Educating osteopaths to be researchers – What role should research methods and statistics have in an undergraduate curriculum?

Professor and Executive Director of the Osteopathic Research Center, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107, USA.
International Journal of Osteopathic Medicine (Impact Factor: 1.2). 02/2008; 11(2):62-68. DOI: 10.1016/j.ijosm.2008.03.003
Source: PubMed


Evidence-based medicine (EBM) involves using research data to enhance the diagnosis and treatment of clinical disorders. Somatic dysfunction and osteopathic manipulative treatment (OMT) are two unique aspects of osteopathy that will benefit from a greater emphasis on scientific evidence. Most evidence in osteopathy is based on expert opinions, case reports, case series, and observational studies. Only one systematic review of randomized controlled trials, involving OMT for low back pain, has been published. Although this study demonstrates the efficacy of OMT for low back pain, other clinical trials are needed to expand the evidence base in osteopathy. Undergraduate osteopathy curricula should ensure that students acquire the tools necessary to become knowledgeable consumers of the research and statistics presented in biomedical journals. Such curricula need to be supplemented with graduate training programs and research funding mechanisms to ensure that young osteopathic researchers are able to produce the research needed to practice and advance evidence-based osteopathy in the future.

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    ABSTRACT: Osteopathic manipulative medicine texts and educators advocate a range of approaches for physical assessment and treatment, but little is known about their use by osteopathic physicians in the United States. A web-based survey using a 5-point Likert scale was developed and e-mailed to 777 practicing osteopathic physician members of the American Academy of Osteopathy. Responses in the "frequently" and "always" categories were combined for reporting purposes. Friedman tests were used to analyze the reported usage of each item. The effect of gender was analyzed using Mann-Whitney tests. One hundred seventy-one osteopathic physicians completed the survey (22%). For the assessment of spinal somatic dysfunction, paraspinal tissue texture (98%), transverse process asymmetry (89%), and tenderness (85%) were most commonly reported. Myofascial release (78%), soft tissue technique (77%), and patient self-stretches (71%) were most commonly used for treatment of the spine. For assessment of pelvic landmark asymmetry, the anterior superior iliac spine (ASIS, 87%), sacral base (82%), posterior superior iliac spine (81%), sacral sulci (78%), iliac crests (77%), and inferior lateral angle of the sacrum (74%) were commonly palpated. For assessment of sacroiliac joint motion, ASIS compression (68%) was most commonly used. Sacroiliac pain provocation tests were also employed although their use was less common than asymmetry or motion tests. Muscle energy (70%), myofascial release (67%), patient self-stretches (66%), osteopathy in the cranial field (59%), muscle strengthening exercises (58%), soft tissue technique (58%), and articulatory technique (53%) were most commonly used for treatment of the pelvis and sacroiliac. The effect of gender was significant for many of the treatment procedures, with females using more soft tissue and muscle energy and males more high-velocity techniques. The majority of respondents document the types of osteopathic manipulative techniques used (83%), document somatic dysfunction with Fryette nomenclature (64%), and bill for osteopathic manipulative treatment (92%). Respondents reported the use of a broad range of assessment and treatment approaches. Results suggest a higher use of myofascial release and cranial technique and lower use of high-velocity techniques in this group of physicians compared to previous studies.
    Osteopathic Medicine and Primary Care 05/2009; 3(1):4. DOI:10.1186/1750-4732-3-4
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