Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
Somatic Dysfunction Mechanisms Ch 3. Manual Diagnostic Procedures Overview Ch 4. Treatment Procedures Overview Ch 5. Mechanical Low Back Pain Ch 6.
Cervicogenic Headache Ch 8. Temporomandibular Joint Dysfunction Ch 9.
Shoulder Pain and Dysfunnction Ch Carpal Tunnel Syndrome Ch Ankle Sprain Ch Manual Medicine Coding Index show more. Overview Ch 2. Somatic Dysfunction Mechanisms Ch 3.
Manual Diagnostic Procedures Overview Ch 4. Treatment Procedures Overview Ch 5.
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Mechanical Low Back Pain Ch 6. Cervicogenic Headache Ch 8. Temporomandibular Joint Dysfunction Ch 9. Shoulder Pain and Dysfunnction Ch Carpal Tunnel Syndrome Ch Ankle Sprain Ch Manual Medicine Coding Index. Postoperative Care. They summarized one retrospective study that analyzed the effect of OMT on 17 of 55 patients after abdominal surgery. The treatment group had a significantly shorter time to flatus and a significantly shorter mean length of stay than the non-treatment group.
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Irritable Bowel Syndrome. In both studies, OMT significantly improved symptoms, 16,17 but the authors noted major limitations of both studies, including self-reported symptoms and small sample sizes. Slattengren et al presented a succinct and practical summary of the state of osteopathic clinical research in the era of evidence-based medicine.
However, the review had some concerning characteristics, which limit its usefulness in guiding clinical practice, including lack of transparency regarding review methodology, incompleteness in presentation of existing data, and absence of ECHO assessment Efficacy, Cost, Harms, and patient Opinions in consideration of application to practice. Unfortunately, the authors did not report their methods regarding study selection or analysis. Results reporting was limited to synopsis of specific studies and did not include the total number of articles reviewed nor the number of studies omitted.
For instance, in addition to the conditions reviewed by the authors, OMT has been studied in many other conditions, including but not limited to: asthma, 18 chronic obstructive pulmonary disease, 19 balance in the elderly, 20 chronic pelvic pain, 21 recurrent otitis media, 22 neonatal prematurity, 23 concussion, 24,25 and infantile colic. When engaging patients in shared decision-making, physicians should keep in mind the ECHO mnemonic as they consider potential treatment options.
In terms of cost to the patient and the healthcare system, OMT appears to be well positioned. Medicare and many private insurers reimburse for OMT, leaving patients with manageable copays. This stands in contrast to many integrative therapies for which patients often must pay out of pocket.
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Furthermore, if a surgery or medication adverse event can be avoided, OMT may save the healthcare system money, as well. Although more research is needed on the effect of OMT on cost of care, existing studies support the intervention as cost-neutral or cost-saving. Regarding potential for harm, the incidence of serious adverse events after OMT is rare.
prodpuncboundcas.tk However, it should be noted that the incidence of mild adverse events, such as increased pain or discomfort, was 2. Patient opinion and preference also must be considered.