TEST 3: A Historical Review of OMM Research Flashcards
1
Q
definitions of OMM research
A
- 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
Q
what is the definition of OMM research from the AOA bureau of research?
A
investigator has to state relevance of proposed project to osteopathic philosophy, principles, theories, mechanisms, and practices
3
Q
Louisa Burns
A
- 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
Q
J. Stedman Denslow
A
- 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
Q
Irvin M. Korr
A
- “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
Q
William L. Johnston
A
- reliability studies
- validity studies
- he looked at many studies and checked their validity and reliability - viscerosomatic reflexes
7
Q
Wilbur Cole
A
- studied with Dr. Burns
- reproduced her experiments and data
- internal validation
8
Q
1918
A
Spanish Influenza Epidemic
9
Q
1932
A
Unit II L.A. County Osteopathic Hospital
10
Q
1999
A
NEJM-LBP Randomized Control Trial
11
Q
Spanish Influenza
A
- 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
Q
Unit II L.A. County Hospital
A
- 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
Q
LA County Hospital DO vs. MD care 1930-32
A
- 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
Q
comparison of osteopathic spinal manipulation with standard care for patients with low back pain (1999)
A
- 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
Q
5 clinical trials from a metabolic perspective
A
- inflammation:
a. pancreatitis
b. ankle sprain - infection:
c. pneumonia
d. otitis media
e. spleen pump
16
Q
CT on pancreatitis
A
- 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
Q
CT on Ankle Sprain
A
- 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
Q
CT on pneumonia
A
- 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
Q
CT on otitis media in children
A
- 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
- OMT group had:
20
Q
CT on spleen pump
A
- 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
Q
special considerations in OMM research
A
- 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
Q
OMM vs. OMT
A
- are you looking at a series of OMT, duration, freq, a specific order of a tx?
- are you looking at just one maneuver? (HVLA)
