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
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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

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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)
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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
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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
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6
Q

William L. Johnston

A
  • reliability studies
  • validity studies
    - he looked at many studies and checked their validity and reliability
  • viscerosomatic reflexes
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7
Q

Wilbur Cole

A
  • studied with Dr. Burns
  • reproduced her experiments and data
  • internal validation
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8
Q

1918

A

Spanish Influenza Epidemic

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9
Q

1932

A

Unit II L.A. County Osteopathic Hospital

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10
Q

1999

A

NEJM-LBP Randomized Control Trial

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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%
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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)
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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
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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
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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
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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
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)