Osteopathy Video

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Osteopathy Video

  1. 1. OSTEOPATHIC APPROACH TO PATIENT CARE AND WELLNESS SMART LIFE FORUM NOVEMBER 16, 2006 HARRY D FRIEDMAN DO
  2. 2. OSTEOPATHIC MEDICINE AS ART, INTEGRATING <ul><li>NATURAL & TECHNOLOGICAL APPROACHES </li></ul><ul><li>SCIENTIFIC & INTUITIVE THINKING </li></ul><ul><li>STRUCTURAL & FUNCTIONAL THERAPY </li></ul><ul><li>PATIENT & DISEASE FOCUSED CARE </li></ul>
  3. 3. DEFINITION OF OSTEOPATHIC MEDICINE <ul><li>“ A complete system of medical care with a philosophy that combines the needs of the patient with the current practice of medicine, surgery and obstetrics; that emphasizes the interrelationship between structure and function; and that has an appreciation for the body’s ability to heal itself.” </li></ul><ul><li>-A.O.A. House of Delegates </li></ul>
  4. 4. OSTEOPATHIC PRINCIPLES <ul><li>THE BODY FUNCTIONS AS A UNIFIED WHOLE WITH AN INHERENT VITALITY THAT IS </li></ul><ul><li>SELF-HEALING AND SELF-REGULATING. </li></ul><ul><li>STRUCTURE & FUNCTION BEING INTERRELATED, </li></ul><ul><li>ALTERATION OF THE BODY’S STRUCTURAL FRAMEWORK AND CONNECTIVE TISSUE SYSTEM CAN LEAD TO ILLNESS AND DISEASE, THE </li></ul><ul><li>CORRECTION OF WHICH IS PART OF RATIONAL OSTEOPATHIC HEALTHCARE </li></ul>
  5. 5. PASSEBECQ (1992) <ul><li>“ TO MAINTAIN A HEALTHY BODY, HOMEOSTASIS MUST BE KEPT CONSTANT…A HEALTHY ORGANIC TERRAIN IS THE BASIS OF HEALTH AND CONVERSLEY DISEASES DEVELOP IN A DEPLETED OR CONGESTED TERRAIN. UPSTREAM OF MOST DISEASES IS AN UNBALANCED TERRAIN.” </li></ul>
  6. 6. BEING COMPRISED MOSTLY OF FLUID, LIVING TERRAIN IS NOT STATIC, BUT CONSTANTLY MOVING, LIKE THE EBB AND FLOW OF THE OCEAN. WHERE THERE IS A LACK OF MOTION, THERE LIES AN UNBALANCED TERRAIN AND THE BEGINNING OF DISEASE.
  7. 7. INTERRELATIONSHIP AND INTERDEPENDENCE OF STRUCTURE-FUNCTION <ul><li>“ DISEASE IS THE RESULT OF ANATOMICAL ABNORMALITIES FOLLOWED BY PHYSIOLOGIC DISCORD” </li></ul><ul><li>“ THE RULE OF THE ARTERY IS SUPREME” </li></ul><ul><li>-A.T. STILL MD </li></ul>
  8. 8. OPTIMAL MULTISYSTEM FUNCTION REQUIRES <ul><li>UNIMPEDED DELIVERY OF BLOOD AND DISPOSAL OF WASTE PRODUCTS </li></ul><ul><li>CENTRAL AND AUTONOMIC NERVOUS SYSTEM BALANCE </li></ul><ul><li>MOTOR SYSTEM COORDINATION </li></ul><ul><li>UNITY OF THE WHOLE THAT ENHANCES THE FUNCTION OF EACH PART </li></ul>
  9. 9. THE WHOLE IS GREATER THAN THE SUM OF ITS PARTS <ul><li>OSTEOPATHIC MANIPULATIVE APPROACHES CAN ALTERNATELY EVALUATE THE FUNCTION OF THE WHOLE OR ITS COMPONENT PARTS AND PROVIDE TREATMENT THAT ENHANCES EACH </li></ul>
  10. 10. OSTEOPATHIC MANIPULATIVE TREATMENT (OMT) <ul><li>THE THERAPEUTIC APPLICATION OF MANUALLY GUIDED FORCES BY AN OSTEOPATHIC PHYSICIAN TO IMPROVE PHYSIOLOGIC FUNCTION AND/OR SUPPORT HOMEOSTASIS THAT HAS BECOME ALTERED BY SOMATIC DYSFUNCTION </li></ul>
  11. 11. SOMATIC DYSFUNCTION <ul><li>“ IMPAIRED OR ALTERED FUNCTION OF RELATED COMPONENTS OF THE SOMATIC (BODY FRAMEWORK) SYSTEM: SKELETAL, ARTHROIDIAL AND MYOFASCIAL STRUCTURES AND RELATED VASCULAR, LYMPHATIC AND NEURAL ELEMENTS.” </li></ul><ul><li>- ICD-9 DIAGNOSTIC CODEBOOK (739.0 -.9) </li></ul>
  12. 12. THE HUNT FOR SOMATIC DYSFUNCTION THINK A.R.T. <ul><li>A FOR ASYMMETRY </li></ul><ul><li>OBSERVE OR PALPATE “UNEVENNESS” </li></ul><ul><li>R FOR RESTRICTION OF MOTION </li></ul><ul><li>PALPATE FOR EARLY “ENDFEEL” </li></ul><ul><li>T FOR TISSUE QUALITY ALTERATIONS </li></ul><ul><li>PALPATE TEXTURE , TEMP, MOISTURE, TENDERNESS </li></ul>
  13. 13. BERNIE SEIGAL, PEACE, LOVE AND HEALING 1989 (#1NY TIMES BEST SELLER) <ul><li>“ THE OSTEOPATHIC STUDENTS HAVE BEEN TAUGHT ABOUT TOUCHING AND MANIPULATING THE BODY, AND WHEN THEY’RE IN MY OFFICE AND A PATIENT WHO HAS SOME PAIN COMES IN, THEY KNOW HOW TO USE MANIPULATION AND MASSAGE TO HELP RELIEVE THAT PAIN. THE MEDICAL STUDENT IS MORE PRONE TO PRESCRIBE A PILL. WE NEED TO TEACH MEDICAL STUDENTS HOW TO TOUCH PEOPLE.” </li></ul>
  14. 14. ANDREW WEIL MD. SPONTANEOUS HEALING 1995 (#1 NYTIMES BEST SELLER) <ul><li>“ I FREQUENTLY REFER PATIENTS TO DO’S FOR OMT AND OFTEN ENCOURAGE MEDICAL STUDENTS TO LEARN THE TECHNIQUE, BECAUSE I HAVE FOUND IT TO BE SAFE AND HIGHLY EFFECTIVE.) </li></ul>
  15. 15. HISTORY OF MANUAL MEDICINE <ul><li>2700 BC CHINESE </li></ul><ul><li>400 BC HIPPOCRATES </li></ul><ul><li>100 BC GALEN, “THE PRINCE OF PHYSICIANS” </li></ul><ul><li>19TH CENTURY BONESETTERS </li></ul><ul><li>19TH CENTURY STILL, PALMER </li></ul><ul><li>20TH CENTURY MENNELL, CYRIAX </li></ul><ul><li>20TH CENTURY SUTHERLAND, BARRAL </li></ul>
  16. 16. TRACTION AND THRUST
  17. 17. AT
  18. 18. ANDREW TAYLOR STILL, MD <ul><li>1854 LICENSED AS MD, SERVED IN CIVIL WAR </li></ul><ul><li>1864 3 FAMILY MEMBERS DIE OF MENINGITIS, RENOUNCES MEDICINE, TAKES UP STUDY OF STRUCTURE-FUNCTION/UNITY OF THE BODY </li></ul><ul><li>1874 PRINCIPLES OF OSTEOPATHY UNVEILED </li></ul><ul><li>1892 AMERICAN SCHOOL OF OSTEOPATHY OPENS </li></ul>
  19. 19. DO SCHOOLS
  20. 20. HOW DOES MANIPULATION WORK? <ul><li>PATHOPHYSIOLOGIC MODELS </li></ul><ul><li>FACET DYSFUNCTION </li></ul><ul><li>NOCICEPTION (PAIN) </li></ul><ul><li>MECHANORECEPTION (PRESSURE) </li></ul><ul><li>PROPRIOCEPTION (POSITION) </li></ul>
  21. 21. REFERRED PAIN
  22. 22. NOCICEPTORS
  23. 23. HOW DOES MANIPULATION WORK? <ul><li>PATHOPHYSIOLOGIC MODELS </li></ul><ul><li>NEURAL FACILITATION </li></ul><ul><li>ALTERED REFLEXES CAUSING HYPERACTIVE OR INHIBITED RESPONSES TO STIMULI OR STRESS </li></ul>
  24. 24. SPINAL REFLEXES
  25. 25. NEURAL FACILITATION <ul><li>VISCERAL (ORGAN) STRESS AND DISEASE ARE REFLECTED IN THE TISSUES SURROUNDING THE SPINAL LEVELS WHICH INNERVATE IT </li></ul><ul><li>ESOPHAGUS T 2-3 </li></ul><ul><li>STOMACH T 5-6 </li></ul><ul><li>HEART T 2-6 </li></ul><ul><li>GALLBLADER T8-9 </li></ul><ul><li>KIDNEY T9-11 </li></ul>
  26. 26. HOW DOES MANIPULATION WORK? <ul><li>PATHOPHYSIOLOGIC MODELS </li></ul><ul><li>MOTOR SYSTEM DYSFUNCTION </li></ul><ul><li>MUSCLE TENSION AND LENGTH ALTERED BY POSTURAL STRESS, INJURY OR ALARM </li></ul><ul><li>OVER AND UNDER STIMULATED MUSCLES AND THEIR ASSOCIATED BODY-WIDE COMPENSATIONS CAUSE DISTURBANCES IN POSTURE, MOTION, AND COORDINATION </li></ul>
  27. 27. MUSCLE SPINDLE
  28. 28. GOALS OF OSTEOPATHIC TREATMENT <ul><li>RESTORE MIDLINE FUNCTION AND MOBILITY OF ALL TISSUES </li></ul><ul><li>IMPROVE POSTURE AND BODY MOVEMENT </li></ul><ul><li>MOBILIZE FLUIDS TO AND FROM ALL TISSUES </li></ul><ul><li>BALANCE CNS/ANS REFLEXES (CALM DOWN HYPERACTIVE NERVES) </li></ul><ul><li>ENHANCE HEALING AND HOMEOSTASIS </li></ul>
  29. 29. <ul><li>M OTION </li></ul><ul><li>RESPIRATI O N </li></ul><ul><li>ME T ABOLISM </li></ul><ul><li>BEHAV I OR </li></ul><ul><li>CIRCULATI O N </li></ul><ul><li>NEURAL I N TEGRATION </li></ul>
  30. 30. CORRECTIVE FORCES CAN BE DIRECT OR INDIRECT <ul><li>DIERCT TECHNIQUES ENGAGE AND OVERCOME TISSUE RESTRICTION </li></ul><ul><li>INDIRECT TECHNIQUES DIS-ENGAGE AND RELEASE TISSUE RESTRICTION WITH AFFERENT REDUCTION </li></ul><ul><li>BOTH STIMULATE THE PATIENT’S INHERENT RESTORATIVE CAPACITY BY ACTIVATING DYNAMIC MIDLINE FUNCTION </li></ul>
  31. 31. DOES IT WORK
  32. 32. REVIEW OF LIT
  33. 33. NEJM ART
  34. 34. RESULTS
  35. 35. WC COST ANALYSIS
  36. 36. EBM DATA
  37. 37. PRE-POST MFR
  38. 38. FRYMANN
  39. 39. THE BODY IS ESSENTIALLY A FLUID CONTAINER, ITS STRUCTURE DETERMINES THE PROPER PLACEMENT AND COORDINATED FUNCTION OF EVERY TISSUE. WHEN STRUCTURE AND FUNCTION ARE IMPAIRED, HOMEOSTASIS FALTERS.
  40. 40. <ul><li>OSTEOPATHIC MANIPULATIVE MEDICINE ENHANCES THE BODY’S STRUCTURE AND FUNCTION, IMPROVING FLUID MOBILITY AND HOMEOSTASIS, IMPARTING HEALTH TO EVERY TISSUE </li></ul>
  41. 41. LINKS <ul><li>WWW.DRAGONFLYVILLAGE.COM/OSTEOPATHY </li></ul><ul><li>WWW.SFIMMS.COM </li></ul><ul><li>WWW.ACADEMYOFOSTEOPATHY.ORG </li></ul><ul><li>WWW.OSTEOHOME.COM </li></ul><ul><li>WWW.OSTEOPATHIC.ORG </li></ul><ul><li>WWW.DO-ONLINE.ORG </li></ul><ul><li>WWW.AACOM.ORG </li></ul>

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