Osteopathic Manipulative Treatment for the Management of Adjacent Segment Pathology.

Adjacent segment pathology is an adverse effect of spinal fusion that precipitates accelerated spinal degenerative changes at vertebral segments contiguous with the fused vertebrae. The accelerated degeneration related to ASP can be challenging to manage, as it can lead to conditions such as radiculopathy and can create the need for reoperation. In the present case, a 50-year-old woman with a previous spinal fusion presented with a 1-year history of progressive low back pain, lumbar radiculopathy, and sciatica. Osteopathic manipulative treatment was used to manage her pain, and the patient reported that the treatment provided long-term resolution of her sciatica symptoms. This case demonstrates an effective use of osteopathic manipulative treatment in the conservative management of lumbar radiculopathy related to adjacent segment pathology.

Effect of a Mandatory Third-Year Osteopathic Manipulative Treatment Course on Student Attitudes.

CONTEXT: Despite interest by osteopathic medical students in learning and incorporating osteopathic manipulative treatment (OMT) techniques into their future practices, most students indicate that OMT is rarely or never taught during many clinical rotations. OBJECTIVE: To determine whether a mandatory OMT course taken during the third year of medical school would influence students' exposure to OMT, confidence in OMT, intent to continue developing OMT skills, and plan to provide OMT as practicing physicians. METHODS: A mandatory pilot OMT course was implemented in the 2014 third-year curriculum. A survey was then developed to assess students' attitudes toward OMT. Surveys were administered to students whose third year was in 2013 and thus had not taken the course (group 1) and to students who had taken the course in 2014 (group 2). RESULTS: Of the 223 students in group 1, 143 (64%) responded. Of the 213 students in group 2, 112 (53%) responded. Students in group 2 reported greater exposure to OMT compared with students in group 1, higher confidence levels in practicing OMT (61 [54%] vs 71 [50%]), greater intent to continue developing OMT skills, and plan to provide OMT as practicing physicians (91 [81%] vs 94 [66%]). CONCLUSION: A pilot course in OMT increased students' levels of confidence in and intent to provide OMT in their future practices.

Predictive relationship of osteopathic manual medicine grades and COMLEX-USA Level 1 total scores and osteopathic principles and practice subscores.

CONTEXT: Osteopathic manual medicine (OMM) encompasses hands-on diagnosis and treatment as part of patient care. The area of osteopathic principles and practice (OPP) is considered a core competency for students and practitioners of this medical tradition. The Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) is a useful tool for assessing candidates' competency. OBJECTIVES: To examine the relationship of COMLEX-USA Level 1 total scores and OPP subscores with OMM course grades, and to determine if these grades are predictive of COMLEX-USA Level 1 OPP performance. METHODS: The authors collected data-COMLEX-USA Level 1 total and OPP subscores, OMM grades (written, practical, and total for first and second academic years), sex, and age-for a cohort of osteopathic medical students at a single institution, and these data were then analyzed by means of correlation analysis. RESULTS: Records were obtained from a second-year class of osteopathic medical students (N=217). The authors' analysis of total scores and OPP subscores on COMLEX-USA Level 1 yielded a statistically significant correlation with all variables. Although the correlations were moderate, second-year written examination grades showed the strongest association with the COMLEX-USA Level 1 OPP subscores (r=0.530) and total scores (r=0.566). CONCLUSION: Performance in the second-year OMM written examination could identify students potentially at risk for poor performance on COMLEX-USA Level 1.