History of Research for OMM DSA Flashcards
What are big things that happened helping the development of research in the Osteopathic profession?
1) the two institutes that were formed
AT still university research institute
Osteopathic research center (ORC) founded at the Texas School.
How do we define OMM research?
1) what are the 5 ways we do research for OMM research?
institutional
autonomic and immune function
spinal cord facilitation
OMT efficacy
Whole patient care
AOA bureau of research defines OMM research how?
investigator has to state relevance of proposed project to osteopathic philosophy and principles, theories, mechanisms, or practice.
Louisa Burns, DO:
1) who is she?
2) what did her research focus on?
Director of AT still research institute, tons of research
induced spinal fixations in animals and noted the effects on the Brian, heart, GI, repro, lungs, kidneys (S-V reflexes)
Wilbur Cole, DO:
1) what did he do?
2) why did he do it?
studied with Dr. Burns
reproduced her experiments and data
internal validation.
J.S. Denslow, DO
what 3 things did he help implement
Looked at muscle and muscle reflex and autonomic changes of somatic dysfunction –> “osteopathic lesion”
Standard terminology Proponent (so we’re all speaking the same language)
Facilitation of the spinal cord
Dr. Korr, PhD.
what 3 things is he associated with?
what term did he coin because of his research?
studies on galvanic skin resistance as a result of disturbances of autonomic function
axoplasmic flow and trophic functions of nerves (movement of proteins to different nerves)
facilitation of spinal cord (with denslow)
sympatheticotonia
Who promoted the entire DO - patient interaction as a research paradigm, not just OMT
what did he do with Still’s anatomical foundation?
what was he also called?
I.M. Korr, Ph.D
added physiological function to it
second great philosopher of osteopathic medicine
William L Johnston, DO
what 3 things is he known for?
reliability studies, validity studies, and viscerosomatic reflexes.
DO vs MD patient care research from the 20th century
spanish influenza epidemic in 1918.
1932 - Unit 2 L.A. County osteopathic hospital
1999 - first osteopathic study posted to NEJM
Influenza 1918:
mortality rate with medical care vs OMM?
what about pneumonia?
2445
110,000 cases of influenza. mortality treated by medical care = 5%, osteopathic manipulation = 0.25% mortality rate
30-60% vs 10%
Unit II L.A. County Hospital in 1928, what happened?
what is the difference between having MD + DO vs just DO
MD unit (unit 1) had 3574 beds
DO unit (unit 2) only had 200 beds
every 10th patient was assigned to unit 2, but DOs saw 1/7 of total # of patients and delivered 1/3 of the OB patients.
–> MD + DO –> 10% mortality, 16 average Length of stay, 14% coroner’s cases
DO only –> 5.53% mortality, 9.7 day average, 14% coroner’s cases
Comparison of Osteopathic Spinal Manipulation with Standard Care for Patients with Low Back Pain, 1999, Anderson G, et al.
difference between MD + DO?
first study published in NEJM
people with back pain for at least 3 weeks but less than 6 months –> used tons of different strategies.
OMT + PT + Meds –> NSaids only used for 24% of cased, M. relaxants 6%, PT 0.2%
if MD + PT + Meds –> saids were 54%, M. relaxants 25%, PT 2.6%
so DO used less meds and less PT, both groups were satisfied with the care they received.
study: OMT and pancreatitis, what happened? (result is most important)
hospitalized patients, half randomly received OMT with general joint mobilization
treatment group had decreased length of stay, decreased analgesic use, and increased patient satisfaction
study: OMT for ankle sprain, what happened? (result is most important)
55 adults with first or second degree acute ankle sprain
randomized OMT or standard care
OMT –> decreased edema, pain, and increased ROM
study: hospitalized elderly with pneumonia?
28 patients OMT + OMM specialist OMT protocol
30 control, light nonspecific touch for equal length of time as OMT (sham)
results –> OMT = less IV antibiotics, less all antibiotics used. LOS less. Oral abx the same.
study: Otitis media in children
what was the results?
6 month old to 6 years old with recurrent otitis media
25 SOC plus OMT, 32 control SOC only.
OMT –> fewer episodes of AOM, fewer surgical procedure, more mean surgery-free months, increased frequency of normal tympanograms
Study: spleen pump
1934 study re-analyzed.
100 patients were given OMT splenic pump –> increased immune cell counts.
currently investigating cell labeling to identify immune activation from abdominal pump.
Lymphatic pump study:
1) what was it done on and how
2) what 3 things happened?
Lymphatic pump treatment on dog (through exercise + cannulation) showed:
increased flow of lymph in the thoracic duct
increase in the # of circulating leukocytes
abdominal pump showed greater increase than thoracic pump.
lymphatic pump study:
1) what cells increased in lymph?
lymphocytes: CD4, CD8, IgA B cells, IgG B-cells
Neutrophils
Monocytes
Lymphatic pump study:
1) how long did it take to get max release from lymph nodes during a treatment?
2) did they only use dogs?
2 min
did it in rats and it got identical results
What does Pneumonia and Influenza due with lymphatic pump in the study?
how did they do it?
what were the results of the LPT group?
what did the LPT group have increased levels of it?
they gave the rats pneumonia and influenza
3 groups: control group, sham treatment with light touch, LPT (all under anesthesia)
LPT group shows decline in infective bacteria in the lung and immune cell concentration decreased over time (not known really)
SP-D, IL-6, 17, 12.. enhances NO2 and IL-6 by alveolar macrophages.
does LPT cause metastasis
what happened with injecting tumor cells in rats then giving LPT?
there’s no data supporting that in its current state.
LPT group had decrease in # of tumors, 40% reduction in lung tumors.. increase in every cell type in lungs and increase in IL-2.
the LPT.. what happened in serum?
what does this tell us?
no changes in serum markers between all groups..
all the data occurred in the lymphatic system, not from the serum.
so LPT is putting chemicals and cells in the tissues where they need to be.
Considerations in osteopathic manipulation research?
5 things
Blinding –> hard to double blind
Control –> sham therapy, light tough.
Placebo
Size - Power - Drop out control (many variables that can hurt the study)
Inclusion criteria
dependent variables - Measures
