Evidence Base for OMM Flashcards
What are the types of research used in osteopathic medicine?
Inter-examiner reliability
standardized technique & treatment protocols
chart review
Who was the true researcher?
AT Still (his questioning made basis for knowledge in current research)
When was the AT Still Research Institute formed?
in 1909 by AOA
What did early research @ COMs focus on in 1900s?
neural & physiologic aspects of SD
effects of OMT on symptoms & immune function
results formed basis of study used today
When was major growth in osteopathic research?
1940s w/ Denslow & Korr (facilitated segment)
What helped lead to increase in research in osteopathic profession?
expansion of new schools in 1970 which meant more faculty & more funding
What is the Osteopathic Research Center?
established at Texas School of Osteopathic Med to coordinate & centralize developing projects toward fundamental research questions facing the profession
What did Louisa Burns study?
impact of SD on animal models
focused on phys of nervous system in relationship to clinical palpation findings
What did Wilbur V Cole II study?
worked w/ Burns & became dean of KCOC
reproduced experiments & data of Burns
What did John Stedman Denslow study?
advocated for use of scientific instruments & measurements for validation of osteopathic clinical findings
used EMG to study effects of SD on muscle reflexes & ANS
What did Denslow propose?
standardized methodology in use of standing postural X ray for purposes of research
promoted development of consistent terminology among clinicians
What did Irvin Korr study?
interaction between skeletal m & ANS
proposed facilitated segment concept (effects of sustained sympathetic tone upon organs)
What was Korr particularly interested in?
study of mind-body relationship & mechanisms that explain how emotional states can escalate impact of increased sympathetic tone
What did William Johnston study?
best inter-examiner reliability studies in 1970s-1980s
demonstrated consistent findings across examiners b/c careful attention to details
How did Johnston make findings more consistent?
examiners worked together for extended time to ensure that able to attend to same palpatory cues
eliminated potential errors in gathering data
Challenges to researching OMM
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
What are some special considerations in OMM research?
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
What are some current areas of osteopathic research?
clinical outcome based
inter-examiner reliability
safety (including tolerance)
cost effective of OMM
Where has OMM research had outcomes in clinic?
AOM in peds
chronic sinusitis
pneumonia
Result of OMM in ped pts w/ AOM
standardized OMT protocol may result in faster resolution of MEE (middle ear effusion) following AOM than standard treatment
Result of OMT in pts w/ lower extremity ulcers
OMT protocol may have reduced edema & reversed trend of wound growth in pts w/ venous stasis ulcers
Osteopathic Approach to Sinusitis
avg decrease in symptom score after OMT
using direct pressure & sinus drainage technique improved overall sinus pain & congestion
Improving inter-examiner reliability
palpatory accuracy of lumbar SP using many bony landmarks
OMT for pneumonia
adjunctive OMT for pneumonia reduced length of stay in adults from 50-74 yo & lowered hospital mortality rates in adults 75+
What are areas of current research in terms of safety?
Is OMT safe in pregnancy?
How well do pts tolerate rib raising techniques?
What are areas of current research in terms of cost-effectiveness of OMM?
Cost effectiveness of OMM to decrease LOS & use of antibiotics (study of pts w/ postoperative ileus)
cost savings to healthcare systems
Example of study for cost-effectiveness of OMT
clinical effectiveness of OMT on reduction of LOS & costs in large population of preterm infants
