Learning Environment, Preparedness and Satisfaction in Osteopathy in Europe: The PreSS Study.

OBJECTIVE: 1) to assess the preparedness to practice and satisfaction in learning environment amongst new graduates from European osteopathic institutions; 2) to compare the results of preparedness to practice and satisfaction in learning environment between and within countries where osteopathy is regulated and where regulation is still to be achieved; 3) to identify possible correlations between learning environment and preparedness to practice. METHOD: Osteopathic education providers of full-time education located in Europe were enrolled, and their final year students were contacted to complete a survey. Measures used were: Dundee Ready Educational Environment Measure (DREEM), the Association of American Medical Colleges (AAMC) and a demographic questionnaire. Scores were compared across institutions using one-way ANOVA and generalised linear model. RESULTS: Nine European osteopathic education institutions participated in the study (4 located in Italy, 2 in the UK, 1 in France, 1 in Belgium and 1 in the Netherlands) and 243 (77%) of their final-year students completed the survey. The DREEM total score mean was 121.4 (SEM: 1.66) whilst the AAMC was 17.58 (SEM:0.35). A generalised linear model found a significant association between not-regulated countries and total score as well as subscales DREEM scores (p<0.001). Learning environment and preparedness to practice were significantly positively correlated (r=0.76; p<0.01). DISCUSSION: A perceived higher level of preparedness and satisfaction was found amongst students from osteopathic institutions located in countries without regulation compared to those located in countries where osteopathy is regulated; however, all institutions obtained a 'more positive than negative' result. Moreover, in general, cohorts with fewer than 20 students scored significantly higher compared to larger student cohorts. Finally, an overall positive correlation between students' preparedness and satisfaction were found across all institutions recruited.

A randomized control trial on the effectiveness of osteopathic manipulative treatment in reducing pain and improving the quality of life in elderly patients affected by osteoporosis.

INTRODUCTION: In the elderly population, a decrease in bone mineral density (osteoporosis) is often associated with a decrease in quality of life and an increase in self reported body pain. This pain originates from the musculoskeletal system and can potentially affect different areas of the body. AIM: The aim of this study was to investigate the effect of osteopathic manipulative treatment (OMT) on self reported pain and quality of life in an elderly population. DESIGN: Randomized placebo controlled trial. METHODS: Patients were recruited from the Geriatric Department, Bassini Hospital (Milan, Italy). Patients were randomly assigned to either 6 sessions of OMT (n = 37 patients) or an equivalent number of sham manipulative treatment (SMT) (n = 35 patients). The main outcome variables were QOL measured by QUALEFFO -41 and overall bodily pain measured using a visual analog scale (VAS). Data were analyzed using a two factor ANOVA (treatment × time) for repeated measurements with an α level set at p ≤ 0.05. RESULTS: Main result of this study was that OMT compared to SMT showed a significant decreased of disability. This effect was demonstrated by a significant interaction in the overall disability score (p =0.001) and the Mental wellbeing (p =0.058), Health perception (p =0.005) and Pain (p =0.003) QUALEFFO -41 subscales, while no significant difference (no interaction) for pain as measured by VAS and for the Daily activities, Walking, Household cleaning and Leisure time activities QUALEFFO -41 subscales (p > 0.05) was found. No adverse effects were recorded during the study. DISCUSSION: This study demonstrated that, in a group of elderly subjects affected by osteoporosis OMT was able to increase self reported QOL while the effect on body pain perception is unclear. This overall improvement in QOL appears to be caused by an improvement in psychological factors (i.e Mental wellbeing and Health perception) rather than physical factors. In fact, all QUALEFFO -41 subscales related to physical function demonstrated no significant interaction. The effect of OMT on Pain perception is less clear. In fact, there was no effect on pain as assessed by VAS while a significant improvement was observed when the QUALEFFO -41 subscale was used. This could be due to the metric properties of the two pain measurement methods; an alternative explanation could be that VAS measures mainly pain quantity while QUA-LEFFO -41 subscales measures mainly pain quality. The lack of effect of OMT on physical function needs to be confirmed by more direct measurements of this variable.