DSA - Historical Review of OMM Research Flashcards
When did the AOA form the AT Still Research Institute?
1909
When was research encouraged at the COMs?
first 1/3 of 1900s
What happened to research post WWII?
Profession was busy getting enough doctors in the community to care for the population.
Research less of a priority
When did the California Merger occur?
Late 1950s
When did the Profession lack a research institiute?
2001-2007
What happened at the Texas School?
Funds provided to the Texas school were used to make the Osteopathic Research Center (ORC)
What is the ORC?
Osteopathic Research Institute
Center was charged to coordinate and centralize the developing mature research questions facing the profession
What was formed after the ORC?
AT Still University Research Institute
When did the expansion in osteopathic research occur?
2008 to present
Who is Louisa Burns?
DO (1870-1958)
Pioneer career osteopathic researcher
Director of AT Still Research institute 1917-1935
Experimentally induced spinal fixations in animals and then noted the effects of these lesions on brain, heart, GI, reproductive organs, lungs, kidneys (S-V) reflexes)
Studied V-S reflexes
Who is Wilbur Cole?
DO
Studied wit Dr. Burns 1948-1950
Reproduced her experiments and data
Internal Validation
Who is J.S. Denslow?
DO (1906-?)
Did numerous studies documenting and quantifying muscle, muscle reflex, and autonomic changes in areas of somatic dysfunction (osteopathic lesion)
Reflex activity in the spinal extensors
Utilized EMG/Palpation correlation: documented spinal muscle reflex changes in areas of osteopathic lesions.
Standard Terminology Proponent
Facilitation of Spinal Cord
Who is I.M. Korr?
PhD (1909-2004)
Performed studies documenting changes in galvanic skin resistance as a result of disturbances in autonomic function, in areas of skin of subjects associated with palpatory findings of somatic dysfunction
Axoplasmic flow and the trophic function of nerves
Facilitation of spinal cord (with Denslow)
Sympatheticotonia
Promoted entire DO-Patient interaction as research paradigm, not just OMT
The Second Great Philosopher of Osteopathic Medicine
Took Stills anatomical foundation and added physiological function to it
Who is William L. Johnston?
DO, FAAO (1921-2003)
Reliability studies
Validity Studies
Viscersomatic Reflexes
What is significant of the Spanish Influenza Epidemic?
In 1918
DOs and MDs provided care to patients. Those treated by DOs with Oteopathic Manipulation had reduced mortality rates than those treated without OMT
What is significant of the Unit II L.A. County Osteopathic Hospital?
In 1932
MD unit (Unit I) had 3574 beds
DO unit (Unit II) had only 196 beds
Every 10th patient was assigned to Unit II
But DOs saw 1/7th of total # of patients (many patients were transferred over)
DOs delivered 1/3 of the OB patients
6000 inpatients per year
200 outpatients per day
What is important about the LA County General Hospital?
In 1933
46,464 inpatients annually
518,377 outpatients
Third largest hospital in the country
What is important about the LAC (Osteopathic) Hospital?
In 1933
210 average inpatients per day
365 amulatory pateients per day
715 admissions per month
126 births per month
37 deaths per month
682 discharges per month
How did the DO care compare to the MD care in 1930-32?
MD + DO
- 9.7% mortality
- 16 days average LOS
- 14% coroner’s cases
DO Only
- 5.53% mortality
- 9.7 days average LOS
- 14% coroner’s cases
What is significant of the Study comparing Spinal OMT with standard care for pt’s with low back pain?
1999 Anderson, G.
- Pain for at least 3 weeks but less than 6 months
- 20-59 year olds, n = 155
- Variety of techniques
- Standard Care vs OMT Plus standard care
- OMT recipients required fewer medications and less physical therapy
What is significant of the study on OMT and Pancreatitis?
1998 Radjieski
n = 30 hospitalized patients
Random assignment: 1/2 OMT
General joint mobilization
- Hips, shoulders
- Sacrum, spine, ribs
Decreased length of stay
Decreased analgesic use
Increased pt satisfaction
What is significant of the Study on OMT for Ankle Sprain?
Eisenhart
N = 55 adults with first or second degree acute ankle sprain presenting to the emergency department
Randomized to OMT or standard care
Results - OMT group had decreased edema, pain, and increased range of motion
What is significant of the study on Hospitalized Elderly with Pneumonia Standard vs OMM?
Noll
Experimental Group
- 28 pt’s OMT and OMM specialist OMT protocol
Control Group
- 30 pt’s light non-specific touch for equal length of time as OMT (sham)
- Experimental group used fewer IV antibiotics, fewer total antibiotics, and shorter average length of stay
What is significant of the Study on Otitis Media in Children?
Mills MV, 2003
- Children 6 months to 6 years
- Recurrent Otitis Media
- 25 standard care plus OMT
- 32 control standard care only
OMT Group had:
- Fewer episodes of AOM
- Fewer surgical procedures
- More mean surgery-free months
- Increased frequency of normal tympanograms
What is significant of the Study on Spleen Pump?
Noll, 2008
1934 study reanalyzed
N=100 infected patients
OMT splenic pump increased immune cell counts
Current investigations are looking at cell labeling to identify immune activation from abdominal pump OMT
What did the Dog Lab with Lymphatic Pump Treatment (LPT) show?
Hodge
Increase of flow of lymph in the thoracic duct
Increase in the Number of circulating leukocytes
Abdominal pump showed greater increase than thoracic pump
Measured cells increased in the lymph
- Lymphocytes: CD4, CD8, IgA B-Cells, IgG B-cells (memory cells already exposed to antigens)
- Neutriphils
- Monocytes
Takes 2 min to get max release from the nodes during treatment (cells, cytokines, proteins)
- Nitric Oxide influences contraction of lymph vessels
- Inflammation stimulates the release of NO
Experiment was repeated in rat model with same results
- Control Group under anesthetic
- Sham treatment group; light touch; under anesthesia
- Experimental group; LPT; under anesthesia
Rate treated 1x / day over 7 days
- 1 pump/sec over 4 minutes
Results:
- Control and sham treatment group showed a steady increase of bacteria in bronchial washings
- LPT group after 2-3 treatments showed a steady decline in # of bacteria in bronchial washings
Supports the hypothesis release of leukocytes in healthy animals
Clinical evidence LPT helps to clear infection in the lung
- Increased lymph flow should decrease number of bacteria in lungs
Summarize the Lymphatic Pump study:
Increases flow in the lymphatic duct
Protection in lung
- Bacteria in pneumonia
- Mechanism unknown
Protective during development of solid tumor in lungs
- Mechanism unknown
