Functional Neuromyofascial Activity: Interprofessional Assessment to Inform Person-Centered Participative Care-An Osteopathic Perspective

: Introduction: Health professionals and bodyworkers may be pivotal in promoting prevention programs, providing tailored advice and guidance to patients' adherence to self-care strategies, such as physical activity. Contemporary evidence encourages manual therapists to involve patients in decision-making and treatment procedures integrating passive and active approaches in treatment planning. This manuscript provides a definition and applications of neuromyofascial movement patterns, discusses the significance of functional assessment, and gives an example of clinical applications in the osteopathic field to highlight how this assessment can promote interdisciplinarity. Methods: The reporting framework used in the current manuscript followed guidelines for writing a commentary. Results: The manuscript highlights the crucial role that the neuromyofascial system plays in human movement and overall well-being and the importance of a functional neuromyofascial activity assessment in the context of person-centered participative care. Conclusions: Understanding individual neuromyofascial patterns could help healthcare practitioners, movement specialists, and bodyworkers in tailoring treatment plans, meeting patients' unique needs, and promoting a more effective personalized approach to care. The current perspective could spark debates within the professional community and provide a research roadmap for developing an evidence-informed interprofessional framework

Exploration des modèles ostéopathiques utilisés pour interpréter les perceptions lors d’un test palpatoire fascial, viscéral ou crânien ::une étude qualitative

Contexte : La palpation est une étape importante dans la prise en charge ostéopathique car elle contribue à l’établissement du diagnostic ostéopathique, du traitement ainsi qu’à établir une relation de confiance entre patient et thérapeute. Objectif : Toute profession de santé incorpore les données acquises de la science dans ses modèles pour garantir des soins éthiques et efficaces. L’objectif était de décrire les modèles actuels utilisés par les ostéopathes pour interpréter leurs perceptions palpatoires dans leur pratique. Méthode : Cette étude qualitative a été effectuée selon le modèle de l’analyse thématique. Des entretiens semistructurés composés de questions ouvertes ont été réalisés et transcrits. L’analyse des données a été faite selon le modèle de Braun & Clarke. Les ostéopathes diplômés Suisses francophones et germanophones utilisant régulièrement des tests palpatoires fasciaux, viscéraux et crâniens constituent la population cible. Le nombre de participants prévu entre 15 et 25 a été atteint avec un total de 20. La technique d’échantillonnage non-probabiliste de type « boule de neige » a servi au recrutement. Résultats : Les entretiens ont montré que l’importance donnée à la palpation dépend des compétences et convictions personnelles des ostéopathes mais que cela n’influence pas le choix des modèles utilisés pour interpréter la palpation. On constate que les ostéopathes ayant le plus grand nombre d’années d’expériences cliniques utilisent le plus grand nombre de modèles dans leur pratique. Conclusion : Cette étude informe sur la vitesse de transfert en pratique clinique des dernières données scientifiques de la profession, compte tenu de sa récente reconnaissance en tant que profession de santé par les pouvoirs publics en Suisse.Background: Palpation is an important step in osteopathic care because it contributes to the establishment of the osteopathic diagnosis and treatment and of a relationship of trust between patient and therapist. Objective: Every health care profession incorporates scientific evidence into its models to ensure ethical and effective care. The objective of this study was to describe the current models used by osteopaths to interpret their palpatory perceptions in their practice. Method: This qualitative study was conducted using a thematic analysis model. Semi-structured interviews consisting of open-ended questions were conducted and transcribed. The data were analyzed according to the Braun and Clarke model. The target population for the study was French- and German-speaking Swiss osteopaths who regularly use fascial, visceral, and cranial palpatory tests. The expected number of between 15 and 25 participants was reached with a total of 20. The non-probabilistic snowball sampling technique was used for recruitment. Results: The interviews showed that the importance given to palpation depends on osteopaths’ personal skills and beliefs but does not influence the choice of models used to interpret palpation. Osteopaths with the most years of clinical experience were found to use the most models in their practice. Conclusion: This study provides information on the speed of transfer of the latest scientific data from the osteop athy profession to clinical practice, given its recent recognition as a health profession by the public authorities in Switzerland

Refining the biopsychosocial model for musculoskeletal practice by introducing religion and spirituality dimensions into the clinical scenario

Addressing religion and spirituality (R/S) dimensions may be uncomfortable for patients and practitioners because they refer to intimate beliefs about existence, vary across the globe and cultures, and are not routinely shared in the modern therapeutic scenario. Often, R/S dimensions are overlooked in musculoskeletal (MSK) practice despite associations with attitudes and behaviour that directly affect quality of life and health outcomes. Inclusion of basic R/S dimensions in the therapeutic alliance may optimise care and establish these dimensions as interactors within the biopsychosocial model. The purpose of this commentary was to provide practitioners with definitions of R/S that are useful for managing care of MSK patients, describe how attitudes towards R/S may be linked to health status, and indicate how R/S dimensions could be discussed in simple ways in a modern therapeutic scenario. Finally, suggestions are provided for MSK practitioners and researchers to address R/S dimensions in Western evidence-oriented healthcare. Highlights Cultural competencies in healthcare include religion/spirituality dimensions. Religion/spirituality dimensions are overlooked in Western manual care. Religion/spirituality within the biopsychosocial model may be clinically relevant. Explicit inclusion of religion/spirituality may optimise the therapeutic alliance. Keywords: Biopsychosocial, Manual therapy, Musculoskeletal care, Religion, Spiritualit

Historical Osteopathic Principles and Practices in Contemporary Care: An Anthropological Perspective to Foster Evidence-Informed and Culturally Sensitive Patient-Centered Care: A Commentary

Historical osteopathic principles and practices (OPP)—considering the patient as a dynamic interaction of the body, mind, and spirit and incorporating the body’s self-healing ability into care—are inherited from traditional/complementary and alternative (CAM) principles. Both concepts are familiar to contemporary osteopathic practitioners, but their incorporation into healthcare for evidence-informed, patient-centered care (PCC) remains unclear. Further, a polarity exists in the osteopathic profession between a ‘traditional-minded’ group following historical OPP despite evidence against those models and an ‘evidence-minded’ group following the current available evidence for common patient complaints. By shifting professional practices towards evidence-based practices for manual therapy in line with the Western dominant biomedical paradigm, the latter group is challenging the osteopathic professional identity. To alleviate this polarity, we would like to refocus on patient values and expectations, highlighting cultural diversity from an anthropological perspective. Increasing an awareness of diverse sociocultural health assumptions may foster culturally sensitive PCC, especially when including non-Western sociocultural belief systems of health into that person-centered care. Therefore, the current medical anthropological perspective on the legacy of traditional/CAM principles in historical OPP is offered to advance the osteopathic profession by promoting ethical, culturally sensitive, and evidence-informed PCC in a Western secular environment. Such inclusive approaches are likely to meet patients’ values and expectations, whether informed by Western or non-Western sociocultural beliefs, and improve their satisfaction and clinical outcomes

Impact of Osteopathic Treatment on Pain in Adult Patients with Cystic Fibrosis – A Pilot Randomized Controlled Study

<div><p>Background</p><p>Pain is a common complication in patients with cystic fibrosis (CF) and is associated with shorter survival. We evaluated the impact of osteopathic manipulative treatment (OMT) on pain in adults with CF.</p><p>Methods</p><p>A pilot multicenter randomized controlled trial was conducted with three parallel arms: OMT (group A, 16 patients), sham OMT (sham treatment, group B, 8 patients) and no treatment (group C, 8 patients). Medical investigators and patients were double-blind to treatment for groups A and B, who received OMT or sham OMT monthly for 6 months. Pain was rated as a composite of its intensity and duration over the previous month. The evolution of chest/back pain after 6 months was compared between group A and groups B+C combined (control group). The evolution of cervical pain, headache and quality of life (QOL) were similarly evaluated.</p><p>Results</p><p>There was no statistically significant difference between the treatment and control groups in the decrease of chest/back pain (difference = −2.20 IC95% [−4.81; 0.42], p = 0.098); also, group A did not differ from group B. However, chest/back pain decreased more in groups A (p = 0.002) and B (p = 0.006) than in group C. Cervical pain, headache and QOL scores did not differ between the treatment and control groups.</p><p>Conclusion</p><p>This pilot study demonstrated the feasibility of evaluating the efficacy of OMT to treat the pain of patients with CF. The lack of difference between the group treated with OMT and the control group may be due to the small number of patients included in this trial, which also precludes any definitive conclusion about the greater decrease of pain in patients receiving OMT or sham OMT than in those with no intervention.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="http://clinicaltrials.gov/ct2/show/NCT01293019" target="_blank">NCT01293019</a></p></div

Need for analgesics in the OMT group, the sham OMT group and the group with usual care.

<p>Need for analgesics in the OMT group, the sham OMT group and the group with usual care.</p

Composite chest/back pain at inclusion (M0), after 3 months (M3) and at the end of the study (M6) in the OMT group (A) and control group (B+C).

<p>VAS: visual analog scale.</p