Browsing by Subject "OMM"
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Item Development of the Attitudes Toward Osteopathic Principles and Practice Scale (ATOPPS): Preliminary Results(2002-05-01) Russo, David P.Russo, David P., Development of the Attitudes Toward Osteopathic Principles and Practice Scale (ATOPPS): Preliminary Results. Master of Public Health, May 2002, 11 pp., 2 tables, bibliography, 19 titles. Little is known about how student attitudes toward osteopathic principles and practice (OPP) develop and evolve over the course of their osteopathic medical education. Interviews were conducted with osteopathic medical students, osteopathic manipulative medicine (OMM) residents, fellows, and physician specialists. These interviews were summarized in a 39-item instrument administered to 127 students at the completion of their core OMM rotation at UNTHSC-TCOM. Factor analysis of student responses to the 39 candidate items yielded two interpretable factors. 14 of the original 39 statements were eliminated and the smaller second factor was dropped. Factor 1 contained items reflecting both positive and negative attitudes toward the application OPP in patient care, medical education, and professional distinctiveness. Two internal consistency estimates of reliability were computer for the revised 25-item ATOPPS. Estimates for the split-half coefficients for part 1 were .89, for part 2 was .87; the Spearman-Brown coefficient alpha was .93Item Effects of Osteopathic Manipulative Treatment on Symptom Severity and Functional Status in Carpal Tunnel Syndrome(2005-05-01) Meyer, Patricia M.Meyer, Patricia M, Effects of Osteopathic Manipulative Treatment on Symptom Severity and Functional Status in Carpal Tunnel Syndrome. Master of Science (Clinical Research and Education), May, 2005, 55pp., 7 tables, 54 figures, bibliography 44. Carpal tunnel syndrome (CTS) is symptoms like paresthesias and weakness caused by compression of the median nerve. It affects up to 10% of the adult population in the U.S. with medical costs exceeding $2 billion annually. The goal of this study is to evaluate the benefits of Osteopathic Manipulative Treatment (OMT) on the symptom severity and daily functioning of subjects with CTS. The OMT group was compared to a ultrasound placebo group. Outcome measures include symptom severity, functional status scores, and strength measures. Subjects receive six treatments with measures taken at three points in the study. Thirty-two subjects were used in the study analysis. The OMT group had significantly improved symptom severity and functional status scores over time. These scores were not significantly different from the changes in the ultrasound group. While outcome measures show trends toward improvement with OMT, they are not significantly different from placebo.Item Immediate Effects of Osteopathic Manipulative Treatments on Immune Function in a Healthy Population: A Pilot Study(2006-05-01) John, Janice Thomas; Scott Stoll; Jerry Simecka; Barbara AtkinsonJanice Thomas, D.O., M.S. Immediate Effects of Osteopathic Manipulative Treatments on Immune Function in a Healthy Population: A Pilot Study. Master of Science (Clinical Research and Education – OMM), May 2006, 75 pp, 3 tables, 5 figures, 66 references, 24 titles. Objectives: The purpose of this pilot study was to investigate the immediate effects of Osteopathic Manipulative Treatment (OMT) on immune function in a healthy population. Methods: This was a randomized, blinded and controlled clinical trial. 50 healthy individuals, ages 18 to 40, were recruited. Subjects were randomly assigned to one of two groups: OMT or Rest (control). Blood and saliva samples were collected pre and post-intervention (thirty minutes of OMT or Rest). Samples were analyzed for a CBC, salivary IgA, and various lymphocyte populations. Results: This study successfully demonstrated the feasibility of this protocol. No statistically significant differences in outcome measures were identified between the two groups, nor were any apparent trends identified. Conclusion: This study established a framework for future research investigating the effects OMT on acute and chronic infection, chronic pain, and immunocompromised populations in human and/or animal populations.Item Inhibitory Rib-Raising and Microneurographic Measurement of Sympathetic Nervous System Activity(2007-05-01) Kinzler, Damien W.; Michael Smith; Russell Gamber; Hollis KingThe clinical effectiveness of osteopathic manipulative therapy (OMT) techniques that are designed to address the autonomic nervous system (ANS) are untested to current research standards. As the concept of “autonomic imbalance” is frequently ascribed as the etiology of various pathologic conditions, it is paramount to undertake basic research into not only efficacy but also possible mechanistic actions and origins. Osteopathic physicians often utilize treatment regimens and techniques for which the given mechanism of action is simply attributed to “balancing the autonomics”. This intuitive concept may finally be at the threshold where enough basic science exists to justify clinical investigations. Osteopathic manual manipulative techniques have shown effectiveness in the treatment of various musculoskeletal conditions and have been shown to lower perceived pain; supporting the use of manual therapy as an effective treatment modality. A brief review yields the following within just the last four years: Eisenhart showed positive range-of-motion outcomes after ankle sprain in the emergency department. Biondi reviews the usefulness of cervical manipulation for tension headache and McReynolds demonstrated an equivalent decrease in acute neck with OMT versus intramuscular ketolac in an emergency department setting, although the dosing was not maximal. German researchers have shown effectiveness in chronic epicondylopathia humeri radialis and research has led to the demonstration of lowered post-operative pain in hip or knee arthroplasty. There has also been decreased post-operative pain medication reported in hysterectomy when compared with a control group. OMT has demonstrated a decrease in fibromyalgia symptoms when used with standard care over standard care alone. Low back pain, perhaps the most extensively studied diagnosis in which OMT has been evaluated, has reported numerous positive outcomes including lower levels of narcotic use and decreased pain in both double-blinded and meta-analysis studies, although there is still considerable debate within this area. There has also been favorable outcomes associated with the management of gain in Parkinson’s disease and preliminary work has shown the efficacy in treatment of carpal tunnel syndrome. Most of the aforementioned musculoskeletal conditions are not amenable to traditional therapies and have a high-cost burden on the economy. Traditional treatments generally have a “wait and see” approach combined with analgesics which may not cause harm, but hampers quality of life and income in the interim. The cost effectiveness of OMT is still in the preliminary stages, but there is evidence supporting a superior cost benefit ratio when compared to standard care and since many of these conditions have no other proven treatment modality available patients will often try anything over nothing. The evaluation of OMT addressing clear autonomic dysfunction is limited. This study closes a small part of that gap by examining the proposed physiologic mechanism of OMT and its’ interaction with the ANS. Small studies have documented changes, namely heart rate variability, in autonomic processes in healthy individuals while other, older studies have found benefit in clinical variables. With few exceptions however, most of these studies lacked a particular technique protocol. Operators were free to use whatever intervention that they chose and most of these studies were not performed under rigorous testing methods with a randomized design. The technique that was evaluated (inhibitory rib-raising) has a documented history from the origins of osteopathic medicine in the United States, and is currently taught to students in osteopathic medical schools as part of their medical education curriculum. Rib-raising is most often taught to enhance the mechanical motion of the ribs, but other paradigms utilize this technique to either enhance or inhibit sympathetic nervous system (SNS) activity. The evaluation of inhibitory rib-raising or its’ proposed mechanism of action has never been rigorously scrutinized to modern scientific standards. The current study was designed to address that gap with both direct and indirect measurement of SNS variable in healthy individuals with the hypothesis that there would be a time-dependent, graded reduction in measured sympathetic nervous system activity (MSNA) in healthy individuals undergoing cold-pressor stimulus.Item Integration of Osteopathic Manipulative Medicine into Differential Diagnosis Training: A Study Evaluating Teaching Strategies and Their Influence on Student Learning(2007-05-01) IrvineMoore, LaPonna Rae; Gamber, Russell; Shores, Jay H.; Oglesby, MichaelIrvineMoore, LaPonna R. Integration of Osteopathic Manipulative Medicine into Differential Diagnosis Training: A study evaluating teaching strategies and their influence on student learning. Master of Science in Clinical Research and Education, May 2007, 109 pp, 16 tables, 14 figures, bibliography 118 titles. This study compared traditional lecture versus a computer-based cognitive science-based approach in training 2nd year medical students to perform low back pain differential diagnosis with integrated osteopathic diagnoses and findings. Research subjects were tested on diagnostic capabilities and outcomes were compared. Students’ opinion and feedback was assessed through a computer-based questionnaire. Although the two groups performed equally with respect to overall mean and osteopathic diagnoses, the treatment group performed better on difficult questions. Eighty percent of student attitudes were positive toward computer-based learning and its utility in uniquely osteopathic concepts. Cognitive science-based teaching modalities may increase diagnostic competencies and positively affect learning of uniquely osteopathic concepts.Item Interexaminer Reliability of Somatic Palpatory Findings Associated with Chronic Low Back Pain(2002-05-01) Russo, David P.; Scott Stoll; John C. Licciardone; Russell GamberRusso, David P., Interexaminer Reliability of Somatic Palpatory Findings Associated with Chronic Low Back Pain. Master of Science, May 2002, 15 pp., 1 table, 1 figure, bibliography, 26 titles. Osteopathic physicians rely on specific clinical palpatory tests to diagnose somatic dysfunction of the neuromusculoskeletal system. The purpose of this study is to compare the interexaminer reliability of six common osteopathic clinical tests to severity ratings of somatic dysfunction in six body regions. Ten trained and clinically supervised predoctoral osteopathic manipulative medicine fellows collected palpatory data using the Standardized Outpatient Osteopathic Soap Note Form (SNF) and recorded findings for six pre-selected osteopathic clinical diagnostic tests as part of a randomized controlled trial of osteopathic manipulative treatment for chronic low back pain. Kappa coefficients were used to assess overall examiner agreement for the osteopathic clinical tests. Intraclass correlational coefficients (ICC) and Chronbach’s alpha were used to assess examiner agreement for the severity ratings. Kappa values for the six clinical tests ranged from 0 to 0.32. The single item ICC was 0.32, average item ICC was .74, and the coefficient alpha for internal consistency of the six body region scores was 0.80. These results indicate that diagnostic impressions of somatic dysfunction severity may be more reliable than outcomes from isolated osteopathic clinical tests.Item Osteopathic Focus in the Biomedical Sciences: A Survey of Biomedical Science Faculty at Osteopathic Medical Schools in the United States(2007-05-01) Ebert, Didi Elise; Rustin E. Reeves; Stuart Williams; Stuart WilliamsEbert, Didi E., Osteopathic Focus in the Biomedical Sciences: A Survey of Biomedical Science Faculty at Osteopathic Medical Schools in the United States. Master of Science (Clinical Research and Education), May, 2007, 73 pp., 6 tables, 2 figures, bibliography, 20 titles. The purpose of this study was to describe and evaluate the knowledge of osteopathic principles and osteopathic manipulative medicine (OMM) among biomedical science faculty at osteopathic medical schools (COMs) and to assess their attitudes towards the integration of osteopathic principles and OMM concepts into the biomedical science curriculum and biomedical science research. A cross-sectional survey was administered to biomedical science research. A cross-sectional survey was administered to biomedical science faculty at COMs within the United States. Descriptive statistics were used to characterize data, and means were compared between health science center faculty and non-health science center faculty and between anatomy faculty and non-anatomy faculty. The survey response rate was 29%. Overall, survey respondents demonstrated positive attitudes and high levels of knowledge regarding osteopathic principles and less positive attitudes toward OMM. Significant differences were noted between faculty at health science centers versus faculty at non-health science centers and between anatomy faculty and non-anatomy faculty. Data from this survey may be useful in designing strategies to increase the integration of osteopathic principles into the biomedical science curriculum.Item OSTEOPATHIC MANIPULATIVE TREATMENT FOR LOW BACK PAIN DURING PREGNANCY: A CASE REPORT(2013-04-12) Hanley, KellyPurpose: In 2010 Licciardone et al. published the landmark paper "Osteopathic manipulative treatment of back pain and related symptoms during pregnancy: a randomized controlled trial" in the American Journal of Obstetrics and Gynecology. They found that osteopathic manipulative treatment (OMT) was effective at slowing or halting the deterioration of back-specific functioning during pregnancy. Since this publication there is been an increase in interest among physicians in the use of OMT as a treatment for back pain during pregnancy. The purpose of this case report is to demonstrate a pregnant patient with low back pain who was successfully treated with OMT. Methods: This case report consisted of a review of a patient's medical file. Results: A 19-year old G1P0 Caucasian female presented at an osteopathic manipulative medicine clinic at 21 weeks gestation for a three month history of low back pain. The patient was found to have somatic dysfunctions of the cervical, thoracic, and lumbar spine, as well as the pelvis and sacrum. She was treated with a variety of OMT techniques and reported reduced pain both immediately after treatment and at her 10 day follow-up appointment. Conclusions: Low back pain is a common complaint among pregnant women and can be treated with OMT to reduce pain and improve function. Osteopathic physicians should continue to offer OMT to their obstetric patients because of its proven effectiveness.Item Preliminary Trial of a Survey Instrument to Detect Outcomes of Curriculum Reform in Osteopathic Manipulative Medicine(2004-05-01) von Lindeman, Alexa; Shores, Jay H.; Cruser, des Anges; Gamber, RusselVon Lindeman, Alexa. Preliminary Trial of as Survey Instrument to Detect Outcomes of Curriculum Reform in Osteopathic Manipulative Medicine. Master of Science (Clinical Research and Education), May 2004; 28 pp; 5 tables; 3 figures; references 17 titles. Purpose: To assess whether the attending physicians at the University of North Texas Health Science Center—Texas College of Osteopathic Medicine would perceive an increased student interest in osteopathy as well as show a personal increased interest in osteopathic principles and practice following a 2001 OMM curricular reform. Study Design: Surveys were mailed at the beginning and end of the 2002-2003 academic year. Responses were matched for pre-post comparisons. Results: Factor analysis identified 13 factors. ANOVA analysis did not achieve statistical significances between pre and post groups. Although regression analysis identified three factors that achieved statistical significance (p≤05), these were attributed to variables such as residency type, medical school and type of practice. Conclusion: The survey instrument was effective in detecting variables that influenced beliefs and practice. Future larger scale studies are needed to confirm the trends in the data.Item The Effect of Osteopathic Manipulative Medicine on Pulmonary Function and Lung Volumes in Healthy Adults(2004-04-01) Bradbury, Joseph Aaron; Michael SmithBradbury, Joseph Aaron, The Effect of Osteopathic Manipulative Medicine on pulmonary function and lung volumes in healthy adults. Master of Science, April, 2004. Osteopathic Manipulative Medicine (OMM) techniques that address the diaphragm are commonly taught in Osteopathic medical schools. The application of these techniques is based on the theory that the physician can alter the mechanics of respiration. We hypothesized that OMM treatment of the diaphragm will allow greater diaphragmatic excursion of the diaphragm into the chest resulting in decreased residual volume (RV). Study design consisted of two groups; treatment and sham treatment. Pulmonary function tests (PFTs) were administered to each subject upon admission to the study. Our data was collected from a MedGraphics PF/Dx 1085D series whole body plethysmography machine. Following a short rest period, the subject received either an OMM treatment or a sham treatment. A post treatment series of PFTs were then administered to the subject. A Paired T test comparing pre and post values within each group showed that RV, TLC, and TGV significantly decreased after the OMM treatment. There were no significant changes in the sham treatment group. Univariate Analysis of Covariance between groups also showed that changes in RV remained significant. From these data we conclude that OMM treatments addressing diaphragm function are effective in altering the mechanisms of respiration and particularly in decreasing residual volume.Item The Impact of Curricular Reform on Student Opinions of Their Osteopathic Manipulative Medicine Education(2003-05-01) Niedzwecki, Christian M.; Stoll, Scott T.; Shores, Jay H.; Alexander, JerryNiedzwecki, Christian, The Importance of Curricular Reform on Student Opinions of their Osteopathic Manipulative Medicine Education. Master of Science (Clinical Research and Education), May 2003; 56 pp; 3 tables; 3 figures; references, 28 titles Purpose. To assess the impact of a curricular reform, which was implemented over the academic year of 2001-2002, on student opinions of their Osteopathic Manipulative Medicine (OMM) education at the University of North Texas Health Science (UNTHSC). Method. Existing data from a standard survey administered by the Academic Information Services (AIS) Department at the UNTHSC-TCOM was analyzed. Results. Scores between Class of 2003 and Class of 2004 in Semester 3 and Semester 4 showed significant differences trending towards greater satisfaction with understanding of Osteopathic Manipulative Medicine, with psychomotor skills, and with the way the course was taught. Conclusion. This suggests that curricular reform met its goals. However, this analysis alone should be only one part of a complete assessment of curricular reform. A complete assessment should include both quantitative measures (surveys and trends in examination scores), and qualitative information (focus groups, interviews, and objective structured clinical examinations).Item The Utility of Exploratory Data Analysis Techniques in Analyzing Outcome Measurers Used in Osteopathic Manipulative Medicine Research(2005-12-01) Whitesell, Rebecca; Singh, Karan; Bae, Sejong; Cruser, des AngesWhitesell, Rebecca, The Utility of Exploratory Data Analysis Techniques in Analyzing Outcome Measures Used in Osteopathic Manipulative Medicine Research. Master of Public Health (Clinical Research), December 2005, 79 pp., 2 tables, 42 illustrations, references, 33 titles. The intent of this thesis project is to describe how Osteopathic Manipulative Medicine (OMM) researchers can use the theory of Exploratory Data Analysis (EDA) to enhance their ability to analyze research findings. This was achieved by evaluating the most frequently used outcome measures in OMM research published since 1993, describing EDA and its relevance to the types of data used in OMM research, and illustrating the ways EDA can be used in two current OMM studies to gain insights into the data and to shape future research questions.