Palpatory tests in manual therapies: an international survey on osteopathic clinical practice.

OBJECTIVES: The primary aim of the study is to explore the knowledge and use of palpatory tests in detecting somatic dysfunction, the second is to assess the knowledge about the inhibitory tests among osteopathic practitioners in Italy, England, and France. METHODS: A quantitative survey was conducted, between March and May 2021, through the administration of a semi-structured questionnaire. The participants had to answer 8 questions. RESULTS: A total of 2,223 e-mails were sent: 423 manual therapy professionals participated in the survey. Subsequently, only the responses of the 385 osteopaths (280 Italian, 23 French and 82 British) were included in the data processing; the 38 excluded were physiotherapists and chiropractors. The most significative outcomes for the total sample were found to: years of working experience and knowledge of a palpatory test that allows to discriminate two dysfunctional anatomical structures was significant with a χ2=12.509 (p-value <0.006); 68.5% answered in the affirmative to this last question. It was found that less work experience is associated with knowledge of a palpatory test to discriminate two dysfunctional structures. The correlation between years of work experience and knowledge of the inhibitory test was explored with the result being statistically significant (p-value <0.001). 64.4% know and use the inhibitory test. 39.1% base the inhibitory test on tissue change. CONCLUSIONS: The clinical practice of Italian and French professionals, makes possible to establish the hierarchy between two somatic dysfunctions with respect to English sample. The osteopaths reported a wider use of the tissue change parameters rather than pain reported by the patient. Furthermore, more than half of the sample-based their discriminatory test on the musculoskeletal and fascial systems. There is a vast knowledge of the inhibition test among osteopaths.

Effects of osteopathic approach in infants with deformational plagiocephaly: an outcome research study.

BACKGROUND: The aim of the present study is to investigate the effects of the osteopathic approach in infants with deformational plagiocephaly at 12-month follow up and to evaluate parental satisfaction and safety of the treatments. METHODS: The authors reviewed charts of infants with a medical diagnosis of deformational plagiocephaly consecutively seen in a private paediatric outpatient in Rome, Italy, between December 2016 and February 2018. After applying the exclusion criteria, infants under 6 months of corrected age, with diagnosis of deformational plagiocephaly and assessed with a plagiocephalometry were included. RESULTS: 37 infants (mean age 16,6±5,7 weeks; 19 females) were eligible for this study, generating 35 unilateral deformational plagiocephaly (21 right-sided) and 18 brachycephaly (16 infants had both). After an average of 6.5±2.8 osteopathic manipulative treatments plus postural advice, a significant reduction of all indices of the plagiocephalometry assessments was reported at 12-month follow up. Oblique Diameter Difference Index decreased from 109 ± 4.5 to 103.7 ± 1.9 (Mean diff - 5.3 CI 95% {-5.83; -3.41}, p<0.001); Cranial Proportional Index decreased from 94.9 ± 3.8 to 85.6 ± 2.4 (mean diff -9.3 CI 95% {-11.39; -7.37}, p<0.001); Ear Deviation Index decreased from 7.7 ± 3.3 to 3 ± 1.6 (mean diff -4.7 CI 95% {-6.1; -2.84}, p <0.001). CONCLUSIONS: Osteopathic approach could be considered an interesting option in the treatment of infants with deformational plagiocephaly. Parents were overall satisfied with this approach. No adverse events or reactions were reported in this study. Multicentre randomized controlled trials are recommended.

Assessment and Management of Somatic Dysfunctions in Patients With Patellofemoral Pain Syndrome.

CONTEXT: Patellofemoral pain syndrome (PFPS) is one of the most common determinants of knee pain. The causes of PFPS are multifactorial, and most treatment approaches are conservative. There are many kinds of therapy for this syndrome, which are based on building strength, flexibility, proprioception, and endurance. Training is functional and progression is gradual. Our hypothesis is that total-body osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) focused on the management of somatic dysfunctions could be useful for managing the pain of patients with PFPS. OBJECTIVE: To investigate the effect of OMTh on pain reduction in patients with PFPS. METHODS: This pilot study was randomized, controlled, and single-blinded with 2 months of follow-up. Qualified participants were randomly assigned to 1 of 2 groups: OMTh group or placebo group. Each participant received either 4 sessions of OMTh or 4 sessions of manual placebo intervention that consisted of passive touching without joint mobilization in a protocolled order. A visual analogue scale (VAS) was used to assess general knee pain, peripatellar pain, pain after prolonged sitting, pain during the patellar compression test, and pain during stair ascent and descent. Pain assessment was performed before the baseline (T0), second (T1), third (T2), and fourth (T3) sessions, and follow-up (T4) was performed 8 weeks after T3. RESULTS: Thirty-five participants were enrolled the study. The VAS score was significantly reduced and clinically relevant in the OMTh group after each treatment and after 2 months of follow-up. The change in the VAS score before each treatment indicates that the most improved areas at T1 compared with T0 were lumbar and sacral with improvements in 83% and 40% of patients, respectively. At T2 compared with T1, the most improved areas were cervical and sacral with improvements found in 58% and 36% of patients, respectively. The number of dysfunctions that were diagnosed decreased during the baseline to T3 period (40% change). The correlation analysis showed significant results for the dysfunction and the compression test at T2 (P=.01, ρ=0.543). CONCLUSION: Significant differences in VAS scores were found between the OMTh and placebo groups. These findings underline how OMTh can lead to reduced pain in patients with PFPS.