Osteopathic manipulative treatment (OMT) training during residency is essential for development of these unique skills and principles as we go out into our future careers. One of the challenges that we have faced over the course of our residency tenure is having on-hand and online OMT resources to further promote learning and retention of knowledge and skills. The purpose of this research project was to gauge the family medicine residents’ OMT fundamental knowledge while also providing a designated preceptor area location for OMT resources for quick access, when needed, during our OMT clinic. At the same time, the residents were also lectured on common musculoskeletal dysfunctions and simple techniques that could be used for quick treatment options during clinic. First, the family medicine residents were first given a 10 question OMT pre-survey (five questions were knowledge based and five questions were short answer) to gauge their baseline fundamental osteopathic clinical knowledge and their knowledge about the pre-existing OMT resources and their locations in our clinic. After the residents completed the OMT pre-survey, the new OMT resources were placed in the new location in our precepting area and then two weeks later the residents were given a lecture about the fundamentals and common contraindications of OMT and the basic approaches to treatment of some routine chronic conditions, including low back pain, neck pain, headaches, and migraines. Also, included at then end of the lecture was the newly acquired OMT resources, including books and online website links, that were compiled for the clinic, and the new designated spot for these materials making them easily accessible during our OMT clinics. The OMT post survey, using the same one as above, was then done by the residents to see the impact on their OMT fundamentals and OMT resource knowledge. The Results from the pre and post surveys were then compared, and the data was graphed accordingly to show the changes. Questions one through five were graded on having “correct” vs “incorrect” answers, and the short answer questions (6-10) were graded on the premise of “positive” vs “negative” answers. Answers were considered positive if they were optimistic, which includes the response “yes”, accurate location in the precepting area, any form of OMT resource, or any amount of time spent in learning, review, or preparations of OMT material for OMT clinics. Answers were considered negative if they were the opposite of the above description. The first eight questions showed a strong positive increase/improvement in the residents’ OMT knowledge and showed that they know the new resources and their location in the clinic, which was the purpose of our project. The last two questions had slightly different outcomes than expected which was addressed if similar research is done in the future.

Osteopathic Manipulative Therapy (OMT) is underutilized in addressing lung function and symptoms in asthma patients. The objective of this study was to determine if a single session of OMT can improve lung function and symptoms in patients suffering from asthma, and if patients can be taught a self-administered home OMT protocol to control their symptoms, in order to develop a protocol by which physicians can apply OMT to address lung disease in patients. This was a purposive randomized controlled quasi-experimental study which took place in family practice, pulmonology, and asthma specialist offices in southwest Virginia. The intervention was a ten-minute semi-individualized OMT protocol and a self administered home OMT education session. Variable baseline, within-subject study design was utilized, allowing each person to serve as his or her own control. Pre and posttest measurements included: participant spirometry FEV1, FVC, and PEF; thoracic excursion upper and lower rib cage motion; and a five-question rating scale to determine current asthma symptoms. A ten-minute OMT session included an individualized thoracic and rib screening and treatment, suboccipital release, diaphragm release, and thoracic pump. Comparison between pre- and post-OMT lung function and symptoms portrayed change. For the second part of the study, the participants were divided into two groups with group two receiving a ten-minute home OMT education session and a handout of the home OMT techniques. All participants returned two weeks later for a follow up lung function assessment. Statistically significant (p<.05) improvements after initial OMT were documented for 8 of 10 measurements. Only two spirometry values, FEV1 and PEF, did not significantly improve. The group who participated in the home OMT education session had statistically significant improvements in 3 of 10 measurements, including the upper and lower thoracic excursion measurements and the overall asthma symptoms rating. With a simple, easy to repeat, 10 minute semi-individualized OMT session, researchers demonstrated improved lung function and symptoms in this group of participants in Southwest Virginia. The addition of a home OMT education session was demonstrated to be at least partially beneficial. Future studies should expand on this pilot study with the researchers recommending using a larger patient population including patients with lower pre-treatment spirometry values in order to accurately monitor potential for change. / Ph. D.

No description available.

abstract: Objective: Examine cardiovascular response to OMT via central and peripheral measurements. Methods: Central and peripheral cardiovascular signals of asymptomatic human subjects were monitored during a procedure with alternating rest and active phases. Active phases included systemic perturbations and application of controlled vertebral pressure (OMT) by an experienced osteopathic physician. Pulse plethysmograph and laser Doppler flow sensors measured peripheral flow from index and middle fingers bilaterally. A three-lead EKG monitored cardiac activity. The biosignals were recorded continuously, in real time, and analyzed in time and frequency domains. Results from the control group (n=11), without OMT, and active group (n=16), with OMT, were compared. Peripheral (n=5) and central responders (n=6), subsets of the active group showing stronger peripheral or central response, were examined. In an additional effort, a modified clinical device recorded spectral Doppler ultrasound signals of the radial and dorsalis pedis arteries of clinically asymptomatic human subjects. Controlled physiologic provocations (limb occlusion and elevation), were performed. Time domain and spectral analyses were completed. Results: In the human subject study, the time wave characteristics and spectral analysis resulted in similar trends. Peripheral blood flow attenuated in the control group over time, while it was maintained in the active group, and increased specifically during OMT in the responder groups. Heart rate remained around 65 BPM in the control group, fluctuated between 64-68 BPM in the active group, and dropped 4 and 3 BPM in the peripheral and central responder groups, respectively. The effect in the OMT group was statistically significant compared to no-OMT, however, was not statistically significant within-groups. For the preliminary spectral ultrasound Doppler study, segmental flow was successfully monitored. A prototype "Quick Assessment" tool was developed, providing instant post-processing results for clinical use. Conclusions: OMT along the vertebral column may influence autonomic processes that regulate heart rate and peripheral vascular flow. / Dissertation/Thesis / Masters Thesis Bioengineering 2014

Hintergrund: Das subacromiale Schmerzsyndrom (SAPS) ist ein häufiges muskuloskelettales Krankheitsbild. Patienten haben eine eingeschränkte schmerzhafte Schulterbeweglichkeit. Der Pathomechanismus ist noch nicht ganz geklärt. Umliegende Gelenke können durch Bewegungseinschränkungen das SAPS beeinflussen. Die vorliegende Bachelorthesis soll eine Literaturübersicht über osteopathische Behandlungsmöglichkeiten beim SAPS geben. Methodik: Sieben medizinische Datenbanken wurden auf zwischen 2010 und 2023 veröffentlichte relevante Artikel durchsucht. Eingeschlossen wurden randomisierte klinische Studien (RCT), in deutscher und englischer Sprache, in denen osteopathische Techniken, bei menschlichen Probanden mit einem SAPS, eingesetzt wurden. Die Ergebnisse wurden mit einer Kontrollgruppe oder anderen Interventionen verglichen. Ergebnisse: Die Suche ergab 782 einzelne Artikel. 14 Studien erfüllten die Einschlusskriterien und wurden in der PICO Übersicht eingeschlossen. Zehn Studien verwendeten Manipulationstechniken und vier Studien Weichteiltechniken mit Heimübungen. Die Ergebnisse zeigen, dass die Techniken sich positiv auf das SAPS auswirken. Eine Signifikanz zwischen den Gruppen ist häufig nicht vorhanden. Schlussfolgerung: Alle Studien zeigen nach osteopathischen Behandlungen eine Verbesserung der Beschwerden mit SAPS. Manipulation reicht als alleinige Behandlung nicht aus, um einen Langzeiteffekt zu erzeugen. Eine individualisierte Kombinationstherapie mit verschiedenen Behandlungstechniken und Heimübungen, ist für die effektive, klinische, Patientenbehandlung besser geeignet. Zukünftige Untersuchungen sollten vermehrt osteopathische Techniken untersuchen, um das positive Bild der osteopathischen Behandlung zu festigen und das mögliche Ausmaß der Verbesserungen zu ermitteln. / Background: Subacromial pain syndrome (SAPS) is a common musculoskeletal condition. Patients have limited painful shoulder mobility. The pathomechanism has not yet been fully elucidated. Surrounding joints can affect the SAPS through movement restrictions. This bachelor thesis is intended to provide a literature review on osteopathic treatment options for SAPS. Methods: Seven medical databases were searched for relevant articles published between 2010 and 2023. Included were randomized clinical trials (RCT), in German and English, in which osteopathic techniques were used on human subjects with SAPS. The results were compared to a control group or other interven-tions. Results: The search returned 782 individual articles. 14 studies met the inclusion criteria and were included in the PICO review. Ten studies used manipulation techniques and four studies used soft-tissue techniques with home exercises. The results show that the techniques have a positive effect on the SAPS. Significance between groups is often absent. Conclusion: All studies show an improvement in symptoms with SAPS after osteopathic treatments. Manipulation alone is not enough to produce a long-term effect. An individualized combination therapy with different treatment techniques and home exercises is more suitable for the effective, clinical, patient treatment. Future investigations should examine more osteopathic techniques in order to consolidate the positive image of osteopathic treatment and to determine the pos-sible extent of the improvements.