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Osteopathic research: elephants, enigmas, and evidence.

Licciardone JC - Osteopath Med Prim Care (2007)

Bottom Line: The intersection of these fundamental aspects of osteopathic medicine suggests that the profession may successfully adopt a generic strategy of "focused differentiation" to attain a competitive advantage in the health care arena.The osteopathic profession should adopt a coherent strategy for developing and promoting its identity.Failure to do so will likely ensure that osteopathic medicine remains "stuck in the middle."

View Article: PubMed Central - HTML - PubMed

Affiliation: Osteopathic Research Center, University of North Texas Health Science Center-Texas College of Osteopathic Medicine, Fort Worth, TX 76107, USA. licciar@hsc.unt.edu

ABSTRACT

Background: The growth and acceptance of osteopathic physicians as conventional medical practitioners in the United States has also raised questions about the distinctive aspects of osteopathic medicine. Although the use of osteopathic manipulative treatment (OMT) and a focus on primary care are most often cited as rationales for the uniqueness of osteopathic medicine, an osteopathic professional identity remains enigmatic.

Discussion: The fledgling basic osteopathic research efforts of the early and mid-twentieth century have not been sustained and expanded over time. Thus, there is presently a scarcity of basic mechanistic and translational research that can be considered to be uniquely osteopathic. To be sure, there have been advances in osteopathic clinical trials, particularly those involving OMT for low back pain. Meta-analysis of these low back pain trials has provided evidence that: (1) OMT affords greater pain reduction than active or placebo control treatments; (2) the effects of OMT are comparable regardless of whether treatment is provided by fully-licensed osteopathic physicians in the United States or by osteopaths in the United Kingdom; and (3) the effects of OMT increase over time. However, much more clinical research remains to be done. The planning and implementation of a large longitudinal study of the natural history and epidemiology of somatic dysfunction, including an OMT component, represents a much-needed step forward. Osteopathic medicine's use of OMT and its focus on primary care are not mutually exclusive aspects of its uniqueness. The intersection of these fundamental aspects of osteopathic medicine suggests that the profession may successfully adopt a generic strategy of "focused differentiation" to attain a competitive advantage in the health care arena. While there are both requisite demands and risks for the osteopathic profession in adopting such a strategy, these are reasonable in relation to the potential rewards to be attained. To help promote an osteopathic identity, "omtology" and its derivative terms are recommended in referring to the study of OMT.

Conclusion: The osteopathic profession should adopt a coherent strategy for developing and promoting its identity. Failure to do so will likely ensure that osteopathic medicine remains "stuck in the middle."

No MeSH data available.


Related in: MedlinePlus

The burden of somatic dysfunction as a function of prevalence and severity. The anatomical regions are: C, cervical; H, head; L, lumbar; LLE, left lower extremity; LUE, left upper extremity; PI, pelvis/innominate; R, ribs; RLE, right lower extremity; RUE, right upper extremity; SP, sacrum/pelvis; T, thoracic.
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Figure 2: The burden of somatic dysfunction as a function of prevalence and severity. The anatomical regions are: C, cervical; H, head; L, lumbar; LLE, left lower extremity; LUE, left upper extremity; PI, pelvis/innominate; R, ribs; RLE, right lower extremity; RUE, right upper extremity; SP, sacrum/pelvis; T, thoracic.

Mentions: The foregoing discussion highlights the need for research on the natural history and epidemiology of somatic dysfunction. Relatively little research has been performed on this integral aspect of osteopathic theory and practice. A retrospective analysis of family medicine patients attending university-based clinics was recently performed to begin addressing this issue [3]. This study measured the burden of somatic dysfunction at various anatomical regions as a function of prevalence and severity. As shown in Figure 2, using cluster analysis, three distinct groups emerged: (1) "high prevalence of somatic dysfunction"; (2) "low prevalence of somatic dysfunction"; and (3) "low severity of somatic dysfunction." It should be emphasized that the prevalence and severity of somatic dysfunction and, consequently, the burden of somatic dysfunction will vary with the methodological rigor and clinical population of a given study.


Osteopathic research: elephants, enigmas, and evidence.

Licciardone JC - Osteopath Med Prim Care (2007)

The burden of somatic dysfunction as a function of prevalence and severity. The anatomical regions are: C, cervical; H, head; L, lumbar; LLE, left lower extremity; LUE, left upper extremity; PI, pelvis/innominate; R, ribs; RLE, right lower extremity; RUE, right upper extremity; SP, sacrum/pelvis; T, thoracic.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1808471&req=5

Figure 2: The burden of somatic dysfunction as a function of prevalence and severity. The anatomical regions are: C, cervical; H, head; L, lumbar; LLE, left lower extremity; LUE, left upper extremity; PI, pelvis/innominate; R, ribs; RLE, right lower extremity; RUE, right upper extremity; SP, sacrum/pelvis; T, thoracic.
Mentions: The foregoing discussion highlights the need for research on the natural history and epidemiology of somatic dysfunction. Relatively little research has been performed on this integral aspect of osteopathic theory and practice. A retrospective analysis of family medicine patients attending university-based clinics was recently performed to begin addressing this issue [3]. This study measured the burden of somatic dysfunction at various anatomical regions as a function of prevalence and severity. As shown in Figure 2, using cluster analysis, three distinct groups emerged: (1) "high prevalence of somatic dysfunction"; (2) "low prevalence of somatic dysfunction"; and (3) "low severity of somatic dysfunction." It should be emphasized that the prevalence and severity of somatic dysfunction and, consequently, the burden of somatic dysfunction will vary with the methodological rigor and clinical population of a given study.

Bottom Line: The intersection of these fundamental aspects of osteopathic medicine suggests that the profession may successfully adopt a generic strategy of "focused differentiation" to attain a competitive advantage in the health care arena.The osteopathic profession should adopt a coherent strategy for developing and promoting its identity.Failure to do so will likely ensure that osteopathic medicine remains "stuck in the middle."

View Article: PubMed Central - HTML - PubMed

Affiliation: Osteopathic Research Center, University of North Texas Health Science Center-Texas College of Osteopathic Medicine, Fort Worth, TX 76107, USA. licciar@hsc.unt.edu

ABSTRACT

Background: The growth and acceptance of osteopathic physicians as conventional medical practitioners in the United States has also raised questions about the distinctive aspects of osteopathic medicine. Although the use of osteopathic manipulative treatment (OMT) and a focus on primary care are most often cited as rationales for the uniqueness of osteopathic medicine, an osteopathic professional identity remains enigmatic.

Discussion: The fledgling basic osteopathic research efforts of the early and mid-twentieth century have not been sustained and expanded over time. Thus, there is presently a scarcity of basic mechanistic and translational research that can be considered to be uniquely osteopathic. To be sure, there have been advances in osteopathic clinical trials, particularly those involving OMT for low back pain. Meta-analysis of these low back pain trials has provided evidence that: (1) OMT affords greater pain reduction than active or placebo control treatments; (2) the effects of OMT are comparable regardless of whether treatment is provided by fully-licensed osteopathic physicians in the United States or by osteopaths in the United Kingdom; and (3) the effects of OMT increase over time. However, much more clinical research remains to be done. The planning and implementation of a large longitudinal study of the natural history and epidemiology of somatic dysfunction, including an OMT component, represents a much-needed step forward. Osteopathic medicine's use of OMT and its focus on primary care are not mutually exclusive aspects of its uniqueness. The intersection of these fundamental aspects of osteopathic medicine suggests that the profession may successfully adopt a generic strategy of "focused differentiation" to attain a competitive advantage in the health care arena. While there are both requisite demands and risks for the osteopathic profession in adopting such a strategy, these are reasonable in relation to the potential rewards to be attained. To help promote an osteopathic identity, "omtology" and its derivative terms are recommended in referring to the study of OMT.

Conclusion: The osteopathic profession should adopt a coherent strategy for developing and promoting its identity. Failure to do so will likely ensure that osteopathic medicine remains "stuck in the middle."

No MeSH data available.


Related in: MedlinePlus