A prospective study of osteopathic medical students' attitudes toward use of osteopathic manipulative treatment in caring for patients.

Two computer-assisted clinical case SOAP (subjective, objective, assessment, plan) note exercises were used for second-year osteopathic medical students, and a standardized patient was used during third year to measure recording behaviors regarding structural examinations and osteopathic manipulative treatment (OMT). Students were questioned before leaving campus for clinical rotations and at pregraduation to determine their attitudes toward use of these skills. Ninety-one percent of the students recorded structural examination findings in both computer-assisted clinical case SOAP notes, and 61% suggested OMT be given on their basic science SOAP (pneumonia). All of the students in the osteopathic theory and methods exercise suggested OMT. On a standardized patient with chronic obstructive pulmonary disease, 11% of the students performed a structural examination, and 0.7% suggested OMT. Preclinically, 73% of the students believed they were prepared to conduct structural examinations, and 71% believed they were prepared to use OMT. Between 64% and 73% of pregraduation students, however, reported they had few opportunities to use these skills during clinical rotations. Most of the students believed they would use palpatory diagnosis and OMT for fewer than 25% of their future patients and primarily for patients with musculoskeletal problems.

Effects of osteopathic manipulative treatment and concentric and eccentric maximal-effort exercise on women with multiple sclerosis: a pilot study.

The research objectives of this study were to evaluate the effects of osteopathic manipulative treatment (OMT) combined with maximal-effort exercise (MEE) on strength, coordination, endurance, and fatigue in female patients with multiple sclerosis (MS). Seven female subjects with MS participated in the 12-week study, which included intervention with OMT and MEE twice per week. Standardized tests for progression of MS and fatigue were used. Strength (maximal effort and impulse) was measured with the IsoPump exercise machine (IsoPump USA, Cleveland, Miss) during the three phases of the exercise protocol. Significant changes occurred in all but one measure of strength and on the 25-foot walk (P < .05), but not on the block-and-box test. The change in fatigue scores was not significantly different. Findings indicate that OMT combined with MEE significantly increases strength and ambulatory levels while not increasing fatigue in female patients with MS who have low to medium impairment. Qualitative data show that this intervention also produces beneficial effects in activities of daily living.