International Journal of Osteopathic Medicine最新文献

{"title":"Work from home-related musculoskeletal pain during the COVID-19 pandemic: A rapid review","authors":"Ivan Neil Gomez ,&nbsp;Consuelo G. Suarez ,&nbsp;Ken Erbvin Sosa ,&nbsp;Maria Lourdes Tapang","doi":"10.1016/j.ijosm.2022.12.001","DOIUrl":"10.1016/j.ijosm.2022.12.001","url":null,"abstract":"<div><h3>Objective</h3><p>This rapid review explores the prevalence of musculoskeletal pain symptoms associated with work from home conditions during the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>We conducted a rapid review across three databases (i.e., PubMed, Medline, and CINAHL) for observational studies that report on the musculoskeletal functions among individuals placed in a work from home setup due to the COVID-19 pandemic, published between December 2019–August 2021. Two independent review authors searched, appraised, and extracted data from the articles included in the final review. A descriptive approach was used to synthesize the narrative evidence.</p></div><div><h3>Results</h3><p>Forty-four articles were initially identified. A total of six (n = 6) studies met the full inclusion criteria and were included. Among them, there were five cross-sectional studies and one case-control study. The highest prevalence reported were neck pain (20.3–76.9%), low back pain (19.5–74.1%), and shoulder pain (3.0–72.9%). The most common instrument used was the Nordic Musculoskeletal Questionnaire. One of the common professions that report musculoskeletal pain symptoms associated with work from home conditions were individuals working in the academic sector.</p></div><div><h3>Conclusion</h3><p>The increased prevalence of musculoskeletal pain symptoms associated with work from home conditions during the COVID-19 pandemic is a concern that should be addressed to prevent negative neuromusculoskeletal outcomes.</p></div><div><h3>Systematic review registration</h3><p>This review is in the Open Science Framework registry (osf.io/vxs4w) and the PROSPERO database (CRD42021266097).</p></div><div><h3>Implications for practice</h3><p></p><ul><li><span>•</span><span><p>A system in the workplace should be developed for the early detection of musculoskeletal pain.</p></span></li><li><span>•</span><span><p>Apart from standard occupational safety and proper ergonomic, sustainable policies and programs that address the mental health issues of employees should also be addressed.</p></span></li><li><span>•</span><span><p>Programs addressing musculoskeletal pain should be available online for employees to address accessibility and ubiquity.</p></span></li></ul></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9731643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10492806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of 3D digital applications in manual therapy education – A scoping review","authors":"Kesava Kovanur Sampath ,&nbsp;Ashokan Arumugam ,&nbsp;Gwendolen Jull","doi":"10.1016/j.ijosm.2022.10.007","DOIUrl":"https://doi.org/10.1016/j.ijosm.2022.10.007","url":null,"abstract":"<div><h3>Background</h3><p>Currently, teaching methods for developing physical assessment and palpation skills in manual therapy is challenging for both learners and educators. 3D digital technologies such as virtual reality (VR) may facilitate and/or address these challenges. However, their current usage in improving learning outcomes in manual therapy education is unknown.</p></div><div><h3>Methods</h3><p>The following electronic databases were searched from Jan 2005 to April 2021: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), Science Direct and Google Scholar. Two independent reviewers reviewed the articles to assess for eligibility. Studies of any methodology that investigated the use or application of the 3D digital applications were included in the review. Primary outcomes included any outcome related to learning based on the updated Blooms taxonomy. Narrative synthesis was used to synthesize data from the included studies.</p></div><div><h3>Results</h3><p>A total of 4 articles were included in the final review. The main findings were classified into the following key concepts: (1) perception of tissue stiffness, (2) improved student self-efficacy in performing MT techniques, and (3) barriers and facilitators for utilizing 3D technologies. All included outcomes met understanding, applying, analysing and evaluating levels of Blooms taxonomy; however, no outcomes met the ‘creating’ level of Bloom's taxonomy.</p></div><div><h3>Discussion</h3><p>Our review found that there are no AR, VR or mixed applications that specifically serve the needs of MT education in relation to joint motion assessment, but applications are available that can be readily used or potentially adapted to train skills of tissue palpation.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49899051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteopathic intervention for infants with breastfeeding difficulty: A retrospective case series","authors":"Kirsty Greenwood ,&nbsp;Roger Engel ,&nbsp;Sandra Grace","doi":"10.1016/j.ijosm.2022.11.005","DOIUrl":"https://doi.org/10.1016/j.ijosm.2022.11.005","url":null,"abstract":"<div><h3>Background</h3><p>The importance of breastfeeding and its effect on reducing the burden of disease is recognised globally. The physical aspect of successful breastfeeding is multifactorial and requires maternal comfort and confidence and an infant's ability to latch and maintain intra-oral sucking functions. Infants need to have sufficient function of their musculoskeletal system to maintain positioning and attachment.</p></div><div><h3>Objectives</h3><p>The primary aim was to investigate the effect of osteopathic intervention on mothers and infants with breastfeeding difficulty. The secondary aim was to record the musculoskeletal dysfunctions found in those infants.</p></div><div><h3>Design</h3><p>A retrospective case series of de-identified patient files.</p></div><div><h3>Setting</h3><p>Osteopathic private practice.</p></div><div><h3>Methods</h3><p>A Breastfeeding Self-Efficacy Scale and Visual Analogue Scale for maternal pain while feeding, ability to latch, ability to maintain latch and noise while feeding were completed before and after osteopathic intervention.</p></div><div><h3>Participants</h3><p>Eighteen mother-infant-dyad files were retrospectively reviewed.</p></div><div><h3>Results</h3><p>Following an average of five osteopathic treatments over 7.4 weeks, all 18 mother-infant-dyads noted improvement in breastfeeding confidence and/or improvements in the ability to latch and maintain latch, maternal pain at the breast and infant noise while feeding. The greatest improvements were seen in the seven mother-infant dyads identified at risk of ceasing breastfeeding at baseline (p=&lt;0.001).</p></div><div><h3>Conclusion</h3><p>This study provides evidence that osteopathic intervention may be capable of delivering benefits in breastfeeding confidence and function. Our results also indicate that osteopathic intervention may benefit mothers at risk of ceasing breastfeeding. Further research, including prospective clinical trials with a comparator group, is warranted.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49899055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the impact of a curriculum intervention using an assessment rubric for communication skill development of osteopathy students","authors":"Lee Muddle,&nbsp;Cindy J. O'Malley,&nbsp;Ieva Stupans","doi":"10.1016/j.ijosm.2022.12.003","DOIUrl":"https://doi.org/10.1016/j.ijosm.2022.12.003","url":null,"abstract":"<div><h3>Objective</h3><p>This paper investigates the impact of a spiral curriculum intervention using a validated assessment rubric for communication skill development of undergraduate osteopathy students.</p></div><div><h3>Method</h3><p>Over a three-year period, students from three cohorts were exposed to zero, one or two semesters of a newly integrated and scaffolded communication curriculum. Using a checklist rubric to collect mean scores and then undertaking comparisons through Pearson chi square analysis, the impact of the curriculum intervention on communication skill development was explored.</p></div><div><h3>Results</h3><p>Cohorts who received zero or two full semesters of communication curriculum performed better (x = 6.34, x = 10.51 respectively) than the cohort who received one (x = 6.03).</p></div><div><h3>Conclusion</h3><p>Despite using an explicit assessment rubric, insufficiently contextualised and integrated curriculum appears to disrupt student learning, whilst a spiralled, scaffolded curriculum delivered at an appropriate level in combination with explicit assessment rubrics work well together to support deeper learning and development.</p></div><div><h3>Implications for practice</h3><p>∙An insufficiently contextualised and integrated curriculum combined with the frequency of content being re-visited (spiral curriculum) can disrupt the students learning experience.</p><p>∙Using a spiralled and scaffolded curriculum significantly improves the development of communication skills.</p><p>∙For deeper learning to occur students require a combination of both explicit curriculum and accompanying assessment rubrics.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49899054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic and stabilization exercises after manual therapy in patients with non-specific chronic neck pain: A randomised clinical trial","authors":"Okan Demir ,&nbsp;Emine Atıcı ,&nbsp;Mustafa Savaş Torlak","doi":"10.1016/j.ijosm.2022.10.001","DOIUrl":"https://doi.org/10.1016/j.ijosm.2022.10.001","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to determine and compare the effects of therapeutic and stabilization exercises prescribed to patients after manual therapy sessions on pain, neck range of motion and disability.</p></div><div><h3>Methods</h3><p>Thirty patients with non-specific chronic neck pain were recruited. After the initial examination, one session of manual therapy was conducted. The examinations were repeated to assess the effect of manual therapy on pain intensity and neck range of motion. After manual therapy, patients were randomly allocated into two groups: stabilization exercise group (SEG) and therapeutic exercise group (2 days/week/6 week). Pain intensity was assessed using the visual analog scale. Joint movements assessed using goniometer and the lateral scapular shift test for scapular dyskinesia. In addition, disability status was assessed using a neck disability index.</p></div><div><h3>Results</h3><p>In all patients, manual therapy decreased pain intensity and increased joint movements (p &lt; 0.05). After 6 weeks of exercise therapy, pain intensity, neck flexion, extension, lateral flexion movement and disability improved in SEG (p &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>This study demonstrated that stabilization exercises combined with manual therapy had more positive effects among patients with non-specific chronic neck pain.</p></div><div><h3>Implications for practice</h3><p></p><ul><li><span>•</span><span><p>The treatment for non-specific chronic neck pain should be supported with exercises after manual therapy sessions for reducing neck pain.</p></span></li><li><span>•</span><span><p>Instead of therapeutic isometric exercises, which are often clinically prescribed as home exercises, stabilization exercises may be preferred as they are performed by maintaining the neutral position of the neck and include stretching.</p></span></li></ul></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49856432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communication strategies in psychologically informed osteopathic practice: A case report","authors":"Hilary Abbey","doi":"10.1016/j.ijosm.2022.10.009","DOIUrl":"https://doi.org/10.1016/j.ijosm.2022.10.009","url":null,"abstract":"<div><h3>Introduction</h3><p>This paper presents qualitative data from communication between an osteopath and patient participating in a research study to develop a new psychologically informed pain management course.</p></div><div><h3>Presentation</h3><p>‘Adam’, aged 49, presented with persistent pain and multiple health problems including HIV and depression. His aim in joining the study was to find ways to stay independent.</p></div><div><h3>Evaluation</h3><p>Existing osteopathic evaluations of musculoskeletal dysfunction were supported by psychological assessments of health beliefs and coping strategies.</p></div><div><h3>Intervention</h3><p>Psychological and mindfulness exercises were integrated into six osteopathic treatment sessions to support symptom relief, patient learning and self-management.</p></div><div><h3>Data analysis</h3><p>Audio-recordings were analysed qualitatively using Linguistic Ethnography.</p></div><div><h3>Outcomes</h3><p>Communication moved from ‘mechanistic’ pain discourses about diagnosis and structural damage towards ‘facilitative’ narratives involving shared sense-making about broader embodied experiences. Physical outcomes were similar to previous osteopathic treatment but with longer lasting effects due to more effective self-management, decreased fear-avoidance and increased physical activity.</p></div><div><h3>Conclusion</h3><p>This patient reported that a psychologically informed pain management course had increased his body awareness and ability to live well despite pain. Individual case findings are not generalisable, but these data appear to support an ecological-enactive model of osteopathic practice and suggest promising directions for future research.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49856441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scientometrics analysis and visualization of low back pain","authors":"Yongli Zuo ,&nbsp;Juntao Zhang ,&nbsp;Xiangyang Leng ,&nbsp;Yihua Fan ,&nbsp;Bifeng Fu ,&nbsp;Ping Wang","doi":"10.1016/j.ijosm.2022.12.002","DOIUrl":"https://doi.org/10.1016/j.ijosm.2022.12.002","url":null,"abstract":"<div><h3>Background</h3><p>Although low back pain (LBP) contributes to the global disease burden, literature on the scientometric analysis of low back pain is limited.</p></div><div><h3>Objective</h3><p>This study aimed to demonstrate the research state and capture developmental dynamics of low back pain utilizing scientometric analysis and visualization methods.</p></div><div><h3>Methods</h3><p>Literature on low back pain from 2011 to 2020 was retrieved from the Web of Science core collection. CiteSpace software was used to generate the relevant knowledge map and carry out scientometric analysis on the volume of literature, cooperation between countries/regions and research institutions, disciplines, journals, highly cited references, and keywords. Research hotspots and trends of the included literature were then stated.</p></div><div><h3>Results</h3><p>A total of 27,968 publications were obtained and the number of annual publications maintained growth continually. Australia and the University of Washington had the maximum centrality. The USA and the University of Sydney were the most prolific country and institution respectively, thus indicating that they are important in this field. Publications were devoted to the disciplines of neurology, orthopedics and rehabilitation. The highest cited journal is Spine (18478), followed by European Spine Journal (11344) and Pain (11097). The systematic review, disease burden, epidemiology, clinical practice recommendations, and primary care management are the key subjects covered by highly cited papers. The keywords were primarily concerned with pain etiology, disease type, clinical treatment, and trials. Burst keywords in LBP were controlled trial, practice guideline, stability, adolescent, individual, activation and expression, which can be regarded as research hotspots and frontiers.</p></div><div><h3>Conclusion</h3><p>In conclusion, the data clearly shows a consistent increase in LBP studies. The historical review provides insight into LBP as well as valuable information for researchers to identify new perspectives on potential cooperative institutions, hot topics, and a strong foundation for future research.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49899053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteopathic education: A scoping review protocol","authors":"A. MacMillan ,&nbsp;Jerry Draper-Rodi","doi":"10.1016/j.ijosm.2022.11.001","DOIUrl":"https://doi.org/10.1016/j.ijosm.2022.11.001","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this scoping review is to chart and appraise the available evidence regarding osteopathic education.</p></div><div><h3>Introduction</h3><p>The extent and quality of the evidence regarding osteopathic education is not known. The available evidence mostly consists of small trials, qualitative interviews, cross-sectional surveys and conceptual commentaries, therefore a review to chart and appraise the available evidence is warranted.</p></div><div><h3>Inclusion criteria</h3><p>The review is intended to include papers related to undergraduate, postgraduate and preregistration osteopathic education. Qualitative, quantitative, mixed methods and opinion pieces and grey literature will be sought. This review will exclude papers regarding education as a treatment modality and will exclude papers regarding osteopathy as a medical profession, as is seen in a North American context.</p></div><div><h3>Methods</h3><p>The study will be conducted using OVID, PubMed, ERIC databases, and hand searches for key words will be conducted in key osteopathic journals. Reference lists of included papers will be screened for relevant papers, forwards and backwards citation tracking and key authors will be searched for similar publications which may be germane.</p><p>Papers not available in English, French, Spanish, German or Portuguese will be excluded. There will be no limit placed upon date of publication.</p></div><div><h3>Implications for practice</h3><p></p><ul><li><span>•</span><span><p>This manuscript is the protocol for a systematic scoping review which is intended to answer the following questions:</p></span></li><li><span>•</span><span><p>What is the extent and nature of the existing evidence regarding osteopathic education?</p></span></li><li><span>•</span><span><p>Are there any elements of the literature which demonstrate good practice that can be adopted in wider osteopathic educational practice?</p></span></li><li><span>•</span><span><p>Are there any gaps within the evidence base which subsequent research can explore?</p></span></li><li><span>•</span><span><p>To date no systematic reviews have been conducted on this topic and this review will highlight the extent of the literature and guide future research priorities.</p></span></li></ul></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49899052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor, regarding: The role of 3D digital applications in manual therapy education – A scoping review","authors":"Chi Ngai Lo","doi":"10.1016/j.ijosm.2022.11.003","DOIUrl":"https://doi.org/10.1016/j.ijosm.2022.11.003","url":null,"abstract":"","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49899057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-rater reliability between osteopaths of differing clinical experience on sagittal plane running gait analysis: A pilot study","authors":"Nicholas Tripodi ,&nbsp;Thomas Dagiandis ,&nbsp;Ali Hameed ,&nbsp;Liam Heilberg ,&nbsp;Erick Olbinski ,&nbsp;Cameron Reid ,&nbsp;Alexander White ,&nbsp;Patrick McLaughlin","doi":"10.1016/j.ijosm.2022.11.006","DOIUrl":"https://doi.org/10.1016/j.ijosm.2022.11.006","url":null,"abstract":"<div><h3>Objective</h3><p>Clinical running analysis is commonly employed in the screening of running related injuries. Currently, there remains little research exploring the use of clinical running analysis within the osteopathic profession. Hence, the aim of this pilot study is to investigate the inter-rater reliability of sagittal plane visual gait observation amongst osteopathic practitioners.</p></div><div><h3>Methods</h3><p>Fourteen osteopaths were recruited through an online platform. Each participant completed five, 11-item gait analysis forms, with each form corresponding to a different running gait video recorded in the sagittal plane. Krippendorff's alpha (Kα) was calculated to determine the inter-rater reliability between all participants, and between groups based on years of clinical experience.</p></div><div><h3>Results</h3><p>Very low inter-rater reliability was found between all participants (Kα&lt;0.67) across all questions. Strong reliability was found for two questions answered by the 5–10 years’ experience group (Kα&lt;0.8155) with regard to foot strike in the runners.</p></div><div><h3>Discussion</h3><p>The poor inter-rater reliability found in this pilot study, is in disagreement with previous research that has identified high inter-rater reliability with practitioners of varied clinical experience on a similar gait analysis task. These discrepancies may be explained by a range of methodological differences and limitations, chiefly the sample size and the objective nature of the kinematic observation tasks.</p></div><div><h3>Conclusion</h3><p>The results of this pilot study indicate there is very low reliability between this group of clinicians interpretation of running gait. Building on from this, future research should investigate clinician inter-rater reliability using more objective gait analysis measures.</p></div>","PeriodicalId":51068,"journal":{"name":"International Journal of Osteopathic Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49899058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}