As her final thesis topic for London College of Osteopathy and Health Sciences (LCO) Diploma in Osteopathic Manual Practice (DOMP) program, Dr. Fadila Naji examines the effects of osteopathy on patients' psychology.
Diploma in Osteopathic Manual Practice (DOMP) graduate, Herbert Carty, examines the effectiveness of manual osteopathy on pain symptoms resulting from temporomandibular joint (TMJ) disorders.
Diploma in Osteopathic Manual Practice (DOMP) student, Justine Teng, explores the benefits of osteopathic manual treatment on aerobic group exercise instructors.
In his Master of Science in Osteopathy (M.Sc.O) thesis for London College of Osteopathy and Health Sciences (LCO), Dr. Arun Vijayan explores the potential benefits of osteopathic treatment techniques on symptoms related to Multiple Sclerosis.
Master of Science in Osteopathy (M.Sc.O) graduate and head instructor at London College of Osteopathy and Health Sciences (LCO), Rachel Pechek, explores the effectiveness of osteopathic treatment on visceral lesions in equines.
Recent advances in Manipulative MedicineSoniya Lohana
What new techniques are been used in manipulative medicine and physical therapy that help the patients to recover better and address their condition by various approaches where surgery is not required.
Diploma in Osteopathic Manual Practice (DOMP) graduate, Herbert Carty, examines the effectiveness of manual osteopathy on pain symptoms resulting from temporomandibular joint (TMJ) disorders.
Diploma in Osteopathic Manual Practice (DOMP) student, Justine Teng, explores the benefits of osteopathic manual treatment on aerobic group exercise instructors.
In his Master of Science in Osteopathy (M.Sc.O) thesis for London College of Osteopathy and Health Sciences (LCO), Dr. Arun Vijayan explores the potential benefits of osteopathic treatment techniques on symptoms related to Multiple Sclerosis.
Master of Science in Osteopathy (M.Sc.O) graduate and head instructor at London College of Osteopathy and Health Sciences (LCO), Rachel Pechek, explores the effectiveness of osteopathic treatment on visceral lesions in equines.
Recent advances in Manipulative MedicineSoniya Lohana
What new techniques are been used in manipulative medicine and physical therapy that help the patients to recover better and address their condition by various approaches where surgery is not required.
To Compare The Effect Of Core Stability Exercises And Muscle Energy Technique...IOSR Journals
Abstract: Low back pain is considered one of the commonest condition in the western and industrialized
countries. It is estimated that up to 50% of adults experience low back pain during their life span. People of all
age group can be effected by this menace irrespective to their gender and quality of life. It has become one of
the leading causes for the visit to physician thus also puts a heavy burden on the currency of the country.
Physiotherapy is the most widely used form of treatment adopted for gaining relief from low back pain. The
exercises include stretching, strengthening, range of motion exercises, McKenzie therapy and core stability
exercises other techniques like muscle energy technique etc. It has been concluded in various studies core
stability exercises and muscle energy technique are beneficial in low back pain patients but comparison of their
effect needs to be established to provide early and better relief from the disability. Therefore objective of the
study was to compare the effect of core stability exercises and muscle energy techniques on low back pain
patients. 60 subjects aged 18 – 45 years with low back pain were made part of the study based on inclusion and
exclusion criteria and were then divided into three groups named A, B and C. Group A received core stability
exercise and conventional physiotheraphy and group B received muscle energy techniques and conventional
physiotherapy. The exercise program was given on alternate days with a total of 24 sessions and progression of
the activity was made within the tolerance of the patient. Pre and post treatment readings were taken of pain,
ROM and quality of life scale. Results were analyzed using paired, unpaired t- test and ANOVA. Results showed
that there is significant effect on pain, ROM and quality of life scale in the three groups but group A was
clinically more significant than the other groups. The study concluded that patients with low back pain are
benefitted more by core stability exercises. So, core stability exercises should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Muscle Energy Technique.
Modern Principles of Osteopathy
The International Academy of Osteopathy provides osteopathic education in Europe and beyond.
Contact us for more information: info@osteopathy.eu
http://www.osteopathie.eu/en/publications
http://www.osteopathie.eu/en
Osteopathic Manipulation Treatment (OMT) is growing rapidly as a preferred and natural family medicine. As a treatment, osteopathic manipulation attempts to improve joint range of motion and balance tissue and muscle mechanics in order to relieve pain.
To Compare The Effect Of Proprioceptive Neuromuscular Facilitation Program Ve...IOSR Journals
Abstract: Low back pain has been a matter of concern, affecting up to 90% of population at some point in
their lifetime, up to 50% have more than one episode. People of all age group can be affected by this menace
irrespective to their gender and quality of life. It has become one of the leading causes for the visit to physician
thus also puts a heavy burden on the currency of the country. Physiotherapy is the most widely used form of
treatment adopted for gaining relief from low back pain. The exercises include stretching, strengthening, range
of motion exercises, McKenzie therapy and core stability exercises other techniques like Proprioceptive
neuromuscular facilitation program etc. It has been concluded in various studies core stability exercises and
Proprioceptive neuromuscular facilitation are beneficial in low back pain patients but comparison of their effect
needs to be established to provide early and better relief from the disability. Therefore objective of the study was
to compare the effect of Proprioceptive neuromuscular facilitation program and Core stabilization exercises on
low back pain patients. 40 subjects aged 30 – 50 years with low back pain for more than 4 weeks were made
part of the study based on inclusion and exclusion criteria and were then divided into two groups named A, B.
Group A received Proprioceptive neuromuscular facilitation and group B received Core stabilization exercises
and hot pack given initially for 10-15 minutes to the lower back. The exercise program was given for 4 weeks
with a total of 24 sessions and progression of the activity was made within the tolerance of the patient. Pre and
post treatment readings were taken of pain, Oswestry Disability Questionnaire and Functional Reach Test.
Results were analyzed using paired, unpaired t- test. Results showed that there is significant effect on pain,
Oswestry Disability Questionnaire and Functional Reach Test in the two groups but group A was clinically
more significant than groups B. The study concluded that patients with low back pain are benefitted more by
Proprioceptive neuromuscular facilitation program. So, Proprioceptive neuromuscular facilitation program
should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Proprioceptive Neuromuscular Facilitation.
Physiotherapy is a primary healthcare profession that
promotes wellness, mobility and independent function. It’s a
scientific discipline used to support and treat a diverse range
of conditions by improving the movement of muscles, joints
and limbs. Physiotherapy plays a significant role in the
further damage.
Dr. Richard Chmielewski, DO, FACEP, NMM/OMM gave a lecture on the ins and outs of Osteopathy and Osteopathic Medicine, including various techniques used by the Doctor on a daily basis.
Bedford Physiotherapy Centre - Providing Services of PhysiotherapyAMI Clinic
AMI Clinic is your friendly Bedford physiotherapy clinic offering its customers the best in therapeutic treatment through its team of professional physiotherapist Bedford treating all types of body pain in a natural way.
Physical Therapy Practice Guidelines: Thoracic manipulation is both safe and effective in treating mechanical neck pain (neck pain with mobility deficits).
What is biofeedback therapy and who can benefit? Biofeedback therapy is a non-drug treatment in which patients learn to control bodily processes that are normally involuntary, such as muscle tension, blood pressure, or heart rate........
To Compare The Effect Of Core Stability Exercises And Muscle Energy Technique...IOSR Journals
Abstract: Low back pain is considered one of the commonest condition in the western and industrialized
countries. It is estimated that up to 50% of adults experience low back pain during their life span. People of all
age group can be effected by this menace irrespective to their gender and quality of life. It has become one of
the leading causes for the visit to physician thus also puts a heavy burden on the currency of the country.
Physiotherapy is the most widely used form of treatment adopted for gaining relief from low back pain. The
exercises include stretching, strengthening, range of motion exercises, McKenzie therapy and core stability
exercises other techniques like muscle energy technique etc. It has been concluded in various studies core
stability exercises and muscle energy technique are beneficial in low back pain patients but comparison of their
effect needs to be established to provide early and better relief from the disability. Therefore objective of the
study was to compare the effect of core stability exercises and muscle energy techniques on low back pain
patients. 60 subjects aged 18 – 45 years with low back pain were made part of the study based on inclusion and
exclusion criteria and were then divided into three groups named A, B and C. Group A received core stability
exercise and conventional physiotheraphy and group B received muscle energy techniques and conventional
physiotherapy. The exercise program was given on alternate days with a total of 24 sessions and progression of
the activity was made within the tolerance of the patient. Pre and post treatment readings were taken of pain,
ROM and quality of life scale. Results were analyzed using paired, unpaired t- test and ANOVA. Results showed
that there is significant effect on pain, ROM and quality of life scale in the three groups but group A was
clinically more significant than the other groups. The study concluded that patients with low back pain are
benefitted more by core stability exercises. So, core stability exercises should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Muscle Energy Technique.
Modern Principles of Osteopathy
The International Academy of Osteopathy provides osteopathic education in Europe and beyond.
Contact us for more information: info@osteopathy.eu
http://www.osteopathie.eu/en/publications
http://www.osteopathie.eu/en
Osteopathic Manipulation Treatment (OMT) is growing rapidly as a preferred and natural family medicine. As a treatment, osteopathic manipulation attempts to improve joint range of motion and balance tissue and muscle mechanics in order to relieve pain.
To Compare The Effect Of Proprioceptive Neuromuscular Facilitation Program Ve...IOSR Journals
Abstract: Low back pain has been a matter of concern, affecting up to 90% of population at some point in
their lifetime, up to 50% have more than one episode. People of all age group can be affected by this menace
irrespective to their gender and quality of life. It has become one of the leading causes for the visit to physician
thus also puts a heavy burden on the currency of the country. Physiotherapy is the most widely used form of
treatment adopted for gaining relief from low back pain. The exercises include stretching, strengthening, range
of motion exercises, McKenzie therapy and core stability exercises other techniques like Proprioceptive
neuromuscular facilitation program etc. It has been concluded in various studies core stability exercises and
Proprioceptive neuromuscular facilitation are beneficial in low back pain patients but comparison of their effect
needs to be established to provide early and better relief from the disability. Therefore objective of the study was
to compare the effect of Proprioceptive neuromuscular facilitation program and Core stabilization exercises on
low back pain patients. 40 subjects aged 30 – 50 years with low back pain for more than 4 weeks were made
part of the study based on inclusion and exclusion criteria and were then divided into two groups named A, B.
Group A received Proprioceptive neuromuscular facilitation and group B received Core stabilization exercises
and hot pack given initially for 10-15 minutes to the lower back. The exercise program was given for 4 weeks
with a total of 24 sessions and progression of the activity was made within the tolerance of the patient. Pre and
post treatment readings were taken of pain, Oswestry Disability Questionnaire and Functional Reach Test.
Results were analyzed using paired, unpaired t- test. Results showed that there is significant effect on pain,
Oswestry Disability Questionnaire and Functional Reach Test in the two groups but group A was clinically
more significant than groups B. The study concluded that patients with low back pain are benefitted more by
Proprioceptive neuromuscular facilitation program. So, Proprioceptive neuromuscular facilitation program
should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Proprioceptive Neuromuscular Facilitation.
Physiotherapy is a primary healthcare profession that
promotes wellness, mobility and independent function. It’s a
scientific discipline used to support and treat a diverse range
of conditions by improving the movement of muscles, joints
and limbs. Physiotherapy plays a significant role in the
further damage.
Dr. Richard Chmielewski, DO, FACEP, NMM/OMM gave a lecture on the ins and outs of Osteopathy and Osteopathic Medicine, including various techniques used by the Doctor on a daily basis.
Bedford Physiotherapy Centre - Providing Services of PhysiotherapyAMI Clinic
AMI Clinic is your friendly Bedford physiotherapy clinic offering its customers the best in therapeutic treatment through its team of professional physiotherapist Bedford treating all types of body pain in a natural way.
Physical Therapy Practice Guidelines: Thoracic manipulation is both safe and effective in treating mechanical neck pain (neck pain with mobility deficits).
What is biofeedback therapy and who can benefit? Biofeedback therapy is a non-drug treatment in which patients learn to control bodily processes that are normally involuntary, such as muscle tension, blood pressure, or heart rate........
Objective: To assess the effect of a kinesitherapeutic
program of special exercises for treatment of pain intensity and
endurance of the extensor trunk muscles in patients with
chronic lumbalgy.
Methods: The study included 110 patients with chronic
lumbalgy, equally distributed in two treatment groups.
Participants in the experimental group performed the
recommended special exercises 3 times a week at home, while
those in the control group only followed the guidelines of a
physician. At the beginning of the study and 12 months later,
the pain intensity of all the participants was assessed by means
of Visual Analog Scale.
Results: In contrast to the participants in the control
group, those in the experimental group at the end of observation
were reported to experience a significant reduction in pain
intensity.
Conclusions: Treatment with specific exercises proved
more effective in terms of pain complaints in patients with
chronic lumbalgy.
PROMOTING BILATERAL SYMMETRY IN THE BODY THROUGH AN EASTERN MEDICAL APPROACH ...IAEME Publication
Sotai (natural motion) therapy offers new therapeutic potential from an Eastern medicine perspective for patients suffering chronic pain, in which plastic changes with pain regulation in the central nervous system and peripheral nervous systems, psychological factors, and the like retard medical treatment because they contribute to the formation of clinical conditions. In this study interventions will be performed via sotai therapy with the goal of improving motion imbalances that are related to chronic pain on healthy men and women in their 20s in order to obtain basic knowledge. It will consider: (1) The validity of intervening from areas of the body that are somewhat removed from the target area by hypothesizing the body’s coordinative structures and (2) The validity of using LLE to assess the accuracy of perceptions of bodily sensations as well as the therapeutic results from sotai therapy from this, with the goal of contributing to scientific explanations of sotai therapy in terms of its therapeutic potential for chronic pain.
CBT is a for of psychological therapy used to alter subjects thoughts to improve behaviors and or feelings. it is great tool to be used for psychological disease or chronic diseases. this presentation cover the basics aspects of CBT with some studies about use of CBT in pulmonary diseases.
In his Diploma in Osteopathic Manual Practice (DOMP) thesis assignment, acupuncurist Colin Harris examines how manual osteopathy can unblock and release energetic malfunctions in the body.
In her final thesis, London College of Osteopathy and Health Sciences (LCO) student, Nikola Dostalova examines the efficacy of osteopathic treatment on post- Covid loss of Smell and taste.
London College of Osteopathy and Health Sciences (LCO) student, Kaitlyn Hough, looks at the impact that OMT can have on emotional storage related to low back pain.
Be careful with your training dollars! This is the second release of Gray Marketing in Osteopathic Training with more information uncovered about Shawn Pourgol and a scheme of dubious schools, organizations and associations.
Diploma in Osteopathic Manual Practice (DOMP) graduate, Kewin Ducrot examines the effect of osteopathic manual therapy on the prevention and treatment of injuries in dancers.
In his Diploma in Osteopathic Manual Practice (DOMP) dissertation, Jeffrey Addley examines the causes of Pudental Neuralgia in professional and amateur cyclists as well as how osteopathic manual therapy can treat this common condition.
Dr. Claudia Mghazli examines how osteopathic manual therapy can aid with tinnitus, a condition that affects an estimated 10-15% of the global population.
London College of Osteopathy graduate, V.S. Chahna, examines how osteopathic treatment works in conjunction with holistic manual therapy. The dissertation presents a structured view of the function of fascia as well as a profound understanding of osteopathic principles and philosophy.
This thesis dissertation by London College of Osteopathy graduate, Marliese Steyn, examines the role of Osteopathic Manual Therapy in combination with Pilates on the rehabilitation of disc herniation and degeneration.
Prior to attending hands on clinical training, Diploma in Osteopathic Manual Practice (DOMP) students are supported by LCO faculty in preparing a thesis dissertation based on a case study or literature review. As part of our ongoing effort to disseminate osteopathic research, we are proud to highlight selected student works.
In her dissertation, Restoration of Bone's Elastic Response Using Osteopathic Techniques”, Canadian based therapist, Vickie Keam, examines how osteopathic treatment approach can be directly guided by the anatomical structure and biomechanical properties of bone tissue.
discover remarkable parallels between Yoga and Osteopathy, and learn how yoga instructors may expand the therapeutic aspect of their practice by integrating osteopathic principles and modalities into their daily work
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Beyond the musculoskeletal system: Effects of osteopathy on patients' psychology
1. ‘Beyond the musculoskeletal system’: Effects of osteopathy on patients’ psychology
Dr. Fadila Naji, MD, DipMedAc, CMTPT
Introduction
OMT is well known for its beneficial effects on the musculoskeletal system; therefore
obviously, one of its main indications is ‘somatic pain’.
Its effects on another aspect of human wellbeing: the patients’ psychological status, is,
however, overlooked.
Pain: a holistic definition
Pain is a complex interdependent psychophysiological phenomenon that cannot be
dissected into individual psychosocial and physical elements. [1, 2]
According to Bendelow, the biomedical approach to pain is reductionist, and commonly
results in both physicians’ and patients’ frustration due to the often-stubborn nature of
pain. [3]
On the other hand, the biopsychosocial model of pain offers a broader view of the
underlying dynamics of chronic pain and provides healthcare providers with additional tools
to address both the biological and the psychosocial aspects of pain.
Osteopathy: a holistic vision
Osteopathy is a patient-centred healthcare practice, whose main tool is manual treatment.
It adopts a holistic approach to patients, based on the principles of interrelation between
the structure and the function of the human body, and the innate body self-healing ability.
The principles of osteopathy are based on a comprehensive clinical and therapeutic
approach considering the patient as a whole entity mechanically, physiologically, and
psychologically.
Osteopathy is mostly popular for musculoskeletal conditions and its positive effects on the
musculoskeletal system are well known. Most studies have focused on the mechanical and
neurophysiologic effects of different osteopathic manipulative approaches [4], whereas its
effects on the patients’ psychological status are less well elucidated, despite the fact that
according to the biopsychosocial model, physical and psychological wellbeing cannot exist
without each other and although the importance of psychological assessment is always
emphasized as part of the clinical assessment of patients suffering from chronic pain.
To that end, several studies have recently looked into the effectiveness of manual treatment
not only on pain, but also on depression and anxiety in chronic pain patients.
The potential impact of OMT on psychological features, such as anxiety, in patients with or
even without musculoskeletal disorders should trigger a more comprehensive outlook on
osteopathy. Obviously, more studies are needed to investigate the non-physical effects of
osteopathic manual practice, especially the potential benefits of OMT for patients with non-
musculoskeletal disorders.
2. According to the scientific literature, does OMT seem to affect patients’ psychological
status?
OMT seems to have an effect, at least on the short term, on anxiety and global body
perception, according to the available scientific literature.
People with musculoskeletal pain may commonly have an underlying, secondary, or
concomitant psychological impairment, and on the other hand, patients with chronic
psychological distress develop increased sympathetic tone and impaired biomechanics in
corresponding areas of the body.[5] The holistic model of osteopathic manipulative
treatment (OMT) seeks to influence mental and emotional status, by targeting these
anatomical locations. Hence, it was proposed that OMT could be used as a treatment
modality for patients with psychological distress and musculoskeletal pain.
A systematic review of the psychological response to spinal manipulation showed
improvement in psychiatric outcomes such as depression and anxiety, suggesting that OMT
may produce a wider scope of benefits to cortical functioning than is commonly believed.
[6,7,]
A trial of patients with neck and back pain in North Wales showed that an osteopathy
primary care clinic improved short-term pain-related outcomes and long-term psychological
outcomes. [8]
CastroSanchez et al. reported that a 20-week massage-myofascial release program
significantly improved anxiety but also quality of sleep and quality of life in patients with
fibromyalgia. The experimental group experienced a significant improvement in anxiety
compared to baseline and to placebo (p< 0.0005). [9]
Findings from the UK Beam trial similarly indicated significant improvement of patients who
received spinal manipulation with respect to pain, back beliefs, and general physical health.
Moreover, interestingly, the study showed improved mental health at three months post
intervention and improved disability at 12 months. [10]
Voigt et al. investigated the effects of OMT on pain and health related quality of life in
patients with migraine and found significant improvements in the intervention group
concerning the number of days lost due to migraine but also in physical functioning, mental
health, vitality and body pain. [11]
The theories behind osteopathic effects on psychology: How can osteopathy influence
psychology?
OMT produces multiple neurophysiological effects.
Studies suggest that OMT increases endocannabinoids in the brain through:
-Stimulation of the periaqueductal grey matter
3. -Stimulation of cannabinoid receptors in the brain by increasing serum levels of anandamide
ANA. [12] Recent research on rats showed that cannabinoid receptor agonism suppresses
anxiety like behavior in rats with essential tremor. [13]
-Down-regulation of the sympathetic system via the Vagus nerve.[14]
OMT can also affect functional connectivity between brain regions involved in pain
modulation.[15] In fact, pain perception seems to be related to distortions of body image in
patients with chronic pain.[16]
Since OMT uses palpation for assessing and treating patients, it is believed that this touch
can create an interaction of sensory inputs such as emotions and physical sensations [17],
which is likely to affect the subject’s emotional status and well-being by influencing body
image and body perception.
Sensory experiences that happen during a body segment movement, are physically and
mentally dependent on the environment as well as on the emotional experiences of the
patient.[18] Similarly, the physician-patient interaction through tactile stimulations may
create physiological changes, increase the patient’s awareness of parts of his body, and thus
possibly increase his compliance with the treatment.
Several studies have reported the effect of touch on anxiety, stress and well-being,[19] and
many have showed significant physiological, biological and psychological changes associated
with it.
Another theory is that OMT improves heart rate variability. [20] In fact, anxiety is associated
with sympathetic system activation, which can be reflected in reduced heart rate variability,
as low variability is associated with a high sympathetic tone. Yergagani et al found low heart
rate variability to be correlated with emotional disorders in children. [21]
Using OMT techniques that can affect heart rate variability is therefore supposed to
decrease anxiety.
Cervical HVLA has been shown to improve heart rate variability in one study of volunteer
patients with neck pain.[22] Osteopathic cranial manipulative medicine has been supposed
to affect heart rate variability through upregulation of the parasympathetic nervous system.
Proximity to this region is likely a factor for the effectiveness of these techniques.
In summary, OMT effects on patients’ psychological status may be related to both the
manipulation of the autonomic nervous system and various effects related to physician
touch.
Study: OMT for stress in osteopathic students
A study was conducted at the Lake Erie College of Osteopathic Medicine-Bradenton in
Florida during the fall 2012 to evaluate the effect of osteopathic manipulative treatment on
self-perceived fatigue, stress, and depression in first-year osteopathic medical students
4. First-year osteopathic medical students voluntarily enrolled in the study and were randomly
assigned to direct OMT, indirect OMT, or control groups. The 2 treatment groups received
treatment by osteopathic physicians weekly for 4 weeks. The control group received no
treatment. All groups completed surveys regarding self-perceived fatigue, stress, and
depression at 0, 2 and 4 weeks of enrolment.
The study concluded that the direct OMT regimen used in the study produced a statistically
significant decrease in self-perceived fatigue in first-year osteopathic medical students, and
that osteopathic manipulative treatment represents a potential modality to reduce self-
perceived distress in medical students. [23]
Suggested manual treatment regimens for anxiety [4,23]
Listed below are possible treatment regime for patients with anxiety. The physician must
use clinical judgment to decide which treatment modality could be best for each individual
patient.
Studies suggest that distress commonly manifests as cervical musculoskeletal dysfunction,
that’s why treatment modalities targeting cervical spine are commonly included in such
treatment protocols.
1. Posterior cervical soft tissue/long axis kneading: performed with the physician at the head
of the table, and his fingertips lateral to the patient’s spinous processes, applying a superior
and lateral pressure on the entire length of the cervical spine.
2. Anterior cervical fascia release: physician applies inferior pressure with his thumb pads in
the patient’s supraclavicular fossa until tension releases, then moves laterally.
3. Suboccipital/Occipito-atlantal decompression: patient lies supine while physician places
index and middle fingers in the suboccipital musculature at the insertion of the extensor
cervical muscles at the occiput and applies anterior and lateral pressure for a period of 2
minutes until relaxation is felt. Effect is probably due to the proximity of the Vagus nerve.
4. Sternocleidomastoid inhibition: physician applies pressure with thumb at the insertion
point of SCM on the mastoid process until a soft tissue release is felt, then grasps the belly
of SCM between his thumbs and fingers, applying inhibitory pressure until relaxation occurs.
Process repeated down the SCM until the insertion point near the jugular notch, where the
physician also applies pressure with his thumb.
5. Levator scapulae inhibition: physician places his thumbs on the participant’s upper medial
border of both scapulae at the levator scapulae insertion points. Inhibitory pressure is
applied until soft tissue tension releases. Pressure is repeated along the scapula and up to
the mid–cervical spine muscle attachment.
6. Compression of the Fourth Ventricle – technique that addresses the periaqueductal grey
area around the fourth ventricle. The physician sits at the head of the supine patient.
Physician’s hands are placed palmar side up and medial to the occipito-mastoid suture.
5. Using thenar eminences on the occiput the physician encourages cranial extension while
limiting cranial flexion until a still point is achieved.
7. Cervical High Velocity/Low Amplitude (cervical HVLA): thought to improve heart rate
variability. Somatic dysfunction barrier is engaged in the cervical spine and short quick
thrust applied to localized segments.
8. Doming of the respiratory diaphragm: Patient is in the supine position, physician inserts
thumbs under the costal margin lateral to the xyphoid process and has the patient breath in
and out while applying a superior and little bit medial pressure.
9. Rib raising, with physician’s finger pads at the rib angles
10. Sacral decompression: Due to the proximity of the parasympathetic nervous system to
the sacral region, a simple side lying sacral decompression may be helpful to decreasing the
level of a patients’ perceived anxiety.
Indirect OMT Protocols have also been used in studies to control for the bias related to the
benefits of experiencing physical contact by a physician in direct OMT therapies.
11. Facilitated positional release of the lower extremities:
Physician grasps patient’s foot with thumb on the dorsum and fingers on the plantar
surface, and externally rotate and abduct the hip while bringing the knee into 90° flexion.
The knee is then allowed to drop laterally, and the foot inverted and internally rotated.
Physician then draws foot inferiorly to straighten and place tension on the knee.
Position held until a release is felt. In the same position, physician grasps calcaneus and
forefoot, flexing and adducting the hip and bending the knee to 90°. The foot is then
externally rotated and drawn inferiorly, straightening, and placing tension on the knee.
12. Unwinding of the lower extremities: physician grasps patients’ ankles, applying
combinations of distraction, traction, compression, twisting, and bending to provide release
of the lower extremities
13. Facilitated positional release of the upper extremities: patient supine while physician
grasps the olecranon with thumb and index finger, with the patient’s elbow bent to 90°.
Using his other hand, the physician grasps the dorsum of the wrist and then rotates the
forearm into pronation, compresses it, and then extends it. This position is held until the
elbow is fully extended and release is felt
14. Unwinding of the upper extremities: physician grasps the participant’s wrists.
Combinations of distraction, traction, compression, twisting, and bending is applied to
provide release of the upper extremity
15. Integrated neuromusculoskeletal release of the pelvis: physician cups the proximal and
distal anterior superior iliac spine with palms, compressing medially and rotating anteriorly
and posteriorly. When resistance is met, position is held until release occurs. Physician then
6. places his caudad hand behind the sacrum, covering the sacroiliac joint with his index and
ring fingers. Then places his cephalad hand on the distal anterior superior iliac spine, with
his forearm on the proximal anterior superior iliac spine. Physician engages barriers using
distraction, compression, and twisting until release is noted.
(Note: the above described manoeuvres were taken from references 4 and 23 with minimal
paraphrasing)
These manoeuvres may represent one part of the treatment protocol that can be used for
psychological distress.
Additionally, patient active contribution in his treatment protocol is always expected to
bring about a better response to treatment and better compliance.
Cardiac coherence training for example can be helpful as an adjunctive or take-home
exercise. Handheld biofeedback tools also can help patients with improving heart rate
variability. Focused mindful breathing can be very helpful as well in decreasing anxiety levels
and can be used in any setting.
Conclusion
Osteopathic manipulative treatment represents an unexplored method to reduce symptoms
of psychological distress. This review suggests that OMT can be used as a treatment
modality to reduce psychological distress. Patients undergoing mental health care may find
benefit of OMT as an adjunct treatment.
In the future, osteopaths might benefit from a better awareness of the way in which their
intervention influences patients' psychosocial outcomes.
Different aspects of care such as the rapport with the patient, good patient education,
patient empowerment and empathy may all contribute to improved patient outcomes.
Osteopaths are ideally positioned to educate patients regarding how certain factors like
psychological distress can contribute to the onset and maintenance of pain.
Being aware of psychosocial factors will also lead to a better understanding of the whole
pain experience and the context in which chronic pain occurs. This should always be an
essential aspect of osteopathic teachings, as osteopathic medicine is holistic medicine.
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