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definitions of OMM research

-institutional--what does your institution define it as
-autonomics and immune fcns--interaction OMM has with viscerosomatic reflexes and immune fcns
-spinal cord facilitation--tissue texture changes, TART
-OMT efficacy--how efficacious is OMM for a certain pt population or how efficacious is a certain technique
-whole pt care


what is the definition of OMM research from the AOA bureau of research?

investigator has to state relevance of proposed project to osteopathic philosophy, principles, theories, mechanisms, and practices


Louisa Burns

-pioneer in osteopathic research
-1st director of AT Still Research Institute (1917-35)
-AOA researcher until 1950
-experimentally induced spinal fixations in animals and then noted the effects of these lesions on brain, heart, GI, reproductive organs, lungs, kidneys (somatovisceral reflexes--reflex in soma with response in viscera)
-V-S reflexes (reflex from viscera with response in soma)


J. Stedman Denslow

-many studies documenting and quantifying muscle, muscle reflex, and autonomic changes in areas of somatic dysfunction
-he documented the existence of somatic dysfcn by using EMG and documenting spinal muscle reflex changes in areas of somatic dysfcns
-standardized terminology in OMT
-facilitation of spinal cord


Irvin M. Korr

-"Second Great Philosopher of Osteopathic Medicine"
-performed studies documenting changes n galvanic skin resistance as a result of disturbances in autonomic fcn, in areas of skin of subjects associated with placatory findings of somatic dysfcn
-discovered axoplasmic flow and trophic fcn of nerves--process of moving fluid down neuron
-facilitation of spinal cord (with Denslow)
-sympatheticotonia--overstimulation of SNS in all dz processes
-brought about peer review of research so it would be valid and respected
-promoted entire DO-pt interaction as a research paradigm, not just OMT
-took Still's anatomical foundation and added physiological fcn to it


William L. Johnston

-reliability studies
-validity studies
-he looked at many studies and checked their validity and reliability
-viscerosomatic reflexes


Wilbur Cole

-studied with Dr. Burns
-reproduced her experiments and data
-internal validation



Spanish Influenza Epidemic



Unit II L.A. County Osteopathic Hospital



NEJM-LBP Randomized Control Trial


Spanish Influenza

-started in middle Kansas with soldiers traveling to Europe to go to battle for WWI
-study looked at 110,120 people treated by 2,445 DOs
-overall mortality
-medical care: 5%
-OMT: 0.25%
-mortality with pneumonia complication
-medical care: 30%
-OMT: 10%


Unit II L.A. County Hospital

-Unit I: MD unit--3574 beds
-Unit II: DO unit--196 beds (1928)
-every 10th pt was assigned to unit II
-but DOs saw 1/7 of total # of patients (many its transferred over)
-DOs delivered 1/3 of babies
-hospital saw 6000 inpatient/yr and 200 outpatient/day
-3 story hospital grew in size for unit II and was the L.A. County Osteopathic Hospital (1933)


LA County Hospital DO vs. MD care 1930-32

-9.7% mortality
-16 days avg LOS (length of stay)
-14% coroner's cases
-DO only
-5.53% mortality
-9.7 days avg LOS
-14% coroner's cases


comparison of osteopathic spinal manipulation with standard care for patients with low back pain (1999)

-study in New England Journal of Medicine
-"at least 3 weeks but less than 6 mos"
-20-59 yo, 155 pts
-variety of techniques, including thrust, muscle energy, counterstain articulation, and myofascial release
-standard care vs. osteopathic manipulation plus std care
-more its on NSAIDS and referred to PT
-outcomes for its were no different, except osteopathic group required less meds and PT


5 clinical trials from a metabolic perspective

a. pancreatitis
b. ankle sprain
c. pneumonia
d. otitis media
e. spleen pump


CT on pancreatitis

-pilot study: 30 pts that were hospitalized
-random assignment to 1/2 with OMT
-gave its general joint mobilization: hips, shoulders, sacrum, spine, ribs
-dec length of stay
-dec analgesic use
-increased pt satisfaction


CT on Ankle Sprain

-sample of 55 adults with 1st or 2nd degree acute ankle sprain presenting to the ER
-randomized to OMT or std care
-results: OMT group had dec edema, pain, and increased ROM


CT on pneumonia

-experimental group: 28 its OMT +OMM specialist with OMM protocol
-control group: 30 its light non-specific taught for equal length of time as OMT (sham)
-both groups had same amount of oral antibiotics
-OMT group had less IV antibiotics
-OMT group had less of all antibiotics
-OMT group had a shorter LOS
-study couldn't be completely reproduced with a larger study


CT on otitis media in children

-subjects were 6mos to 6yo with recurrent otitis media
-25 std care+OMT
-32 control std care only
-OMT group had:
-fewer episodes of acute otitis media
-fewer surgical procedures
-more mean surgery free mos
-increased freq of normal tympanograms


CT on spleen pump

-1934 study is reanalyzed
-group of 100 infected pts
-OMT splenic pump increased immune cell counts
-current investigations are looking at cell labeling to identify immune activation from abdominal pump OMT


special considerations in OMM research

-blinding-can't be double blind b/c physician can't not know what he is performing
-size-power-drop out control
-inclusion criteria
-dependent variables--measures



-are you looking at a series of OMT, duration, freq, a specific order of a tx?
-are you looking at just one maneuver? (HVLA)