Evidence Base for OMM

Question 1

What are the types of research used in osteopathic medicine?

Answer 1

Inter-examiner reliability

standardized technique & treatment protocols

chart review

Question 2

Who was the true researcher?

Answer 2

AT Still (his questioning made basis for knowledge in current research)

Question 3

When was the AT Still Research Institute formed?

Answer 3

in 1909 by AOA

Question 4

What did early research @ COMs focus on in 1900s?

Answer 4

neural & physiologic aspects of SD

effects of OMT on symptoms & immune function

results formed basis of study used today

Question 5

When was major growth in osteopathic research?

Answer 5

1940s w/ Denslow & Korr (facilitated segment)

Question 6

What helped lead to increase in research in osteopathic profession?

Answer 6

expansion of new schools in 1970 which meant more faculty & more funding

Question 7

What is the Osteopathic Research Center?

Answer 7

established at Texas School of Osteopathic Med to coordinate & centralize developing projects toward fundamental research questions facing the profession

Question 8

What did Louisa Burns study?

Answer 8

impact of SD on animal models

focused on phys of nervous system in relationship to clinical palpation findings

Question 9

What did Wilbur V Cole II study?

Answer 9

worked w/ Burns & became dean of KCOC

reproduced experiments & data of Burns

Question 10

What did John Stedman Denslow study?

Answer 10

advocated for use of scientific instruments & measurements for validation of osteopathic clinical findings

used EMG to study effects of SD on muscle reflexes & ANS

Question 11

What did Denslow propose?

Answer 11

standardized methodology in use of standing postural X ray for purposes of research

promoted development of consistent terminology among clinicians

Question 12

What did Irvin Korr study?

Answer 12

interaction between skeletal m & ANS

proposed facilitated segment concept (effects of sustained sympathetic tone upon organs)

Question 13

What was Korr particularly interested in?

Answer 13

study of mind-body relationship & mechanisms that explain how emotional states can escalate impact of increased sympathetic tone

Question 14

What did William Johnston study?

Answer 14

best inter-examiner reliability studies in 1970s-1980s

demonstrated consistent findings across examiners b/c careful attention to details

Question 15

How did Johnston make findings more consistent?

Answer 15

examiners worked together for extended time to ensure that able to attend to same palpatory cues

eliminated potential errors in gathering data

Question 16

Challenges to researching OMM

Answer 16

objective findings that appreciated by subjective experience

variability in skills of applying OMM

resources needed to administer OMT to enough pts to achieve good study

Question 17

What are some special considerations in OMM research?

Answer 17

blinding of examiners

control group

placebo v sham v light touch group

of “arms” in study (how many groups & combos?)

size of groups & drop out rate

dependent variables-measures

Question 18

What are some current areas of osteopathic research?

Answer 18

clinical outcome based

inter-examiner reliability

safety (including tolerance)

cost effective of OMM

Question 19

Where has OMM research had outcomes in clinic?

Answer 19

AOM in peds
chronic sinusitis
pneumonia

Question 20

Result of OMM in ped pts w/ AOM

Answer 20

standardized OMT protocol may result in faster resolution of MEE (middle ear effusion) following AOM than standard treatment

Question 21

Result of OMT in pts w/ lower extremity ulcers

Answer 21

OMT protocol may have reduced edema & reversed trend of wound growth in pts w/ venous stasis ulcers

Question 22

Osteopathic Approach to Sinusitis

Answer 22

avg decrease in symptom score after OMT

using direct pressure & sinus drainage technique improved overall sinus pain & congestion

Question 23

Improving inter-examiner reliability

Answer 23

palpatory accuracy of lumbar SP using many bony landmarks

Question 24

OMT for pneumonia

Answer 24

adjunctive OMT for pneumonia reduced length of stay in adults from 50-74 yo & lowered hospital mortality rates in adults 75+

Question 25

What are areas of current research in terms of safety?

Answer 25

Is OMT safe in pregnancy?

How well do pts tolerate rib raising techniques?

Question 26

What are areas of current research in terms of cost-effectiveness of OMM?

Answer 26

Cost effectiveness of OMM to decrease LOS & use of antibiotics (study of pts w/ postoperative ileus)

cost savings to healthcare systems

Question 27

Example of study for cost-effectiveness of OMT

Answer 27

clinical effectiveness of OMT on reduction of LOS & costs in large population of preterm infants