Post-surgical Median Arcuate Ligament Syndrome (MALS) Symptom Exacerbation Treated With Osteopathic Manipulative Treatment (OMT): A Case Report.

Median arcuate ligament syndrome (MALS, also known as celiac artery compression syndrome, celiac axis syndrome, celiac trunk compression syndrome, Dunbar syndrome, or Harjola-Marable syndrome) is a rare condition characterized by abdominal pain attributed to the compression of the celiac artery and celiac ganglia by the median arcuate ligament. Pain can occur post-prandially and may be accompanied by weight loss, nausea, or vomiting. Following angiographic diagnosis, current definitive treatment may include open or laparoscopic decompression surgery with celiac ganglion removal (if affected), which has been found to provide relief. In this case report, we outline a young female patient with a MALS diagnosis and subsequent surgery, but whose pain recurred in various stress-related instances even after surgical intervention. After a particular pain episode, osteopathic manipulative treatment (OMT) was applied, with a focus on restoring autonomic balance through the use of various gentle osteopathic treatment techniques. A significant reduction in pain was reported post-treatment, followed by complete pain resolution, indicating a great benefit to the incorporation of OMT into the treatment plan of MALS patients in future osteopathic practice.

Manual Therapy of Dysphagia in a Patient with Amyotrophic Lateral Sclerosis: A Case Report.

Amyotrophic lateral sclerosis (ALS) is an incurable rare neurodegenerative condition, with 45% of cases showing the symptom of dysphagia; its clinical signs are atrophy, weakness, and fasciculations of the facial muscles, tongue, and pharynx. Furthermore, dysphagia is the main cause of aspiration pneumonia. The traditional treatment for dysphagia varies based on the patient's difficulty of swallowing. The initial phase consists of dietary consistency adjustments, progressing to alternatives like nasogastric tubes or percutaneous endoscopic gastrostomy (PEG) in advanced stages. Osteopathic manipulative treatment (OMT) is a complementary 'hands-on' approach that has already shown positive results as an add-on therapy in various health conditions. This study is a case report of a man diagnosed with ALS with initial dysphagia, managed with a protocol that extraordinarily included OMT. The patient showed somatic dysfunctions in the mediastinal region, upper cervical region, and occipital area which are all anatomically related to the nervous system, especially the glossopharyngeal reflex. At the end of the rehabilitation protocol, there was a reduction in the swallowing problems measured with Strand Scale and swallowing tests, and the patient reported an improved psycho-physical well-being assessed with the Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ-40). Instead, the neurological function measured with ALSFRS-S remained stable. Although the nature of this study design prevents any causal assumption, the positive results should lead to future randomized controlled trials to assess the effectiveness of OMT as an adjunctive therapeutic proposal to improve the health of ALS patients.

Abstracts From the First Annual Research Day Hosted by the Michigan State University College of Osteopathic Medicine, Novi, Michigan, May 15, 2023.

The Spartan Medical Research Journal (SMRJ) is pleased to publish abstracts from the First Annual Research Day hosted by the Michigan State University College of Osteopathic Medicine (MSUCOM), held in Novi, Michigan, on May 15, 2023. Sponsored by MSUCOM, the Statewide Campus System (SCS), and Research, Innovation, and Scholarly Engagement (RISE), this event showcased a total of 139 selected research abstracts following a meticulous blinded review by the MSUCOM Research Day Planning Committee and SMRJ editorial staff. These abstracts were subsequently presented at the MSUCOM First Annual Research Day in 2023, with awards for exceptional oral and poster presentations conferred on May 15, 2023. Of the 139 presentations that were ultimately chosen, 45 authors consented and elected to have their abstracts published in SMRJ. The abstracts from 2023 encompass a wide array of contemporary medical and clinical subjects, incorporating a variety of research designs that cover basic science, clinical research, case reports, medical education, and quality improvement. While abstracts offer concise overview of research projects or presentations, they do not permit a comprehensive evaluation of the scientific rigor employed in the respective works. Although these abstracts offer preliminary results that may necessitate further refinement and validation, they serve a vital function in disseminating novel research concepts and advancements in the discipline of medicine. This knowledge-sharing promotes meaningful dialogue among researchers, clinicians, and educators, thereby making a valuable contribution to the collective body of knowledge in the fields of medical sciences and osteopathic medicine. Andrea Amalfitano, DO, PhD Osteopathic Heritage Foundation Professor of Pediatrics, Microbiology and Molecular Genetics Professor, BioMolecular Science Gateway Editor-in-Chief, Spartan Medical Research Journal (SMRJ) MSU College of Osteopathic Medicine- Statewide Campus System C. Patricia Obando S., PhD Associate Dean and DIO, Graduate Medical Education Associate Professor- MSU College of Osteopathic Medicine- Statewide Campus System Rana Ismail, PhD, MSc, CPHQ Director of Research Editor, Spartan Medical Research Journal (SMRJ) MSU College of Osteopathic Medicine- Statewide Campus System Francis Akenami, BMLS, PhD, MSc, FIMLS Managing Editor Spartan Medical Research Journal (SMRJ) MSU College of Osteopathic Medicine- Statewide Campus System.

Use of Osteopathic Manipulative Treatment for the Management of Pectus Excavatum: A Single Case Study.

Pectus excavatum (PE) is a congenital defect that presents with an anterior depression of the chest wall, which can impact cardiopulmonary function. A 25-year-old hypermobile male presented with a history of PE and chronic dyspnea on exertion, chronic cough, and intermittent chest wall pain. This study explores osteopathic manipulative treatment (OMT) as a possible alternative to improve symptoms associated with PE. Osteopathic structural exam (OSE), volumetric measurements of the thoracic cavity, vitals, and pulmonary function tests were evaluated at baseline and after OMT. The patient was treated with 14 weeks of weekly OMT for his exertional dyspnea, cough, and chest wall pain. Somatic dysfunctions were addressed through OMT, which all improved by the end of the 14-week treatment. Notably, the excursion at the sternal angle increased by threefold after complete treatment. The patient reported subjective improvement in all symptoms, with durable improvement in chest wall pain at 10 months after cessation of treatment. The application of OMT can help alleviate symptoms of pectus excavatum and aid in the management of patients who have not received surgical interventions.

Role of Sport Vision in Performance: Systematic Review.

Sport Vision is a speciality of multidisciplinary interest aimed at improving the performance of the visual system to achieve benefits in practiced sports, as well as in daily life and in preventive care. The type of training practiced by the athlete, his or her physical condition, cognitive level, and level of fatigue condition affects the speed of the reaction time and, consequently, the speed of motor response. Specific orthoptic exercises, the use of technological devices, the recovery of static and dynamic postural stability by using unstable platforms and the dual-task paradigm can help to achieve the expected results. The aim of this systematic review of Sport Vision was to assess the overall existing literature on Sport Vision, paying particular attention to the effects of visual training and its application in different sports and in rehabilitation and preventive settings. We analysed published English language studies about the role of sport vision in athletic performance from 1950 to 2023. We searched through the Medline database. The PRISMA 2020 checklist was used to assess the transparency and reproducibility of this review. The enrolled papers were evaluated with the Jadad Scale, Amstar 2 Scale and Newcastle-Ottawa Scale. 25 (16 studies, 5 reviews, 2 comments, 1 editorial, 1 descriptive paper) out of 476 studies met the inclusion criteria. Due to the variability in the age of the samples, the different techniques, the treatments among the participants in the studies and the finding of non-evaluable articles, a meta-analysis was not conducted. The limitations of this review are the single database research, the studies analyzed contain a non-statistically representative sample size and the lack of a control group. There is no standardized test to measure performance. It was shown that the development of visual skills can benefit athletes in injury prevention, and can lead to improved sports performance and motor function at any age, acquiring adaptive motor behaviour even when the visual system is impaired, due to task repetition and familiarity of the gesture. We intended to identify a multidisciplinary approach and a manual treatment scheme to optimize the circuitry involved in sport vision in order to increase the results that are achieved, but further studies will be needed to this end.

Professional Development and Scholarly Activity Weeks to Enhance the Master Adaptive Learner and Foster Future Educators.

One osteopathic medical school designated 4 weeks per year in the first-year curriculum to Professional Development and Scholarly Activity. The aim of these weeks is to foster the development of Master Adaptive Learners. This metacognitive learning theory promotes adaptive expertise which supports students as educators in a variety of settings.

Epistemological Flexibility in Person-Centered Care: The Cynefin Framework for (Re)Integrating Indigenous Body Representations in Manual Therapy.

BACKGROUND: Chiropractic, osteopathy, and physiotherapy (COP) professionals regulated outside the United States traditionally incorporate hands-on procedures aligned with their historical principles to guide patient care. However, some authors in COP research advocate a pan-professional, evidence-informed, patient-centered approach to musculoskeletal care, emphasizing hands-off management of patients through education and exercise therapy. The extent to which non-Western sociocultural beliefs about body representations in health and disease, including Indigenous beliefs, could influence the patient-practitioner dyad and affect the interpretation of pillars of evidence-informed practice, such as patient-centered care and patient expectations, remains unknown. METHODS: our perspective paper combines the best available evidence with expert insights and unique viewpoints to address gaps in the scientific literature and inform an interdisciplinary readership. RESULTS: A COP pan-professional approach tends to marginalize approaches, such as prevention-oriented clinical scenarios traditionally advocated by osteopathic practitioners for patients with non-Western sociocultural health assumptions. The Cynefin framework was introduced as a decision-making tool to aid clinicians in managing complex clinical scenarios and promoting evidence-informed, patient-centered, and culturally sensitive care. CONCLUSION: Epistemological flexibility is historically rooted in osteopathic care, due to his Indigenous roots. It is imperative to reintroduce conceptual and operative clinical frameworks that better address contemporary health needs, promote inclusion and equality in healthcare, and enhance the quality of manual therapy services beyond COP's Western-centered perspective.

Community Health Benefits Through a Student-Run Nonprofit Pediatric Wellness Clinic.

Purpose Community screening programs have been in effect since they were utilized in the 19th century at county fairs. A free pediatric health screening program was created by an osteopathic medical school in South Carolina in collaboration with a pediatric dental outreach organization to engage the local underserved community and train community-minded medical professionals. This study sought to demonstrate the efficacy and need for a student-run monthly pediatric health screening program in an underserved pediatric demographic. Methods A retrospective study of preexisting de-identified data obtained from a student-run health screening program was analyzed to determine the efficacy of the screening program in detecting chronic health risk factors in children in an underserved population. Patients were recruited through a partnership with a free dental clinic for underserved and uninsured children. Patients who attended the clinic were offered the opportunity to have a free, comprehensive health assessment following their dental visit. The function of this program was unique in that uninsured, underserved patients were provided free dental care and a free health assessment. Pediatric patients were screened for basic health information such as weight, height, BMI, vision, cardiovascular health, hypertension, asthma (reported via questionnaire by either the parent or child when applicable), nutrition, and lead poisoning (via questionnaire). The program also offered families additional support by connecting them to local resources and answering any questions they had about their children's health. Data from 14 health screening events was collected for quality improvement and efficacy monitoring. Descriptive analyses were performed. Results and analysis The health screening program assessed 124 children between October 2021 and March 2023 over 14 health screening events. The patients ranged from one year old to 26 years old, with a mean age of 9.65 years. Patients were predominantly Hispanic (79.67%). About one-third (27.64%) of children who were screened had positive findings associated with increased risk for chronic disease. Nearly half (43.90%) of families that were screened requested further information on ways to obtain health insurance and regular primary care services (utilized Access Health). Of the one-third of children with positive risk factors, 12.20% reported positive findings associated with asthma. Of the patients with positive risk factors, 8.94% had vision abnormalities, most of whom had not been seen by an ophthalmologist. This preliminary analysis will be followed by a secondary analysis that further investigates patient demographics (primarily Hispanic) as well as age distribution across various risk factors. Conclusion This pediatric health screening program has demonstrated a basic level of efficacy by successfully identifying increased risk for chronic disease in the underserved pediatric population. The need for these screening events was highlighted by the identification of untreated positive findings.

The Effects of Osteopathic Manipulative Treatment (OMT) on Postoperative Length of Stay: A Meta-Analysis.

Osteopathic manipulative treatment (OMT) is a therapy used by osteopathic physicians in various medical settings. Postoperatively, OMT can be utilized to optimize the body's function and recovery. This meta-analysis examines the efficacy of OMT in reducing the length of postoperative hospital stays. Given the significant implications of prolonged hospitalization for both patients and healthcare resources, research strategies to safely shorten this period are crucial. This meta-analysis examined five select studies that measured the length of hospital stay in postoperative patients who received OMT compared with postoperative patients who did not. A random effects model was applied in our statistical analysis to account for heterogeneity due to variations in surgical procedures, hospitals, and patient populations. Individually, three studies reported statistically significant reductions in hospital stay for OMT patients, while two did not. This meta-analysis, comprising five studies and 519 patients, found a mean difference of -2.37 days in favor of OMT; however, this finding did not reach a statistical significance (P = 0.06). The substantial heterogeneity observed (heterogeneity tau2 = 6.75, chi2 = 34.6, df = 4, P < 0.00001, I2 = 88%) suggests that clinical dissimilarities among the five studies may have resulted in our inconclusive findings. While OMT shows promise in postoperative care, further research with standardized protocols and more homogenous patient populations is needed to assess its true impact.

Efficacy of Osteopathic Manipulative Treatment for Pain Reduction in Patients With Patellofemoral Pain Syndrome: A Meta-Analysis of Randomized Controlled Trials.

Patellofemoral pain syndrome (PFPS) is among the most common causes of musculoskeletal pain in the United States. It is defined as retropatellar or peripatellar pain that is reproduced with functional activities that load the patellofemoral joint in a flexed position, such as stair climbing or squatting. While it presents in both adolescents and adults, it is commonly found in physically active individuals, such as athletes and military recruits. Exploring the role of osteopathic manipulative treatment (OMT) in PFPS is of particular interest given the absence of a definitive treatment and the poor long-term prognosis associated with PFPS. This meta-analysis includes three studies exploring the use of OMT to reduce pain in patients suffering from PFPS and exploring the efficacy of OMT as a primary intervention. In these studies, pain assessments, pre-treatment, and post-treatment follow-up of at least 30 days were performed using a 10-cm visual analog scale (VAS). The mean difference in pain between OMT and no treatment (NT) groups using the random effects model was -3.95 (-6.39; -1.50) with a p<0.01, suggesting OMT resulted in significant knee pain reduction in those with PFPS. A measure of heterogeneity, known as I2, was found to be high at 97%, which suggests caution should be taken when interpreting the overall results. Given the lack of definitive treatment and the poor long-term prognosis for PFPS, the authors suggest OMT provides an effective option for pain relief in patients with PFPS. Further research is needed to provide results that may be more clinically applicable or valuably interpreted.

Comparison of the effects of abdominal massage and osteopathic manipulative treatment home program on constipation in children with cerebral palsy.

Background and Aim: The aim of this study is to compare the effects of osteopathic manipulative therapy home program (OMT-H) versus abdominal massage home program (AMHP) in treating constipation in children with cerebral palsy (CP). Methods: Twenty-nine children with CP with a mean age of 12.2 ± 3.76 years, who were constipated and were not on medication, were divided into three randomized groups: (i) control group (n = 10), (ii) AMHP (n = 10), and (iii) OMT-H (n = 9). In AMHP and OMT-H groups, treatment was applied as 20-min sessions every other day for 10 sessions for 3 weeks. Modified Constipation Assessment Scale (MCAS), Rome III criteria, and the Bristol Stool Form Scale (BSFS) were used for evaluation before treatment and once a week during treatment. Results: While there was no change in constipation symptoms in the control group, there was an improvement in constipation symptoms after treatment in the AMHP and OMT-H groups (AMHP, P = 0.003; OMT-H, P = 0.000014). While the treatment showed to be effective from the first week in the OMT-H group, the change in BSFS (P = 0.026) and MCAS sub-parameters was found to be superior. Conclusion: AMHP and OMT-H are effective and beneficial in treating constipation. In children with CP, OMT-H was found to be quicker and more successful compared with AMHP. The OMT-H can be effectively used in clinical practice in relieving constipation in CP.

A systematic review of manual therapy modalities and anxiety.

CONTEXT: Anxiety disorders have a far-reaching impact on society, with profound implications on both mental and physical health. In response, there is growing interest in manual therapy modalities, with emerging research suggesting their potential to alleviate related symptoms. OBJECTIVES: To establish a consensus regarding manual therapy modalities for addressing anxiety symptoms, a systematic review of current literature was conducted. METHODS: A literature search was conducted between May and August 2023, utilizing a systematic search on both PubMed and Google Scholar, adhering to the defined inclusion criteria. In addition, information was gathered utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Both authors (KLW and TH) conducted the literature review. The inclusion criteria include articles written in English, peer-reviewed, anxiety conditions documented, and manual therapy delivered by a respectfully qualified professional. Manual therapy modalities include massage therapy, osteopathic manipulative treatment (OMT), foot reflexology, acupressure, manual therapy, healing touch, therapeutic touch, and gentle touch. After initial data collection, both researchers independently screened articles utilizing two metrics: a level of evidence (LOE) table and a screening criterion incorporating unique elements from the search process. The quality of the included articles was assessed utilizing Strength of Recommendation Taxonomy (SORT). When reviewer discrepancies arose, authors reread full-text studies and discussed the inclusion and exclusion criteria to achieve consensus. RESULTS: The data searches identified 8,979 articles, with 239 articles remaining after duplicates and nonapplicable articles were removed. A total of 42 articles met the inclusion criteria, with only 40 articles able to be obtained for full-article review. After full review and the exclusion of articles with invalid author conclusions, meta-analysis, or systematic reviews, 34 articles were included in the review. All articles received an LOE rating of 2 or better and aligned with our specific screening criteria. Based on SORT, each modality was assigned a "B" rating. Among the included articles, n=27 demonstrated statistical significance in favor of manual therapy modalities as an anxiety treatment. The positive results for the aforementioned manual therapies on anxiety symptom improvement are shown: 15/18 (83 %) massage therapy, 2/6 (33 %) OMT, 5/5 (100 %) foot reflexology, 1/1 (100 %) acupressure, 1/1 (100 %) manual therapy, 0/2 (0 %) healing touch, 1/1 (100 %) therapeutic touch, and 1/1 (100 %) gentle touch. CONCLUSIONS: A pattern emerged, wherein individuals receiving manual therapy interventions displayed a statistically significant reduction in anxiety intensity. Considering the positive results, manual therapy should be considered an effective strategy for anxiety management.

Effects of a novel osteopathic visceral technique for the pancreas on pain and range of motion in a patient with neck pain: Case report.

INTRODUCTION: Neck pain is a leading cause of disability worldwide. Visceral referred pain is a common form of disease-induced pain, with visceral nociception being referred to somatic tissues. OBJECTIVE: The aim of this case report was to evaluate the immediate and long term effects of a novel osteopathic visceral technique (OVT) on pain and cervical range of motion (CROM) in a patient with nonspecific neck pain (NS-NP). METHOD: A case of a 47-year-old female suffering with NS-NP for four months. The patient had sought physiotherapy treatment several times, and occasionally used anti-inflammatory medication to relieve symptoms. The patient presented muscle cervical tenderness and hyperalgesia over the spinous processes of C3-C4 spinal segments with limited CROM. A novel osteopathic visceral manipulation (OVM) technique was applied in the epigastric region targeting the pancreas. Immediately after the treatment, the patient reported reduction in pain evaluated with the numerical evaluation scale (NRS), and a clinically significant increase in pressure pain threshold (PPT) in C3 spinous process. Improvement in CROM was also observed. The post-treatment improvements have been maintained at 1-month of follow-up assessment. CONCLUSION: A single OVT was effective in reducing cervical pain and increasing CROM in a patient with NS-NP caused by a viscerosomatic reflex. The results of this case study provides preliminary evidence that OVM can produce hypoalgesia in somatic tissues with segmentally related innervation. This finding encourages future research to gain a better understanding of the mechanisms of regional inhibitory interdependence involving the viscerosomatic reflexes of OVM.

Post-operative osteopathic manipulative treatment of Morel-Lavallee syndrome assessed using infrared thermal imaging: A case report.

INTRODUCTION: The Morel-Lavallee lesion (MLL) is a closed, degloving soft-tissue injury, wherein the skin and subcutaneous tissue are separated from the underlying fascia. This syndrome causes disruption of wound healing. Infrared thermography is a noninvasive and pain-free tool that can be used to evaluate scar and the influence of osteopathic manipulative treatment. OBJECTIVE: To evaluate the influence of post-operative osteopathic manipulative treatment (OMT) of Morel-Lavallee lesions (MLL). METHODS: During four osteopathic sessions on one volunteer patient, 28-year-old male, resulting in MLL of the left knee after motorcycle accident. The effects of OMT were assessed using an infrared thermal imaging camera and qualitative palpation examination of osteopathic dysfunction, scored on a scale of 1-4. RESULTS: and discussion: Both scar and peri-scar area temperatures increased after OMT. The difference in temperature between the scar and the peri-scar area decreased after OMT. Increase in temperature was greater when the OMT was applied around the scar than when applied at a distance from the scar site. The palpation score for dysfunction of the MLL scar site decreased from 4/4 to 2/4 after the final session. CONCLUSION: Several OMT sessions focusing on the MLL scar site appear necessary to obtain noteworthy results. OMT improved mobility and increased the temperature of the scar and the peri-scar area.

Osteopathic Manipulative Medicine and Disorders: An Overview of Peer-Reviewed Publications 2018-2022.

Context Osteopathic manipulative medicine (OMM) has been claimed to be effective in various human disorders and conditions. There have been many anecdotal claims to lend credence to the efficacy of this treatment modality. Recently, much work has been done in evidence-based, government-funded projects, and clinical trials in OMM research, and these studies have further demonstrated the efficacy of OMM as direct, integrated, or complementary mechanisms in treating various conditions. Objectives As the field of OMM research has grown significantly in the past few years, we set out to analyze the peer-reviewed publications on OMM in human disorders between January 2018 and December 2022. Methods We used keywords and terms which included "osteopath," "osteopathic," osteopathic manipulative medicine," "osteopathic manipulative treatment," and "disorder," to systematically sample two public databases, PubMed and Science Direct. After the first query was recorded, we then applied more specific and stringent criteria to identify publications that (a) were written in English, (b) contained at least one human disorder/condition treated by OMM, (c) were co-authored by at least one osteopathic physician-scientist, and (d) contained at least one OMM technique. Results Our initial sampling of databases resulted in 404 publications. After applying our screening criteria, we identified and analyzed 249 (62%; 249/404) qualified publications in "OMM and Human Disorders" We then categorized them into (a) types of publications, (b) country origins of corresponding author(s), (c) groups of disorder and condition, (d) classification of the OMM used, and (e) relating the treated conditions with the five models of OMM. We found that in the 249 publications, 158 (63%) are research articles, 66 (27%) review papers, and 25 (10%) case reports. In addition, nine countries, the United States, Italy, Brazil, Spain, France, Germany, Canada, the United Kingdom (UK), and Australia contributed most of the publications of OMM. VOSviewer analysis identified a wide range of human disorders that were effectively treated with OMM. These included musculoskeletal, low back pain, neurological, headache, inflammation (including autoimmune conditions, COVID-19, lymphatic drainage), neonate/preterm infant disorders, anxiety, and dizziness. Conclusions Our comprehensive analysis showed that there has been a significant increase in peer-reviewed OMM publications in recent years, led by the United States osteopathic physician-scientists and European osteopathic scientists. OMM was found effective in treating not only common conditions such as pneumonia, low back pain, and musculoskeletal disorders, but also disorders such as inflammation, dizziness, headache, anxiety, and neonate/preterm infant disorders.

Chronic E. Coli Drug-Resistant Cystitis Treated with a Sequence of Modulated Extremely Low-Frequency Electromagnetic Fields: A Randomized Study of 148 Cases.

(1) Background: This study investigated the effects of sequenced electromagnetic fields, modulated at extremely low frequencies and intensities, in the treatment of drug-resistant Escherichia coli (E. coli)-induced chronic bacterial cystitis. (2) Methods: A total of 148 female participants, aged 18 to 80 years diagnosed with chronic bacterial cystitis caused by drug-resistant E. coli, were recruited for this study. Participants were randomly assigned to two groups: an experimental group (n = 74) with osteopathic palpation and assessment treated with a sequence of electromagnetic fields, and a control group (n = 74) receiving a placebo treatment. Both groups were assessed at this study's outset, 4 weeks after eight applications, and at 12 weeks for symptomatic presentation and laboratory parameters. (3) Results: After 4 weeks of treatment, a significant difference was observed between the two groups regarding D-DIMER levels, IL-6 levels, erythrocyte levels, leukocyte levels, and E. coli levels (p < 0.001). By the 12th week, the experimental group continued to exhibit a significant reduction in the examined parameters compared to the control group (p < 0.001). Additionally, the treatment did not induce any side effects in the patients in the experimental group. (4) Conclusions: Treatment with coherently sequenced electromagnetic fields, modulated at an extremely low frequency and intensity, not only appears to provide an effective alternative for the symptoms of chronic bacterial cystitis caused by drug-resistant E. coli but also demonstrates a potent antibacterial effect.

Implementing PathElective as an organized means of supplementing pathology education in an osteopathic medical school-the New York Institute of Technology College of Osteopathic Medicine experience.

Pathology is not traditionally chosen by medical students applying to residency. In osteopathic medical schools, limited access to dedicated pathology faculty further complicates this issue. Because of a lack of pathology experiences, osteopathic medical students may not be as familiar with a pathology career. The purpose of this brief report is to describe the pilot experience of implementing a pre-existing web-based, free virtual platform for pathology education as alternative, supplemental exposure to pathology for osteopathic medical students at our institution. We began to offer the online pathology elective for Academic Year 2022-2023. Using the online free service of PathElective, this course provided a valuable exposure to pathology with multiple modules in anatomic, clinical, and digital/molecular pathology, before and after assessments, recorded videos by pathology experts, handouts, and reading assignments. During the first week, three introductory modules were required followed by weeks 2-4, in which the students would complete a total of 10 modules of their own choice. In total, 14 students participated in this virtual rotation from August 2022-May 2023. All chose cardiac pathology as the most popular module. Three of the 14 students matched into pathology residencies. This small cohort of 4th year medical students at our osteopathic medical school successfully completed a virtual elective rotation with the resources of PathElective. We report the success of this experience and hope to continue monitoring progress.

How do Australian osteopaths manage migraines? Outcomes from a national practice-based research network.

BACKGROUND: Individuals who experience migraines often seek out a variety of treatment options including manual or physical therapy. Evidence suggests that manual therapy, including osteopathy, can play a role in the management of migraines. Whilst there is some literature on the role osteopathy therapy plays in migraine management, none describes the treatment approaches used by practitioners. OBJECTIVES: To explore the demographic, practice and clinical management characteristics of Australian osteopaths who report treating migraine 'often' in clinical practice. METHODS: Secondary analysis of a cross-sectional survey of 988 osteopaths from the Osteopathy Research and Innovation Network (ORION), an Australian practice-based research network. Regression analysis was used to identify demographic, practice and clinical management characteristics of Australian osteopaths who reported 'often' treating migraine patients. RESULTS: Over 40% of respondents (n = 400) indicated treating patients with migraines 'often'. These osteopaths were less likely to be involved in research and be co-located with a dietician compared to osteopaths who do 'not often' treat migraine. Osteopaths who reported 'often' treating migraine were: five times as likely to treat non-English speaking ethnic groups; 2.5 times as likely to treat chronic pain, temporomandibular joint disorders and hand musculoskeletal complaints; compared to those that do not treat migraines 'often'. CONCLUSION: Australian osteopaths who treat migraine are five times more likely to treat non-English speaking ethnic groups; twice as likely to treat chronic pain; temporomandibular joint disorders, and hand musculoskeletal complaints. More research is needed to identify the practices and patient outcomes associated with osteopathy care for those experiencing migraines.

Effect of manual manipulation on mechanical gait parameters.

CONTEXT: A variety of manual manipulation techniques are utilized in clinical practice to alleviate pain and improve musculoskeletal function. Many manual practitioners analyze gait patterns and asymmetries in their assessment of the patient, and an increasing number of gait motion capture studies are taking place with recent improvements in motion capture technology. This study is the first systematic review of whether these manual modalities have been shown to produce an objectively measurable change in gait mechanics. OBJECTIVES: This study was designed to perform a systematic review of the literature to assess the impact of manual medicine modalities on biomechanical parameters of gait. METHODS: A master search term composed of keywords and Medical Subject Headings (MeSH) search terms from an initial scan of relevant articles was utilized to search six databases. We screened the titles and abstracts of the resulting papers for relevance and then assessed their quality with the Cochrane Risk of Bias Tool. Clinical trials that featured both a manual manipulation intervention and multiple mechanical gait parameters were included. Case reports and other studies that only measured gait speed or other subjective measures of mobility were excluded. RESULTS: We included 20 studies in our final analysis. They utilize manipulation techniques primarily from osteopathic, chiropractic, massage, and physiotherapy backgrounds. The conditions studied primarily included problems with the back, knee, and ankle, as well as healthy patients and Parkinson's patients. Control groups were highly variable, if not absent. Most studies measured their gait parameters utilizing either multicamera motion capture systems or force platforms. CONCLUSIONS: Twelve of 20 papers included in the final analysis demonstrated a significant effect of manipulation on gait variables, many of which included either step length, walking speed, or sagittal range of motion (ROM) in joints of the lower extremity. However, the results and study design are too heterogeneous to draw robust conclusions from these studies as a whole. While there are initial indications that certain modalities may yield a change in certain gait parameters, the quality of evidence is low and there is insufficient evidence to conclude that manual therapies induce changes in biomechanical gait parameters. Studies are heterogeneous with respect to the populations studied and the interventions performed. Comparators were variable or absent across the studies, as were the outcome variables measured. More could be learned in the future with consistent methodology around blinding and sham treatment, and if the gait parameters measured were standardized and of a more robust clinical significance.

Effect of physiotherapy on infertility treatment in polycystic ovary syndrome patients.

Introduction: Polycystic ovary syndrome (PCOS) is a complex hormonal condition associated with psychological, reproductive, and metabolic features. Low-grade inflammation is a recognised factor causing metabolic and reproductive disorders in PCOS, which is why anti-inflammation approaches in PCOS treatment, especially during the COVID pandemic, are considered. A promising therapeutic option is osteopathic manipulative treatment (OMT), which activates the cholinergic anti-inflammatory pathway and can inhibit proinflammatory cytokines, such as TNF, IL-1ß, and TNF-ß. In our paper we analysed the influence of OMT in women with PCOS. Material and methods: Seventy-three patients, aged 29-46 years, with a history of reproductive failure, who underwent a physiotherapeutic treatment were evaluated. Six months after the end of a physiotherapy session, a follow-up questionnaire was performed. Results: The results show that most women (83.6%) were satisfied with the therapeutic process, and that the sessions met the patient's expectations. Reducing the level of anxiety related to infertility treatment and pregnancy was declared by 60 (82.2%) women, an improvement in well-being was declared by 72 (97.3%) (p = 0.04), and increasing awareness of the body after physiotherapy sessions was declared by 70 (95.9%) women. Conclusions: The physiotherapeutic sessions improved infertility treatment, enhanced quality of life, and had a positive effect on overall health in PCOS women.