The use of 3D printing for osteopathic medical education of rib disorders.

Context: With the advent of increasingly accessible three-dimensional (3D) printing, the possibility to efficiently design and generate prototype innovations is also increasing. This type of manufacturing can potentially enhance medical education by allowing design of models specific to osteopathic manipulative medicine (OMM). Objectives: To determine the viability of a 3D-printed mechanically moveable rib cage in enhancing the teaching of rib osteopathic principles. Methods: A single-blind, qualitative study was conducted to evaluate the use of educating students with this novel 3D-printed, movable rib model vs. a traditional static rib model. A total of 237 first-year medical students participated in the study and received the same standardized lecture on the rib dysfunction. Students were also assigned at random to either a comparison group, which would utilize the 3D printed rib model, or the control group, which would utilize the traditional static model. Students would also complete an entrance and exit surveys assessing subjective scores of overall student satisfaction and objective scores for knowledge of OMM rib dysfunction and treatment. An independent samples t-test was applied to assess potential differences between select student evaluation scores (those with continuous variables) of the rib model in the comparison and experiment groups. Chi-square goodness of fit test was conducted to determine if there were any significant differences in entry and exit survey responses between the two groups. Descriptive statistics of the mean and standard deviation were also reported. Results: For both comparison and control groups, the mean score on an 11-point scale for the evaluation question, "Please rank on a scale of 0-10 how helpful you thought the rib models were to your education," was 9.08 (SD, 1.397). Independent t-test results showed that the comparison group had higher scores than the control group when queried about whether they felt the model accurately depicted the material presented (comparison group mean, 9.55 [SD, 978] vs. control group mean, 9.06 [SD, 1.33; t(235) = 3.253; p=0.01). Chi-square test of goodness-of-fit showed that the differences between the number of correct answers chosen by participants for Item 3 (a case-based question asking students which rib they would treat for a patient presenting to an OMT clinic) was statistically significantly higher for the comparison group (51.9% correct in comparison group vs. 48.1% in control group), even though both groups scored similarly on this item during the entry survey. Conclusions: The results of this study suggest that utilizing 3D printing to demonstrate somatic dysfunctions of the rib cage may improve understanding and student satisfaction for diagnosis and treatment.

Osteopathic Manipulative Treatment to Manage Ophthalmic Conditions.

Although there is little evidence-based literature regarding osteopathic manipulative treatment for ophthalmic conditions, the general principles and techniques of osteopathic manipulative medicine can be used to manage various ophthalmic pathologic conditions. Additional research to support these treatment options and evaluate the role of OMT as a potential conservative treatment option used by ophthalmologists is needed.

Effects of somatic dysfunction on leg length and weight bearing.

CONTEXT: Somatic dysfunctions of the pelvis, sacrum, and lumbar spine are common. Their association with leg length discrepancies has been observed; however, it is unclear which dysfunctions lead to mild changes in leg length or weight bearing distribution in asymptomatic individuals. OBJECTIVES: To determine which somatic dysfunctions of the pelvic, sacral, and lumbar spine lead to minor leg length discrepancies and weight-bearing differences and to determine which of these dysfunctions are most common in the asymptomatic population. METHODS: Asymptomatic participants between the ages of 18 and 40 years without a recent history of trauma were enrolled. Participants were measured from the anterior superior iliac spine to the medial malleolus; only those with mild leg length discrepancies (less than a quarter inch) were included. Weight-bearing distribution through each lower extremity was measured on a quadruped scale. Participants were then evaluated for somatic dysfunctions of the pelvis, sacrum, and lower lumbar spine. RESULTS: Ninety-eight participants completed the study. The most common somatic dysfunctions were superior innominate shears, left-on-left sacral torsions, and right rotated lower lumbar spine segments. Several statistically significant associations were found. Most participants with right anterior innominate dysfunctions exhibited an ipsilateral longer leg and a contralateral shorter leg when measured in the supine position (P=.05). Participants with a left superior shear tended to exhibit a shorter left leg in the supine position (P=.05). For sacral somatic dysfunctions, participants with a left-on-left sacral torsion tended to exhibit a shorter left leg while standing (P=.02). In addition, a statistically significant association was found between right anterior innominate rotation dysfunctions and weight-bearing differences (P=.02). A greater percentage of patients with a right anterior innominate dysfunction bore more weight through their left lower extremity (45%). CONCLUSION: Specific pelvic and sacral somatic dysfunctions have the potential to influence leg lengths, leading to mild disparities in length and in weight-bearing distribution through the lower extremities. (ClinicalTrials.gov number NCT01097109).