TEST 3: A Historical Review of OMM Research Flashcards Preview

Osteopathic Skills--Lexie > TEST 3: A Historical Review of OMM Research > Flashcards

Flashcards in TEST 3: A Historical Review of OMM Research Deck (22)
Loading flashcards...
1

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

2

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

3

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)

4

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

5

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

6

William L. Johnston

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

7

Wilbur Cole

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

8

1918

Spanish Influenza Epidemic

9

1932

Unit II L.A. County Osteopathic Hospital

10

1999

NEJM-LBP Randomized Control Trial

11

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%

12

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)

13

LA County Hospital DO vs. MD care 1930-32

-MD+DO
-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

14

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
-OMT+PT+Meds
-MD+PT+Meds
-more its on NSAIDS and referred to PT
-outcomes for its were no different, except osteopathic group required less meds and PT

15

5 clinical trials from a metabolic perspective

-inflammation:
a. pancreatitis
b. ankle sprain
-infection:
c. pneumonia
d. otitis media
e. spleen pump

16

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
-results:
-dec length of stay
-dec analgesic use
-increased pt satisfaction

17

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

18

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)
-results:
-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

19

CT on otitis media in children

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

20

CT on spleen pump

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

21

special considerations in OMM research

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

22

OMM vs. OMT

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