medical students to perform osteopathic
manipulative treatment techniques.
Boulet JR, Gimpel JR, Dowling DJ, Finley M.
National Board of Osteopathic Medical Examiners, Chicago, Ill, USA. [email protected]
While osteopathic and allopathic medicine share many commonalities, there are key
practice-based differences that uniquely characterize the two professions. For osteopathic
medicine, one such defining feature is the use of osteopathic manipulative treatment
(OMT). Unfortunately, while various treatment modalities are taught in osteopathic medical
schools, there has been relatively little work done to establish standardized evaluation
protocols. The purpose of this investigation was to explore the use of OMT assessment in
the context of a multistation standardized patient examination. Analysis of performance
data from 121 fourth-year osteopathic medical students indicated that the ability to do
OMT can be reliably and validly assessed using a combination of simulated patient
encounters, trained osteopathic physician raters, and an objective rating tool. Additional
studies that incorporate a larger sample of students and focus on modifications to the
assessment tool and rating protocols are warranted.
- 82 -
Comment in:
J Am Osteopath Assoc. 2004 Oct;104(10):405-6; author reply 406.
A randomized controlled trial of osteopathic manipulative treatment
following knee or hip arthroplasty.
Licciardone JC, Stoll ST, Cardarelli KM, Gamber RG, Swift JN Jr, Winn WB.
University of North Texas Health Science Center at Fort Worth-Texas College of
Osteopathic Medicine, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA.
[email protected]
CONTEXT: Preliminary study results suggest that osteopathic manipulative treatment
(OMT) may reduce pain, improve ambulation, and increase rehabilitation efficiency in
patients undergoing knee or hip arthroplasty. OBJECTIVE: To determine the efficacy of
OMT in patients who recently underwent surgery for knee or hip osteoarthritis or for a hip
fracture. DESIGN: Randomized controlled trial involving hospital and postdischarge phases.
SETTING: Hospital-based acute rehabilitation unit. PATIENTS: A total of 42 women and 18
men who were hospitalized between October 1998 and August 1999. INTERVENTION:
Patients were randomly assigned to groups that received either OMT or sham treatment in
addition to standard care. Manipulation was individualized and performed according to study
guidelines regarding frequency, duration, and technique. MAIN OUTCOME MEASURES:
Changes in Functional Independence Measure (FIM) scores and in daily analgesic use during
the rehabilitation unit stay; length of stay; rehabilitation efficiency--defined as the FIM
total score change per rehabilitation unit day; and changes in Medical Outcomes Study
Short Form-36 scores from rehabilitation unit admission to 4 weeks after discharge.
RESULTS: Of 19 primary outcome measures, the only significant difference between groups
was decreased rehabilitation efficiency with OMT (2.0 vs 2.6 FIM total score points per
day; P = .01). Stratified analyses demonstrated that poorer OMT outcomes were confined to
patients with osteoarthritis who underwent total knee arthroplasty (length of stay, 15.0 vs
8.3 days; P = .004; rehabilitation efficiency, 2.1 vs 3.4 FIM total score points per day; P <
.001). CONCLUSION: The OMT protocol used does not appear to be efficacious in this
hospital rehabilitation population.
Publication Types:
Clinical Trial
- 83 -
30: Forsch Komplementarmed Klass Naturheilkd. 2004 Apr;11(2):93-7.
[Osteopathic versus orthopedic treatments for chronic epicondylopathia
humeri radialis: a randomized controlled trial]
[Article in German]
Geldschlager S.
Praxis fur Osteopathie/Naturheilkunde, Munchen, Germany.
BACKGROUND: The Epicondylopathia humeri radialis is mainly caused by an overload of the
extensor muscles of the hand, the afflicted side is generally the dominant hand. There is a
multitude of treatment methods, none of them, however, can guarantee success.
OBJECTIVE: Can an osteopathic treatment of the chronic Epicondylopathia humeri radialis
reduce the pain more effectively than an orthopedic treatment? STUDY DESIGN:
Randomized controlled clinical study. MATERIAL AND METHODS: 53 patients were
randomly distributed among examination and control group. They were treated for 8 weeks.
The osteopathic treatment was done exclusively manually, with parietal, visceral, and
craniosacral techniques, individually chosen for each patient. The orthopedic treatment was
performed with chiropractic techniques, antiphlogistics, and mostly with injections of
cortison. Four common tests were used, all 4 valuing pain and development of power:
pressure pain test, Thomsen test, middlefinger extension test, and test for strength.
Additionally a questionnaire about the attendant circumstances of the chronic
Epicondylopathia humeri radialis was raised. RESULTS: Subjective pain sensation reduced
from 50% to 33% (p < 0.01) in the intervention group and from 48% to 32% (p = 0.03) in the
orthopedic group. A reduction of pain as well as an increase of power could be measured.
The difference between the two treatment methods, however, was not statistically
significant. CONCLUSIONS: In this study it was possible to successfully treat the chronic
Epicondylopathia humeri radialis with an osteopathic approach. A significant difference to
an orthopedic treatment could not be proved. Copyright 2004 S. Karger GmbH, Freiburg
Publication Types:
Clinical Trial
32: Clin Pediatr (Phila). 2004 May;43(4):349-53.
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Parental perceptions of the therapeutic effect from osteopathic
manipulation or acupuncture in children with spastic cerebral palsy.
Duncan B, Barton L, Edmonds D, Blashill BM.
University of Arizona, Department of Pediatrics, Tucson, AZ 85724, USA.
Fifty children were involved in a randomized, controlled trial to evaluate the effectiveness
of either osteopathic manipulation or acupuncture as a 6-month therapeutic adjunct for
children with spastic cerebral palsy. Exit interviews were used to obtain parental
perceptions and form the basis of this report. Only 2 of 17 parents reported positive gains
while their child was in a wait-list control period but all 17 reported gains while in the
treatment phase of the study. Ninety-six percent (48 of 50) of the parents reported some
improvement while their child was receiving treatments but the gains varied from child to
child. The most frequent gains were seen in improvement in the use of arms or legs (61% and
68%) and more restful sleep (39% and 68%) in the osteopathic and the acupuncture groups,
respectively. Improvement in mood and improved bowel function were also very common
benefits noted by the parents in both groups.
Publication Types:
Clinical Trial
- 85 -
35: J Am Osteopath Assoc. 2004 Feb;104(2):76-81.
Outpatient osteopathic single organ system musculoskeletal exam form:
training and certification.
Sleszynski SL, Glonek T, Kuchera WA.
Midwestern University's Chicago College of Osteopathic Medicine, Downer's Grove, Illinois,
The Outpatient Osteopathic Single Organ System Musculoskeletal Exam Form (SOS form)
is a standardized examination data form. A standardized form is necessary to ensure that
essential quality data are collected during osteopathic studies and that each submitted
form is completed adequately and uniformly. Use of the standardized form permits reliable
statistical computations from the collected data. The training process for the SOS form
incorporated the following elements: (1) training investigators to use the form; (2) having
trainees transcribe three clinical case examples onto SOS forms; (3) comparing each
transcribed clinical case to a prepared key; (4) evaluating the trainees' work for accuracy;
and (5) statistically evaluating the trainees' records for intraexaminer and interexaminer
reliability. The success or failure of trainees to receive certification in their training
process involved evaluating their ability to accurately and appropriately record data
collected from three case examples. These cases were designed to evaluate recording
accuracy and intraexaminer and interexaminer reliability. All trainees scored 80% or better
for accuracy, and their work had good intraexaminer and interexaminer reliability. As a
result, all trainees were awarded a numbered certificate for successful completion of the
training process. Having a pool of well-trained, certified investigators available and ready to
participate in the gathering of data through the use of the SOS form ensures that
necessary data are collected and that the resulting databases are unified. It will also
facilitate comparisons and statistical analysis of osteopathic research projects.
Standardized forms and certified investigators will improve the quality of osteopathic
research throughout the profession.
36: J Am Osteopath Assoc. 2004 Feb;104(2):73-5, 66.
- 86 -
Erratum in:
J Am Osteopath Assoc. 2004 Apr;104(4):147.
Why are our patients still in pain? Finding a balance in treating patients
for nonmalignant pain.
Porcelli MJ.
Western University of Health Services College of Osteopathic Medicine of the Pacific,
Pomona, Calif, USA. [email protected]
Osteopathic physicians would agree that the cornerstone principle of osteopathic medicine
is enveloped in the Latin phrase, Primum non nocere (first, do no harm). Are physicians doing
patients harm by allowing them to remain in chronic pain? Conversely, are physicians doing
patients harm by supporting a dependence on pain-relieving medication that allows normal
functions of daily life? There is a delicate balance that each physician must find in the
context of his or her practice of medicine.
- 87 -
38: J Am Osteopath Assoc. 2004 Jan;104(1 Suppl 1):S1-8.
Osteopathic approach to sexual dysfunction: holistic care to improve
patient satisfaction and prevent mortality and morbidity.
Martin RB.
Department of Family Medicine, Nova Southeastern University, College of Osteopathic
Medicine, Fort Lauderdale, FL 33328-2018, USA. [email protected]
Erectile dysfunction has multiple causes; most commonly the causes are mixed, a
combination of physical and physiologic dysfunction. Two hypothetical case presentations
provide the context for a discussion of the neurologic basis of erectile dysfunction and
sexual dysfunction from the perspective of osteopathic medicine's holistic approach. Both
offer osteopathic physicians the challenge of correcting structural, biological, and chemical
defects to restore normal function. One of the cases is representative of patients who do
not tell their physicians about sexual dysfunction unless their physicians specifically ask,
and even then, these patients are most likely to lie to protect their self-esteem. The second
hypothetical patient is representative of those patients who consult their physicians for any
reason other than sexual dysfunction, expecting their physicians to figure out the real
problem. Both of the hypothetical patients require not only support, but also education and
counseling to motivate them to adopt healthier lifestyles and choices. Both would benefit
from osteopathic manipulative treatment to correct structural abnormalities, and an oral
medication such as a phosphodiesterase type 5 inhibitor offers both patients a good and
easily accepted treatment option for erectile dysfunction.
Publication Types:
Review
Review, Tutorial
- 88 -
Comment in:
J Am Osteopath Assoc. 2004 Aug;104(8):315.
Osteopathic emergency physician training and use of osteopathic
Ray AM, Cohen JE, Buser BR.
University of New England College of Osteopathic Medicine, Biddeford, Maine, USA.
Previous studies of osteopathic manipulative treatment (OMT) have examined its use in
several clinical settings, but no study to date has been specific to emergency medicine. This
article examines the use of OMT in the practice of emergency medicine by osteopathic
physicians. Osteopathic physicians who identified their practice as emergency medicine
were surveyed to determine OMT use, including techniques used, graduate medical
education, and factors affecting usage. Use of OMT was common (55%), with a large
minority (28%) of osteopathic physicians reporting daily or weekly usage. Techniques most
often used include soft tissue treatment, high velocity/low amplitude treatment, and muscle
energy treatment. Factors affecting usage include residency training, undergraduate
medical experiences, and practice environment. These findings indicate that further
investigation into the indications and efficacy of OMT in emergency medicine is warranted.
- 89 -
42: J Am Osteopath Assoc. 2003 Dec;103(12):583-96.
Comment in:
Review of integrated neuromusculoskeletal release and the novel application
of a segmental anterior/posterior approach in the thoracic, lumbar, and
sacral regions.
Danto JB.
Botsford General Hospital, Farmington Hills, Michigan, USA. [email protected]
Integrated neuromusculoskeletal release (INR) using a segmental anterior/posterior
approach is an osteopathic manipulative treatment technique that is easily learned and
applied. The segmental anterior/posterior approach to INR was developed as a practical
osteopathic manipulative treatment procedure for the inpatient setting, but also has equal
efficacy in the outpatient setting. It builds on the principles of INR and myofascial release
techniques, as well as other techniques. This approach focuses on both the anterior and
posterior connectivity of the body through the neuromusculoskeletal system and uses this
connectivity to effectively treat somatic dysfunctions. The principles of INR are discussed,
as well as the role of INR in the diagnosis and treatment of somatic dysfunctions in the
thoracic, lumbar, and sacral regions.
Publication Types:
Review
Review, Tutorial
- 90 -
Comment in:
Osteopathic manipulative treatment in prenatal care: a retrospective case
control design study.
King HH, Tettambel MA, Lockwood MD, Johnson KH, Arsenault DA, Quist R.
Western University of Health Sciences College of Osteopathic Medicine of the Pacific,
Pomona, Calif, USA. [email protected]
The use of osteopathic manipulative treatment (OMT) during pregnancy has a long tradition
in osteopathic medicine. A retrospective study was designed to compare a group of women
who received prenatal OMT with a matched group that did not receive prenatal OMT. The
medical records of 160 women from four cities who received prenatal OMT were reviewed
for the occurrence of meconium-stained amniotic fluid, preterm delivery, use of forceps,
and cesarean delivery. The randomly selected records of 161 women who were from the
same cities, but who did not receive prenatal OMT, were reviewed for the same outcomes.
The results of a logistic regression analysis were statistically reliable, chi2 (4, N = 321) =
26.55; P < .001, indicating that the labor and delivery outcomes, as a set, were associated
with whether OMT was administered during pregnancy. According to the Wald criterion,
prenatal OMT was significantly associated with meconium-stained amniotic fluid (Z = 13.20,
P < .001) and preterm delivery (Z = 9.91; P < .01), while the use of forceps was found to be
marginally significant (Z = 3.28; P = .07). The case control study found evidence of improved
outcomes in labor and delivery for women who received prenatal OMT, compared with women
who did not. A prospective study is proposed as the next step in evaluating the effects of
prenatal OMT.
44: Man Ther. 2004 Feb;9(1):30-5.
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Long-term follow-up of patients with low back pain attending for
manipulative care: outcomes and predictors.
Burton AK, McClune TD, Clarke RD, Main CJ.
Spinal Research Unit, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK.
[email protected]
Psychosocial factors are known to act as obstacles to recovery from low back pain, but
predictors of longer-term outcomes are not established. An average 4-year follow-up of a
cohort of 252 low back pain patients attending for manipulative care was conducted to
describe the longer-term course of low back pain, and to identify predictors of outcomes.
Clinical and psychosocial data were obtained at baseline. Mailed questionnaires collected
self-reported outcomes (pain, disability, recurrence and care seeking). Among the 60% who
responded, the statistically significant reduction in mean Roland Disability Questionnaire
score seen at 1 year did not improve further during follow-up. At the 4-year point, 49% of
respondents reported residual disability, and 59% reported at least 'mild' pain. Symptom
recurrence beyond the 1-year point was reported by 78% of respondents, with half of them
seeking further care. Recurrence and care seeking were related to fear avoidance beliefs
and duration of presenting symptoms. The disability score at 4-years was statistically
significantly related to baseline depressive symptoms and higher pain intensity. Low back
pain presenting for manipulative care is characterized by high levels of recurrence and care
seeking over at least 4-years for many patients. Because psychosocial factors at
presentation exert a long-term influence, they need to be considered by manual therapists.
- 92 -
45: Man Ther. 2004 Feb;9(1):22-9.
Inter- and intraexaminer reliability in palpation of the "primary
respiratory mechanism" within the "cranial concept".
Sommerfeld P, Kaider A, Klein P.
Department of Medical Computer Sciences at the University of Vienna, Austria.
[email protected]
Inevitable subjectivity makes interexaminer reliability of manual assessment procedures a
special matter of concern. The cranial concept (CC), one aspect of osteopathy, deals with
very subtle changes that have to be palpated. One of the main principles of the CC is the
primary respiratory mechanism (PRM), which is hypothesized to be a palpable physiological
phenomenon that occurs in rhythmic cycles, called flexion- and extension-phase, which are
independent from cardiac and respiratory rates. Palpation of the PRM is one of the first
steps in assessment within the CC. An inter- and intraexaminer reliability study design for
repeated measures was used in this study. Forty nine healthy subjects were palpated
simultaneously twice, once at the head and once at the pelvis. PRM-frequency (f), the mean
duration of the flexion phase and the mean ratio of flexion- to extension-phase were used
as the main outcome measures. Inter- and intraexaminer reliability and correlations to the
respiratory rates were analysed for all three parameters. Inter- as well as intraexaminer
agreement could not be described beyond chance agreement, as the range within the 95%
limits of agreement (e.g. for f=6.6 cycles/90 s) for all cases resembled the total range of
values (e.g. for f=7 cycles/90 s) that were produced. A significant effect of the examiners'
respiration was found for both examiners at the pelvis (P=0.004 for one examiner, P <0.0001
for the other examiner), and for one examiner only at the head (P=0.0017). No correlation
could be found for the subjects' respiratory rates. In conclusion, PRM-rates could not be
palpated reliably and under certain conditions were influenced by the examiners'
respiratory rates. These results do not support the hypotheses behind the PRM. The role of
PRM palpation for clinical decision making and the models explaining the PRM should
therefore be rethought.
Publication Types:
Clinical Trial
Controlled Clinical Trial
46: Fam Pract. 2003 Dec;20(6):662-9.
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Randomized osteopathic manipulation study (ROMANS): pragmatic trial for
spinal pain in primary care.
Williams NH, Wilkinson C, Russell I, Edwards RT, Hibbs R, Linck P, Muntz R.
Department of General Practice, University of Wales College of Medicine, Institute of
Medical and Social Care Research, University of Wales-Bangor, Bangor, Wales, UK.
[email protected]
BACKGROUND: Spinal pain is common and frequently disabling. Management guidelines have
encouraged referral from primary care for spinal manipulation. However, the evidence base
for these recommendations is weak. More pragmatic trials and economic evaluations have
been recommended. OBJECTIVES: Our aim was to assess the effectiveness and health care
costs of a practice-based osteopathy clinic for subacute spinal pain. METHODS: A
pragmatic randomized controlled trial was carried out in a primary care osteopathy clinic
accepting referrals from 14 neighbouring practices in North West Wales. A total of 201
patients with neck or back pain of 2-12 weeks duration were allocated at random between
usual GP care and an additional three sessions of osteopathic spinal manipulation. The
primary outcome measure was the Extended Aberdeen Spine Pain Scale (EASPS). Secondary
measures included SF-12, EuroQol and Short-form McGill Pain Questionnaire. Health care
costs were estimated from the records of referring GPs. RESULTS: Outcomes improved
more in the osteopathy group than the usual care group. At 2 months, this improvement was
significantly greater in EASPS [95% confidence interval (CI) 0.7-9.8] and SF-12 mental
score (95% CI 2.7-10.7). At 6 months, this difference was no longer significant for EASPS
(95% CI -1.5 to 10.4), but remained significant for SF-12 mental score (95% CI 1.0-9.9).
Mean health care costs attributed to spinal pain were significantly greater by 65 UK pounds
in the osteopathy group (95% CI 32-155 UK pounds). Though osteopathy also cost 22 UK
pounds more in mean total health care cost, this was not significant (95% CI - 159 to 142 UK
pounds). CONCLUSION: A primary care osteopathy clinic improved short-term physical and
longer term psychological outcomes, at little extra cost. Rigorous multicentre studies are
now needed to assess the generalizability of this approach.
Publication Types:
Clinical Trial
47: J Am Osteopath Assoc. 2003 Nov;103(11):543-9.
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Comment in:
Implementation of an osteopathic manipulative medicine clinic at an
allopathic teaching hospital: a research-based experience.
Przekop PR Jr, Tulgan H, Przekop A, DeMarco WJ, Campbell N, Kisiel S.
Department of Preventative Medicine, Loma Linda University, Loma Linda, Calif, USA.
[email protected]
Mastery of osteopathic palpatory skills and the skilled delivery of osteopathic manipulative
treatment is a life-long venture that demands from practitioners increasingly sophisticated
manual skills. Specific receptors and neural networks within the brain allow for the gradual
development of refined manual skills that parallel responsive alterations and refinements
that develop with repeated experience. During clinical training, most graduates of colleges
of osteopathic medicine are not given opportunities to hone their palpatory skills. This is
unfortunate because there is an increasing public demand for the nonpharmacologic
treatment modalities osteopathic physicians could supply. At Berkshire Medical Center in
Pittsfield, Mass, a major teaching affiliate of the University of Massachusetts Medical
School in Worcester, the authors assembled a team of osteopathic and allopathic physicians
to found an osteopathic manipulative medicine clinic. In this article, the authors share their
experience in the creation of this research-based osteopathic medical clinic.
- 95 -
48: Am J Orthop. 2003 Nov;32(11):531-8.
Rehabilitation of the arthrofibrotic knee.
Millett PJ, Johnson B, Carlson J, Krishnan S, Steadman JR.
Harvard Shoulder Service/Sports Medicine, Harvard Medical School, and Brigham and
Women's Hospital, Boston, Massachusetts 02115, USA. [email protected]
This paper describes the postoperative rehabilitation of the arthrofibrotic knee, with
specific emphasis on modern rehabilitation techniques. The significance of prevention and
early recognition is discussed. The importance of early motion and patellar mobility is
emphasized and specific exercises to prevent and treat stiffness are described. Continuous
passive motion, bracing, and exercise--on the stationary bicycle, on the treadmill, and in
water--are adjuncts in the program. Strengthening is added when motion is re-established
and there is no swelling or pain. Sport-specific activities are added if progress is
satisfactory and motion is maintained. If pain, swelling, or stiffness develops, exercises
should be discontinued. Modalities such as cryotherapy, ultrasound, electrical stimulation,
rest, and manipulation can be used judiciously. Anti-inflammatory and analgesic medications
should be used to prevent inflammation, to control pain, and to allow more aggressive
rehabilitative exercises.
Publication Types:
Review
Review, Tutorial
- 96 -
49: J Am Osteopath Assoc. 2003 Oct;103(10):470-8.
Comment in:
A prospective study of osteopathic medical students' attitudes toward use
of osteopathic manipulative treatment in caring for patients.
Chamberlain NR, Yates HA.
Department of Microbiology and Immunology, Kirksville College of Osteopathic Medicine,
800 W Jefferson St, Kirksville, MO 63501-1443, USA. [email protected]
Two computer-assisted clinical case SOAP (subjective, objective, assessment, plan) note
exercises were used for second-year osteopathic medical students, and a standardized
patient was used during third year to measure recording behaviors regarding structural
examinations and osteopathic manipulative treatment (OMT). Students were questioned
before leaving campus for clinical rotations and at pregraduation to determine their
attitudes toward use of these skills. Ninety-one percent of the students recorded
structural examination findings in both computer-assisted clinical case SOAP notes, and 61%
suggested OMT be given on their basic science SOAP (pneumonia). All of the students in the
osteopathic theory and methods exercise suggested OMT. On a standardized patient with
chronic obstructive pulmonary disease, 11% of the students performed a structural
examination, and 0.7% suggested OMT. Preclinically, 73% of the students believed they
were prepared to conduct structural examinations, and 71% believed they were prepared to
use OMT. Between 64% and 73% of pregraduation students, however, reported they had
few opportunities to use these skills during clinical rotations. Most of the students believed
they would use palpatory diagnosis and OMT for fewer than 25% of their future patients
and primarily for patients with musculoskeletal problems.
- 97 -
50: J Am Osteopath Assoc. 2003 Sep;103(9):417-21.
Osteopathic manipulative treatment in the emergency department for
patients with acute ankle injuries.
Eisenhart AW, Gaeta TJ, Yens DP.
Department of Emergency Medicine, St Barnabas Hospital, Bronx, NY, USA.
STUDY OBJECTIVE: The purpose of this study was to evaluate the efficacy of osteopathic
manipulative treatment (OMT) as administered in the emergency department (ED) for the
treatment of patients with acute ankle injuries. METHODS: Patients aged 18 years and
older with unilateral ankle sprains were randomly assigned either to an OMT study group or
a control group. Independent outcome variables included edema, range of motion (ROM), and
pain. Both groups received the current standard of care for ankle sprains and were
instructed to return for a follow-up examination. Patients in the OMT study group also
received one session of OMT from an osteopathic physician. RESULTS: Patients in the OMT
study group had a statistically significant (F = 5.92, P = .02) improvement in edema and pain
and a trend toward increased ROM immediately following intervention with OMT. Although
at follow-up both study groups demonstrated significant improvement, patients in the OMT
study group had a statistically significant improvement in ROM when compared with patients
in the control group. CONCLUSIONS: Data clearly demonstrate that a single session of
OMT in the ED can have a significant effect in the management of acute ankle injuries.
Publication Types:
Clinical Trial
- 98 -
54: Spine. 2003 Aug 1;28(15):1717-24.
The passive straight leg raising test in the diagnosis and treatment of
lumbar disc herniation: a survey of United kingdom osteopathic opinion and
clinical practice.
Rebain R, Baxter GD, McDonough S.
University of Ulster, Rehabilitation Sciences Research Group, County Atrim, Northern
Ireland.
STUDY DESIGN: Postal questionnaire survey. OBJECTIVES: To carry out a confidential postal
survey of United Kingdom osteopaths in order to record and assess their use of the passive
straight leg raising test in the diagnosis of, and choice of, manipulation for lumbar disc
herniation. The study also sought to determine whether an association existed between
osteopaths' manipulation of suspected lumbar disc herniation and their use of the straight leg
raising test, the length of their working hours, and their use of manipulation for the treatment
of other lumbar conditions. SUMMARY OF BACKGROUND DATA: The literature is not agreed
on important aspects of the straight leg raising test, or on the use of spinal manipulation for
suspected lumbar disc herniation. This is thought to be the first study to investigate opinion
and practice in a large group of spinal manipulators, in this case United Kingdom osteopaths.
METHODS: A questionnaire was sent to all 1030 United Kingdom osteopaths registered with the
General Osteopathic Council in January 2000. It comprised four sections: personal
characteristics, professional characteristics, background to low back pain cases, details of
straight leg raising test understanding and use within the diagnosis and treatment of lumbar
disc herniation. RESULTS: A response rate of 44% was achieved. United Kingdom osteopaths'
opinions of low back pain and lumbar disc herniation clinical presentations, details of straight leg
raising test mode of action, procedure, and interpretation were in keeping with the literature.
Fifty-four percent of respondents sometimes employed manipulation in the treatment of lumbar
disc herniation, but most of the others described the practice as "dangerous." The literature is
similarly divided on the practice. Chi-square and Cramer V analysis implied that respondents
were not influenced in choosing manipulation for lumbar disc herniation by their use of the
straight leg raising test (chi2 = 4.002, df = 3, Cramer V = 0.0959, P = 0.261, alpha 0.05, n = 435).
A moderate association implied that the frequency of use of such manipulation for all lumbar
conditions influenced the choice of that treatment for lumbar disc herniation (chi2 = 81.808, df
= 4, Cramer V = 0.4302, P < 0.001, alpha = 0.05, n = 442). There was also a weak association
suggesting that hours worked per week influenced the choice of manipulation for lumbar disc
herniation (chi2 = 9.840, df = 3, Cramer V = 0.1499, P = 0.020, alpha = 0.05, n = 438).
CONCLUSIONS: Respondents to this survey frequently treated low back pain and often
employed the straight leg raising test in its diagnosis. Their recognition of the clinical
presentation of lumbar disc herniation and their use and understanding of the straight leg
raising test were in keeping with the literature. Respondents were divided nearly equally
between those who would expect patient benefit from the use of manipulation for lumbar disc
herniation and those who criticized the practice. There is a need for further research into the
clinical reasoning employed for the manipulative treatment of lumbar disc herniation.
55: Heart Dis. 2003 Jul-Aug;5(4):272-8.
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Osteopathic manipulative medicine in the treatment of hypertension: an
alternative, conventional approach.
Spiegel AJ, Capobianco JD, Kruger A, Spinner WD.
Department of Osteopathic Medicine, New York College of Osteopathic Medicine, Old
Westbury, NY 11568, USA.
The branch of medicine known as osteopathy was founded by Andrew Taylor Still in the mid
to late 19th century. Osteopathy is a philosophy of medicine. Osteopathic physicians use
techniques collectively referred to as osteopathic manipulative medicine (OMM). One of the
most common diseases suffered by those residing in westernized nations is hypertension.
Although osteopathic physicians are taught to incorporate OMM into the management of
medical disorders, the usefulness of OMM in treating hypertension is less clear. This review
reflects on the past 90 years of biomedical literature and attempts to address the utility
of OMM used alone, or in combination with other treatments including antihypertensive
medication, for the effective management of hypertension. Preliminary evidence may
suggest a role for OMM in treating hypertension within the context of a multifaceted and
long-lasting treatment regimen that may include traditional pharmacotherapeutics. To have
universal acceptance, controlled and blinded outcome studies are needed to determine the
effectiveness of OMM for the routine treatment of hypertension.
Publication Types:
Review
Review, Tutorial
- 100 -
57: BMC Complement Altern Med. 2003 Jul 7;3:3. Epub 2003 Jul 7.
Searching biomedical databases on complementary medicine: the use of
controlled vocabulary among authors, indexers and investigators.
Murphy LS, Reinsch S, Najm WI, Dickerson VM, Seffinger MA, Adams A, Mishra SI.
Science Library Reference Department, University of California, Irvine 926233-9557, USA.
[email protected]
BACKGROUND: The optimal retrieval of a literature search in biomedicine depends on the
appropriate use of Medical Subject Headings (MeSH), descriptors and keywords among
authors and indexers. We hypothesized that authors, investigators and indexers in four
biomedical databases are not consistent in their use of terminology in Complementary and
Alternative Medicine (CAM). METHODS: Based on a research question addressing the
validity of spinal palpation for the diagnosis of neuromuscular dysfunction, we developed
four search concepts with their respective controlled vocabulary and key terms. We
calculated the frequency of MeSH, descriptors, and keywords used by authors in titles and
abstracts in comparison to standard practices in semantic and analytic indexing in
MEDLINE, MANTIS, CINAHL, and Web of Science. RESULTS: Multiple searches resulted
in the final selection of 38 relevant studies that were indexed at least in one of the four
selected databases. Of the four search concepts, validity showed the greatest
inconsistency in terminology among authors, indexers and investigators. The use of spinal
terms showed the greatest consistency. Of the 22 neuromuscular dysfunction terms
provided by the investigators, 11 were not contained in the controlled vocabulary and six
were never used by authors or indexers. Most authors did not seem familiar with the
controlled vocabulary for validity in the area of neuromuscular dysfunction. Recently,
standard glossaries have been developed to assist in the research development of manual
medicine. CONCLUSIONS: Searching biomedical databases for CAM is challenging due to
inconsistent use of controlled vocabulary and indexing procedures in different databases. A
standard terminology should be used by investigators in conducting their search strategies
and authors when writing titles, abstracts and submitting keywords for publications.
Publication Types:
Evaluation Studies
Validation Studies
58: Spine. 2003 Jul 1;28(13):1355-62.
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Osteopathic manipulative treatment for chronic low back pain: a
randomized controlled trial.
Licciardone JC, Stoll ST, Fulda KG, Russo DP, Siu J, Winn W, Swift J Jr.
Department of Family Medicine, Texas College of Osteopathic Medicine, University of
North Texas Health Science Center, Fort Worth 76107, USA. [email protected]
STUDY DESIGN: A randomized controlled trial was conducted. OBJECTIVE: To determine
the efficacy of osteopathic manipulative treatment as a complementary treatment for
chronic nonspecific low back pain. SUMMARY OF BACKGROUND DATA: Osteopathic
manipulative treatment may be useful for acute or subacute low back pain. However, its role
in chronic low back pain is unclear. METHODS: This trial was conducted in a universitybased clinic from 2000 through 2001. Of the 199 subjects who responded to recruitment
procedures, 91 met the eligibility criteria. They were randomized, with 82 patients
completing the 1-month follow-up evaluation, 71 completing the 3-month evaluation, and 66
completing the 6-month evaluation. The subjects were randomized to osteopathic
manipulative treatment, sham manipulation, or a no-intervention control group, and they
were allowed to continue their usual care for low back pain. The main outcomes included the
SF-36 Health Survey, a 10-cm visual analog scale for overall back pain, the Roland-Morris
Disability Questionnaire, lost work or school days because of back pain, and satisfaction
with back care. RESULTS: As compared with the no-intervention control subjects, the
patients who received osteopathic manipulative treatment reported greater improvements
in back pain, greater satisfaction with back care throughout the trial, better physical
functioning and mental health at 1 month, and fewer cotreatments at 6 months. The
subjects who received sham manipulation also reported greater improvements in back pain
and physical functioning and greater satisfaction than the no-intervention control subjects.
There were no significant benefits with osteopathic manipulative treatment, as compared
with sham manipulation. CONCLUSIONS: Osteopathic manipulative treatment and sham
manipulation both appear to provide some benefits when used in addition to usual care for
the treatment of chronic nonspecific low back pain. It remains unclear whether the benefits
of osteopathic manipulative treatment can be attributed to the manipulative techniques
themselves or whether they are related to other aspects of osteopathic manipulative
treatment, such as range of motion activities or time spent interacting with patients, which
may represent placebo effects.
Publication Types:
Clinical Trial
- 102 -
Osteopathic manipulative treatment techniques preferred by contemporary
osteopathic physicians.
Johnson SM, Kurtz ME.
Michigan State University College of Osteopathic Medicine's, Department of Family and
Community Medicine, B211B West Fee Hall, East Lansing, MI 48824, USA.
Data presented in this study were gathered through a national mail survey of 3000
randomly selected osteopathic physicians. A total of 955 questionnaires were usable for
analysis. Osteopathic physicians' likelihood of using eleven osteopathic manipulative
treatment (OMT) techniques (articulatory, counterstrain, cranial, facilitated positional
release, fascial ligamentous release, functional, high-velocity low-amplitude thrust,
lymphatic, muscle energy, myofascial/integrated neuromuscular release, and soft tissue) was
determined. The relative frequency of use from most (soft tissue) to least (cranial) used
was also determined. Respondents were more likely to use direct techniques than indirect or
direct-indirect techniques. Demographic variables of gender, age, and specialty training
were found to be related to the techniques used most. Female osteopathic physicians and
older osteopathic physicians were more likely to use indirect techniques, whereas male and
younger physicians preferred direct techniques. Moreover, OMT specialists used a broader
range of techniques than other osteopathic physicians, and family physicians were more apt
to use high-velocity low-amplitude thrust than other primary care or non-primary care
osteopathic physicians. These results not only have implications for curricular planning in all
phases of osteopathic undergraduate medical education, graduate medical education, and
continuing medical education programs, but also for research on the quality and
effectiveness of various OMT techniques.
- 103 -
62: J Manipulative Physiol Ther. 2003 May;26(4):220-5.
Somatovisceral response following osteopathic HVLAT: a pilot study on the
effect of unilateral lumbosacral high-velocity low-amplitude thrust
technique on the cutaneous blood flow in the lower limb.
Karason AB, Drysdale IP.
British College of Osteopathic Medicine, London, UK.
INTRODUCTION: Spinal manipulative treatment is widely used among manual therapists,
although knowledge regarding the absolute physiological effects has not been clearly
established. In this study, 20 healthy male subjects underwent a unilateral high-velocity
low-amplitude thrust (HVLAT) to the lumbosacral junction, while the cutaneous blood flow in
the corresponding dermatome of the lower limb was monitored. METHODS: Subjects
underwent a sham manipulation before the actual manipulation and acted as their own
control. Laser Doppler flowmetry was used to measure relative changes in the cutaneous
blood flow over the L5 dermatome for 5 minutes before the sham manipulation, for 5
minutes between the sham and the actual manipulation, and for 5 minutes after the spinal
adjustment. Analysis of variance (ANOVA) and Tukey post hoc analysis was used in the
interpretation of the data. RESULTS: Twelve nonsmoking subjects, who received a
successful HVLAT manipulation, showed a significant increase (P <.001) in blood perfusion,
both ipsilaterally and contralaterally. Six smokers responded with a significant decrease in
blood flow ipsilaterally (P <.01) and contralaterally (P <.001) after HVLAT manipulation.
CONCLUSION: The results from this study support previous published hypotheses that
spinal adjustments outside the region of the sympathetic outflow result in an increase in
cutaneous blood flow. Further studies will be needed to confirm the outcome of this study,
and more knowledge is needed regarding the specific neurophysiological effects of spinal
manipulation.
Publication Types:
Clinical Trial
- 104 -
64: Ann Readapt Med Phys. 2003 Feb;46(1):33-40.
[Complications following vertebral manipulation-a survey of a French region
physicians]
[Article in French]
Dupeyron A, Vautravers P, Lecocq J, Isner-Horobeti ME.
Service de medecine physique et readaptation, hopitaux universitaires, avenue Moliere,
67000, Strasbourg, France. [email protected]
INTRODUCTION: Recent studies have emphasized the incidence and the general
underestimation in literature of spinal manipulation (SM) linked accident. The aim of this
study was to estimate the frequency and the incidence of strokes, myelopathies,
radiculopathies or osteoarticular accidents in a major French area. MATERIAL AND
METHOD: We made a survey among 240 neurologists, neurosurgeons, rhumatologists and
physicians concerning the number of accidents observed during the preceding two years.
RESULTS: We obtained a response from 133 physicians and 93 cases of complication were
reported. Most of these complications were radiculopathies (69%). Approximatively 50%
occurred at the cervical level, less than 24 hours after SM with or without sligth
aftereffects in 68%. The incidence of vertebro-basilar accidents was 30 times higher than
in published series. CONCLUSION: Spinal manipulations should remain under very strict
medical control.Physicians who practice SM should be able to choose the manual treatment
and perform it themselves in order to minimize risks of complications, especially at the
cervical level.
- 105 -
65: Man Ther. 2003 Feb;8(1):46-51.
Spinal manipulation for low-back pain: a treatment package agreed to by
the UK chiropractic, osteopathy and physiotherapy professional
associations.
Harvey E, Burton AK, Moffett JK, Breen A; UK BEAM trial team.
Department of Health Sciences, Alcuin College, University of York, York, UK.
[email protected]
Trials of manipulative treatment have been compromised by, amongst other things,
different definitions of the therapeutic procedures involved. This paper describes a spinal
manipulation package agreed by the UK professional bodies that represent chiropractors,
osteopaths and physiotherapists. It was devised for use in the UK Back pain Exercise And
Manipulation (UK BEAM) trial--a national study of physical treatments in primary care
funded by the Medical Research Council and the National Health Service Research and
Development Programme. Although systematic reviews have reported some beneficial
effects of spinal manipulation for low-back pain, due to the limited methodological quality of
primary studies and difficulties in defining manipulation, important questions have remained
unanswered. The UK BEAM trial was designed to answer some of those questions. Early in
the design of the trial, it was acknowledged that the spinal manipulation treatment regimes
provided by practitioners from the three professions shared more similarities than
differences. Because the trial design specifically precluded comparison of the effect
between the professions, it was necessary to devise a homogenous package representative
of, and acceptable to, all three. The resulting package is 'pragmatic', in that it represents
what happens to most people undergoing manipulation, and 'explanatory' in that it excludes
discipline-specific variations and other ancillary treatments.
Publication Types:
Review
Review, Tutorial
- 106 -
66: Man Ther. 2003 Feb;8(1):42-5.
The effect of postoperative ataralgesia by manual therapy after
pulmonary resection.
Hirayama F, Kageyama Y, Urabe N, Senjyu H.
Department of Thoracic Surgery, Numazu City Hospital, Hideaki Senjyu 550 Harunoki,
Higashi-shiiji, Numazu, Shizuoka 410-0302, Japan. [email protected]
Muscle therapy, a form of manual therapy, was applied to control pain persisting for more
than 1 week following posterolateral thoracotomy, and its efficacy for the alleviation of pain
was investigated. Eight patients who underwent posterolateral thoracotomy and lung
resection for cancer (n=7) or emphysema (n=1) received manual therapy to incised muscles
and the muscles inserting into the ribs in the affected area for an average of 17 days
postoperatively. Pressure-friction and stretching techniques were used. Treatment was
continued until the intensity of the pressure-friction technique reached a level at which the
patient complained of pain and a decrease in muscle tone was detected. Treatment was
performed once a week for 3 weeks. Pain severity was measured using a visual analog scale
(VAS) (0-10). Before the first treatment, the VAS was set at 10, and changes of the score
were observed before and after the treatment as well as over time. After three sessions,
all patients showed a decrease in pain from 10 to an average of 1.9 (range 1.3-2.6).
- 107 -
67: Man Ther. 2003 Feb;8(1):2-9.
Manipulation of the cervical spine.
Hing WA, Reid DA, Monaghan M.
School of Physiotherapy, Faculty of Health Studies, Auckland University of Technology,
Auckland 1020, New Zealand. [email protected]
In New Zealand, a new approach to manual therapy of the cervical spine has integrated
physiotherapy and osteopathy techniques. The combination of the philosophies of these two
professions has added a new dimension to the management of cervical spine pain. Emphasis
is placed on issues of safety, such as the degree of cervical rotation and comfort for both
the patient and the therapist. This is combined with biomechanical considerations, which
have made the teaching and learning of these manipulative techniques less complicated and
easily progressed from palpation to mobilization and onto manipulation. Appropriate patient
screening and selection identified through thorough subjective and objective assessments
are important aspects of this approach and reflective interpretation of all clinical findings
is essential. The refinement of cervical joint positioning and an increased anatomical
awareness have led to the utilization of new upper cervical high-velocity thrust techniques.
Consequently, it is envisaged that an increase in the safety and specificity of cervical
manipulative techniques is achieved.
Publication Types:
Review
Review, Tutorial
- 108 -
Comment in:
J Am Osteopath Assoc. 2003 Jun;103(6):264; author reply 264-5.
Use of osteopathic manipulative treatment by Ohio osteopathic physicians
in various specialties.
Spaeth DG, Pheley AM.
Department of Family Medicine, Ohio University College of Osteopathic Medicine, Athens,
Ohio 45701, USA. [email protected]
The authors mailed a survey designed to determine the use of osteopathic manipulative
treatment (OMT) to the 2,318 active osteopathic physicians registered with the Ohio
Osteopathic Association; 871 responses were received, for a response rate of 38%.
Approximately 75% of the respondents had not or had rarely used OMT: 44% of these
respondents did not use any OMT and 31% reported treating fewer than 10 patients with
OMT during the week before the survey. Approximately 25% of the surveyed osteopathic
physicians treated more than 10 patients with OMT, and about 6% of these treated more
than 30 patients with OMT. Respondents represented 40 specialty disciplines. All of the
osteopathic physicians in 17 specialties reported no OMT use, osteopathic physicians in 9
specialties reported using OMT for fewer than 10 patients during the previous week, and
osteopathic physicians in 9 specialties reported using OMT for more than 10 patients during
the previous week. Of the somatic dysfunctions listed in the survey, low back disorders
were treated with OMT most often. Few osteopathic specialists used OMT for patients
with asthma or chronic obstructive pulmonary disease. The data suggest that a great
opportunity exists to increase the use of OMT by osteopathic physicians, especially those
who are specialists.
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71: Injury. 2003 Feb;34(2):159-61.
Assessment of the efficacy of Proguard RR-2 radio-protective gloves
during forearm manipulation.
Calder PR, Tennent TD, Allen PW.
Royal London Hospital, Whitechapel, London, UK. [email protected]
The hazards of ionising radiation are well known and precautions, such as lead aprons and
thyroid shields are routinely used. Orthopaedic surgeon's hands are at particular risk from
direct and scatter radiation, when manipulating forearm fractures, due to the proximity of
the image intensifier. The use of lead gloves has been recommended in the literature but
are seldom employed. Proguard RR-2 gloves provide similar tactile sensitivity to double
gloves and are claimed by the manufacturer to provide up to 55% protection in vitro at a
direct beam energy level of 60 kV. This claim was tested in a clinical setting. The gloves
were worn during forearm manipulations and the radiation dose measured using
thermoluminescent dosimeters (TLDs). The results demonstrated a radiation attenuation of
60-64%.These gloves appear to achieve a good compromise between protection and
sensitivity and should be included in routine protection against ionising radiation during
MUA.
- 110 -
72: Cochrane Database Syst Rev. 2002;(4):CD001002.
Update in: Cochrane Database Syst Rev. 2005;(2):CD001002.
Update of: Cochrane Database Syst Rev. 2001;(1):CD001002.
Consortial Center for Chiropractic, 30W009 Willow Court, Warrenville, Illinois 60555-1018,
BACKGROUND: A variety of manual therapies with similar postulated biologic mechanisms of
action are commonly used to treat patients with asthma. Manual therapy practitioners are also
varied, including physiotherapists, respiratory therapists, chiropractic and osteopathic
physicians. A systematic review across disciplines is warranted. OBJECTIVES: To evaluate the
evidence for the effects of manual therapies for treatment of patients with bronchial asthma.
SEARCH STRATEGY: Trials were searched in computerized general (EMBASE, CINAHL and
MEDLINE) and specialized databases (Cochrane Complementary Medicine Field, Cochrane
Rehabilitation Field, ICL, and MANTIS). In addition, bibliographies from included studies were
assessed, and authors of known studies were contacted for additional information about
published and unpublished trials. Date of most recent search: February 2002. SELECTION
CRITERIA: Trials were included if they: (1) were randomised; (2) included asthmatic children or
adults; (3) examined one or more types of manual therapy; and (4) included clinical outcomes.
DATA COLLECTION AND ANALYSIS: All three reviewers independently extracted data and
assessed trial quality using a standard form. MAIN RESULTS: From 393 unique citations, 59
full text articles were retrieved and evaluated, which resulted in nine citations to five RCTs
(290 patients) suitable for inclusion. Trials could not be pooled statistically because studies
that addressed similar interventions used disparate patient groups or outcomes. The
neither trial found significant differences between chiropractic spinal manipulation and a sham
manoeuvre on any of the outcomes measured. Quality of the remaining three trials was poor.
One small trial compared massage therapy with a relaxation control group and found significant
differences in many of the lung function measures obtained. However, this trial had poor
reporting characteristics and the data have yet to be confirmed. One small trial compared chest
physiotherapy to placebo and one small trial compared footzone therapy to a no treatment
control. Neither trial found differences in lung function between groups. REVIEWER'S
CONCLUSIONS: There is insufficient evidence to support the use of manual therapies for
patients with asthma. There is a need to conduct adequately-sized RCTs that examine the
effects of manual therapies on clinically relevant outcomes. Future trials should maintain
observer blinding for outcome assessments, and report on the costs of care and adverse events.
Currently, there is insufficient evidence to support or refute the use of manual therapy for
patients with asthma.
Publication Types:
Meta-Analysis
Review
74: Altern Ther Health Med. 2002 Nov-Dec;8(6):74-6.
- 111 -
The effect of cranial manipulation on the Traube-Hering-Mayer oscillation
as measured by laser-Doppler flowmetry.
Sergueef N, Nelson KE, Glonek T.
Department of Osteopathic Manipulative Medicine, Chicago College of Osteopathic
Medicine, Midwestern University, Downers Grove, Ill, USA.
CONTEXT: A correlation has been established between the Traube-Hering-Mayer
oscillation in blood-flow velocity, measured by laser-Doppler flowmetry, and the cranial
rhythmic impulse. OBJECTIVE: To determine the effect of cranial manipulation on the
Traube-Hering-Mayer oscillation. DESIGN: Of 23 participants, 13 received a sham
treatment and 10 received cranial manipulation. SETTING: Osteopathic Manipulative
Medicine Department, Midwestern University, Downers Grove, Ill. PARTICIPANTS: Healthy
adult subjects of both sexes participated (N = 23). INTERVENTION: A laser-Dopper
flowmetry probe was placed on the left earlobe of each subject to obtain a 5-min baseline
blood-flow velocity record. Cranial manipulation, consisting of equilibration of the global
cranial motion pattern and the craniocervical junction, was then applied for 10 to 20 min;
the sham treatment was palpation only. MAIN OUTCOME MEASURE: Immediately following
the procedures, a 5-min posttreatment laser-Doppler recording was acquired. For each
cranial treatment subject, the 4 major components of the blood-flow velocity record, the
thermal (Mayer) signal, the baro (Traube-Hering) signal, the respiratory signal, and the
cardiac signal, were analyzed, and the pretreatment and posttreatment data were
compared. RESULTS: The 10 participants who received cranial treatment showed a thermal
signal power decrease from 47.79 dB to 38.49 dB (P < .001) and the baro signal increased
from 47.40dB to 51.30 dB (P < .021), while the respiratory and cardiac signals did not change
significantly (P > .05 for both). CONCLUSION: Cranial manipulation affects the blood-flow
velocity oscillation in its low-frequency Traube-Hering-Mayer components. Because these
low-frequency oscillations are mediated through parasympathetic and sympathetic activity,
it is concluded that cranial manipulation affects the autonomic nervous system.
- 112 -
75: Soc Sci Med. 2002 Dec;55(12):2141-8.
Perceptions of philosophic and practice differences between US
osteopathic physicians and their allopathic counterparts.
Department of Family and Community Medicine, Michigan State University College of
Osteopathic Medicine, Michigan State University, East Lansing, MI 48824-1316, USA.
[email protected]
Data were gathered through a random national mail survey of 3000 US osteopathic
physicians. Nine hundred and fifty-five questionnaires were usable for analysis. Through
open-ended questions, osteopathic physicians identified philosophic and practice
differences that distinguished them from their allopathic counterparts, and whether they
believed the use of osteopathic manipulative treatment (OMT), a key identifiable feature of
the osteopathic profession, was appropriate in their specialty. Seventy-five percent of the
respondents to the question regarding philosophic differences answered positively, and 41
percent of the follow-up responses indicated that holistic medicine was the most
distinguishing characteristic of their profession. In response to the question on practice
differences, 59 percent of the respondents believed they practiced differently from
allopathic physicians, and 72 percent of the follow-up responses indicated that the
osteopathic approach to treatment was a primary distinguishing feature, mainly
incorporating the application of OMT, a caring doctor-patient relationship, and a hands-on
style. More respondents who specialized in osteopathic manipulative medicine and family
practice perceived differences between them and their allopathic counterparts than did
other practitioners. Almost all respondents believed OMT was an efficacious treatment, but
19 percent of all respondents felt use of OMT was inappropriate in their specialty. Thirtyone percent of the pediatricians and 38 percent of the non-primary care specialists shared
this view. Eighty-eight percent of the respondents had a self-identification as osteopathic
physicians, but less than half felt their patients identified them as such. When responses
are considered in the context of all survey respondents (versus only those who provided
open-ended responses) not a single philosophic concept or resultant practice behavior had
concurrence from more than a third of the respondents as distinguishing osteopathic from
allopathic medicine. Rank and file osteopathic practitioners seem to be struggling for a
legitimate professional identification. The outcome of this struggle is bound to have an
impact on health care delivery in the US. Copyright 2002 Elsevier Science Ltd.
76: J Am Osteopath Assoc. 2002 Oct;102(10):527-32, 537-40.
- 113 -
Comment in:
Conditions and diagnoses for which osteopathic primary care physicians and
specialists use osteopathic manipulative treatment.
Department of Family and Community Medicine at the Michigan State University College of
Osteopathic Medicine in East Lansing, USA.
Data presented in this study were gathered in 1998 through a national mail survey of 3000
randomly selected osteopathic physicians. Of 979 (33.4%) questionnaires returned, 955
(97.5%) were usable for analysis. The use of osteopathic manipulative treatment (OMT) was
determined for primary care physicians and specialists. Osteopathic manipulative treatment
specialists and family physicians provided OMT significantly more frequently than other
primary care physicians and non-primary care specialists. More than 50% of respondents
(513) administered OMT on less than 5% of their patients. Nevertheless, it should be noted
that physicians from 40 of 46 specialties and subspecialties represented in the survey (678,
71%) identified an average of 3.3 conditions and diagnoses per physician that were managed
with OMT. The conditions and diagnoses for which OMT is used have been enumerated and
codified. More than 50% of conditions (1135) for which respondents treated patients with
OMT related to the musculoskeletal system, but extensive overlap among other body
systems and body regions attests to the continued incorporation of OMT into holistic
patient care by a broad range of osteopathic physicians.
77: Man Ther. 2002 Aug;7(3):150-3.
- 114 -
The effect of soft tissue deloading tape on thoracic spine pressure pain
thresholds in asymptomatic subjects.
O' Leary S, Carroll M, Mellor R, Scott A, Vicenzino B.
Department of Physiotherapy, University of Queensland, St. Lucia, Australia.
The application of tape to deload soft tissue is used in the management of thoracic spine
pain. A reported clinical feature of this treatment is reduced tenderness of the spine
during postero-anterior mobilizations. A randomized, single blind, placebo controlled,
repeated measures design study was employed to investigate the effects of deloading tape
on pressure pain threshold measurements at the level of the T7 spinous process in an
asymptomatic group of 24 subjects. Pressure pain thresholds were assessed prior to and
following the application of deloading tape, placebo sham tape and no-tape control
conditions. All subjects received all three conditions in a randomized order on three
separate days. Differences between the pre- and post-measurements were used as
indicators of change in a subject's pressure pain threshold. No significant change in
pressure pain threshold measurements was found between conditions. In summary, this
study demonstrated that deloading tape applied to the level of the T7 spinous process did
not significantly change pressure pain threshold measurements in asymptomatic subjects,
raising the possibility that any pain relieving effect may well be conditional upon pain being
present.
Publication Types:
Clinical Trial
78: J Am Osteopath Assoc. 2002 Sep;102(9 Suppl 3):S5-8.
- 115 -
Osteopathic manipulative treatment for postoperative pain.
Nicholas AS, Oleski SL.
Department of Osteopathic Manipulative Medicine at Philadelphia College of Osteopathic
Medicine, Philadelphia, USA.
Osteopathic manipulative treatment (OMT) is an important aspect of pain management and
disease prevention. Advantages of OMT administered postoperatively include easy
implementation and cost-effectiveness in terms of shortened hospital stays resulting from
effective relief of acute pain. Patients who receive morphine preoperatively and OMT
postoperatively tend to have less postoperative pain and require less intravenously
administered morphine. In addition, OMT and relief of pain lead to decreased postoperative
morbidity and mortality and increased patient satisfaction. Also, soft tissue manipulative
techniques and thoracic pump techniques help to promote early ambulation and body
movement.
- 116 -
79: J Am Osteopath Assoc. 2002 Aug;102(8):417-22.
Comment in:
J Am Osteopath Assoc. 2002 Oct;102(10):524; author reply 524-5.
J Am Osteopath Assoc. 2003 Aug;103(8):354-5; author reply 355-6.
A retrospective study of cranial strain patterns in patients with idiopathic
Parkinson's disease.
Rivera-Martinez S, Wells MR, Capobianco JD.
Department of Osteopathic Manipulative Medicine, New York College of Osteopathic
Medicine of New York Institute of Technology, Old Westbury 11568-8000, USA.
[email protected]
While providing osteopathic manipulative treatment to patients with Parkinson's disease at
the clinic of the New York College of Osteopathic Medicine of New York Institute of
Technology, physicians noted that these patients may exhibit particular cranial findings as a
result of the disease. The purpose of this study was to compare the recorded observations
of cranial strain patterns of patients with Parkinson's disease for the detection of common
cranial findings. Records of cranial strain patterns from physician-recorded observations of
30 patients with idiopathic Parkinson's disease and 20 age-matched normal controls were
compiled. This information was used to determine whether different physicians observed
particular strain patterns in greater frequency between Parkinson's patients and controls.
Patients with Parkinson's disease had a significantly higher frequency of bilateral
occipitoatlantal compression (87% vs. 50%; P < .02) and bilateral occipitomastoid
compression (40% vs. 10%; P < .05) compared with normal controls. Over subsequent visits
and treatments, the frequency of both strain patterns were reduced significantly
(occipitoatlantal compression, P < .01; occipitomastoid compression, P < .05) to levels found in
the control group.
- 117 -
80: J Am Osteopath Assoc. 2002 Jul;102(7):387-96.
Improving functional ability in the elderly via the Spencer technique, an
osteopathic manipulative treatment: a randomized, controlled trial.
Knebl JA, Shores JH, Gamber RG, Gray WT, Herron KM.
Division of Geriatrics, University of North Texas Health Science Center, Fort Worth
Twenty-nine elderly patients with preexisting shoulder problems voluntarily enrolled as
subjects in this study, which was undertaken to determine the efficacy of osteopathic
manipulative treatment (OMT) in an elderly population to increase functional independence,
increase range of motion (ROM) of the shoulder, and decrease pain associated with common
shoulder problems. Each subject had chronic pain, decreased ROM, and/or decreased
functional ability in the shoulder before entering the study. Subjects were randomly
assigned to either a treatment (OMT) group or a control group for 14 weeks. Over the
course of treatment, both groups had significantly increased ROM (P < .01) and decreased
perceived pain (P < .01). All subjects continued on their preexisting course of therapy for
any concurrent medical problems. After treatment, those subjects who had received OMT
demonstrated continued improvement in their ROM, while ROM in the placebo group
decreased.
Publication Types:
Clinical Trial
- 118 -
81: J Am Osteopath Assoc. 2002 Jul;102(7):371-5; discussion 375.
Comment in:
J Am Osteopath Assoc. 2002 Nov;102(11):573; author reply 573.
Quantifiable effects of osteopathic manipulative techniques on patients
with chronic asthma.
Bockenhauer SE, Julliard KN, Lo KS, Huang E, Sheth AM.
Department of Family Practice, Lutheran Medical Center, Brooklyn, NY, USA.
[email protected]
In this pilot study, the authors evaluated the immediate effects of osteopathic
manipulative procedures compared with sham procedures on 10 subjects who were diagnosed
with chronic asthma. The research followed a pretest-posttest crossover design wherein
each subject served as her own control. Blinded examiners recorded respiratory excursion,
peak expiratory flow rates, and subjective measures of asthma symptoms. Measurements of
both upper thoracic and lower thoracic forced respiratory excursion statistically increased
after osteopathic manipulative procedures compared with sham procedures. Changes in peak
expiratory flow rates and asthma symptoms were not statistically significant.
Publication Types:
Clinical Trial
- 119 -
Osteopathic manipulative treatment in conjunction with medication relieves
pain associated with fibromyalgia syndrome: results of a randomized
clinical pilot project.
Gamber RG, Shores JH, Russo DP, Jimenez C, Rubin BR.
Department of Osteopathic Manipulative Medicine, Texas College of Osteopathic Medicine,
University of North Texas Health Science Center, Fort Worth 76107, USA.
[email protected]
Osteopathic physicians caring for patients with fibromyalgia syndrome (FM) often use
osteopathic manipulative treatment (OMT) in conjunction with other forms of standard
medical care. Despite a growing body of evidence on the efficacy of manual therapy for the
treatment of selected acute musculoskeletal conditions, the role of OMT in treating
patients with chronic conditions such as FM remains largely unknown. Twenty-four female
patients meeting American College of Rheumatology criteria for FM were randomly assigned
to one of four treatment groups: (1) manipulation group, (2) manipulation and teaching group,
(3) moist heat group, and (4) control group, which received no additional treatment other
than current medication. Participants' pain perceptions were assessed by use of pain
thresholds measured at each of 10 bilateral tender points using a 9-kg dolorimeter, the
Chronic Pain Experience Inventory, and the Present Pain Intensity Rating Scale. Patients'
affective response to treatment was assessed using the Self-Evaluation Questionnaire.
Activities of daily living were assessed using the Stanford Arthritis Center Disability and
Discomfort Scales: Health Assessment Questionnaire. Depression was assessed using the
Center for Epidemiological Studies Depression Scale. Significant findings between the four
treatment groups on measures of pain threshold, perceived pain, attitude toward treatment,
activities of daily living, and perceived functional ability were found. All of these findings
favored use of OMT. This study found OMT combined with standard medical care was more
efficacious in treating FM than standard care alone. These findings need to be replicated to
determine if cost savings are incurred when treatments for FM incorporate
nonpharmacologic approaches such as OMT.
Publication Types:
Clinical Trial
- 120 -
Erratum in:
J Am Osteopath Assoc 2002 Jun;102(6):306. Protapapas Marina G [corrected to Protopapas
Marina G].
Joint cracking and popping: understanding noises that accompany articular
release.
Protopapas MG, Cymet TC.
Good Samaritan Hospital, Baltimore, MD, USA.
Articular release is a physiologic event that may or may not be audible. It is seen in patients
with healthy joints as well as those with somatic dysfunction. After an articular release,
there is a difference in joint spacing-with the release increasing the distance between
articular surfaces. Not all noise that emanates from a joint signifies an articular release. A
hypothesis about the noise that frequently accompanies this release is offered and includes
anatomic, physiologic, and functional models of articular release. Repeated performance of
articular release may decrease the occurrence of arthritis. Potential problems from
repeated articular release (eg, hypermobility) are also examined.
Publication Types:
Review
Review, Tutorial
- 121 -
Effects of osteopathic manipulative treatment and concentric and eccentric
maximal-effort exercise on women with multiple sclerosis: a pilot study.
Yates HA, Vardy TC, Kuchera ML, Ripley BD, Johnson JC.
Department of Manipulative Medicine, Kirksville College of Osteopathic Medicine, MO
The research objectives of this study were to evaluate the effects of osteopathic
manipulative treatment (OMT) combined with maximal-effort exercise (MEE) on strength,
coordination, endurance, and fatigue in female patients with multiple sclerosis (MS). Seven
female subjects with MS participated in the 12-week study, which included intervention
with OMT and MEE twice per week. Standardized tests for progression of MS and fatigue
were used. Strength (maximal effort and impulse) was measured with the IsoPump exercise
machine (IsoPump USA, Cleveland, Miss) during the three phases of the exercise protocol.
Significant changes occurred in all but one measure of strength and on the 25-foot walk (P <
.05), but not on the block-and-box test. The change in fatigue scores was not significantly
different. Findings indicate that OMT combined with MEE significantly increases strength
and ambulatory levels while not increasing fatigue in female patients with MS who have low
to medium impairment. Qualitative data show that this intervention also produces beneficial
effects in activities of daily living.
- 122 -
Quality of life in referred patients presenting to a specialty clinic for
osteopathic manipulative treatment.
Licciardone JC, Gamber RG, Russo DP.
Department of Family Medicine, Texas College of Osteopathic Medicine, University of
North Texas Health Science Center at Fort Worth, 76107-2644, USA. [email protected]
Previous research has found that patients of osteopathic physicians tend to report poorer
general health perceptions than persons in the general population or than patients of
allopathic physicians. Quality of life and level of healthcare satisfaction in patients
referred to a specialty clinic for osteopathic manipulative treatment (OMT) at a college of
osteopathic medicine were measured in 1997. Data from the Medical Outcomes Study 36Item Short Form (SF-36) were used to compute standardized scores in the following eight
health scales: physical functioning, role limitations because of physical problems, bodily pain,
general health perceptions, vitality, social functioning, role limitations because of emotional
problems, and mental health. There were 185 patients who returned the survey (mean
response rate, 90%), including 22 new and 163 established patients. Patients reported
poorer health than the general population on all eight scales (P < .001). Patients frequently
reported poorer quality of life than referents with hypertension, congestive heart failure,
type 2 diabetes mellitus, recent acute myocardial infarction, or clinical depression. More
than 97% of established patients were satisfied or very satisfied with the healthcare
received at the clinic. This study suggests that referred patients presenting to osteopathic
physicians for OMT may have poorer quality of life than is generally recognized when relying
only on traditional diagnostic approaches. Early detection and treatment of musculoskeletal
conditions may be important factors in preventing chronicity and its impact on quality of
life.
- 123 -
Evaluation of osteopathic manipulative treatment training by practicing
physicians in Ohio.
Spaeth DG, Pheley AM.
Ohio University College of Osteopathic Medicine, Department of Family Practice, Athens
45701, USA. [email protected]
The authors mailed a survey designed to evaluate beliefs about osteopathic manipulative
treatment (OMT) training to the 2318 osteopathic physicians registered with the Ohio
Osteopathic Association. Responses were received from 871 osteopathic physicians
(response rate, 38%). Fifty-three percent of the respondents had used OMT with patients
at least once during the week before the survey. With regard to OMT training, 60% rated
their experience during medical school as acceptable; during postgraduate training the
acceptable rating dropped to 9%. Osteopathic manipulative treatment training through
continuing medical education programs was rated as acceptable by 26% who had
participated in these programs. Forty percent of the respondents reported that they were
practicing less OMT now than when they originally entered practice, while 20% reported
using OMT procedures more often. No significant correlation was observed between OMT
training satisfaction during medical school and current use of OMT. However, a strong
negative correlation was observed between satisfaction with postgraduate OMT training
and OMT use. This survey did not detect any association between year of graduation and
use of OMT.
- 124 -
91: Aust J Physiother. 2002;48(1):25-30.
Comment in:
Aust J Physiother. 2002;48(2):154-5; author reply 155-6.
Aust J Physiother. 2002;48(2):154; author reply 155-6.
An evaluation of Superthumb and the Kneeshaw device as manual therapy
tools.
Maher CG, Latimer J, Starkey I.
School of Physiotherapy, The University of Sydney, Sydney, NSW, 1825, Australia.
[email protected]
This research evaluated two hand-held tools (Superthumb and Kneeshaw device) that have
been developed in order to reduce hand pain associated with the performance of manual
therapy. Two studies were conducted: one evaluated the ability to perceive elastic stiffness
with the devices and the other evaluated physiotherapist and patient comfort when the
devices were used to apply a mobilisation to the lumbar spine. In the first study we found
that the two tools and the pisiform grip provided equivalent ability to detect small
differences in elastic stiffness, however the tools introduced a bias so that the stiffness
stimuli felt stiffer than when assessed with the pisiform grip. In the second study we found
that the two tools were substantially less comfortable than the pisiform grip, for both
patient and therapist, when a therapist applied a Grade III mobilisation to the lumbar spine.
The results suggest that neither tool, in its current form, is suitable for clinical practice.
- 125 -
Comment in:
J Am Osteopath Assoc. 2002 Mar;102(3):120; author reply 120-1.
Patient satisfaction and clinical outcomes associated with osteopathic
Licciardone J, Gamber R, Cardarelli K.
Department of Family Medicine, University of North Texas Health Science Center, Fort
Worth 76107, USA. [email protected]
A patient survey was used to measure and explain patient satisfaction and clinical outcomes
associated with osteopathic manipulative treatment (OMT). Participating in the survey were
459 people who attended an ambulatory OMT specialty clinic from March 1998 through
September 1998 and who had received OMT there at least twice previously. Standardized
patient satisfaction scores were greatest for overall performance (0.61 +/- 0.29) and
interpersonal manner (0.61 +/- 0.24). Satisfaction with finances (0.11 +/- 0.31) was
significantly lower than for all other global dimensions of care (P < .001). Subjects perceived
OMT to be highly efficacious (0.74 +/- 0.34) and reported significant relief from pain or
discomfort (P < .001) and improvement in mobility (P < .001). Of all the respondents, 8.6%
attributed an adverse reaction to OMT. Perception of OMT efficacy was significantly
associated with all dimensions of patient satisfaction (P values ranged from less than .001 to
.003). Relief from pain or discomfort was significantly associated with overall satisfaction
(P < .001). Females had greater reduction in pain or discomfort than males (P = .001).
Respondents perceived significant community shortages of OMT services through primary
care (-0.45 +/- 0.50; P < .001) and specialty (-0.35 +/- 0.54; P < .001) physicians, and
reported significant dissatisfaction with insurance coverage for OMT services (-0.09 +/0.57; P = .001). These findings suggest the need for greater access to OMT services.
- 126 -
93: Cranio. 2002 Jan;20(1):34-8.
Radiographic evidence of cranial bone mobility.
Oleski SL, Smith GH, Crow WT.
Philadelphia College of Osteopathic Manipulative Medicine, PA 19131, USA.
The purpose of this retrospective chart review was to determine if external manipulation of
the cranium alters selected parameters of the cranial vault and base that can be visualized
and measured on x-ray. Twelve adult patient charts were randomly selected to include
patients who had received cranial vault manipulation treatment with a pre- and posttreatment x-ray taken with the head in a fixed positioning device. The degree of change in
angle between various specified cranial landmarks as visualized on x-ray was measured. The
mean angle of change measured at the atlas was 2.58 degrees, at the mastoid was 1.66
degrees, at the malar line was 1.25 degrees, at the sphenoid was 2.42 degrees, and at the
temporal line was 1.75 degrees. 91.6% of patients exhibited differences in measurement at
3 or more sites. This study concludes that cranial bone mobility can be documented and
measured on x-ray.
- 127 -
94: Med Clin North Am. 2002 Jan;86(1):91-103.
Fiechtner JJ, Brodeur RR.
Division of Rheumatology, Michigan State University, Colleges of Osteopathic and Human
Medicine, East Lansing, Michigan, USA. [email protected]
Table 1 summarizes many of the studies cited in this article. Can we specifically answer the
question, "Does manipulation effectively treat musculoskeletal disorders and arthritis?" It
is apparent that many individuals make decisions to see therapists who use manual
techniques for pain relief and improved function even though few third-party payers cover
such treatments. If this question could unequivocally be answered in the affirmative, these
treatments would likely be reimbursed by the payers. The studies noted in Table 1 show
mixed results for several conditions. Each study has its strengths and weaknesses, but the
most powerful ones indicate that manual techniques are beneficial for back and neck pain
when compared with no treatment or "placebo." Comparative studies against other
techniques such as physical therapy, education, or exercise do not show a clear superiority
for manual therapy, however. Thus, one would have to conclude that these techniques have
usefulness, primarily as adjuncts to a comprehensive treatment program. Particularly,
manual techniques are useful for painful conditions as a means to break the pain cycle and
increase tolerance of exercise and other educational approaches. Although clinical trials do
provide important information, they do not provide information on the mechanism by which
the therapy assists in the healing process. Further work is needed to understand the
mechanism by which manipulation affects pain and motion. Such research should clarify the
discrepancies reported in the clinical trials and provide better designs for future studies.
Publication Types:
Review
Review, Tutorial
- 128 -
The muscle hypothesis: a model of chronic heart failure appropriate for
osteopathic medicine.
Rogers FJ.
Michigan State University College of Osteopathic Medicine, East Lansing, MI 48824-1316,
Chronic heart failure is one of the most serious medical problems in the United States,
affecting some 4 million persons. In spite of its common occurrence, and comprehensive
literature regarding this condition, no unifying hypothesis has been accepted to explain the
signs and symptoms of chronic heart failure. The cardiocirculatory and neurohormonal
models place an emphasis on left ventricular ejection fraction and cardiac output and do not
provide appropriate explanations for the symptoms of breathlessness and fatigue. The
muscle hypothesis supplements these conventional models. It proposes that abnormal
skeletal muscle in heart failure results in activation of muscle ergoreceptors, leading to an
increase in ventilation and sensation of breathlessness, the perception of fatigue, and
sympathetic activation. At least one fourth of patients with chronic heart failure are
limited by skeletal muscle abnormalities rather than cardiac output. Cardiac rehabilitation
exercise can lead to an increase in exercise capacity that is superior to that gained from
digitalis or angiotensin-converting enzyme inhibitors. Exercise tends to reverse the skeletal
muscle myopathy of chronic heart failure and reduces the abnormal ergoreflex. Other
interventions that have been shown to have a favorable outcome include localized muscle
group training, respiratory muscle training, and dietary approaches. The possibility that
osteopathic manipulative treatment might be of benefit is an attractive, but untested,
possibility.
Publication Types:
Review
Review, Tutorial
- 129 -
99: Man Ther. 2001 Nov;6(4):229-34.
Development of an instrumented couch to measure forces during manual
physiotherapy treatment.
Chiradejnant A, Maher CG, Latimer J.
School of Physiotherapy, Faculty of Health Sciences, The University of Sydney, NSW,
Australia. [email protected]
This paper reports on an instrumented couch developed to measure the forces applied
during posteroanterior (PA) mobilization to the lumbar spine. The couch was evaluated for
reliability by applying known weights to the empty couch, while accuracy was investigated by
applying weights both to the empty couch and to a human subject lying on the couch. The
equipment appears highly reliable when measuring forces in three directions (ICC(2,1); 99%
CI=0.99-1.00) and also demonstrates acceptable accuracy; a maximum error of less than 2%
being obtained when measuring forces applied to human subjects. The results demonstrate a
highly linear relationship (r2=0.99) between the force readings and the known weights. In
conclusion, the instrumented couch demonstrates suitable accuracy and reliability for
measuring the force applied to a subject during the application of PA mobilization to the
lumbar spine. Copyright 2001 Harcourt Publishers Ltd.
- 130 -
Adjunctive osteopathic manipulative treatment in women with depression: a
pilot study.
Plotkin BJ, Rodos JJ, Kappler R, Schrage M, Freydl K, Hasegawa S, Hennegan E, HilchieSchmidt C, Hines D, Iwata J, Mok C, Raffaelli D.
Department of Microbiology, Chicago College of Osteopathic Medicine of Midwestern
University, USA. [email protected]
The authors assessed the impact of osteopathic manipulative treatment (OMT) as an
adjunct to standard psychiatric treatment of women with depression. Premenopausal women
with newly diagnosed depression were randomly assigned to either control (osteopathic
structural examination only; n = 9) or treatment group (OMT; n = 8). Both groups received
conventional therapy consisting of the antidepressant paroxetine (Paxil) hydrochloride plus
weekly psychotherapy for 8 weeks. Attending psychiatrists and psychologists were blinded
to group assignments. No significant differences existed between groups for age or
severity of disease. After 8 weeks, 100% of the OMT treatment group and 33% of the
control group tested normal by psychometric evaluation. No significant differences or
trends were observed between groups in levels of cytokine production (IL-1, IL-10, IL-2, IL4, and IL-6) or in levels of anti-HSV-1, anti-HSV-2, and anti-EBV antibody. There was no
pattern to the osteopathic manipulative structural dysfunctions recorded. The findings of
this pilot study indicate that OMT may be a useful adjunctive treatment for alleviating
depression in women.
Publication Types:
Clinical Trial
101: J Manipulative Physiol Ther. 2001 Sep;24(7):457-66.
- 131 -
Efficacy of spinal manipulation for chronic headache: a systematic review.
Bronfort G, Assendelft WJ, Evans R, Haas M, Bouter L.
Department of Research, Wolfe-Harris Center for Clinical Studies, Northwestern Health
Sciences University, Bloomington, MN 55431, USA. [email protected]
BACKGROUND: Chronic headache is a prevalent condition with substantial socioeconomic impact.
Complementary or alternative therapies are increasingly being used by patients to treat
headache pain, and spinal manipulative therapy (SMT) is among the most common of these.
OBJECTIVE: To assess the efficacy/effectiveness of SMT for chronic headache through a
systematic review of randomized clinical trials. STUDY SELECTION: Randomized clinical trials
on chronic headache (tension, migraine and cervicogenic) were included in the review if they
compared SMT with other interventions or placebo. The trials had to have at least 1 patientrated outcome measure such as pain severity, frequency, duration, improvement, use of
analgesics, disability, or quality of life. Studies were identified through a comprehensive search
of MEDLINE (1966-1998) and EMBASE (1974-1998). Additionally, all available data from the
Cumulative Index of Nursing and Allied Health Literature, the Chiropractic Research Archives
Collection, and the Manual, Alternative, and Natural Therapies Information System were used,
as well as material gathered through the citation tracking, and hand searching of non-indexed
chiropractic, osteopathic, and manual medicine journals. DATA EXTRACTION: Information
about outcome measures, interventions and effect sizes was used to evaluate treatment
efficacy. Levels of evidence were determined by a classification system incorporating study
validity and statistical significance of study results. Two authors independently extracted data
and performed methodological scoring of selected trials. DATA SYNTHESIS: Nine trials
involving 683 patients with chronic headache were included. The methodological quality (validity)
scores ranged from 21 to 87 (100-point scale). The trials were too heterogeneous in terms of
patient clinical characteristic, control groups, and outcome measures to warrant statistical
pooling. Based on predefined criteria, there is moderate evidence that SMT has short-term
efficacy similar to amitriptyline in the prophylactic treatment of chronic tension-type headache
and migraine. SMT does not appear to improve outcomes when added to soft-tissue massage for
episodic tension-type headache. There is moderate evidence that SMT is more efficacious than
massage for cervicogenic headache. Sensitivity analyses showed that the results and the overall
study conclusions remained the same even when substantial changes in the prespecified
assumptions/rules regarding the evidence determination were applied. CONCLUSIONS: SMT
appears to have a better effect than massage for cervicogenic headache. It also appears that
SMT has an effect comparable to commonly used first-line prophylactic prescription
medications for tension-type headache and migraine headache. This conclusion rests upon a few
trials of adequate methodological quality. Before any firm conclusions can be drawn, further
testing should be done in rigorously designed, executed, and analyzed trials with follow-up
periods of sufficient length.
Publication Types:
Meta-Analysis
- 132 -
102: J Back Musculoskeletal Rehabil. 1998;11(2):89-130.
The origin and relief of common pain.
Irvin RE.
Section of Osteopathic Principles and Practices, Oklahoma State University, Tulsa, USA.
Where pain of the musculoskeletal system is present, commonly, this pain is without objective
evidence of disease, trauma, or disorder. Absence of an apparent cause for common pain
prompts the consideration of mechanical stress as a contributing factor. The principal stress of
the musculoskeletal system is postural. By posture it is usually meant the distribution of body
mass with respect to gravity. Past efforts to predict chronic pain by postural analysis or to
reduce such pain by strengthening, conscious control or splinting of posture has had marginal
success. Past failure to relate posture to pain is attributable to (1) ubiquity of sub-optimal
posture that precludes clinical comparison to those with optimal posture; (2) presupposition that
the causal relation between posture and pain is of the observational class of causality rather
than the manipulable kind; (3) a definition of posture that is too narrow to complete the picture;
and (4) inadequate methods for reduction of postural asymmetry to an extent that is sufficient
to elicit a significant and enduring effect on sub-optimal posture and related pain. Posture can
be defined more broadly as the stance of the body performing within the boundaries of posture
and which is mediated by the Postural Control System towards greatest stability (Fx. 1). The
stance of the body is the arrangement of the body with respect to gravity and other
accelerative forces. The postural boundaries are the set of forces that resist acceleration and
thereby provide the limits within which one functions stably, and this resistance is currently
approximated by six principal sources of resistance to acceleration: viscous, elastic,
neuromuscular, rigid, viscoelastic, and inertial. The Postural Control System is located in the
brainstem and modulates body stance to more economically and stably effect and resist
acceleration. The rigid boundaries can be so with respect to compressive, tractive, or tensile
qualities that permits three kinds of motion: translation, rotation and oscillation. An example of
postural boundaries that are rigid with respect to compression and tensile character are the
bones that bear weight. In contrast, ligaments provide a tractive rigidity and musculotendons a
relatively elastic boundary. Joint surfaces are considered boundaries that are rigid but not
perfectly so. Of fundamental importance are those joints that arc lowermost in a column of the
musculoskeletal system namely: (1) the feet and ankles that support the entirety of the
musculoskeletal system and; (2) the base of the sacrum that supports the vertebral spine. This
broadened definition of posture leads to a greatly enhanced manipulability of posture in the
upright stance and alleviation of more than two-thirds of common pain by the coherent
combination of (1) manual manipulation to reduce somatic dysfunction; (2) foot orthotics to
optimize the amplitude of the arches of the feet and vertically align the ankle; (3) a heel lift to
level the sacral base; (4) and a group of therapeutic postures configured to minimize restriction
of peripheral soft tissue reflective of the earlier posture, all aimed to optimize posture.
Mediated by the postural control system, manipulation of postural boundaries accordingly
modifies the structure and function of the entire musculoskeletal system. Typically, this relief
is maintained by foot orthotic and heel lift alone without maintenance by manual manipulation,
medication, or exercise.
104: Man Ther. 2001 Aug;6(3):130-8.
- 133 -
Patient positioning and spinal locking for lumbar spine rotation manipulation.
Gibbons P, Tehan P.
School of Health Science, Osteopathic Medicine, Victoria University, Melbourne, Australia.
[email protected]
High velocity low amplitude (HVLA) thrust techniques are widely used by many manual
therapists to treat low back pain. There is increasing evidence that spinal manipulation
produces positive patient outcomes for acute low back pain. HVLA thrust techniques are
associated with an audible release in the form of a pop or cracking sound that is widely
accepted to represent cavitation of a spinal zygapophyseal joint. This audible release
distinguishes these techniques from other manual therapy interventions. When using long
lever HVLA thrust techniques spinal locking is necessary to localize forces and achieve
cavitation at a specific vertebral segment. A critical factor in applying lumbar spine
manipulation with minimal force is patient positioning and spinal locking. A knowledge of
coupled movements of the lumbar spine aids an understanding of the patient positioning
required to achieve spinal locking consistent with maximal patient comfort and cooperation.
Excessive rotation can result in pain, patient resistance and failed technique. This
masterclass presents a model of patient positioning for the lumbar spine that minimizes
excessive use of rotation to achieve spinal locking prior to the application of the thrust.
Copyright 2001 Harcourt Publishers Ltd.
Publication Types:
Review
Review, Tutorial
- 134 -
Osteopathic philosophy and emergent treatment in acute respiratory
failure.
Stretanski MF, Kaiser G.
Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, USA.
[email protected]
Osteopathic manipulation has been used to treat a wide range of diseases in largely
outpatient settings. The authors describe the emergent use of osteopathic manipulative
treatment to improve respiratory mechanics in a critically ill patient with acute respiratory
failure. High-velocity mobilization of cervical and thoracic dysfunctions resulted in a
decreased work of breathing, improved arterial oxygenation, resolution of tachycardia, and
an overall improvement in the patient's clinical condition.
Publication Types:
Case Reports
- 135 -
Manual medicine diversity: research pitfalls and the emerging medical
paradigm.
Mein EA, Greenman PE, McMillin DL, Richards DG, Nelson CD.
Meridian Institute, 1853 Old Donation Parkway, Suite 1, Virginia Beach, VA 23454, USA.
[email protected]
Recent studies published in leading medical journals have concluded that chiropractic
treatment is not particularly helpful for relieving asthma and migraine symptoms because
even though study participants showed notable improvement in symptoms, those subjects
who received sham manual medicine treatments also showed improvement. Yet the sham
treatment received by control groups in these studies is reminiscent in many ways of
traditional osteopathic manipulation. This seems to represent not only a failure to recognize
the value of many manual medicine techniques but also an ignorance of the broad spectrum
of manual medicine techniques used by various practitioners, from osteopathic physicians to
chiropractors to physical therapists. Such blind spots compromise research methodology
with regard to manual medicine studies, which could, in turn, diminish the role of manual
medicine in clinical practice. Osteopathic manipulative treatment provides an excellent
model for recognizing and integrating the full range of manual medicine techniques into
research and clinical applications because of the wide range of techniques employed. The
potential exists for these techniques to contribute much to medical research and clinical
practice--provided that osteopathic physicians and other manual medicine practitioners
work to alleviate ignorance about the efficacy of various forms of manipulation.
- 136 -
109: Acad Med. 2001 Aug;76(8):821-8.
Diminished use of osteopathic manipulative treatment and its impact on the
uniqueness of the osteopathic profession.
Department of Family and Community Medicine, College of Osteopathic Medicine, Michigan
State University, East Lansing, 48824-1316, USA.
PURPOSE: To determine whether osteopathic manipulative treatment (OMT), a key
identifiable feature of osteopathic medicine, is becoming a "lost art" in the profession, and
whether the long-term evolution of osteopathic medicine into mainstream medicine and
particularly specialization has had a similar impact on the use of OMT by family
practitioners and specialists. METHOD: In April 1998, a two-page questionnaire was mailed
to 3,000 randomly selected osteopathic physicians in the United States to assess factors
affecting their use of OMT. Descriptive statistics, linear regression analyses, and analysis
of variance techniques were used to test for differences. RESULTS: The response rate was
33.2%. Over 50% of the responding osteopathic physicians used OMT on less than 5% of
their patients, and analysis of variance revealed OMT use was significantly affected by
practice type, graduation date, and family physicians versus specialists. For specialists, 58%
of the variance regression was attributed to barriers to use, practice protocol, attitudes,
and training, whereas for family physicians, 43% of the variance regression was attributed
to barriers to use, practice protocol, and attitudes. More important, the eventual level of
OMT use was related to whether postgraduate training had been undertaken in osteopathic,
allopathic, or mixed staff facilities, particularly for osteopathic specialists.
CONCLUSIONS: The evidence supports the assertion that OMT is becoming a lost art
among osteopathic practitioners. Osteopathic as well as allopathic medical educators and
policymakers should address the impact of the diminished use of OMT on both U.S. health
care and the unique identifying practices associated with the osteopathic profession.
- 137 -
Student perceptions of osteopathic manipulative treatment after
completing a manipulative medicine rotation.
Gamber RG, Gish EE, Herron KM.
Department of Manipulative Medicine, University of North Texas Health Science Center at
Fort Worth, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107, USA.
[email protected]
Recent studies have demonstrated a decline in the use of osteopathic manipulative
treatment (OMT) by osteopathic physicians, reflecting a trend that may begin in medical
school. The authors used a questionnaire to examine the teaching and use of OMT in five
rotations and the perceptions of 86 graduating osteopathic medical students of their
experiences following their core manipulative medicine rotation. Most students indicated
that they applied osteopathic principles sometimes (39.5%) or often (29.1%) during
rotations. Forty-three percent of students rated their ability to apply osteopathic
principles as average. The number of students who indicated that they rarely used OMT
during their rotations was 31 (36.0%) for internal medicine, 21 (24.4%) for surgery, 23
(26.7%) for pediatrics, and 24 (27.9%) for obstetrics/gynecology. When asked why OMT
was not used during a rotation, 47.2% of respondents cited time constraints, and 21.7%
stated that their attending physicians discouraged the use of OMT. These results
demonstrate a distinction between students' perceived level of osteopathic principles and
skills and their application during clinical rotations.
- 138 -
115: Curr Pain Headache Rep. 2001 Aug;5(4):369-75.
Cervicogenic headache: manual and manipulative therapies.
Grimshaw DN.
Osteopathic Manipulative Medicine Clinic, Michigan State University College of Osteopathic
Medicine, A 419 East Fee Hall, East Lansing, MI 48824, USA. [email protected]
This article reviews current literature on the role of manual medicine in the diagnosis and
treatment of cervicogenic headache. Manual diagnostic procedures and treatment
procedures are described for the cervical spine. Emphasis is placed on accurate diagnosis
using a biomechanical model and precise localization of forces. Muscle energy technique is
suggested as a safe and effective treatment when somatic dysfunction of the cervical spine
is found in association with the diagnostic criteria for cervicogenic headache. Lastly, a
suggested clinical approach to this problem from a manual medicine perspective is given.
Publication Types:
Review
Review, Tutorial
- 139 -
116: J Am Osteopath Assoc. 2001 Apr;101(4 Suppl Pt 2):S6-11.
A nonsurgical approach to low back pain.
Jermyn RT.
University Back Pain Center, University of Medicine and Dentistry of New Jersey-School of
Osteopathic Medicine, Stratford, NJ, USA. [email protected]
Low back pain, a leading cause of disability in the United States, has a significant economic
impact not only on lost productivity but also on healthcare expenditures. Approximately a
fifth of patients will see multiple physicians in their quest for relief of low back pain.
Primary care physicians therefore play a crucial role in the initial approach to these
patients. A thorough history and physical examination directed toward the neurologic,
orthopedic, and osteopathic evaluation are essential. This article reviews the diagnosis and
assessment of pain levels and a triad system of therapy involving cortical, spinal, and
peripheral levels. Options include antidepressants, neuroleptics, neurostimulants, and
osteopathic manipulative treatment (OMT) (cortical level); opiates, tramadol hydrochloride,
and transcutaneous electrical nerve stimulators (spinal level); and nonsteroidal antiinflammatory drugs, epidural injections, spinal blocks, antispasmodics, physical therapy,
muscle relaxants, exercise, and OMT (peripheral level), By choosing a modality directed at
each level, the clinician may provide the patient with a pain management program that will
maximize the chosen mode of therapy and restore function and mobility.
Publication Types:
Review
Review, Tutorial
- 140 -
117: J Am Osteopath Assoc. 2001 Apr;101(4 Suppl Pt 2):S18-20.
Osteopathic treatment considerations for rheumatic diseases.
Tettambel MA.
Department of Osteopathic Manipulative Medicine, Kirksville College of Osteopathic
Medicine, 800 W Jefferson, Kirksville, MO 63501, USA. [email protected]
Patients who receive medical care for musculoskeletal pain of rheumatic diseases often
benefit from additional osteopathic manipulative treatment. This article offers a brief
description of commonly used treatment modalities. It also includes discussion of indications
as well as contraindications of operator-director versus operator-monitored techniques.
Publication Types:
Review
Review, Tutorial
- 141 -
Segmental definition--Part IV. Updating the differential for somatic and
visceral inputs.
Johnston WL, Golden WJ.
Osteopathic Medicine, USA. [email protected]
The first three parts of this series presented a standardized method of motion testing for
motor behaviors specific to segmental dysfunction. When applied to clinical research
studies, analysis of these palpatory data differentiated viscero-somatic from somatosomatic reflex manifestations in the thoracic region of subjects with renal dysfunction
and/or hypertension. This update for the differential adds new observations regarding
palpable findings, specifically at the spinal levels where linkage of costal and vertebral
motion asymmetries identified the presence of increased visceral inputs. At each level, the
examiner can make a simple comparison for accord in response to two sidebending motion
tests in the seated position, one introduced through the shoulders and trunk and one
through the head and neck. Lack of accord is a distinctive characteristic of the linked
spinal/costal site of visceral input. Also, with regard to linkage sites, behavioral responses
to motion tests introduced through the lower extremities suggest new applications for
manipulative intervention. The new descriptive clinical data about segmental motion
behaviors described in this report provide a basis for new questions in neuromusculoskeletal
research.
Publication Types:
Review
Review, Tutorial
- 142 -
Update of: Cochrane Database Syst Rev. 2000;(2):CD001002.
Consortial Center for Chiropractic, 30W009 Willow Court, Warrenville, Illinois, USA,
60555-1018. [email protected]
BACKGROUND: A variety of manual therapies with similar postulated biologic mechanisms of
action are commonly used to treat patients with asthma. Manual therapy practitioners are also
varied, including physiotherapists, respiratory therapists, chiropractic and osteopathic
physicians. A systematic review across disciplines is warranted. OBJECTIVES: To evaluate the
evidence for the effects of manual therapies for treatment of patients with bronchial asthma.
SEARCH STRATEGY: Trials were searched in computerized general (EMBASE, CINAHL and
MEDLINE) and specialized databases (Cochrane Complementary Medicine Field, Cochrane
Rehabilitation Field, ICL, and MANTIS). In addition, bibliographies from included studies were
assessed, and authors of known studies were contacted for additional information about
published and unpublished trials. Date of most recent search: December 1998. SELECTION
CRITERIA: Trials were included if they: (1) were randomised; (2) included asthmatic children or
adults; (3) examined one or more types of manual therapy; and (4) included clinical outcomes.
DATA COLLECTION AND ANALYSIS: All three reviewers independently extracted data and
assessed trial quality using a standard form. MAIN RESULTS: From an initial 316 unique
citations, 48 full text articles were retrieved and evaluated, which resulted in nine citations to
five RCTs (290 patients) suitable for inclusion. Trials could not be pooled statistically because
studies that addressed similar interventions used disparate patient groups or outcomes. The
neither trial found significant differences between chiropractic spinal manipulation and a sham
manoeuvre on any of the outcomes measured. Quality of the remaining three trials was poor.
One small trial compared massage therapy with a relaxation control group and found significant
differences in many of the lung function measures obtained. However, this trial had poor
reporting characteristics and the data have yet to be confirmed. One small trial compared chest
physiotherapy to placebo and one small trial compared footzone therapy to a no treatment
control. Neither trial found differences in lung function between groups. A further search
conducted in July 2000 did not yield any more studies REVIEWER'S CONCLUSIONS: There is
insufficient evidence to support the use of manual therapies for patients with asthma. There is
a need to conduct adequately-sized RCTs that examine the effects of manual therapies on
clinically relevant outcomes. Future trials should maintain observer blinding for outcome
assessments, and report on the costs of care and adverse events. Currently, there is
insufficient evidence to support or refute the use of manual therapy for patients with asthma.
Publication Types:
Review
- 143 -
Thoracic lymphatic pumping and the efficacy of influenza vaccination in
healthy young and elderly populations.
Breithaupt T, Harris K, Ellis J, Purcell E, Weir J, Clothier M, Boesler D.
Department of Biochemistry, Des Moines University Osteopathic Medical Center, 3200
Grand Ave, Des Moines, IA 50312, USA. [email protected]
The authors investigated whether thoracic lymphatic pumping (TLP) after FluShield
vaccination enhanced the production of anti-influenza immunoglobulins in elderly individuals,
who are at particular risk for influenza. Osteopathic students and non-TLP-treated elderly
subjects served as controls. Serum antibody titers were quantified with enzyme-linked
immunosorbent assay, and hemagglutination inhibition assay, both of which generated
comparable results. While approximately 70% of the younger controls had increased antiinfluenza immunoglobulin production on vaccination, only 30% to 35% of the aged population
had increased antibody production. There was no significant enhancement in anti-influenza
immunoglobulin production in the TLP-treated subjects. The authors' findings suggest that
TLP in conjunction with influenza vaccination does not enhance immunization against
influenza in otherwise healthy and active populations. However, such techniques may be of
value when applied in conjunction with vaccination to nonambulatory patients or on actual
influenza exposure of at-risk individuals.
- 144 -
Comment in:
Benefits of osteopathic manipulative treatment for hospitalized elderly
patients with pneumonia.
Noll DR, Shores JH, Gamber RG, Herron KM, Swift J Jr.
Division of Medicine, Kirksville College of Osteopathic Medicine, 800 W Jefferson St,
Kirksville, MO 63501, USA.
While osteopathic manipulative treatment (OMT) is thought to be beneficial for patients
with pneumonia, there have been few clinical trials--especially in the elderly. The authors'
pilot study suggested that duration of intravenous antibiotic use and length of hospital stay
were promising measures of outcome. Therefore, a larger randomized controlled study was
conducted. Elderly patients hospitalized with acute pneumonia were recruited and randomly
placed into two groups: 28 in the treatment group and 30 in the control group. The
treatment group received a standardized OMT protocol, while the control group received a
light touch protocol. There was no statistical difference between groups for age, sex, or
simplified acute physiology scores. The treatment group had a significantly shorter duration
of intravenous antibiotic treatment and a shorter hospital stay.
Publication Types:
Clinical Trial
- 145 -
Galbreath technique: a manipulative treatment for otitis media revisited.
Pratt-Harrington D.
Ohio University College of Osteopathic Medicine, Athens, USA.
Otitis media is a common disorder that results in numerous visits to the physician each year.
Antimicrobials, antihistamines, steroids, and surgery have all been used to treat otitis
media; however, the literature makes little mention of osteopathic manipulative treatment
in this regard. This article describes a technique that was first described in 1929 by
William Otis Galbreath, DO. By simple mandibular manipulation, the eustachian tube is made
to open and close in a "pumping action" that allows the ear to drain accumulated fluid more
effectively. Physicians can easily teach this procedure to parents for use at home.
Publication Types:
Case Reports
Review
Review, Tutorial
- 146 -
Effects of a structured curriculum in osteopathic manipulative treatment
(OMT) on osteopathic structural examinations and use of OMT for
hospitalized patients.
Shubrook JH Jr, Dooley J.
Firelands Community Hospital, Ohio University College of Osteopathic Medicine, Athens
45701, USA.
Osteopathic manipulative treatment (OMT) is a defining feature of osteopathic medicine;
however, use of OMT by osteopathic physicians is declining. Recent studies reveal that many
osteopathic physicians are abandoning use of OMT as early as medical school. Current
national efforts are aimed at reversing this trend by standardizing osteopathic medical
records and clinical training in OMT. The authors found that a structured clinical curriculum
in OMT taught to house staff significantly increased the percentage of patients who
received osteopathic structural examinations and the percentage of patients who received
OMT as part of their hospital care.
- 147 -
134: J Orthop Sci. 2000;5(4):411-7.
The use of spinal manipulation in the treatment of low back pain: a review
of goals, patient selection, techniques, and risks.
Eck JC, Circolone NJ.
University of Health Sciences, College of Osteopathic Medicine, 1750 Independence
Avenue, Kansas City, MO 64124, USA.
Spinal manipulation is routinely obtained for low back pain by much of the general public, but
there remains a lack of understanding of its rationale and effectiveness in the medical
community. Because of the increasing use of manipulation, it is advantageous for back
specialists to gain a better understanding of these techniques in order to counsel patients
on the associated risks and benefits of manipulation. The purpose of this review is to
present the specific goals of spinal manipulation, with emphasis on proper patient selection,
specific techniques, and associated risks.
Publication Types:
Review
Review, Tutorial
- 148 -
135: Altern Ther Health Med. 2000 Sep;6(5):77-81.
The effectiveness of osteopathic manipulative treatment as complementary
therapy following surgery: a prospective, match-controlled outcome study.
Jarski RW, Loniewski EG, Williams J, Bahu A, Shafinia S, Gibbs K, Muller M.
Complementary Medicine and Wellness Program, Oakland University, Rochester, Mich., USA.
[email protected]
CONTEXT: Osteopathic manipulative treatment has been reported to relieve a variety of
conditions, but no studies have examined the outcome effects of osteopathic manipulative
treatment as a complementary modality for treating musculoskeletal problems during
postoperative recovery. OBJECTIVE: To assess osteopathic manipulative treatment as a
complementary therapy for patients undergoing elective knee or hip arthroplasty. DESIGN:
Prospective, single-blinded, 2-group, match-controlled outcome study. SETTING:
Osteopathic teaching hospital. PATIENTS: Of 166 eligible patients, 38 were assigned to a
treatment group and matched with 38 control subjects. INTERVENTION: The treatment
group received osteopathic manipulative treatment on postoperative days 2 through 5.
MAIN OUTCOME MEASURES: Days to independent negotiation of stairs, distance
ambulated, supplemental intramuscular analgesic use, length of hospital stay, and patients'
perceptions of treatment. RESULTS: Compared to control subjects, the intervention group
negotiated stairs 20% earlier (mean = 4.3 postoperative days, SD = 1.2; control subjects 5.4,
SD = 1.6, P = .006) and ambulated 43% farther on the third postoperative day (mean = 24.3
m, SD = 18.3; controls = 13.9, SD = 14.4, P = .008). The intervention group also required less
analgesia, had shorter hospital stays, and ambulated farther on postoperative days 1, 2, and
4. CONCLUSIONS: Patients receiving osteopathic manipulative treatment in the early
postoperative period negotiated stairs earlier and ambulated greater distances than did
control group patients.
Publication Types:
Clinical Trial
136: Joint Bone Spine. 2000;67(4):272-6.
- 149 -
Cervical spine manipulation and the precautionary principle.
Vautravers P, Maigne JY.
Physical and Rehabilitation Therapy Unit, Hautepierre Hospital, Strasbourg Teaching
Hospitals, France.
Cervical manipulations can cause severe neurologic complications, which are both exceedingly
rare and generally unpredictable. To meet the requirements of the principles of prevention
and precaution, we believe the number of cervical manipulations should be reduced. To this
end, we suggest that five recommendations developed by consensus be followed: unwanted
effects, however minor, of previous manipulation should be looked for routinely and taken as
absolute contraindications to further manipulation; a thorough physical examination,
including a neurological evaluation, should be performed prior to manipulation; all known
contraindications and indications should be followed; manipulation should be performed only
by physicians experienced in this technique; and special caution should be exercised when
performing first-line cervical manipulation.
Publication Types:
Review
Review, Tutorial
- 150 -
Use of a computer-assisted clinical case (CACC) SOAP note exercise to
assess students' application of osteopathic principles and practice.
Chamberlain NR, Yates HA.
Department of Microbiology/Immunology, Kirksville College of Osteopathic Medicine, MO
Osteopathic medical students are future osteopathic physicians, and how they view the
manipulative aspect of patient care will have an effect on the distinctiveness of osteopathic
medicine. To encourage students' application of osteopathic principles and practice, a Webbased computer-assisted clinical case (CACC) was designed, for which students were
required to submit a SOAP (Subjective, Objective, Assessment, Plan) note. Results from the
CACC-SOAP note exercise indicate that the experience engages medical students and can
determine the students' abilities to recognize osteopathic principles in patient care.
- 151 -
139: Eur Spine J. 2000 Jun;9(3):202-7.
Single-blind randomised controlled trial of chemonucleolysis and
manipulation in the treatment of symptomatic lumbar disc herniation.
Burton AK, Tillotson KM, Cleary J.
Spinal Research Unit, University of Huddersfield, UK.
This single-blind randomised clinical trial compared osteopathic manipulative treatment with
chemonucleolysis (used as a control of known efficacy) for symptomatic lumbar disc
herniation. Forty patients with sciatica due to this diagnosis (confirmed by imaging) were
treated either by chemonucleolysis or manipulation. Outcomes (leg pain, back pain and selfreported disability) were measured at 2 weeks, 6 weeks and 12 months. The mean values for
all outcomes improved in both groups. By 12 months, there was no statistically significant
difference in outcome between the treatments, but manipulation produced a statistically
significant greater improvement for back pain and disability in the first few weeks. A
similar number from both groups required additional orthopaedic intervention; there were
no serious complications. Crude cost analysis suggested an overall financial advantage from
manipulation. Because osteopathic manipulation produced a 12-month outcome that was
equivalent to chemonucleolysis, it can be considered as an option for the treatment of
symptomatic lumbar disc herniation, at least in the absence of clear indications for surgery.
Further study into the value of manipulation at a more acute stage is warranted.
Publication Types:
Clinical Trial
- 152 -
141: J Am Osteopath Assoc. 2000 May;100(5):301-4, 309.
Increasing osteopathic manipulative treatment skills and confidence through
mastery learning.
Mann DD, Eland DC, Patriquin DA, Johnson DF.
Department of Social Medicine, Ohio University College of Osteopathic Medicine, Athens,
USA.
Several recent studies document the declining use of osteopathic manipulative treatment
(OMT) in clinical practice. In this article, the authors contend that developing new teaching
materials based on the mastery learning approach can augment time-tested methods of
teaching OMT and help to stop or reverse this decline. The Spencer technique for shoulder
manipulation is used to demonstrate the development and evaluation of OMT mastery
learning materials. These materials could be developed as part of a progressive teaching
sequence requiring increasing diagnostic acumen, palpatory skill, and therapeutic subtlety.
Such a program could be used throughout osteopathic medical training and for continuing
medical education to increase skills and confidence in the use of OMT.
- 153 -
142: J Am Osteopath Assoc. 2000 May;100(5):285-6, 289-98.
Progressive inhibition of neuromuscular structures (PINS) technique.
Dowling DJ.
Department of Osteopathic Manipulative Medicine, New York College of Osteopathic
Medicine, New York Institute of Technology, Old Westbury 11568, USA.
Progressive inhibition of neuromuscular structures (PINS) is a technique that can be
included in the osteopathic manipulative treatment repertoire. It relies on knowledge of
anatomy and neuromuscular physiologic features as well as on standard forms of osteopathic
palpatory diagnosis and treatment. It is a variant of the inhibition technique that has been
taught as an osteopathic manipulative technique for many years, and it bears some
resemblance to other manual medicine techniques. The emphasis of the approach is the
determination of the alteration of the tissues due to dysfunction, delivering treatment
based on palpatory evaluation and patient feedback. Two related points are initially chosen,
followed by a progression from one to the other. Relationships to similar techniques are also
discussed. Theoretical as well as selected practical applications are presented.
Publication Types:
Case Reports
- 154 -
143: Complement Ther Med. 2000 Mar;8(1):8-14.
Communication between general and manipulative practitioners: a survey.
Breen A, Carrington M, Collier R, Vogel S.
Institute for Musculoskeletal Research and Clinical Implementation, AECC, Bournemouth,
UK.
A survey of general practitioners (GPs) in the south of England was undertaken to
determine their understanding and communication needs in referring patients to
practitioners of manipulation. Eighty-six out of 309 GPs replied to a postal questionnaire
(28% response). The results suggest that, while routine communication is important for
improving understanding, GPs appear to have a preference for disciplines of which they have
personal experience. The majority of responders favoured receiving a report on one side of
A5 paper when the patient completes treatment. This should contain the nature of
treatment and advice given and an indication of its outcome. Those who desired an initial
report wanted it to contain a summary of the nature of the problem, a brief history, a
summary of relevant findings from the examination, any investigations and a prognosis. Many
GPs commented that they were more comfortable in referring to physiotherapists because
they felt they had a better understanding of the treatment involved. Furthermore,
chiropractic and osteopathic terminologies were reported to be confusing more often than
physiotherapy terminology. Bearing in mind the potential bias in responses due to its
geographical limitations and low response rate, this study provides useful indicators for
manipulative and GPs who wish to work more closely together.
- 155 -
144: J Clin Epidemiol. 2000 May;53(5):485-9.
Location bias in controlled clinical trials of complementary/alternative
therapies.
Pittler MH, Abbot NC, Harkness EF, Ernst E.
Department of Complementary Medicine, School of Postgraduate Medicine and Health
Sciences, University of Exeter, Exeter, United Kingdom. [email protected]
To systematically investigate location bias of controlled clinical trials in
complementary/alternative medicine (CAM). Methods: Literature searches were performed
to identify systematic reviews and meta-analyses, which were used to retrieve controlled
clinical trials. Trials were categorised by whether they appeared in CAM-journals or
mainstream medical (MM)-journals, and by their direction of outcome, methodological
quality, and sample size. Results: 351 trials were analysed. A predominance of positive trials
was seen in non-impact factor CAM- and MM-journals, (58) / (78) (74%) and (76) / (102)
(75%) respectively, and also in low impact factor CAM- and MM-journals. In high impact
factor MM-journals there were equal numbers of positive and negative trials, a distribution
significantly (P < 0.05) different from all other journal categories. Quality scores were
significantly lower for positive than negative trials in non-impact factor CAM-journals (P <
0.02). A similar trend was seen in low-impact factor CAM journals, but not to a level of
significance (P = 0.06). There were no significant differences between quality scores of
positive and negative trials published in MM-journals, except for high impact factor
journals, in which positive trials had significantly lower scores than negative trials (P =
0.048). There was no difference between positive and negative trials in any category in
terms of sample size. Conclusion: More positive than negative trials of complementary
therapies are published, except in high-impact factor MM-journals. In non-impact factor
CAM-journals positive studies were of poorer methodological quality than the corresponding
negative studies. This was not the case in MM-journals which published on a wider range of
therapies, except in those with high impact factors. Thus location of trials in terms of
journal type and impact factor should be taken into account when the literature on
complementary therapies is being examined.
- 156 -
145: J Am Osteopath Assoc. 2000 Apr;100(4):218-24, 227.
National study of the impact of managed care on osteopathic physicians.
Horan J.
Department of State and Socioeconomic Affairs, American Osteopathic Association,
Chicago, Ill. 60611, USA. [email protected]
The study reported here was designed to provide insight into the impact managed care has
had on osteopathic physicians' ability to practice medicine, as well as data to substantiate
the prevalence of the specific problems encountered by the 40,000 osteopathic physicians
in the United States. New data on the extent to which osteopathic physicians use
osteopathic manipulative treatment was also obtained, as a review of the literature revealed
only two previous surveys on the use of osteopathic manipulative treatment. The American
Osteopathic Association hired an independent research company to conduct the survey.
- 157 -
Western States Chiropractic College, 2900 NE 132nd Avenue, Portland, Oregon 972303099, USA. [email protected]
BACKGROUND: A variety of manual therapies with similar postulated biologic mechanisms
of action are commonly used to treat patients with asthma. Manual therapy practitioners
are also varied, including physiotherapists, respiratory therapists, chiropractic and
osteopathic physicians. A systematic review across disciplines is warranted. OBJECTIVES:
To evaluate the evidence for the effects of manual therapies for treatment of patients
with bronchial asthma. SEARCH STRATEGY: Trials were searched in computerized general
(EMBASE, CINAHL and MEDLINE) and specialized databases (Cochrane Complementary
Medicine Field, Cochrane Rehabilitation Field, ICL, and MANTIS). In addition,
bibliographies from included studies were assessed, and authors of known studies were
contacted for additional information about published and unpublished trials. Date of most
recent search: December 1998. SELECTION CRITERIA: Trials were included if they: (1)
were randomised; (2) included asthmatic children or adults; (3) examined one or more types
of manual therapy; and (4) included clinical outcomes. DATA COLLECTION AND
ANALYSIS: All three reviewers independently extracted data and assessed trial quality
using a standard form. MAIN RESULTS: From an initial 316 unique citations, 48 full text
articles were retrieved and evaluated, which resulted in nine citations to five RCTs (290
patients) suitable for inclusion. Trials could not be pooled statistically because studies that
addressed similar interventions used disparate patient groups or outcomes. The
neither trial found significant differences between chiropractic spinal manipulation and a
sham manoeuvre on any of the outcomes measured. Quality of the remaining three trials was
poor. One small trial compared massage therapy with a relaxation control group and found
significant differences in many of the lung function measures obtained. However, this trial
had poor reporting characteristics and the data have yet to be confirmed. One small trial
compared chest physiotherapy to placebo and one small trial compared footzone therapy to
a no treatment control. Neither trial found differences in lung function between groups.
REVIEWER'S CONCLUSIONS: There is insufficient evidence to support the use of manual
therapies for patients with asthma. There is a need to conduct adequately-sized RCTs that
examine the effects of manual therapies on clinically relevant outcomes. Future trials
should maintain observer blinding for outcome assessments, and report on the costs of care
and adverse events. Currently, there is insufficient evidence to support or refute the use of
manual therapy for patients with asthma.
Publication Types:
Review
- 158 -
Comment in:
J Am Osteopath Assoc. 2000 Jun;100(6):344.
Refractory torticollis after a fall.
Kaprow MG, Sandhouse M.
Nova Southeastern University, College of Osteopathic Medicine, Osteopathic Treatment
Center, Ft Lauderdale, Fla. 33328, USA.
Though multiple medical and psychiatric causes of torticollis have been described, cervical
dystonias resulting from distant somatic dysfunctions have not. This article describes the
treatment of a 62-year-old woman in whom refractory retrotorticollis of surmised pelvic
etiology developed after a fall. Structurally, cervical dystonias have been addressed as
problems that originate in the head and neck, but this limited view of the musculoskeletal
component of torticollis may prevent physicians from directing osteopathic manipulative
treatment to the underlying problem.
Publication Types:
Case Reports
- 159 -
156: Rheum Dis Clin North Am. 2000 Feb;26(1):83-96, ix.
Fiechtner JJ, Brodeur RR.
Division of Rheumatology, Michigan State University, Colleges of Osteopathic and Human
Medicine, East Lansing, USA.
Manipulation is practiced primarily by chiropractors and osteopaths and is one of the most
commonly utilized alternative treatments for rheumatic diseases. Low back pain and neck
pain are the most frequently treated disorders, but manipulation is also used to treat a
broad range of rheumatic diseases. Manipulation has been shown to decrease joint pain and
normalize function. The mechanisms of action, however, are not well understood. Current
theories propose an imbalance of muscle activity is a source of pain that manipulation can
relieve through reflexive actions. Such muscle imbalances would exacerbate rheumatic and
arthritic conditions, suggesting that manipulation may be an important therapy that is
appropriate for early conservative care as part of a comprehensive treatment program.
Publication Types:
Review
Review, Tutorial
- 160 -
Standardized medical record: a new outpatient osteopathic SOAP note
form: validation of a standardized office form against physician's progress
notes.
Sleszynski SL, Glonek T, Kuchera WA.
Chicago College of Osteopathic Medicine, USA.
The accuracy and efficiency of recording information on a one-page standardized
Outpatient Osteopathic SOAP Note Form (SNF) was compared with that obtained using the
physician's progress notes (PPN). Use of the SNF in lieu of the PPN would assure the
physician that proper clinical data were recorded to ensure proof of need and care in any
instances of refused reimbursement. Moreover, standardized SNFs could be used to
document and analyze present treatment protocols, enabling medical advances. Ten
osteopathic physicians, who were skilled in osteopathic manipulative treatment (OMT),
enrolled 300 patients. Initial and follow-up examinations totaled 959 visits (statistical
cases); 76 statistical variables were compared. Essentially all information recorded in the
PPN was recorded on the SNF. A significant difference (P < .05) was found between the PPN
data set and the SNF data set in all but 17 of the 76 variables. Greater content of
information almost always was found with the SNF data set. In addition, the SNF contained
information not found in the PPN, most notably the severity and response to treatment of
detected somatic dysfunctions. Participating physicians stated that the SNF takes about
the same amount of time to fill in as the PPN. This makes the SNF a practical instrument
for accurately and efficiently obtaining patient data in all physicians' offices. The validation
study conducted demonstrated that the Outpatient Osteopathic SOAP Note Form easily
and accurately reflected information recorded in the PPN and that data recorded may be
used by physicians in their individual practices or for the conduct of osteopathic research.
- 161 -
162: Arch Fam Med. 1999 Nov-Dec;8(6):477-84.
An overview of osteopathic medicine.
Lesho EP.
Internal Medicine Service, US Army Medical Activity, Heidelberg, Germany.
Despite an initial lack of acceptance by mainstream medicine, and amidst projections of a
serious oversupply of physicians, the osteopathic profession continues to grow, successfully
competing for shrinking health care resources and attracting the attention of insurers and
those in managed care. However, a recent telephone survey of 800 health maintenance
organization beneficiaries suggested that the public is not yet familiar with osteopathic
medicine. The history, philosophy, and current status of the osteopathic profession are
presented, along with theories of the physiologic basis of and supporting evidence for
palpatory diagnosis and manipulative therapy.
Publication Types:
Historical Article
Review
Review, Tutorial
- 162 -
164: N Engl J Med. 1999 Nov 4;341(19):1426-31.
Comment in:
N Engl J Med. 1999 Nov 4;341(19):1465-8.
N Engl J Med. 2000 Mar 16;342(11):817-8; author reply 819-20.
N Engl J Med. 2000 Mar 16;342(11):817; author reply 819-20.
A comparison of osteopathic spinal manipulation with standard care for
patients with low back pain.
Andersson GB, Lucente T, Davis AM, Kappler RE, Lipton JA, Leurgans S.
Department of Orthopedic Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago,
IL 60612, USA. [email protected]
BACKGROUND: The effect of osteopathic manual therapy (i.e., spinal manipulation) in
patients with chronic and subchronic back pain is largely unknown, and its use in such
patients is controversial. Nevertheless, manual therapy is a frequently used method of
treatment in this group of patients. METHODS: We performed a randomized, controlled
trial that involved patients who had had back pain for at least three weeks but less than six
months. We screened 1193 patients; 178 were found to be eligible and were randomly
assigned to treatment groups; 23 of these patients subsequently dropped out of the study.
The patients were treated either with one or more standard medical therapies (72 patients)
or with osteopathic manual therapy (83 patients). We used a variety of outcome measures,
including scores on the Roland-Morris and Oswestry questionnaires, a visual-analogue pain
scale, and measurements of range of motion and straight-leg raising, to assess the results
of treatment over a 12-week period. RESULTS: Patients in both groups improved during the
12 weeks. There was no statistically significant difference between the two groups in any of
the primary outcome measures. The osteopathic-treatment group required significantly less
medication (analgesics, antiinflammatory agents, and muscle relaxants) (P< 0.001) and used
less physical therapy (0.2 percent vs. 2.6 percent, P<0.05). More than 90 percent of the
patients in both groups were satisfied with their care. CONCLUSIONS: Osteopathic manual
care and standard medical care had similar clinical results in patients with subacute low
back pain. However, the use of medication was greater with standard care.
Publication Types:
Clinical Trial
165: J Manipulative Physiol Ther. 1999 Jun;22(5):280-91.
- 163 -
Comparison of work and time estimates by chiropractic physicians with
those of medical and osteopathic providers.
Hess JA, Mootz RD.
University of Iowa, Department of Biomedical Engineering, Iowa City, USA.
[email protected]
BACKGROUND: Resource-based relative value scales (RBRVS) have become a standard
method for identifying costs and determining reimbursement for physician services.
Development of RBRVS systems and methods are reviewed, and the RBRVS concept of
physician "work" is defined. OBJECTIVE: Results of work and time inputs from chiropractic
physicians are compared with those reported by osteopathic and medical specialties. Last,
implications for reimbursement of chiropractic fee services are discussed. METHODS:
Total work, intraservice work, and time inputs for clinical vignettes reported by
chiropractic, osteopathic, and medical physicians are compared. Data for chiropractic work
and time reports were drawn from a national random sample of chiropractors conducted as
part of a 1997 workers' compensation chiropractic fee schedule development project.
Medical and osteopathic inputs were drawn from RBRVS research conducted at Harvard
University under a federal contract reported in 1990. Both data sets used the same or
similar clinical vignettes and similar methods. Comparisons of work and time inputs are made
for clinical vignettes to assess whether work reported by chiropractors is of similar
magnitude and variability as work reported by other specialties. RESULTS: Chiropractic
inputs for vignettes related to evaluation and management services are similar to those
reported by medical specialists and osteopathic physicians. The range of variation between
chiropractic work input and other specialties is of similar magnitude to that within other
specialties. Chiropractors report greater work input for radiologic interpretation and lower
work input for manipulation services. CONCLUSIONS: Chiropractors seem to perform
similar total "work" for evaluation and management services as other specialties. No basis
exists for excluding chiropractors from using evaluation and management codes for
reimbursement purposes on grounds of dissimilar physician time or work estimates. Greater
work input by chiropractors in radiology interpretation may be related to a greater
importance placed on findings in care planning. Consistently higher reports for osteopathic
work input on manipulation are likely attributable to differences in reference vignettes used
in the respective populations. Research with a common reference vignette used for
manipulation providers is recommended, as is development of a single generic approach to
coding for manipulation services.
- 164 -
Comment in:
J Am Osteopath Assoc. 1999 Oct;99(10):506.
J Am Osteopath Assoc. 1999 Oct;99(10):506, 508-9.
An osteopathic approach to asthma.
Rowane WA, Rowane MP.
Department of Family Medicine/Case Western Reserve University, Cleveland, Ohio 441064950, USA.
Asthma has become a serious challenge to clinical medicine today, with an increase in
incidence, morbidity, and mortality over the past two decades. Asthma continues to be a
problem despite increased knowledge of the pathophysiology of asthma coupled with the
development of a variety of new and innovative medications that can be used to treat
asthma. Five areas involving asthma management are reviewed and involve a failure to do the
following: (1) identify disease instability and progression; (2) adopt an optimal pharmacologic
treatment plan; (3) identify and help the patient avoid environmental triggers; (4) evaluate
and treat certain disruptive psychodynamic issues; and (5) use essential non-pharmacologic
modes of therapy such as osteopathic manipulation, nutritional considerations, physical
training, and controlled breathing techniques that may help to favorably modify the asthma
disease process.
Publication Types:
Review
Review, Tutorial
- 165 -
170: J Am Osteopath Assoc. 1999 Mar;99(3):143-6, 151-2.
Comment in:
J Am Osteopath Assoc. 1999 Mar;99(3):140.
Adjunctive osteopathic manipulative treatment in the elderly hospitalized
with pneumonia: a pilot study.
Noll DR, Shores J, Bryman PN, Masterson EV.
Department of Internal Medicine, University of North Texas Health Science Center at Fort
Worth, USA.
To evaluate the benefit of osteopathic manipulative treatment in the elderly with
pneumonia, the authors recruited 21 individuals older than 60 years who were hospitalized
with acute pneumonia. Eleven patients were randomly assigned to the treatment group and
ten to the control group. The treatment group received specific osteopathic manipulative
treatment for somatic dysfunction and a standardized treatment protocol. Both groups
received conventional therapy, and the attending physician was blind to group assignments.
No significant difference existed between groups for age, sex, or severity of illness.
Although the mean duration of leukocytosis, intravenous antibiotic treatment, and length of
stay were shorter for the treatment group, these measures did not reach statistical
significance. However, the mean duration of oral antibiotic use did reach statistical
significance at 3.1 days for the treatment group and 0.8 day for the control group.
Osteopathic manipulative treatment may reduce antibiotic use and length of stay; however,
a larger study is needed to clarify this outcome.
Publication Types:
Clinical Trial
- 166 -
Comment in:
J Am Osteopath Assoc. 1999 Feb;99(2):75.
Standard osteopathic manipulative treatment acutely improves gait
performance in patients with Parkinson's disease.
Wells MR, Giantinoto S, D'Agate D, Areman RD, Fazzini EA, Dowling D, Bosak A.
Department of Biomechanics and Bioengineering, New York College of Osteopathic Medicine,
New York Institute of Technology, Old Westbury 11568-8000, USA.
Patients with Parkinson's disease exhibit a variety of motor deficits which can ultimately
result in complete disability. The primary objective of this study was to quantitatively
evaluate the effect of osteopathic manipulative treatment (OMT) on the gait of patients
with Parkinson's disease. Ten patients with idiopathic Parkinson's disease and a group of
eight age-matched normal control subjects were subjected to an analysis of gait before and
after a single session of an OMT protocol. A separate group of 10 patients with Parkinson's
disease was given a sham-control procedure and tested in the same manner. In the treated
group of patients with Parkinson's disease, statistically significant increases were observed
in stride length, cadence, and the maximum velocities of upper and lower extremities after
treatment. There were no significant differences observed in the control groups. The data
demonstrate that a single session of an OMT protocol has an immediate impact on
Parkinsonian gait. Osteopathic manipulation may be an effective physical treatment method
in the management of movement deficits in patients with Parkinson's disease.
- 167 -
Comment in:
J Am Osteopath Assoc. 1998 Dec;98(12):662.
Manipulative treatment of carpal tunnel syndrome: biomechanical and
osteopathic intervention to increase the length of the transverse carpal
ligament.
Sucher BM, Hinrichs RN.
Center For Carpal Tunnel Studies, Paradise Valley, AZ 85253, USA. [email protected]
To quantify the amount of transverse carpal ligament (TCL) elongation in response to
osteopathic manipulation or sustained load bearing (or both), a study involving seven cadaver
limbs was conducted. Distances from the trapezium to the hamate (distance A) and from
the scaphoid to the pisiform (distance B) were measured in five mounted cadaver limbs
during and after the limbs bore the weight (2 newtons [N] to 4 N) for 2 several-hour
periods. A several-hour period occurred between the weight bearing to assess recoil.
Distances A and B were measured before and after the limbs were manipulated, according
to previously described techniques, as well as with a new maneuver, termed the "guywire"
technique. Two dissected limbs also were subjected to further weight bearing, this time
increased to 8 N. Greater weight loads produced greater lengthening of the TCL, and recoil
after removal of weight loads was slower than recoil after manipulation. Manipulation was
more effective than weight loading for increasing distance A (distal canal), but weight
loading generally was more effective than manipulation for increasing distance B (proximal
canal). The guywire manipulation combined with direct transverse extension appeared to
have the greatest impact on lengthening the TCL distally. These results show promise for
the effective use of manipulation and load bearing for TCL elongation and nonsurgical relief
of pressure on the median nerve in patients with carpal tunnel syndrome.
- 168 -
176: Rev Med Brux. 1998 Sep;19(4):A283-9.
[Osteopathy and chiropractic]
[Article in French]
Klein P.
Institut Superieur d'Education Physique et de Kinesitherapie, Unite de Recherche en
Therapies Manuelles, U.L.B.
Osteopathy and chiropractic represent two challenging domains with a specific degree of
multiplicity and complexity. This makes a complete appraisal difficult and impossible to
appreciate in one single analysis. These disciplines exist since more than one century. An
hermeneutic approach permits to understand their genesis but indicates also the nonsense
of trying to transfer and apply earliest principles nowadays. It seems that most, but not all,
practicing clinicians take into account recent developments in physiology, biomechanics and
pathophysiology. Clinical studies and especially their meta-analyses on base of precise
criteria permit to clarify the indications, therapeutic efficiency as well as socio-economic
advantages. The meta-analyses point also at the poor quality of most clinical studies even if
in the last years an improvement can be noted. Fundamental studies exist in both domains
revealing interesting information that have permitted to reject several preconceived ideas
and to clarifs others. Research topics as the morphology of the intervertebral disk before
and after application of a manipulative technique are discussed. Results of experimental
determination of global and segmental amplitudes in the cervical and in the lumbar spine
during a manipulation in healthy subjects are reported. Finally the necessity but also the
difficulties inherent to research studies in osteopathy and in chiropractic will be discussed.
Publication Types:
Review
Review, Tutorial
- 169 -
Erratum in:
J Am Osteopath Assoc 1998 Jul;98(7):408.
Effect of osteopathic manipulative treatment of length of stay for
pancreatitis: a randomized pilot study.
Radjieski JM, Lumley MA, Cantieri MS.
Michigan Hospital and Medical Center, Detroit, USA.
There have been few randomized, controlled studies of the effects of osteopathic
manipulative treatment (OMT). In this outcomes research study, the authors randomly
assigned patients with pancreatitis to receive standard care plus daily OMT for the
duration of their hospitalization (n = 6) or to receive only standard care (n = 8). Osteopathic
manipulative treatment involved 10 to 20 minutes daily of a standardized protocol, using
myofascial release, soft tissue, and strain-counterstrain techniques. Attending physicians
were blinded as to group assignment. Results indicated that patients who received OMT
averaged significantly fewer days in the hospital before discharge (mean reduction, 3.5
days) than control subjects, although there were no significant differences in time to food
intake or in use of pain medications. These findings suggest the possible benefit of OMT in
reducing length of stay for patients with pancreatitis.
Publication Types:
Clinical Trial
- 170 -
Communication for osteopathic manipulative treatment (OMT): the language
of lived experience in OMT pedagogy.
Gaines E, Chila AG.
West Virginia School of Osteopathic Medicine, Lewisburg, USA.
Questions about the scientific merits of osteopathic manipulative treatment (OMT) and the
search for consistent, effective teaching methods for OMT persist in the discourse of the
osteopathic medical curriculum. Although grounded on scientific principles, the philosophy
of osteopathic medicine in the words of Andrew Taylor Still, William G. Sutherland, and
other prominent osteopathic medical scholars advances concepts in metaphoric language
that may seem obscure and dated to many of today's students. Evidence in the literature of
osteopathic medicine supports the congruence of phenomenology with the philosophy and
methods used to teach OMT. Phenomenology offers an alternative paradigm to address
questions of scientific merit and could provide a consistent language to a rigorous, scientific
approach to communication for OMT pedagogy. The authors propose a solution for the
tactical adaptation of a communication strategy based on an interpretation of osteopathic
medical methodology and phenomenology.
- 171 -
Effect of lymphatic and splenic pump techniques on the antibody response
to hepatitis B vaccine: a pilot study.
Jackson KM, Steele TF, Dugan EP, Kukulka G, Blue W, Roberts A.
Department of Structural Biology, West Virginia School of Osteopathic Medicine, Lewisburg
Osteopathic manipulative treatment (OMT) facilitates the movement of lymphatic fluid and
may enhance the immunologic response to infection or injected antigen. In this investigation,
two groups of volunteers were vaccinated with recombinant hepatitis B vaccine, given at 0,
5, and 25 weeks. The experimental group (n = 20) received OMT (lymphatic and splenic
pump) three times per week for 2 weeks after each vaccination. Control subjects (n = 19)
received vaccine but no OMT. Resultant serum antibody levels were measured by enzyme
immunoassay. Fifty percent of subjects in the treatment group achieved protective
antibody titers (> or = 10 mIU/mL) on the 13th week with an average titer of 374 mIU/mL.
Only 16% of the control subjects had positive antibody responses, with average titers of 96
mIU/mL. At all time points from week 6 on, the average anti-hepatitis B titer was higher in
the treatment group than in the control group. These data suggest an enhanced immunologic
response in subjects who received OMT.
Publication Types:
Clinical Trial
- 172 -
181: J Orthop Sports Phys Ther. 1998 Mar;27(3):213-8.
Craniosacral rhythm: reliability and relationships with cardiac and
respiratory rates.
Hanten WP, Dawson DD, Iwata M, Seiden M, Whitten FG, Zink T.
Texas Woman's University, Houston 77030, USA.
Craniosacral rhythm (CSR) has long been the subject of debate, both over its existence and
its use as a therapeutic tool in evaluation and treatment. Origins of this rhythm are
unknown, and palpatory findings lack scientific support. The purpose of this study was to
determine the intra- and inter-examiner reliabilities of the palpation of the rate of the CSR
and the relationship between the rate of the CSR and the heart or respiratory rates of
subjects and examiners. The rates of the CSR of 40 healthy adults were palpated twice by
each of two examiners. The heart and respiratory rates of the examiners and the subjects
were recorded while the rates of the subjects' CSR were palpated by the examiners.
Intraclass correlation coefficients were calculated to determine the intra- and interexaminer reliabilities of the palpation. Two multiple regression analyses, one for each
examiner, were conducted to analyze the relationships between the rate of the CSR and the
heart and respiratory rates of the subjects and the examiners. The intraexaminer
reliability coefficients were 0.78 for examiner A and 0.83 for examiner B, and the
interexaminer reliability coefficient was 0.22. The result of the multiple regression analysis
for examiner A was R = 0.46 and adjusted R2 = 0.12 (p = 0.078) and for examiner B was R =
0.63 and adjusted R2 = 0.32 (p = 0.001). The highest bivariate correlation was found
between the CSR and the subject's heart rate (r = 0.30) for examiner A and between the
CSR and the examiner's heart rate (r = 0.42) for examiner B. The results indicated that a
single examiner may be able to palpate the rate of the CSR consistently, if that is what we
truly measured. It is possible that the perception of CSR is illusory. The rate of the CSR
palpated by two examiners is not consistent. The results of the regression analysis of one
examiner offered no validation to those of the other. It appears that a subject's CSR is not
related to the heart or respiratory rates of the subject or the examiner.
Publication Types:
Clinical Trial
- 173 -
Comment in:
Transient basophilia following the application of lymphatic pump techniques:
a pilot study.
Mesina J, Hampton D, Evans R, Ziegler T, Mikeska C, Thomas K, Ferretti J.
Lake Erie College of Osteopathic Medicine (LECOM), PA 16509-1025, USA.
Lymphatic pump techniques (LPTs) consisting of pectoral traction and splenic pump were
performed on seven male medical students following blood collection for baseline value
determinations. Blood was collected from each subject at 15, 30, 60, 120, and 240 minutes
post-LPT. The samples were analyzed for serum chemistry and complete blood cell count. All
subjects showed an increase in the percentage of basophils. There was variation in the time
points for the initial occurrence of basophilia among the subjects. A separate cohort of five
male medical students served as control subjects. The control group did not receive LPTs.
Blood samples collected at the same time points as the experimental group did not show the
basophilia.
- 174 -
185: Br J Gen Pract. 1997 Oct;47(423):653-5.
Managing back pain in general practice--is osteopathy the new paradigm?
Williams N.
Health Centre, Llanfairfechan, North Wales.
Back pain is a common problem in general practice, and is of enormous economic importance.
A recent report urges general practitioners (GPs) to refer early for manual therapies, such
as osteopathy. The key concept to understanding osteopathic principles is somatic
dysfunction. This is a disorder of function, rather than pathology, of the musculoskeletal
and related systems. Its characteristic features are asymmetry of anatomical landmarks,
asymmetry of joint movement, tissue texture changes, and tenderness. The scientific basis
of the tissue texture changes and tenderness can be explained in terms of the 'facilitated
segment', but the cause of movement asymmetry remains elusive. Randomized controlled
trials provide some support for the use of osteopathic treatment in acute low back pain. It
is proposed that somatic dysfunction is the new paradigm for non-specific back pain.
Publication Types:
Review
Review, Tutorial
- 175 -
186: J Manipulative Physiol Ther. 1998 Jan;21(1):14-8.
A pilot study of the purchase of manipulation services for acute low back
pain in the United Kingdom.
Scheurmier N, Breen AC.
Wiltshire Health Authority, England.
BACKGROUND: The purchasing arrangements for acute low back pain recommended to UK
health ministers by the Clinical Standards Advisory Group (CSAG) in 1994 as a cost-neutral
way of reducing back pain disability have not been tested in practice. OBJECTIVE: To test
the CSAG's recommendations in primary care, studying their cost implications and
identifying the professional relationships between general practitioners (GPs) and
manipulation practitioners. DESIGN: Retrospective and prospective observational study
with cohorts balanced for similar features in terms of age, gender, diagnosis, severity and
work loss at entry point. PARTICIPANTS: One hundred and ninety-four retrospective
patients with acute low back pain presenting to 11 GP practices between July and October
1995. Three hundred and forty-four prospective patients with the complaint presenting to
the same practices between November 1995 and March 1996. Referrals to local
chiropractic, osteopathic and manipulation physiotherapy practices as well as to usual
secondary care services. OUTCOME MEASURES: Waiting time for first attendances,
sickness certification, number of consultations, drug use and costs, recovery time, x-ray
utilization, cost of care. MAIN RESULTS: Substantial shift of referrals to manipulation
practitioners under the scheme. Prospective patients had fewer referrals to secondary care
than retrospective patients, fewer GP consultations, less drug use, fewer certified sickness
days. Prospective patients had shorter waiting times to be seen by manipulating
physiotherapists. Chiropractors used X-rays more often than other practitioners.
Demonstrable savings in sickness incapacity benefits were evident by following CSAG
recommendations. CONCLUSION: GPs complied with CSAG management recommendations
when funding of manipulation services was made available. Implementation was associated
with better outcomes generally. A fully funded study including chronic back patients is
justified.
190: J Am Osteopath Assoc. 1997 Jun;97(6):347-52, 355.
- 176 -
Chest pain and the role of somatic dysfunction.
Wax CM, Abend DS, Pearson PH.
Allegheny University Hospital-City Avenue Hospital, (Philadelphia, Pa)., USA.
[email protected]
The symptom of chest pain may be a result or manifestation of somatic dysfunction of the
musculoskeletal system. Chest pain is a common chief complaint among patients in a family
practice office or in the emergency room. Various intrathoracic and extrathoracic factors
may be responsible. The authors describe their experience with one patient in whom
osteopathic manipulative treatment was used along with accepted medical tests and therapy
to diagnose and treat this patient. If chest pain is effectively diagnosed and promptly
treated, OMT can provide the most thorough, cost-effective, and satisfying care available.
Publication Types:
Case Reports
- 177 -
Osteopathic medical considerations of reflex sympathetic dystrophy.
Nelson KE.
Division of Osteopathic Manipulative Medicine, Chicago College of Osteopathic Medicine,
Downers Grove, IL 60515, USA.
Review of current medical literature reveals little understanding of the physiology
underlying the complex signs and symptoms that accompany reflex sympathetic dystrophy
(RSD). The author surveyed the osteopathic medical literature and found a significant body
of research documenting the physiology of somatic dysfunction. The manifestations of
upper thoracic somatic dysfunction are strikingly similar to those of RSD and may offer
insight into its heretofore unexplained physiology of this disorder.
Publication Types:
Review
Review, Tutorial
- 178 -
Repositioning maneuver for benign paroxysmal positional vertigo (BPPV).
Brooks JG, Abidin MR.
With vertigo, the symptom of unsteadiness is a common presenting complaint and the
etiology protean. However, the specific subset of this patient population with benign
paroxysmal positional vertigo (BPPV) is more defined. Cupololithiasis and canalithiasis are
perhaps the best known and best described pathologic conditions resulting in vertigo. This
condition occurs when otoconia from the utricle are displaced into the Posterior
semicircular canal-cupula. The abnormal position of the otoconia often results in a
pathological condition. The location of displacement is most often in the posterior
semicircular canal. A better understanding of the etiology of BPPV has led to a simple and
effective particle repositioning maneuver that allows the practitioner to alleviate vertigo
symptoms for most patients using a simple manipulation.
Publication Types:
Case Reports
Review
Review, Tutorial
- 179 -
195: J Am Osteopath Assoc. 1997 Apr;97(4):207-14.
Comment in:
Establishment of behavioral parameters for the evaluation of osteopathic
treatment principles in a rat model of arthritis.
Hallas B, Lehman S, Bosak A, Tierney S, Galler R, Jacovina P, Scandalis TA, Wells M.
New York College of Osteopathic Medicine of New York Institute of Technology, Old
Westbury, NY 11568-8000, USA.
Unilateral arthritis was produced in rats by use of methylated bovine serum albumin in a
model of antigen-induced arthritis. The progression of arthritis was measured by
computerized motion analysis, bilateral joint circumference, voluntary extension force of
the hindlegs, and length of ankle extension. Animals with induced arthritis were assigned to
treated and untreated groups on the basis of approximately equal deficits by the
parameters measured. A third group of rats, which did not have arthritis induced and
received no treatment, served to establish mean normal parameters. Modified techniques of
muscle energy, passive movement of the ankle and knee, and passive myofascial stretch were
applied to the animals, and the animals were exercised in a mechanized exercise wheel.
Parameters associated with gait were examined by computerized motion analysis of walking.
Animals treated with manipulation and exercise improved significantly relative to untreated
animals with antigen-induced arthritis in vertical ankle lift, ankle-based and foot-based
stride lengths, knee circumference, and normalized extension of the ankle. The results
demonstrate that the parameters identified can be used to detect functional deficits and
significant improvement from those deficits can be derived from a nonpharmacologic
treatment paradigm that includes osteopathic manipulation and exercise in an animal model
of arthritis. These parameters may be useful in the identification of the relative benefits
of independent treatment variables including frequency of osteopathic manipulation and
exercise and the relative benefits of each in this model. Also, they may elucidate how these
treatments produce their beneficial effects clinically.
- 180 -
Comment in:
Osteopathic manipulative treatment: student attitudes before and after
intensive clinical exposure.
Magnus WW, Gamber RG.
Department of Manipulative Medicine, University of North Texas Health Science Center at
Fort Worth, USA.
It is widely known that family practice osteopathic physicians actively use osteopathic
manipulative treatment (OMT) as a part of their everyday practices, but many DOs in other
specialty areas fail to use OMT at all. Physicians who use this modality often limit its use to
musculoskeletal complaints. This pattern likely begins during undergraduate training at the
time that OMT is taught. To warm student attitudes to OMT and provide a more integrated
OMT training background, the University of North Texas Health Science Center at Fort
Worth/Texas College of Osteopathic Medicine has added to the clinical curriculum a
required 1-month rotation in manipulative medicine. With the rotation in place for a full
academic year, it was important to determine the efficacy of the rotation curriculum. This
assessment has been accomplished using a specialized protocol designed to gauge student
attitudes and opinions regarding OMT, osteopathic medicine, and their own OMT skills.
- 181 -
Erratum in:
J Am Osteopath Assoc 1997 Apr;97(4):202.
Comment in:
Variables influencing the use of osteopathic manipulative treatment in
family practice.
Johnson SM, Kurtz ME, Kurtz JC.
Osteopathic Medicine, East Lansing 48824-1316, USA.
A questionnaire was mailed to 2000 randomly selected osteopathic physicians to assess use
of osteopathic manipulative treatment (OMT). In all, 1055 responses were summarized for
the study. The contention is supported that OMT is being used less and less by practicing
physicians. Only 6% of the respondents treated more than 50% of their patients with OMT,
and nearly one third used OMT on less than 5% of their patients. A progressive de-emphasis
of OMT use correlated with more recent graduation from osteopathic medical colleges.
Thirty-eight percent of the variance regarding OMT use was attributed to two factors:
barriers to use, and OMT protocol used. Perceptions by physicians of insufficient OMT
training were not predictive of decreased use of OMT. Significantly more OMT was used in
solo practice as opposed to other settings. The results present a wake-up call for the
osteopathic medical profession. The profession must strive to remove barriers that
preclude OMT use by justifying to policymakers, health professionals, and the public the
cost-benefits of OMT in holistic healthcare.
Publication Types:
Meta-Analysis
- 182 -
A manipulative technique of Andrew Taylor Still as reported by Charles
Hazzard, DO, in 1905.
Van Buskirk RL.
This article presents rediscovered osteopathic manipulative techniques described by
Charles Hazzard in 1905 and ascribed by him to Andrew Taylor Still, the founder of
osteopathic medicine. Still refrained from writing about his manipulative techniques in any
significant detail, apparently intentionally. The techniques published by Hazzard have both
internal consistency and similarity to those less well described by Still, suggesting that the
attribution is accurate. The techniques are analyzed and presented as a variant of a direct
articulatory technique with axial compression. In honour of their originator, they are being
termed the Still techniques.
- 183 -
201: Fiziol Zh Im I M Sechenova. 1996 Jul;82(7):36-45.
[The role of the CSF dynamic component in forming the periodic
fluctuations in the electric impedance of the head]
[Article in Russian]
Moskalenko IuE, Kravchenko TI, Vainshtein GB, Semernia VN, Chervotok AE, Mitrofanov VF.
In patients with partial craniospinal blocks, the impedance responses to certain functional
tests were by 20-30% less obvious. Osteopathic procedures normalised the impedance
fluctuations. The data obtained suggest that the CSF dynamics plays an important role in
genesis and changes of the head impedance.
- 184 -
Osteopathic manipulative treatment applications for the emergency
department patient.
Paul FA, Buser BR.
Riverside Osteopathic Hospital, Trenton, MI 48183, USA.
The emergency department (ED) setting offers osteopathic physicians multiple
opportunities to provide osteopathic manipulative treatment (OMT) as either the primary
therapy or as an adjunct to the intervention. In doing so, osteopathic physicians can
decrease or eliminate the morbidity and symptoms associated with protracted dysfunction.
Low back pain, chest pain, torticollis, asthma, and sinusitis are some of the illnesses in which
OMT should be implemented as part of the management plan, note the authors. They
provide a guide to the general usage of OMT when the aforementioned illnesses present
themselves in ED patients, but also emphasize the importance of first ruling out any
underlying illnesses that could be manifested by musculoskeletal symptoms.
- 185 -
Suboccipital dermatomyotomic stimulation and digital blood flow.
Purdy WR, Frank JJ, Oliver B.
The effect of gentle, soft tissue manipulation in the suboccipital region on digital blood
flow, as a measure of sympathetic nervous system activity, was studied. Digital strain gauge
plethysmography was used to measure the changes in pulse contour during (1) a normative
test period with the subject in the supine position, (2) after a control interval (placebo)
during which the investigator placed his hands under the suboccipital region, and (3) after
an interval during which the investigator's fingers applied slow, steady, circular kneading in
the suboccipital triangle region. Twenty-five studies were performed in a crossover design
with the patient as his or her own control. Total pulse amplitude (Y) and the height from the
dicrotic notch to the peak (X) were measured. Examination of the total data of all subjects
revealed the occurrence of a significant change in X and Y with simply touching the
suboccipital region with the hands. An even more favorable response ensued when
suboccipital manipulation was applied. Those subjects reporting comfort or neutral
responses had larger significant changes with manipulation when compared with the group
reporting the experience as uncomfortable. The response within each group suggests that
favorable autonomic changes (sympathetic dampening) occur with specific suboccipital
manipulation as well as, indeed, the simple touching of the suboccipital triangle.
Publication Types:
Clinical Trial
- 186 -
The safety of manipulative treatment: review of the literature from 1925
to 1993.
Vick DA, McKay C, Zengerle CR.
Department of Osteopathic Manipulative Medicine, University of North Texas Health
Science Center at Fort Worth-Texas College of Osteopathic Medicine 76107-2699, USA.
Many osteopathic medical students and physicians have an inherent fear of injuring patients
when they perform osteopathic manipulative treatment (OMT). Based on the estimated
several hundred million treatments performed each year in the United States as well as a
review of the literature over the past six decades, only 185 reports of injury were found.
However, besides good training in these techniques, the key to the safety of OMT is the
taking of a thorough patient history and performing a thorough physical examination before
the application of any manipulative procedure.
Publication Types:
Multicenter Study
Review
- 187 -
Update on osteopathic medical concepts and the lymphatic system.
Degenhardt BF, Kuchera ML.
Medicine, Mo 63501, USA.
The osteopathic medical profession has long recognized the importance of the lymphatic
system in maintaining health. A review of scientific studies shows much information on the
mechanisms and importance of lymph circulation. Many osteopathic manipulative techniques
designed to treat patients with tissue congestion are based on early research recognizing
that lymph flow is influenced by myofascial compression. Osteopathic manipulative
treatment of the diaphragm was substantiated when pressure differentials created by the
thoracic diaphragm were shown to influence lymph flow. Current research demonstrates
that autonomically mediated, intrinsic lymphatic contractility plays a significant role in
lymph propulsion, supporting the use of osteopathic manipulative techniques directed at
influencing the autonomic nervous system to improve lymphatic circulation. Although
research provides an explanation of how osteopathic manipulative techniques influence the
lymphatic system, experimentation to test the direct influence of manipulation on lymph
circulation is needed. Clinical outcomes studies are also necessary to substantiate the
clinical efficacy of osteopathic manipulative techniques.
Publication Types:
Review
Review, Tutorial
- 188 -
Preliminary findings on the use of osteopathic manipulative treatment by
osteopathic physicians.
Fry LJ.
College of Osteopathic Medicine, Nova Southeastern University, North Miami Beach, Fla.
USA.
The literature suggests that the extent to which osteopathic physicians actually use
osteopathic manipulative treatment (OMT) and the factors that predict the use of OMT
remain virtually unexplored. A mailed survey of practicing osteopathic physicians was used
to query respondents about their use of OMT and about the effects of a number of factors
on use of OMT. The survey showed that 71% of 100 practicing physicians used OMT with 5%
or more of their patients, and 14% in 50% or more of their patients. Multivariate statistical
procedures revealed that a physician's having learned a new OMT format since graduation
from medical school was the primary predictor of the use of OMT, followed by interest in
OMT during internship. The other predictor was whether the respondent had a family
member who was also a DO. Physician's specialty, emphasis on OMT during graduate and
postgraduate training, and the era during which DOs received their training were not
significant predictors of OMT use. These results indicate a need for further research on
OMT use and the variables examined in this study.
- 189 -
209: Eur J Appl Physiol Occup Physiol. 1996;73(3-4):387-92.
The effects of joint angle on electromyographic indices of fatigue.
Weir JP, McDonough AL, Hill VJ.
Program in Physical Therapy, University of Osteopathic Medicine and Health Sciences, Des
Moines, IA 50312, USA.
The purpose of this study was to examine the effect of manipulation of joint angle on
electromyographic (EMG) fatigue curves at different sites over the quadriceps muscle
group. Eight subjects performed isometric knee extensions at 0.26, 0.79, and 1.31 rad from
full extension for 1 min at 50% of maximum. EMG signals were recorded with a branched
electrode lead system at proximal and distal sites over the vastus lateralis and vastus
medialis. The 1-min contractions were analyzed for changes in integrated EMG (IEMG) and
median power frequency (MPF) over time. The results showed that the fatigue slopes for
IEMG were greatest at 0.79 rad. However, the MPF data showed the greatest slopes at
0.26 rad. We hypothesize that the decline in MPF at 0.26 rad is due to activation failure
while the increase in IEMG at 0.79 rad is driven by contractile failure. In addition, the EMG
fatigue rates within each joint angle were similar at all sites.
- 190 -
210: Am J Phys Med Rehabil. 1995 Nov-Dec;74(6):439-43.
Interest in manual medicine among residents in physical medicine and
rehabilitation. The need for increased instruction.
Atchison JW, Newman RL, Klim GV.
Department of Physical Medicine and Rehabilitation University of Kentucky College of
Medicine, Lexington 40536-0284, USA.
Manual medicine is an important part of the practice of physical medicine and rehabilitation
(PM&R). Using a two-part questionnaire, we surveyed PM&R residents to determine their
level of interest in manual medicine, their attitudes about this type of treatment, and the
amount of formal training in manual medicine offered in PM&R residencies. Questionnaires
were sent to all 75 PM&R residency training programs. Responses were received from 470
residents (41.6%) of 1126 potential respondents; this represented 55 (73%) of the
programs surveyed. Of the 470 respondents, 363 (77.2%) believed that manual medicine
should be a part of PM&R, 386 (82.1%) wanted more training in manual medicine, 389
(82.8%) believed that manual medicine is useful in the treatment of back/neck pain, and 392
(83.4%) would refer patients for manual medicine treatment. However, only 124 (27.3%)
were receiving formal instruction in manual medicine during their PM&R residency training.
Most of the 305 respondents who had received some exposure to manual medicine had done
so through conferences (88.7%) and independent reading (66.9%). The results of this
survey of PM&R residents demonstrate both a widespread interest in the use of manual
medicine and an unmet desire for more instruction. Educational experiences in manual
medicine should be provided so that, as residents become practicing physiatrists, they can
either utilize this form of treatment or appropriately refer patients to other practitioners.
- 191 -
Comment in:
J Am Osteopath Assoc. 1995 Sep;95(9):522, 524.
Hospital guidelines for diagnosis-related groups/osteopathic manipulative
treatment.
Feely RA.
Division of Osteopathic Manipulative Medicine, Chicago College of Osteopathic Medicine of
Midwestern University, IL, USA.
The DRG/OMT [Diagnosis-Related Groups/Osteopathic Manipulative Treatment] Master
Matrix is a tabulated guideline for helping osteopathic physicians and hospitals document
their unique form of health-care. The DRG/OMT Master Matrix is a quality management
tool designed for osteopathic physician care of hospitalized patients. It furnishes a
mechanism for relating various diagnostic entities to probable areas of somatic dysfunction.
This matrix and the accompanying patient record aid the physician in recording diagnosis
and treatment, thus providing the hospital with documentation of osteopathic patient care's
competitive advantage. In a hospital record review, OMT use increased from 5% to 15% of
patients after the DRG/OMT Master Matrix was introduced.
- 192 -
Palpatory diagnosis and manipulative management of carpal tunnel
syndrome: Part 2. 'Double crush' and thoracic outlet syndrome.
Sucher BM.
Center for Carpal Tunnel Studies, Paradise Valley, AZ 85253, USA.
The physician treating carpal tunnel syndrome needs to be aware of the possible
concomitant occurrence of thoracic outlet syndrome, the so-called double crush syndrome.
Palpation is used to differentiate carpal tunnel syndrome from thoracic outlet syndrome.
Such palpatory examination assists the physician in planning the initial treatment, including
osteopathic manipulation and self-stretching maneuvers, targeted specifically at the most
clinically significant pathologic region. Supplemental physical medicine modalities such as
ultrasound may enhance the treatment response. Some illustrative cases are reported.
Publication Types:
Case Reports
- 193 -
Nerve compression syndromes as models for research on osteopathic
Luckenbill-Edds L, Bechill GB.
Department of Biological Sciences, Ohio University College of Osteopathic Medicine, Athens
45701, USA.
Experimental and clinical studies of nerve compression syndromes show that ischemia or
edema, singly or combined, causes responses in nerves that lead to alterations in impulse
conduction and to commonly observed clinical signs. Because osteopathic manipulative
treatment (OMT) is thought to affect microcirculation and anatomic positioning of
structures, nerve compression syndromes appear ideal as models for studying how OMT
accomplishes results. We recommend that researchers develop experimental protocols or
clinical studies of nerve compression syndromes that will use anatomic, histologic, and
physiologic criteria to monitor the effects of OMT. Techniques such as soft tissue, muscle
energy, counterstrain, or myofascial release are appropriate for study in nerve compression
syndromes. Such studies are necessary to understand the biologic basis of OMT.
Publication Types:
Review
Review, Tutorial
- 194 -
215: Am J Orthop. 1995 Mar;24(3):241-50.
Comment in:
Am J Orthop. 1995 Sep;24(9):708, 713.
Conservative options in the management of spinal disorders, Part II.
Exercise, education, and manual therapies.
Reitman C, Esses SI.
Baylor College of Medicine, Houston, Texas, USA.
At this time, evidence supports exercise as an efficacious form of treatment for individuals
suffering from back pain. The incorporation of education regarding posture, body
mechanics, and ergonomics as part of a progressive exercise program appears justified.
While there is empirical evidence available for the use of biofeedback, there are no specific
studies supporting its efficacy in the treatment of the spine. Manual therapies such as
mobilization and/or manipulation appear to shorten the course of subacute back pain, but do
not alter the natural history and do not appear to be efficacious as monotherapy for chronic
back pain.
Publication Types:
Review
Review, Tutorial
- 195 -
216: J Am Osteopath Assoc. 1995 Mar;95(3):182-8; 191-2.
Cranial findings and iatrogenesis from craniosacral manipulation in patients
with traumatic brain syndrome.
Greenman PE, McPartland JM.
Department of Biomechanics, Michigan State University College of Osteopathic Medicine,
East Lansing, USA.
Craniosacral findings were recorded for all patients with traumatic brain injury entering an
outpatient rehabilitation program between 1978 and 1992. The average cranial rhythmic
impulse was low in all 55 patients (average, 7.2 c/min). At least one cranial strain pattern
was exhibited by 95%, and 87% had one or more bony motion restrictions. Sacral findings
were similar to those in patients with low back pain. Although craniosacral manipulation has
been found empirically useful in patients with traumatic brain injury, three cases of
iatrogenesis occurred. The incidence rate is low (5%), but the practitioner must be
prepared to deal with the possibility of adverse reactions.
Publication Types:
Case Reports
- 196 -
Comment in:
J Am Osteopath Assoc. 1994 Aug;94(8):632, 640.
Palpatory diagnosis and manipulative management of carpal tunnel
syndrome.
Sucher BM.
Center for Carpal Tunnel Studies, Paradise Valley, AZ 85253.
Carpal tunnel syndrome was studied by use of supplemental palpatory diagnosis in 20
abnormal wrists. Restriction in motion at the carpal tunnel was quantified with a rating
system. All wrists with carpal tunnel syndrome revealed at least moderate restriction to
motion, as compared with only mild or no restriction in 20 wrists in normal, symptom-free
subjects. Several participants (16 abnormal wrists) underwent osteopathic manipulative
treatment, including a new "opponens roll" maneuver, and self-stretching, or a similar
treatment accomplished by use of a self-treatment accomplished by use of a self-treatment
appliance. In those treated, palpatory restriction decreased into the normal range, often
before symptoms decreased. Improvement in nerve conduction studies usually followed
within 1 to 3 months. Palpatory diagnosis is a useful adjunctive method of assessing patient
status in carpal tunnel syndrome and helpful in prognosticating outcome. The modified
manipulative technique described for the treatment of mild to moderate carpal tunnel
syndrome may be effective in more severe cases.
Publication Types:
Clinical Trial
Review
- 197 -
223: J Am Osteopath Assoc. 1994 Mar;94(3):217-20, 223-6.
Comment in:
Effects of adding sacral base leveling to osteopathic manipulative
treatment of back pain: a pilot study.
Hoffman KS, Hoffman LL.
Department of Statistics, University of Central Florida, Orlando.
A selected group of patients with sacral base unleveling greater than 2 mm were studied to
determine the effects of osteopathic manipulative treatment (OMT) and heel lifting on
chronic low-back pain. The McGill-Melzack Pain Questionnaire administered by trained
personnel was used to assess the patient's pain before and after treatments. Five patients
with no experience with manual treatment were treated with nonsteroidal anti-inflammatory
drugs (NSAIDs) and OMT for restrictions in spinal motion. Their improvement was
statistically significant. Seven patients who had been treated previously with OMT and
NSAIDs received heel lifts of graduated thickness until the sacral base was within 2 mm of
being level. Attaining a "level" sacral base with heel lifts also provided a statistically
significant relief from low-back pain.
- 198 -
Whiplash as a total-body injury.
Cisler TA.
In our highly active society, individuals and groups push their physical limits. Consequently,
the incidence of whiplash injury is increasing. Patients may not recover rapidly or fully from
a whiplash injury, thus leading to chronic neck and spinal symptoms and litigation. Physicians
must recognize whiplash injury as a manifestation of total-body trauma and treat
accordingly, with particular emphasis on alleviating abnormal tension of the fascia. Precise
description of the accident, followed by healing methods tailored to well-defined bodily
injury, aids in effective management. Whiplash injury poses a challenge to the osteopathic
physician to sharpen skills in defining the injury based on the details of the accident and to
incorporate myofascial release treatment into traditional modes of whiplash treatment.
Fortunately, many highly respected osteopathic physicians have written extensively on the
subject and the tools are at hand to refine treatment for both acute and chronic whiplash.
Publication Types:
Review
Review, Tutorial
- 199 -
Effects of osteopathic manipulative treatment in patients with
cervicothoracic pain: pilot study using thermography.
Walko EJ, Janouschek C.
Chicago College of Osteopathic Medicine of Midwestern University, Downers Grove, Ill.
To provide information on how cervicothoracic pain responds to osteopathic manipulative
treatment, five subjects with acute or chronic pain received appropriate medication and
three osteopathic manipulative treatments by the principal investigator using thrust and
nonthrust techniques. The mean number of findings by both investigators on structural
examination decreased considerably immediately after each of the three treatments. The
number of findings increased in week 2 and decreased in week 3. The principal investigator
observed a further decrease by the final session, but the coinvestigator reported an
increase. The pain scale score improved an average of nearly 30%. Thermography showed
cooling of the cervicothoracic region in all subjects and conversion to a normal pattern in
four. Osteopathic manipulative treatment should be considered for patients with acute or
chronic cervicothoracic pain. The use of thermographic analysis in clinical osteopathic
research seems warranted.
- 200 -
226: Soc Sci Med. 1994 Feb;38(4):497-507.
Danger and safety in medicines.
O'Neill A.
Department of Health Administration and Education, Lincoln School of Health Sciences, La
Trobe University, Victoria, Australia.
Convictions about established medical safety and the danger of alternative remedies and
practitioners are discussed in this article. While most alternative medicines continue to be
denounced as unscientific and unsafe, government reviews have concluded that chiropractic
and osteopathy and (more recently) acupuncture should be registered occupations and that
qualifying courses of tertiary education should be instituted in Australia. This paradoxical
result follows the widespread adoption of acupuncture and spinal manipulation by
established practitioners of medicine and physiotherapy. The practices become intrinsically
dangerous as their efficacy is accepted. Consequently, the argument is that only established
practitioners are safe enough to use them. But alternative groups can use the established
announcement of danger to represent the desirability of official action to protect the
public. The article concludes with a review of the idea that therapies become dangerous as
they are introduced.
Publication Types:
Review
Review, Tutorial
- 201 -
227: Br J Gen Pract. 1994 Jan;44(378):25-9.
Musculoskeletal clinic in general practice: study of one year's referrals.
Peters D, Davies P, Pietroni P.
Marylebone Health Centre, London.
BACKGROUND. A musculoskeletal clinic, staffed by a general practitioner trained in
osteopathy, medical acupuncture and intralesional injections, was set up in an inner London
general practice in 1987. AIM. A retrospective study was undertaken of one year's
referrals to the clinic in 1989-90 to determine how general practitioners were using the
clinic in terms of problems referred; consultation patterns of patients attending the clinic
and 12 months after initially being seen; and how access to the clinic influenced referrals to
relevant hospital departments. METHOD. Day sheets were studied which recorded
information on demographic characteristics of patients referred to the clinic and their
problems, diagnoses made, duration of symptoms, number and range of treatments given,
and recurrence of problems. Use of secondary referral sources was also examined.
RESULTS. During the study year 154 of 3264 practice patients were referred to the
musculoskeletal clinic, and attended a mean of 3.5 times each. Of all the attenders 64%
were women and 52% were 30-54 years old. Eighty one patients (53%) presented with neck,
back or sciatic pain. A specific traumatic, inflammatory or other pathological process could
be ascribed to only 19% of patients. Regarding treatment, 88% of patients received
osteopathic manual treatment or acupuncture, or a combination of these treatments and 4%
received intralesional injections. Nine patients from the clinic (6%) were referred to an
orthopaedic specialist during the year, two with acute back pain. Referrals to orthopaedic
specialists by the practice as a whole were not significantly lower than the national average,
although the practice made fewer referrals to physiotherapy and rheumatology
departments than national figures would have predicted. Seventeen patients (11%) returned
to the clinic with a recurrence of their main complaint within a year of their initial
appointment; second courses of treatment were usually brief. CONCLUSION. The clinic
encouraged a relatively low referral rate to musculoskeletal specialists outside the practice.
However, a need was identified for better communication about the potential of the
approaches used in order that referrals to secondary specialists, particularly orthopaedic
specialists, could be further reduced.
- 202 -
235: Schweiz Rundsch Med Prax. 1993 Aug 17;82(33):875-9.
[Forgotten expertise about chiropractic]
[Article in German]
Geiser M.
Two forgotten experts on chiropractic are revived to expose the lack of scientific
foundation of osteopathy, chiropractic and manual medicine. It is reemphasized that for the
majority of patients with back complaints a precise and tangible pathologic finding
explaining the pain can not be established. Likewise the correlation between radiologic,
tomographic and patho-anatomic alterations with the patients complaints leaves much to be
desired, particularly for the spinal column. Back ailments plagued humanity already in
ancient times, their crippling effects seem, however, to be of iatrogenic origin originating in
the 20th century. To explain the success stories of manual healers it is important to
distinguish between medical science and the actions of the healer.
- 203 -
236: J Am Osteopath Assoc. 1993 Aug;93(8):834-8, 843-5.
Comparison of thoracic manipulation with incentive spirometry in preventing
postoperative atelectasis.
Sleszynski SL, Kelso AF.
Department of Surgery, Chicago-College of Osteopathic Medicine of Midwestern University
(CCOM), Ill.
Atelectasis is a preventable complication that often occurs after upper abdominal surgery.
In our 1-year randomized, researcher-blinded trial, low-risk cholecystectomy patients were
subjected to either the thoracic lymphatic pump (n = 21) or incentive spirometry (n = 21) to
prevent atelectasis. The treatment groups were equal with respect to risk factors for
atelectasis and deviation of preoperative respiratory parameters (forced vital capacity
[FVC] and forced expiratory volume in one second [FEV1]) from the predicted values.
Atelectasis occurred in 2 (5%) of 21 patients regardless of whether incentive spirometry or
thoracic lymphatic pump treatment was used. Study patients treated with the thoracic
lymphatic pump technique had an earlier recovery and quicker return toward preoperative
values for FVC and FEV1 than patients treated with incentive spirometry.
Publication Types:
Clinical Trial
- 204 -
240: J Am Osteopath Assoc. 1993 Feb;93(2):203-8, 213-4.
Comment in:
Efficacy of high-velocity low-amplitude manipulative technique in subjects
with low-back pain during menstrual cramping.
Boesler D, Warner M, Alpers A, Finnerty EP, Kilmore MA.
Department of Osteopathic Manipulative Medicine, University of Osteopathic Medicine,
Health Sciences College of Osteopathic Medicine, Des Moines, Iowa 50312.
Previous studies have shown that dysmenorrhea produces low-back pain and an
electromyographic (EMG) pattern typical of trauma-induced low-back pain. To determine the
effects of high-velocity low-amplitude osteopathic manipulative treatment (OMT) on this
type of low-back pain, 12 dysmenorrheic subjects were assigned to a group receiving OMT
or to a group not receiving OMT (or both). Eight subjects participated in both groups, the
other four being equally distributed between groups. Osteopathic manipulative treatment
significantly decreased EMG activity during extension of the lumbar spinae erector muscles
and abolished the spontaneous EMG activity. These EMG changes coincided with the
patient's report of alleviated low-back pain and menstrual cramping. Osteopathic
manipulative treatment did not change the creatinine kinase, lactate dehydrogenase or
lactate-dehydrogenase isoenzyme activity, or myoglobin concentration.
Publication Types:
Clinical Trial
- 205 -
242: Br J Gen Pract. 1993 Jan;43(366):15-8.
Comment in:
Br J Gen Pract. 1993 Jun;43(371):261-2.
Study of 500 patients attending an osteopathic practice.
Pringle M, Tyreman S.
Department of General Practice, Nottingham University Medical School.
The experiences of 500 consecutive patients presenting with a new episode of illness at a
five practitioner osteopathic practice in an east midlands town is reported. The osteopath
completed a structured questionnaire about each patient who then completed two symptom
questionnaires, one before treatment and a second four months later. Questionnaires were
completed by osteopaths for 495 patients (99.0%). Almost all patients completed the first
questionnaire (98.6%) and 367 patients (73.4%) completed the second questionnaire. Female
patients had more treatment sessions than male patients (3.2 versus 2.7 over the four
month period, P < 0.01) and suffered from more spinal muscular problems and postural
imbalance than males (P < 0.05). The commonest diagnostic group was spinal joint sprain and
patients with this diagnosis reported significantly better symptom improvement at four
months than those in other diagnostic groups. Greater improvement at four months was also
associated with shorter duration of illness before treatment (P < 0.001). The 147 patients
who had seen their general practitioner before attending the osteopath had worse
symptoms of a longer duration than the 347 patients who had not seen their general
practitioner (P < 0.001), but showed greater improvement in symptoms over the subsequent
four months. It is concluded that suitable patients should be encouraged to attend an
osteopath early on in an illness. In subsequent episodes, if osteopathic treatment is of
benefit to them, patients should attend before they see their general practitioner.
- 206 -
243: J Manipulative Physiol Ther. 1993 Jan;16(1):33-6.
Manual force, mechanically assisted articular chiropractic technique using
long and/or short level contacts.
Bergmann TF.
OBJECTIVE: To identify what has been theorized and/or written about the manual
techniques generically classified as manual force, mechanically assisted articular
chiropractic technique that utilize either short-lever contacts or a combination of shortand long-lever contacts. DATA SOURCES: A search of the Medline bibliographic database
using MeSH key words (chiropractic/methods; osteopathic manipulation) was performed.
The Index to Chiropractic Literature and Chiropractic Research Abstracts Collection
(CRAC) were searched for the past 10 yr using the key terms of chiropractic-methods;
chiropractic techniques; manipulation, chiropractic, manipulation, osteopathic, manipulation,
spinal; and manipulation, joint. A hand search of textbooks was undertaken as well as review
of the references included in books, monographs and collected papers. STUDY SELECTION:
Studies in English were included, but it must be noted that these include publications that
are not peer reviewed or refereed in any way. DATA EXTRACTION: Descriptions that
discussed aspects of manipulative procedures with the characteristics were extracted by a
single author. DATA SYNTHESIS: Very little was found or accessible with traditional
methods of literature retrieval. Descriptions of characteristics for the attributes of
techniques which use mechanical assistance to impart a force applied to specific contacts in
combination with short and long levers are provided. The technique procedures which fall
into this category use the mechanical assistance of specialized table parts, including drop
sections and distracting sections, to achieve functional changes in the vertebral three-joint
complex. Conjecture and speculation as to the advantages of mechanical assistance are
presented. CONCLUSIONS: This type of review is considered the first step in the
evaluative process for a chiropractic technique procedure. It demonstrates that very little
has been written in an accessible fashion relative to techniques which are classified as
manual force, mechanically assisted articular chiropractic techniques that utilize either
short-lever contacts or a combination of short- and long-lever contacts. Controlled
prospective clinical trials to evaluate efficacy in using these technique procedures are
nonexistent. Furthermore, there are no comparison studies to determine whether the
techniques which fit into this category are any more effective or efficient in producing a
positive clinical outcome than techniques in other categories. The proponents of these
technique procedures should be performing the studies and publishing the results that
either support or deny the usefulness of these procedures.
Publication Types:
Review
Review, Tutorial
244: J Am Osteopath Assoc. 1993 Jan;93(1):92-4, 100-1.
- 207 -
Myofascial release of carpal tunnel syndrome.
Sucher BM.
Current treatment for carpal tunnel syndrome may be ineffective or associated with
complications or recurrence. In the case reported here, a myofascial release by the
physician combined with the patient's self-stretch reduced pain and numbness and improved
electromyographic results. The manipulative approach releases the transverse carpal
ligament,-and "opens" or dilates the canal. The patient stretches the wrist, digits, and
thumb, including myofascial components. An aggressive, conservative approach lessens the
need for surgery in mild to moderate cases. Studies with magnetic resonance imaging may
be helpful to document canal size before and after treatment.
Publication Types:
Case Reports
- 208 -
245: J Am Osteopath Assoc. 1993 Jan;93(1):118, 123-5.
Integrate osteopathic principles and practices in postgraduate medical
education--now.
Kasovac M, Jones JM 3rd.
Department of Clinical Sciences, College of Osteopathic Medicine of the Pacific, Pomona,
Calif. 91766-1889.
We issue a call for an "osteopathic medical renaissance" in teaching osteopathic principles
and osteopathic manipulative techniques. This article describes a seminar series in the
postdoctoral training program at the College of Osteopathic Medicine of the Pacific. We ask
osteopathic physicians to enhance their manual dexterity skills to better serve as role
models for physicians-in-training. We challenge osteopathic physicians to stimulate a
renewed emphasis in teaching distinctive osteopathic medical care.
- 209 -
246: Presse Med. 1992 Dec 5;21(42):2050-2.
Comment in:
Presse Med. 1993 Apr 17;22(14):689.
[Complications of cervical spine manipulation. A case of "locked-in
syndrome"]
[Article in French]
Kponkton A, Hamonet C, Montagne A, Devailly JP.
Laboratoire Georges Lambert, Service de Readaptation medicale, CHU Henri-Mondor et
Albert-Chenevier, Creteil.
The current craze for cervical spine manipulation is due to its rapid and even dramatic
results and to the ineffectiveness of many treatments prescribed by physicians.
Complications of thoracic or lumbar spine manipulation are very rarely reported, but this is
not the case with the cervical spine. We present the case of a woman who suffered a
severely disabling complication caused by an "osteopathic" manoeuvre. This technique should
be rejected as it is dangerous and as harmless methods can be used with good results in
common cervicalgia, even if it is very severe.
Publication Types:
Case Reports
- 210 -
247: Phys Ther. 1992 Dec;72(12):843-52.
Manual therapy: a critical assessment of role in the profession of physical
therapy.
Farrell JP, Jensen GM.
Kaiser-Hayward Physical Therapy Residency Program in Advanced Orthopedic Manual
Therapy, Kaiser Permanente Medical Center, Hayward, CA 94541.
Interest in manual therapy appears to continue to grow among physical therapy clinicians
and educators throughout the world even though the underlying concepts and techniques
have not been justified by a knowledge base. The purposes of this article are to critically
assess the role of manual therapy within the physical therapy profession and to provide an
introduction to the other articles in this special issue. Eisner's model of explicit, implicit,
and null curricula is used as a framework for our analysis and our discussion of manual
therapy. The explicit area of manual therapy includes discussions of the definition and the
role of manual therapy, the scientific rationale for manual therapy, and manual therapy in
education and a comparison of manual therapy evaluative frameworks. The implicit area
deals with the role of clinical decision making and critical thinking in manual therapy in
education and rehabilitation. In the null (unaddressed) area of manual therapy, we suggest
directions for future development and research.
Publication Types:
Review
- 211 -
248: J Manipulative Physiol Ther. 1992 Nov-Dec;15(9):591-5.
Short lever, specific contact articular chiropractic technique.
Bergmann TF.
OBJECTIVE: To identify what has been theorized and/or written about the manual
techniques generically classified as direct, but using specific contacts on short levers while
using forces that may vary in speed and amplitude. DATA SOURCES: A search of the
MEDLINE bibliographic database using MeSH key words (chiropractic/methods;
osteopathic manipulation) was conducted. The Index to Chiropractic Literature and
Chiropractic Research Abstracts Collection were searched through the past 10 yr using the
key terms of chiropractic-methods; chiropractic techniques; manipulation, chiropractic;
manipulation, osteopathic, manipulation, spinal; and manipulation, joint. A hand search of
text-books was undertaken as well as review of the references included in books,
monographs and collected papers. STUDY SELECTION: Studies in English were included,
but it must be noted that these include publications that are not peer reviewed or refereed
in any way. DATA EXTRACTION: Descriptions that discussed aspects of manipulative
procedures with the appropriate characteristics were extracted by a single author. DATA
SYNTHESIS: Very little was found or accessible using traditional methods of literature
retrieval. Lack of common terminology as well as multiple technique systems developed in
isolation contributed to the problem. Descriptions of characteristics for the attributes of
techniques which use specific contacts on short levers are provided. The high-velocity, lowamplitude thrust technique is presented as one of the oldest and most widely used forms of
manual medicine and remains one of the most frequently used forms of manual medicine.
Derivation of applied forces as well as speculation as to the roll of specificity are discussed.
CONCLUSIONS: This type of review is considered the first step in the evaluative process
for a chiropractic technique procedure. It demonstrates that very little has been written in
an accessible fashion relative to techniques which use specific contacts on short levers
while applying forces that may vary in speed and amplitude. Statements made concerning
the appropriateness or effectiveness consist of opinions only, with no reference to any form
of injury or testing. The need for clinical trials and studies comparing different techniques
is great.
Publication Types:
Review
249: Schweiz Rundsch Med Prax. 1992 Sep 8;81(37):1087-91.
- 212 -
[Manual medicine of the spine--indication, diagnostic and therapeutic
possibilities]
[Article in German]
Kissling RO, Hochstrasser R, Kubli D.
Abteilung fur Physikalische Medizin und Rheumatologie, Orthopadische Universitatsklinik
Balgrist, Zurich.
Manual medicine developed rapidly during the last 40 years and became an integral part of
standard medicine. The basic idea behind the methods used is that several acute and
chronic disorders the spine and peripheral articulations are caused by functional
disturbances in one or more spinal motion segments, and also in peripheral joints, always
accompanied by reflectory muscular reactions. These changes must be detected and
treated specifically. The diagnosis for manual therapy is always complementary to general
medical examination. Knowledge of absolute and relative contraindications is the basis for
every manual therapy. Therapeutically, apart from the actual mobilization with or without
impulse, the so-called neuromuscular techniques are used; these are acting together with
the muscle force of the patient and with the thereby triggered reflex-mechanisms.
Whereas the latter techniques are also used in physiotherapy, mobilization with impulse
should be practised nowadays only by trained physicians and chiropractitioners, since the
risks involved are considerable. It is of great importance that the therapy is not limited
just to the manipulation of the functionally disturbed motion segment but that in addition
muscular disbalance is treated.
- 213 -
250: J Am Osteopath Assoc. 1992 Sep;92(9):1159-60, 1167-70.
Manipulation with the patient under anesthesia.
Greenman PE.
Department of Biomechanics, Michigan State University, College of Osteopathic Medicine,
East Lansing 48824-1316.
Manipulation while the patient is under anesthesia is an old, widely recognized procedure in
musculoskeletal medicine. It is used for treating acute and chronic musculoskeletal
conditions with significant biomechanical dysfunction unresponsive to conservative therapy.
The procedure is helpful when muscle spasm and irritability preclude success without
anesthetization of the patient. Safety and effectiveness are favored by appropriate
selection of patients, knowledge of indications and contraindications, suitable anesthetic,
and services of a qualified physician trained in structural diagnosis and manipulative
technique. A team approach is recommended. To illustrate effective use of the procedure, a
classic case is described.
Publication Types:
Case Reports
- 214 -
251: J Am Osteopath Assoc. 1992 Sep;92(9):1134-6, 1139-46.
Comment in:
J Am Osteopath Assoc. 1993 Apr;93(4):426, 428.
The evolution of osteopathic manipulative technique: the Spencer
technique.
Patriquin DA.
Department of Family Medicine, University College of Osteopathic Medicine, Athens, Ohio
45701.
The Spencer technique is a standardized series of shoulder treatments with broad
application in diagnosis, treatment, and prognosis. The evolution of this technique is traced
from 1916 to date to try to identify factors in the development of manipulative methods.
Few suggestions about the basic steps to be followed in developing any new manipulative
technique were seen. Of chief importance were changes in sequence, the addition of steps,
and the combination of one technique with another, as in the addition of muscle-energy
methods to each step. One change, accidentally introduced in the 1970s, displaced a critical
step in the procedure. The principal element guiding the development of the Spencer
technique appears to be clinical necessity interpreted in terms of anatomy and pathology.
Publication Types:
Historical Article
- 215 -
252: J Am Osteopath Assoc. 1992 Mar;92(3):334, 337-41.
Comment in:
J Am Osteopath Assoc. 1992 Aug;92(8):964, 967.
Nociceptive considerations in treating with counterstrain.
Bailey M, Dick L.
College of Osteopathic Medicine of the Pacific, Pomona, Calif.
The proprioceptive mechanistic model of somatic dysfunction proposed by Korr is accepted
as the neurophysiologic basis of counterstrain by the developer of that manipulative
technique. We suggest that the physician should also take into account the physical damage,
if any, that the original trauma produced. We propose that with tissue injury, nociceptive
reflexes could produce patterns of motion restriction opposite that predicted by a solely
proprioceptive model. A nociceptive component is suggested as an explanation for the origin
and maintenance of somatic dysfunction and its response to the counterstrain technique. In
actuality, both proprioceptive and nociceptive responses may occur in dysfunctional states.
Other physiologic responses also may be involved. These views are consistent with clinical
experience.
Publication Types:
Review
Review, Tutorial
- 216 -
254: Postgrad Med. 1991 Aug;90(2):175-8, 183-5.
Burning pain in an extremity. Breaking the destructive cycle of reflex
sympathetic dystrophy.
Levine DZ.
Department of Family Medicine, Michigan State University College of Osteopathic Medicine,
East Lansing.
The pathogenesis of reflex sympathetic dystrophy is controversial, but the condition can
result from a major or seemingly minor injury to a limb, or even an insult to an organ, such as
stroke or myocardial infarction. Onset can be sudden or insidious. The syndrome is
characterized primarily by localized, deep, burning pain in a limb--pain that may not follow
any logical distribution. Nonpitting edema, skin hyperesthesia, and guarding of the limb
usually accompany the pain. If treatment is not instituted, deformity, contracture, and
wasting of the limb can eventually occur. With appropriate therapy, the process can be
stopped and often reversed. The keys are a high index of suspicion, early diagnosis, and
aggressive treatment.
Publication Types:
Case Reports
Review
Review, Tutorial
- 217 -
255: J Am Osteopath Assoc. 1991 Apr;91(4):370, 373-6.
An alternative method of teaching strain/counterstrain manipulation.
Woolbright JL.
Aeromedical Services, Maxwell AFB, AL 36113-1102.
The range-of-motion box enables the operator to visualize how to carry a joint through
extremes of motion range for range-of-motion evaluations and to locate the position of
comfort in relaxation of tender points. It is helpful for teaching the novice counterstrain
manipulation and for instructing fellow practitioners. Examples are illustrated for the
cervicothoracic region, but the concept is applicable to other parts of the body as well.
- 218 -
258: J Am Osteopath Assoc. 1991 Feb;91(2):156, 161-8, 170-1.
Osteopathic research: the needed paradigm shift.
Korr IM.
The purposes of this article are twofold: (1) To assist scientists on the faculties of colleges
of osteopathic medicine in the design of research projects relevant to osteopathic medical
theory and practice; and (2) to assist clinical investigators in the development of research
protocols that are best suited to the assessment of clinical outcomes of osteopathic
medical practice. Toward this end, the central osteopathic medical principles are
heuristically interpreted and elaborated, with the intention of facilitating the formulation
of fundamental questions by researchers in the various biomedical disciplines and the design
of clinical research projects by osteopathic physicians. A few of the questions evoked by
such elaboration of the osteopathic medical principles and awaiting study are suggested for
consideration by researchers. Such research questions require and, in part, compose a
research paradigm that differs basically from, yet complements and "completes," the
prevailing and highly productive reductionist paradigm. It is, in the original sense of the
word, a "holistic" paradigm that places emphasis on the organismic context in which the
biological mechanisms exist and operate. Conventional clinical research protocols for the
assessment of efficacy of most chemical and physical therapeutic agents are ill-suited for
the assessment of osteopathic medical care, of manipulative treatment in particular. It is
emphasized that osteopathic medical care must be evaluated as it is practiced and not as a
contrived, unreal version; and that it must be tested as a derivative of, and in the context
of, that philosophy by criteria consonant with that philosophy.(ABSTRACT TRUNCATED AT
250 WORDS)
Publication Types:
Review
Review, Tutorial
- 219 -
260: Agressologie. 1991;32(2):134-6.
[Changes in posture induced by 2 osteopathic manipulations are coherent
with the sagittal or frontal orientation they involve]
[Article in French]
Scheibel A, Debusschere M.
The effects of two osteopathic handlings were studied by two stabilometric criteria: the
Cervical Symetry Quotient and the Spectrum of Amplitude. Out of 60 people, half were
subjected to a High Velocity Technique the force of which was located in a frontal (leftright) plane of the body, the other half to a Fascial Technique the force of which was in the
saggital (antero-posterior) plane of the body. The High Velocity Technique induces a
significative modification of the Cervical Symetry Quotient which tends to be normal two
days later; the Fascial Technique does not modify this criterium 20 min nor 7 days later.
Both techniques modify significantly the Spectrum of Amplitude, High Velocity Technique in
the 0.16-0.22 Hz band and in the frontal (left-right) plane, the Fascial Technique in the 0.3
Hz band and in the saggital (antero-posterior) plane of the body. These modifications last
for up to 2 and 7 days respectively. So each of these two osteopathic techniques induce
postural effects in the concerned plane of the body and not (or little) in the perpendicular
plane.
- 220 -
Thoracic outlet syndrome--a myofascial variant: Part 1. Pathology and
diagnosis.
Sucher BM.
Mountain View Center, Paradise Valley, AZ 85253.
Four cases of thoracic outlet syndrome are described, with observations to support a
primary myofascial etiology involving the scalene and smaller pectoral muscles. It is believed
that thermography can be extremely helpful as an aid in diagnosis of thoracic outlet
syndrome and, when combined with Doppler blood flow studies and photoplethysmography,
can help localize the site of the pathosis. Thermography is a sensitive, non-invasive test
that most clearly demonstrates pathology in the hand views. Global changes throughout the
entire hand suggest vascular or reflex autonomic involvement, while a more dermatomal
distribution suggests specific neurologic involvement. Vigorous stretching and a unique form
of myofascial release manipulation has been successful in rapidly treating patients with
thoracic outlet syndrome. Follow-up thermography (perhaps hand and forearm views only)
can be used to monitor response to treatment and to objectively document improvement.
Publication Types:
Case Reports
Review
Review, Tutorial
- 221 -
264: J Am Osteopath Assoc. 1990 Jul;90(7):602-4, 607-12.
Pharmacologic manipulation of the respiratory control center in the infant.
Locke RG, Salvia JV.
Department of Pediatrics, University of Medicine and Dentistry of New Jersey, School of
Osteopathic Medicine, Stratford.
The respiratory control center receives afferent stimuli from mechanical and
neuromechanical sources. Information from both these sources, combined with voluntary
and involuntary CNS control, effects stimulation of the respiratory muscles. In the infant,
insufficiency of one or more of these elements of the respiratory control center is
associated with considerable morbidity and mortality. Pharmacologic manipulation may
provide a means of intervention. The xanthine derivative theophylline has been successfully
used in the treatment of bronchopulmonary dysplasia and apnea in the infant. Naloxone, an
endorphin antagonist, is widely used for the reversal of narcotic-induced respiratory
depression but has not been shown to be clinically effective for either severely or
moderately asphyxiated infants. Although doxapram has not been extensively studied and
lacks an oral preparation, it is a potentially viable therapy in the treatment of refractory
apnea and congenital hypoventilation syndromes. Almitrine's success in adults with chronic
obstructive pulmonary disease has not been duplicated in infants with similar respiratory
impairments. Progesterone and prostaglandin, although proved to influence respiratory
activity, should be regarded as very experimental therapeutic modalities.
Publication Types:
Review
Review, Tutorial
- 222 -
Comment in:
J Am Osteopath Assoc. 1990 Sep;90(9):759, 766, 768.
Quality assurance monitoring of osteopathic manipulative treatment.
Koss RW.
Medicine, MO 63501.
The quality assurance review program of military medicine has implications for civilian
osteopathic medicine. Clinical monitors need to be developed that are based on the
principles of osteopathy. Components of a quality assurance screening checklist for
osteopathic manipulative treatment include credentials of the osteopathic physician, the
diagnosis, either somatic dysfunction or other condition, the type of osteopathic
manipulative treatment applied, and specific contraindications. A checklist applicable to
osteopathic manipulative treatment that could be used by military and civilian sectors is
suggested.
- 223 -
266: Spine. 1990 May;15(5):364-70.
Erratum in:
Spine 1991 Jan;16(1):104.
An open controlled assessment of osteopathic manipulation in nonspecific
low-back pain.
MacDonald RS, Bell CM.
London College of Osteopathic Medicine, England.
An open controlled pilot trial on nonspecific low-back pain sufferers demonstrated
responsiveness to osteopathic manipulation of some patients presenting with pain durations
of 14 to 28 days. No response was demonstrated in those with shorter episodes at
presentation. The advantage to manipulated patients was maximal between 1 and 2 weeks
after commencing treatment, but was not discernable after 4 weeks. The demonstration of
a similar responsive stratum by other investigators, with both teams totally unaware of each
other's work during data collection, suggests a high degree of reliability for this finding.
Publication Types:
Clinical Trial
- 224 -
268: J Am Osteopath Assoc. 1990 Feb;90(2):145-6, 151-5.
Facilitated positional release.
Schiowitz S.
Office for Clinical Affairs, New York College of Osteopathic Medicine, Old Westbury
11568.
The facilitated positional release techniques described here introduce motion into the
direction of freedom of movement. Achievement of neutral position is made easier by
modifying sagittal posture, and a facilitating force is then applied. The treatment is
directed at normalizing tissue texture changes but can be modified to influence the deep
muscles involved in joint mobility. This modality is easily applied, nontraumatic, and
efficient.
Publication Types:
Review
Review, Tutorial
- 225 -
270: J Am Osteopath Assoc. 1989 Oct;89(10):1309-14, 1319-22.
Postoperative osteopathic manipulative management of median sternotomy
patients.
Dickey JL.
More than 250,000 patients yearly undergo coronary bypass graft surgery accomplished via
the median sternotomy incision, an approach that has been gaining widespread acceptance.
This surgical approach has been associated with a growing number of patients with
structural complaints. This article describes a postoperative treatment protocol for
improving healing and reducing musculoskeletal disability associated with such cardiac
procedures and presents a logical sequence of treatment graded to the patient's changing
condition and stage of healing. The author challenges the osteopathic medical profession to
meet the opportunity that exists to educate patients and physicians about the benefits of
osteopathic healthcare.
Publication Types:
Case Reports
- 226 -
An integrated osteopathic treatment approach in acute otitis media.
Pintal WJ, Kurtz ME.
Ear pain is a common patient complaint in the practice of the primary care physician. Acute
otitis media can affect a person of any age, although it is more often seen in children than
in adults. The disease is usually caused by Streptococcus pneumoniae (Diplococcus
pneumoniae) or Haemophilus influenzae. The differential diagnosis and subsequent
treatment of otitis media is approximately the same for children and adults. First-line
therapy usually consists of an antibiotic regimen of amoxicillin in combination with
autoinflation exercises. In the case presented, a pharmacologic regimen was combined with
osteopathic manipulation.
Publication Types:
Case Reports
- 227 -
An osteopathic approach to conservative management of thoracic outlet
syndromes.
Dobrusin R.
Thoracic outlet syndromes (TOS) are a group of disorders in which there is compression of
the brachial plexus or the subclavian artery or vein or both as they pass through the
thoracic outlet. Most patients have neurologic symptoms of the arm and hand. These
syndromes are generally named according to the site of compression or the compressing
structures. There are many factors that predispose patients to the development of TOS.
The differential diagnosis includes many diseases that can add to or imitate TOS symptoms.
Diagnosis is based mainly on the findings of the history and physical examination. Most
patients respond well to a conservative care regimen, which should be tailored to the
individual patient's needs. In most instances, surgery should be reserved as a treatment of
last resort.
Publication Types:
Review
Review, Tutorial
- 228 -
Chronic cervical dysfunction: correlation of myoelectric findings with
clinical progress.
Beal MC, Vorro J, Johnston WL.
In this pilot study, four patients with motion impairment and chronic cervical pain after
cervical spine injury received osteopathic manipulative treatment for spinal dysfunction for
periods in excess of 3 months. Records were compared for changes in the patient's
subjective complaints, in the physician's findings, and in the standardized measurement of
electrical activity of the cervical spine musculature. All three measures demonstrated
parallel improvement in the health status of these patients. Attention to functional aspects
of a neuromusculoskeletal problem appears to provide reliable indicators for directing
treatment of somatic dysfunction and registering both subjective and objective change.
Publication Types:
Case Reports
- 229 -
279: Anal Biochem. 1988 Oct;174(1):239-50.
Labeling methods for the study of poly- and mono(ADP-ribose) metabolism
in cultured cells.
Aboul-Ela N, Jacobson EL, Jacobson MK.
Department of Biochemistry, Texas College of Osteopathic Medicine, University of North
Texas, Fort Worth 76107.
Methods are described for the radiolabeling and determination of NAD+, poly(ADP-ribose),
and protein-bound monomers of ADP-ribose in cultured mammalian cells. The adenine
nucleotide pools of confluent monolayer cell cultures are radiolabeled using high-specificactivity [3H]adenine. Following any desired experimental manipulation, cultures are treated
with trichloroacetic acid. Radiolabel in NAD+ can be rapidly determined from the acidsoluble fraction using dihydroxyboronyl Sepharose (DHB-Sepharose). The acid-insoluble
material can be analyzed for radiolabeled polymers of ADP-ribose and protein-bound
monomers of ADP-ribose. Polymers are separated from interfering material using
dihydroxyboronyl-Bio-Rex 70 (DHB-Bio-Rex). Protein-bound monomers are separated from
noncovalently bound ADP-ribose and different classes of (ADP-ribosyl) protein linkages are
released by specific chemical treatments. The released ADP-ribose is then separated from
interfering materials using DHB-Bio-Rex and DHB-Sepharose. Control experiments have
demonstrated the sensitivity, selectivity, and precision of the methods. Major advantages
of the methods are that they allow many simultaneous determinations and all components
can be determined from material derived from a single dish of cultured cells. The methods
should prove useful for detailed studies of the metabolism of both protein-bound monomers
and polymers of ADP-ribose in cultured mammalian cells.
- 230 -
282: J Virol Methods. 1988 Mar-Apr;19(3-4):239-47.
A simple method of drying virus on inanimate objects for virucidal testing.
Allen LB, Kehoe MJ, Hsu SC, Barfield R, Holland CS, Dimitrijevich SD.
Department of Microbiology and Immunology, Texas College of Osteopathic Medicine, Fort
Worth.
A simple method for drying virus on inanimate objects (cover slips) under vacuum in the cold
is described. Following this procedure virus maintains high titers (10(6-7)) for periods of 13 wk at -70 degrees C depending on the virus. For virucidal assay of disinfectants, cover
slips are exposed to medium simulating the disinfectant (virus control) or disinfectant in an
upright position in an Ultra-Vu cuvette. Cover slips are readily removed and placed in tissue
culture medium for dilution of virus and determination of virus titer. Cytotoxicity of
disinfectant is determined by exposing cover slip without virus to disinfectant, then placing
it in medium, diluting the medium and incubating with the indicator cells. The use of this
technique results in high titers of virus on cover slips, which are inanimate objects requiring
minimal manipulation. The titration of virus or cytotoxicity in microplates is cell, medium,
serum, and labware economical.
- 231 -
283: J Comp Neurol. 1988 Feb 22;268(4):469-88.
Anatomical consequences of neonatal infraorbital nerve transection upon
the trigeminal ganglion and vibrissa follicle nerves in the adult rat.
Klein BG, Renehan WE, Jacquin MF, Rhoades RW.
Department of Neuroscience, New York College of Osteopathic Medicine of NYIT, Old
Westbury 11568.
A large body of experimental literature has demonstrated that neonatal infraorbital nerve
damage in rodents produces anatomical and/or functional alterations of the normal whisker
representation in central trigeminal structures. Less is known about the organization of
primary afferent components of the trigeminal system following this manipulation. Such
information provides an important basis for interpreting the central changes observed
following damage of infraorbital nerve fibers at birth. We have therefore examined the
composition and order of peripheral innervation in the pathway from the trigeminal ganglion
to the vibrissa follicles in adult rats subjected to unilateral neonatal infraorbital nerve
transection. Electron microscopy was used to determine the number and diameter of
myelinated and unmyelinated fibers in vibrissa follicle nerves of these animals. Wheat germ
agglutinin-horseradish peroxidase and fluorescent retrograde tracers were employed to
examine the number and diameter, as well as the topographic organization and branching, of
ganglion cells innervating the vibrissae in these rats. The data presented below indicate
that neonatal infraorbital nerve transection has the following consequences within the adult
trigeminal nerve and ganglion: 1) an alteration of the gross morphology of vibrissal nerves, 2)
a significant reduction in the average number (85.4%) and diameter (32.6%) of myelinated,
but not unmyelinated, follicle nerve axons, 3) a significant decrease in the average number
(36.8%) of trigeminal ganglion cells innervating vibrissa follicles, 4) no significant change in
the distribution of ganglion cell diameters, 5) an increase in peripheral branching (1.8-fold)
of these ganglion cell axons, and 6) an alteration of somatotopic order within the trigeminal
ganglion. Taken together, these data indicate that neonatal infraorbital nerve transection
produces a profound reorganization of the primary afferent component of the trigeminal
neuraxis.
- 232 -
290: Laryngoscope. 1986 Feb;96(2):166-70.
Sudden sensorineural hearing loss following manipulation of the cervical
spine.
Brownson RJ, Zollinger WK, Madeira T, Fell D.
Review of the otolaryngologic literature reveals no reports of sudden sensorineural hearing
loss resulting from manipulation of the cervical spine. Indeed, in previously reported cases
of vertebrobasilar artery injury following spinal manipulation, hearing loss has received little
attention. Two patients with sudden sensorineural hearing loss following cervical spine
manipulation are presented. The audiologic findings and cerebral arteriograms are reviewed
and treatment is discussed. A review of the anatomy and pathophysiology is also included,
and a possible mechanism of injury to the vertebral artery is proposed.
Publication Types:
Case Reports
- 233 -
296: Lancet. 1985 Jun 1;1(8440):1258-61.
Controlled comparison of short-wave diathermy treatment with osteopathic
treatment in non-specific low back pain.
Gibson T, Grahame R, Harkness J, Woo P, Blagrave P, Hills R.
The effectiveness of spinal manipulation carried out by a non-medical qualified osteopath
was compared with that of short-wave diathermy (SWD) and a placebo (detuned SWD) in
109 patients with low back pain. More than half the subjects in each of the 3 treatment
groups benefited immediately from therapy. Significant improvements were observed in the
3 groups at the end of 2 weeks' treatment, and these were still apparent at 12 weeks. The
outcome of treatment was unrelated to the initial severity or duration of pain or to the
trend of pain towards deterioration or improvement. It is, therefore, unlikely that the
results simply reflect the natural history of low back pain. Benefits obtained with
osteopathy and SWD in this study may have been achieved through a placebo effect.
Publication Types:
Clinical Trial
- 234 -
304: Br Med J (Clin Res Ed). 1983 Jul 30;287(6388):337-9.
Young doctors' views on alternative medicine.
Reilly DT.
A survey was undertaken to explore attitudes to alternative medicine among 100 general
practitioner trainees. A positive attitude emerged from the 86 respondents, with 18
doctors using at least one alternative method themselves and 70 wanting to train in one or
more. A total of 31 trainees had referred patients for such treatments; 12 of these doctors
made referrals to non-medically qualified practitioners. The most commonly used alternative
treatments were hypnosis, manipulation, homoeopathy, and acupuncture. A total of 22
doctors had been treated, or had treated themselves, by an alternative treatment, and this
personal experience was linked to a greater professional use. These findings indicate that
alternative methods of treatment are currently being used to complement orthodox
medicine and an expansion in their use appears imminent.
- 235 -
313: Rheumatol Rehabil. 1981 Nov;20(4):239-46.
Back pain in osteopathic practice.
Burton AK.
The case records of 5310 patients attending Registered Osteopaths were examined in this
retrospective study. Analysis of the data revealed that over half presented with low back
pain and were comparable to those normally seen in orthodox medical practice, except that
their symptoms were of longer duration. The patients were generally examined in a
conventional manner but it was not possible to identify specific diagnostic categories. The
majority received one or more manual therapeutic techniques but 6% were rejected as
unsuitable for treatment. The implications of the results for future research are discussed.
- 236 -
325: Med Hypotheses. 1977 Jan-Feb;3(1):9-12.
Biological significance of piezoelectricity in relation to acupuncture, Hatha
Yoga, osteopathic medicine and action of air ions.
Lipinski B.
Piezoelectric properties of biological macromolecules such as proteins, nucleic acids and
mucopolysaccharides are reviewed in this paper. It is indicated that the structural elements
of the human body composed of these piezoelectric substances are capable of transducing a
mechanical energy into an electric current. Such a transduction may be brought about by
movements of an acupuncture needle, osteopathic manipulations; Hatha Yoga postures or
action of negatively charged air irons. It is postulated that electric current induced by
stimulation of the specific sites on the surface of human body flows towards the internal
organs along the semiconductive channels of biologic macromolecules. Electric current
induced either by the piezoelectric transduction or directly applied from an external source
may in turn stimulate individual cells in the target organ. Involvement of electrical
phenomena in regulatory mechanisms on cellular and molecular levels is discussed.
- 237 -
326: Am J Chin Med (Gard City N Y). 1977 Spring;5(1):79-84.
Musculoskeletal changes immediately following acupuncture.
Roppel RM, Mitchell FL Jr, Ch'an KC.
Electrically augmented acupuncture stimulation was applied to two volunteer subjects who
presented with a variety of symptoms. The subjects were given osteopathic musculoskeletal
examinations immediately before and after acupuncture stimulation. Prior to stimulation,
both subjects were found to have musculoskeletal dysfunctions affecting a number of body
regions. After acupuncture had been administered at loci selected with reference to
traditional methodology, some but not all of the dysfunctions were found to be altered in
the direction of normalization. Those which had changed were the ones judged most likely
to be related to the symptoms of the subjects.
Publication Types:
Case Reports
- 238 -
331: Rheumatol Rehabil. 1975 Aug;14(3):191-9.
Heterodox practitioners and the availability of specialist advice.
Hewitt D, Wood PH.
The characteristics of the principal categories of more professional heterodox practice are
examined. It is concluded that rheumatic diseases are one of the likeliest fields for conflcit
between orthodox and fringe medicine. The distribution of manpower engaged in alternative
systems of health care is compared with that of orthodox medical services. The limited
data on utilization of unorthodox remedies are reviewed. Far from conflict ensuing, it is
argued that dialogue must develop in order to submit procedures like manipulation to
satisfactory clinical trial.
- 239 -
336: Laryngol Rhinol Otol (Stuttg). 1975 Mar;54(3):263-7.
[The acute cervical vertigo under otologic and osteopathic view (author's
transl)]
[Article in German]
Hulse M, Partsch CJ, Wolff HD.
The acute cervical vertigo with the single symptome of rotary vertigo is most probably
caused by a functional disturbance in the upper third of the cervical spine. Distinct pathoanatomical changes could not be observed. The findings on the cervical spine are based on an
osteopathic examination. The therapy of choice is a manipulation. Three cases are reported.
- 240 -
Répertoire des premiers signataires
Cette liste regroupe les premiers signataires des publications repérées dans PubMed.
Leur adresse est mentionnée en dessous de leur nom quand elle est indiquée dans
l’article. Si un même auteur a signé en premier plusieurs articles et si différentes
adresses sont mentionnées, elles sont inscrites ci-dessous les unes à la suite des autres.
Abend DS.
Aboul-Ela N
Department of Biochemistry, Texas College of Osteopathic Medicine,
University of North Texas, Fort Worth 76107.
Allen LB
Department of Microbiology and Immunology,
Texas College of Osteopathic Medicine, Fort Worth.
Allen TW
Andersson GB
Department of Orthopedic Surgery,
Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA. [email protected]
Atchison JW
Department of Physical Medicine and Rehabilitation University of Kentucky College of Medicine,
Lexington 40536-0284, USA.
Bailey HW.
Bailey M
College of Osteopathic Medicine of the Pacific, Pomona, Calif.
Baird RE
Balon JW
Department of Graduate Studies and Research, Canadian Memorial Chiropractic College,
Ottawa, Ontario. [email protected]
- 241 -
Beal MC
Becker AD.
Belcastro MR
Bentley EM.
Bergmann TF.
Bernard H.
Biondi DM.
Harvard Medical School, Boston, MA, USA.
Bledsoe BE.
Bockenhauer SE
Department of Family Practice, Lutheran Medical Center, Brooklyn, NY, USA.
[email protected]
Boehm KM
Boesler D
Department of Osteopathic Manipulative Medicine, University of Osteopathic Medicine,
Health Sciences College of Osteopathic Medicine, Des Moines, Iowa 50312.
Boulet JR
National Board of Osteopathic Medical Examiners, Chicago, Ill, USA. [email protected]
Brand PL
Isala Klinieken, Amalia kinderafdeling, Postbus 10.500, 8000 GM Zwolle. [email protected]
Bratzler DW.
Breen A
Institute for Musculoskeletal Research and Clinical Implementation, AECC, Bournemouth, UK.
- 242 -
Breithaupt T
Department of Biochemistry, Des Moines University Osteopathic Medical Center,
3200 Grand Ave, Des Moines, IA 50312, USA. [email protected]
Brolinson PG.
Bronfort G
Department of Research, Wolfe-Harris Center for Clinical Studies,
Northwestern Health Sciences University, Bloomington, MN 55431, USA.
[email protected]
Brooks JG
Brownson RJ
Burns L.
Burns SB
The Burns Archive Productions, Ltd, New York, NY 10016, USA.
Burton AK
Spinal Research Unit, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK.
[email protected]
Calder PR
Royal London Hospital, Whitechapel, London, UK. [email protected]
Cali GE.
Canter PH
Peninsula Medical School, Complementary Medicine, University of Plymouth, Exeter, UK.
[email protected]
Caviezel H.
Celander E
- 243 -
Chamberlain NR
Department of Microbiology and Immunology, Kirksville College of Osteopathic Medicine,
800 W Jefferson St, Kirksville, MO 63501-1443, USA. [email protected]
CHANDLER LC.
Chapman JD.
Cherkin D.
Chiradejnant A
School of Physiotherapy, Faculty of Health Sciences, The University of Sydney, NSW,
Australia. [email protected]
Cipolla VT
Cisler TA.
Clymer DH
Cohen AM
Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.
Cole TJ.
COLE WV.
Connolly TP.
Cooper GJ.
Corbett RM.
Coston JL
Coughlin P
- 244 -
Crosby JB.
Crow RM.
Cyriax JH.
D'Alonzo GE Jr.
Danto JB
Department of Family Practice, Oakland General Hospital, Madison Heights, Mich., USA.
[email protected]
Danto JB.
Botsford General Hospital, Farmington Hills, Michigan, USA. [email protected]
Davis C.
Degenhardt BF
Department of Osteopathic Manipulative Medicine, Kirksville College of Osteopathic Medicine,
Mo 63501, USA.
Denslow JS.
Dickey JL.
Dinnar U
Dobrusin R.
Dove CI.
- 245 -
Dowling DJ.
Department of Osteopathic Manipulative Medicine, New York College of Osteopathic Medicine,
New York Institute of Technology, Old Westbury 11568, USA.
Dudley G.
Duncan B
University of Arizona, Department of Pediatrics, Tucson, AZ 85724, USA.
Dupeyron A
Service de medecine physique et readaptation, hopitaux universitaires, avenue Moliere,
67000, Strasbourg, France. [email protected]
Eck JC
University of Health Sciences, College of Osteopathic Medicine, 1750 Independence Avenue,
Kansas City, MO 64124, USA.
Eisenhart AW
Department of Emergency Medicine, St Barnabas Hospital, Bronx, NY, USA.
Ellestad SM
Elliott JM
11080 Circle Point Road, Suite 140, Westminster, CO 80020, USA. [email protected]
Eshleman J
Farrell JP
Kaiser-Hayward Physical Therapy Residency Program in Advanced Orthopedic Manual Therapy,
Kaiser Permanente Medical Center, Hayward, CA 94541.
Feely RA.
Division of Osteopathic Manipulative Medicine,
Chicago College of Osteopathic Medicine of Midwestern University, IL, USA.
- 246 -
Fiechtner JJ
Division of Rheumatology, Michigan State University,
Colleges of Osteopathic and Human Medicine, East Lansing, Michigan, USA. [email protected]
Foellner RP
Foster D
Friedman H.
Friedman HD.
Fry LJ.
College of Osteopathic Medicine, Nova Southeastern University, North Miami Beach, Fla. USA.
Fuller DB.
Gaines E
West Virginia School of Osteopathic Medicine, Lewisburg, USA.
Galewaler JE.
Gamber RG
Department of Osteopathic Manipulative Medicine, Texas College of Osteopathic Medicine,
University of North Texas Health Science Center, Fort Worth 76107, USA. [email protected]
Gamber RG
Department of Manipulative Medicine,
University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Boulevard,
Fort Worth, TX 76107, USA. [email protected]
Geiser M.
Geldschlager S.
Praxis fur Osteopathie/Naturheilkunde, Munchen, Germany.
Gerber A.
- 247 -
Gibbons P
School of Health Science, Osteopathic Medicine, Victoria University, Melbourne, Australia.
[email protected]
Gibson T
Gimlett DM.
Goldstein FJ
Philadelphia College of Osteopathic Medicine, 4170 City Avenue, Philadelphia, PA 19131-1610, USA
[email protected]
Goldstein M.
National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda
Md 20892.
Goodridge JP.
Gotfried R.
Gramer JH.
Greenman PE
Department of Biomechanics, Michigan State University College of Osteopathic Medicine,
East Lansing, USA.
Greenspan J
Grieve GP.
Grimshaw DN.
Osteopathic Manipulative Medicine Clinic,
Michigan State University College of Osteopathic Medicine, A 419 East Fee Hall, East Lansing,
MI 48824, USA. [email protected]
Guiney PA
Family Practice Residency Program, Department of Family Practice, Peninsula Hospital Center,
51-15 Beach Channel Dr, Far Rockaway, NY 11691-1042, USA. [email protected]
- 248 -
Gunby P.
Guthrie RA
Hallas B
New York College of Osteopathic Medicine of New York Institute of Technology, Old Westbury,
NY 11568-8000, USA.
Hanten WP
Texas Woman's University, Houston 77030, USA.
Harakal JH.
Harvey E
Department of Health Sciences, Alcuin College, University of York, York, UK.
[email protected]
Heath DM.
Hess JA
University of Iowa, Department of Biomedical Engineering, Iowa City, USA. [email protected]
Hewitt D
Higgins BE
Hing WA
School of Physiotherapy, Faculty of Health Studies, Auckland University of Technology,
Auckland 1020, New Zealand. [email protected]
Hirayama F
Department of Thoracic Surgery, Numazu City Hospital, Hideaki Senjyu 550 Harunoki,
Higashi-shiiji, Numazu, Shizuoka 410-0302, Japan. [email protected]
Hirschkoff S.
Hoffman KS
- 249 -
Department of Statistics, University of Central Florida, Orlando.
Holmes JA.
Hondras MA
Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA 52803, USA.
[email protected]
Hondras MA
Consortial Center for Chiropractic, 30W009 Willow Court, Warrenville, Illinois 60555-1018, USA.
[email protected]
Hondras MA
Western States Chiropractic College, 2900 NE 132nd Avenue, Portland, Oregon 97230-3099,
Hoover HV.
Hopp RJ.
Horan J.
Department of State and Socioeconomic Affairs, American Osteopathic Association,
Chicago, Ill. 60611, USA. [email protected]
Howell JD.
Howell RK
Hoyt WH
Hruby RJ.
Hulse M
Irvin RE.
Section of Osteopathic Principles and Practices, Oklahoma State University, Tulsa, USA.
Isaacson PR.
- 250 -
Jackson KM
Department of Structural Biology, West Virginia School of Osteopathic Medicine,
Lewisburg 24901, USA. [email protected]
Jarski RW
Complementary Medicine and Wellness Program, Oakland University, Rochester, Mich., USA.
[email protected]
Jermyn RT.
University Back Pain Center,
University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine, Stratford,
NJ, USA. [email protected]
Johnson SM
Michigan State University College of Osteopathic Medicine's,
Department of Family and Community Medicine, B211B West Fee Hall, East Lansing, MI 48824,
USA.
Johnson SM
Department of Family and Community Medicine, College of Osteopathic Medicine, Michigan State
University, East Lansing, 48824-1316, USA.
Johnston WL
Department of Family and Community Medicine,
Michigan State University College of Osteopathic Medicine, USA. [email protected]
Jones LH.
KALTENBORN-BRUUN F.
Kaprow MG
Nova Southeastern University, College of Osteopathic Medicine, Osteopathic Treatment Center,
Ft Lauderdale, Fla. 33328, USA.
Karason AB
British College of Osteopathic Medicine, London, UK.
Kasovac M
- 251 -
Department of Clinical Sciences, College of Osteopathic Medicine of the Pacific, Pomona, Calif.
91766-1889.
Keller JA.
Kelso AF
Kimberly PE.
King HH
Western University of Health Sciences College of Osteopathic Medicine of the Pacific, Pomona,
Calif, USA. [email protected]
King HH.
American Academy of Osteopathy.
Kirk CE.
Kissling RO
Abteilung fur Physikalische Medizin und Rheumatologie, Orthopadische Universitatsklinik Balgrist
Zurich.
Klein BG
Department of Neuroscience, New York College of Osteopathic Medicine of NYIT,
Old Westbury 11568.
Klein P.
Institut Superieur d'Education Physique et de Kinesitherapie,
Unite de Recherche en Therapies Manuelles, U.L.B.
- 252 -
Knebl JA
Division of Geriatrics, University of North Texas Health Science Center,
Fort Worth 76107-2644, USA. [email protected]
Kolman S
Korr IM.
Korzh AA
Koss RW.
MO 63501.
Kponkton A
Laboratoire Georges Lambert, Service de Readaptation medicale,
CHU Henri-Mondor et Albert-Chenevier, Creteil.
Kuchera WA.
Lacey R.
Larson NJ.
Lawlor TH.
Lay EM.
Le Corre F.
Leiber JD.
Malcolm Grow Medical Center Family Medicine Residency, Andrews Air Force Base, Md.
Lesho EP.
Internal Medicine Service, US Army Medical Activity, Heidelberg, Germany.
Levine DZ.
- 253 -
Department of Family Medicine, Michigan State University College of Osteopathic Medicine,
East Lansing.
Levine HM.
Licciardone JC
Osteopathic Research Center, University of North Texas Health Science Center, Fort Worth,
TX 76107, USA. [email protected]
Licciardone JC
Dep. of Family Medicine, Univ. of North Texas Health Science Center at Fort Worth-Texas
College of Osteopathic Medicine, 3500 Camp Bowie Blvd, Fort Worth, TX 76107-2604, USA.
[email protected]
Lipinski B.
Littlejohn JM.
Llorens C.
Locke RG
Department of Pediatrics, University of Medicine and Dentistry of New Jersey,
School of Osteopathic Medicine, Stratford.
Lomakin PV.
Lowenstein MB.
Luckenbill-Edds L
Department of Biological Sciences, Ohio University College of Osteopathic Medicine,
Athens 45701, USA.
Lyon DA.
MacDonald RS
London College of Osteopathic Medicine, England.
Magnus WW
- 254 -
Department of Manipulative Medicine,
University of North Texas Health Science Center at Fort Worth, USA.
Magoun HI Jr.
Mahal J.
Maher CG
School of Physiotherapy, The University of Sydney, Sydney, NSW, 1825, Australia.
[email protected]
Mall R.
Mann DD
Department of Social Medicine, Ohio University College of Osteopathic Medicine, Athens, USA.
Martin RB.
Department of Family Medicine, Nova Southeastern University, College of Osteopathic Medicine,
Fort Lauderdale, FL 33328-2018, USA. [email protected]
McPartland JM
Unitec Institute of Technology, Auckland, New Zealand. [email protected]
Meacham WB.
Mein EA
Meridian Institute, 1853 Old Donation Parkway, Suite 1, Virginia Beach, VA 23454, USA.
[email protected]
Mesina J
Lake Erie College of Osteopathic Medicine (LECOM), PA 16509-1025, USA.
Millett PJ
Harvard Shoulder Service/Sports Medicine, Harvard Medical School,
and Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. [email protected]
Mills MV.
- 255 -
Mirman MJ.
Moncman MG.
Morehouse M.
Morey LW Jr.
Morgan JP
Moskalenko IuE
Moss L.
Murphy LS
Science Library Reference Department, University of California, Irvine 926233-9557, USA.
[email protected]
Neame A.
Nelson KE.
Division of Osteopathic Manipulative Medicine, Chicago College of Osteopathic Medicine,
Downers Grove, IL 60515, USA.
Newswanger DL
Nicholas AS
Department of Osteopathic Manipulative Medicine at Philadelphia College of Osteopathic Medicine
Philadelphia, USA.
Noll DR
Department of Internal Medicine, Kirksville College of Osteopathic Medicine,
A. T. Still University of Health Sciences, Kirksville, MO 63501-1443, USA. [email protected]
Noll DR
Division of Medicine, Kirksville College of Osteopathic Medicine, 800 W Jefferson St, Kirksville,
MO 63501, USA.
- 256 -
Noll DR
Department of Internal Medicine,
University of North Texas Health Science Center at Fort Worth, USA.
Norris SH.
Northup GW.
Norton JM.
O' Leary S
Department of Physiotherapy, University of Queensland, St. Lucia, Australia.
Obarski TP.
Oleski SL
Philadelphia College of Osteopathic Manipulative Medicine, PA 19131, USA.
O'Neill A.
Department of Health Administration and Education, Lincoln School of Health Sciences,
La Trobe University, Victoria, Australia.
Oppenheim JS.
Orlando C
Orman R.
Ormos G.
Padgett DK.
Paterson JK.
Patriquin DA.
Department of Family Medicine, University College of Osteopathic Medicine, Athens, Ohio 45701.
- 257 -
Patterson MM.
Paul FA
Riverside Osteopathic Hospital, Trenton, MI 48183, USA.
Paul RT
Payson SM
Pearson RH.
Peckham FF.
Perrin RN
Telford Research Institute, University of Salford, Greater Manchester, UK.
Peters D
Marylebone Health Centre, London.
Peterson B.
Pichichero ME.
Pintal WJ
Pittler MH
Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences,
University of Exeter, Exeter, United Kingdom. [email protected]
Plotkin BJ
Department of Microbiology, Chicago College of Osteopathic Medicine of Midwestern University,
Porcelli MJ.
Western University of Health Services College of Osteopathic Medicine of the Pacific, Pomona,
Calif, USA. [email protected]
Pratt-Harrington D.
- 258 -
Pringle M
Department of General Practice, Nottingham University Medical School.
Protopapas MG
Good Samaritan Hospital, Baltimore, MD, USA.
Przekop PR Jr
Department of Preventative Medicine, Loma Linda University, Loma Linda, Calif, USA.
[email protected]
Purdy WR
PURSE FM.
Radjieski JM
Michigan Hospital and Medical Center, Detroit, USA.
Ray AM
University of New England College of Osteopathic Medicine, Biddeford, Maine, USA.
Rebain R
University of Ulster, Rehabilitation Sciences Research Group, County Atrim, Northern Ireland.
Reilly DT.
Reitman C
Baylor College of Medicine, Houston, Texas, USA.
Renckens CN.
Richards BS
Texas Scottish Rite Hospital for Children, Dallas, Texas, USA. [email protected]
Richardson ME.
- 259 -
Rivera-Martinez S
Department of Osteopathic Manipulative Medicine,
New York College of Osteopathic Medicine of New York Institute of Technology,
Old Westbury 11568-8000, USA. [email protected]
Rogers FJ.
Downriver Cardiology Consultants, 2205 Riverside Dr, Trenton, MI 48183-2101, USA.
[email protected]
Rogers FJ.
Michigan State University College of Osteopathic Medicine, East Lansing, MI 48824-1316, USA.
[email protected]
Roppel RM
Rowane WA
Department of Family Medicine/Case Western Reserve University, Cleveland, Ohio 44106-4950,
USA.
Rubinstein L.
Rumney IC.
Saedt E
Salamon E
Neuroscience Research Institute, State University of New York, College at Old Westbury,
Samorukov AE.
Scheibel A
Scheurmier N
Wiltshire Health Authority, England.
Schiowitz S.
- 260 -
Office for Clinical Affairs, New York College of Osteopathic Medicine, Old Westbury 11568.
Schmidt IC.
Sergueef N
Department of Osteopathic Manipulative Medicine, Chicago College of Osteopathic Medicine,
Midwestern University, Downers Grove, Ill, USA.
Shekelle PG
West Los Angeles Veterans Affairs Medical Center, California, USA.
Shubrook JH Jr
Firelands Community Hospital, Ohio University College of Osteopathic Medicine, Athens 45701,
USA.
Shuman D.
Siehl D
Sleszynski SL
Midwestern University's Chicago College of Osteopathic Medicine, Downer's Grove, Illinois,
Sleszynski SL
Department of Surgery, Chicago-College of Osteopathic Medicine of Midwestern University
(CCOM), Ill.
Smith RM.
Sommerfeld P
Department of Medical Computer Sciences at the University of Vienna, Austria.
[email protected]
Soutas-Little RW.
Spaeth DG
Department of Family Medicine, Ohio University College of Osteopathic Medicine, Athens,
Ohio 45701, USA. [email protected]
- 261 -
Spiegel AJ
Department of Osteopathic Medicine, New York College of Osteopathic Medicine,
Steiner C.
Department of Osteopathic Sciences, University of Medicine and Dentistry of New Jersey-Schoo
of Osteopathic Medicine, Stratford.
Stiles EG.
STODDARD A.
Stookey JR.
Strassburg HM.
Univ.-Kinderklinik und Fruhdiagnosezentrum, Josef Schneider-Str. 2, 97080 Wurzburg.
Stretanski MF
Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, USA.
[email protected]
Sucher BM
Center for Carpal Tunnel Studies, 10585 N Tatum Blvd, Ste D135, Paradise Valley,
AZ 85253-1073, USA. [email protected]
Sucher BM.
Mountain View Center, Paradise Valley, AZ 85253.
Sweetman BJ.
Taylor AJ
Nottingham Nuffield Hospital, 748 Mansfield Road, Woodthorpe, Nottingham NG5 3FZ, UK.
Tessien RM.
Tettambel MA.
- 262 -
800 W Jefferson, Kirksville, MO 63501, USA. [email protected]
Turney J.
College of Cranio-Sacral Therapy, London.
Van Buskirk RL.
Vautravers P
Physical and Rehabilitation Therapy Unit, Hautepierre Hospital, Strasbourg Teaching Hospitals,
France.
Vick DA
Department of Osteopathic Manipulative Medicine,
University of North Texas Health Science Center at Fort Worth-Texas
College of Osteopathic Medicine 76107-2699, USA.
Waitley DD.
Walko EJ
Chicago College of Osteopathic Medicine of Midwestern University, Downers Grove, Ill.
Wax CM
Allegheny University Hospital-City Avenue Hospital, (Philadelphia, Pa)., USA.
[email protected]
Wax CM.
Weiner LB
Weir JP
Program in Physical Therapy, University of Osteopathic Medicine and Health Sciences,
Des Moines, IA 50312, USA.
Wells MR
Department of Biomechanics and Bioengineering, New York College of Osteopathic Medicine,
New York Institute of Technology, Old Westbury 11568-8000, USA.
Williams N.
- 263 -
Health Centre, Llanfairfechan, North Wales.
Williams NH
Department of General Practice, University of Wales College of Medicine,
Institute of Medical and Social Care Research, University of Wales-Bangor, Bangor, Wales, UK.
[email protected]
Wood LR.
Woolbright JL.
Aeromedical Services, Maxwell AFB, AL 36113-1102.
Wright RM.
Yates HA
Department of Manipulative Medicine, Kirksville College of Osteopathic Medicine,
MO 63501-1443, USA. [email protected]
Ylinen J
Finland.
Zorski KC
- 264 -
Liste des revues
Cette liste regroupe les publications repérées dans PubMed et classées par ordre
alphabétique. Pour chaque revue, les références bibliographiques de tous les articles
repérés sont mentionnées les unes après les autres, selon l’ordre chronologique de
parution. Les publications françaises ou francophones sont imprimées en caractères gras.
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Altern Ther Health Med. 2000 Sep;6(5):77-81.
Altern Ther Health Med. 2002 Nov-Dec;8(6):74-6.
Altern Ther Health Med. 2003 Jul-Aug;9(4):112, 108-9.
Altern Ther Health Med. 2004 Jul-Aug;10(4):74-6.
Am Fam Physician. 1993 Nov 1;48(6):1023-4.
Am Fam Physician. 1994 Jan;49(1):63.
Am Fam Physician. 1994 Jul;50(1):51, 54; author reply 55.
Am Fam Physician. 1994 Jul;50(1):51.
Am Fam Physician. 1994 Jul;50(1):54-5.
Am Fam Physician. 2000 Dec 1;62(11):2414-5.
Am J Chin Med (Gard City N Y). 1977 Spring;5(1):79-84.
Am J Orthop. 1995 Mar;24(3):241-50. Review.
Am J Orthop. 2003 Nov;32(11):531-8. Review.
Am J Phys Med Rehabil. 1995 Nov-Dec;74(6):439-43.
Anal Biochem. 1988 Oct;174(1):239-50.
Ann Allergy Asthma Immunol. 2004 Aug;93(2 Suppl 1):S55-60. Review.
Ann Intern Med. 1993 Apr 15;118(8):651; author reply 652-3.
Ann Intern Med. 1993 Apr 15;118(8):651-2; author reply 652-3.
Ann Readapt Med Phys. 2003 Feb;46(1):33-40. French.
- 265 -
Arch Fam Med. 1994 Jun;3(6):487-9.
Arch Fam Med. 1999 Nov-Dec;8(6):477-84. Review.
Arch Pediatr Adolesc Med. 2003 Sep;157(9):852-3.
Aust J Physiother. 2002;48(1):25-30.
BMC Complement Altern Med. 2003 Jul 7;3:3. Epub 2003 Jul 7.
BMC Musculoskelet Disord. 2005 Aug 4;6:43.
Br J Gen Pract. 1993 Jan;43(366):15-8.
Br J Gen Pract. 1994 Jan;44(378):25-9.
Br J Gen Pract. 1997 Oct;47(423):653-5. Review.
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Br Med J (Clin Res Ed). 1985 Dec 14;291(6510):1720-1.
Br Med J (Clin Res Ed). 1985 Nov 30;291(6508):1540-1.
Br Med J (Clin Res Ed). 1986 Dec 6;293(6560):1482-3.
Br Med J (Clin Res Ed). 1986 Jan 18;292(6514):205.
Br Med J. 1975 May 10;2(5966):334.
Cah Coll Med Hop Paris. 1968 Sep;9(10):861-6. French.
Clin J Sport Med. 2003 Mar;13(2):69-70.
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Cochrane Database Syst Rev. 2005 Apr 18;(2):CD001002. Review.
Complement Ther Med. 2000 Mar;8(1):8-14.
- 266 -
Cranio. 1987 Jul;5(3):278-85.
Cranio. 2002 Jan;20(1):34-8.
Curr Pain Headache Rep. 2001 Aug;5(4):369-75. Review.
Duodecim. 1996;112(14):1264-73. Review. Finnish.
Eur J Appl Physiol Occup Physiol. 1996;73(3-4):387-92.
Eur Spine J. 2000 Jun;9(3):202-7.
Fam Med. 2005 Nov;37(10):693-5.
Fam Pract. 2003 Dec;20(6):662-9.
Fam Pract. 2004 Dec;21(6):643-50. Epub 2004 Nov 5.
Fiziol Zh Im I M Sechenova. 1996 Jul;82(7):36-45. Russian.
Headache. 2005 Jun;45(6):738-46. Review.
Heart Dis. 2003 Jul-Aug;5(4):272-8. Review.
Hosp Pract (Off Ed). 1989 Jul 15;24(7):17, 20.
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Hosp Pract (Off Ed). 1989 Sep 30;24(9A):12-4.
Inf Dent. 1982 Oct 28;64(37):3583-615. Review. French.
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Int J Mol Med. 2004 Sep;14(3):443-9. Review.
J Altern Complement Med. 2002 Apr;8(2):109-10.
- 267 -
J Am Osteopath Assoc. 1961 Dec;61:274-6.
J Am Osteopath Assoc. 1963 Dec;63:343-50.
- 268 -
J Am Osteopath Assoc. 1984 Sep;84(1 Suppl):152-6.
J Am Osteopath Assoc. 1989 Nov;89(11):1379, 1384, 1387 passim.
J Am Osteopath Assoc. 1990 Feb;90(2):145-6, 151-5. Review.
J Am Osteopath Assoc. 1990 Jul;90(7):602-4, 607-12. Review.
- 269 -
J Am Osteopath Assoc. 1990 Dec;90(12):1051.
J Am Osteopath Assoc. 1991 Feb;91(2):117, 121.
J Am Osteopath Assoc. 1991 Feb;91(2):156, 161-8, 170-1. Review.
J Am Osteopath Assoc. 1991 Mar;91(3):218, 220.
J Am Osteopath Assoc. 1991 Apr;91(4):370, 373-6.
J Am Osteopath Assoc. 1991 Nov;91(11):1054.
J Am Osteopath Assoc. 1992 Mar;92(3):334, 337-41. Review.
J Am Osteopath Assoc. 1993 Jan;93(1):118, 123-5.
J Am Osteopath Assoc. 1993 Jan;93(1):92-4, 100-1.
J Am Osteopath Assoc. 1993 Feb;93(2):203-8, 213-4.
J Am Osteopath Assoc. 1993 Aug;93(8):834-8, 843-5.
J Am Osteopath Assoc. 1993 Sep;93(9):888.
J Am Osteopath Assoc. 1994 Aug;94(8):647-63. Review.
J Am Osteopath Assoc. 1995 Mar;95(3):182-8; 191-2.
- 270 -
Erratum in: J Am Osteopath Assoc 1997 Apr;97(4):202.
Erratum in: J Am Osteopath Assoc 1998 Jul;98(7):408.
J Am Osteopath Assoc. 1998 Sep;98(9):476.
J Am Osteopath Assoc. 1999 Nov;99(11):561, 565.
J Am Osteopath Assoc. 2000 Apr;100(4):218-24, 227.
J Am Osteopath Assoc. 2000 May;100(5):285-6, 289-98.
J Am Osteopath Assoc. 2000 May;100(5):301-4, 309.
- 271 -
J Am Osteopath Assoc. 2001 Jul;101(7):402.
J Am Osteopath Assoc. 2001 Oct;101(10):625.
J Am Osteopath Assoc. 2002 Mar;102(3):120; author reply 120-1.
- 272 -
Erratum in: J Am Osteopath Assoc 2002 Jun;102(6):306. Protapapas Marina G
J Am Osteopath Assoc. 2002 Sep;102(9 Suppl 3):S5-8.
J Am Osteopath Assoc. 2002 Nov;102(11):573; author reply 573.
J Am Osteopath Assoc. 2003 Jun;103(6):264; author reply 264-5.
J Am Osteopath Assoc. 2003 Aug;103(8):354-5; author reply 355-6.
J Am Osteopath Assoc. 2003 Dec;103(12):583-96. Review.
J Am Osteopath Assoc. 2004 Jan;104(1 Suppl 1):S1-8. Review.
J Am Osteopath Assoc. 2004 Jan;104(1):8, 12.
J Am Osteopath Assoc. 2004 Feb;104(2):71; author reply 71.
J Am Osteopath Assoc. 2004 Feb;104(2):73-5, 66.
Erratum in: J Am Osteopath Assoc. 2004 Apr;104(4):147.
J Am Osteopath Assoc. 2004 Aug;104(8):315.
- 273 -
J Am Osteopath Assoc. 2004 Oct;104(10):405-6; author reply 406.
J Am Osteopath Assoc. 2004 Nov;104(11 Suppl 8):S13-8. Review.
J Am Osteopath Assoc. 2005 Jan;105(1):22.
Erratum in: J Am Osteopath Assoc. 2005 May;105(5):238.
J Am Osteopath Assoc. 2005 May;105(5):237; author reply 237-8.
J Back Musculoskeletal Rehabil. 1998;11(2):89-130.
J Clin Epidemiol. 2000 May;53(5):485-9.
J Comp Neurol. 1988 Feb 22;268(4):469-88.
J Fam Pract. 1993 Sep;37(3):221-2.
J Manipulative Physiol Ther. 1992 Nov-Dec;15(9):591-5. Review.
J Manipulative Physiol Ther. 1993 Jan;16(1):33-6. Review.
J Manipulative Physiol Ther. 1998 Jan;21(1):14-8.
J Manipulative Physiol Ther. 1999 Jun;22(5):280-91.
J Manipulative Physiol Ther. 2001 Sep;24(7):457-66.
J Med Eng Technol. 1998 Jan-Feb;22(1):1-13.
J Occup Med. 1972 Nov;14(11):851-3.
J Occup Med. 1972 Dec;14(12):892.
J Orthop Sci. 2000;5(4):411-7. Review.
J Orthop Sports Phys Ther. 1998 Mar;27(3):213-8.
- 274 -
J Pediatr Orthop. 2005 Jan-Feb;25(1):98-102.
J Spinal Disord. 1997 Jun;10(3):223-8. Review.
J Virol Methods. 1988 Mar-Apr;19(3-4):239-47.
JAMA. 1983 Jun 17;249(23):3148-50.
Joint Bone Spine. 2000;67(4):272-6. Review.
Kinderkrankenschwester. 2000 Oct;19(10):408-11. German.
Lancet. 1970 Feb 21;1(7643):412-3.
Lancet. 1979 Jun 23;1(8130):1350.
Lancet. 1985 Jun 1;1(8440):1258-61.
Laryngol Rhinol Otol (Stuttg). 1975 Mar;54(3):263-7. German.
Laryngoscope. 1986 Feb;96(2):166-70.
Man Ther. 2001 Aug;6(3):130-8. Review.
Man Ther. 2001 Nov;6(4):229-34.
Man Ther. 2002 Aug;7(3):150-3.
Man Ther. 2003 Feb;8(1):42-5.
Man Ther. 2004 Feb;9(1):22-9.
Man Ther. 2004 Feb;9(1):30-5.
Man Ther. 2004 May;9(2):109-13.
Man Ther. 2005 Feb;10(1):73-7.
Med Clin North Am. 2002 Jan;86(1):91-103. Review.
Med Hypotheses. 1977 Jan-Feb;3(1):9-12.
N Engl J Med. 1999 Nov 4;341(19):1426-31.
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N Engl J Med. 1999 Nov 4;341(19):1465-8.
N Engl J Med. 2000 Mar 16;342(11):817-8; author reply 819-20.
N Z Med J. 1989 Mar 8;102(863):112.
Ned Tijdschr Geneeskd. 2005 Mar 26;149(13):703-7. Review. Dutch.
Ned Tijdschr Geneeskd. 2005 May 28;149(22):1237; author reply 1237-8. Dutch.
Ned Tijdschr Geneeskd. 2005 May 28;149(22):1238-9; author reply 1239. Dutch.
Nord Med. 1963 Jun 6;69:684-7. Norwegian.
Nord Med. 1963 Jun 6;69:684-7. Norwegian.
Nurs Mirror Midwives J. 1972 Feb 25;134(7):24-7.
Ortop Travmatol Protez. 1980 Oct;(10):69-76. Review. Russian.
Ortop Travmatol Protez. 1989 May;(5):55-8. Russian.
Orv Hetil. 1993 Aug 29;134(35):1948-9. Hungarian.
Phys Ther. 1992 Dec;72(12):843-52. Review.
Phys Ther. 1996 Jun;76(6):664-6. Erratum in: Phys Ther 1996 Aug;76(8):896.
Physiotherapy. 1970 Jan 10;56(1):29-30.
Physiotherapy. 1982 Apr;68(4):104.
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Presse Med. 1992 Dec 5;21(42):2050-2. French.
Rev Med Brux. 1998 Sep;19(4):A283-9. Review. French.
Rheum Dis Clin North Am. 2000 Feb;26(1):83-96, ix. Review.
Rheumatol Rehabil. 1975 Aug;14(3):191-9.
Rheumatol Rehabil. 1981 Nov;20(4):239-46.
Rhumatologie. 1968 Dec;20(10):411-4. French.
Schweiz Rundsch Med Prax. 1974 Jul 9;63(27):829-36. German.
Schweiz Rundsch Med Prax. 1992 Sep 8;81(37):1087-91. German.
Schweiz Rundsch Med Prax. 1993 Aug 17;82(33):875-9. German.
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Va Med Mon (1918). 1975 Jan;102(1):25-8.
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- 277 -

MacMut Biblio N°1 osteopathic Manipulation V2

Transcription

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