Osteopathy

Background: Peer physical examination (PPE) is an efficient and practical educational approach whereby students can practise their examination skills on each other before commencing clinical practice with actual patients. Little is known about the use of PPE in osteopathy education.

In the panorama of scientific literature, there is a paucity of literature on how to palpate the heart area in
the osteopathic setting and relevant indications on which palpatory sensations the clinician should perceive
during the evaluation. The article reviews the fascial anatomy of the heart area and the heart movements
derived from magnetic resonance imaging (MRI) studies and describes the landmarks used by the cardiac
surgeon to visualize the mediastinal area. The text sets out possible suggestions for a more adequate
osteopathic palpatory evaluation and describes any tactile sensations arising from the patient's chest. To the
knowledge of the authors, this is the first article that seeks to lay solid foundations for the improvement of
osteopathic manual medicine in the cardiology field.

La nouvelle édition critique de l'Autobiographie de A.T. Still établie par Jean-Marie Gueullette bénéficie des recherches historiques menées depuis la traduction pionnière de Pierre Tricot et de l'expertise de l'École de traduction et relations internationales de l'Université Catholique de Lyon. Elle comprend la traduction révisée, une nouvelle introduction et de nouvelles notes identifiant les variantes des premières éditions, donnant les références des citations ainsi que des informations biographiques et des citations de documents. Cet appareil critique, indispensable pour replacer l'œuvre dans son contexte, en permet une meilleure appréciation reposant sur des bases solides.

Andrew Taylor Still (1828-1917), le fondateur de l'ostéopathie, a vécu dans l'Ouest américain à l'époque héroïque des pionniers de la « frontière » et de la guerre de Sécession. Dans son Autobiographie, il évoque d'abord son enfance, son cheminement, les épreuves qui ont motivé sa recherche, les résistances de ses contemporains, et comment il en vint à découvrir les principes essentiels de l'ostéopathie, ceux qui régissent le fonctionnement de la vie, de l'état de santé et de maladie. Ce récit fascinant de la naissance de l'ostéopathie, replacée dans son cadre naturel, est complété par une série de conférences dans lesquelles Still présente ce qui était à ses yeux les fondements de l'ostéopathie, et sa différence radicale avec la médecine.

Cet ouvrage majeur, où souffle l'esprit de l'ostéopathie, a été traduit en français par Pierre Tricot en 1998, inaugurant ainsi une série de traductions qui ont permis aux lecteurs francophones d'accéder aux ouvrages fondateurs de l'ostéopathie.

Cette nouvelle édition révisée de l'Autobiographie de A.T. Still reproduit les illustrations de l'édition originale.

- L'ostéopathie, prévention et soins dès la naissance
Page :13,
Fabien Collombelle
Avant-propos
Déclaration de liens d’intérêts
http://dx.doi.org/10.1016/j.melaen.2018.06.002

- Les bienfaits de l'ostéopathie pour le bébé
Page :14-16,
Dany Heinz-Blondy
Mots clés : corps, ostéopathie, prévention, santé, vaccin
Résumé :
La prévention en ostéopathie prend en considération la capacité du corps à s’adapter aux contraintes et à s’en libérer. La précocité de la visite chez l’ostéopathe après la naissance est fondamentale. La libération de dysfonctions mineures à ce stade permet d’éviter l’apparition d’un certain nombre de troubles fonctionnels pouvant perturber l’équilibre général de l’enfant.
Plan :
Les principaux motifs de consultation
Un dialogue subtil
Prévention dès la naissance
Ostéopathie et vaccination
Conclusion
Déclaration de liens d’intérêts
http://www.dx.doi.org/10.1016/j.melaen.2018.06.003

- Prise en charge ostéopathique des pathologies de la sphère ORL chez le jeune enfant
Page :17-19,
Thierry Leboursier
Mots clés : immunité, ostéopathie, prévention, sphère ORL, thérapie manuelle
Résumé :
Les pathologies ORL de l’enfant sont le motif de consultation le plus fréquent en ostéopathie pédiatrique comme en pédiatrie. L’ostéopathie est adaptée à la prévention et à la prise en charge des situations de récidives et de chronicité en s’intéressant à l’amélioration du terrain immunitaire de l’enfant.
Plan :
Signes d’appel et diagnostic
L’otite
La sinusite
Nécessité d’un diagnostic spécialisé
Définition de l’ostéopathie
Cadre et principes thérapeutiques
Le traitement ostéopathique
Conclusion
Déclaration de liens d’intérêts
http://www.dx.doi.org/10.1016/j.melaen.2018.06.004

- Plagiocéphalie et torticolis du nouveau-né
Page :20-22,
Jean Ducourneau
Mots clés : asymétrie, ostéopathie, plagiocéphalie, psychomotricité, torticolis
Résumé :
Repérer la plagiocéphalie et les “attitudes en torticolis” du bébé est fondamental pour pouvoir orienter les parents le plus judicieusement possible. Des éléments d’observation permettent de mieux comprendre cette problématique. Le travail en continuité avec les professionnels de la petite enfance est précieux, en relais des ostéopathes et des kinésithérapeutes.
Plan :
Définitions
Traitement de la plagiocéphalie
Évolution du traitement
Conclusion
Déclaration de liens d’intérêts
http://www.dx.doi.org/10.1016/j.melaen.2018.06.005

- De la fusion à la capacité d’être seul, apports de l’ostéopathie
Page :23-25,
Chantal Ropars
Mots clés : ostéopathie, pare-excitation, portage, séparation, toucher
Résumé :
L’ostéopathe, intervenant précoce dans le suivi des tout-petits, a un rôle important auprès des parents. Il les guide notamment dans l’apprentissage d’un portage et d’un toucher justes, respectueux des besoins du bébé, qui vont de la fusion à l’apprentissage de la séparation, c’est-à-dire à la capacité d’être seul en présence d’un autre.
Plan :
Première séance d’ostéopathie
Aider l’enfant à construire son pare-excitation
Conclusion
Déclaration de liens d’intérêts
http://www.dx.doi.org/10.1016/j.melaen.2018.06.006

Excerpt from Chapter 1: Copyright © 2004-2021 by Dr Alex Vasquez. Published most recently in Inflammation Mastery, 4th Edition (InflammationMastery.com) and Textbook of Clinical Nutrition and Functional Medicine.    All rights reserved and enforced. See update/overview 14Aug2021 at HealthyThinking.substack.com

The interdisciplinary approach is becoming more widely used by modern Russian dentistry. This approach covers both dentistry disciplines and general medical field. It often leads to hyper diagnostics and inadequate treatment, with results in a patient’s overtreatment and their psychological state.
Osteopathy has gained a lot of popularity, especially cranio-osteopathy, to treat patients with TMD (TemporoMandibular Disorders). It becomes obvious that the relation between supporting-motor apparatus and masticatory system evokes great interest.
    Some authors claim that TMD is caused by poor posture and spine disorders but not by problems in maxillofacial area.
    Many scientific conferences have been held all over the world. A lot of clinics have taken on osteopaths.
    The use of alternative medicine techniques in our field is very risky as no enough scientific evidence has been found yet to prove the effectiveness of such methods of treatment.
    The aim of our research is to determine the effectiveness of the use of cranio-osteopathic methods in dentistry field.

Tout prête à croire à une inflammation  : une main ou un pied rouge, enflé, réellement plus chaud, des sensations de brûlures cuisantes à l’intérieur de l’articulation. Autant de symptômes d’un syndrome effroyable, laissant, au petit matin, la personne épuisée après une nuit sans repos. A Budapest, après trois jours de délibérations, une réunion consensuelle de 38 experts valide les critères diagnostiques précis de ce syndrome : le syndrome douloureux régional complexe (SDRC de … Budapest). PAS incurable.

Objective: To compare changes in pressure pain threshold (PPT) following spinal high-velocity low-amplitude thrust manipulation (HVLAT) and spinal mobilisation.

Design: Fifty asymptomatic subjects (mean age 27 (6) years; 29 males and 21 females) volunteered to participate in a randomised controlled, singled blinded design study. Subjects were screened for suitability and were randomly allocated into one of three intervention groups where they received either a unilateral spinal HVLAT or a spinal mobilisation of the lumbar spine, or a sham ‘laser’ procedure (control). PPT measurements were made immediately pre- and post-intervention, using a hand-held algometer which was positioned directly over the lumbar spinous process. A two-way ANOVA with repeated measures was conducted to determine PPT changes between the groups. Statistical significance was set at the 0.05 level.

Results: There were no significant differences in PPT across time for each of the groups (P = 0.584). The mobilisation group displayed a small increase, though not a significant change in the mean pressure pain threshold (0.434(0.55) kg/cm2), although effect size was considered to be large (ES = 0.78). The HVLAT group demonstrated a decrease in the mean PPT (−0.173(0.48)) (ES = 0.36, small), and a smaller decrease was noted for the control group (0.105(0.425) kg/cm2) (ES = 0.25, small).

Conclusion: Neither spinal HVLAT nor mobilisation had a significant effect on PPT of the lumbar spine in asymptomatic subjects. Only spinal mobilisation appeared to have a greater mean increase in PPT and effect size than the control group. Further investigation into the hypoalgesic effects of these techniques on symptomatic subjects is suggested.

Inflammation Mastery / Functional Inflammology, Volume 1 (2014, updated and expanded in 2016). This work is the culmination of several thousand research publications combined with Dr Vasquez's many years of clinical experience and teaching graduate-level students and doctorate-level clinicians worldwide. With radiographs, photos, acronyms, illustrations, flowcharts, and detailed-yet-simplifying explanations, Dr Vasquez makes it easier than ever for clinicians to grasp important concepts in integrative care and functional medicine and then to translate the basic science research and molecular biology into treatment plans that can be explained and used in " the real world " of clinical practice with patients. The associated video tutorials and recorded live conference presentations further help students and clinicians " get it " via Dr Vasquez's effective teaching style which embraces complexity while always emphasizing clinical applicability and psychosocial context. The Inflammation Mastery & Functional Inflammation Mastery & Functional Inflammation Mastery & Functional Inflammation Mastery & Functional Inflammology series of books and videos Inflammology series of books and videos Inflammology series of books and videos Inflammology series of books and videos translates important concepts and nutritional/biomedical science into easy and practical clinical applications for the prevention and treatment of disorders of sustained inflammation, which Dr Vasquez describes as " patterns of metabolic disturbance and inflammatory dysfunction " existing in three sequential and overlapping categories: 1) metabolic inflammation, 2) allergic inflammation, 3) autoimmune inflammation. This book includes access to video presentations which introduce the origin and components of the Functional Inflammology Protocol and FINDSEX ® acronym. Post-publication updates to this information and important social and clinical contextualization are made available in videos and online repositories (access provided in the book), and the e-newsletter available from ICHNFM.ORG. This textbook also provides access, via reprints or hyperlinks, to Dr Vasquez's published articles—an example of which is his recent paradigm-shifting editorial published in the journal Alternative Therapies in Health and Medicine (2014 January). The updated section on pain management allows students and clinicians to understand and apply manual, pharmacologic, nutritional and botanical medicine treatments for musculoskeletal pain, thereby providing better relief for patients and avoiding the hazards of NSAIDs, coxibs, steroids, opioids, immunosuppressants and biologics.

Comparative analysis between orthopaedic manual therapy and osteopathy : focus on the Belgian situation Summary : Orthopaedic manual therapy (OMT) and osteopathy have been coexisting since a long time in Belgium to manage musculoskeletal disorders (MSDs). There are millions of consultations per year in these both disciplines. Both of them offer good clinical outcomes as well as patient satisfaction with care, good cost-effectiveness , as well as minor side effects. Nevertheless, a major misunderstanding remains in Belgium concerning these both professions. A narrative review by Belgian experts in osteopathy and/or in OMT has been undertake. In Belgium, both professions present several major differences concerning the primary first care access, the recognition as health care profession, tailored reimbursement systems, types and organization of education, the use of rehabilitation and motor control, the integration of evidence based practice concept, the reasons/indications of consultation, the degree of confidence within the therapeutic touch concept. In the meantime, several similarities also exist including the integration of the bio-psycho-social model, the evaluation of the neuromusculoskeletal system and the treatment of MSDs using sometimes identical manual techniques, as well as the use of therapeutic education of the patient and specific clinical reasoning. This analysis may help health professionals, students and patients to better understand the convergences and divergences between these both disciplines of musculoskeletal care in Belgium Résumé : La thérapie manuelle orthopédique (TMO) et l'ostéopathie coexistent depuis longtemps en Belgique pour prendre en charge les troubles musculosquelet-tiques (TMS). On comptabilise des millions de consultations par an pour ces deux disciplines. Chacune offre, à la fois, une bonne satisfaction des patients et une bonne efficacité clinique, un bon rapport coût-efficacité, ainsi que des effets secondaires mineurs. Néanmoins, une mécon-naissance majeure demeure en Belgique au sujet de ces approches thérapeutiques. Une revue narrative rédigée par des experts Belges en ostéopathie et/ou en thérapie manuelle a été réalisée. La TMO et l'ostéopathie pré-sentent plusieurs différences majeures en Belgique. Elles concernent l'accès direct, la reconnaissance comme profession de santé, les systèmes de remboursement, les types et l'organisation de l'enseignement, l'utilisation de la rééducation et du contrôle moteur, l'intégration du concept d' «evidence-based-practice», les motifs/indications de consultation, le degré de confiance dans le toucher à des fins diagnostiques et thérapeutiques. Cependant, plu-sieurs similitudes existent également, dont l'intégration du modèle bio-psycho-social, l'évaluation du système neuro-musculo-squelettique, l'utilisation de techniques manuelles parfois identiques pour le traitement des TMS, une édu-cation thérapeutique du patient ainsi que l'utilisation d'un raisonnement clinique, propre, cependant, à chacune des disciplines. Cette analyse devrait aider les professionnels de la santé, les étudiants, ainsi que les patients à mieux comprendre les convergences et les divergences entre ces deux disciplines en Belgique. Mots-clés : Revue-Thérapie manuelle orthopédique-Kinésithérapie-Ostéopathie-Musculo-squelettique.

Abstract:

L’argomento di questa tesi nasce dall'esperienza congiunta di rievocazione storica ed archeologia sperimentale che ho maturato con gli anni. Appassionato di rievocazione dal 2007,
ho praticato (e continuo tuttora a praticare) la scherma ed il reenactment relativi a svariati periodi della storia della Sardegna: il periodo medioevale (giudicale), quello romano-imperiale e da ultimo quello nuragico. La necessità di avere maggiori informazioni, non disponibili tramite le fonti scritte, iconografiche e archeologiche legate sopratutto a quest’ultimo periodo, mi ha portato con gli anni a pormi ulteriori quesiti sull’argomento. Quella dei nuragici era una società pacifica? In caso contrario come combattevano i suoi guerrieri? Che tipo di struttura gerarchico-militare avevano? Le risposte a queste domande diventavano sempre più impellenti man mano che mi confrontavo con il pubblico (e spesso con i pregiudizi legati a questo lontano periodo). Desideroso di avere delle risposte, coadiuvato dall’esperienza di artigiano-archeotecnico del bronzo che porto avanti nei ritagli di tempo, ispirato da studi sulla cosiddetta “archeologia del combattimento” e dalle tecniche forensi applicate nell'archeologia, sono giunto a conclusione che solo studiando i resti umani di quegli
uomini vissuti 3000 e più anni fa, avrei potuto ricavare maggiori risposte alle mie domande.
Nel presente lavoro ho esaminato i casi più noti in letteratura di reperti scheletrici con visibili segni traumatici, ponendo particolare attenzione ai periodi preistorici. Come paragone
per lo studio dei reperti nuragici è stato utilizzato lo scheletro di un presunto soldato medioevale, il quale presentava diversi traumi da combattimento. I resti ossei nuragici consistono in tre crani appartenenti a tre diverse sepolture collettive localizzate in aree della Sardegna tra loro molto distanti. Per questi tre casi si è provveduto a determinare il tipo di trauma osservato, che tipo di arma ha provocato la ferita e lo scenario ipotetico dell’aggressione che ha interessato ciascun individuo. Lo studio di questi casi ha permesso una ricostruzione delle modalità di combattimento più verosimili per tale periodo; queste hanno
permesso di dedurre quali ferite e in quali aree del corpo si potrebbero riscontrare più frequentemente i traumi. La riproduzione dei traumi mediante prove d’archeologia sperimentale (test di taglio) hanno permesso di capire quali lesioni potrebbero essere prodotte da alcune specifiche armi dell’età del Bronzo. Come ultima analisi sono stati elencati i principali casi di trapanazioni craniche per poter determinare se tali pratiche siano da mettere in relazione a traumi conseguenti ad episodi violenti o a pratiche etnoiatriche.

The subject of this thesis was born from a joint of historical reenactment and experimental archeology that I have gained over the years. Fond of living history since 2007, I practiced (and still continuing to practice) the fencing and the reenactment related to various periods of the history of Sardinia: the medieval period (Judicial), the Roman Empire and finally the nuragic one (Age of Bronze). The need to have more information, not available through the written sources, iconographic and archaeological related especially in the latter period, led me through the years to ask me more questions on the subject.
Nuragics was that of a peaceful society? Otherwise how his warriors fought? What kind of hierarchical-military had? The answers to these questions became more compelling as I compared them with the public (and often with the prejudices related to this distant period). Eager to get answers, aided by the experience of bronze artisan-archaeotecnic that I carry in my spare time, inspired by studies on the so-called "archeology of combat" and forensic techniques applied in archaeology, I have come to the conclusion that only by studying the human remains of those men lived 3000 years and more ago, I could get more answers to my questions.
In this paper I have examined the best known cases in the literature of skeletal remains with visible signs of trauma, paying particular attention to prehistoric times. As a comparison for the study of the nuragic finds, was used the skeleton of a supposed medieval soldier, who presented several combat trauma. The skeletal nuragic remains consist of three skulls belonging to three different collective burials located in areas of Sardinia each other very distant. For these three cases, it was decided to determine the type of trauma observed, what kind of weapon caused the wound and the hypothetical scenario of the attack that affected each individual. The study of these cases has allowed a reconstruction of how to combat the most plausible for that period; These have enabled us to deduce which wounds and in which areas of the body could be encountered more frequently trauma. Reproduction of trauma by tests of experimental archeology (test cutting) has allowed us to understand what injuries could be produced by a number of specific Bronze Age weapons. As the final analysis were listed the main cases of cranial drilling to determine whether such practices are to be related to trauma resulting from violent incidents or etnoiatric practices.

"This thesis examines the extent to which the development of expertise in diagnostic palpation in osteopathic medicine is associated with changes in cognitive processing. Chapter 2 and Chapter 3 review, respectively, the literature on the role of analytical and non-analytical processing in osteopathic and medical clinical decision making; and the relevant research on the use of vision and haptics and the development of expertise within the context of an osteopathic clinical examination.

The two studies reported in Chapter 4 examined the mental representation of knowledge and the role of analogical reasoning in osteopathic clinical decision making. The results reported there demonstrate that the development of expertise in osteopathic medicine is associated with the processes of knowledge encapsulation and script formation. The four studies reported in Chapters 5 and 6 investigate the way in which expert osteopaths use their visual and haptic systems in the diagnosis of somatic dysfunction. The results suggest that ongoing clinical practice enables osteopaths to combine visual and haptic sensory signals in a more efficient manner. Such visuo-haptic sensory integration is likely to be facilitated by top-down processing associated with visual, tactile, and kinaesthetic mental imagery.

Taken together, the results of the six studies reported in this thesis indicate that the development of expertise in diagnostic palpation in osteopathic medicine is associated with changes in cognitive processing. Whereas the experts’ diagnostic judgments are heavily influenced by top-down, non-analytical processing; students rely, primarily, on bottom-up sensory processing from vision and haptics. Ongoing training and clinical practice are likely to lead to changes in the clinician’s neurocognitive architecture.

This thesis proposes an original model of expertise in diagnostic palpation which has implications for osteopathic education. Students and clinicians should be encouraged to appraise the reliability of different sensory cues in the context of clinical examination, combine sensory data from different channels, and consider using both analytical and non-analytical reasoning in their decision making. Importantly, they should develop their skills of criticality and their ability to reflect on, and analyse their practice experiences in and on action."

INTRODUCTION: The term Cerebrovascular accident (CVA) describes all of the clinical consequences emerging from a cerebral vessels lesion, whether there is one or more affected. The patient can experiment a diversity of problems in those functions: motricity, sensory, cognitive, communication or urinary. He could feel emotional unease and experience diverse symptoms like fatigue. Data from 2015 indicated that CVA was the second cause of mortality in the world. The trends of the absolute numbers regarding the incidence and the prevalence of CVA are going to potentially increase during the next thirty years in the world, Canada and Quebec.
Thanks to numerous researches a health continuum and rehabilitation program have been created on a medical level. Osteopathy does not belong to the continuum in the three countries from which came the participants: Canada, England and France. Even if the continuum allows for patient's management care, new researches are still broadening the field of knowledge, notably on how the brain works, neuroplasticity, recovery mechanisms and rehabilitation methods. Those researches allowed to challenge the myth of the immutable brain bringing out the knowledge on neuroplasticity and the myth of the six months delay on post CVA recovery.
METHODS: This study subscribes in the constructive paradigm in qualitative research. The design is a focussed ethnography. The chosen sampling method was non probabilistic and the sampling type was done by networking. Population was constituted of two groups: patients and osteopaths. Six patients and seven osteopaths (6 DO and 1 IO) were recruited. Osteopaths-participants came from three different countries as to where they were trained and where they practiced. The patients-participants were all Canadians. Semi-directed interviews permitted to collect data which was analyzed according to the analysis method by writing. Numerous strategies were put in place to reach a certain methodology rigour: verification of the collecting data tools, triangulation, peer debriefing, saturation, additional training of the researcher and logbook.
RESULTS: Results were articulated in four axes: protagonists (patient and osteopath) and their exchanges (uni-directional exchanges like advices and bi- directional like the protagonist’s synergy) ; approaches, clinical principles, specificity and utility of osteopathy ; the therapeutic component (and especially the results) osteopathic intervention and the factors influencing this intervention.
DISCUSSION AND CONCLUSION: Data originating from the participants was a lot richer than data coming from the collected literature. This present study carries strength like the strategy used to reach a certain methodology rigour, bilingualism, country diversity in training and practice (3 countries) for the osteopath-participants and additional training undertook by the researcher. Weaknesses are in relation with the data collecting tool, the origin of the patients-participants (only Canada) and a
xiv
bias of social desirability which was controlled. Given the state of current knowledge and this study results, it seems appropriate to perform new qualitative and quantitative studies on the osteopathic intervention in a CVA context.
To conclude, the osteopathic intervention in a CVA context is complex. It articulates around the patient and the osteopath. Various elements like personal experience, attitudes, beliefs, patient and osteopath perceptions are all important factors influencing the osteopathic intervention and its results.
Keywords : Cerebrovascular accident, osteopathic intervention, personal experience, patients, osteopaths, brain, neuroplasticity, qualitative study, focussed ethnography.

Recent studies are showing that lymph stasis causes cancer by reducing immune function. This article draws on these studies to further explain how constriction from tight bras results in lymphatic impairment in the breasts and an increased incidence of breast cancer.

Infographics: D3 dose size determines clinical effect: Modest physiologic doses (demonstrated above) follow first-order pharmacokinetics characterized by a dose-response relationship that is predictable and also which does not result in significant accumulation of D3 relative to 25(OH)D; in contrast, unnatural bolus dosing of D3 follows unpredictable zero-order kinetics resulting in >500x non-physiologic elevations of D3 relative to deficient 25(OH)D with antagonistic biochemical/physiological effects leading to negative clinical consequences (Heaney Am J Clin Nutr 2008 Jun; Vieth, "Chapter 57: Pharmacology of Vitamin D" in Vitamin D, 3rd Ed., Academic, 2011).

The Educational Council on Osteopathic Principles (ECOP) annually renews and reviews the fundamental
osteopathic principles that Dr. Still left behind for osteopathic medicine (OM). These tenets represent a
guide and rationale for the osteopathic manual approach. The non-profit research organization, Foundation
of Osteopathic Research and Clinical Endorsement (FORCE), which was founded in 2013 under the auspices
of different international professionals, wishes to propose changes to these principles based on scientific
knowledge, which did not exist in the nineteenth century, as well as all the information discovered
subsequently. The proposal is not a constraint, but a further stimulus to improve the vision of OM. We
believe, in fact, that a principle or a point of view never ceases to evolve: the inspiration of every science is
its change.

This article reviews and discusses the biological and psychological mechanisms that may be responsible for therapeutic effect in an osteopathic therapeutic encounter.  Although many of the reviewed mechanisms require additional high-quality evidence, osteopathic treatment may reduce pain and improve movement and function from a ‘bottom-up’ influence on tissues and tissue receptors and from a ‘top-down’ influence on cognitive and psychological states.  Osteopathic models and manipulative technique have traditionally emphasized tissue and biomechanical mechanisms, but this emphasis is misplaced given the paucity of clinical evidence for these effects.  In recent decades, growing evidence supports the importance of neurological and psychosocial factors in musculoskeletal pain, making the ‘biopsychosocial’ model of pain management a mainstream consideration for the management of pain.  This article proposes that both biological and psychosocial therapeutic mechanisms may contribute to therapeutic effect and that tissue and neurological effects on pain and motion, albeit small and temporary, may complement cognitive reassurance and education to promote improved confidence and control in movement.  Judgement of the dominating factors will help determine the clinical approach.  Part 2 will explore the clinical approaches that arise from an understanding of the mechanisms likely involved in manual therapy.

The inspiration of this thesis comes from two severe cases that took place in the
Netherlands during the past seven years. In 2005, a baby died in the hospital after
treatment by a Cranio Sacral therapist. In 2009, a baby of three months, died after a
manipulative treatment by a Manual Therapist (Micha Holla 2009). The technique
which has been used in both cases, is the "folding technique” taught in the training of
Upledger in the Netherlands, in which the baby is forced in a fetal position with a full
flexion of the neck.
In subsequent media hype osteopathy was included in the list of practitioners who work
on the necks of children. This resulted in a negative association with osteopathy and
subsequent fewer referrals by physicians to osteopaths. Physicians, especially
pediatricians, rated osteopathy as a harmful form of treatment. The incentive of this
thesis is that osteopathy, even though both treatments were no osteopathic treatments,
was accused and found guilty, while the "folding technique" (Micha Holla 2009) is in
fact not even taught to osteopaths. Osteopathy is not a technique but encompasses
both a philosophy ,which is different from regular medicine, and a skill which is holistic
mostly in its diagnosis.
The current study into adverse events in pediatric osteopathy is done through an
inventory of pediatric background of osteopaths and pediatric osteopaths in the
Netherlands. A comparison is made between the training of pediatric and regular
osteopaths with pediatricians and pediatric physiotherapists. Thereafter an analysis
was made to see if there was a difference in amount of adverse events between
regular osteopaths and pediatric trained osteopaths. This was not the case (Micha
Holla 2009). The effect of pediatric osteopathic treatment in children is assessed by a
literature study. There are, for example, studies that have investigated the effect of
osteopathic manual treatment for certain symptoms in children. These studies are
inventoried. It is about finding the best evidence for clinical questions (Hawk, Schneider
et al. 2009).
In this study the safety of osteopathic treatment in the Netherlands in patients aged
zero to fourteen is investigated by a questionnaire about side effects and adverse
events. This was performed in twenty seven practices of osteopaths across the
country. 785 treatments were analyzed. The results show that there were no serious or
mild but just minor adverse events in only twenty percent, which lasted on average not
more than three days. Recommendations are made to further improve osteopathy in
pediatric patients and to make sure that osteopathic treatments remain safe.

PRESENTATION TRANSCRIPT: Integrating Functional and Naturopathic Medicine Concepts and Therapeutics into Medical Practice for Common Primary Care and Specialty Conditions: Key Concepts and Paradigm Shifts in Clinical Care, 2020 May; because of the difficulty in uploading updates to this Academia website, any future updates will be posted to: https://www.inflammationmastery.com/medical
Date of most recent update: 18 May 2020

The biopsychosocial mechanisms for therapeutic effect in an osteopathic treatment encounter for people with somatic pain were reviewed and discussed in Part 1 of this article.  The author argued that both biological and psychosocial therapeutic mechanisms are potentially important in clinical practice, although the relative importance of these mechanisms differs depending on the person’s presentation and the nature and chronicity of the involved pain.  In Part 2, clinical implications of the differing processes of pain and therapeutic mechanisms of osteopathic techniques are discussed.  A rationale is presented for osteopathic management based on an understanding of the likely biological and psychological factors present and for the complementary actions of manual therapy with a cognitive behavioural approach to pain and disability.  Appropriate communication, reassurance, education, and empowerment can result in positive attitudes and behaviours to pain and complement the specific biological effects of osteopathic manipulative treatment.  This article will aid the clinical reasoning process and provide guidance to osteopaths for treatment selection based on patient presentation and the likely biological and psychological factors involved in pain and disability.

Réalisatrice - Monteuse

L'enquête d'anthropologie visuelle effectuée dans le cadre de mon travail de thèse "L'apprentissage de l'ostéopathie en France" (2008) a donné lieu à seize films documentaires et cinq documents filmiques non-montés. Chacun des films est autonome et présente un aspect particulier de l’apprentissage de l'ostéopathie et du toucher thérapeutique. « À la maternité » est un film dont les séquences ont été tournées lors des stages d'observation en maternité d'étudiant·es en 5e année.

STUDY DESIGN:
Systematic literature review and meta-analysis.
OBJECTIVE:
IN SYMPTOMATIC SUBJECTS TO: (1) examine the effects of a single session of joint mobilization on pain at rest and with most painful movement, and (2) compare the effects when joint mobilization is provided to a specific or non-specific spinal level.
BACKGROUND:
Joint mobilization is routinely used for treating spinal pain in conjunction with other interventions, but its unique effect is not well understood. Further, there is controversy about the role of 'specific level' techniques in producing benefit.
METHODS:
Searches were performed for randomized controlled trials (RCTs) using electronic databases (MEDLINE, CINAHL, and PEDro) from 1966 through November 2010. Methodological quality was assessed using previously detailed criteria. Meta-analysis and meta-regression were conducted on eligible studies.
RESULTS:
Eight RCTs with a mean methodological score of 10/12 were included. Significant heterogeneity (P = 0.075) was found in the overall meta-analysis estimate. When stratified by body location, no significant individual effect was found for pain at rest. However, there was a statistical mean difference [0.71 (95% confidence interval: 0.13-1.28)] between pain at rest for the cervical and lumbar individual means.
CONCLUSIONS:
We found multiple studies which provided evidence that a single session of joint mobilization can lead to a reduction of pain at rest and with most painful movement. When using joint mobilization, the need for specific versus non-specific level mobilization may be influenced by anatomical region; the direction of effect in the cervical spine was toward specific mobilization and in the lumbar spine towards non-specific mobilization.
KEYWORDS:
Pain; Specific level; Spinal mobilization

This paper is offered as an introduction to qualitative research, with the hope that it informs and stimulates osteopaths and researchers who are unfamiliar with this area of research. This paper discusses the potential contribution of qualitative research in exploring the complex and multiple aspects of osteopathy and how the findings of qualitative studies may contribute to the knowledge base of osteopathy. A definition of qualitative research is provided, and a number of different methodologies are discussed. Finally it suggests examples of how the findings of qualitative research could potentially help inform osteopathic practice.

Abnormal uterine bleeding is characterized by painful and/or excessive menor-rhea, chronic pelvic pain due to the endometriosis (Em). Osteopathic treatment is commonly used in the gynecological dysfunctions. The aim of the present case study was to explore the effect of osteopathic treatment (OT) for a woman with abnormal uterine bleeding related pain

Background
Chronic pain remains an unresolved issue in clinical practice despite the extensive research investigating its behavioural and neural correlates. Evidence demonstrates that chronic pain results in altered representation of the body in the brain. Arguably, this impacts on the perception of the self and its associated processes; namely, interoceptive awareness and body awareness. However, there is minimal research investigating the links between interoceptive awareness, body awareness and chronic pain.

Objectives and Method
This case-control study investigated the relationship between chronic pain and interoceptive awareness; and the links between interoceptive awareness and body awareness. A sample of 59 participants comprising of 22 patients with chronic pain and 37 individuals without a history of chronic pain were assessed using a heartbeat monitoring task (HBMT) and the Body Awareness Questionnaire (BAQ). The HBMT was used to measure interoceptive awareness; and the BAQ to measure body awareness. Data from variables regarded as potential confounders, were also collected.

Results
The findings did not reveal a statistical significant difference in interoceptive awareness and body awareness across the groups. Moreover, activities likely to enhance proprioception or mindfulness based practice did not influence interoceptive awareness. Notwithstanding this, a positive trend was identified between body awareness and mindfulness based activities.

Conclusions
Several limitations of this study suggest scope for further research investigating putative changes in interoceptive awareness in the presence of chronic pain and the effect of osteopathic treatment on the perception of the self. The role of mindfulness based activities in the management of chronic pain is also discussed.

Krishna's Kinetikinetic Manual Therapy® (KKMT®) is the latest school of thought in manual therapy founded by Dr. Krishna N. Sharma, a Physiotherapist from India. KKMT® Joint Mobilization is a part of KKMT® as a whole. The KKMT® protocol includes assessment, mobilization and prevention. The mobilization techniques are based on the following principles: 1) Proper arthrokinematic motion and homeostatic kinetic forces are essential for proper and smooth osteokinematic motion. 2) Homeostatic kinetics of the joint is important to maintain static and dynamic alignment of a joint. The homeostatic kinetic forces help the joint come back in its proper alignment after a motion. The factors that produce and govern the homeostatic kinetics of joint are: a) Local/ Intrinsic factors: e.g. ligament, cartilage, meniscus, etc. b) Global/Extrinsic factors: e.g. muscles, fascia, gravity, etc. 3) Limitation or restrictions in the arthrokinematic motion can be restored by facilitating homeostatic kinetics of the intrinsic and extrinsic factors. The techniques to be covered during the 2 days of hands on workshop shall be Joint Gaping®, Functional Articular Rolling® and 3D Gliding® of the peripheral joints. The students will be certified by the Academy of Krishna's Kinetikinetic Manual Therapy, India.