Critical literature review
Osteopathic manipulative medicine pertains to a medical approach that focuses in providing total care to a patient (Kuchera 2005). This constituent of osteopathic medicine emphasizes the philosophy of healing using body-based treatments. One unique feature of this field of medicine is to achieve a condition that balances the use of the latest trends for medical intervention and patient-centered caring. Two advantages are strongly associated with osteopathic manipulative medicine, namely the extended differential of etiologies that are usually considered treatable, and a personalized treatment of pain that makes use of osteopathic principles. This two-pronged approach results in a treatment regimen that offers relatively low risks to the patient, that is consequently effective in the healing process of the patient.
Rationale and osteopathic relevance
This study aims to conduct a comprehensive research on the evidence-based reports on the use of cranial osteopathic techniques in the treatment of patients suffering from chronic pain. It should be understood that osteopathic medicine was earlier considered as a field of medicine that did not have a distinct feature in terms of use for patient care (Rogers 2005). Osteopathic medicine arose through the establishment of theoretical principles yet the number of medical reports that fully support this kind of approach was then insufficient.
A number of medical reports have been published in the last few decades describing the effectiveness and safety of osteopathic approaches, thus prompting its integration to general patient care. According to Rogers (2005), osteopathic manipulative treatment is fueled by three basic tenets, namely the fundamentalist approach to patient care, the traditional concepts established in the 1920s and the progressive component that is mainly based on the current application of osteopathic treatments in healthcare. It is therefore time to review the available literature on the use of osteopathic modalities in specific medical conditions in order to determine the actual efficacy and safety of this regimen in patient care. This literature review will focus on the application of osteopathic medical treatment of cranial conditions, including that of pain and other disorders involving the central nervous system.
The application of cranial osteopathic treatments in patient care
Osteopathic treatment modalities have been used in the field of medicine for the last 100 years. This approach is mainly based on the dogma that healing is influenced by positive energies from the body, as well as the employment of medical techniques that are technically considered as allopathic medical approaches.
This combination essentially results in a patient-centered approach to treatment. Initial documentation of the positive results of osteopathic medical treatments were based on anecdotal reports issued by physicians and thus this created an illusion that this field needed a more extensive examination into its effectiveness and safety.
Osteopathic medical approaches have been extensively used in pain management. According to Kuchera (2005), this medical field operates through the achievement of unity with the human body through the acknowledgment of interrelationships between the body and the mind. Unfortunately, osteopathic medical approaches have not been extensively used by majority of physicians and this may possibly be due to its underlying principles and tenets. One possible factor that influenced the low degree of application of this approach is perception of allopathic physicians of the field of osteopathic medicine. In a research study conducted by Reeves Burke (2009), the poor perceptions of allopathic physicians of the field of osteopathic medicine is largely due to its unavailability across the entire United States. Using a 20-item questionnaire that employed the Likert scale in converting the responses of the study participants, the investigators showed that the concentration of osteopathic physicians in the northern states of the United States has resulted in the under- and misrepresentation of the field of osteopathic medicine. Their report provides evidence that the study and application of cranial osteopathy needs to be revisited the field of osteopathic medicine.
An accumulation of medical reports has been seen in the last few decades, bringing about the need to revisit the osteopathic medical approach. A number of reports are described in this literature review, including essential points that provide descriptions of the promising benefits of the use of cranial osteopathy. According to Fryer, Morse Johnson (2009), osteopathic physicians mainly employ osteopathic medical approaches for cranial and myofascial conditions. Cranial osteopathy is an effective approach in the treatment of children with cerebral palsy (Duncan et al 2008). This randomized clinical trial engaged approximately 55 children within the age range of 1.6 to 12 years to participate in cranial osteopathy, acupuncture or a control program to compare the resulting mobility after participating in the program. The study showed that cranial osteopathy resulted in the significant improvement of the childrens motor functions, while acupuncture and the control setup did not generate any improvements.
In a study conducted by Timoshkin Sandhouse (2008), cranial strain problems commonly afflict the general population, thus increasing the importance of osteopathic medical approach. Their report determined the baseline information on the patterns of cranial strain among the normal, healthy population was determined. Using approximately 142 healthy study participants as the target population, the study showed that the most common cranial strain problems were comprised of torsion, as well as side bending rotation, making up approximately 72 of the cases. In addition, specific directional features were observed in the study population, wherein right torsion issues were more prevalent than left torsion problems, while left side-bending problems were more common than right side-bending problems.
Osteopathic physicians are also trained in using palpatory tests for the diagnosis of cranial dysfunctions (Halma et al 2008). Approximately 48 subjects were examined in their study, of which each was grouped as asthma, headache or control. The blinded osteopathic physicians were assessed in terms of their precision in diagnosing health problems. The study showed that cranial strain problems were the most reliable diagnoses that were generated by the osteopathic physicians. Another effective osteopathic approach is the muscle energy technique, which is has long been employed in treating dysfunctions of the central nervous system. A study conducted by Burns Wells (2006), focusing on the application of this technique on cervical problems in motion, showed a significant improvement in cervical movement of individuals who were subjected to the muscle energy technique. The improvement of these patients was far better in outcome as compared to that of the control group.
Osteopathic medical approaches have also been employed in end-of-life care of patients. According to a study conducted by Mason et al (2008), majority (89) of the osteopathic physicians expressed that they are well prepared to provide care to terminally ill patients. In addition, most (79) osteopathic physicians feel that osteopathic techniques can significantly augment the condition of these patients. A report published by Pomykala et al (2008) described the results of an investigation on the perceptions of patients regarding osteopathic manipulative treatments during their stay in the hospital. The study was conducted by providing questionnaires to study participants approximately 24 hours after osteopathic treatment. Majority (94) of the patients indicated that there was a significant decrease in their pain after osteopathic treatment, while 98 of the respondents recognized osteopathic approaches as a key factor to their recovery.
Summary and conclusions
Osteopathic treatment modalities pertain to a combinatorial form of healing that is influenced by positive energies from the body, as well as the employment of medical techniques. This patient-centered approach to treatment is currently considered as a highly effective and safe medical approach that yet needs to be extensively recognized in the medical field. Research reports have published positive results generated from the application of osteopathic approaches, especially in cases involving cranial dysfunctions, central nervous system disorders and end-of-life conditions. The improvement of specific medical conditions thus prompts the need to further employ osteopathic approaches in patient care.
Rationale and osteopathic relevance
This study aims to conduct a comprehensive research on the evidence-based reports on the use of cranial osteopathic techniques in the treatment of patients suffering from chronic pain. It should be understood that osteopathic medicine was earlier considered as a field of medicine that did not have a distinct feature in terms of use for patient care (Rogers 2005). Osteopathic medicine arose through the establishment of theoretical principles yet the number of medical reports that fully support this kind of approach was then insufficient.
A number of medical reports have been published in the last few decades describing the effectiveness and safety of osteopathic approaches, thus prompting its integration to general patient care. According to Rogers (2005), osteopathic manipulative treatment is fueled by three basic tenets, namely the fundamentalist approach to patient care, the traditional concepts established in the 1920s and the progressive component that is mainly based on the current application of osteopathic treatments in healthcare. It is therefore time to review the available literature on the use of osteopathic modalities in specific medical conditions in order to determine the actual efficacy and safety of this regimen in patient care. This literature review will focus on the application of osteopathic medical treatment of cranial conditions, including that of pain and other disorders involving the central nervous system.
The application of cranial osteopathic treatments in patient care
Osteopathic treatment modalities have been used in the field of medicine for the last 100 years. This approach is mainly based on the dogma that healing is influenced by positive energies from the body, as well as the employment of medical techniques that are technically considered as allopathic medical approaches.
This combination essentially results in a patient-centered approach to treatment. Initial documentation of the positive results of osteopathic medical treatments were based on anecdotal reports issued by physicians and thus this created an illusion that this field needed a more extensive examination into its effectiveness and safety.
Osteopathic medical approaches have been extensively used in pain management. According to Kuchera (2005), this medical field operates through the achievement of unity with the human body through the acknowledgment of interrelationships between the body and the mind. Unfortunately, osteopathic medical approaches have not been extensively used by majority of physicians and this may possibly be due to its underlying principles and tenets. One possible factor that influenced the low degree of application of this approach is perception of allopathic physicians of the field of osteopathic medicine. In a research study conducted by Reeves Burke (2009), the poor perceptions of allopathic physicians of the field of osteopathic medicine is largely due to its unavailability across the entire United States. Using a 20-item questionnaire that employed the Likert scale in converting the responses of the study participants, the investigators showed that the concentration of osteopathic physicians in the northern states of the United States has resulted in the under- and misrepresentation of the field of osteopathic medicine. Their report provides evidence that the study and application of cranial osteopathy needs to be revisited the field of osteopathic medicine.
An accumulation of medical reports has been seen in the last few decades, bringing about the need to revisit the osteopathic medical approach. A number of reports are described in this literature review, including essential points that provide descriptions of the promising benefits of the use of cranial osteopathy. According to Fryer, Morse Johnson (2009), osteopathic physicians mainly employ osteopathic medical approaches for cranial and myofascial conditions. Cranial osteopathy is an effective approach in the treatment of children with cerebral palsy (Duncan et al 2008). This randomized clinical trial engaged approximately 55 children within the age range of 1.6 to 12 years to participate in cranial osteopathy, acupuncture or a control program to compare the resulting mobility after participating in the program. The study showed that cranial osteopathy resulted in the significant improvement of the childrens motor functions, while acupuncture and the control setup did not generate any improvements.
In a study conducted by Timoshkin Sandhouse (2008), cranial strain problems commonly afflict the general population, thus increasing the importance of osteopathic medical approach. Their report determined the baseline information on the patterns of cranial strain among the normal, healthy population was determined. Using approximately 142 healthy study participants as the target population, the study showed that the most common cranial strain problems were comprised of torsion, as well as side bending rotation, making up approximately 72 of the cases. In addition, specific directional features were observed in the study population, wherein right torsion issues were more prevalent than left torsion problems, while left side-bending problems were more common than right side-bending problems.
Osteopathic physicians are also trained in using palpatory tests for the diagnosis of cranial dysfunctions (Halma et al 2008). Approximately 48 subjects were examined in their study, of which each was grouped as asthma, headache or control. The blinded osteopathic physicians were assessed in terms of their precision in diagnosing health problems. The study showed that cranial strain problems were the most reliable diagnoses that were generated by the osteopathic physicians. Another effective osteopathic approach is the muscle energy technique, which is has long been employed in treating dysfunctions of the central nervous system. A study conducted by Burns Wells (2006), focusing on the application of this technique on cervical problems in motion, showed a significant improvement in cervical movement of individuals who were subjected to the muscle energy technique. The improvement of these patients was far better in outcome as compared to that of the control group.
Osteopathic medical approaches have also been employed in end-of-life care of patients. According to a study conducted by Mason et al (2008), majority (89) of the osteopathic physicians expressed that they are well prepared to provide care to terminally ill patients. In addition, most (79) osteopathic physicians feel that osteopathic techniques can significantly augment the condition of these patients. A report published by Pomykala et al (2008) described the results of an investigation on the perceptions of patients regarding osteopathic manipulative treatments during their stay in the hospital. The study was conducted by providing questionnaires to study participants approximately 24 hours after osteopathic treatment. Majority (94) of the patients indicated that there was a significant decrease in their pain after osteopathic treatment, while 98 of the respondents recognized osteopathic approaches as a key factor to their recovery.
Summary and conclusions
Osteopathic treatment modalities pertain to a combinatorial form of healing that is influenced by positive energies from the body, as well as the employment of medical techniques. This patient-centered approach to treatment is currently considered as a highly effective and safe medical approach that yet needs to be extensively recognized in the medical field. Research reports have published positive results generated from the application of osteopathic approaches, especially in cases involving cranial dysfunctions, central nervous system disorders and end-of-life conditions. The improvement of specific medical conditions thus prompts the need to further employ osteopathic approaches in patient care.
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