Journal of Osteopathic Medicine最新文献

{"title":"Signs and symptoms of vertebrobasilar insufficiency secondary to atherosclerosis: a systematic review.","authors":"Chris Moors, Claire Stapleton","doi":"10.1515/jom-2024-0203","DOIUrl":"10.1515/jom-2024-0203","url":null,"abstract":"<p><strong>Context: </strong>Clinicians face a difficult challenge in identifying vertebrobasilar insufficiency (VBI) resulting from atherosclerosis. VBI is a term utilized to describe a reduction in blood flow to the vertebral and basilar arteries that supply the posterior cerebral system. For musculoskeletal clinicians, diagnostic differentiation of VBI is essential, because its presence directly impacts the clinical use of manual treatment interventions. Clinical guidelines provide a set of cardinal symptoms (inclusive of Coman's 5D's) in which VBI may manifest, the accuracy of which is under contestation because literature provides evidence suggesting a wider set of symptoms.</p><p><strong>Objectives: </strong>The objectives of this study were to gather all relevant literature reporting features of VBI pertaining to atherosclerosis, with the aim to help provide evidence that may guide clinical practice in the use of manual therapy interventions and to raise awareness of the manifestations that VBI may present.</p><p><strong>Methods: </strong>Six databases were searched from inception to September 2024 (Allied and Alternative Medicine Database [AMED], AgeLine, SPORTDiscus, Medical Literature Analysis and Retrieval System Online [MEDLINE], Cochrane, and Cumulative Index of Nursing and Allied Health (CINAHL Plus). Articles were screened in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards, The included articles required a diagnosis of VBI through clinical examination with radiological evidence of atherosclerotic lesions, without evidence of existing or previous neurological infarcts, concomitant arterial pathology, or any other form of pathological mechanism. Primary data were extracted utilizing a template, and the methodological quality was assessed utilizing the Joanna Briggs Institute critical appraisal tool. Findings were summarized utilizing a narrative synthesis and a table of descriptive statistics.</p><p><strong>Results: </strong>Two hundred and eighty-three papers were identified, and 15 were included (93 cases, 50M/43F, age 64 years old ± 9 standard deviation [SD] yrs). Vertigo was the most common reported symptom, within a total of 37 different symptoms reported either in isolation or combination. Symptoms inclusive to Coman's 5D's accounted for 22 % of reported features.</p><p><strong>Conclusions: </strong>Vertigo is the most common symptom (27.7 %) of VBI induced by atherosclerosis. However, there is not sufficient data to make concrete conclusions, although results do instill doubt over the sole use of Coman's 5D's in clinical practice. Prospective observational studies with standardized data extraction for VBI symptoms and their pattern of behavior are warranted.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DO (under) representation in US guideline development: an investigation of guideline authors from 2021-2023.","authors":"Alfred B Amendolara, Steven Salazar, Tiffany Nguyen, Porter Fife, Blake Harris, Alessandra M Rivera, Kennedy Madrid, Yvannia Gray, Stephen Stacey","doi":"10.1515/jom-2024-0187","DOIUrl":"https://doi.org/10.1515/jom-2024-0187","url":null,"abstract":"<p><strong>Context: </strong>Research and scholarship are core drivers of medicine in the modern era. Evidence-based practice continues to replace expert opinion and long-held practice beliefs. Involvement in the development and writing of these guidelines is critical for Doctors of Osteopathic Medicine (DOs) to maintain a seat at the academic table. According to the American Osteopathic Association (AOA), 11 % of practicing physicians in the US are DOs. This number is growing, as nearly 25 % of current medical students attend an osteopathic medical school. Without involvement in guideline development, DOs risk giving up control of their own practice of medicine.</p><p><strong>Objectives: </strong>To quantify the contribution of DOs to the body of literature guiding practice, author information was extracted from all US-based guidelines published in the years 2021, 2022, and 2023 listed in the Emergency Care Research Institute (ECRI) Guidelines Trust database.</p><p><strong>Methods: </strong>Authors of US-based guidelines listed in the ECRI Trust database from the years 2021-2023 were counted and categorized into one of three groups based on terminal degree: MD holders, DO holders, and Other-degree holders. Authors whose degrees could not be identified were counted as \"Unidentifiable.\" Additional data including sponsoring organization, organization type, and specialty were collected.</p><p><strong>Results: </strong>A total of 674 guidelines were published by US organizations in 2021, 2022, and 2023, with 604 reporting author information. A total of 9,376 authors were counted. Of that, 7,253 held an MD (77 %), 110 held a DO (1.2 %), and 1,848 held another terminal degree (19.7 %); meanwhile, 1.66 % of counted authors did not have an identifiable degree. A total of 604 guidelines published by US organizations were identified. Of these, 88 (14.6 %) contained at least one DO author in their author list. Sixty-two unique specialties were identified, along with 130 unique sponsoring organizations. Of those specialties, 28 (44.4 %) had at least one DO author of at least one guideline. Of 130 sponsoring organizations, 44 (33.8 %) developed at least one guideline with at least one DO author. No osteopathic sponsoring organizations were identified.</p><p><strong>Conclusions: </strong>Based on these results, we conclude that DOs are underrepresented in the development of guidelines.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel simulation enhanced education for osteopathic manipulation of hospitalized patients.","authors":"Andrew P Eilerman, Gianna Libonate, Sophia Pothen, Melissa Rudie, Shirley Zardoost, Briana Donaldson, Brad Gable","doi":"10.1515/jom-2024-0118","DOIUrl":"https://doi.org/10.1515/jom-2024-0118","url":null,"abstract":"<p><strong>Context: </strong>Simulation-based medical education (SBME) is a method for enhancing learner skill prior to initiating care for real patients. Although the use of SBME continues to grow, there is limited data on simulations related to osteopathic medical training. Osteopathic manipulative medicine (OMM) applies hands-on techniques to facilitate healing. We hypothesized that the use of SBME to closely mimic OMM provided to the hospitalized patient would help to increase individual knowledge and comfort with OMM techniques and increase the likelihood of a learner utilizing OMM techniques on patients.</p><p><strong>Objectives: </strong>This study aimed to determine the effectiveness of the SBME lab to enhance the learning of medical learners of OMM on hospitalized patients, and to determine the favorability of the OMM SBME experience by learners.</p><p><strong>Methods: </strong>This was a single-institution pilot quality improvement project that utilized a novel simulation to provide OMM to critically ill and hospitalized patients. The simulation was a single instructor-led event lasting 2 h. The OMM experience utilized specialized simulation gowns and hospital beds to mimic the treatment of postsurgical ileus, acute respiratory failure, and congestive heart failure (CHF) exacerbation. Learners alternated between the role of physician (practicing technique) and the patient (wearing the simulation gown). Pre- and postsurveys evaluated learners' knowledge and comfort regarding OMM in hospitalized patients. Graduate medical residents/fellows from five osteopathic-recognized programs and medical students on rotations (n=35) participated in the simulation, and n=32 completed the postsimulation survey. The survey included 15 questions and utilized a 5-point Likert Scale. Results were analyzed with the chi-square test.</p><p><strong>Results: </strong>The average knowledge pretest score ranged from 2.5 to 3.5 for the 15 questions. Learner knowledge improved for all areas evaluated, with a range of 3.6-4.6 for the postsurvey. The p-value was significant for each question. In addition, lab, simulation, and lecturers were evaluated and were received positively.</p><p><strong>Conclusions: </strong>This study demonstrates that simulation may be an effective way to increase knowledge and comfort on how to apply OMM in a hospital setting.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soft tissue manipulation enhances recovery of muscle mass in a disuse model of sarcopenia.","authors":"Basil Mustaklem, Mary Terry Loghmani, Abigail K Waterfill, Mackenzie Caron, Daren A Glore, Nathaniel R Meyer, Luke D Shelton, Elicza A Day, Carmela Marciano, Addison Gepfert, Connor C Wakefield, Hailey Brown, Sierra Street, Madeline M Sasse, Jacob Snyder, Taylor Hiland, Julia M Hum, David C Eland, Tien-Min Gabe Chu, Jonathan W Lowery","doi":"10.1515/jom-2024-0247","DOIUrl":"https://doi.org/10.1515/jom-2024-0247","url":null,"abstract":"<p><strong>Context: </strong>Sarcopenia is a disease characterized by low muscle mass and function that places individuals at greater risk of disability, loss of independence, and death. Current therapies include addressing underlying performance issues, resistance training, and/or nutritional strategies. However, these approaches have significant limitations, and chronic inflammation associated with sarcopenia may blunt the anabolic response to exercise and nutrition. This presents an unmet need for treatment strategies that promote gains in muscle function. One such possibility is soft tissue manipulation (STM), which is a noninvasive, nonpharmacological mechanotherapy employed by osteopathic physicians, physiotherapists, and massage therapists, wherein soft tissues are subjected to mechanical forces delivered by hand or by an instrument. However, the molecular effects of STM in sarcopenia remain largely unknown.</p><p><strong>Objectives: </strong>In the present study, we utilized a rat model of sarcopenia due to disuse atrophy and examined the effects of STM on recovery of muscle mass and regulation of pro-/anti-inflammatory cytokines.</p><p><strong>Methods: </strong>Ten-week-old male Brown Norway rats were subjected to 2-week hindlimb suspension (HLS) and then allowed to re-ambulate for 8 days with or without instrument-assisted soft tissue manipulation (IASTM) applied to the right hindlimb. Muscle weights were determined for treated and nontreated hindlimbs, and membrane-based cytokine arrays were performed on treated tissue and serum.</p><p><strong>Results: </strong>Following suspension, IASTM enhanced the effectiveness of re-ambulation (Re-A) on muscle mass recovery in both treated and contralateral limbs. This was associated with changes in numerous cytokines in treated skeletal muscle and sera. Several factors we observe to be regulated were also shown to be regulated by STM in other studies, including ciliary neurotrophic factor (CNTF), IL-1β, IL-2, IL-3, IL-13, ICAM-1, and tumor necrosis factor alpha (TNF-α), whereas others are reported for the first time.</p><p><strong>Conclusions: </strong>Our study adds further support for the role of manual therapy in musculoskeletal health and details molecular-level effects in both target tissue and circulation. STM may hold promise for recovering muscle mass and function related in conditions of atrophy such as age-related sarcopenia.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding COMLEX-USA Level-1 as a Pass/Fail examination: impact and opportunities.","authors":"Ashley Gerhardson, Melissa Efurd, Patricia Sexton, Donald Sefcik","doi":"10.1515/jom-2024-0139","DOIUrl":"https://doi.org/10.1515/jom-2024-0139","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Context: &lt;/strong&gt;In late 2020, the National Board of Osteopathic Medical Examiners (NBOME) announced that the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) Level 1 would discontinue reporting numeric scores, only providing a Pass/Fail designation. The National Board of Medical Examiners (NBME) changed the core reports for the United States Medical Licensing Examination (USMLE) Step-1 to Pass/Fail in early 2020. Subsequently, residency program directors were reported to migrate toward increased reliance on COMLEX-USA Level 2CE and USMLE Step 2CK scores, the prestige of medical schools, and the status of the authors of letters of reference during their review of residency applicants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Funded by an American Association of Colleges of Osteopathic Medicine (AACOM) research grant, A.T. Still University - Kirksville College of Osteopathic Medicine (ATSU-KCOM) and the Arkansas College of Osteopathic Medicine (ARCOM) generated a series of five hypotheses to investigate the perceived impact of the transition to Pass/Fail scoring.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Both institutional review boards (IRBs) provided exempt status for this study. The hypotheses were examined through surveys distributed to current osteopathic medical students (OMS), recent graduates (classes of 2021 and 2022), academic advisors, and college of osteopathic medicine (COM) curriculum committee members in this cohort study. The investigative process consisted of two surveys: an initial survey to collect data on all five hypotheses and a focused, follow-up survey designed to better understand the impact of the scoring change. The surveys collected respondent feedback based on a Likert Scale. Standard descriptive statistics were assembled and analyzed. Qualitative responses were coded into thematic elements to examine response patterns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The initial survey collected responses from 302 respondents (23.2 % response rate) based on a scale from 1 (strongly disagree) to 4 (strongly agree). The survey results revealed the means for the following items based on a 4-point Likert scale (1=Strongly Disagree; 2=Disagree; 3=Agree; 4=Strongly Agree): (1) Increase chances of matching into residency: 2.35; (2) Pass/Fail is a positive change: 2.71; (3) Pass/Fail will reduce competition in competitive residency programs: 1.94; (4) clinical skills will be more strongly considered: 2.60; and (5) new score reports provide a robust analysis of strengths and weaknesses in basic science: 2.24. Almost half (46 %) of the respondents expressed negative sentiments toward the Pass/Fail change. Reasons included more emphasis on COMLEX-USA Level 2CE, decreased motivation to perform on COMLEX-USA Level 1, and the perceived disadvantages that resulted during the residency match process.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Among the survey respondents, many, especially students, do not view the change as favorable. Respon","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a single osteopathic manipulative treatment on intraocular pressure reduction: a pilot study.","authors":"Hollis H King, Robert N Weinreb, Evan Walker, Linda M Zangwill","doi":"10.1515/jom-2024-0206","DOIUrl":"https://doi.org/10.1515/jom-2024-0206","url":null,"abstract":"<p><strong>Context: </strong>Research on the effects of osteopathic manipulative treatment (OMT) on visual functions and conditions is very limited. This study continues the exploration on the application of OMT with the intent of lowering intraocular pressure (IOP).</p><p><strong>Objectives: </strong>A pilot randomized clinical trial was conducted to assess the impact of one OMT session on patients diagnosed with suspected ocular hypertension (OHT) or glaucoma.</p><p><strong>Methods: </strong>Patients meeting the inclusion and exclusion criteria were randomized to OMT treatment or no-treatment control groups. Total n=16: treatment=9, control=7. The OMT included osteopathic cranial manipulative medicine (OCMM) along with myofascial release (MFR) and soft-tissue procedures. There were no adverse events reported in either cohort. Each patient was seen in AM and PM sessions for 5 days; the first 2 days established eligibility to be randomized to treatment or control cohorts after the Day 3 AM IOP assessment. Subjects in the control group laid on the treatment table with no OMT performed. Immediately after the intervention, the patient had a second Day 3 IOP assessment, then a PM IOP assessment. On Day 4, the patient received an AM and PM IOP assessment, and on Day 5, at the 1-week follow-up time period the patients again received AM and PM IOP assessments.</p><p><strong>Results: </strong>In the OMT treatment group, significant IOP reductions were detected posttreatment with differences between the Day 3 initial AM pre-randomization IOP level and the immediate postintervention IOP (p=0.027; -1.361 mmHg), the Day 4 PM (p=0.016; -1.556 mmHg), and the Day 5 PM (p=0.014; 1.382 mmHg).</p><p><strong>Conclusions: </strong>The application of OMT shows potential benefit in the reduction of IOP in patients with suspected OHT and patients with suspected glaucoma.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of osteopathic tests on heart rate and heart rate variability: an observational study on osteopathic students.","authors":"Flora Gillet, Mathilde Gault, Vincent Dussault, Saïda Cheggour, Marilyne Grinand, Pierrick Martinez","doi":"10.1515/jom-2024-0240","DOIUrl":"https://doi.org/10.1515/jom-2024-0240","url":null,"abstract":"<p><strong>Context: </strong>Osteopathic listening tests are diagnostic tools utilized in manual therapies, but their impact on physiological markers of the autonomic nervous system (ANS), such as heart rate (HR) and heart rate variability (HRV), remains unclear. This study examines these effects to clarify the role of listening tests within osteopathic practice.</p><p><strong>Objectives: </strong>This study aims to evaluate the influence of osteopathic listening tests on HR and HRV markers, including the root mean square of successive differences (rMSSD) and the low-frequency/high-frequency (LF/HF) ratio, in healthy participants, and to contextualize the findings within existing osteopathic research on ANS modulation.</p><p><strong>Methods: </strong>51 osteopathic students were randomized into three groups: (1) an osteopathic test group (OTG) receiving listening tests; (2) a light pressure group (LPG) experiencing non-therapeutic light pressure; and (3) a control group (CG) receiving no intervention. Measurements of HR, rMSSD, and LF/HF ratio were collected during the first and last 30 s of the protocol utilizing validated software. Data from 48 participants were analyzed after excluding artifacts.</p><p><strong>Results: </strong>No significant changes in HR, rMSSD, or LF/HF ratio were observed in any group during the protocol. For OTG, the HR changed minimally (69.17 ± 9.58 beats per minute [bpm] to 69.10 ± 10.24 bpm; p=0.884), while the rMSSD and LF/HF ratio also showed no significant alterations (p=0.064 and p=0.106, respectively). Similar null findings were observed in the LPG and CG, suggesting that neither osteopathic tests nor light pressure induced measurable effects on the ANS markers chosen.</p><p><strong>Conclusions: </strong>This study found no evidence that osteopathic listening tests influence HR or HRV markers in healthy participants. Although listening tests serve as diagnostic tools for identifying somatic dysfunctions, they do not appear to exert therapeutic effects on ANS regulation. These findings contrast with previous studies on osteopathic manipulative treatment (OMT), which have demonstrated significant modulation of ANS activity. Future studies should investigate the differential effects of diagnostic tests and therapeutic techniques to better define the scope of the osteopathic interventions.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal outcomes among patients with fibromyalgia, chronic widespread pain, or localized chronic low back pain.","authors":"John C Licciardone, Elizabeth Brownell, Uchechi Nwaichi, Arpan Patel, Khanh Do","doi":"10.1515/jom-2024-0087","DOIUrl":"https://doi.org/10.1515/jom-2024-0087","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to compare longitudinal outcomes of patients with FM, CWP, or localized chronic low back pain (LBP) to determine whether FM is an extreme manifestation of the CWP continuum.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted within a national pain research registry from August 2019 to July 2023. A total of 310 participants with FM (and CWP), CWP (without FM), or LBP were followed for 12 months to measure pain intensity, back-related disability, and health-related quality of life (HRQOL). Multivariable analyses were performed with generalized estimating equations (GEEs), including baseline and longitudinal covariates to adjust for potential confounding.</p><p><strong>Results: </strong>The mean age of the participants was 52.3 (standard deviation [SD], 13.6) years, and 238 (76.8 %) were female. There were 64 (20.6 %) participants with FM, 56 (18.1 %) with CWP, and 190 (61.3 %) with LBP. There were no differences in pain intensity among the groups. Compared with back-related disability in the LBP group (mean, 12,7; 95 % confidence interval [CI], 11.4-14.1), the FM group (mean, 15.3; 95 % CI, 13.7-17.0; p=0.006) and CWP group (mean, 16.2; 95 % CI, 14.8-17.7; p<0.001) had greater disability. There were no clinically relevant differences in pain and disability between the FM and CWP groups. Compared with the LBP group, the FM group had worse outcomes on five HRQOL scales, and the CWP group had worse outcomes on all seven scales. Clinically relevant HRQOL differences between the FM and CWP groups involved anxiety and depression, with results favoring the FM group.</p><p><strong>Conclusions: </strong>These findings do not support the view that FM is an extreme manifestation of the CWP continuum, involving greater pain, disability, or HRQOL deficits.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing intubation techniques of Klippel-Feil syndrome patients in the last 10 years: a systematic review.","authors":"Mitchell Fisher, Andrew Simonsen, Christopher Stewart, Salma Alkhatib, Abbigail Niewchas, Alex Otto, Randall Hansen, Kent McIntire, Suporn Sukpraprut-Braaten","doi":"10.1515/jom-2024-0136","DOIUrl":"https://doi.org/10.1515/jom-2024-0136","url":null,"abstract":"<p><strong>Context: </strong>Klippel-Feil syndrome (KFS) is a rare congenital abnormality characterized by cervical vertebral fusion. Patients typically present with a triad of short neck, low posterior hairline, and limited cervical range of motion. The location and quantity of vertebral fusions in KFS makes airway management challenging in the field of anesthesia. Anesthesiologists select intubation methods based on perceived difficulty, making this paper essential to the field.</p><p><strong>Objectives: </strong>The purpose of this study is to analyze first-attempt intubation success rates of KFS patients by intubation technique and stratified by location and quantity of cervical fusions and a Mallampati score if reported.</p><p><strong>Methods: </strong>This is a systematic review of all case reports on PubMed in the last 10 years utilizing the keywords \"KFS,\" and subsequently screened searching \"anesthesia\" and \"intubation.\" Examiners reviewed the remaining 27 articles for fusion abnormalities and intubation techniques utilized. The articles detail fiberoptic, direct, laryngeal mask airway (LMA), and video-guided intubation techniques, and the success rates were analyzed.</p><p><strong>Results: </strong>Of the 1234 KFS articles found, 657 were case reports with 157 being in the last 10 years. After review, 27 case reports presenting 30 cases were included. The average age reported was 25.4 ± 21.6 and 73.3 % were female. Direct (n=10), fiberoptic (n=12), video-guided (n=6), and LMA (n=2) were the chosen first-attempt intubation maneuvers. Fiberoptic and video-guided intubations reported 83 % success, while direct and LMA reported 50 % success. Higher success rates were found in patients with two cervical segment fusions (70 %) when compared to three or more fusions (33 %). Inferior vertebral fusions (C5-T1) reported higher success than midcervical fusions (C3-C5), 100 % and 33 %, respectively. Mallampati class 4 had the highest success (100 %), although further analysis showed fiberoptic intubation was utilized in each of these cases, skewing the data.</p><p><strong>Conclusions: </strong>Fiberoptic and video-guided intubation in KFS patients offers the highest success rates of intubation. There were limitations in this study due to the number of case reports available. Although there may be confounding variables to consider based on the case presentation and surgery performed, fiberoptic endotracheal intubation should be considered the gold standard when intubating KFS patients.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pioneering the future: incorporating lifestyle medicine tools in osteopathic medical education.","authors":"Shipra Bansal, Jay H Shubrook","doi":"10.1515/jom-2024-0121","DOIUrl":"https://doi.org/10.1515/jom-2024-0121","url":null,"abstract":"<p><p>The role of lifestyle has taken a renewed importance in disease prevention and chronic disease management. Osteopathic medicine has long focused on comprehensive, holistic care for our patients, and the tenets support the role of lifestyle medicine (LM) in osteopathic clinical care. In this commentary, the authors make the argument for incorporating LM more formally into the clinical curriculum at colleges of osteopathic medicine and will draw parallels with these two programs.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}