The Journal of the American Osteopathic Association, 2010/08, 110(8):452. doi: 10.7556/jaoa.2010.110.8.445, type of study: ,obs,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2010.110.8.445/html)

Keywords:

geriatrics [141]
observational study [246]
OMT [3925]
osteopathic manipulative treatment [3946]
pneumonia [43]

Abstract:

Purpose: The purpose of the training program for the Multicenter Osteopathic Pneumonia Study in the Elderly (MOPSE) was to standardize osteopathic manipulative treatment techniques commonly used to treat patients with pneumonia. For three of the techniques, rib raising, suboccipital inhibition, and thoracic lymphatic pump, a pressure mapping system was used to assist in the training of the treatment providers at the sites, to objectively evaluate the characteristics of the techniques, and to better standardize the performance of the techniques. Materials and Methods: Depending on the technique, 66 to 73 physician treatment providers were evaluated and trained using the pressure sensing instrument (XSensor, Sensor Products LLC, East Hanover, NJ) on 1 to 3 occasions over a 3-year period. A calibrated flexible sensor pad (4.6 cm × 4.6 cm with 4096 sensors) was placed between the patient and one of the clinicians' hands for the thoracic lymphatic pump or both hands in the other techniques. The maximum and average pressure, frequency and consistency of force applied, and contact area were measured while physicians performed these techniques primarily on one standardized patient. Results: For rib raising, the mean (95% CI) maximum and minimum forces applied were 284 N (177-391) and 181 N (93-268). The mean interval between cycles was 2.7 seconds (2.3-3.1). For suboccipital inhibition, the mean force applied was 209 N (182-236). For the thoracic lymphatic pump, the mean initial force was 957 N (732-1182) and the peak force was 1914 N (1696-2132). The change in force per second was 41 N. (39-42). Conclusion: Results are the first attempt to objectively quantify manipulative techniques performed by a large number of osteopathic physicians. Findings demonstrate that there was significant variability in the performance of the techniques. Using this methodology, it may be possible with further research to more accurately determine what technique characteristics are most therapeutic. Acknowledgment: MOPSE was funded by a group of osteopathic medicine supportive foundations lead by the Osteopathic Heritage Foundation and the Foundation for Osteopathic Health Services.