Enabling health potential: exploring nonlinear and complex results of osteopathic manual medicine through complex systems theory.

Osteopathic medicine is a holistic, patient-specific approach. Explaining the impact of osteopathic manipulative medicine (OMM) has been problematic because many of its effects are nonlinear. Complex systems theory (CST) is explored as a mechanism of understanding the interplay of the body's anatomy and physiology, an illness process, and the effects of OMM. Tensegrity is discussed as an example of an emergent property of the body's systems that affects not only biomechanics but also pathophysiology. Previous explanations of osteopathic philosophy are reviewed. The Host + Disease=Illness paradigm is a way to think through the impact of host and disease factors on an illness state, and how targeted interventions may affect the illness. The Osteopathic 5 Models are another way to view the body's complexity. The area of greatest restriction (AGR) screen can be understood to direct OMM in a way that respects complexity and enables asymmetric and nonlocal results to realize health potential. The impact of this framework is in coherently explaining the impact of osteopathic philosophy and OMM and exploring new approaches to research.

Cardiorespiratory Model-Based Data-Driven Approach for Sleep Apnea Detection.

Obstructive sleep apnea (OSA) is a chronic sleep disorder affecting millions of people worldwide. Individuals with OSA are rarely aware of the condition and are often left untreated, which can lead to some serious health problems. Nowadays, several low-cost wearable health sensors are available that can be used to conveniently and noninvasively collect a wide range of physiological signals. In this paper, we propose a new framework for OSA detection in which we combine the wearable sensor measurement signals with the mathematical models of the cardiorespiratory system. Vector-valued Gaussian processes (GPs) are adopted to model the physiological variations among different individuals. The GP covariance is constructed using the sum of separable kernel functions, and the GP hyperparameters are estimated by maximizing the marginal likelihood function. A likelihood ratio test is proposed to detect OSA using the widely available heart rate and peripheral oxygen saturation (SpO ) measurement signals. We conduct experiments on both synthetic and real data to show the effectiveness of the proposed OSA detection framework compared to purely data-driven approaches.

Topology and random-walk network representation of cardiac dynamics for localization of myocardial infarction.

While detection of acute cardiac disorders such as myocardial infarction (MI) from electrocardiogram (ECG) and vectorcardiogram (VCG) has been widely reported, identification of MI locations from these signals, pivotal for timely therapeutic and prognostic interventions, remains a standing issue. We present an approach for MI localization based on representing complex spatiotemporal patterns of cardiac dynamics as a random-walk network reconstructed from the evolution of VCG signals across a 3-D state space. Extensive tests with signals from the PTB database of the PhysioNet databank suggest that locations of MI can be determined accurately (sensitivity of ∼88% and specificity of ∼92%) from tracking certain consistently estimated invariants of this random-walk representation.

Osteopathic manipulative treatment and its relationship to autonomic nervous system activity as demonstrated by heart rate variability: a repeated measures study.

BACKGROUND: The relationship between osteopathic manipulative treatment (OMT) and the autonomic nervous system has long been acknowledged, but is poorly understood. In an effort to define this relationship, cervical myofascial release was used as the OMT technique with heart rate variability (HRV) as a surrogate for autonomic activity. This study quantifies that relationship and demonstrates a cause and effect. METHODS: Seventeen healthy subjects, nine males and eight females aged 19-50 years from the faculty, staff, and students at Oklahoma State University Center for Health Sciences College of Osteopathic Medicine, acted as their own controls and received interventions, administered in separate sessions at least 24 hours apart, of cervical myofascial OMT, touch-only sham OMT, and no-touch control while at a 50-degree head-up tilt. Each group was dichotomized into extremes of autonomic activity using a tilt table. Comparisons were made between measurements taken at tilt and those taken at pre- and post-intervention in the horizontal.The variance of the spectral components of HRV, expressed as frequencies, measured the response to change in position of the subjects. Normalized low frequency (LF) and high frequency (HF) values, including LF/HF ratio, were calculated and used to determine the effect of position change on HRV. RESULTS: Predominantly parasympathetic responses were observed with subjects in the horizontal position, while a 50-degree tilt provided a significantly different measure of maximum sympathetic tone (p < 0.001). Heart rate changed in all subjects with change in position; respirations remained constant. When OMT was performed in a sympathetic environment (tilt), a vagal response was produced that was strong enough to overcome the sympathetic tone. There was no HRV difference between sham and control in either the horizontal or tilt positions. CONCLUSION: The vagal response produced by the myofascial release procedure in the maximally stimulated sympathetic environment could only have come from the application of the OMT. This demonstrates the association between OMT and the autonomic nervous system. The lack of significance between control and sham in all positions indicates that HRV may be a useful method of developing sham controls in future studies of OMT. TRIAL REGISTRATION: clinicaltrials.gov NCT00516984.