The effectiveness of Biodynamics (bioenergetic Osteopathy) of children 0-6 months with non-synostotic plagiocephaly in relation to counterpositioning therapy - Susanne Tauwel
Der Effekt von biodynamischer/energetischer Osteopathie auf Babys 0-6 Monate mit nicht synostotischer Plagiocephalie im Vergleich zur standardisierten Lagerungstherapie (counterpositioning) – Susanne Tauwel Studiendesign: Eine pragmatisch randomisierte, kontrollierte Studie (RCT). Schlüsselwörter: Biodynamische/energetische Osteopathie, nicht synostotische Plagiocephalie, Babys 0-6 Monate, Lagerung (counterpositioning), CVAI (cranial vault asymmetry index) Ziel: Dieses RCT untersucht, ob es einen messbaren positiven Effekt von 3-maliger biodynamisch (energetischer) Osteopathie auf Babys 0-6 Monate mit nicht synostotischer Plagiocephalie im Vergleich zur Lagerung (counterpositioning) auf der nicht abgeflachten Schädelseite gibt. Methodik: Es wurden 30 Babys aus verschiedenen Kinderarzt-, Hebammenpraxen und Kliniken, im Durchschnitt 8 Wochen alt, nach Diagnosestellung „nicht synostotische Plagiocephalie“ in eine Interventions- und eine Kontrollgruppe randomisiert. Beide Gruppen erhielten eine standardisierte Lagerungsempfehlung. Die Interventionsgruppe erhielt zusätzlich 3 biodynamisch/energetische Osteopathiebehandlungen im Abstand von 2-3 Wochen. Als Messparameter wurde im Prä- und Posttest der CVAI zugrunde gelegt, welcher mittels Craniometer als kephalo-metrische Messung vor und nach den Interventionen, und vor und nach der Lagerung in der Kontrollgruppe, erhoben wurde. Nach der Lagerungsperiode erhielten auch die Babys der Kontrollgruppe 3 biodynamisch/energetische Behandlungen. Ergebnisse: Die Ergebnisse zeigen einen hoch signifikanten Effekt (p< 0,0001) der biodynamisch/energetischen Osteopathie kombiniert mit der Lagerung gegenüber der alleinigen standardisierten Lagerung (p < 0,019). Diskussion: Biodynamisch/energetische Osteopathie sollte im interdisziplinären Team mit zu den empfohlenen Behandlungen bei nicht synostotischer Plagiocephalie gehören. Konklusion: Biodynamisch/energetische Osteopathie in Kombination mit Lagerung bei nicht synostotischer Plagiocephalie kann in kurzer Zeit beste Ergebnisse erreichen.
Der Effekt von biodynamischer/energetischer Osteopathie auf Babys 0-6 Monate mit nicht synostotischer Plagiocephalie im Vergleich zur standardisierten Lagerungstherapie (counterpositioning) – Susanne Tauwel
The effectiveness of Biodynamics (bioenergetic Osteopathy) of children 0-6 months with non-synostotic plagiocephaly in relation to counterpositioning therapy - Susanne Tauwel Study dessign: Pragmatic randomized controlled trial (RCT). Keywords: Biodynamic/energetic Osteopathy, non-synostotic Plagiocephaly, Babys 0-6 months, counterpositioning, CVAI (cranial vault asymmetry index) Aims: Showing the positive effect of three times biodynamic osteopathy treatment on babys with non-synostotic plagiocephaly in relation to counterpositioning. Methods: Thirty babys, with an average age of 8 weeks, with non-synostotic plagiocephaly, were randomized from two physicians, two midwifes and one clinic in 2 groups, an intervention group and a control group. Both groups were told to counterposition the babys to the non-favorite side/ the non-flattened side of its head during sleep and to train prone position in awake phase („tummy time“). In the intervention group the babys were additionally treated 3 times with biodynamic/energetic osteopathic treatment every two or three weeks. Both groups were observed for 10 weeks. Pre- and posttest kephalo-metric measurements were done using a craniometer resulting in CVAI values. After this period the control-group got additionally three osteopathic treatments, same as the intervention group before. Results: The improvements in the intervention group are high significant (p< 0,0001). Compared to these, the improvements in the control group are just significant (p<0,019). The results in the follow up measurement in the control group after been treated were also high significant. Discussion: The results suggest expanding standard care for Plagiocephaly, i.e. positioning and physiotherapy, by osteopathic treatment to an interdisciplinary setting. Conclusion: Biodynamic, osteopathic treatment in combination with counterpositioning reaches best results in shortest timeframes.
Biodynamische/energetische Osteopathie, nicht synostotische Plagiocephalie, Babys 0-6 Monate, Lagerung (counterpositioning), CVAI (cranial vault asymmetry index)
Status post abortus - Usefulness of osteopathic treatment after miscarriage.
The aim of my study was to prove that women after miscarriage, who where treated osteopathicly, do recover much better from different problems, which appear after abortion, then those who have not received a treatment. I also was interested which kind of problems do appear generally after an abortion and which can be influenced by an osteopathic treatment. Methodology: I established two groups of women; a treatment group ( 10 women ) and a control group ( 10 women ). Both groups consisted of women who had an abortion in the first four months of pregnancy, where as the members of the control group did not live in my surroundings and/or did not want to be treated by me and they were not allowed to be treated osteopathicly. They received only the questionnaires for acquisition of their physical condition after the abortion. The questionnaire I used is a variant of the “Munich Model”. It includes questions of the clinic psychology concerning condition of the clients regarding mood, social functions, daily functions etc. I added specific questions about the expected problems after miscarriage. Both groups had to fill out the questionnaire immediately after abortion, one month after abortion and three months after the abortion. The members of the treated group received a different amount of osteopathic treatments regarding their individual needs. Results: Significant improvement in comparison to the control group: general lack of energy, trembling, pain or tension in the heart area, nervousness, irritability, restlessness, change of mood, envy, lump in the throat or stomach, joint problems, pain or tenseness of the spine, sensitivity to cold, stomach ache, reduced sexual appetite, pain during coitus Slight improvement: susceptibility to infects, loss of appetite, slowed down reaction, lack of concentration, depression, feeling to have failed as woman, head ache, vertigo, irregular heart beat, increased blood pressure, diarrhoea, sensitivity to noise, hesitation, timidness, feeling guilty Same course as in the control group: Sleeplessness, weakness, partial amnesia, grief, loss of weight, bleeding caused by an abortion. Summary: The occurring problems are mostly the attribute to an increased Adrenaline and Glucocorticoid level and result in physical and psychical problems. General some of the problems are summed up under the term vegetative dystonia. The problematic nature is extensive and extensive should be the treatment. A woman after an abortion needs help in every way: visceral – cranial – structural. To achieve an even better result, a team is need which consists of four “professions”: Gynaecologist, Psychologist, Osteopath and friends.
Women in Osteopathy. A Synopsis of the Journals “DO” and “Osteopathic Medicine”
Gender medicine and gender mainstreaming is gaining ground. As explained in Part I of the work on hand, research on this theme has multiplied during the last years. Meanwhile, questions to gender medicine are shown increasingly at the coverage of daily papers. Recently the journal “profile” dedicated a five-page article to gender-medicine (profile 26, 07), gender congresses are held, and in Austria consideration is being given to the introduction of a special study course for "gender” in medicine. But where is the gender-thought in the field of osteopathy? In casting a glance on Part II of the present work it seems that gender-mainstreaming in osteopathy is still in a state of slumber. A content analysis is the used method. The study on hand deals mainly with quantitative data collection and is based on the comparison between the frequency of presence of women versus the frequency of presence of men. The results leave no doubt. Women are significantly less referred to in the analyzed magazines, are significantly less speaking up and are significantly less quoted. Significantly less books of women as of men are introduced, and among the authors in the editorial team there are significant less women than men. Only in 5.3% of all analyzed articles female or neutral forms of address were used. Terms like gender mainstreaming or gender medicine do not exist in any of the analyzed editions. Studies which contain gender-sensible data are searched in vain. Only in 2 of 27 studies of the analyzed papers is it mentioned how many women respectively men were among the test persons, and also in these two cases no separate data evaluation was done. The existence of differences in the osteopathic treatment of women and men, respectively whether women and men react differently to an osteopathic treatment, is obviously not a research subject. With the aid of the study on hand, it is stated to be of absolute interest to permit the gender-thought to slip into osteopathy increasingly – for the benefit of the female osteopaths, and last but not least also for the benefit of the female patient.
Gender Medicine,German Osteopathic Journals,Female Osteopaths
The influence of osteopathic treatments on the flexibility, technique and performance of juvenile high performance swimmers and high performance triathletes
It seems that osteopathic treatments have significant positive influence on flexibility. All tests and research gave positive results. It was also nice, that the group realized the improvement too and was able to give a proper feedback. Very positive are the results concerning improvement of technique. The biggest improvement was reached surprisingly within the group of triathletes. They where able to improve the length of stroke for 12 cm on the 1000 m freestyle swim. When all is said and done, it seems that osteopathic treatments have a significant positive influence on technique. Concerning the performance tests it is nice to have an improvement being proved statistically with a significant improvement on the 100 m freestyle and 500 m backstroke distances. To be honest I had hoped to have clearer results. It is on the other hand not surprising that they were not able to improve the state of their performances more. Usually a certain amount of training is necessary to improve the exertion factor to have benefit from the longer stroke and it is impossible to improve this within 10 days. I had hoped that the swimmers would be able to swim more economically after the treatments, which would have been more impressive. It seems to be evident that I was not very lucky with the testing profile for performance. I’m personally convinced that the result of the 1000 m freestyle test would have been significant as well, if the overall group would have been able to swim the retest 6.28 seconds slower. Automatically the heart rate would have been lower as well. The improvement of performance was not able to be proven statistically significant on the 100 m backstroke and the 1000 m freestyle distance. In both cases I can cite an improvement of performance without giving statistical proof. It was the aim to swim both tests at the same speed to be able to compare the heart rate of the two tests. On the second test the heart rate should have been lower. Possibly it would have been better to force the swimmers to swim at full speed. But to prove this it would have been necessary to make lactate acid tests. The problem is that the swim test lasted about 2.5 hours. With lactate acid tests it would have lasted approximately twice as much time. From the logistic point of view this is almost impossible to get the swimming pool two times for such a long time because they are completely booked up. What’s more, is that a team would have been necessary to make the blood tests, which would have been very expensive.
Comparison of osteopathy with manual therapy (according to the CRAFTA® concept) for the treatment of patients with craniomandibular dysfunctions (CMD).
Study Design Randomized controlled trial (RCT) / Clinical pilot study Outline/Problem Definition Research Question & Objective Hypothesis Osteopathy shows better results in the treatment of patients with craniomandibular dysfunctions than manual therapy (according to the CRAFTA® concept). Relevance for the Patients Relevance for Osteopathy Methodology •Patients: 20 participants (18 female and 2 male) aged between 19 and 65 years. The patients were randomly divided into two groups. The result was a distribution of 10 patients (9 female and 1 male) in the study group osteopathy and 10 patients (9 female and 1 male) in the comparison group manual therapy (according to the CRAFTA® concept). •Measurement parameters (and measuring methods): Pain (VAS assessment and SES questionnaire), health-related quality of life (SF36 questionnaire), mouth opening (inter-incisor distance (IID) measurement), muscle tension (Biofeedback EMG measurement). •Inclusion criteria: Pain in the region of the muscles of mastication, bruxism (grinding) or bracing (compressing), deviation when opening the mouth, restricted ability to open the mouth, clicking noise when opening the mouth. •Exclusion criteria: Pronounced dysgnathia, facial pain due to systemic, neurological or psychiatric diseases, acute or chronic TMJ trauma, sinusitis. •Treatment procedure: Three treatments per patient within a period of two weeks following a black-box approach. The measurements and interrogations were carried out before the first and after the last treatment. The patients in the study group osteopathy were treated by the author Anett Hörster, the patients of the comparison group by a certified CRAFTA® therapist. Results Regarding the measurement parameters pain, mouth opening and muscle tension both, osteopathy and manual therapy (according to the CRAFTA® concept) facilitate significant improvements for the treatment of patients with CMD. In this context osteopathy is significantly more effective concerning the parameter pain. Regarding the health-related quality of life only osteopathy has a significant effect and in comparison works significantly better than manual therapy (according to the CRAFTA® concept) which could not achieve an improvement of this parameter at all. Critical Reflection/Perspectives/Conclusions A follow-up study over a longer period of time (with an additional final check-up appointment) and with more participants, who are treated alternately by a team of therapists is recommended to verify the results of the present study and to put them on a sound basis. Additional Information
Exploring European osteopathic identity: An analysis of professional websites of European osteopathic organizations
Study Design Introduction: A sociologically confirmed identity crisis in osteopathy exists in the USA. The crisis lies in the fact that the practical activity of the DOs is no longer sufficiently demarcated from the allopathic activity of the MDs. In Europe we find that differences in terminology and practices exist within the osteopathic professional group, making communication difficult between osteopaths. However, the distinctive identity of European osteopathy is an important precondition for defining a professional profile that would clearly demarcate osteopathy from other medical occupations and that would also set the ultimate goals for a qualitatively protected osteopathic degree program meeting the requirements for state recognition. The result would be improved communication among the osteopaths themselves and with outsiders, to the benefit also of the patient. Systematic, historical and comparative analysis of the literature and of websites Outline/Problem Definition - Research Question & Objective How do the national professional unions & registers and the international osteopathic organizations in Europe currently present osteopathy? Hypothesis - Relevance for the Patients - Relevance for Osteopathy - Methodology By means of an analysis of the literature we searched for the terms identity, identity crisis and professionalization in reference to osteopathy. To answer our main question: How do the national professional unions & registers and the international osteopathic organizations in Europe currently present osteopathy? we systematically analyzed 29 European unions and/or registers (from 19 countries) and 3 international organizations according to a list of questions arranged in 11 categories. Results Identity is a collective term covering personal, collective and professional identity. It refers to a state of unity, continuity and coherence. Identity is inconceivable without the setting of boundaries and the formation of oppositions. There exist identity-constituting features of osteopathy that altogether make up its distinctive identity. Osteopathy is not uniformly characterized by the professional unions & registers and international osteopathic organizations, however. To summarize some of our results: 31% define osteopathy as medicine, and 38% define it as a form of therapeutic method or treatment. Only 21% see the role of osteopathy to lie in first-line medical care. 24% define osteopathy as complementary and 7% as complementary or alternative. The form of recognition of osteopathy also varies: In some countries osteopathy is an independent profession and in others represents only further training for other health professions (i.e. physiotherapy). Critical Reflection/Perspectives/Conclusions Significant intraprofessional differences exist in the presentation of osteopathy among the European professional unions & registers and international osteopathic organizations, and the existence of these differences conflicts with the idea of a collective identity. The criteria for a professionalization of osteopathy as an academic profession are not fulfilled at present. We may therefore infer that osteopathy is undergoing a crisis of identity in Europe, which can only be resolved creatively, through a common orientation of professional values. Additional Information This thesis was originally written in German language,little deviations in meaning from the original texts cannot be ruled out.
Osteopathische Interventionsevidenz bei Craniomandibulärer Dysfunktion – ein systematischer Review
Background Apart from toothache temporomandibular disorders belong to the second most common complaints of the masticatory system. The present paper deals with osteopathic intervention evidence in case of temporomandibular disorders and presents the current state of studies for this subject in terms of a systematic review. Methodology Medical and osteopathic data bases have been researched systematically. Pubmed, Osteopathic Research web and further data bases that are not listed have been researched. Main search items were TMD and OMT. After reviewing the inclusion criteria six randomised controlled studies have been selected and have been described detailed. Results All studies included showed defects in case of blinding the investigator and the therapist. But all studies have been valued with at least 7 of 10 points using the Pedro scale. Therefore a significant improvement of the main measured parameters pain and oral aperture could be realised within the considered studies. In case of the side measured parameters muscle tone and muscle palpation pain could be improved amongst others. One study discovered a decrease of medication within the osteopathic team. Outlook Analysis and interpretation of the current state of studies show that an integration and interdisciplinary cooperation between dentistry and osteopathic medicine in practice would be reasonable. Further studies of high methodological quality are required to strengthen the position of osteopathic medicine in case of TMD.
Hintergrund Craniomandibuläre Dysfunktionen erweisen sich nach Zahnschmerzen als die zweithäufigsten Beschwerden im Kausystem. Die vorliegende Arbeit setzt sich mit der osteopathischen Interventionsevidenz bei Craniomandibulärer Dysfunktion auseinander und stellt die aktuelle Studienlage zu diesem Thema in Form eines systematischen Reviews dar. Methodik Zur Ermittlung der geeigneten Studien wurde eine systematische Literaturrecherche in medizinischen und osteopathischen Datenbanken durchgeführt. Hierbei wurden Pubmed, Osteopathic Research Web sowie weitere nicht gelistete Datenbanken durchsucht. Als Hauptsuchbegriffe wurden die Begriffe bzw. die Abkürzungen „TMD“ und „OMT“ verwendet. Nach Prüfung der Einschlusskriterien wurden sechs randomisierte kontrollierte Studien selektiert, die im nächsten Schritt ausführlich beschrieben wurden. Ergebnisse Alle eingeschlossenen Studien hatten in Verblindung des Untersuchers und des Therapeuten Mängel aufzuweisen, jedoch wurden alle Studien mittels PEDro-Skala mit min. 7 von 10 Punkten bewertet. Folglich konnte bei allen betrachteten Studien eine signifikante Verbesserung bei den Hauptmessparametern Schmerz und Mundöffnung erzielt werden. Bei den Nebenmessparametern konnten unter anderem Muskeltonus und Muskelpalpations-schmerz signifikant verbessert werden. Bei einer Studie wurde eine Reduzierung der Medikation in der Osteopathiegruppe festgestellt. Ausblick Die Analyse und Interpretation der bisherigen Studienlage zeigt, dass eine Integration und interdisziplinäre Zusammenarbeit zwischen Zahnmedizin und osteopathischer Medizin in der Praxis als sinnvoll erscheint. Um die Position der osteopathischen Medizin bei der Behandlung von Craniomandibuläre Dysfunktionen zu festigen bedarf es weiterer Studien von hoher methologischer Qualität.
Stress and Stress Management of Osteopaths
Karin Homa-Konrad: Stress und Stressmanagement bei OsteopathInnen Stress kann vor allem in Sozial- und Gesundheitsberufen zu einem Zustand innerlicher und äußerlicher Erschöpfung führen. Dies zeigt Auswirkungen im Sinne von steigender Fehleranfälligkeit und sinkender Qualität in Bezug auf medizinische und pflegerische Leistungen für die PatientInnen. OsteopathInnen als Vertreter eines Gesundheitsberufs sind in direktem Kontakt mit PatientInnen und arbeiten an der Verbesserung der Gesundheit der Bevölkerung. Deshalb wurden für den empirischen Teil233 überwiegend freiberufliche OsteopathInnen in Österreich mittels stressbezogener Tätigkeitsanalyse bei KlinikärztInnen und -ärzten - Kurzfassung (ISAK-K) online und postalisch befragt. Erwartet wurden geschlechtsspezifische Unterschiede sowie Unterschiede nach Berufserfahrung und Art der Tätigkeit. Die Ergebnisse haben gezeigt, dass weibliche Osteopathen und berufserfahrenere OsteopathInnen eine signifikant geringere Unsicherheit aufweisen. Außerdem zeigen erfahrenere OsteopathInnen seltener Frustration wegen übergeordneter Ziele. Sie sind durch emotionale Dissonanz seltener belastet, das gleiche gilt für männliche Befragte. Tendenziell schätzen erfahrenere OsteopathInnen ihre Weiterentwicklungsmöglichkeiten positiver ein. Im Team tätige OsteopathInnen weisen signifikant mehr Ressourcen durch soziale Unterstützung (Kollegen und Vorgesetzte) auf. Befragt nach eigenen Stressreaktionen gaben 47 % psychische und 34 % körperliche Reaktionen an, genannt wurden auch arbeitsbezogene Reaktionen (4 %) sowie Ressourceneinsatz (8 %). An eigenen Ressourcen wurde am häufigsten körperlicher Ausgleich (41 %), gefolgt von Handlungsspielraum (26 %) und mentalen Ressourcen (17 %) angegeben. Grundsätzlich weisen die Befragten ein hohes Maß an Ressourcen und ein ausgeprägtes Bewusstsein für die Gefahren und Konsequenzen von Stresserleben auf. Stichworte: OsteopathInnen, Stress, Ressourcen, Arbeit
Karin Homa-Konrad: stress and stress management of osteopaths Especially in health and care professions stress can lead to a state of inner and outward fatigue. Consequences are an increasing error rate and deteriorating quality regarding medication and care for the patients. As representatives of a health care professional group, osteopaths are in close contact with patients and are working to improve society’s health. This was the reason why for the empiric part 233 mainly free-lance osteopaths have been interviewed by filling out online and postal questionnaires based on the instrument of the stress-related job analysis of clinicians (ISAK-K, Instrument zur stressbezogenen Arbeitsanalyse bei KlinikärztInnen – short version). The results have shown that female and experienced osteopaths are significantly less insecure and that experienced osteopaths show less frustration because of overall objectives. They are less burdened by emotional dissonance, so are male osteopaths. Osteopaths that have more experience in their job are more likely to estimate their opportunities to further development at work in a positive way. Team-working osteopaths have more resources, due to social support by colleagues and superiors. When questioned for individual stress reactions, 47 % of the participants named psychological, 34 % physical and 4% work-related reactions. 8% of the participants stated to deploy their resources. Examples for personal resources were physical activity (41 %), followed by freedom of action (26 %) and mental resources (17 %). Basically the participants show a high level of resources and a comprehensive awareness of risks and consequences of living stress. Keywords: osteopaths, stress, resources, work
OsteopathInnen, Stress, Ressourcen, Arbeit
Stress und Stressmanagement bei OsteopathInnen
Effectiveness of osteopathic treatment in patients with Failed Back Surgery Syndrome (FBSS)
Efectividad del tratamiento osteopático en pacientes con síndrome de espalda fallida (FBSS)
Background: " Failed Back Surgery Syndrome” (FBSS) is one of the most frequent and serious complications of the interventions of the spine. Because of its complexity is usually recommended pain management by a multidisciplinary team. Objective: To describe the response to osteopathic treatment in patients with FBSS. Designe: Descriptive observational study. Method: The response to 5 sessions of osteopathic treatment is assessed. The sessions consist of one hour over 2 months in 15 patients diagnosed with FBSS by an anesthesiologist. Treatment involved Mitchell, Jones and Visceral techniques. Results: Before treatment, patients described their pain visual analog scale from 0 to 10, with a mean of 5.73 and finally 4.46. Functional capacity was checked by Roland Morris Questionnaire: the average score changed from 10 to 6.06 after treatment. The type of analgesic used and developments taking painkillers with analgesic ladder was considered, the mean went from 2.93 to 1.93. Conclusion: The largest part of the patients reported improvement of their clinical condition, no side effects were reported.
Introducción: el Síndrome de espalda fallida es una de las complicaciones más frecuentes y graves de las intervenciones del raquis. Por su complejidad se suele recomendar el manejo del dolor por parte de un equipo multidisciplinar. Objetivo: describir la respuesta al tratamiento osteopático en pacientes afectados de FBSS. Método: Estudio observacional descriptivo se valora la respuesta a 5 sesiones de tratamiento osteopático de una hora a lo largo de 2 meses en 15 pacientes diagnosticados por médico anestesista de FBSS. Se utilizaron técnicas de Mitchell, de Jones y viscerales. Resultados: Antes del tratamiento los pacientes describieron su dolor con escala visual analógica (EVA) de 0 a 10 con una media de 5,73 y al final del tratamiento de 4,46. Se valoró la capacidad funcional con el Cuestionario Roland Morris: la puntuación media pasó de 10 a 6,06 después del tratamiento. Se consideró el tipo de analgésico utilizado y la evolución de la toma de analgésicos con una escalera analgésica de 0 a 4 puntos: la media pasó de 2,93 a 1,93. Conclusión: Se describe una evolución clínica favorable en la mayoría de los pacientes sin reportar efectos secundarios al tratamiento.
Relationship between the weber test and cervical somatic dysfunction. A pilot study
Relación entre el test de weber y la disfunción somática cervical. Un estudio piloto
INTRODUCTION: The Weber Test lateralized and the Evaluation of Cervical Somatic Dysfunction are often carried out by osteopaths in their daily practice. The results of both tests seemed to be somehow connected. Therefore, this study was conducted to determine whether a relationship exists between them. METHODOLOGY: A cross-sectional observational pilot study was performed to a convenience sample consisting of a rugby team and a human towers group. A total of 74 individuals were assessed with both tests by two examiners. Collected data was processed in several statistical methods. RESULTS: 50.7% got a central TW, 27.4% to the left and 21.9% to the right. 24.7% DSC were lateralized to the left, 58.9% to the right and 16.4% were balanced. In addition, incidence of 68.4% of the DSC in extension and a 31.63% in flexion was observed. CONCLUSION: Stadistical data from the analised simple inform about the relationship between lateralized WT and the DSC in extension and to the other side. This information is considered valid for future experimental research.
INTRODUCCIÓN: El test de Weber (TW) lateralizado y la valoración de disfunciones somáticas cervicales (DSC) son dos exploraciones comunes que se realizan a los pacientes en la consulta de osteopatía. Aparentemente y a priori puede parecer que exista una relación directa entre los resultados obtenidos de ambos test. Por lo que este estudio observará y estudiará si existe una relación. METODOLOGIA: Se realizó un estudio piloto observacional transversal a una muestra de conveniencia formado por un equipo de rugby y una colla castellera. Se aplicaron ambos métodos exploratorios sobre los 73 individuos participantes y se procesaron los datos en diferentes métodos estadísticos. RESULTADOS: Un 50,7% obtuvieron un TW centrado, 27,4% a la izquierda y 21,9% a la derecha. Mientras que las DSC estuvieron lateralizadas hacia la izquierda en un 24,7%, 58,9% a la derecha y equilibrado en un 16,4%. También cabe destacar que un 68,4% de las DSC son en extensión sobre un 31,6% en flexión. CONCLUSIONES: Los datos estadísticos de la muestra estudiada informan de la relación entre el TW lateralizado y las DSC en extensión y hacia el lado contrario. Esta información se considera válida para plantear futuros estudios experimentales de mayor nivel científico.
Cervical spine; neck pain; Hearing Loss; Tuning Fork
To compare exercises prescribed by osteopaths and fitness instructors to rehabilitate a person with low back pain in a gym environment using the FITT principle
Method. One hundred identical questionnaires were equally distributed between fifty osteopaths from the BSO clinic faculty, and fifty fitness instructors randomly selected from six local health clubs. The questionnaires were designed to ask, 1) the mode of exercise prescribed, 2) at what intensity, 3) the duration and, 4) at what frequency, for the rehabilitation of a person with low back pain (LBP). The participants were asked to complete and return the questionnaires by a specific date, using the stamped addressed envelopes provided, or placing the forms into a box file located on each team point at the BSO. Results and Clinical Significance. A Mann-Whitney test found that there was significant difference between the recommended exercise duration (p=0.0149), and frequency (p=0.0304) in the training programmes between the two subject groups. The results of the study may influence osteopaths when prescribing future exercise programmes for the rehabilitation of patients with LBP.Conclusion. Osteopaths and fitness instructors prescribe significantly different training programmes to rehabilitate LBP when advising exercise frequency and duration.
Rehabilitation Exercises,Rehabilitation,Exercise Therapy,Exercise
NAME: Brebels Geert TUTOR: Cox Stijn METHODOLOGICAL TUTOR: Quaghebeur Jörgen YEAR: 2019 TITLE: Vertical jump in basketball players. RESEARCH TITLE: Research as to the added value of osteopathic techniques on vertical jump height (VJH) in basketball players: a single randomized controlled trial. BACKGROUND: VJH is an important asset in sports performance, screening tools and talent detection programs. An optimal resting state of the diaphragm is suggested to maximise its functioning and optimise sports performance. Osteopathic techniques are assumed to optimise blood flow circulation and achieve recovery and conservation of the body’s health. OBJECTIVE: To investigate the effect of a specific set of osteopathic techniques on VJH in basketball players (n=24). METHOD: After VJH measurement for 3 different jumps (a countermovement jump (CMJ), a two-legged running vertical jump with take off from right (TRVJR) and left (TRVJL) leg), the experimental group (EG) received, in addition to regular team practices, treatment with a set of osteopathic techniques once a week, for 2 consecutive weeks. After the second treatment VJH measurement were repeated. The control group (CG) underwent the same VJH measurements, but only participated in team practices. RESULTS: In this study (n = 24), EG (8 males, 4 females, 20,6 ±4,34 years of age) compared to the CG (8 males, 4 females, 19,4 ±2,23 years of age), the two-sample test showed no significant improvement for the average VJH in CMJ (p = 0,67), TRVJR (p = 0,13) and TRVJL (p = 0,81). Two-sample t-test showed no significant improvement for the maximum VJH (p = 0,59) and TRVJL (p = 0,90) in CMJ. Instead TRVJR showed significant improvement in the CG for VJH (Two-sample t-test: p = 0,015). DISCUSSION: A larger sample size and a more holistic treatment approach is advised to determine a possible added value of an osteopathic treatment on VJH. CONCLUSION: No significant contribution of osteopathic intervention on VJH in basketball players is found when comparing the EG and the CG.
Dutch Abstract NAAM: Brebels Geert TUTOR: Cox Stijn METHODOLOGISCHE TUTOR: Quaghebeur Jörgen JAAR: 2019 TITEL: Spronghoogte bij basketballers ONDERZOEKSTITEL: Onderzoek naar toegevoegde waarde van osteopatische technieken op spronghoogte (VJH) bij basketbal spelers: een gerandomiseerde gecontroleerde klinische studie. ACHTERGROND: VJH is een belangrijk aspect in sport, screening en talent detectie. Een optimale toestand van het diafragma wordt verondersteld zijn functioneren te maximaliseren en sport prestaties te verbeteren. Osteopatische technieken worden geacht de bloedcirculatie te optimaliseren en het herstel en behoud van lichamelijke gezondheid te behouden. OBJECTIEF: Het effect van een specifieke set van osteopatische technieken op VJH bij basketbal spelers te onderzoeken (n=24). METHODE: Na VJH metingen voor 3 verschillende sprongen (countermovement sprong (CMJ), tweevoetige sprong na aanloop met afstoot rechts (TRVJR) en links (TRVJL)), kreeg de experimentele groep (EG) naast de ploeg trainingen een behandeling met osteopatische technieken 1x per week, gedurende 2 opeenvolgende weken. Na de tweede behandeling werden VJH metingen opnieuw uitgevoerd. De controle groep (CG) onderging dezelfde VJH metingen, maar kreeg alleen team trainingen. RESULTATEN: In dit onderzoek (n = 24), EG (8 mannen, 4 vrouwen 20,6 ±4,34 jaar oud) vergeleken met de CG (8 mannen, 4 vrouwen 19,4 ±2,23 jaar oud), toonde de two-sample t-test geen significante verbetering voor gemiddelde VJH in CMJ (p = 0,67), TRVJR (p = 0,13) en TRVJL (p = 0,81). De two-sample t-test toonde geen significante verbetering voor maximale VJH in CMJ (p = 0,59) en TRVJL (p = 0,90). TRVJR daarentegen toonde een significante verbetering in de CG voor TRVJR (p = 0,015). DISCUSSIE: Een grotere steekproef en meer holistische behandeling zijn aangeraden om een mogelijk toegevoegd effect van een osteopatische behandeling op VJH te bepalen. CONCLUSIE: Geen bijdrage van een osteopatische interventie op VJH bij basketbal spelers werd gevonden wanneer EG vergeleken werd met CG.
osteopathy, osteopathic medicine, jump height, vertical jump performance, basketball, diaphragm
An investigation into the profile of osteopaths practising in Switzerland
Background: The Swiss osteopathic profession has undergone significant changes since regulations were implemented in January 2007, setting new rules for inter-cantonal exams and governing ability to practise from 2013. Objective: The aim of this study was to gain an insight into the demographics and current practice patterns of osteopaths in Switzerland. Design: A questionnaire survey, based on the Snapshot Survey conducted by the General Osteopathic Council (GOsC 2001) in the United Kingdom and a similar study in France (Magnouat 2008). Method: A survey pack was sent to 250 registered osteopaths of the Swiss Osteopathic Federation (FSO-SVO). A proportion of members representing the 3 main national languages were randomly selected by the Ethical Committee of the FSO-SVO. Results: A 60% response rate was obtained (n=151). 51% of osteopaths (n=77) had qualified from full-time institutions and 43% (n=64) had originally trained as physiotherapists. 67% of the osteopaths (n=102) graduated from a Swiss college. 71% of participants (n=107) worked primarily alone, whilst 21% (n=32) worked mainly in a team. Osteopaths trained in Switzerland tended to be younger, have less years experience in practice and be more likely to practise only osteopathy. Conclusion: The results suggest that osteopathy is flourishing in Switzerland. However, there may be 2 distinct groups of osteopaths, those who have been trained for a number of years and were initially physiotherapists, and a younger group of newly qualified Swiss-trained osteopaths.
Switzerland, osteopathic medicine, osteopathic manipulation, musculoskeletal manipulations, chiropractic, physiotherapy, orthopaedic, physical therapy
BackgroundHysterectomy is the most common non-obstetric operation performed in the United States. Benign conditions account for over three quarters of the hysterectomies performed worldwide. There is little information from clinical trials on the effectiveness of the procedure for relieving symptoms and improving quality of life. Concerns about the appropriateness of the surgery have been heightened by reports of problems following the surgery, including changes in urinary function and depression. Method A sixteen point retrospective questionnaire was designed in order to ascertain hysterectomised women's demographic details. One hundred participants took part in the study. They were all patients at BCOM. The aim of the study was to ascertain if they had tried or would have liked to try natural alternatives to their surgery. Results Twenty-two women had tried natural alternatives, the remaining seventy-eight would all have liked to try alternatives, but were unaware of any. Of the 22 participants who tried natural alternatives, the majority (20), were largely educated above the age of 18. The main indications for hysterectomy were Leiomyomata, menstrual problems, Endometriosis and prolapse. Leiomyomata were found to be the most important indication in nulliparous women whilst prolapse was found to be the main indication in women with three or more children. Black women had their hysterectomies at the youngest age whilst Asian women were the oldest women to have hysterectomies. As well as symptoms, such as pain and heavy bleeding, disappearing post-hysterectomy a variety of new problems arose after surgery including incontinence and hot flashes. Conclusion The ultimate judge of whether hysterectomy is successful is to ascertain whether participants would have the surgery again. Many factors may influence this decision, route and type of hysterectomy as well as partner supportiveness. Almost one fifth of participants would not undergo this procedure again. This shows that there is a place for natural approaches to common indications for hysterectomy. Research and public awareness must be increased, to stop unnecessary surgery.
Work Recovery in Response to Osteopathic Treatment after Hemilaminectomy for Lumbar Disc Herniation; A Prospective Clinical Study with Comparison Group
Study design: Twenty one patients, who never undergone spinal surgery, were assessed, by the author and the medical team of department of Neurosurgery of the Centre Hospitalier Universitaire Vaudois in Lausanne (Switzerland), after indication for hemilaminectomy and discectomy was established for a single one-level mediolaterally lumbar disc herniation. Objective: The aim of this study was to assess the effectiveness of a classical osteopathic treatment on work recovery, at 6 weeks and three months follow-up. Methods: In addition to symptoms, signs, and sociodemographic data, we included, in a clinical form, questionnaires on pain and disability, and a rating scale to assess work recovery. Standard mobility tests were also performed. Results: The osteopathic group had a significantly low level of pain and disability, and a significantly better work recovery at 6 weeks, and it were the most important factors differentiating the groups, compared with the objective results which showed only significant difference in improvement of mobility in sidebending. At three months, there was no major statistical differences between the groups both for the subjective and the objective findings. However, the group treatment showed more clinical improvement in term of pain, disability and work recovery. Conclusion : We show short-term and a relatively long term benefit of osteopathy, as a useful and safety therapy, in the rehabilitation of patients after lumbar disc surgery. Rehabilitation is superior than just advicing patients on posture, and to performe a daily self-adimistrated standard exercices program. Osteopathy should be recommended for patients who underwent lumbar disc surgery, and used with more collaboration of orthodox medicine.
Osteopathy,Low Back Pain,Disc Disorders,Surgery,Manipulative Treatment
EFFECTS OF THE MECHANICAL VIBRATION ON THE PAINFUL POINTS OF CRANIALSUTURES: APPLICATION ON THE SAGITAL SUTURE
EFECTOS DE LA VIBRACIÓN MECÁNICA SOBRE LOS PUNTOS DOLOROSOS DE LAS SUTURAS CRANEALES: APLICACIÓN SOBRE LA SUTURA SAGITAL
The aim of this study is to determine the influence that a mechanical vibration can have over the cranial sutures' tender points, taking the sagittal suture as aim. There are numerous techniques from the cranial osteopathy that support that the effect of the vibration is able to diminish the pain and/or increase the sutural mobility. It is seek to validate this affirmation by verifying whether it exists any repercussion from the vibration on the pain. It will be used a standard tuning-fork employed in medical practice, of 128 Hz, which will be situated on the sagittal suture's tender point making it vibrate continuously, for 3 minutes. Previously, by touching, this point of highest sensitivity had been located and marked on the skin, measuring its location in relation to the complete suture, from the Bregma point. On this point of highest sensitivity an algometer will be applied before and after the vibration. A control group will be established to which the tuning-fork will be equally applied but without making it vibrate. Results have been satisfactory: an 82% of the experimental group showed an increase of the pain threshold, in different degrees, while the control group only showed a 20%. Moreover it has been verified that the points of highest sensitivity from the sagittal suture are gathered round the centre of it. The ultimate conclusion is that the mechanical vibration is a factor that influences on the diminution of the pain or on the increase of the pain threshold.
El objetivo de este estudio es determinar la influencia que puede tener la vibración mecánica sobre los puntos dolorosos de las suturas craneales, tomando la sutura sagital como objetivo. Numerosas técnicas en la osteopatía craneal sostienen que es el efecto de la vibración el que consigue disminuir el dolor y/o aumentar la movilidad sutural. Pretendemos validar esta afirmación comprobando inicialmente si existe alguna repercusión de la vibración sobre el dolor. Para ello se utilizará un diapasón común de la práctica médica, de 128 Hz, el cual se colocará sobre el punto doloroso de la sutura sagital haciéndolo vibrar de forma continua, durante un tiempo de 3 minutos. Previamente, por palpación, se habrá localizado este punto de sensibilidad máxima y se habrá señalado sobre la piel, midiendo su localización respecto al total de la sutura, desde el punto Bregma. En este punto de máxima sensibilidad se aplicará un algómetro antes y después de la vibración. Se establecerá un grupo control al cual se le aplicará igualmente el diapasón pero sin hacerlo vibrar. Los resultados han sido satisfactorios: el 82% del grupo experimetal presentó aumento del umbral del dolor, en diversos grados, mientras que el grupo control sólo presentó un 20%. Además hemos podido constatar que los puntos de mayor sensibilidad en la sutura sagital se agrupan en torno al centro de la misma. La conclusión definitiva es que la vibración mecánica sí es un factor que influye en la disminución del dolor o aumento del umbral del mismo.
Effect of Two Different Osteopathic Treatments on Lumbar Spine Mobility in Icehockey Players
Kahden osteopaattisen hoidon vaikutus jääkiekkoilijan lannerangan liikkuvuuteen
The purpose of this project was to find out the direct effect of two different osteopathic treatments on the lumbar spine mobility in icehockey players. We also tried to investigate how these two osteopathic treatments affected the lumbar spine movement in icehockey players. An additional goal was to report how the players experienced osteopathic treatments and the effect of the treatments. Altogether sixteen players from two teams (Finnish hockey league) took part in this study. Teamsþ physiotherapist chose the players for the study. The criteria was firstly that the players felt pain or stiffness in their lumbar spine area and secondly that the physiotherapist had noticed a change in the playerþs posture. The osteopathic treatment for team A included soft tissue treatment and joint articulation of the lumbar spine area. The players in team B had joint articulation treatment. All players received treatment once a week for a period of three weeks. The active range of movement of the lumbar spine, flexion, extension and lateral flexion, was measured before and after interventions.To measure we used a goniometer and a measuring tape (in centimeters). The players wrote their feelings about their lumbar spinal pain and/or stiffness on forms we had given them. After the three weeksþ period players wrote down how they felt about given osteopathic treatments in general. Our results (using methods mentioned above) showed that both osteopathic treatments increased the mobility of lumbar spine. The players with more stiffness around their lumbar spine area benefited more from the treatments than the players with more mobile lumbar spines. The players experienced that osteopathic treatment somewhat decreased stiffness and pain in the lumbar spine area. They also thought that the treatment was pleasant. In team B (using our methods) that received joint articulation treatment, there was a bigger change in the mobility of lumbar spine. The players in team A, however, had better mobility of lumbar spines before the treatments than the players in team B. Thus, we cannot say which one of the two treatments used affected the mobility of lumbar spine more. The players were willing to continue osteopathic treatment also after the study. Cooperation between osteopaths, professional athletes and their organisations was felt as a positive challenge
Tämän opinnäytetyön tarkoituksena oli kuvata kahden osteopaattisen hoidon välitöntä vaikutusta jääkiekkoilijan lannerangan liikkuvuuteen, samoin näiden hoitojen vaikuttavuuden eroja. Lisäksi selvitetään tutkimushenkilöiden subjektiivisia tuntemuksia osteopaattisista hoidoista ja niiden vaikutuksesta. Tutkimukseen osallistui yhteensä kuusitoista pelaajaa kahdesta SM-tason jääkiekkojoukkueesta. Joukkueiden fysioterapeutit valitsivat tutkimukseen osallistuvat henkilöt. Valintakriteereinä olivat tutkimushenkilöiden kokema lannerangan jäykkyys tai kipu sekä fysioterapeutin huomioima posturaalisen asennon muutos. Joukkueen A osteopaattinen hoito koostui pehmytkudoskäsittelystä ja nivelartikulaatiosta. Joukkueen B osteopaattinen hoito sisälsi nivelartikulaation. Molempien joukkueiden tutkimushenkilöille tehtiin osteopaattinen hoito kerran viikossa kolmen viikon ajan. Ennen ja jälkeen interventioiden mitattiin tutkimushenkilöiden lannerangan aktiivinen liikkuvuus fleksio- ja ekstensiosuuntiin sekä selän aktiivinen lateraalifleksio. Tutkimustulokset saatiin goniometrin ja senttimetrimitan avulla. Tutkimushenkilöt kirjasivat subjektiiviset tuntemukset lannerangan jäykkyydestä ja kivusta ennen ja jälkeen hoitojakson kyselylomakkeille. Hoitojakson jälkeen tutkimushenkilöt kirjasivat kyselylomakkeelle myös subjektiiviset tuntemuksensa osteopaattisesta hoidosta. Tutkimustulokset osoittivat molempien osteopaattisten hoitojen lisäävän jääkiekkoilijan lannerangan liikkuvuutta. Liikkuvuuksiltaan jäykät tutkimushenkilöt saivat paremman vasteen osteopaattisesta hoidosta verrattuna liikkuvampiin tutkimushenkilöihin. Tutkimushenkilöiden mielestä osteopaattinen hoito vähensi jonkin verran lannerangan jäykkyyttä ja kipua sekä tuntui miellyttävältä. Joukkueen B artikulaatio hoito oli numeerisesti vaikuttavampi. Joukkueen A tutkimushenkilöt olivat kuitenkin lähtötasoltaan liikkuvampia kuin joukkueen B tutkimushenkilöt. Näin ei pystytä sanomaan, kumpi osteopaattisista hoidoista vaikutti enemmän jääkiekkoilijan lannerangan liikkuvuuteen. Tutkimushenkilöt olivat halukkaita jatkamaan osteopaattiseen hoitoon osallistumista tutkimuksen päättymisen jälkeenkin. Yhteistyö osteopaattien, ammattilaisurheilijoiden ja organisaatioden välillä on tulevaisuuden positiivinen haaste.
Helsinki Metropolia University of Applied Sciences
A retrospective survey of a season’s worth of injuries amongst a team of rugby players analysed by playing position, and treatment history.
Introduction: The aim of the dissertation is to investigate the effect of injuries sustained over a rugby season of an entire rugby team. Briefly mentioning comparisons and differences between Rugby Union, Rugby League and American football. Method: Questionnaire study I) a team of 30 rugby players from a local team. Forming a comparison between two population groups- forwards and backs injuries. 2) 150 questionnaires sent to Osteopaths over England regarding treatment of sports injury. Results: With regards to the rugby players there was no significant difference between forwards and backs and the injuries they sustained that were tested. Secondly, with regards to the osteopathic questionnaire it was found that there was a relationship between injury and advice given and injury and requiring imaging. With regards to treatment techniques and rehabilitation hypotheses were found to be not significant. Discussion: The results from this study do correlate with other studies though the main hypotheses were found to be not significant. It was found that the studies from the literature had gone into more depth with regards to obtaining more information about player history of the injury such as video analysis and risk factors associated with 'rnjury. Conclusion: More research needs to be conducted in order to get a more significant outcome from the data. The main criticism of the study would be to increase sample size and more information to be gathered from players regarding their injuries
Rugby playing; injuries; Player position.
Does wearing a correctly fitted bra have an effect on incidence of and location of back pain?
This investigation looks at the influence of bra fit has on females suffering back pain. It explores not only the effect on frequency and duration of back pain but also the influence of bra fit on location of back pain and locations of pain around the bra itself. The distinction between bra fit and size must be made as this investigation is primarily concerned with fit but conclusions are also drawn about the sizes worn by subjects. There were three hypotheses Bad fitting bras will cause increased duration and or frequency of back pain. 2 Ill fitted areas of the bra will cause local pain.3. The fit of the bra will have an effect on the location of back pain. Null hypotheses:1 Bad fitting bras will not cause increased duration or frequency of back pain. 2 III fitting areas of the bra will not cause local pain. 3 The fit of the bra will not have an effect on the location of back pain.This study consisted of 63 female subjects using a survey and tape measure. They were chosen at random from Osteopathic students, bar workers and a local sports team KRG. These were then split into four groups as a basis for comparison these were good fit, bad fit, pain and pain free. Out of the 63 subjects 30 were identified as wearing a well fitting bra, 33 were not. The pain and pain free groups contained 34 and 29 subjects respectively. With statistical analysis it was revealed that badly fitting bras did significantly effect the pain duration with a P value <5% but not the frequency of pain P value >10% however the raw data did show an increase in frequency in the bad fit group. So the null hypotheses a bad fitting bra will not cause increased frequency and or duration of back pain could not be rejected. P values of
The long-term efficacy of psychological interventions in the management of irritable bowel syndrome: a review of randomized controlled trials.
Background The multifactorial aetiology of irritable bowel syndrome (IBS) and the recent advances in the understanding of the bidirectional network between the gastrointestinal tract and the brain have provided a pathophysiologic basis for the implementation of psychological interventions in the management of IBS. Although reviews have found that psychological interventions help IBS sufferers in coping with their symptoms, limited evidence supports the long-term sustainability of treatment efficacy. Objective This study was conducted to evaluate the efficacy of psychological interventions in the management of IBS symptoms and to determine whether treatment benefits are sustained in the long-term. Furthermore, to inform clinical practice regarding the feasibility of psychological interventions as a long-term management option for patients. Design Structured literature review. Methods Three databases were reviewed for relevant research published between 2008 and 2018 applying Boolean logic. Search returns were filtered according to inclusion/exclusion criteria to address the research question. Data regarding characteristics and outcomes of included studies was extracted. A methodological quality assessment of the included studies was performed using the modified JADAD scale, SORT and EVAT checklists. The standardized mean difference was calculated to measure and compare effect sizes across studies. A regression analysis and calculation of the r-squared value were carried to determine long-term treatment sustainability. Results A total of fifteen studies matched all the inclusion criteria and were included in the final review. Across the scoring systems used, none of the studies obtained ultimate scores, indicating an overall moderate quality. Results from the regression analysis indicated a significant weak relationship between mean effect size and length of follow-up. Discussion Overall patients’ ratings of IBS symptoms improved over the course of the interventions and this effect was sustained during follow-up, however, the consistency of results was questionable due to the large degree of heterogeneity. Interpretation of study results was made difficult by the variety of outcome assessments used. As a whole, the effect of psychological interventions decreased significantly as the length of follow-up increased. Conclusion This review highlighted the limitations in the literature supporting the longevity of psychological interventions in the management of IBS. Although psychological interventions are safe therapeutic modalities, the long-term efficacy remains questionable. Physicians should be aware of these limitations when considering the long-term management care of their patients.
Irritable Bowel Syndrome (IBS), Literature Review, Long-term Efficacy, Psychological Intervention
visceral osteopathic treatment in infant colic. Case of series
Tratamient osteopático visceral en el cólico del lactante. Serie de casos
Macías Teomiro, Jose Luís; García García, Marta; Guilemany Castilla, Xavi
Introduction: Infant colic is a benign disorder characterized by inconsolable crying and irritability in healthy infants.This study aimed to evaluate the clinical improvement of infants with colic, applying a specific treatment protocol using visceral techniques on the liver complex and adjacent structures in patients with infant colic. Method: 10 babies, duly selected by a medical team, underwent 4 treatments on a weekly basis. The FLACC scale was used to assess the acute pain of the baby at the beginning and end of the study. By means of a daily survey, the frequency and duration of infant colic, the elimination of gases and the frequency of bowel movements were also measured. Results: An evident improvement of the pain variable was observed when we compared the onset (8.8 ±2.1) with the end (4.4 ±1.65) of the study. The quantity variable also improved (in babies with more than 4 colics per day it decreased from an initial 21.43% to a 0% at the end),in the end, 79.17% had only one. The elimination of gases and frequency of depositions increased (beginning 22.86% vs final 66.67%). There was a decrease in the duration of colic, in which initially lasted one hour (15.71% initial vs. 66.67% final). Conclusions: Visceral techniques for infant colic treatment seems to be useful. But a larger study with a control group is necessary to confirm these results.
Introducción: El cólico del lactante es un trastorno benigno que se caracteriza por llanto inconsolable e irritabilidad en lactantes sanos. Este estudio pretendió evaluar la mejora de la clínica de los cólicos, aplicando un protocolo concreto de tratamiento mediante técnicas viscerales sobre el complejo hepático y las estructuras adyacentes. Método: Diez bebés previamente seleccionados, se sometieron a 4 tratamientos con una frecuencia semanal. Se usó la escala FLACC para valorar el dolor al inicio y final. Mediante una encuesta diaria, se midieron la frecuencia y duración de los cólicos, la eliminación de gases y la cantidad de las deposiciones. Resultados: Se observó una mejora de la variable dolor cuando comparamos el inicio (8,8 ±2,1) respecto el final (4,4 ±1,65). Mejoró también la variable cantidad, en bebés con más de 4 CL al día disminuyó de un 21,43% a un 0%, y al final un 79,17% tenían solo uno. La eliminación de gases y frecuencia de las deposiciones incrementó (inicio 22,86% vs 66,67% final). Hubo una disminución en la duración del CL, en los que inicialmente duraba una hora (15,71% inicial vs 66,67% final). Conclusiones: Las técnicas viscerales parecen resultar útiles. Pero un estudio más amplio con grupo control es necesario para confirmar estos resultados.
infantile, pediatric, colic, intestinal, osteopathy, crying, gallbladder, cholecystokinin, intestinal microflora, sleep, autonomic nervous system
The effectiveness of Manual Therapy vs Probiotic Lactobacillus Reuteri DSM 17938 towards the management of Infantile Colic: a review of randomised control trials
Background Infantile colic (IC) is defined as an infant paroxysmal crying and fussing for three consecutive hours, more than three days a week and for more than three weeks in otherwise healthy infants. Until the moment this review was done, there were still no guidelines in the UK with significant clinical relevance with positive outcome to deal with IC (NICE 2017). Objective This study was conducted to evaluate the effectiveness of MT and LR DSM 17938 in the management of IC by synthesise, critically appraise the collated literature and verify the quality of the included studies included. Furthermore, to consider these interventions to future clinical applicability in IC and the impact it may cause in parents’ quality of life. Design Structured literature review. Methods Four databases were reviewed for relevant studies published between 2012 and 2019, applying Boolean Logic. Search returns were filtered by the author and according to inclusion/exclusion criteria to reflect the research question. A total of 14 studies were eligible and summarised into tables to perform a quality methodological assessment using The Delphi List and SORT analysis. Study characteristics and outcomes was also extracted. Results Overall crying times decreased in both intervention groups. None of the studies presented ultimate scores across the scoring systems utilised, but a moderate overall quality was identified with a mode score of 2B and 8/9, respectively SORT and Delphi List, which coincided with a general moderate blinding and intention-to-treat analysis amongst the studies. Discussion Heterogeneity resulted in a limitation of data interpretation and analysis. Outcome measures were associated with increased risk of bias as well as reduced credibility of the outdated outcome measurement scale. Furthermore, interpretation of results was made difficult thanks to scarce clinical significance. Statistical significance was reported with a relative decrease in crying times. Conclusion The collated findings point towards relative positive results, however interpretation should be taken with caution due to the high heterogeneity, lack of reliability of measures and poor statistical reporting. In spite of that, a global improvement in the quality of the studies was observed compared with the landmark review of Dobson et al. (2012).
Crying; Infantile Colic; Lactobacillus Reuteri; Manual therapy
In patients with epilepsy, is cannabidiol in addition to anti-epileptic drugs more effective than only anti-epileptic drug therapy? A structured literature review
Background Epilepsy is still one of the most debilitating diseases of mankind and even with anti-epileptic drugs being available not all patients can claim to be seizure free. Over the last couple of years, Cannabidiol (CBD) has become more and more interesting due to intensive research and it is discussed as an add-on therapy to help decrease seizure frequency. Objective This study was conducted to evaluate whether or not CBD as add-on therapy for epilepsy is more effective in the reduction of seizure frequency. Design Structured literature review. Methods Three databases were reviewed for relevant research using Boolean logic and according to inclusion and exclusion criteria addressing the research question search results were filtered. The data regarding outcome and characteristics of included studies was extracted. SORT was used to evaluate methodological quality. Result A total of 13 studies matching all inclusion and exclusion criteria were included in the review. None of the studies reached the ultimate score and therefore indicating a moderate to low quality. With the used quality assessment scoring system, none of the studies achieved the highest score. CBD showed a statistical significance change in seizure frequency reduction in three out of thirteen studies. However, the true effect of CBD is questionable. Discussion All studies reviewed patient’s seizure frequency has seemingly improved during the course of intervention, however, the accuracy and consistency of the results was questionable due to a degree of heterogeneity. Additionally, due to a diversity of representation of outcome data in the study, interpretation of the results was hampered, and no conclusion could be drawn. Conclusion This review highlighted the limitation of the available literature and there is not yet adequate and acceptable high-quality evidence to support the use of CBD therapy to concomitant AEDs over AED therapy on its own.
Cannabidiol (CBD), epilepsy, seizure frequency reduction
Interventions for the treatment of Pelvic Girdle Pain during pregnancy: A review of recent randomised controlled trials.
Background Pelvic Girdle Pain is a painful and debilitating condition that is common during pregnancy. Despite its significant effects on quality of life, it is commonly dismissed as trivial by health care professionals. To date, there is no gold standard regarding the treatment of PGP during pregnancy. Previous systematic reviews evaluating various treatment modalities for PGP during pregnancy emphasized the potential for further research. Objective This study was conducted to synthesise and critically evaluate the literature of randomised controlled trials (RCTs) published since 2015, regarding the effect of different interventions to treat PGP during pregnancy, in terms of improvements in pain and/or functional disability. Furthermore, to inform clinical practice by building on the evidence concerning treatment recommendations. Design Structured literature review. Methods Five electronic databases were searched using a list of relevant keywords to identify all eligible research published between January 2015 and October 2019. Search results were screened and filtered according to inclusion/exclusion criteria. The final selected studies were then assessed for methodological quality using the Physiotherapy Evidence Database (PEDro) scale and Strength Of Recommendation Taxonomy (SORT). Finally, data regarding study characteristics, main findings and statistical results were extracted from each study. Results A total of 12 studies matched the inclusion criteria and were included in this review. Seven different treatment interventions were identified and evaluated, including: exercise therapy, acupuncture, pelvic belts, muscle energy technique, chiropractic manipulation, foot manipulation, and reflexology. Across both quality scoring systems used, none of the studies obtained ultimate scores mainly due to lack of blinding, indicating an overall moderate quality. Discussion The clinical and methodological heterogeneity amongst the studies made it difficult to interpret and analyse results. Moreover, the varying quality, limited quantity of studies and low evidence strength, made it impossible to draw accurate conclusions and recommendations. Nonetheless, in agreement to previous studies, this review found limited evidence supporting the use of exercise therapy for reducing pain and disability caused by PGP during pregnancy. Conclusion Due to limitations in the studies, no conclusions can be drawn. Further high-quality research is required to determine the effect of the interventions identified in this review, in the treatment of PGP during pregnancy, to inform evidence based recommendations.
Literature review, Pelvic Girdle Pain, Pregnancy, Treatment Interventions.
What is the most effective therapy in the treatment of tinnitus, comparing physical therapy versus CBT? A review of randomised controlled trials
Background Tinnitus is a widespread, often disabling condition where phantom sounds are perceived, without an external source. A cure has not yet been found for tinnitus but recommendations exist for managing the condition related destress and quality of life. The current NICE guidelines mention sound therapy, CBT and the use of hearing aids as treatment options. Current management focuses on reducing the distress caused by tinnitus rather than addressing the perception of sound. More recent studies have found that manual therapy might positively influence tinnitus. Objective The purpose of this review is to search the existing literature on manual therapy and CBT interventions for the treatment of tinnitus so as to compare and determine the most effective treatment. Design Structured literature review Methods Four databases were searched for suitable articles published between 2010 and 2019 applying Boolean logic. The findings were screened according to inclusion/exclusion criteria to address the research question. Date was extracted and methodological quality was assessed using the Delphi list. Results Fifteen eligible studies were identified and included in the final review. The all-over quality of the studies was moderate. None of the studies obtained ultimate scoring. Data analysis throughout the trails indicated statistically significant change in terms of evaluated p-values. Although, a comparability between the intervention types was impossible due to the lack of reported effect sizes. Discussion Participants across the studies improved in some of the investigated outcome measures, however an interpretation of findings was limited by large heterogeneity. The methodological quality assessment showed moderate to low quality across both, CBT and manual therapy trails. Conclusion Both manual therapy and CBT have shown efficacy as modalities in the treatment of tinnitus. The deficiency of effect size reporting and the heterogeneity in outcome measures makes comparisons between treatment modalities challenging. Future research should incorporate greater homogeneity across procedures and outcome measures, and consider subtypes of tinnitus and demographics to help establish individual-specific treatment approaches.
Tinnitus, Literature Review, CBT, Physical Therapy.
The effectiveness of interventions used to treat women with Post-Partum Post-Traumatic Stress Disorder following a Caesarean Section
Background: Post-Partum Post-Traumatic Stress Disorder (PP-PTSD) is a psychological disorder that occurs as a result of a traumatic birth. Caesarean section is widely referred to as a traumatic birth and in many cases is the cause of some women’s PP-PTSD. Research into the prevalence and risk factors of PP-PTSD are extensively investigated, however studies into the treatments options and their effectiveness are limited. Objective: This study is conducted to collate and synthesis current literature into treatments of PP-PTSD post CS. Providing an overview of treatment options whilst succinctly comparing and contrasting effectiveness to discover which treatment option is currently the most successful and can therefore be a recommend in clinical practice. Design: Structure Literature Review. Methods: A systematic search applying Boolean logic was conducted on 3 databases, to obtain appropriate research published between 2007 and 2018. A total of 196 studies were obtained and then filtered according to the inclusion and exclusion criteria. A total of 9 eligible studies were found and summarised into tables regarding their characteristics and outcomes and then critically evaluated using the Strength of Recommendation Taxonomy (SORT) to determine the study quality. Results: All interventions effectively reduced Post-Traumatic Stress Symptoms (PTSS) after the completion of treatment in postpartum women. However none of the studies obtained ultimate scores with the mode SORT score being 2B, indicating an overall moderate to poor quality of included studies. Discussion: Though all studies resulted in a positive outcome they each contained significant limitations. With the consistency of results made questionable due to the degree of heterogeneity across studies and interpretation made difficult by the variety of outcome assessments used. The study is made vulnerable to examiner and selection bias, and lacked external and internal validity due to the study styles adopted, sample sizes obtained and length of follow ups carried out. Conclusion: Overall the results demonstrate a number of interventions that effectively treat PP-PTSD. With no stand out intervention it may be valuable to investigate patient lead treatment approaches that allow the patient the option to choose an intervention that best suits them. Further well designed research is required to gain a more definitive conclusion that can be implemented in clinical practice.
Caesarean Section, Post-Partum Post-traumatic Stress Disorder, Structured Literature Review, Treatment Methods