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Interdisciplinary interaction between osteopathic physicians and dentists is important due to the lack of consensus on the causes, development, and treatment of temporomandibular joint dysfunction (TMJD). To date, there is no unified classification that considers not only pathological processes in the joint itself and the adjacent musculotendinous apparatus, but also the influence of extraocclusal, i.e., extraarticular, pathologies on the development of TMJD. The aim of this study was to model occlusal and extraocclusal irregularities in a lab environment to illustrate their impact on mandibular biomechanics. The study involved twenty volunteers between the ages of 20 and 40, who underwent examinations by a dentist and an osteopathic doctor to rule out occlusal and extraocclusal disorders. Changes in the path lengths of the gnathion, gonion, mouth angle (mimic musculature), and pupils (postural sensor) during mouth opening and closing were compared. Recordings were taken at 5-minute intervals with intermediate osteopathic testing to exclude residual phenomena. The presence of occlusal and extraocclusal disorders significantly alters the biomechanics of the mandible (p<0.05). Modeling extraocclusal disorders resulted in a reduction in the path lengths of the measured points (p<0.05), which is consistent with the data obtained from testing for the presence of extraocclusal disorders. On the other hand, modeling occlusal disorders showed a significant increase in the path lengths of measured points (p<0.05). A significant increase in pupil movement path lengths was found, suggesting an adaptation of postural system due to sensor injury. The obtained results demonstrate the impact of occlusal and extraocclusal disorders on mandibular biomechanics. Further research is recommended with a larger number of participants and more examination parameters. [ABSTRACT FROM AUTHOR]

Individuals who experience migraines often seek out a variety of treatment options including manual or physical therapy. Evidence suggests that manual therapy, including osteopathy, can play a role in the management of migraines. Whilst there is some literature on the role osteopathy therapy plays in migraine management, none describes the treatment approaches used by practitioners. To explore the demographic, practice and clinical management characteristics of Australian osteopaths who report treating migraine 'often' in clinical practice. Secondary analysis of a cross-sectional survey of 988 osteopaths from the Osteopathy Research and Innovation Network (ORION), an Australian practice-based research network. Regression analysis was used to identify demographic, practice and clinical management characteristics of Australian osteopaths who reported 'often' treating migraine patients. Over 40% of respondents (n = 400) indicated treating patients with migraines 'often'. These osteopaths were less likely to be involved in research and be co-located with a dietician compared to osteopaths who do 'not often' treat migraine. Osteopaths who reported 'often' treating migraine were: five times as likely to treat non-English speaking ethnic groups; 2.5 times as likely to treat chronic pain, temporomandibular joint disorders and hand musculoskeletal complaints; compared to those that do not treat migraines 'often'. Australian osteopaths who treat migraine are five times more likely to treat non-English speaking ethnic groups; twice as likely to treat chronic pain; temporomandibular joint disorders, and hand musculoskeletal complaints. More research is needed to identify the practices and patient outcomes associated with osteopathy care for those experiencing migraines. • Osteopaths who reported 'often' treating migraine were five times as likely to treat non-English speaking ethnic groups and 2.5 times as likely to treat chronic pain. • Australian osteopaths who reported 'often' treating migraine patients were also more likely to report sending referrals to psychologists. • Australian osteopaths who reported 'often' treating patients with migraines were more likely to engage in discussions with patients about a range of lifestyle measures. [ABSTRACT FROM AUTHOR]

Der Artikel thematisiert eine osteopathische Praxeologie, die phänomenologisch-anthropologisch innerviert ist. Besprochen werden die Tastwelt der Osteopath*innen, eine mittels Tastsinn berührende Erlebnispraxis zwischen Osteopath*in und Patienten*in und die diese Praxis bestimmenden Regelwerke. Begründet werden soll eine Wahrnehmungs- und Handlungswissenschaft, in der Deskriptionen und Analysen der subjektiven Bewusstseinsleistung systematisch beforscht werden, am besten zu verstehen als ein Forschungsfeld, in dem die Akteur*innen der Osteopathie im Fokus stehen – weniger die Ergebnisse ihrer Handlungen, denn dies klärt die Stellung, das berufliche Selbst- und Weltverhältnis unserer Profession für den Diskurs zu anderen Wissenschaftsfeldern. Die osteopathische Forschungsgemeinschaft sollte interessiert sein, hier zu investieren. An osteopathic praxeology is discussed that is perspectively phenomenologically-anthropologically innervated. The world of touch of the osteopath with his or her acting set of rules is discussed in order to establish a science of perception and osteopathic action; thus to be understood as a future field of research in which also the actor of osteopathy is the focus of research and not only the results of his or her action. [ABSTRACT FROM AUTHOR]

Mehr und mehr wissenschaftliche Studien belegen, dass was Osteopath*innen schon lange wissen: die Wirksamkeit osteopathischer Behandlungen. Schon Still war sich der Wichtigkeit einer objektiven wissenschaftlichen Betrachtung der Osteopathie bewusst; Osteopathie ist wegen des „Hands-on" durch eine besondere physikalische Nähe gekennzeichnet. Umso wichtiger ist die Reflexion der eigenen subjektiven Erfahrungen der Osteopath*innen. Wissenschaftliche Betrachtungen werden durch die intersubjektiven Wechselwirkungen verkompliziert. Vor allem die Beschreibung und Kritik an der kraniosakralen Therapie verdeutlichen die Wichtigkeit wissenschaftlicher Studien dieses Bereichs in der osteopathischen Medizin. Dies war und ist das Ziel des Projektes. Erste Ergebnisse auf dem Weg zu validen Wirksamkeitsnachweisen sollen im Folgenden beschrieben werden. The philosophy of osteopathy by A.T. Still allows a scientific study of osteopathy as an object, whereby the limit of the search for knowledge must be extended to the intersubjectivity of osteopaths and patients. This becomes especially clear for the palpation of inherent rhythms. Today craniosacral rhythms can be measured scientifically, i. e. objectively, reliably, validly, and they can also be scientifically understood and interpreted intersubjectively. [ABSTRACT FROM AUTHOR]

In diesem Kommentar werden die grundlegenden Annahmen, Praktiken und die behaupteten Besonderheiten, auf denen die Osteopathie basiert, kritisch untersucht. 5 Bereiche werden als höchst problematisch für die Osteopathie angesehen: die schwache theoretische Basis, die inhärente Biomedikalisierung, der Monointerventionismus, die standardmäßige Zentrierung auf die Therapeutin resp. den Therapeuten und die Vorliebe für nicht plausible Mechanismen. Wir argumentieren, dass diese Bereiche überdacht und Maßnahmen ergriffen werden müssen, um die Entwicklung, Einheit und Legitimität des osteopathischen Berufs nicht zu gefährden. Die zugrunde liegenden Theorien, Annahmen und daraus abgeleiteten Fähigkeiten müssen auf der Grundlage aktueller Erkenntnisse und des Wissens aus nicht-osteopathischen Disziplinen neukonzipiert werden. Implikationen für die Praxis: • Die schwache theoretische Basis der Osteopathie, die Biomedikalisierung, der Monointerventionismus, die Praxiszentriertheit und die nicht plausiblen Mechanismen sind problematisch und stellen eine große Gefahr für die Entwicklung, Einheit und Legitimität der Osteopathie dar. • Ständige kritische Reflexion, Neukonzipierung der Praxis und Forschung sind für die osteopathische Professionalität erforderlich. • Osteopath*innen sollten sich auf Theorien und Erkenntnisse aus nicht-osteopathischen Fachbereichen stützen. This commentary critically examines the foundational assumptions, practices and claimed distinctiveness upon which osteopathy was built and continues to be structured. Five areas which are considered to be highly problematic for osteopathy, namely its weak theoretical basis, inherent biomedicalism, monointerventionism, default practitioner-centredness and predilection for implausible mechanisms. It is argued that these areas require considerable reflection and action as if not remedied, they constitute a major threat to the development, unity and legitimacy of the osteopathic profession. Ongoing reconceptualisation of underpinning theories, assumptions and associated skills informed by current evidence and knowledge from disciplines outside of the osteopathic domain is necessary for professional maturation. Implications for practice: • Osteopathy's weak theoretical basis, biomedicalism, monointerventionism, practitionercentredness and implausible mechanisms are problematic. • These constitute a major threat to the development, unity and legitimacy of osteopathy. • Ongoing critical reflection, practice reconceptualisation and research are needed for professional maturation. • Osteopaths should draw on theory and evidence from outside the osteopathic domain. [ABSTRACT FROM AUTHOR]

Einleitung – Patient*innen mit atopischer Dermatitis (AD) nehmen häufig Akupunktur (ACU) und osteopathische Medizin (OM) in Anspruch. Das Ziel war es, die Wirksamkeit von ACU und OM bei Patient*innen mit AD zu untersuchen. Methoden – In einer dreiarmigen, randomisiert kontrollierten, offenen, explorativen klinischen Studie erhielten Erwachsene mit AD entweder ACU, OM oder keine Studienintervention (CG), jeweils zusätzlich zur Routineversorgung. Zu den Endpunkten gehörten die Erkrankungsschwere (SCORing Atopic Dermatitis, SCORAD), die Intensität des Juckreizes (Visuelle Analogskala, VAS) und die Häufigkeit der Nutzung topischer Kortikosteroide (TCS) innerhalb von 7 Tagen. Die Endpunkte wurden mittels Kovarianzanalyse, adjustiert für den jeweiligen Baselinewert und die TCS-Nutzung, statistisch analysiert. Ergebnisse – Insgesamt wurden 121 Patient*innen (92 Frauen) mit einem Durchschnittsalter (± 14;SD) von 31,4 14;± 14;10,5 Jahren randomisiert. Nach 12 Wochen betrugen die adjustierten Mittelwerte (95 14;% KI) für ACU, OM und CG jeweils SCORAD 22,3 (18,3; 26,3), 26,4 (22,6; 30,2), 23,7 (19,9; 27,5), p = 0,321; VAS Juckreiz 27,9 (19,5; 36,4), 35,0 (26,9; 43,0), 42,3 (34,7; 50,0), p = 0,047; TCS-Nutzung 2,3 (0,8; 3,9), 1,9 (0,4; 3,5), 4,3 (2,6; 6,0), p = 0,101. Schlussfolgerung – Obwohl keine Gruppenunterschiede in der Erkrankungsschwere festgestellt wurden, deuten unsere Ergebnisse darauf hin, dass ACU den Juckreiz bei Patient*innen mit AD verringern könnte. Zudem zeigen ACU und OM eine Tendenz zur Verringerung der TCS-Nutzung. Introduction – Patients with atopic dermatitis (AD) often use acupuncture (ACU) and osteopathic medicine (OM). The aim was to investigate the effectiveness of ACU and OM in patients with AD. Methods – In a three-armed randomized controlled single-center open explorative clinical trial, adults with AD received ACU, OM, or no study intervention (CG) plus routine care each. Outcomes included disease severity (SCORing Atopic Dermatitis, SCORAD), itching intensity (Visual Analog Scale, VAS), and frequency of topical corticosteroid (TCS) use within 7 days. Endpoints were analyzed by analysis of covariance adjusted for the respective baseline value and TCS use. Results – Overall, 121 patients (92 female) with a mean (± 14;SD) age of 31.4 14;± 14;10.5 years were randomized. After 12 weeks, the adjusted means (95 14;% CI) for ACU, OM, and CG were SCORAD 22.3 (18.3; 26.3), 26.4 (22.6; 30.2), 23.7 (19.9; 27.5), p = 0.321; VAS itching 27.9 (19.5; 36.4), 35.0 (26.9; 43.0), 42.3 (34.7; 50.0), p = 0.047; TCS use 2.3 (0.8; 3.9), 1.9 (0.4; 3.5), 4.3 (2.6; 6.0), p = 0.101. Conclusion – Although no differences in disease severity were found, our findings indicate that ACU might reduce itching in patients with AD. Furthermore, ACU and OM show a trend toward reducing TCS use. [ABSTRACT FROM AUTHOR]

Für komplexe osteopathische Begriffe, wie Potency, Tide, Fulkrum, primär respiratorischer Mechanismus (PRM) und auch energetische Aspekte lassen sich heute naturwissenschaftlich Entsprechungen finden, die einen geeigneten kommunikativen Austausch mit anderen naturwissenschaftlichen Bereichen ermöglichen. Besonders der Teilnehmer*innenaspekt, den schon Rollin Becker als Beteiligtsein der osteopathischen Behandler*innen in der palpatorischen Beziehung mit Patient*innen aufbrachte, kann dadurch beleuchtet werden. Scientific equivalents can now be found for complex osteopathic terms such as potency, tide, fulcrum, primary respiratory mechanism (PRM) and also energetic aspects, which enable a communicative exchange with other scientific areas. In particular, the participant aspect, which Rollin Becker already brought up as the participation of the osteopathic practitioners in the palpatory relationship with patients, can be illuminated in this way. [ABSTRACT FROM AUTHOR]

Introduction: There is significant interest in allied health and the role it plays in health care for rural and remote populations. In Australia, osteopaths are allied health professionals who manage predominantly musculoskeletal complaints using manual therapy, exercise and patient education. Workforce distribution is a significant issue for osteopathy in Australia with most practitioners centred in the metropolitan regions of Victoria and New South Wales. There is limited evidence about the role osteopathy plays in the musculoskeletal health of Australian rural and remote populations. This research sought to profile the characteristics of Australian osteopaths who practise in rural and remote settings. Methods: A secondary analysis of the Osteopathy Research and Innovation Network (ORION) data was undertaken to identify the demographic, practice and clinical management characteristics of Australian osteopaths in rural and remote settings. ORION is a practice-based research network for the Australian osteopathy profession. The ORION questionnaire comprised 27 items regarding osteopaths' characteristics. Inferential statistics were used to identify characteristics that were significantly different between Australian osteopaths practising in rural and remote settings compared to those practising in urban settings. Logistic regression was used to calculate adjusted odds ratios (AOR) relating to characteristics significantly associated with practising in a rural and remote setting. Results: Of 992 osteopaths who responded to the ORION questionnaire, 18.3% (n=172) indicated practising in a rural and remote setting. Australian osteopaths in rural and remote settings were more likely to report receiving referrals from massage therapists (AOR 2.17), send referrals to other osteopaths (AOR 1.64), and often treat patients over the age of 65 years (AOR 2.25) compared to their urban counterparts. Osteopaths in rural and remote setting were less likely to report using private health insurance claim systems (AOR 0.36) and to treat non-English-speaking patients (AOR 0.09). Conclusion: This secondary analysis identified several practitioner and practice characteristics that differ between osteopaths practising in rural and remote settings and those practising in urban settings. These findings contribute to the emerging picture of the practice of rural and remote Australian osteopaths. Further research is required to understand the role osteopaths play in rural and remote health care, and how the current data can inform workforce and health policy development. [ABSTRACT FROM AUTHOR]

Sports medicine (SM) fellowship training has become popular among residents. Thus, an analysis was undertaken to assess data on matching rates from 2010 to 2021. The purpose of this study is to analyze trends in SM fellowship applications using National Resident Matching Program data. Retrospective study with analysis of applicants applying into accredited SM fellowships between 2010 and 2021. The number of accredited programs and fellowship positions have more than doubled from 2010 to 2021. There was a significant increase in match rates over time (P < 0.001); match rates were at 70% or below prior to 2015 and above 70% after 2015. The average number of applicants per position stayed consistent. The number of Doctor of Osteopathic Medicine applicants increased 110% whereas the number of U.S. born foreign and non-U.S. citizen applicants decreased 20.8%. SM fellowship training has increased since 2010. Acceptance rates and number of applicants have increased over time because of the growth in fellowship programs and accredited positions. [ABSTRACT FROM AUTHOR]

As contemporary osteopathy is increasingly mainstreamed into the broader field of American medicine, it is important to understand how osteopathic physicians' professional identities are shaped, from medical education to practice. This study examines the way in which osteopathic professionals negotiate their identities in relation to the ideas and legacy of osteopathy's 19 th century founder, Dr. Andrew Taylor Still. A thematic analysis of ten years of articles from the Journal of Osteopathic Medicine allowed the researchers to examine themes arising in the dataset, which in turn served as the basis for a thematic distillation of how those themes illuminate negotiations of osteopathic professional identity. JOM authors evoked Still for several reasons. First, decontextualized "name-checking" served to ground investigations into osteopathic principles and skills in osteopathic history. Second, authors evoke Still's name and influence on the early profession to negotiate a range of contemporary questions, from identity to health policy. Within this second category, this study finds that American osteopaths engage in a speculative practice about what Still would or would not think about contemporary osteopathic medical education and practice. If osteopathy is concerned with training future generations of practitioners who will continue the traditions that have distinguished osteopathy from mainstream medicine, then understanding its history is an essential step toward professional self-understanding. This study suggests that a close look at how American osteopathic medical professionals relate to Still reveals a great deal, not only about the education and practice of osteopathy, but professional identity formation generally. [ABSTRACT FROM AUTHOR]

Game-based simulation education is becoming an integral component in healthcare programs. It is defined as any educational activity implying simulation procedures to recreate clinical scenarios. Previous studies have shown that simulation can improve patient safety by enhancing healthcare providers' competencies. However, few studies have investigated students' perceptions of simulation within osteopathic programs. This study aimed to measure and compare Year three osteopathy students' perceptions of a game-based simulation versus traditional clinical training. Year three students at the end of their 12 weeks clinical training were invited to participate in this research project. This included filling out a Likert-based survey and semi-structured interviews. Three clinical training modalities were implemented and evaluated: a demonstration clinic , a video-streamed demonstration clinic , and a game-based simulation, the clinical battle. Sixty-seven Year three osteopathy students completed the surveys, and eight students were interviewed. The clinical battle was significantly felt as the most engaging, most useful to gain feedback, and least stressful of the three training modalities proposed (p < 0.05). The clinical battle was also perceived as similar to a demonstration clinic in formulating a diagnosis and for reflective practice (p > 0.05). The semi-structured interviews offered deep structured explanatory narratives drawn from thematic analyses. Five themes were identified: engagement, clinical reasoning improvement, stress, ideas for improving clinical training, and reflective practice and self-assessment. The simulation-based training implemented in this study was positively perceived by students for their clinical education. Future research could focus on the effectiveness of game-based simulation versus traditional training on clinical competencies acquisition. [ABSTRACT FROM AUTHOR]

The Osteopaths' Therapeutic Approaches Questionnaire (Osteo-TAQ) is a novel 36-item instrument developed from qualitative grounded theory research with osteopaths in the United Kingdom. The Osteo-TAQ has the potential to measure multiple domains of osteopaths' practice including their therapeutic approach, clinical decision-making and therapeutic relationship with patients. It is unknown how well the items in the Osteo-TAQ relate to the practice of Australian osteopaths. To assess and improve the quality of the Osteo-TAQ survey items prior to utilising the Osteo-TAQ amongst the Australian osteopathic profession. Cognitive interviews with six Australian registered osteopaths (n = 6) were used to generate data on how participants interpreted and understood the Osteo-TAQ items. Interviews were transcribed verbatim and content analysis was used to identify issues of comprehension and problem areas relating to the Osteo-TAQ. Three areas for improvement were identified in relation to the core aspects of clinical practice (the patient, examination, treatment and management), use of possessive pronouns and Likert scale frequency response options. These problems may reflect the similarities in osteopathic practice in the UK and Australia, but also indicate subtle differences in the terminology utilised by osteopaths to describe and communicate areas of their clinical practice. [ABSTRACT FROM AUTHOR]

Patient-reported outcome measures (PROMs) provide information on patients' views of their symptoms, functional status, health related quality of life and are an important part of evidence-informed practice and patient-centred care. The utilisation of and attitudes to PROMs by Australian osteopaths is unknown. An online survey was designed to investigate the self-reported utilisation of PROMs by Australian osteopaths, including the frequency of use, the types of PROMs used, the features of PROMs are most useful, the attitudes towards PROMs, and the barriers and enablers for use of PROMs. The survey was a 14-item questionnaire that used a 5-point Likert scale or required free text answers. The effect of gender and years in practice was analysed using Mann-Whitney U tests. Effect sizes were calculated where possible. 166 (male = 69, female = 97) osteopaths participated in the survey. Nearly half (47.6%) reported that pain scales were used 'frequently' or 'always', but there was less frequent use of PROMs other than pain scales (14.2%), except for third party paying patients (57.4%). Australian osteopaths reported using PROMs most frequently for patients with neck pain (31%) and low back pain (29%). The majority agreed PROMs were important for tracking improvement in patients (61%). The greatest barrier identified by osteopaths was the burden on consultation time. This study highlighted only the minority of Australian osteopaths use PROMs frequently and consider them important. Professional organisations should consider professional development aimed to upskill and support practitioners in the efficient use of PROMs in practice. • Nearly half (47.6%) of 166 osteopaths reported using pain scales 'frequently' or 'always', but there was a less frequent use of PROMs other than pain scales (14.2%), except for third party paying patients (57.4%). • The majority of osteopaths agreed that PROMs were important for tracking clinical improvement in patients (61%), although only 48% agreed that PROMs were important in osteopathic practice. • The greatest barrier identified by osteopaths to using PROMs was the burden on consultation time and most common enabler was the requirement of PROMs by third party payers. [ABSTRACT FROM AUTHOR]

Osteopathy requires reliable and valid research tools to generate evidence on the different aspects of practice including how osteopaths approach the clinical care of patients. Such research will help the osteopathy profession understand its contribution to healthcare provision and communicate this to stakeholders. However, current quantitative tools to measure the different aspects of osteopathic practice are either focused on single pain conditions or developed from other health professional contexts. The Osteopaths' Therapeutic Approaches Questionnaire (Osteo-TAQ) is a novel tool developed from qualitative research and aims to measure and describe multiple dimensions of osteopaths' therapeutic approach to patient care. The aim of this study was to further develop the Osteo-TAQ to assess the content validity of the tool. A modified nominal group technique (NGT) was employed to establish whether the Osteo-TAQ items were consistent with the underlying construct and to ascertain the prevalence and strength of agreement amongst the expert group panel members (N = 11). A content validity index (CVI) was performed to obtain the evidence for the content validity for a revised version of the Osteo-TAQ. Two rounds of review and feedback by an expert panel as part of the NGT resulted in the revision of 13 of the 37 candidate items and refinement of the previously published Osteo-TAQ. Item CVI scores after phase 1 ranged from 0.44 to 1.0 and agreement was reached after two rounds. Data from the expert panel supports the content validity of the revised Osteo-TAQ items based on high levels of agreement with respect to coverage of the construct being measured. This preliminary work to revise and refine the Osteo-TAQ resulted in a measure that is suitable for further testing as part of a validation research program. • Osteopathy requires reliable and valid research tools to generate evidence on the different aspects of practice including how practitioners approach the clinical care of patients. • Such research will help the profession describe the complexity and variation of osteopaths' therapeutic approaches and understand and communicate osteopathy's contribution to healthcare provision. • The Osteo-TAQ is a 36-item questionnaire developed from qualitative grounded theory research which appears to be a have good content validity and is a feasible instrument to characterise osteopaths' therapeutic approach. [ABSTRACT FROM AUTHOR]

Dissipative Strukturen sind stabile Nichtgleichgewichtszustände offener Systeme, wie z. B. Lebewesen, die veränderliche „Spiel-Räume" für die Zustände somatischer Funktionen darstellen. Dekompensationszustände sind Zustände sich widersprechender Kompensationszustände somatischer Funktionen. Osteopathische Behandlungen rekompensiert diese Zustände zu dissipativen Strukturen. Osteopathische Medizin ist dissipative Medizin, die aufgrund des entropischen Prinzips eine Veränderungsfreiheit somatischer Funktionen mit individuellen, fließgleichgewichtigen Bewegungen für ein Kohärenzgefühl und Gesundsein unterstützt. Dissipative structures are stable, non-equilibrium states of open systems, such as living beings, that represent variable „scopes" for the states of somatic functions. Decompensation states are states of contradictory compensation states of somatic functions. Osteopathic treatments recompensates these states to dissipative structures. Osteopathic medicine is dissipative medicine, which, based on the entropic principle, supports freedom of change in somatic functions with individual, flow-balanced movements for a feeling of coherence and well-being. [ABSTRACT FROM AUTHOR]

Sleep disorders and chronic musculoskeletal pain are highly prevalent conditions that are often comorbid clinically. The role of sleep disorder on the chronification of musculoskeletal pain is well documented, although the mechanisms have not yet been fully established. Here we present a case study demonstrating the clinical comorbidity of sleep disorder with chronification of musculoskeletal pain in an older adult with clinical history of hypothyroidism. The aim of this case is to highlight important risk factors of age, gender and hypothyroidism, which the clinician should be aware of for their potential contributory role in the development of sleep disorder and chronification of musculoskeletal pain. Patient presented with a flare-up of pain in right shoulder and neck that had been intermittently present for several years but of which the intensity had become increasingly worse over time. The patient was diagnosed with chronic right rotator cuff tendonitis and a grade III supraspinatus tear. Clinical history revealed that significant sleep disorder and hypothyroidism were also present in this case. Treatment focused on relieving pain and restoring function to the right shoulder. Interventions including passive mobilization, manual ischemic trigger point therapy, and passive traction were applied. Patient also provided with diaphragmatic breathing exercises to help alleviate her sleep disorder. After 12 weeks patient reported decreased pain levels and improved ROM of the right shoulder. Patient also reported improved sleep, both in quality and quantity. This case demonstrates the importance of considering the association between sleep disorder and the chronification of musculoskeletal pain in older adults. This study highlights common potential risk factors of age, gender and hypothyroidism which may contribute to the development of these conditions in older patients. [ABSTRACT FROM AUTHOR]

Patient-Reported Outcome Measures (PROMs) are instruments that capture patients' perspectives of their own health status and quality of life. As part of rising advocacy for their use in clinical practice, PROMs are said to hold promise for the management of long-term conditions. This study aimed to describe and explore New Zealand osteopaths' use of PROMs for patients with chronic low back pain. An online survey was adapted to investigate New Zealand osteopaths' use of PROMs with patients who have chronic LBP. Topics included frequency of use, purposes for use, and determinants to use. Respondents were recruited via anonymous and non-randomised sampling across multiple platforms. Frequencies, means, and standard deviations were calculated for all numerical data. Content analysis was used to analyse textual data on determinants to use. In total, 79 osteopaths were included in data analysis. These respondents most often used PROMs to monitor patients' pain intensity (80%) and sometimes also functional disability (27%). Although the respondents had some regard for their capability to use PROMs, they also claimed to be constrained by limited time and social or professional norms. Respondents were more attentive to the consequences of PROMs for patients than for other stakeholders. Although New Zealand osteopaths may use PROMs to monitor the burden of chronic LBP, they probably do not use PROMs for the multidimensional assessment of pain or psychosocial factors. New Zealand osteopaths may be most receptive to adopting PROMs if they are presented with relevant interventions and evidence of their benefits for patients. [ABSTRACT FROM AUTHOR]

Anatomy has been a cornerstone of osteopathic theory, practice and identity since the discipline's emergence in the 1800s and continues to be viewed as core knowledge to the present day. The domain of anatomical knowledge has provided seemingly endless rationales and explanations to justify osteopathic diagnosis, assessment and treatment. Moreover, knowledge of anatomy has been foundational for osteopaths' professional identity and conception of healthcare practice. Anatomical possibilism refers to the imagined, exaggerated, implausible and unproven relationships which are claimed to exist between anatomical structures. In persisting with such an approach to theory, practice and reasoning osteopathy may waste time, energy and intellectual capital and as a result fail to take advantage of opportunities to develop more plausible, ethical and person-focused approaches to patient care. [ABSTRACT FROM AUTHOR]

Cognitive biases appear to be one of the most common causes of incorrect medical diagnosis. It affects students during their training and could persist after post-graduation. This could deteriorate patient care. Among them, anchoring bias can impair haptic perception and lead to a biased diagnosis. Our study assessed the anchoring bias of first-year osteopathic students by determining whether information regarding the PRM rhythm could influence their haptic perception. Forty first-year osteopathic students were randomly assigned to three groups. They were given different anchoring values during a PRM rhythm evaluation (3, 10 or 17 movements per minute, mpm). All information were given through video documents. Perceived rhythms were collected before and after anchoring. Wilcoxon and Kruskal-Wallis tests were used to compare intra and intergroup values. Before receiving the anchor, groups significantly (p = 0.105) perceived the same rhythms (11.8 ± 6.6mpm; 20.9 ± 9.9mpm; 18.2 ± 10.6mpm; respectively) with high variance among students. After receiving the anchor, students perceived significantly different rhythms; 3.5 ± 1.7mpm; 11.4 ± 2.8mpm; 16.8 ± 6.6mpm, respectively (p < 0.0001). Variance decreased significantly. An anchoring bias might occur among first-year osteopathic students regarding their perception of the PRM rhythm. These results provide insights into the importance of the way of presenting information to students, especially controversial ones. Indeed, the way in which changing the ontological framework can modify the epistemological approach needs to be investigated. This could have implications on a student's clinical diagnosis. Students are encouraged to believe in their haptic ability, but also to use critical thinking. • Anchoring bias appears significant among first-year osteopathic students. • It could affect haptic perception and could act as a confounding factor during diagnosis. • Learning strategies must be set up to limit this bias and the risk of its persistence among post-graduate practitioners. • Teachers have to provide science-based courses and to improve student's critical thinking from the first year. [ABSTRACT FROM AUTHOR]

Pseudoscience has harmful effects on individual patient care, professions and society more broadly. The propagation of pseudoscience and spread of misinformation by a healthcare discipline raises questions as to their legitimacy and ethical standing as a profession. Osteopaths and osteopathic physicians are regulated by law as healthcare professionals in many parts of the world with an expectation that relevant aspects of practice are suitably aligned with the scientific paradigm in the form of a commitment to the values of evidence-based practice. This article discusses the system of pseudoscience and considers its historic, present and potential negative impacts on osteopathy and professional progress. We identify possible incentives for some aspects of osteopathy and osteopaths to engage in pseudoscientific thinking and in doing so we discuss osteopathy's susceptibility to pseudoscience and how practitioners may become more aware of and recognise pseudoscientific information and pseudoexpertise. • Pseudoscience is information presented as scientific, but on closer examination fails to meet established standards to be considered as science. • Pseudoscience has harmful effects on individual patient care and society more broadly. • There are historical, professional and sociological factors which make osteopathy susceptible to pseudoscience. • These factors may facilitate the propagation of pseudoscientific claims by osteopaths. • The incorporation of pseudoscience into osteopathy's knowledge base, threatens the claimed legitimacy and credibility of the profession. • It is important that osteopaths are aware of pseudoscience and recognise when it might be presented as scientific knowledge. [ABSTRACT FROM AUTHOR]

Therapeutische Wahrnehmungserfahrungen, die in der Berührung bzw. dem Tasten entstehen, zeigen sich im leiblichen Erleben eines Zwischen – so in der berührenden Erlebnispraxis zwischen Osteopath*in und Patient*in. Das Zwischen fasse ich dort als Erlebnisraum dieser Erlebnispraxis zur Welt auf. Als der Erlebnisraum meiner leiblichen Erfahrung und verbunden damit die des oder der Patientin. Somit gilt es, dies Zwischen als einen geteilten Artikulationsraum von wechselseitigen Bezügen zu bestimmen. Denn dort befragt der oder die wahrnehmende Osteopathin die Leiblichkeit der oder des Anderen. In dieser Berührungspraxis zeigen sich Phänomene von Eigen- und Zwischenleiblichkeit, die sich als sinnliches Erleben der Tastenden präsentieren. Sie sind elementare Voraussetzung, um ein Handlungsfeld von berührender Heilung zu konstituieren. Denn mit dem Tasten vollzieht sich eine Veränderung der Elementarverhältnisse zwischen Berührenden und Berührten – vice versa. Damit wird die Relation selbst erlebender Wahrnehmung zu einer vital erlebten implizierten Zwischenleiblichkeit konstituiert, die die Wahrnehmung im leiblichen Selbst aufzuspüren vermag. Mir geht es in diesem Beitrag einerseits um den Tastsinn, der dieser Erlebnispraxis im Zwischen zugrunde liegt, andererseits um die Wirkung des Tastens im eigenleiblichen Erleben. Hierzu gibt es Zeugnisse klinisch tätiger Osteopath*innen, über die es zu berichten gilt. Denn das Wissen um die 1.-Person-Perspektive kann sich in dieser Praxis erklären. Therapeutic, perceptual experiences that arise within touch or the actio palpationis present themselves in the bodily experience of intercorporeity, i. e., in the touching experience between osteopath and patient. I understand this space between as the space of this practice toward the world, as the space for my lived body, existential experience. It is necessary to define this between as a space of articulation of mutual relations. There, the perceiving osteopath questions the corporeity of the other. In this practice of touching, phenomena of inner and intermediate corporeity are revealed, which present themselves as sensual experiences to the touching person. They are an elementary prerequisite for constituting a field of action of haptic healing because through touch changes take place in the elementary relations between touching and touched. In this way, the relation of self-perceived-perception is constituted into a vitally lived intercorporeity which allows the tracing of perception in the corporeal self. In my talk I want to focus on the sense of touch which underlies this lived practice (the subjects' lived experience) within intercorporeity. I am also interested in the effect of touch on the subjects' own corporeal experience. For this reason, I have collected testimonies of clinically active osteopaths, for the 1st-person science of consciousness can be explained through practice. [ABSTRACT FROM AUTHOR]

In der osteopathischen Lehre wird der Unterricht – didaktisch wertvoll – in einzelne Kapitel und Konzepte unterteilt. Das ist auch sinnvoll, um eine breite Wissens- und Technikbasis zu erlernen. In der osteopathischen Praxis „halten" sich die Patient*innen jedoch höchst selten an einzelne Kapitel und Konzepte. Das erfordert von Osteopath*innen dann eine entsprechende Verknüpfung der in der Ausbildung erlernten Einzelteile. Deshalb folgt dieser Artikel – ein Fallbeispiel einer komplexen Patientin – dem vorangegangenen Artikel Stress, Kampf, Flucht – Die Rolle der Nebennieren im osteopathischen Handeln [ 1 ]. Das soll die Verbindung zwischen Theorie und Praxis herstellen. In osteopathic teaching, the lessons are divided into individual chapters and concepts – which is didactically valuable. This is also useful for gaining a broad knowledge and learn various techniques. In osteopathic practice, however, patients very rarely „stick" to individual chapters and concepts. This requires the osteopath to link the individual parts learned in the training accordingly. Therefore, this article – a case study of a complex patient – follows the previous article about stress, fight, flight – the role of the adrenal glands in osteopathic practice [ 1 ]. This is intended to create a connection between theory and practice. [ABSTRACT FROM AUTHOR]

Background: Persistent pain represents a significant burden for individuals and society, exerting a profound effect on quality of life and posing a significant strain on healthcare resources. Novel interventions are needed to reduce the impact of psychological comorbidities on people who live with pain but also to improve pain self-management. The aim of this research was to investigate the feasibility and acceptability of a brief group-based ACT intervention designed to osteopathy for people who live with persistent pain and psychological comorbidities. A mixed-method approach has been utilized that comprised of qualitative interviews providing an insight into peoples' experiences of participating and quantitative data including psychological flexibility, depression, anxiety, fear avoidance and general health status. This preliminary report will only present the qualitative findings. A total of 9 participants took part in the intervention. The participants engaged well with the exercises and with the ACT model in general. Program attendance was high (4 out of the 9 participants attended all the 6 sessions, (further attendance is shown in the Supplementary file 7); all 9 took part in the post-intervention interview). Three major themes were identified from the interview data: Engaging with the ACT model, Experiences of taking part in the intervention and Perceived changes. The participants reported positive experiences: they found being able to connect with people who experience similar issues valuable and expressed that they liked the content and structure of the program. The intervention appeared to be feasible with the support of the osteopaths. Delivering a brief ACT-based intervention for people living with persistent pain was found to be feasible and acceptable. The collaboration between osteopaths and psychologists in supporting people who live with persistent pain demonstrates potential and should be further explored in the future. [ABSTRACT FROM AUTHOR]

Practitioners' fear-avoidance beliefs can influence positively or negatively therapeutic outcomes in their patients. This study reports pain knowledge and fear-avoidance beliefs of French osteopathy students and educators towards the management of chronic low back pain (cLBP). An online cross-sectional survey was proposed to educators and students. It included sociodemographic characteristics and two questionnaires: the FABQ-HC to assess beliefs on the effects of physical and work activities for people with cLBP, and the NPQ to assess participants' knowledge of pain. Participants (N = 172) had mean FABQ-HC subscale scores of 11.02 ± 4.44 (Physical activity) and 24.37 ± 11.78 (Work). The mean NPQ total score was 11.90 ± 2.05. There were no significant score differences between students and educators (p > 0.05). Results showed that Year 4 students (N = 65) had a significantly better score (p < 0.05) at the FABQ-HC Physical Activity than Year 5 students (N = 71). Educators (N = 36) having less than 10 years of practice in osteopathy had better scores than other educators (p < 0.01) at the FABQ-HC Work. Educators and students in the study show similar scores to other French HCPs and international osteopaths on the FABQ-HC Physical activity. In contrast, they scored lower on the FABQ-HC Work. The main finding was that educators and students belonging to the same OEI have no significantly different beliefs about cLBP and no significantly differing knowledge of pain. There is potential to improve pain education especially concerning the beliefs around cLBP concerning work activity. [ABSTRACT FROM AUTHOR]

Objective structured clinical examinations (OSCEs) are often used to assess the clinical competence of students in preprofessional osteopathy training. During the COVID-19 global pandemic, the final year OSCE in the RMIT University osteopathy program was redeveloped leveraging online technologies within COVID-19 guidelines such as hygiene and occupancy limitations. Final year osteopathy students were assessed using a hybrid ten station OSCE, comprising both online and face-to-face components. The examination was led by a pre-recorded narrated PowerPoint video. The video contained instructions, case information for five cases and prompts for the practical stations. A student model stepped into the room as needed for practical stations. The examiner assessed students from another room via video streaming, with limited interaction with students. The hybrid OSCE was conducted safely during Stage 4 restrictions adhering to COVID Safe guidelines, allowing robust competency assessment of final year students, enabling timely graduation and transition to practice. Institutional support, technology infrastructure, clear communication and stakeholder collaboration are key to successful implementation. The hybrid OSCE format offers a potential solution for institutions delivering high-stakes assessment in the continuing challenges of clinical assessment in the post COVID landscape. Adopting hybrid assessment formats may facilitate remote assessment of students in clinical placements. [ABSTRACT FROM AUTHOR]

Despite the promotion of international osteopathic recommendations and registration guidelines, relational competencies and patient education practices present a challenge in the clinical setting due to lack of training. In France, the latest national osteopathic standards for education and practice defined a relational competency that includes patient education. Little is known about its integration in curricula and how French osteopathic practitioners are subsequently trained for relational competency. To determine teaching, learning, and assessment methods related to relational competency in French initial osteopathic training programs and identify the role of patient education in this relational competency. An online questionnaire was designed and sent to all initial training institutes in France (n = 28). Eight institutes answered the survey. The relational competencies appeared in various courses, enhanced by clinical learning. However, the courses were not specific to this competency and the volume of hours was relatively low. Patient education was seen as part of relational competency but was poorly implemented. This competency-based approach is still considered an emerging practice in these institutes. There is a misalignment among intended learning outcomes, teaching, and assessment. Current educational practices are not sufficient to support relational competency, specifically regarding patient education. Further research is needed on how French standards are understood, how they are assimilated by educators, and how they are translated into educational practice. In addition, the adequacy of educators' training for effective implementation of the competency-based approach should be questioned. • Relational competency remains undervalued in the context of French initial training programs for osteopathy. • The standards for osteopathic education and practice need to be clarified before truly integrating patient education into relational competency. • Teaching, learning, and assessment methods must evolve to be consistent with a comprehensive competency-based approach. • There is a need to train educators in this relational competency and in the competency-based approach. [ABSTRACT FROM AUTHOR]

In Germany, more parents have been seeking help from osteopaths for their infants and children in recent years. This implies an increasing demand of reliable evidence regarding the effectiveness of osteopathic intervention for this group. To identify the 'typical' (most common) health concerns of parents when presenting their infants (age 0–12 months) in pediatric osteopathic practices. For the purpose of this survey, well-trained osteopaths who specialize in the treatment of children and infants were selected. A documentation form containing a list of the likely most common infant health problems, developed by means of systematic literature analyses, was provided to experienced osteopaths to assess which health problems were seen most frequently. Eighty-one osteopaths were contacted, of which 64 (79 %) responded and returned the documentation form. Nine documentation forms could not be evaluated. The remaining 55 documentation forms included information on 2833 health concerns. Quantitatively, there was no dominant health problem, but five problems were found to be common: 21 % of the cases were idiopathic infant asymmetry, 17 % were plagiocephaly, 16 % were excessive crying, and 14 % were feeding and sleep disorders. All other problems were observed as far less frequent. In addition, osteopaths reported 423 other health concerns that were not specified in the documentation form. In this survey, infants that were presented in osteopathic practices often had one or more of those five health problems mentioned above. A large observational trial is currently underway to document changes observed during osteopathic treatment of these health problems. [ABSTRACT FROM AUTHOR]

This case study describes a joint pilot project to implement interprofessional education (IPE) between a United States college of osteopathic medicine and a college of pharmacy co-located on one campus. The pilot was intended to address the Interprofessional Education Collaborative (IPEC) domains and competencies and to serve as a first step and bridge toward future multidisciplinary endeavors. We describe the process of creating an IPE team, developing a workshop and gathering feedback. The key elements for a successful IPE program are identified as: administrative support, faculty engagement, and long-term planning. Challenges to effective implementation encountered were: scheduling conflicts, faculty engagement, and a specific IPE budget. The aim of this paper is to provide insights and share lessons learned regarding approaches taken to implement this IPE initiative. We advance the premise that while IPE is an essential foundation for preparing health professions students for interprofessional patient-centered practices, its implementation has many challenges. [ABSTRACT FROM AUTHOR]

This paper presents partial results of a research-intervention, through training of PHC work teams. Initial consultation was made in a group by HC professionals, and the osteopath then performed the consultation. The socialization and training of practical knowledge and techniques of the osteopathic approach was done between consultations. Multiprofessional teams from three health centers from Florianópolis, southern Brazil, participated in the training, and the process was audio and videorecorded, along with a final interview. Data was analyzed using the Grounded Theory. Apprehending the osteopathic knowledge was a triggering tool for reflective processes about care. Faced with the efficiency and resolution of this approach in practice, participants showed a willingness to transform their acts of care of patients and also their self-care. The professionals argue that the common understanding about self-regulating mechanisms and the inclusion of the tissue mobility in their anamnesis, including the stimulation of endogenous mechanisms, contributed to less protocol-based care, more appropriate care for each case, better multidisciplinary team work, the rational use of additional tests, medication, and surgical procedures. [ABSTRACT FROM AUTHOR]

In the age of social media, the qualifications and capabilities of osteopathic professionals have been brought into question on a national scale due to the lack of awareness and misconceptions held by many Americans with social platforms. This article investigates the misperceptions behind the recent media coverage of osteopathic physicians. This article highlights the history of osteopathic medicine, as well as the education and training physicians receive. Additionally, this paper offers suggestions on how to combat the stigma in everyday life. [ABSTRACT FROM AUTHOR]

Many parents seek osteopathic care for their infants with colic. Our aim was to test the effectiveness of usual light touch osteopathic treatment on crying time for infants with 'colic'. A superiority, two arm, single blinded (parent) multi-centre (UK, Australia and Switzerland), randomised controlled trial, included healthy infants between 1 and 69 days of age who excessively cried, fussed, or were distressed and difficult to console. The Test intervention consisted of usual light touch osteopathic treatment, the Control intervention simple light touch to random body locations with no treatment intent. Both groups received best practice advice and guidance. The primary outcome was the daily crying time, reported hourly by parents in a diary, for two-weeks. Secondary outcomes were parenting confidence, global change, satisfaction, and experience of care. Sixty-six infants were recruited (32 Test: 34 Control group). Mean average daily crying time in the Test group was 124 min (SD = 69, n = 26) and in the Control 115 min (SD = 49, n = 29). After adjustment, infants in the Test group cried 2.2 min more per day than those in the Control group (CI95 % −20 to 25 min, p = 0.849). Parents' perceptions of global change in symptoms, satisfaction with, and experience of care were high and similar in both groups. There were no serious adverse events related to the treatments or the trial. Usual light touch osteopathic treatment was not superior to simple light touch without treatment intent. The biomechanical explanatory models and underpinning assumptions about the mechanisms of osteopathic intentional light touch care may require reconsideration. ACTRN12620000047998 (January 22, 2020). [ABSTRACT FROM AUTHOR]

This commentary proposes a framework for considering the philosophical foundations that support osteopathic practice, using the metaphor of 'tectonic plates'. It is argued that reflective osteopathic practitioners, and the organisations they make up, would benefit from engaging with the differing ontological and epistemological traditions that underpin healthcare theory, evidence and practice. It is proposed that having more insight into the philosophical traditions of reality (ontologies) and forms of knowledge (epistemologies), that underpin medicine and healthcare, will support ethical, reflective practice, informed by the concepts of ontic integrity and epistemic humility. We focus particularly on phenomenological ontology and epistemology, which we propose underpins the relational and embodied concept of osteopathy as hermeneutic, enactive, intersubjective healthcare, locating it within the sphere of phenomenological and enactivist theory and research. [ABSTRACT FROM AUTHOR]

Advice, reassurance and education are recommended as first line treatments for musculoskeletal pain conditions such as low back pain. Osteopaths are registered primary contact allied health professionals in the Australian healthcare system who primarily manage acute and chronic musculoskeletal pain conditions. This study aimed to investigate the proportion of Australian osteopaths who do and do not utilise advice, reassurance and education (pain counselling) in their clinical practice, and determine the characteristics associated with the frequency of using pain counselling in clinical practice. A secondary analysis of practice characteristics from a nationally representative sample of Australian osteopaths was undertaken. Participants completed a 27-item practice characteristics questionnaire between July-December 2016. Bivariate analyses were used to identify significant variables for inclusion in a backward multiple logistic regression model. Adjusted odds ratios (OR) were calculated for significant variables. Responses were received from 991 Australian osteopaths, representing 49% of the profession. Of these 264 (26.64%) indicated often utilising pain counselling, and 727 (73.36%) reported not often utilising pain counselling. Those who utilised pain counselling were more than twice as likely to report research evidence had a high impact on their clinical practice (OR 2.11), and nearly twice as likely to discuss physical activity with their patients (OR 1.84). Pain counselling is under-utilised by nearly three quarters of the Australian osteopathic profession as a management strategy. Future studies are required to explore the reasons why most in the profession comprised in this sample are infrequently utilising this guideline recommendation. Given the frequency of chronic musculoskeletal pain conditions presenting to Australian osteopaths, strategies appear to be needed to advance the profession via professional development in accessing and using evidence-based care for pain conditions. [ABSTRACT FROM AUTHOR]

Although the COVID-19 pandemic affects predominantly the respiratory function, epidemiological studies show that multiple systems can be affected. The severe complications of SARS-CoV-2 infection seem to be induced by an inflammatory dysregulation ("cytokine storm"), which can also induce an immunodepression. Several studies highlight beneficial effects of osteopathic medicine on inflammation and immune regulation. A careful review of evidence-based literature brings to the fore significant improvements of osteopathic manipulative treatment (OMT) in adjunction to conventional care. OMT can improve the condition of infected patients by decreasing symptoms and boosting the efficiency of conventional care. OMT might also benefit surviving patients by reducing the long-lasting consequences of the infection as well as improving their quality of life during convalescence. This review should constitute an argument in favor of multidisciplinary care, although further biological and clinical research is essential to better assess the potential beneficial contributions of adjunct osteopathic medicine to conventional care in the fight against pandemics such as COVID-19. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the attitudes held by a group of Italian osteopaths toward osteopathic evaluation, treatment, and management in the neonatal and pediatric field. A thematic analysis with elements of grounded-theory approaches was used. Purposive sampling was used to recruit expert osteopaths in the neonatal and pediatric field. Data were gathered from July 2017 to January 2018 by individual semistructured interviews and transcribed verbatim. A thematic analysis of the data was then performed. The Consolidated Criteria for Reporting Qualitative Research checklist was used to structure the design of this qualitative study. Eight osteopaths participated. Data analysis generated 3 main themes: the role of the osteopath in the collaborative process of care, osteopathic diagnostic-clinical reasoning in the neonatal and pediatric field, and osteopathic treatment in the neonatal and pediatric field. The present study highlights that Italian osteopaths may prefer interprofessional and integrative activities aimed at supporting adaptive capacity and resilience for pediatric patients. [ABSTRACT FROM AUTHOR]

Osteopathische Artikel zur „Spanischen Grippe" oder zur Behandlung von Infektionskrankheiten im Allgemeinen [ 1 ]–[ 7 ] verweisen gerne auf die großen Behandlungserfolge der Osteopathie in den USA im Vergleich zur medikamentösen Therapie während der großen Influenzapandemie 1918/19. Da die meisten Erkrankten nicht an der Grippe selbst, sondern an einer Pneumonie verstarben, werden dazu ergänzend oft zwei neuere osteopathische Studien zitiert [ 8 ], [ 9 ]. Doch wie zuverlässig sind die angeführten Zahlen, die die Erfolge der Osteopathie untermauern sollen, und welche Ergebnisse liefern die Studien zur Pneumonie? Dieser Beitrag stellt viele Fragen und versucht, einige Antworten zu geben. Osteopathic articles on the "Spanish flu" or the treatment of infectious diseases in general [ 1 ]–[ 7 ] like to refer to the great successes of osteopathy in the USA compared to drug therapy during the great pandemic influenza of 1918/19. Since most of the sick died from pneumonia rather than the flu itself, two more recent osteopathic studies on this topic are cited frequently [ 8 ], [ 9 ]. Actually, how reliable are the figures given, which are intended to back up the success of osteopathic treatment, and which results do the studies on pneumonia deliver? This article is asking a lot of questions and trying to give some answers. [ABSTRACT FROM AUTHOR]

Recent debates inside the osteopathic community have underlined the need to revise and to implement osteopathic traditional clinical concepts in relation to the process of clinical reasoning. Nevertheless, clinical reasoning has to be based on models and evidence to enhance the quality and to maximise the effectiveness of the therapeutic act. Among models, the five osteopathic models (OMs) are supposed to guide osteopathic clinical reasoning. However, there is a lack of studies on how OMs characterise clinical practice. The primary purpose of this study was to explore Italian osteopaths' attitudes and beliefs toward the five OMs and their application in clinical reasoning and practice. 19 Italian professional osteopaths with clinical and educational experience formed the purposive sample of this qualitative study. Data were collected through recorded semi-structured interviews, transcribed verbatim and coded by using elements of a constructivist grounded theory approach. Three main themes were identified: 1) Ambiguity of the professional identity; 2) OMs: an enigma of clinical reasoning, 3) Osteopathic knowledge paths: evolutionary on-going trajectories. The results of the present study suggest a heterogenic theoretical and practical conceptualisation of OMs within the Italian osteopathic field, identifying a gap between knowledge and tradition. This study may contribute to reducing this gap promoting a framework to clarify current understanding of the OMs in order to guide the profession towards the definition of an updated osteopathic paradigm. • The Italian osteopathic community needs a debate about the interpretation and the use of OMs. • Participants call for a revision of the relationship between OMs and other osteopathic foundations. • There is a need to develop a shared osteopathic professional identity to be included within the Italian Health Service. • Results are relevant for both professional and educational field. [ABSTRACT FROM AUTHOR]

Work-related injuries constitute a significant proportion of osteopaths' practice. This study was designed to determine the practitioner and practice characteristics of osteopaths who treat people with work-related injuries and to identify the impact of workers' compensation scheme status on the use of osteopathic medicine. A cross-sectional survey was distributed to a nationally-representative sample of 992 Australian osteopaths. Multivariate logistic regression modelling was performed to identify the practitioner and practice characteristics of osteopaths that were statistically significantly associated with the treatment of work-related injuries. A total of 847 osteopaths (86%) at least sometimes treated people with work-related injuries within the previous 12-months. One hundred and three participating osteopaths indicated they often treated people with work-related injuries who were covered by a workers' compensation scheme and 341 participating osteopaths indicated they often treated people with work-related injuries who were not covered by a workers' compensation scheme. Osteopaths who often treated work-related injuries were also more likely to often treat people with sports-related injuries, often treat people with traffic-related injuries, and/or often discuss medications with patients. A large proportion of Australian osteopaths treat people with work-related injuries. Further examination of osteopathic medicine use for work-related injuries is warranted. • More than 85% of osteopaths at least sometimes treated people with work-related injuries within the previous 12 months. • A total of 35% of osteopaths often treated injured workers who were not covered by the Workers' Compensation Scheme. • Numerous variations exist in osteopathic treatments for injured workers with and without a Workers' Compensation Scheme. [ABSTRACT FROM AUTHOR]

Evidence-based practice (EBP) is integral to the provision of ethical, safe and high-quality health care. While osteopathy is an established and registered health profession in many countries, it is a developing, unregistered health profession in Sweden. This study explored the perceptions, skills, use, barriers and enablers of EBP among Swedish osteopaths. Osteopath members of the Swedish Osteopathic Association were invited by email to participate in an anonymous online survey - a Swedish-translated and pilot-tested version of the Evidence-Based Practice Attitude and Utilisation Survey. Data collection was conducted between January and March 2019. Thirty-one per cent (78/249) of invited osteopaths responded to the survey. Respondents were largely supportive of EBP and most agreed or strongly agreed that EBP assisted clinical decision-making (84.7%), improved quality of patient care (83.3%), and was necessary in the practice of osteopathy (80.8%). Respondents typically reported moderate to moderate-high levels of EBP skills, whereas their level of engagement in EBP activities was variable and infrequent. The main reported barrier for EBP uptake was lack of clinical evidence in osteopathy. Workplace access to the internet and free online databases, and the ability to download full-text journal articles, were considered very useful enablers of EBP. The responding Swedish osteopaths appeared largely supportive of EBP, reported moderate to moderate-high levels of EBP skills but participated infrequently in EBP activities. Studies of interventions aimed at enhancing the skills and clinical use of EBP in osteopathy are warranted. [ABSTRACT FROM AUTHOR]

Psychosocial influences in musculoskeletal complaints are widely recognized to contribute to chronicity of the complaint. A number of patient-report outcome measures have been published to screen for the presence of these influences. Explore the relationship between health demographics and behaviours and the short-form Orebro Musculoskeletal Pain Questionnaire (OMPQ-10). Cohort study. University teaching clinic. Patients were invited to complete a demographic and health questionnaire in addition to the OMPQ-10 prior to their consultation. Descriptive and inferential statistics were used to explore the relationships between health behaviours, determinants of health and the OMPQ-10. Patients attending the Victoria University Osteopathy Clinic for their initial osteopathy consultation. Data from 353 patients were analysed. Mean age was 33.4 (±11.5) years and 93.8% were employed. OMPQ-10 mean total score was 38 (±12). Reliability estimations did not support the calculation of a total score - analysis was undertaken using the OMPQ-10 Domain areas. No significant difference was identified between Domain area score and gender, presenting complaint region, speaking English at home, having had blood pressure assessed in the last 6 months or employment status. Patients with a chronic condition demonstrated significantly higher Pain Experience (p < 0.01, d = 0.79) and Return to Work (p = 0.033, d = 0.26) domain area scores. Associations with health behaviors and determinants were identified. The utility of the OMPQ-10 may be limited given the high number of patients who were employed. Further work is required to evaluate other psychosocial screening tools that may be useful for an osteopathy patient population. [ABSTRACT FROM AUTHOR]