@article{keter_integrating_2024,
	title = {Integrating {Person}-{Centered} {Concepts} and {Modern} {Manual} {Therapy}},
	volume = {2},
	url = {https://www.jospt.org/doi/abs/10.2519/josptopen.2023.0812},
	doi = {10.2519/josptopen.2023.0812},
	abstract = {SYNOPSIS: Person-centered care places the whole patient at the center of the assessment and treatment plan. This includes an appreciation of the biological, psychological, and social contributors to the patient?s status; use of shared decision-making to arrive at a feasible, person-centered care plan; and planning beyond the clinical encounter. Whereas person-centered care has been trending among musculoskeletal pain care, the application of this concept in a management plan that incorporates manual therapy (MT) has yet to be explored. Traditionally, MT has involved a practitioner leading the treatment session and providing the technique; however, recent advances in the MT literature and training are more reflective of a person-centered care model. The objectives of this clinical commentary are to outline our vision of person-centered MT, including support on why and how it should be applied. We endeavor to answer What is person-centered MT? Why should person-centered MT be adopted? How should person-centered MT be utilized? We present literature answering each of these questions and present a clinical framework to link evidence to practice in which we outline person-centered MT-based assessment and intervention. JOSPT Open 2024;2(1):60-70. Epub 13 November 2023. doi:10.2519/josptopen.2023.0812},
	number = {1},
	urldate = {2024-03-13},
	journal = {JOSPT Open},
	author = {Keter, Damian and Hutting, Nathan and Vogsland, Rebecca and Cook, Chad E},
	month = jan,
	year = {2024},
	note = {Publisher: Journal of Orthopaedic \& Sports Physical Therapy},
	pages = {60--70},
}

SYNOPSIS: Person-centered care places the whole patient at the center of the assessment and treatment plan. This includes an appreciation of the biological, psychological, and social contributors to the patient?s status; use of shared decision-making to arrive at a feasible, person-centered care plan; and planning beyond the clinical encounter. Whereas person-centered care has been trending among musculoskeletal pain care, the application of this concept in a management plan that incorporates manual therapy (MT) has yet to be explored. Traditionally, MT has involved a practitioner leading the treatment session and providing the technique; however, recent advances in the MT literature and training are more reflective of a person-centered care model. The objectives of this clinical commentary are to outline our vision of person-centered MT, including support on why and how it should be applied. We endeavor to answer What is person-centered MT? Why should person-centered MT be adopted? How should person-centered MT be utilized? We present literature answering each of these questions and present a clinical framework to link evidence to practice in which we outline person-centered MT-based assessment and intervention. JOSPT Open 2024;2(1):60-70. Epub 13 November 2023. doi:10.2519/josptopen.2023.0812

@article{thomson_pseudoscience_2024,
	title = {Pseudoscience - {A} skeleton in osteopathy's closet?},
	issn = {17460689},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1746068924000099},
	doi = {10.1016/j.ijosm.2024.100716},
	language = {en},
	urldate = {2024-02-24},
	journal = {International Journal of Osteopathic Medicine},
	author = {Thomson, Oliver P. and Martini, Carlo},
	month = feb,
	year = {2024},
	pages = {100716},
}

@article{vismara_reliability_2024,
	title = {Reliability and {Validity} of the {Variability} {Model} {Testing} {Procedure} for {Somatic} {Dysfunction} {Assessment}: {A} {Comparison} with {Gait} {Analysis} {Parameters} in {Healthy} {Subjects}},
	volume = {12},
	issn = {2227-9032},
	shorttitle = {Reliability and {Validity} of the {Variability} {Model} {Testing} {Procedure} for {Somatic} {Dysfunction} {Assessment}},
	url = {https://www.mdpi.com/2227-9032/12/2/175},
	doi = {10.3390/healthcare12020175},
	abstract = {Somatic dysfunction (SD) is an altered body function involving the musculoskeletal system. However, its clinical signs—tissue texture abnormalities, positional asymmetry, restricted range of motion, and tissue tenderness—did not achieve satisfactory results for reliability. A recent theoretical model proposed a revision assessing the movement variability around the joint rest position. The asymmetry and restriction of motion may characterize functional assessment in osteopathic clinical practice, demonstrating the reliability required. Hence, this study investigated the reliability of the new variability model (VM) with gait analysis (GA). Three blind examiners tested 27 young healthy subjects for asymmetry of motion around rest position and the SD grade on six body regions. The results were compared to the VICON procedure for 3D-GA. The inter-rater agreement for the detection of reduced movement variability ranged from 0.78 to 0.54, whereas for SD, grade ranged from 0.64 to 0.47. VM had a sensitivity and specificity of 0.62 and 0.53, respectively, in SD detection compared to step length normality. Global severity grade of SD demonstrated moderate to good correlation with spatial-temporal parameters. The VM showed palpatory reliability and validity with spatial–temporal parameters in GA. Those findings contribute to the innovation for SD examination with implications for the clinical practice.},
	language = {en},
	number = {2},
	urldate = {2024-01-13},
	journal = {Healthcare},
	author = {Vismara, Luca and Bergna, Andrea and Tarantino, Andrea Gianmaria and Dal Farra, Fulvio and Buffone, Francesca and Vendramin, Davide and Cimolin, Veronica and Cerfoglio, Serena and Pradotto, Luca Guglielmo and Mauro, Alessandro},
	month = jan,
	year = {2024},
	pages = {175},
}

Somatic dysfunction (SD) is an altered body function involving the musculoskeletal system. However, its clinical signs—tissue texture abnormalities, positional asymmetry, restricted range of motion, and tissue tenderness—did not achieve satisfactory results for reliability. A recent theoretical model proposed a revision assessing the movement variability around the joint rest position. The asymmetry and restriction of motion may characterize functional assessment in osteopathic clinical practice, demonstrating the reliability required. Hence, this study investigated the reliability of the new variability model (VM) with gait analysis (GA). Three blind examiners tested 27 young healthy subjects for asymmetry of motion around rest position and the SD grade on six body regions. The results were compared to the VICON procedure for 3D-GA. The inter-rater agreement for the detection of reduced movement variability ranged from 0.78 to 0.54, whereas for SD, grade ranged from 0.64 to 0.47. VM had a sensitivity and specificity of 0.62 and 0.53, respectively, in SD detection compared to step length normality. Global severity grade of SD demonstrated moderate to good correlation with spatial-temporal parameters. The VM showed palpatory reliability and validity with spatial–temporal parameters in GA. Those findings contribute to the innovation for SD examination with implications for the clinical practice.

@article{gessa_role_2024,
	title = {The role of touch in osteopathic clinical encounters – {A} scoping review},
	volume = {51},
	issn = {17460689},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1746068923000482},
	doi = {10.1016/j.ijosm.2023.100704},
	language = {en},
	urldate = {2024-01-13},
	journal = {International Journal of Osteopathic Medicine},
	author = {Gessa, Alessio and Greaves, Ian and Draper-Rodi, Jerry},
	month = mar,
	year = {2024},
	pages = {100704},
}

@article{carrasco-uribarren_clinical_2024,
	title = {Clinical {Effectiveness} of {Craniosacral} {Therapy} in {Patients} with {Headache} {Disorders}: {A} {Systematic} {Review} and {Meta}-analysis},
	volume = {25},
	issn = {15249042},
	shorttitle = {Clinical {Effectiveness} of {Craniosacral} {Therapy} in {Patients} with {Headache} {Disorders}},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1524904223001534},
	doi = {10.1016/j.pmn.2023.07.009},
	language = {en},
	number = {1},
	urldate = {2024-01-13},
	journal = {Pain Management Nursing},
	author = {Carrasco-Uribarren, Andoni and Mamud-Meroni, Lucas and Tarcaya, Germán E. and Jiménez-Del-Barrio, Sandra and Cabanillas-Barea, Sara and Ceballos-Laita, Luis},
	month = feb,
	year = {2024},
	pages = {e21--e28},
}

@article{carrasco-uribarren_clinical_2024-1,
	title = {Clinical {Effectiveness} of {Craniosacral} {Therapy} in {Patients} with {Headache} {Disorders}: {A} {Systematic} {Review} and {Meta}-analysis},
	volume = {25},
	issn = {15249042},
	shorttitle = {Clinical {Effectiveness} of {Craniosacral} {Therapy} in {Patients} with {Headache} {Disorders}},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1524904223001534},
	doi = {10.1016/j.pmn.2023.07.009},
	language = {en},
	number = {1},
	urldate = {2024-01-13},
	journal = {Pain Management Nursing},
	author = {Carrasco-Uribarren, Andoni and Mamud-Meroni, Lucas and Tarcaya, Germán E. and Jiménez-Del-Barrio, Sandra and Cabanillas-Barea, Sara and Ceballos-Laita, Luis},
	month = feb,
	year = {2024},
	pages = {e21--e28},
}

@article{nicholls_what_2024,
	title = {What is wrong with osteopathy? {A} response to {Thomson} and {MacMillan}},
	volume = {51},
	issn = {17460689},
	shorttitle = {What is wrong with osteopathy?},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S174606892300038X},
	doi = {10.1016/j.ijosm.2023.100694},
	language = {en},
	urldate = {2023-12-22},
	journal = {International Journal of Osteopathic Medicine},
	author = {Nicholls, David A.},
	month = mar,
	year = {2024},
	pages = {100694},
}

@article{rada_genetics_2023,
	title = {Genetics of spontaneous cervical and coronary artery dissections},
	volume = {4},
	issn = {2673-5059},
	url = {https://www.frontiersin.org/articles/10.3389/fgwh.2023.1007795/full},
	doi = {10.3389/fgwh.2023.1007795},
	abstract = {Objectives
              Spontaneous cervical artery dissections (SCeAD) and coronary artery dissections (SCoAD) are major causes of neurovascular and cardiovascular morbidity in young adults. Although multiple aspects of their etiology are still unknown, most consensuses are focused on the presence of constitutional genetic aspects and environmental triggers. Since recent evidence of genetic contribution points to a possible overlap between these conditions, we aimed to describe current information on SCeAD and SCoAD genetics and their potential shared pathological aspects.
            
            
              Materials and methods
              A narrative review is presented. Publications in English and Spanish were queried using database search. The articles were evaluated by one team member in terms of inclusion criteria. After collecting, the articles were categorized based on scientific content.
            
            
              Results
              
                Given that patients with SCeAD and SCoAD rarely present connective tissue disorders, other genetic loci are probably responsible for the increased susceptibility in some individuals. The common variant rs9349379 at
                PHACTR1
                gene is associated with predisposition to pathologies of the arterial wall, likely mediated by variations in Endothelin-1 (ET-1) levels. The risk of arterial dissection may be increased for those who carry the rs9349379(A) allele, associated with lower expression levels of ET-1; however, the local effect of this vasomotor imbalance remains unclear. Sex differences seen in SCeAD and SCoAD support a role for sex hormones that could modulate risk, tilting the delicate balance and forcing vasodilator actions to prevail over vasoconstriction due to a reduction in ET-1 expression.
              
            
            
              Conclusions
              New evidence points to a common gene variation that could explain dissection in both the cervical and coronary vasculatures. To further confirm the risk conferred by the rs9349379 variant, genome wide association studies are warranted, hopefully in larger and ethnically diverse populations.},
	urldate = {2024-03-18},
	journal = {Frontiers in Global Women's Health},
	author = {Rada, Isabel and Calderón, Juan Francisco and Martínez, Gonzalo and Muñoz Venturelli, Paula},
	month = may,
	year = {2023},
	pages = {1007795},
}

Objectives Spontaneous cervical artery dissections (SCeAD) and coronary artery dissections (SCoAD) are major causes of neurovascular and cardiovascular morbidity in young adults. Although multiple aspects of their etiology are still unknown, most consensuses are focused on the presence of constitutional genetic aspects and environmental triggers. Since recent evidence of genetic contribution points to a possible overlap between these conditions, we aimed to describe current information on SCeAD and SCoAD genetics and their potential shared pathological aspects. Materials and methods A narrative review is presented. Publications in English and Spanish were queried using database search. The articles were evaluated by one team member in terms of inclusion criteria. After collecting, the articles were categorized based on scientific content. Results Given that patients with SCeAD and SCoAD rarely present connective tissue disorders, other genetic loci are probably responsible for the increased susceptibility in some individuals. The common variant rs9349379 at PHACTR1 gene is associated with predisposition to pathologies of the arterial wall, likely mediated by variations in Endothelin-1 (ET-1) levels. The risk of arterial dissection may be increased for those who carry the rs9349379(A) allele, associated with lower expression levels of ET-1; however, the local effect of this vasomotor imbalance remains unclear. Sex differences seen in SCeAD and SCoAD support a role for sex hormones that could modulate risk, tilting the delicate balance and forcing vasodilator actions to prevail over vasoconstriction due to a reduction in ET-1 expression. Conclusions New evidence points to a common gene variation that could explain dissection in both the cervical and coronary vasculatures. To further confirm the risk conferred by the rs9349379 variant, genome wide association studies are warranted, hopefully in larger and ethnically diverse populations.

@article{ryan_investigating_2023,
	title = {Investigating the current published literature where osteopathic manual therapy is used as an intervention: {A} scoping review},
	volume = {50},
	issn = {17460689},
	shorttitle = {Investigating the current published literature where osteopathic manual therapy is used as an intervention},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1746068923000093},
	doi = {10.1016/j.ijosm.2023.100665},
	language = {en},
	urldate = {2024-03-10},
	journal = {International Journal of Osteopathic Medicine},
	author = {Ryan, Harmony and Friedlander, Tim and Anderson, Helen and Mason, Jesse},
	month = dec,
	year = {2023},
	pages = {100665},
}

@article{silva_instruments_2023,
	title = {Instruments to {Assess} {Evidence}-{Based} {Practice} {Among} {Health} {Care} {Professionals}: {A} {Systematic} {Review}},
	issn = {1552-6127},
	shorttitle = {Instruments to {Assess} {Evidence}-{Based} {Practice} {Among} {Health} {Care} {Professionals}},
	doi = {10.1177/10901981231170154},
	abstract = {BACKGROUND: The use of measurement instruments to assess the use of Evidence-Based Practice by health professionals has been frequently reported in studies.
AIMS: This systematic review aimed to summarize, describe, and evaluate the measurement properties of the instruments that evaluate the use of Evidence-Based Practice in health professionals.
METHODS: The search was carried out in four databases considering three groups of search terms: evidence-based practice, evaluation, and measurement proprieties. Studies were included that described the use of instruments to assess Evidence-Based Practice in health professionals, with the full-text publication, which analyzed the measurement properties, in English. The methodological quality of the studies was evaluated using COnsensus-based Standards for the selection of health Measurement INstruments.
RESULTS: In total, 6,429 were found and only 92 were eligible for data analysis. Forty new instruments were identified most were developed for nursing and physical therapist. The investigators performed at least 1 type of validity test on 73\% of the instruments. Reliability was tested at 90\%, through internal consistency. Responsiveness was tested on less than half of the instruments (30\%). Most of the instruments identified are reliable and valid to measure evidence-based practice in health professionals.
CONCLUSION: Although the Fresno Test remains the most complete instrument, and adequate for use. The COnsensus-based Standards for the selection of health Measurement INstruments checklist classified 7 (seven) instruments as suitable for the target audience.},
	language = {eng},
	journal = {Health Education \& Behavior: The Official Publication of the Society for Public Health Education},
	author = {Silva, Anderson Martins da and Valentim, Daniela Pereira and Martins, Adriana Leite and Padula, Rosimeire Simprini},
	month = jun,
	year = {2023},
	pmid = {37264545},
	keywords = {formative evaluation, health education, healthcare, measurement},
	pages = {10901981231170154},
}

BACKGROUND: The use of measurement instruments to assess the use of Evidence-Based Practice by health professionals has been frequently reported in studies. AIMS: This systematic review aimed to summarize, describe, and evaluate the measurement properties of the instruments that evaluate the use of Evidence-Based Practice in health professionals. METHODS: The search was carried out in four databases considering three groups of search terms: evidence-based practice, evaluation, and measurement proprieties. Studies were included that described the use of instruments to assess Evidence-Based Practice in health professionals, with the full-text publication, which analyzed the measurement properties, in English. The methodological quality of the studies was evaluated using COnsensus-based Standards for the selection of health Measurement INstruments. RESULTS: In total, 6,429 were found and only 92 were eligible for data analysis. Forty new instruments were identified most were developed for nursing and physical therapist. The investigators performed at least 1 type of validity test on 73% of the instruments. Reliability was tested at 90%, through internal consistency. Responsiveness was tested on less than half of the instruments (30%). Most of the instruments identified are reliable and valid to measure evidence-based practice in health professionals. CONCLUSION: Although the Fresno Test remains the most complete instrument, and adequate for use. The COnsensus-based Standards for the selection of health Measurement INstruments checklist classified 7 (seven) instruments as suitable for the target audience.

@article{du_spinal_2023,
	title = {Spinal posture assessment and low back pain},
	volume = {8},
	issn = {2058-5241},
	url = {https://eor.bioscientifica.com/view/journals/eor/8/9/EOR-23-0025.xml},
	doi = {10.1530/EOR-23-0025},
	abstract = {Postural assessment can help doctors and therapists identify risk factors for low back pain and determine appropriate follow-up treatment.
                
                
                  Postural alignment is not perfectly symmetrical, and small asymmetries can instead represent norms and criteria for postural evaluation.
                
                
                  It is necessary to comprehensively observe patients’ posture in all directions and analyze the factors related to posture evaluation.
                
                
                  The results of reliability show that in general intra-rater reliability is higher than inter-rater reliability, and inclinometers are being more reliable than other instrumentations.
                
                
                  Some common postural problems can cause lumbar discomfort, and prolonged poor posture is a potential risk factor for lumbar spine injuries.
                
                
                  On the basis of previous studies on posture evaluation, a unified standardized method for posture evaluation must be established in future research.},
	number = {9},
	urldate = {2024-02-25},
	journal = {EFORT Open Reviews},
	author = {Du, Shu-Hao and Zhang, Yong-Hui and Yang, Qi-Hao and Wang, Yu-Chen and Fang, Yu and Wang, Xue-Qiang},
	month = sep,
	year = {2023},
	pages = {708--718},
}

Postural assessment can help doctors and therapists identify risk factors for low back pain and determine appropriate follow-up treatment. Postural alignment is not perfectly symmetrical, and small asymmetries can instead represent norms and criteria for postural evaluation. It is necessary to comprehensively observe patients’ posture in all directions and analyze the factors related to posture evaluation. The results of reliability show that in general intra-rater reliability is higher than inter-rater reliability, and inclinometers are being more reliable than other instrumentations. Some common postural problems can cause lumbar discomfort, and prolonged poor posture is a potential risk factor for lumbar spine injuries. On the basis of previous studies on posture evaluation, a unified standardized method for posture evaluation must be established in future research.

@article{banton_relational_2023,
	title = {Relational clinical practice: {A} hermeneutic, enactive, intersubjective model of osteopathy},
	issn = {17460689},
	shorttitle = {Relational clinical practice},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1746068923000512},
	doi = {10.1016/j.ijosm.2023.100707},
	language = {en},
	urldate = {2024-01-28},
	journal = {International Journal of Osteopathic Medicine},
	author = {Banton, Amanda and Vogel, Steven},
	month = dec,
	year = {2023},
	pages = {100707},
}

@article{ryan_investigating_2023-1,
	title = {Investigating the current published literature where osteopathic manual therapy is used as an intervention: {A} scoping review},
	volume = {50},
	issn = {17460689},
	shorttitle = {Investigating the current published literature where osteopathic manual therapy is used as an intervention},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1746068923000093},
	doi = {10.1016/j.ijosm.2023.100665},
	language = {en},
	urldate = {2024-02-09},
	journal = {International Journal of Osteopathic Medicine},
	author = {Ryan, Harmony and Friedlander, Tim and Anderson, Helen and Mason, Jesse},
	month = dec,
	year = {2023},
	pages = {100665},
}

@article{von_schoen-angerer_traditional_2023,
	title = {Traditional, complementary and integrative healthcare: global stakeholder perspective on {WHO}’s current and future strategy},
	volume = {8},
	issn = {2059-7908},
	shorttitle = {Traditional, complementary and integrative healthcare},
	url = {https://gh.bmj.com/lookup/doi/10.1136/bmjgh-2023-013150},
	doi = {10.1136/bmjgh-2023-013150},
	abstract = {As the ‘WHO Traditional Medicine Strategy: 2014–2023’ is entering its final phase, reflection is warranted on progress and the focus for a new strategy. We used WHO documentation to analyse progress across the objectives of the current strategy, adding the role of traditional, complementary and integrative healthcare (TCIH) to address specific diseases as a dimension absent in the current strategy. Our analysis concludes on five areas. First, TCIH research is increasing but is not commensurate with TCIH use. TCIH research needs prioritisation and increased funding in national research policies and programmes. Second, WHO guidance for training and practice provides useful minimum standards but regulation of TCIH practitioners also need to reflect the different nature of formal and informal practices. Third, there has been progress in the regulation of herbal medicines but TCIH products of other origin still need addressing. A risk-based regulatory approach for the full-range of TCIH products seems appropriate and WHO should provide guidance in this regard. Fourth, the potential of TCIH to help address specific diseases is often overlooked. The development of disease strategies would benefit from considering the evidence and inclusion of TCIH practices, as appropriate. Fifth, inclusion of TCIH in national health policies differs between countries, with some integrating TCIH practices and others seeking to restrict them. We encourage a positive framework in all countries that enshrines the role of TCIH in the achievement of universal health coverage. Finally, we encourage seeking the input of stakeholders in the development of the new WHO Traditional Medicine Strategy.},
	language = {en},
	number = {12},
	urldate = {2024-02-05},
	journal = {BMJ Global Health},
	author = {Von Schoen-Angerer, Tido and Manchanda, Raj Kumar and Lloyd, Iva and Wardle, Jon and Szöke, Janka and Benevides, Iracema and Martinez, Natalia Sofia Aldana and Tolo, Festus and Nicolai, Ton and Skaling-Klopstock, Cristal and Parker, Tabatha and Suswardany, Dwi Linna and Van Haselen, Robbert and Liu, Jianping},
	month = dec,
	year = {2023},
	pages = {e013150},
}

As the ‘WHO Traditional Medicine Strategy: 2014–2023’ is entering its final phase, reflection is warranted on progress and the focus for a new strategy. We used WHO documentation to analyse progress across the objectives of the current strategy, adding the role of traditional, complementary and integrative healthcare (TCIH) to address specific diseases as a dimension absent in the current strategy. Our analysis concludes on five areas. First, TCIH research is increasing but is not commensurate with TCIH use. TCIH research needs prioritisation and increased funding in national research policies and programmes. Second, WHO guidance for training and practice provides useful minimum standards but regulation of TCIH practitioners also need to reflect the different nature of formal and informal practices. Third, there has been progress in the regulation of herbal medicines but TCIH products of other origin still need addressing. A risk-based regulatory approach for the full-range of TCIH products seems appropriate and WHO should provide guidance in this regard. Fourth, the potential of TCIH to help address specific diseases is often overlooked. The development of disease strategies would benefit from considering the evidence and inclusion of TCIH practices, as appropriate. Fifth, inclusion of TCIH in national health policies differs between countries, with some integrating TCIH practices and others seeking to restrict them. We encourage a positive framework in all countries that enshrines the role of TCIH in the achievement of universal health coverage. Finally, we encourage seeking the input of stakeholders in the development of the new WHO Traditional Medicine Strategy.

@article{banton_making_2023,
	title = {Making sense of cranial osteopathy: {An} interpretative phenomenological analysis},
	volume = {50},
	issn = {17460689},
	shorttitle = {Making sense of cranial osteopathy},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1746068923000172},
	doi = {10.1016/j.ijosm.2023.100673},
	language = {en},
	urldate = {2024-01-28},
	journal = {International Journal of Osteopathic Medicine},
	author = {Banton, Amanda and Vogel, Steven and Lee-Treweek, Geraldine},
	month = dec,
	year = {2023},
	pages = {100673},
}

@article{vaughan_osteopathy_2023,
	title = {Osteopathy {Referrals} to and from {General} {Practitioners}: {Secondary} {Analysis} of {Practitioner} {Characteristics} from an {Australian} {Practice}-{Based} {Research} {Network}},
	volume = {12},
	issn = {2227-9032},
	shorttitle = {Osteopathy {Referrals} to and from {General} {Practitioners}},
	doi = {10.3390/healthcare12010048},
	abstract = {Australian osteopaths engage in multidisciplinary care and referrals with other health professionals, including general practitioners (GPs), for musculoskeletal care. This secondary analysis compared characteristics of Australian osteopaths who refer to, and receive referrals from, GPs with osteopaths who do not refer. The analysis was undertaken to identify pertinent characteristics that could contribute to greater engagement between Australian osteopaths and GPs. Data were from the Australian osteopathy practice-based research network comprising responses from 992 osteopaths (48.1\% response rate). Osteopaths completed a practice-based survey exploring their demographic, practice, and clinical management characteristics. Backward logistic regression identified significant characteristics associated with referrals. Osteopaths who reported sending referrals (n = 878, 88.5\%) to GPs were more likely than their non-referring colleagues to receive referrals from GPs (aOR = 4.80, 95\% CI [2.62-8.82]), send referrals to a podiatrist (aOR = 3.09, 95\% CI [1.80-5.28]) and/or treat patients experiencing degenerative spinal complaints (aOR = 1.71, 95\% CI [1.01-2.91]). Osteopaths reporting receiving referrals (n = 886, 89.3\%) from GPs were more likely than their non-referring colleagues to send referrals to GPs (aOR = 4.62, 95\% CI [2.48-8.63]) and use the Medicare EasyClaim system (aOR = 4.66, 95\% CI [2.34-9.27]). Most Australian osteopaths who report engaging in referrals with GPs for patient care also refer to other health professionals. Referrals from GPs are likely through the Chronic Disease Management scheme. The clinical conditions resulting in referrals are unknown. Further research could explore the GP-osteopath referral network to strengthen collaborative musculoskeletal care. The outcomes of this study have the potential to inform Australian osteopaths participating in advocacy, public policy and engagement with Australian GPs.},
	language = {eng},
	number = {1},
	journal = {Healthcare (Basel, Switzerland)},
	author = {Vaughan, Brett and Fleischmann, Michael and Grace, Sandra and Engel, Roger and Fitzgerald, Kylie and Steel, Amie and Peng, Wenbo and Adams, Jon},
	month = dec,
	year = {2023},
	pmid = {38200954},
	pmcid = {PMC10778730},
	keywords = {allied health occupations, consultation, general practice, health workforce, musculoskeletal pain, osteopathic medicine, primary health care, referral},
	pages = {48},
}

Australian osteopaths engage in multidisciplinary care and referrals with other health professionals, including general practitioners (GPs), for musculoskeletal care. This secondary analysis compared characteristics of Australian osteopaths who refer to, and receive referrals from, GPs with osteopaths who do not refer. The analysis was undertaken to identify pertinent characteristics that could contribute to greater engagement between Australian osteopaths and GPs. Data were from the Australian osteopathy practice-based research network comprising responses from 992 osteopaths (48.1% response rate). Osteopaths completed a practice-based survey exploring their demographic, practice, and clinical management characteristics. Backward logistic regression identified significant characteristics associated with referrals. Osteopaths who reported sending referrals (n = 878, 88.5%) to GPs were more likely than their non-referring colleagues to receive referrals from GPs (aOR = 4.80, 95% CI [2.62-8.82]), send referrals to a podiatrist (aOR = 3.09, 95% CI [1.80-5.28]) and/or treat patients experiencing degenerative spinal complaints (aOR = 1.71, 95% CI [1.01-2.91]). Osteopaths reporting receiving referrals (n = 886, 89.3%) from GPs were more likely than their non-referring colleagues to send referrals to GPs (aOR = 4.62, 95% CI [2.48-8.63]) and use the Medicare EasyClaim system (aOR = 4.66, 95% CI [2.34-9.27]). Most Australian osteopaths who report engaging in referrals with GPs for patient care also refer to other health professionals. Referrals from GPs are likely through the Chronic Disease Management scheme. The clinical conditions resulting in referrals are unknown. Further research could explore the GP-osteopath referral network to strengthen collaborative musculoskeletal care. The outcomes of this study have the potential to inform Australian osteopaths participating in advocacy, public policy and engagement with Australian GPs.

@article{ciardo_importance_2023,
	title = {The importance of constructing an osteopathic profession around modern common academic values and avoiding pseudoscience: {The} {Spanish} experience},
	issn = {22129588},
	shorttitle = {The importance of constructing an osteopathic profession around modern common academic values and avoiding pseudoscience},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S2212958823000782},
	doi = {10.1016/j.aimed.2023.09.003},
	language = {en},
	urldate = {2024-01-13},
	journal = {Advances in Integrative Medicine},
	author = {Ciardo, Antonio and Sánchez, Mar García and Fernández, Moisés Cobo},
	month = sep,
	year = {2023},
	pages = {S2212958823000782},
}

@article{khalaf_valid_2023,
	title = {Valid and {Invalid} {Indications} for {Osteopathic} {Interventions}: {A} {Systematic} {Review} of {Evidence}-{Based} {Practices} and {French} {Healthcare} {Society} {Recommendations}},
	issn = {2168-8184},
	shorttitle = {Valid and {Invalid} {Indications} for {Osteopathic} {Interventions}},
	url = {https://www.cureus.com/articles/202523-valid-and-invalid-indications-for-osteopathic-interventions-a-systematic-review-of-evidence-based-practices-and-french-healthcare-society-recommendations},
	doi = {10.7759/cureus.49674},
	language = {en},
	urldate = {2024-01-13},
	journal = {Cureus},
	author = {Khalaf, Zeinab M and Margulies, Pierre and Moussa, Mohamad K and Bohu, Yoann and Lefevre, Nicolas and Hardy, Alexandre},
	month = nov,
	year = {2023},
}

@article{unger_defining_2023,
	title = {Defining the landscape of patient harm after osteopathic manipulative treatment: synthesis of an adverse event model},
	volume = {23},
	issn = {2662-7671},
	shorttitle = {Defining the landscape of patient harm after osteopathic manipulative treatment},
	url = {https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-023-04230-2},
	doi = {10.1186/s12906-023-04230-2},
	abstract = {Abstract
            
              Background
              In the United States, osteopathic manipulative treatment (OMT), is a popular complementary physical health approach for the treatment of neuromusculoskeletal disorders. However, post-OMT adverse events (AEs) are poorly defined in terms of frequency, severity, and temporal evolution. To date, no benchmark for patient safety exists. To improve understanding in this field, we set out to model the landscape of patient harm after OMT.
            
            
              Methods
              We conducted a comprehensive search of all available primary clinical research studies reporting on the occurrence of post-OMT AEs in nonpregnant, adult outpatients treated by an osteopathic physician in the United States. The methodology of eligible studies was then reviewed to select those containing the minimum required dataset to model the post-OMT AEs. The minimum required dataset consisted of four model parameters: ‘post-OMT interval’, ‘OMT encounters with post-OMT interval assessment’, ‘AEs preceded by an OMT encounter’, and ‘AE severity.’ We used the dataset extracted from selected studies to calculate a patient safety benchmark defined as the incidence rate of AEs per 100 post-OMT interval-days.
            
            
              Results
              
                From 212 manuscripts that we identified, 118 primary clinical research studies were assessed for eligibility. A total of 23 studies met inclusion criteria for methodological review, of which 13 studies passed and were selected for modeling. Mild AEs were the most frequent, accounting for
                n
                 = 161/165 (98\%) of total AEs observed in the literature. The cumulative incidence of mild AEs was also significantly greater (
                P
                 = 0.01) than both moderate and severe grades. The benchmark incidence rate was 1.0 AEs per 100 post-OMT interval-days.
              
            
            
              Conclusions
              The majority of post-OMT AEs observed in the primary clinical literature were of mild severity. Modeling of the combined dataset on post-OMT AEs allowed for the derivation of a patient safety benchmark that, to date, has not been established in the field of osteopathic manipulative medicine. Additional research is needed to improve model resolution during the post-OMT period. This work conceptualized a model for identifying and grading post-OMT AEs, which should facilitate future comparisons between institutions in order to continually improve patient safety standards in the field of osteopathic manipulative medicine.},
	language = {en},
	number = {1},
	urldate = {2024-01-13},
	journal = {BMC Complementary Medicine and Therapies},
	author = {Unger, Mark D. and Barr, Jackilyn N. and Brower, Jacob A. and Kingston, Joseph C. and Heller, Gregory R. and Palmer, Joy L.},
	month = nov,
	year = {2023},
	pages = {407},
}

Abstract Background In the United States, osteopathic manipulative treatment (OMT), is a popular complementary physical health approach for the treatment of neuromusculoskeletal disorders. However, post-OMT adverse events (AEs) are poorly defined in terms of frequency, severity, and temporal evolution. To date, no benchmark for patient safety exists. To improve understanding in this field, we set out to model the landscape of patient harm after OMT. Methods We conducted a comprehensive search of all available primary clinical research studies reporting on the occurrence of post-OMT AEs in nonpregnant, adult outpatients treated by an osteopathic physician in the United States. The methodology of eligible studies was then reviewed to select those containing the minimum required dataset to model the post-OMT AEs. The minimum required dataset consisted of four model parameters: ‘post-OMT interval’, ‘OMT encounters with post-OMT interval assessment’, ‘AEs preceded by an OMT encounter’, and ‘AE severity.’ We used the dataset extracted from selected studies to calculate a patient safety benchmark defined as the incidence rate of AEs per 100 post-OMT interval-days. Results From 212 manuscripts that we identified, 118 primary clinical research studies were assessed for eligibility. A total of 23 studies met inclusion criteria for methodological review, of which 13 studies passed and were selected for modeling. Mild AEs were the most frequent, accounting for n  = 161/165 (98%) of total AEs observed in the literature. The cumulative incidence of mild AEs was also significantly greater ( P  = 0.01) than both moderate and severe grades. The benchmark incidence rate was 1.0 AEs per 100 post-OMT interval-days. Conclusions The majority of post-OMT AEs observed in the primary clinical literature were of mild severity. Modeling of the combined dataset on post-OMT AEs allowed for the derivation of a patient safety benchmark that, to date, has not been established in the field of osteopathic manipulative medicine. Additional research is needed to improve model resolution during the post-OMT period. This work conceptualized a model for identifying and grading post-OMT AEs, which should facilitate future comparisons between institutions in order to continually improve patient safety standards in the field of osteopathic manipulative medicine.

@article{da_silva_effectiveness_2023,
	title = {Effectiveness of visceral fascial therapy targeting visceral dysfunctions outcome: systematic review of randomized controlled trials},
	volume = {23},
	issn = {2662-7671},
	shorttitle = {Effectiveness of visceral fascial therapy targeting visceral dysfunctions outcome},
	url = {https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-023-04099-1},
	doi = {10.1186/s12906-023-04099-1},
	abstract = {Abstract
            
              Background
              Fascial Therapy is an ancient and widespread practice throughout the world. These approaches are very common in osteopathic practice and taught in workshops for professionals from different areas of health care, including Physiotherapy. This type of treatment is quite specialized and centered on the therapist. However, there is a lack of high-quality and low-risk bias studies that justify the use of this practice. Despite this, there is little scientific evidence about the effectiveness of Fascial Therapy to treat some visceral disorders. The purpose of this study was to critically appraise the scientific literature concerning the clinical efficacy of techniques used in Fascial Therapy targeting the visceral system.
            
            
              Methods
              This systematic review included randomized controlled trials in any language or date of publication. All primary outcomes reported were included. The methodological quality and statistical reporting of each eligible trial were evaluated using the version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). This systematic review provided a synthesis of current evidence on the effects of Fascial Therapy in patients with visceral disorders and/or pain. A total of 11 studies were included, with five of them covering gastrointestinal dysfunction, two covering cardiorespiratory dysfunction, two covering musculoskeletal dysfunction, and two covering urogenital dysfunction.
            
            
              Results
              Fascial Therapy targeting the visceral system has been shown to be effective in reducing pain over the long term in people with low back pain when combined with standard physical therapy and effective in reducing gastroesophageal reflux symptoms over the short term. Considering the overall bias, six studies were at high risk of bias, two studies had some concerns and only three studies were at low risk of bias. Of the three studies with a low risk of bias, only two showed positive results and were effective in improving the studied outcome.
            
            
              Conclusion
              This systematic review shows that currently, there is poor evidence for the efficacy of the techniques used in Fascial Therapy targeting the visceral system, and this information can help healthcare professionals in decision-making related to the use of Fascial Therapy targeting the visceral system in patients with visceral disorders and/or pain.},
	language = {en},
	number = {1},
	urldate = {2024-01-13},
	journal = {BMC Complementary Medicine and Therapies},
	author = {Da Silva, Fabiana C. and Vieira, Leonardo S. and Santos, Lucas V. and Gaudreault, Nathaly and Cruvinel-Júnior, Ronaldo H. and Santos, Gilmar M.},
	month = jul,
	year = {2023},
	pages = {274},
}

Abstract Background Fascial Therapy is an ancient and widespread practice throughout the world. These approaches are very common in osteopathic practice and taught in workshops for professionals from different areas of health care, including Physiotherapy. This type of treatment is quite specialized and centered on the therapist. However, there is a lack of high-quality and low-risk bias studies that justify the use of this practice. Despite this, there is little scientific evidence about the effectiveness of Fascial Therapy to treat some visceral disorders. The purpose of this study was to critically appraise the scientific literature concerning the clinical efficacy of techniques used in Fascial Therapy targeting the visceral system. Methods This systematic review included randomized controlled trials in any language or date of publication. All primary outcomes reported were included. The methodological quality and statistical reporting of each eligible trial were evaluated using the version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). This systematic review provided a synthesis of current evidence on the effects of Fascial Therapy in patients with visceral disorders and/or pain. A total of 11 studies were included, with five of them covering gastrointestinal dysfunction, two covering cardiorespiratory dysfunction, two covering musculoskeletal dysfunction, and two covering urogenital dysfunction. Results Fascial Therapy targeting the visceral system has been shown to be effective in reducing pain over the long term in people with low back pain when combined with standard physical therapy and effective in reducing gastroesophageal reflux symptoms over the short term. Considering the overall bias, six studies were at high risk of bias, two studies had some concerns and only three studies were at low risk of bias. Of the three studies with a low risk of bias, only two showed positive results and were effective in improving the studied outcome. Conclusion This systematic review shows that currently, there is poor evidence for the efficacy of the techniques used in Fascial Therapy targeting the visceral system, and this information can help healthcare professionals in decision-making related to the use of Fascial Therapy targeting the visceral system in patients with visceral disorders and/or pain.

@article{degenhardt_profession-based_2023,
	title = {Profession-based manual therapy nomenclature: exploring history, limitations, and opportunities},
	issn = {1066-9817, 2042-6186},
	shorttitle = {Profession-based manual therapy nomenclature},
	url = {https://www.tandfonline.com/doi/full/10.1080/10669817.2023.2288495},
	doi = {10.1080/10669817.2023.2288495},
	language = {en},
	urldate = {2023-12-29},
	journal = {Journal of Manual \& Manipulative Therapy},
	author = {Degenhardt, Brian and Van Dun, Patrick L.S. and Jacobson, Eric and Fritz, Sandy and Mettler, Paul and Kettner, Norman and Franklin, G. and Hensel, Kendi and Lesondak, David and Consorti, Giacomo and Frank, Leah and Reed, William R. and MacDonald, Cameron and Kremen, Vaclav and Martin, Crystal and Landels, Bernie and Standley, Paul},
	month = dec,
	year = {2023},
	pages = {1--15},
}

@article{dube_one_2023,
	title = {One and {Done}? {The} {Effectiveness} of a {Single} {Session} of {Physiotherapy} {Compared} {With} {Multiple} {Sessions} to {Reduce} {Pain} and {Improve} {Function} and {Quality} of {Life} in {Patients} {With} a {Musculoskeletal} {Disorder}: {A} {Systematic} {Review} {With} {Meta}-analyses},
	issn = {00039993},
	shorttitle = {One and {Done}?},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S000399932300549X},
	doi = {10.1016/j.apmr.2023.09.017},
	language = {en},
	urldate = {2023-12-22},
	journal = {Archives of Physical Medicine and Rehabilitation},
	author = {Dubé, Marc-Olivier and Dillon, Sarah and Gallagher, Kevin and Ryan, Jake and McCreesh, Karen},
	month = oct,
	year = {2023},
	pages = {S000399932300549X},
}

@article{thomson_whats_2023,
	title = {What's wrong with osteopathy?},
	volume = {48},
	issn = {17460689},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1746068923000032},
	doi = {10.1016/j.ijosm.2023.100659},
	language = {en},
	urldate = {2023-12-22},
	journal = {International Journal of Osteopathic Medicine},
	author = {Thomson, Oliver P. and MacMillan, Andrew},
	month = jun,
	year = {2023},
	pages = {100659},
}

@article{yao_management_2023,
	title = {Management of chronic pain secondary to temporomandibular disorders: a systematic review and network meta-analysis of randomised trials},
	issn = {1756-1833},
	shorttitle = {Management of chronic pain secondary to temporomandibular disorders},
	url = {https://www.bmj.com/lookup/doi/10.1136/bmj-2023-076226},
	doi = {10.1136/bmj-2023-076226},
	abstract = {Abstract
            
              Objective
              We explored the comparative effectiveness of available therapies for chronic pain associated with temporomandibular disorders (TMD).
            
            
              Design
              Systematic review and network meta-analysis of randomised clinical trials (RCTs).
            
            
              Data sources
              MEDLINE, EMBASE, CINAHL, CENTRAL, and SCOPUS were searched to May 2021, and again in January 2023.
            
            
              Study selection
              Interventional RCTs that enrolled patients presenting with chronic pain associated with TMD.
            
            
              Data extraction and synthesis
              Pairs of reviewers independently identified eligible studies, extracted data, and assessed risk of bias. We captured all reported patient-important outcomes, including pain relief, physical functioning, emotional functioning, role functioning, social functioning, sleep quality, and adverse events. We conducted frequentist network meta-analyses to summarise the evidence and used the GRADE approach to rate the certainty of evidence and categorise interventions from most to least beneficial.
            
            
              Results
              233 trials proved eligible for review, of which 153—enrolling 8713 participants and exploring 59 interventions or combinations of interventions—were included in network meta-analyses. All subsequent effects refer to comparisons with placebo or sham procedures. Effects on pain for eight interventions were supported by high to moderate certainty evidence. The three therapies probably most effective for pain relief were cognitive behavioural therapy (CBT) augmented with biofeedback or relaxation therapy (risk difference (RD) for achieving the minimally important difference (MID) in pain relief of 1 cm on a 10 cm visual analogue scale: 36\% (95\% CI 33 to 39)), therapist-assisted jaw mobilisation (RD 36\% (95\% CI 31 to 40)), and manual trigger point therapy (RD 32\% (29 to 34)). Five interventions were less effective, yet more effective than placebo, showing RDs ranging between 23\% and 30\%: CBT, supervised postural exercise, supervised jaw exercise and stretching, supervised jaw exercise and stretching with manual trigger point therapy, and usual care (such as home exercises, self stretching, reassurance).
              Moderate certainty evidence showed four interventions probably improved physical functioning: supervised jaw exercise and stretching (RD for achieving the MID of 5 points on the short form-36 physical component summary score: 43\% (95\% CI 33 to 51)), manipulation (RD 43\% (25 to 56)), acupuncture (RD 42\% (33 to 50)), and supervised jaw exercise and mobilisation (RD 36\% (19 to 51)). The evidence for pain relief or physical functioning among other interventions, and all evidence for adverse events, was low or very low certainty.
            
            
              Conclusion
              When restricted to moderate or high certainty evidence, interventions that promote coping and encourage movement and activity were found to be most effective for reducing chronic TMD pain.
            
            
              Registration
              PROSPERO (CRD42021258567)},
	language = {en},
	urldate = {2023-12-22},
	journal = {BMJ},
	author = {Yao, Liang and Sadeghirad, Behnam and Li, Meixuan and Li, Jing and Wang, Qi and Crandon, Holly N and Martin, Grace and Morgan, Rebecca and Florez, Ivan D and Hunskaar, Birk Stokke and Wells, Jeff and Moradi, Sara and Zhu, Ying and Ahmed, Muhammad Muneeb and Gao, Ya and Cao, Liujiao and Yang, Kehu and Tian, Jinhui and Li, Jialing and Zhong, Linda and Couban, Rachel J and Guyatt, Gordon H and Agoritsas, Thomas and Busse, Jason W},
	month = dec,
	year = {2023},
	pages = {e076226},
}

Abstract Objective We explored the comparative effectiveness of available therapies for chronic pain associated with temporomandibular disorders (TMD). Design Systematic review and network meta-analysis of randomised clinical trials (RCTs). Data sources MEDLINE, EMBASE, CINAHL, CENTRAL, and SCOPUS were searched to May 2021, and again in January 2023. Study selection Interventional RCTs that enrolled patients presenting with chronic pain associated with TMD. Data extraction and synthesis Pairs of reviewers independently identified eligible studies, extracted data, and assessed risk of bias. We captured all reported patient-important outcomes, including pain relief, physical functioning, emotional functioning, role functioning, social functioning, sleep quality, and adverse events. We conducted frequentist network meta-analyses to summarise the evidence and used the GRADE approach to rate the certainty of evidence and categorise interventions from most to least beneficial. Results 233 trials proved eligible for review, of which 153—enrolling 8713 participants and exploring 59 interventions or combinations of interventions—were included in network meta-analyses. All subsequent effects refer to comparisons with placebo or sham procedures. Effects on pain for eight interventions were supported by high to moderate certainty evidence. The three therapies probably most effective for pain relief were cognitive behavioural therapy (CBT) augmented with biofeedback or relaxation therapy (risk difference (RD) for achieving the minimally important difference (MID) in pain relief of 1 cm on a 10 cm visual analogue scale: 36% (95% CI 33 to 39)), therapist-assisted jaw mobilisation (RD 36% (95% CI 31 to 40)), and manual trigger point therapy (RD 32% (29 to 34)). Five interventions were less effective, yet more effective than placebo, showing RDs ranging between 23% and 30%: CBT, supervised postural exercise, supervised jaw exercise and stretching, supervised jaw exercise and stretching with manual trigger point therapy, and usual care (such as home exercises, self stretching, reassurance). Moderate certainty evidence showed four interventions probably improved physical functioning: supervised jaw exercise and stretching (RD for achieving the MID of 5 points on the short form-36 physical component summary score: 43% (95% CI 33 to 51)), manipulation (RD 43% (25 to 56)), acupuncture (RD 42% (33 to 50)), and supervised jaw exercise and mobilisation (RD 36% (19 to 51)). The evidence for pain relief or physical functioning among other interventions, and all evidence for adverse events, was low or very low certainty. Conclusion When restricted to moderate or high certainty evidence, interventions that promote coping and encourage movement and activity were found to be most effective for reducing chronic TMD pain. Registration PROSPERO (CRD42021258567)

@article{sherriff_musculoskeletal_2023,
	title = {Musculoskeletal practitioners’ perceptions of contextual factors that may influence chronic low back pain outcomes: a modified {Delphi} study},
	volume = {31},
	issn = {2045-709X},
	shorttitle = {Musculoskeletal practitioners’ perceptions of contextual factors that may influence chronic low back pain outcomes},
	url = {https://chiromt.biomedcentral.com/articles/10.1186/s12998-023-00482-4},
	doi = {10.1186/s12998-023-00482-4},
	abstract = {Abstract
            
              Background
              Optimal shaping of contextual factors (CFs) during clinical encounters may be associated with analgesic responses in treatments for musculoskeletal pain. These CFs (i.e., the patient-practitioner relationship, patient’s and practitioner’s beliefs/characteristics, treatment characteristics, and environment) have not been widely evaluated by musculoskeletal practitioners. Understanding their views has the potential to improve treatment quality and effectiveness. Drawing on a panel of United Kingdom practitioners’ expertise, this study aimed to investigate their perceptions of CFs during the management of patients presenting with chronic low back pain (LBP).
            
            
              Methods
              A modified two-round online Delphi-consensus survey was conducted to measure the extent of panel agreement regarding the perceived acceptability and influence of five main types of CFs during clinical management of patients with chronic LBP. Qualified musculoskeletal practitioners in the United Kingdom providing regular treatment for patients with chronic LBP were invited to take part.
            
            
              Results
              The successive Delphi rounds included 39 and 23 panellists with an average of 19.9 and 21.3 years of clinical experience respectively. The panel demonstrated a high degree of consensus regarding approaches to enhance the patient-practitioner relationship (18/19 statements); leverage their own characteristics/beliefs (10/11 statements); modify the patient’s beliefs and consider patient’s characteristics (21/25 statements) to influence patient outcomes during chronic LBP rehabilitation. There was a lower degree of consensus regarding the influence and use of approaches related to the treatment characteristics (6/12 statements) and treatment environment (3/7 statements), and these CFs were viewed as the least important. The patient-practitioner relationship was rated as the most important CF, although the panel were not entirely confident in managing a range of patients’ cognitive and emotional needs.
            
            
              Conclusion
              This Delphi study provides initial insights regarding a panel of musculoskeletal practitioners’ attitudes towards CFs during chronic LBP rehabilitation in the United Kingdom. All five CF domains were perceived as capable of influencing patient outcomes, with the patient-practitioner relationship being perceived as the most important CF during routine clinical practice. Musculoskeletal practitioners may require further training to enhance their proficiency and confidence in applying essential psychosocial skills to address the complex needs of patients with chronic LBP.},
	language = {en},
	number = {1},
	urldate = {2023-12-13},
	journal = {Chiropractic \& Manual Therapies},
	author = {Sherriff, Bronwyn and Clark, Carol and Killingback, Clare and Newell, Dave},
	month = apr,
	year = {2023},
	pages = {12},
}

Abstract Background Optimal shaping of contextual factors (CFs) during clinical encounters may be associated with analgesic responses in treatments for musculoskeletal pain. These CFs (i.e., the patient-practitioner relationship, patient’s and practitioner’s beliefs/characteristics, treatment characteristics, and environment) have not been widely evaluated by musculoskeletal practitioners. Understanding their views has the potential to improve treatment quality and effectiveness. Drawing on a panel of United Kingdom practitioners’ expertise, this study aimed to investigate their perceptions of CFs during the management of patients presenting with chronic low back pain (LBP). Methods A modified two-round online Delphi-consensus survey was conducted to measure the extent of panel agreement regarding the perceived acceptability and influence of five main types of CFs during clinical management of patients with chronic LBP. Qualified musculoskeletal practitioners in the United Kingdom providing regular treatment for patients with chronic LBP were invited to take part. Results The successive Delphi rounds included 39 and 23 panellists with an average of 19.9 and 21.3 years of clinical experience respectively. The panel demonstrated a high degree of consensus regarding approaches to enhance the patient-practitioner relationship (18/19 statements); leverage their own characteristics/beliefs (10/11 statements); modify the patient’s beliefs and consider patient’s characteristics (21/25 statements) to influence patient outcomes during chronic LBP rehabilitation. There was a lower degree of consensus regarding the influence and use of approaches related to the treatment characteristics (6/12 statements) and treatment environment (3/7 statements), and these CFs were viewed as the least important. The patient-practitioner relationship was rated as the most important CF, although the panel were not entirely confident in managing a range of patients’ cognitive and emotional needs. Conclusion This Delphi study provides initial insights regarding a panel of musculoskeletal practitioners’ attitudes towards CFs during chronic LBP rehabilitation in the United Kingdom. All five CF domains were perceived as capable of influencing patient outcomes, with the patient-practitioner relationship being perceived as the most important CF during routine clinical practice. Musculoskeletal practitioners may require further training to enhance their proficiency and confidence in applying essential psychosocial skills to address the complex needs of patients with chronic LBP.

@article{keter_international_2023,
	title = {An international consensus on gaps in mechanisms of forced-based manipulation research: findings from a nominal group technique},
	issn = {1066-9817, 2042-6186},
	shorttitle = {An international consensus on gaps in mechanisms of forced-based manipulation research},
	url = {https://www.tandfonline.com/doi/full/10.1080/10669817.2023.2262336},
	doi = {10.1080/10669817.2023.2262336},
	language = {en},
	urldate = {2023-12-01},
	journal = {Journal of Manual \& Manipulative Therapy},
	author = {Keter, Damian L. and Bent, Jennifer A. and Bialosky, Joel E. and Courtney, Carol A. and Esteves, Jorge E. and Funabashi, Martha and Howarth, Samuel J. and Injeyan, H. Stephen and Mazzieri, Anna Maria and Glissmann Nim, Casper and Cook, Chad E.},
	month = oct,
	year = {2023},
	pages = {1--7},
}

@article{whedon_association_2023,
	title = {The association between cervical artery dissection and spinal manipulation among {US} adults},
	volume = {32},
	issn = {0940-6719, 1432-0932},
	url = {https://link.springer.com/10.1007/s00586-023-07844-9},
	doi = {10.1007/s00586-023-07844-9},
	language = {en},
	number = {10},
	urldate = {2023-12-01},
	journal = {European Spine Journal},
	author = {Whedon, James M. and Petersen, Curtis L. and Schoellkopf, William J. and Haldeman, Scott and MacKenzie, Todd A. and Lurie, Jon D.},
	month = oct,
	year = {2023},
	pages = {3497--3504},
}

@article{bordoni_rethinking_2023,
	title = {Rethinking the {Origin} of the {Primary} {Respiratory} {Mechanism}},
	volume = {15},
	issn = {2168-8184},
	doi = {10.7759/cureus.46527},
	abstract = {Spheno-occipital synchondrosis (SOS) is the joint regarded as the most important foundation for understanding cranial osteopathy and craniosacral therapy. SOS is the origin of the primary respiratory mechanism (PRM), a movement between the posterior surface of the body of the sphenoid bone and the anterior surface of the base of the occipital bone. From the PRM perspective, an alteration of the position between the two bone surfaces would create cranial and/or craniosacral dysfunction. These positional alterations of the SOS (in adults and children) would determine specific and schematical movements of the bones of the entire skull, whose movements are recognizable by palpation by trained operators. PRM expression is influenced by other elements, such as movement of the cranial bones, inherent movement of the central nervous system, cyclic movement of cerebrospinal fluid (CSF), mechanical tension of the cranial meninges, and passive movement of the sacral bone between the iliac bones. The article reviews the most up-to-date information on the evolution of cranial sutures/joints and meninges in adulthood, the fluctuations of the CSF, brain, and spinal mass movements. Research should reconsider the motivations that induce the operator to discriminate the palpable cranial rhythmic impulse, and probably, to rethink new cranial dysfunctional patterns.},
	language = {eng},
	number = {10},
	journal = {Cureus},
	author = {Bordoni, Bruno and Escher, Allan R.},
	month = oct,
	year = {2023},
	pmid = {37808591},
	pmcid = {PMC10552882},
	keywords = {craniosacral therapy, fascia, osteopathic manipulation, osteopathy, spheno-occipital synchondrosis},
	pages = {e46527},
}

Spheno-occipital synchondrosis (SOS) is the joint regarded as the most important foundation for understanding cranial osteopathy and craniosacral therapy. SOS is the origin of the primary respiratory mechanism (PRM), a movement between the posterior surface of the body of the sphenoid bone and the anterior surface of the base of the occipital bone. From the PRM perspective, an alteration of the position between the two bone surfaces would create cranial and/or craniosacral dysfunction. These positional alterations of the SOS (in adults and children) would determine specific and schematical movements of the bones of the entire skull, whose movements are recognizable by palpation by trained operators. PRM expression is influenced by other elements, such as movement of the cranial bones, inherent movement of the central nervous system, cyclic movement of cerebrospinal fluid (CSF), mechanical tension of the cranial meninges, and passive movement of the sacral bone between the iliac bones. The article reviews the most up-to-date information on the evolution of cranial sutures/joints and meninges in adulthood, the fluctuations of the CSF, brain, and spinal mass movements. Research should reconsider the motivations that induce the operator to discriminate the palpable cranial rhythmic impulse, and probably, to rethink new cranial dysfunctional patterns.

@article{pelz_validation_2023,
	title = {Validation of subjective manual palpation using objective physiological recordings of the cranial rhythmic impulse during osteopathic manipulative intervention},
	volume = {13},
	issn = {2045-2322},
	doi = {10.1038/s41598-023-33644-8},
	abstract = {Intermediate (IM) band physiology in skin blood flow exhibits parallels with the primary respiratory mechanism (PRM) or cranial rhythmic impulse (CRI), controversial concepts of osteopathy in the cranial field (OCF). Owing to inconsistent manual palpation results, validity of evidence of PRM/CRI activity has been questionable. We therefore tried to validate manual palpation combining instrumented tracking and algorithmic objectivation of frequencies, amplitudes, and phases. Using a standard OCF intervention, cranial vault hold (CVH), two OCF experts palpated and digitally marked CRI frequencies in 25 healthy adults. Autonomic nervous system (ANS) activity in low frequency (LF) and IM band in photoplethysmographic (PPG) forehead skin recordings was probed with momentary frequency of highest amplitude (MFHA) and wavelet amplitude spectra (WAS) in examiners and participants. Palpation errors and frequency expectation bias during CVH were analyzed for phases of MFHA and CRI. Palpated CRI frequencies (0.05-0.08 Hz) correlated highly with mean MFHA frequencies with 1:1 ratio in 77\% of participants (LF-responders; 0.072 Hz) and with 2:1 ratio in 23\% of participants (IM-responders; 0.147 Hz). WAS analysis in both groups revealed integer number (harmonic) waves in (very) low and IM bands in {\textgreater} 98\% of palpated intervals. Phase analyses in participants and examiners suggested synchronization between MFHA and CRI in a subset of LF-responders. IM band physiology in forehead PPG may offer a sensible physiological correlate of palpated CRI activity. Possible coordination or synchronization effects with additional physiological signals and between examiners and participants should be investigated in future studies.},
	language = {eng},
	number = {1},
	journal = {Scientific Reports},
	author = {Pelz, Holger and Müller, Gero and Keller, Micha and Mathiak, Klaus and Mayer, Johannes and Borik, Stefan and Perlitz, Volker},
	month = apr,
	year = {2023},
	pmid = {37095164},
	pmcid = {PMC10126088},
	keywords = {Adult, Forehead, Humans, Manipulation, Osteopathic, Palpation, Skin, Skull},
	pages = {6611},
}

Intermediate (IM) band physiology in skin blood flow exhibits parallels with the primary respiratory mechanism (PRM) or cranial rhythmic impulse (CRI), controversial concepts of osteopathy in the cranial field (OCF). Owing to inconsistent manual palpation results, validity of evidence of PRM/CRI activity has been questionable. We therefore tried to validate manual palpation combining instrumented tracking and algorithmic objectivation of frequencies, amplitudes, and phases. Using a standard OCF intervention, cranial vault hold (CVH), two OCF experts palpated and digitally marked CRI frequencies in 25 healthy adults. Autonomic nervous system (ANS) activity in low frequency (LF) and IM band in photoplethysmographic (PPG) forehead skin recordings was probed with momentary frequency of highest amplitude (MFHA) and wavelet amplitude spectra (WAS) in examiners and participants. Palpation errors and frequency expectation bias during CVH were analyzed for phases of MFHA and CRI. Palpated CRI frequencies (0.05-0.08 Hz) correlated highly with mean MFHA frequencies with 1:1 ratio in 77% of participants (LF-responders; 0.072 Hz) and with 2:1 ratio in 23% of participants (IM-responders; 0.147 Hz). WAS analysis in both groups revealed integer number (harmonic) waves in (very) low and IM bands in \textgreater 98% of palpated intervals. Phase analyses in participants and examiners suggested synchronization between MFHA and CRI in a subset of LF-responders. IM band physiology in forehead PPG may offer a sensible physiological correlate of palpated CRI activity. Possible coordination or synchronization effects with additional physiological signals and between examiners and participants should be investigated in future studies.

@article{de_sire_myths_2023,
	title = {Myths and truths on biophysics-based approach in rehabilitation of musculoskeletal disorders},
	volume = {15},
	issn = {1759-720X},
	doi = {10.1177/1759720X231183867},
	abstract = {Musculoskeletal disorders (MSD) are a crucial issue in current literature due to their impact on physical function, social, and economic costs. Rehabilitation plays a pivotal role in the therapeutic management of these disabling conditions with growing evidence underlining positive effects in improving functional outcomes. However, to date, several questions are still open about the mechanisms underpinning functional improvements while recent research is now focusing on a deeper understanding of the biophysical processes underpinning the macroscopical effects of these treatments. Thus, this narrative review aims at providing a comprehensive overview about the state of the art of biophysical dimensions of currently available treatments for MSD. PubMed, Scopus, CENTRAL, PEDro, and Web of Science were searched between March 2022 and October 2022 for in vitro and in vivo studies, clinical trials, systematic reviews, and meta-analysis addressing the issue of biophysics-based approach in rehabilitation of MSD. Our findings showed that a biophysical approach might be integrated into regenerative rehabilitation, aiming at enhancing regenerative processes by mechanical and biophysical stimuli. In addition, a biophysical-based approach has been proposed to improve knowledge about several instrumental physical therapies, including shock wave therapies, low-level laser therapy, ultrasound, short-wave diathermy, electrical stimulation, pulsed electromagnetic field, and vibration therapy. In accordance, emerging research is now focusing on the biophysical properties of several medical procedures to improve pain management in patients with MSD. Taken together, our results showed promising results of the integration of a biophysical-based approach in rehabilitation, albeit several limitations currently limit its implementation in routine clinical setting. Unfortunately, the state of the art is still inconclusive, and the low quality of clinical studies based on the biophysical approach did not provide clear treatment protocols. Further studies are needed to promote a precise rehabilitation approach targeting biological modification and enhancing the functional improvement of patients with MSDs.},
	language = {eng},
	journal = {Therapeutic Advances in Musculoskeletal Disease},
	author = {de Sire, Alessandro and Lippi, Lorenzo and Marotta, Nicola and Ferrillo, Martina and Folli, Arianna and Turco, Alessio and Ammendolia, Antonio and Invernizzi, Marco},
	year = {2023},
	pmid = {37484926},
	pmcid = {PMC10359654},
	keywords = {biophysics, musculoskeletal disorders, pain, regenerative medicine, rehabilitation},
	pages = {1759720X231183867},
}

Musculoskeletal disorders (MSD) are a crucial issue in current literature due to their impact on physical function, social, and economic costs. Rehabilitation plays a pivotal role in the therapeutic management of these disabling conditions with growing evidence underlining positive effects in improving functional outcomes. However, to date, several questions are still open about the mechanisms underpinning functional improvements while recent research is now focusing on a deeper understanding of the biophysical processes underpinning the macroscopical effects of these treatments. Thus, this narrative review aims at providing a comprehensive overview about the state of the art of biophysical dimensions of currently available treatments for MSD. PubMed, Scopus, CENTRAL, PEDro, and Web of Science were searched between March 2022 and October 2022 for in vitro and in vivo studies, clinical trials, systematic reviews, and meta-analysis addressing the issue of biophysics-based approach in rehabilitation of MSD. Our findings showed that a biophysical approach might be integrated into regenerative rehabilitation, aiming at enhancing regenerative processes by mechanical and biophysical stimuli. In addition, a biophysical-based approach has been proposed to improve knowledge about several instrumental physical therapies, including shock wave therapies, low-level laser therapy, ultrasound, short-wave diathermy, electrical stimulation, pulsed electromagnetic field, and vibration therapy. In accordance, emerging research is now focusing on the biophysical properties of several medical procedures to improve pain management in patients with MSD. Taken together, our results showed promising results of the integration of a biophysical-based approach in rehabilitation, albeit several limitations currently limit its implementation in routine clinical setting. Unfortunately, the state of the art is still inconclusive, and the low quality of clinical studies based on the biophysical approach did not provide clear treatment protocols. Further studies are needed to promote a precise rehabilitation approach targeting biological modification and enhancing the functional improvement of patients with MSDs.

@article{altinbilek_evaluation_2023,
	title = {Evaluation of effectiveness of osteopathic visceral manipulation in patients with chronic mechanical low back pain: {A} multi-center, single-blind, randomized-controlled study},
	volume = {69},
	issn = {25871250},
	shorttitle = {Evaluation of effectiveness of osteopathic visceral manipulation in patients with chronic mechanical low back pain},
	url = {https://www.ftrdergisi.com/uploads/pdf/pdf_4480.pdf},
	doi = {10.5606/tftrd.2023.12541},
	abstract = {Objectives: In this study, we aimed to evaluate the effectiveness of osteopathic visceral manipulation (OVM) combined with physical therapy in pain, depression, and functional impairment in patients with chronic mechanical low back pain (LBP). Patients and methods: A total of 118 patients with chronic mechanical LBP were assessed, and 86 who met the inclusion criteria were included in the randomized-controlled study between January 2021 and August 2022. The patients were randomized to either Group 1 (n=43), which underwent physical therapy (5 days/week, for a total of 15 sessions) combined with OVM (2 days/week with three-day intervals), or Group 2 (n=43), which underwent physical therapy (5 days/week, for a total of 15 sessions) combined with sham OVM (2 days/week with three-day intervals). Both groups were assessed before and after treatment and at the fourth week post-treatment. Results: Seven patients were lost to follow-up, and the study was completed with 79 patients (25 males, 54 females; mean age: 46.87±14.12 years; range, 19 to 75 years). Pain, depression, and functional impairment scores were all improved in both groups (p=0.001 for all). This improvement was sustained at week four after the end of treatment. However, improvement in the pain, depression, and functional impairment scores was significantly higher in Group 1 than in Group 2 (p=0.001 for all). Conclusion: The results suggest that OVM combined with physical therapy is useful to improve pain, depression, and functional impairment in patients with chronic mechanical low back pain. We believe that OVM techniques should be combined with other physical therapy modalities in this patient population.},
	number = {4},
	urldate = {2023-11-11},
	journal = {Turkish Journal of Physical Medicine and Rehabilitation},
	author = {Altınbilek, Turgay},
	month = oct,
	year = {2023},
	pages = {500--509},
}

Objectives: In this study, we aimed to evaluate the effectiveness of osteopathic visceral manipulation (OVM) combined with physical therapy in pain, depression, and functional impairment in patients with chronic mechanical low back pain (LBP). Patients and methods: A total of 118 patients with chronic mechanical LBP were assessed, and 86 who met the inclusion criteria were included in the randomized-controlled study between January 2021 and August 2022. The patients were randomized to either Group 1 (n=43), which underwent physical therapy (5 days/week, for a total of 15 sessions) combined with OVM (2 days/week with three-day intervals), or Group 2 (n=43), which underwent physical therapy (5 days/week, for a total of 15 sessions) combined with sham OVM (2 days/week with three-day intervals). Both groups were assessed before and after treatment and at the fourth week post-treatment. Results: Seven patients were lost to follow-up, and the study was completed with 79 patients (25 males, 54 females; mean age: 46.87±14.12 years; range, 19 to 75 years). Pain, depression, and functional impairment scores were all improved in both groups (p=0.001 for all). This improvement was sustained at week four after the end of treatment. However, improvement in the pain, depression, and functional impairment scores was significantly higher in Group 1 than in Group 2 (p=0.001 for all). Conclusion: The results suggest that OVM combined with physical therapy is useful to improve pain, depression, and functional impairment in patients with chronic mechanical low back pain. We believe that OVM techniques should be combined with other physical therapy modalities in this patient population.

@article{chhabra_spine20_2023,
	title = {{SPINE20} recommendations 2023: {One} {Earth}, one family, one future {WITHOUT} spine {DISABILITY}},
	issn = {27725294},
	shorttitle = {{SPINE20} recommendations 2023},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S2772529423009761},
	doi = {10.1016/j.bas.2023.102688},
	language = {en},
	urldate = {2023-10-11},
	journal = {Brain and Spine},
	author = {Chhabra, Harvinder S. and Tamai, Koji and Alsebayel, Hana and AlEissa, Sami and Alqahtani, Yahya and Arand, Markus and Basu, Saumyajit and Blattert, Thomas R. and Bussières, André and Campello, Marco and Costanzo, Giuseppe and Côté, Pierre and Darwano, Bambang and Franke, Jörg and Garg, Bhavuk and Hasan, Rumaisah and Ito, Manabu and Kamra, Komal and Kandziora, Frank and Kassim, Nishad and Kato, So and Lahey, Donna and Mehta, Ketna and Menezes, Cristiano M. and Muehlbauer, Eric J. and Mullerpatan, Rajani and Pereira, Paulo and Roberts, Lisa and Ruosi, Carlo and Sullivan, William and Shetty, Ajoy P. and Tucci, Carlos and Wadhwa, Sanjay and Alturkistany, Ahmed and Busari, Jamiu O. and Wang, Jeffrey C. and Teli, Marco G.A. and Rajasekaran, Shanmuganathan and Mulukutla, Raghava D. and Piccirillo, Michael and Hsieh, Patrick C. and Dohring, Edward J. and Srivastava, Sudhir K. and Larouche, Jeremie and Vlok, Adriaan and Nordin, Margareta},
	month = oct,
	year = {2023},
	pages = {102688},
}

@article{ciardo_importance_2023-1,
	title = {The importance of constructing an osteopathic profession around modern common academic values and avoiding pseudoscience: {The} {Spanish} experience},
	issn = {22129588},
	shorttitle = {The importance of constructing an osteopathic profession around modern common academic values and avoiding pseudoscience},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S2212958823000782},
	doi = {10.1016/j.aimed.2023.09.003},
	language = {en},
	urldate = {2023-10-11},
	journal = {Advances in Integrative Medicine},
	author = {Ciardo, Antonio and Sánchez, Mar García and Fernández, Moisés Cobo},
	month = sep,
	year = {2023},
	pages = {S2212958823000782},
}

@book{mittelmark_handbook_2022,
	address = {Cham},
	title = {The {Handbook} of {Salutogenesis}},
	isbn = {978-3-030-79514-6 978-3-030-79515-3},
	url = {https://link.springer.com/10.1007/978-3-030-79515-3},
	language = {en},
	urldate = {2024-02-10},
	publisher = {Springer International Publishing},
	editor = {Mittelmark, Maurice B. and Bauer, Georg F. and Vaandrager, Lenneke and Pelikan, Jürgen M. and Sagy, Shifra and Eriksson, Monica and Lindström, Bengt and Meier Magistretti, Claudia},
	year = {2022},
	doi = {10.1007/978-3-030-79515-3},
}

@article{vogel_relevance_2022,
	title = {Relevance of historical osteopathic principles and practices in contemporary care: {Another} perspective from traditional/complementary and alternative medicine},
	volume = {44},
	issn = {17460689},
	shorttitle = {Relevance of historical osteopathic principles and practices in contemporary care},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1746068922000232},
	doi = {10.1016/j.ijosm.2022.04.008},
	language = {en},
	urldate = {2024-01-28},
	journal = {International Journal of Osteopathic Medicine},
	author = {Vogel, Steven and Zegarra-Parodi, Rafael},
	month = jun,
	year = {2022},
	pages = {1--2},
}

@article{fitzgerald_no_2022,
	title = {No gain without pain education: {Improving} knowledge and biopsychosocial attitudes and beliefs in a predominantly non-health-related undergraduate target audience},
	volume = {20},
	issn = {1557-0681},
	shorttitle = {No gain without pain education},
	doi = {10.1002/msc.1630},
	abstract = {OBJECTIVES: Chronic pain (CP) impacts individuals and society and is the leading cause of disability globally. Pain education interventions are often evaluated in patients and health professional students, but not in non-health student groups. Increasing knowledge of pain may facilitate shifts in attitudes and beliefs towards sufferers. We report on changes in pain knowledge, attitudes and beliefs of predominantly non-health-related tertiary degree students participating in online education.
METHODS: Quantitative cohort study design. Students reported demographics and completed the Chronic Pain Myth Scale and 12-item Neurophysiology of Pain Questionnaire (NPQ) before (T1) and after (T2) the 7-week online module at The University of Sydney in 2020.
RESULTS: Twenty-two students undertaking predominantly non-health-related bachelor's degrees (16.5\% response rate, 90.9\% female, mean = 19.5 years) participated. NPQ scores increased from 47.3\% to 62.9\%. Attitudes and beliefs towards biopsychosocial impact improved (p {\textless} 0.027) but not towards individuals suffering from CP or treatment of CP. A negative correlation was found between age and people suffering from CP (ρ = -0.437, p {\textless} 0.042) and age and towards treatment of CP; ρ = -0.556, p {\textless} 0.007) at T2.
CONCLUSION: Completing the elective online module resulted in improved knowledge and biopsychosocial attitudes towards CP in this predominantly non-health cohort, as reported in health and patient cohorts.},
	language = {eng},
	number = {3},
	journal = {Musculoskeletal Care},
	author = {Fitzgerald, Kylie and Vaughan, Brett and Devonshire, Elizabeth and Schneider, Carl and Denham, Rebecca},
	month = sep,
	year = {2022},
	pmid = {35278023},
	keywords = {Attitude of Health Personnel, Chronic Pain, Cohort Studies, Female, Health Knowledge, Attitudes, Practice, Humans, Male, Pain Measurement, Students, Surveys and Questionnaires, attitudes, chronic pain, education, students, surveys and questionnaires},
	pages = {660--665},
}

OBJECTIVES: Chronic pain (CP) impacts individuals and society and is the leading cause of disability globally. Pain education interventions are often evaluated in patients and health professional students, but not in non-health student groups. Increasing knowledge of pain may facilitate shifts in attitudes and beliefs towards sufferers. We report on changes in pain knowledge, attitudes and beliefs of predominantly non-health-related tertiary degree students participating in online education. METHODS: Quantitative cohort study design. Students reported demographics and completed the Chronic Pain Myth Scale and 12-item Neurophysiology of Pain Questionnaire (NPQ) before (T1) and after (T2) the 7-week online module at The University of Sydney in 2020. RESULTS: Twenty-two students undertaking predominantly non-health-related bachelor's degrees (16.5% response rate, 90.9% female, mean = 19.5 years) participated. NPQ scores increased from 47.3% to 62.9%. Attitudes and beliefs towards biopsychosocial impact improved (p \textless 0.027) but not towards individuals suffering from CP or treatment of CP. A negative correlation was found between age and people suffering from CP (ρ = -0.437, p \textless 0.042) and age and towards treatment of CP; ρ = -0.556, p \textless 0.007) at T2. CONCLUSION: Completing the elective online module resulted in improved knowledge and biopsychosocial attitudes towards CP in this predominantly non-health cohort, as reported in health and patient cohorts.

@article{thomson_osteopaths_2022,
	title = {The {Osteopaths}’ {Therapeutic} {Approaches} {Questionnaire} ({Osteo}-{TAQ}) - {A} content validity study},
	volume = {45},
	issn = {17460689},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1746068922000645},
	doi = {10.1016/j.ijosm.2022.07.001},
	language = {en},
	urldate = {2024-01-28},
	journal = {International Journal of Osteopathic Medicine},
	author = {Thomson, Oliver P. and Vaughan, Brett and Sampath, Kesava and Draper-Rodi, Jerry and Fleischmann, Michael and Cerritelli, Francesco},
	month = sep,
	year = {2022},
	pages = {48--54},
}

@article{miki_effect_2022,
	title = {The effect of cognitive functional therapy for chronic nonspecific low back pain: a systematic review and meta-analysis},
	volume = {16},
	issn = {1751-0759},
	shorttitle = {The effect of cognitive functional therapy for chronic nonspecific low back pain},
	url = {https://bpsmedicine.biomedcentral.com/articles/10.1186/s13030-022-00241-6},
	doi = {10.1186/s13030-022-00241-6},
	abstract = {Abstract
            
              Background
              To apply the Bio-Psych-Social (BPS) model into clinical practice, it is important not to focus on psychosocial domains only since biomedical factors can also contribute to chronic pain conditions. The cognitive functional therapy (CFT) is the management system based on the BPS model for chronic nonspecific low back pain (CNSLBP).
            
            
              Objectives
              This study aimed to compare CFT with the other interventions for CNSLBP regarding pain, disability/functional status, QoL and psychological factors.
            
            
              Design
              This study was a systematic review and meta-analysis of a randomised controlled trial.
            
            
              Method
              Literature Search was conducted in electronic search engines. Enrolled participants included 1) CNSLBP and 2) primary, secondary, or tertiary care patients. CFT was the interventions included. Comparisons were any types of treatment.
            
            
              Results
              Three studies met the eligibility criteria. The total number of participants was 336. For pain intensity, MD [95\% CIs] was -1.38 [-2.78 − 0.02] and -1.01 [-1.92 − -0.10] at intermediate and long term for two studies, respectively. About disability/functional status, SMD [95\% CIs] was -0.76 [-1.46 − -0.07] at the intermediate for three studies and MD [95\% CIs] was -8.48 [-11.47 − -5.49] at long term for two studies. About fear of physical activity, MD [95\% CIs] was -3.01 [-5.14 − -0.88] and -3.56 [-6.43 − -0.68] at intermediate and long term for two studies, respectively. No studies reported scores associated with QOL. All the quality of the evidence was very low.
            
            
              Conclusions
              Three studies were included and the quality of all the evidence was very low. Although the study found statistically significant differences in some measures, the effectiveness of the CFT will need to be re-evaluated in the future.
            
            
              Trial registration
              
                PROSPERO registration number
                CRD42020158182
                .},
	language = {en},
	number = {1},
	urldate = {2024-01-13},
	journal = {BioPsychoSocial Medicine},
	author = {Miki, Takahiro and Kondo, Yu and Kurakata, Hiroshi and Buzasi, Eva and Takebayashi, Tsuneo and Takasaki, Hiroshi},
	month = dec,
	year = {2022},
	pages = {12},
}

Abstract Background To apply the Bio-Psych-Social (BPS) model into clinical practice, it is important not to focus on psychosocial domains only since biomedical factors can also contribute to chronic pain conditions. The cognitive functional therapy (CFT) is the management system based on the BPS model for chronic nonspecific low back pain (CNSLBP). Objectives This study aimed to compare CFT with the other interventions for CNSLBP regarding pain, disability/functional status, QoL and psychological factors. Design This study was a systematic review and meta-analysis of a randomised controlled trial. Method Literature Search was conducted in electronic search engines. Enrolled participants included 1) CNSLBP and 2) primary, secondary, or tertiary care patients. CFT was the interventions included. Comparisons were any types of treatment. Results Three studies met the eligibility criteria. The total number of participants was 336. For pain intensity, MD [95% CIs] was -1.38 [-2.78 − 0.02] and -1.01 [-1.92 − -0.10] at intermediate and long term for two studies, respectively. About disability/functional status, SMD [95% CIs] was -0.76 [-1.46 − -0.07] at the intermediate for three studies and MD [95% CIs] was -8.48 [-11.47 − -5.49] at long term for two studies. About fear of physical activity, MD [95% CIs] was -3.01 [-5.14 − -0.88] and -3.56 [-6.43 − -0.68] at intermediate and long term for two studies, respectively. No studies reported scores associated with QOL. All the quality of the evidence was very low. Conclusions Three studies were included and the quality of all the evidence was very low. Although the study found statistically significant differences in some measures, the effectiveness of the CFT will need to be re-evaluated in the future. Trial registration PROSPERO registration number CRD42020158182 .

@article{miki_effect_2022-1,
	title = {The effect of cognitive functional therapy for chronic nonspecific low back pain: a systematic review and meta-analysis},
	volume = {16},
	issn = {1751-0759},
	shorttitle = {The effect of cognitive functional therapy for chronic nonspecific low back pain},
	url = {https://bpsmedicine.biomedcentral.com/articles/10.1186/s13030-022-00241-6},
	doi = {10.1186/s13030-022-00241-6},
	abstract = {Abstract
            
              Background
              To apply the Bio-Psych-Social (BPS) model into clinical practice, it is important not to focus on psychosocial domains only since biomedical factors can also contribute to chronic pain conditions. The cognitive functional therapy (CFT) is the management system based on the BPS model for chronic nonspecific low back pain (CNSLBP).
            
            
              Objectives
              This study aimed to compare CFT with the other interventions for CNSLBP regarding pain, disability/functional status, QoL and psychological factors.
            
            
              Design
              This study was a systematic review and meta-analysis of a randomised controlled trial.
            
            
              Method
              Literature Search was conducted in electronic search engines. Enrolled participants included 1) CNSLBP and 2) primary, secondary, or tertiary care patients. CFT was the interventions included. Comparisons were any types of treatment.
            
            
              Results
              Three studies met the eligibility criteria. The total number of participants was 336. For pain intensity, MD [95\% CIs] was -1.38 [-2.78 − 0.02] and -1.01 [-1.92 − -0.10] at intermediate and long term for two studies, respectively. About disability/functional status, SMD [95\% CIs] was -0.76 [-1.46 − -0.07] at the intermediate for three studies and MD [95\% CIs] was -8.48 [-11.47 − -5.49] at long term for two studies. About fear of physical activity, MD [95\% CIs] was -3.01 [-5.14 − -0.88] and -3.56 [-6.43 − -0.68] at intermediate and long term for two studies, respectively. No studies reported scores associated with QOL. All the quality of the evidence was very low.
            
            
              Conclusions
              Three studies were included and the quality of all the evidence was very low. Although the study found statistically significant differences in some measures, the effectiveness of the CFT will need to be re-evaluated in the future.
            
            
              Trial registration
              
                PROSPERO registration number
                CRD42020158182
                .},
	language = {en},
	number = {1},
	urldate = {2024-01-13},
	journal = {BioPsychoSocial Medicine},
	author = {Miki, Takahiro and Kondo, Yu and Kurakata, Hiroshi and Buzasi, Eva and Takebayashi, Tsuneo and Takasaki, Hiroshi},
	month = dec,
	year = {2022},
	pages = {12},
}

Abstract Background To apply the Bio-Psych-Social (BPS) model into clinical practice, it is important not to focus on psychosocial domains only since biomedical factors can also contribute to chronic pain conditions. The cognitive functional therapy (CFT) is the management system based on the BPS model for chronic nonspecific low back pain (CNSLBP). Objectives This study aimed to compare CFT with the other interventions for CNSLBP regarding pain, disability/functional status, QoL and psychological factors. Design This study was a systematic review and meta-analysis of a randomised controlled trial. Method Literature Search was conducted in electronic search engines. Enrolled participants included 1) CNSLBP and 2) primary, secondary, or tertiary care patients. CFT was the interventions included. Comparisons were any types of treatment. Results Three studies met the eligibility criteria. The total number of participants was 336. For pain intensity, MD [95% CIs] was -1.38 [-2.78 − 0.02] and -1.01 [-1.92 − -0.10] at intermediate and long term for two studies, respectively. About disability/functional status, SMD [95% CIs] was -0.76 [-1.46 − -0.07] at the intermediate for three studies and MD [95% CIs] was -8.48 [-11.47 − -5.49] at long term for two studies. About fear of physical activity, MD [95% CIs] was -3.01 [-5.14 − -0.88] and -3.56 [-6.43 − -0.68] at intermediate and long term for two studies, respectively. No studies reported scores associated with QOL. All the quality of the evidence was very low. Conclusions Three studies were included and the quality of all the evidence was very low. Although the study found statistically significant differences in some measures, the effectiveness of the CFT will need to be re-evaluated in the future. Trial registration PROSPERO registration number CRD42020158182 .

@article{toloui-wallace_when_2022,
	title = {When worlds collide: {Experiences} of physiotherapists, chiropractors, and osteopaths working together},
	volume = {60},
	issn = {24687812},
	shorttitle = {When worlds collide},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S2468781222000637},
	doi = {10.1016/j.msksp.2022.102564},
	language = {en},
	urldate = {2023-12-22},
	journal = {Musculoskeletal Science and Practice},
	author = {Toloui-Wallace, Joshua and Forbes, Roma and Thomson, Oliver P. and Setchell, Jenny},
	month = aug,
	year = {2022},
	pages = {102564},
}

@article{arcuri_what_2022,
	title = {“{What} you feel under your hands”: exploring professionals’ perspective of somatic dysfunction in osteopathic clinical practice—a qualitative study},
	volume = {30},
	issn = {2045-709X},
	shorttitle = {“{What} you feel under your hands”},
	url = {https://chiromt.biomedcentral.com/articles/10.1186/s12998-022-00444-2},
	doi = {10.1186/s12998-022-00444-2},
	abstract = {Abstract
            
              Background
              Despite controversy regarding its validity and clinical usefulness, manual examination findings still have an important role for manipulative therapies. As an example, somatic dysfunction (SD) remains central to osteopathic practice.This study aims to explore the experienced osteopaths' attitudes concerning SD and its role in osteopathic practice. This qualitative research could contribute to building a consistent paradigm for manual intervention in all musculoskeletal manipulations.
            
            
              Methods
              A thematic analysis with grounded theory elements was used. Data were collected through semi-structured interviews carried out between February and April 2021. A purposive sample of twenty professional osteopaths with past experience in osteopathic care was chosen to reflect the phenomenon's variety. The data analysis was done inductively and in tandem with the recruiting to keep track of data saturation.
            
            
              Results
              Eleven osteopaths participated in the study. Three main themes emerged from the data analysis: (1) SD as a safe tissue-touch-based communication tool between operator and person complex adaptive health system; (2) The treatment of SD is shareable between osteopaths, other health professionals, and the patients involved in the therapeutic pathway improving body awareness and health; (3) The development of the SD concept in research and practice to better clarify osteopathic profession identity and definition.
            
            
              Conclusions
              A panel of expert osteopaths consider the concept of SD as a valuable tool integrated into the osteopathic evaluation and treatment process. The shared concept and clinical application of SD is informed by person-centered care concepts and from the fields of neuroscience, cognitive and complexity science. Our study reports a common need among osteopaths to develop an evidence-based framework of SD to allow the best development of the osteopathic profession.},
	language = {en},
	number = {1},
	urldate = {2023-10-11},
	journal = {Chiropractic \& Manual Therapies},
	author = {Arcuri, Lorenzo and Consorti, Giacomo and Tramontano, Marco and Petracca, Marco and Esteves, Jorge Eduardo and Lunghi, Christian},
	month = aug,
	year = {2022},
	pages = {32},
}

Abstract Background Despite controversy regarding its validity and clinical usefulness, manual examination findings still have an important role for manipulative therapies. As an example, somatic dysfunction (SD) remains central to osteopathic practice.This study aims to explore the experienced osteopaths' attitudes concerning SD and its role in osteopathic practice. This qualitative research could contribute to building a consistent paradigm for manual intervention in all musculoskeletal manipulations. Methods A thematic analysis with grounded theory elements was used. Data were collected through semi-structured interviews carried out between February and April 2021. A purposive sample of twenty professional osteopaths with past experience in osteopathic care was chosen to reflect the phenomenon's variety. The data analysis was done inductively and in tandem with the recruiting to keep track of data saturation. Results Eleven osteopaths participated in the study. Three main themes emerged from the data analysis: (1) SD as a safe tissue-touch-based communication tool between operator and person complex adaptive health system; (2) The treatment of SD is shareable between osteopaths, other health professionals, and the patients involved in the therapeutic pathway improving body awareness and health; (3) The development of the SD concept in research and practice to better clarify osteopathic profession identity and definition. Conclusions A panel of expert osteopaths consider the concept of SD as a valuable tool integrated into the osteopathic evaluation and treatment process. The shared concept and clinical application of SD is informed by person-centered care concepts and from the fields of neuroscience, cognitive and complexity science. Our study reports a common need among osteopaths to develop an evidence-based framework of SD to allow the best development of the osteopathic profession.

@article{monari_vertebral_2021,
	title = {Vertebral artery dissection in term pregnancy after cervical spine manipulation: a case report and review the literature},
	volume = {15},
	issn = {1752-1947},
	shorttitle = {Vertebral artery dissection in term pregnancy after cervical spine manipulation},
	url = {https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-021-03090-z},
	doi = {10.1186/s13256-021-03090-z},
	abstract = {Abstract
            
              Background
              Vertebral artery dissection is an uncommon, but potentially fatal, vascular event. This case aimed to describe the pathogenesis and clinical presentation of vertebral artery dissection in a term pregnant patient. Moreover, we focused on the differential diagnosis, reviewing the available evidence.
            
            
              Case presentation
              A 39-year-old Caucasian woman presented at 38 + 4 weeks of gestation with a short-term history of vertigo, nausea, and vomiting. Symptoms appeared a few days after cervical spine manipulation by an osteopathic specialist. Urgent magnetic resonance imaging of the head was obtained and revealed an ischemic lesion of the right posterolateral portion of the brain bulb. A subsequent computed tomography angiographic scan of the head and neck showed a right vertebral artery dissection. Based on the correlation of the neurological manifestations and imaging findings, a diagnosis of vertebral artery dissection was established. The patient started low-dose acetylsalicylic acid and prophylactic enoxaparin following an urgent cesarean section.
            
            
              Conclusion
              Vertebral artery dissection is a rare but potential cause of neurologic impairments in pregnancy and during the postpartum period. It should be considered in the differential diagnosis for women who present with headache and/or vertigo. Women with a history of migraines, hypertension, or autoimmune disorders in pregnancy are at higher risk, as well as following cervical spine manipulations. Prompt diagnosis and management of vertebral artery dissection are essential to ensure favorable outcomes.},
	language = {en},
	number = {1},
	urldate = {2024-03-10},
	journal = {Journal of Medical Case Reports},
	author = {Monari, Francesca and Busani, Stefano and Imbrogno, Maria Giovanna and Neri, Isabella and Girardis, Massimo and Ghirardini, Annamaria and Cavalleri, Francesca and Facchinetti, Fabio},
	month = dec,
	year = {2021},
	pages = {530},
}

Abstract Background Vertebral artery dissection is an uncommon, but potentially fatal, vascular event. This case aimed to describe the pathogenesis and clinical presentation of vertebral artery dissection in a term pregnant patient. Moreover, we focused on the differential diagnosis, reviewing the available evidence. Case presentation A 39-year-old Caucasian woman presented at 38 + 4 weeks of gestation with a short-term history of vertigo, nausea, and vomiting. Symptoms appeared a few days after cervical spine manipulation by an osteopathic specialist. Urgent magnetic resonance imaging of the head was obtained and revealed an ischemic lesion of the right posterolateral portion of the brain bulb. A subsequent computed tomography angiographic scan of the head and neck showed a right vertebral artery dissection. Based on the correlation of the neurological manifestations and imaging findings, a diagnosis of vertebral artery dissection was established. The patient started low-dose acetylsalicylic acid and prophylactic enoxaparin following an urgent cesarean section. Conclusion Vertebral artery dissection is a rare but potential cause of neurologic impairments in pregnancy and during the postpartum period. It should be considered in the differential diagnosis for women who present with headache and/or vertigo. Women with a history of migraines, hypertension, or autoimmune disorders in pregnancy are at higher risk, as well as following cervical spine manipulations. Prompt diagnosis and management of vertebral artery dissection are essential to ensure favorable outcomes.

@article{orrock_clinical_2021,
	title = {Clinical characteristics of {Australian} osteopaths who teach: {A} national sample},
	volume = {22},
	issn = {2204-7662},
	shorttitle = {Clinical characteristics of {Australian} osteopaths who teach},
	url = {https://fohpe.org/FoHPE/article/view/526},
	doi = {10.11157/fohpe.v22i3.526},
	abstract = {Background: Health professionals involved in teaching future practitioners have been studied to some extent, but our knowledge of their clinical characteristics is variable. Our study sought to profile the clinical characteristics of osteopaths who teach in the three Australian universities delivering pre-professional osteopathy education.Materials: This study is a secondary analysis of data collected via the Australian Osteopathy Research and Innovation Network (ORION) project. Descriptive statistics were generated for each of the 27-item questionnaire variables. For binary responses, unadjusted odds ratios were calculated, and for continuous variables, independent t-tests were used. Backward step-wise regression modelling was used to identify significant characteristics associated with university teaching in osteopathy. Results: The survey demonstrated 9.9\% of Australian osteopaths reported being involved in university teaching. Compared to non-teaching survey respondents, the osteopaths involved in university teaching were more likely to be female (OR 1.56), older (p  0.01) and in clinical practice for longer (p  0.01) but report fewer patient care hours (p  0.01) and patient visits per week (p  0.01). Osteopaths involved in university teaching were also more likely to be involved in research (OR 18.54) and clinical supervision (OR 12.39). They also reported a broader range of patient presentations and therapeutic modalities than their counterparts.Conclusions: This nationally representative survey demonstrates a small percentage of the Australian osteopathy profession are engaged in university teaching. Our secondary analysis has highlighted several characteristics associated with involvement in university teaching that begin to shed light on the composition of the Australian osteopathy teaching workforce. This data may inform development of a skilled and experienced teaching workforce.},
	number = {3},
	urldate = {2024-01-28},
	journal = {Focus on Health Professional Education: A Multi-Professional Journal},
	author = {Orrock, Paul and Vaughan, Brett and Fleischmann, Michael and Fitzgerald, Kylie},
	month = nov,
	year = {2021},
	pages = {94--109},
}

Background: Health professionals involved in teaching future practitioners have been studied to some extent, but our knowledge of their clinical characteristics is variable. Our study sought to profile the clinical characteristics of osteopaths who teach in the three Australian universities delivering pre-professional osteopathy education.Materials: This study is a secondary analysis of data collected via the Australian Osteopathy Research and Innovation Network (ORION) project. Descriptive statistics were generated for each of the 27-item questionnaire variables. For binary responses, unadjusted odds ratios were calculated, and for continuous variables, independent t-tests were used. Backward step-wise regression modelling was used to identify significant characteristics associated with university teaching in osteopathy. Results: The survey demonstrated 9.9% of Australian osteopaths reported being involved in university teaching. Compared to non-teaching survey respondents, the osteopaths involved in university teaching were more likely to be female (OR 1.56), older (p  0.01) and in clinical practice for longer (p  0.01) but report fewer patient care hours (p  0.01) and patient visits per week (p  0.01). Osteopaths involved in university teaching were also more likely to be involved in research (OR 18.54) and clinical supervision (OR 12.39). They also reported a broader range of patient presentations and therapeutic modalities than their counterparts.Conclusions: This nationally representative survey demonstrates a small percentage of the Australian osteopathy profession are engaged in university teaching. Our secondary analysis has highlighted several characteristics associated with involvement in university teaching that begin to shed light on the composition of the Australian osteopathy teaching workforce. This data may inform development of a skilled and experienced teaching workforce.

@article{alvarez_national_2021,
	title = {A national cross-sectional survey of the attitudes, skills and use of evidence-based practice amongst {Spanish} osteopaths},
	volume = {21},
	issn = {1472-6963},
	doi = {10.1186/s12913-021-06128-6},
	abstract = {BACKGROUND: Although evidence-based practice (EBP) is largely supported across healthcare professions, its implementation in manual therapy professions such as osteopathy remains limited and debated. There is currently little knowledge of how Spanish osteopaths relate to EBP.
OBJECTIVES: The main aim of this study was to investigate the attitudes, skills and use of EBP among Spanish osteopaths. A secondary aim was to identify barriers and facilitators for the adoption of EBP in the Spanish osteopathic context.
METHODS: National cross-sectional survey of Spanish osteopaths registered and non-registered to an osteopathic association in Spain. Eligible participants were invited by a range of recruitment strategies including email and social media campaigns to complete the Spanish-translated Evidence-Based practice Attitude and utilization Survey (EBASE) anonymously online.
RESULTS: A total of 567 osteopaths completed the survey which represents an approximate response rate of 9\%. Participant's attitudes toward EBP were largely positive. Most respondents agreed or strongly agreed that EBP was necessary in the practice of osteopathy (89.6\%) and that professional literature and research findings were useful to their day-to-day practice (88.9\%). Levels of perceived skill in EBP were reported as low to moderate with lowest levels for items related to 'research conduct'. Except reading/reviewing professional literature and using online search engines to find practice-related literature, participant engagement in all other EBP-related activities was generally infrequent. The perceived proportion of clinical practice that was based on clinical research evidence was reported to be very small. Main barriers to EBP uptake included a lack of clinical evidence in osteopathy and insufficient skills for applying research findings. Main facilitators of EBP uptake included access to full-text articles, internet at the workplace and online databases.
CONCLUSIONS: Spanish osteopaths were largely supportive of evidence-based practice, had low to moderate skills in EBP and engaged in EBP activities infrequently. Formal regulation of the profession in Spain and the inclusion of osteopathic programs into the university sector would potentially improve EBP skills and use.},
	language = {eng},
	number = {1},
	journal = {BMC health services research},
	author = {Alvarez, Gerard and Justribo, Cristian and Sundberg, Tobias and Thomson, Oliver P. and Leach, Matthew J.},
	month = feb,
	year = {2021},
	pmid = {33563266},
	pmcid = {PMC7874623},
	keywords = {Attitude of Health Personnel, Cross-Sectional Studies, Cross-sectional studies, Evidence-Based Practice, Evidence-based practice, Health Knowledge, Attitudes, Practice, Health Personnel, Health care surveys, Humans, Osteopathic Physicians, Osteopathic medicine, Spain, Surveys and Questionnaires},
	pages = {130},
}

BACKGROUND: Although evidence-based practice (EBP) is largely supported across healthcare professions, its implementation in manual therapy professions such as osteopathy remains limited and debated. There is currently little knowledge of how Spanish osteopaths relate to EBP. OBJECTIVES: The main aim of this study was to investigate the attitudes, skills and use of EBP among Spanish osteopaths. A secondary aim was to identify barriers and facilitators for the adoption of EBP in the Spanish osteopathic context. METHODS: National cross-sectional survey of Spanish osteopaths registered and non-registered to an osteopathic association in Spain. Eligible participants were invited by a range of recruitment strategies including email and social media campaigns to complete the Spanish-translated Evidence-Based practice Attitude and utilization Survey (EBASE) anonymously online. RESULTS: A total of 567 osteopaths completed the survey which represents an approximate response rate of 9%. Participant's attitudes toward EBP were largely positive. Most respondents agreed or strongly agreed that EBP was necessary in the practice of osteopathy (89.6%) and that professional literature and research findings were useful to their day-to-day practice (88.9%). Levels of perceived skill in EBP were reported as low to moderate with lowest levels for items related to 'research conduct'. Except reading/reviewing professional literature and using online search engines to find practice-related literature, participant engagement in all other EBP-related activities was generally infrequent. The perceived proportion of clinical practice that was based on clinical research evidence was reported to be very small. Main barriers to EBP uptake included a lack of clinical evidence in osteopathy and insufficient skills for applying research findings. Main facilitators of EBP uptake included access to full-text articles, internet at the workplace and online databases. CONCLUSIONS: Spanish osteopaths were largely supportive of evidence-based practice, had low to moderate skills in EBP and engaged in EBP activities infrequently. Formal regulation of the profession in Spain and the inclusion of osteopathic programs into the university sector would potentially improve EBP skills and use.

@article{licciardone_patient-centered_2021,
	title = {Patient-centered care or osteopathic manipulative treatment as mediators of clinical outcomes in patients with chronic low back pain},
	volume = {121},
	issn = {2702-3648},
	url = {https://www.degruyter.com/document/doi/10.1515/jom-2021-0113/html},
	doi = {10.1515/jom-2021-0113},
	abstract = {Abstract
            
              Context
              Patient-centered care is often considered a characteristic of osteopathic medicine, in addition to the use of osteopathic manipulative treatment (OMT) in such musculoskeletal conditions as low back pain.
            
            
              Objectives
              This study aimed to determine if patient-centered care or OMT are mediators of the clinical outcomes of osteopathic medicine in patients with chronic low back pain.
            
            
              Methods
              A comparative effectiveness study was conducted within the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation (PRECISION Pain Research Registry). Eligible patients met the diagnostic criteria recommended by the National Institutes of Health Task Force on Research Standards for Chronic Low Back Pain and completed four consecutive quarterly encounters between April 2016 and November 2020. The Consultation and Relational Empathy instrument for patient-centered care was used at the baseline encounter and OMT use was measured at the final encounter. The clinical outcome measures included low back pain intensity on a numerical rating scale (NRS) from 0 to 10, back-related functioning on the Roland-Morris Disability Questionnaire (RMDQ), and pain impact on the National Institutes of Health Minimum Dataset for Chronic Low Back Pain (NIH-MDS). A parallel multiple mediator model was used to compute the direct and indirect effects of osteopathic medicine in achieving each of the three clinical outcomes.
            
            
              Results
              The 404 study patients had a mean age of 52.2 years (standard deviation, 13.1 years) and 288 (71.3\%) were female. The 88 (21.8\%) patients treated by osteopathic physicians reported more favorable scores for patient-centered care (mean, 41.3; 95\% CI 39.0–43.5) than patients treated by allopathic physicians (mean, 38.0; 95\% CI 36.8–39.3) (p=0.02). Fifty-six (63.6\%) patients treated by osteopathic physicians used OMT. The age- and sex-adjusted outcomes for patients of osteopathic vs. allopathic physicians across all four encounters were: mean, 5.4; 95\% CI 5.0–5.7 vs. mean, 5.9; 95\% CI 5.7–6.1 on the NRS for pain intensity (p=0.01); mean, 11.3; 95\% CI 10.1–12.6 vs. mean, 14.0; 95\% CI 13.3–14.7 on the RMDQ for back-related disability (p{\textless}0.001); and mean, 26.8; 95\% CI 24.9–28.7 vs. mean, 30.1; 95\% CI 29.1–31.1 on the NIH-MDS for pain impact (p=0.002). Patient-centered care did not mediate any outcome of osteopathic medicine, whereas OMT mediated better outcomes in low back pain intensity.
            
            
              Conclusions
              This appears to be the first study to simultaneously address both patient-centered care and OMT as potential mediators of the effect of osteopathic medicine in treating chronic pain. Patient-centered care did not mediate the effects of osteopathic medicine and OMT only mediated outcomes relating to low back pain intensity. More research is needed to identify other aspects of osteopathic medicine that mediate its beneficial effects in patients with chronic low back pain.},
	language = {en},
	number = {10},
	urldate = {2024-01-13},
	journal = {Journal of Osteopathic Medicine},
	author = {Licciardone, John C. and Aryal, Subhash},
	month = sep,
	year = {2021},
	pages = {795--804},
}

Abstract Context Patient-centered care is often considered a characteristic of osteopathic medicine, in addition to the use of osteopathic manipulative treatment (OMT) in such musculoskeletal conditions as low back pain. Objectives This study aimed to determine if patient-centered care or OMT are mediators of the clinical outcomes of osteopathic medicine in patients with chronic low back pain. Methods A comparative effectiveness study was conducted within the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation (PRECISION Pain Research Registry). Eligible patients met the diagnostic criteria recommended by the National Institutes of Health Task Force on Research Standards for Chronic Low Back Pain and completed four consecutive quarterly encounters between April 2016 and November 2020. The Consultation and Relational Empathy instrument for patient-centered care was used at the baseline encounter and OMT use was measured at the final encounter. The clinical outcome measures included low back pain intensity on a numerical rating scale (NRS) from 0 to 10, back-related functioning on the Roland-Morris Disability Questionnaire (RMDQ), and pain impact on the National Institutes of Health Minimum Dataset for Chronic Low Back Pain (NIH-MDS). A parallel multiple mediator model was used to compute the direct and indirect effects of osteopathic medicine in achieving each of the three clinical outcomes. Results The 404 study patients had a mean age of 52.2 years (standard deviation, 13.1 years) and 288 (71.3%) were female. The 88 (21.8%) patients treated by osteopathic physicians reported more favorable scores for patient-centered care (mean, 41.3; 95% CI 39.0–43.5) than patients treated by allopathic physicians (mean, 38.0; 95% CI 36.8–39.3) (p=0.02). Fifty-six (63.6%) patients treated by osteopathic physicians used OMT. The age- and sex-adjusted outcomes for patients of osteopathic vs. allopathic physicians across all four encounters were: mean, 5.4; 95% CI 5.0–5.7 vs. mean, 5.9; 95% CI 5.7–6.1 on the NRS for pain intensity (p=0.01); mean, 11.3; 95% CI 10.1–12.6 vs. mean, 14.0; 95% CI 13.3–14.7 on the RMDQ for back-related disability (p\textless0.001); and mean, 26.8; 95% CI 24.9–28.7 vs. mean, 30.1; 95% CI 29.1–31.1 on the NIH-MDS for pain impact (p=0.002). Patient-centered care did not mediate any outcome of osteopathic medicine, whereas OMT mediated better outcomes in low back pain intensity. Conclusions This appears to be the first study to simultaneously address both patient-centered care and OMT as potential mediators of the effect of osteopathic medicine in treating chronic pain. Patient-centered care did not mediate the effects of osteopathic medicine and OMT only mediated outcomes relating to low back pain intensity. More research is needed to identify other aspects of osteopathic medicine that mediate its beneficial effects in patients with chronic low back pain.

@article{cashin_disentangling_2021,
	title = {Disentangling contextual effects from musculoskeletal treatments},
	volume = {29},
	issn = {10634584},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1063458420312280},
	doi = {10.1016/j.joca.2020.12.011},
	language = {en},
	number = {3},
	urldate = {2023-12-08},
	journal = {Osteoarthritis and Cartilage},
	author = {Cashin, A.G. and McAuley, J.H. and Lamb, S.E. and Lee, H.},
	month = mar,
	year = {2021},
	pages = {297--299},
}

@article{requena-garcia_objectivation_2021,
	title = {Objectivation of an {Educational} {Model} in {Cranial} {Osteopathy} {Based} on {Experience}},
	volume = {57},
	issn = {1648-9144},
	doi = {10.3390/medicina57030246},
	abstract = {Background and Objectives: The techniques directed to the cranial field in osteopathy are the most questioned due to the lack of scientific evidence. In osteopathic practice, manual palpation is essential and, therefore, measuring reliability is fundamental. The objective of this study is to assess the precision and objectification of an educational model in cranial osteopathy based on experience. Materials and Methods: A reliability study was conducted in a cadaver skull where a strain gauge was placed on the sphenobasilar synchondrosis (SBS) of the base of the skull. Three cranial osteopathic techniques (lateral compression, anteroposterior compression, and compression maneuver of the mastoids) were performed 25 times by osteopaths with different degrees of experience (5-10 years, 1-5 years, {\textless}1 year). Measurements were computed for each of the three techniques of each group in comparison with the osteopath with {\textgreater}15 years of experience. Data were analyzed to check for inter- and intra-observer reliability using intra-class correlation coefficients (ICC). Results: Reliability in osteopaths with 5-10 years' experience (observer 1 and observer 2) performing all three techniques was higher (p {\textless} 0.001) than the osteopath with {\textgreater}15 years' experience. Little or no reliability were observed in osteopaths with less experience. Conclusions: The experience of the osteopaths determines the reliability and effectiveness of the cranial techniques, a fundamental part in objectifying these techniques. This model can help implement objective training in cranial osteopathy formation.},
	language = {eng},
	number = {3},
	journal = {Medicina (Kaunas, Lithuania)},
	author = {Requena-García, Jesús and García-Nieto, Evelyn and Varillas-Delgado, David},
	month = mar,
	year = {2021},
	pmid = {33808011},
	pmcid = {PMC7998663},
	keywords = {Humans, Manipulation, Osteopathic, Models, Educational, Osteopathic Physicians, Palpation, Reproducibility of Results, cranial osteopathy, integrative medicine, osteopathic manipulation, osteopathic medicine, reproducibility},
	pages = {246},
}

Background and Objectives: The techniques directed to the cranial field in osteopathy are the most questioned due to the lack of scientific evidence. In osteopathic practice, manual palpation is essential and, therefore, measuring reliability is fundamental. The objective of this study is to assess the precision and objectification of an educational model in cranial osteopathy based on experience. Materials and Methods: A reliability study was conducted in a cadaver skull where a strain gauge was placed on the sphenobasilar synchondrosis (SBS) of the base of the skull. Three cranial osteopathic techniques (lateral compression, anteroposterior compression, and compression maneuver of the mastoids) were performed 25 times by osteopaths with different degrees of experience (5-10 years, 1-5 years, \textless1 year). Measurements were computed for each of the three techniques of each group in comparison with the osteopath with \textgreater15 years of experience. Data were analyzed to check for inter- and intra-observer reliability using intra-class correlation coefficients (ICC). Results: Reliability in osteopaths with 5-10 years' experience (observer 1 and observer 2) performing all three techniques was higher (p \textless 0.001) than the osteopath with \textgreater15 years' experience. Little or no reliability were observed in osteopaths with less experience. Conclusions: The experience of the osteopaths determines the reliability and effectiveness of the cranial techniques, a fundamental part in objectifying these techniques. This model can help implement objective training in cranial osteopathy formation.

@article{rasmussen_direct_2021,
	title = {Direct measurement of the rhythmic motions of the human head identifies a third rhythm},
	volume = {26},
	issn = {1532-9283},
	doi = {10.1016/j.jbmt.2020.08.018},
	abstract = {INTRODUCTION: Central to the osteopathic cranial field, and at the same time controversial, is the concept of a unique rhythmic movement believed to originate from a primary respiratory mechanism (PRM). Further, the PRM is reported to manifest as a cranial rhythmic impulse (CRI) on the living human skull. This study explores the rhythmic oscillations of the human head measured directly as physical movements. The aim is to investigate the existence of a third rhythm distinct from the head movements caused by respiratory breathing and arterial pulsing, in an objective and purely experimental study.
EXPERIMENTAL: In 50 healthy individuals, rhythmic oscillations of the head were measured in real-time for 42 min in a supine resting state without any intervention. A newly developed machine for tracking rhythmic movements was used for measurements.
RESULTS: In all individuals, a third rhythm was distinguished as separate from the arterial and respiratory rhythm at all times. The third rhythm was observed as a dynamic physiological phenomenon with a narrow range in resting healthy individuals with a mean of 6.16 cycles/minute (4.25-7.07). The significant contribution to the amplitude of the measured movements was the respiratory breathing and this third rhythm, whereas the contribution from the arterial pulsing were minor.
CONCLUSION: The present study demonstrates the existence, and normative range of a third physical rhythm detected on the human head. Having developed an objective approach to studying this third rhythm might form the future basis for clinical and physiological studies of craniosacral function and dysfunction.},
	language = {eng},
	journal = {Journal of Bodywork and Movement Therapies},
	author = {Rasmussen, Thomas Rosenkilde and Meulengracht, Karl Christian},
	month = apr,
	year = {2021},
	pmid = {33992252},
	keywords = {Head, Humans, Movement, Osteopathic Medicine, Physical Examination, Respiration},
	pages = {24--29},
}

INTRODUCTION: Central to the osteopathic cranial field, and at the same time controversial, is the concept of a unique rhythmic movement believed to originate from a primary respiratory mechanism (PRM). Further, the PRM is reported to manifest as a cranial rhythmic impulse (CRI) on the living human skull. This study explores the rhythmic oscillations of the human head measured directly as physical movements. The aim is to investigate the existence of a third rhythm distinct from the head movements caused by respiratory breathing and arterial pulsing, in an objective and purely experimental study. EXPERIMENTAL: In 50 healthy individuals, rhythmic oscillations of the head were measured in real-time for 42 min in a supine resting state without any intervention. A newly developed machine for tracking rhythmic movements was used for measurements. RESULTS: In all individuals, a third rhythm was distinguished as separate from the arterial and respiratory rhythm at all times. The third rhythm was observed as a dynamic physiological phenomenon with a narrow range in resting healthy individuals with a mean of 6.16 cycles/minute (4.25-7.07). The significant contribution to the amplitude of the measured movements was the respiratory breathing and this third rhythm, whereas the contribution from the arterial pulsing were minor. CONCLUSION: The present study demonstrates the existence, and normative range of a third physical rhythm detected on the human head. Having developed an objective approach to studying this third rhythm might form the future basis for clinical and physiological studies of craniosacral function and dysfunction.

@article{amatuzzi_acute_2021,
	title = {Acute and {Time}-{Course} {Effects} of {Osteopathic} {Manipulative} {Treatment} on {Vascular} and {Autonomic} {Function} in {Patients} {With} {Heart} {Failure}: {A} {Randomized} {Trial}},
	volume = {44},
	issn = {01614754},
	shorttitle = {Acute and {Time}-{Course} {Effects} of {Osteopathic} {Manipulative} {Treatment} on {Vascular} and {Autonomic} {Function} in {Patients} {With} {Heart} {Failure}},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S0161475421000774},
	doi = {10.1016/j.jmpt.2021.06.003},
	language = {en},
	number = {6},
	urldate = {2023-10-06},
	journal = {Journal of Manipulative and Physiological Therapeutics},
	author = {Amatuzzi, Fellipe and Gervazoni Balbuena De Lima, Alexandra Correa and Da Silva, Marianne Lucena and Cipriano, Graziella França Bernardelli and Catai, Aparecida Maria and Cahalin, Lawrence Patrick and Chiappa, Gaspar and Cipriano, Gerson},
	month = jul,
	year = {2021},
	pages = {455--466},
}

@article{vogel_continuing_2020,
	title = {Continuing debates about models of practice},
	volume = {37},
	issn = {17460689},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1746068920301887},
	doi = {10.1016/j.ijosm.2020.09.001},
	language = {en},
	urldate = {2024-01-28},
	journal = {International Journal of Osteopathic Medicine},
	author = {Vogel, Steven},
	month = sep,
	year = {2020},
	pages = {1--2},
}

@article{levelink_priorities_2020,
	title = {Priorities of patients, caregivers and health‐care professionals for health research – {A} systematic review},
	volume = {23},
	issn = {1369-6513, 1369-7625},
	url = {https://onlinelibrary.wiley.com/doi/10.1111/hex.13090},
	doi = {10.1111/hex.13090},
	abstract = {Abstract
            
              Background
              Based on subjective experience, patients can identify research priorities important for health services research. A systematic method for priority setting has been developed by the James Lind Alliance.
            
            
              Objective
              This article reviews the literature on the research priorities of patients, caregivers and health‐care professionals and presents the prioritized research themes and prioritization methods used.
            
            
              Search strategy
              Three electronic databases were searched on 22 May 2018. The search was not limited to any time period or language.
            
            
              Inclusion criteria
              The included studies reported the identification and prioritization of research priorities involving patients, relatives and caregivers. Each included paper addressed a specific ICD‐coded health problem, and at least one‐third of the sample involved in the prioritization process was affected by the health problem.
            
            
              Data extraction and synthesis
              The 10 top‐ranked research priorities were included in the thematic analysis. With an inductive approach, a system of identified themes and subthemes was developed from the research priorities. Each research priority was assigned to one research theme.
            
            
              Main results
              The priority lists of 34 publications involving 331 research priorities were included. Nine main themes represent the content of the research priorities. The most frequently represented main themes are ‘Treatment’, ‘Patients’ and ‘Health condition’. The distribution of the research priorities varied depending on the health conditions and prioritization methods.
            
            
              Discussion and conclusions
              This review provides a comprehensive overview of the overarching research themes in research priorities of affected individuals. The results can guide future patient‐oriented research.},
	language = {en},
	number = {5},
	urldate = {2024-01-14},
	journal = {Health Expectations},
	author = {Levelink, Michael and Voigt‐Barbarowicz, Mona and Brütt, Anna Levke},
	month = oct,
	year = {2020},
	pages = {992--1006},
}

Abstract Background Based on subjective experience, patients can identify research priorities important for health services research. A systematic method for priority setting has been developed by the James Lind Alliance. Objective This article reviews the literature on the research priorities of patients, caregivers and health‐care professionals and presents the prioritized research themes and prioritization methods used. Search strategy Three electronic databases were searched on 22 May 2018. The search was not limited to any time period or language. Inclusion criteria The included studies reported the identification and prioritization of research priorities involving patients, relatives and caregivers. Each included paper addressed a specific ICD‐coded health problem, and at least one‐third of the sample involved in the prioritization process was affected by the health problem. Data extraction and synthesis The 10 top‐ranked research priorities were included in the thematic analysis. With an inductive approach, a system of identified themes and subthemes was developed from the research priorities. Each research priority was assigned to one research theme. Main results The priority lists of 34 publications involving 331 research priorities were included. Nine main themes represent the content of the research priorities. The most frequently represented main themes are ‘Treatment’, ‘Patients’ and ‘Health condition’. The distribution of the research priorities varied depending on the health conditions and prioritization methods. Discussion and conclusions This review provides a comprehensive overview of the overarching research themes in research priorities of affected individuals. The results can guide future patient‐oriented research.

@techreport{carnes_oia_2020,
	title = {The {OIA} {Global} {Report}:  {Global} {Review} of {Osteopathic} {Medicine} and {Osteopathy} 2020},
	url = {https://oialliance.org/wp-content/uploads/2021/02/OIA_Report_2020_FINAL.pdf},
	institution = {Osteopathic International Alliance},
	author = {Carnes, Dawn and Ellwood, Julie and Hunt, Charles and Feirrera, Ana Paula and Byerwalter, Amy},
	year = {2020},
}

@article{stilwell_enactive_2019,
	title = {An enactive approach to pain: beyond the biopsychosocial model},
	volume = {18},
	issn = {1572-8676},
	url = {https://doi.org/10.1007/s11097-019-09624-7},
	doi = {10.1007/s11097-019-09624-7},
	abstract = {We propose a new conceptualization of pain by incorporating advancements made by phenomenologists and cognitive scientists. The biomedical understanding of pain is problematic as it inaccurately endorses a linear relationship between noxious stimuli and pain, and is often dualist or reductionist. From a Cartesian dualist perspective, pain occurs in an immaterial mind. From a reductionist perspective, pain is often considered to be “in the brain.” The biopsychosocial conceptualization of pain has been adopted to combat these problematic views. However, when considering pain research advancements, paired with the work of phenomenologists’ and cognitive scientists’ advanced understanding of perception, the biopsychosocial model is inadequate in many ways. The boundaries between the biological, psychological, and social are artificial, and the model is often applied in a fragmented manner. The model has a limited theoretical foundation, resulting in the perpetuation of dualistic and reductionist beliefs. A new framework may serve to better understand and treat pain. In this paper, we conceptualize pain as a 5E process, arguing that it is: Embodied, Embedded, Enacted, Emotive, and Extended. This perspective is applied using back pain as an exemplar and we explore potential clinical applications. With enactivism at the core of this approach, pain does not reside in a mysterious immaterial mind, nor is it an entity to be found in the blood, brain, or other bodily tissues. Instead, pain is a relational and emergent process of sense-making through a lived body that is inseparable from the world that we shape and that shapes us.},
	number = {4},
	journal = {Phenomenology and the Cognitive Sciences},
	author = {Stilwell, Peter and Harman, Katherine},
	month = sep,
	year = {2019},
	pages = {637--665},
}

We propose a new conceptualization of pain by incorporating advancements made by phenomenologists and cognitive scientists. The biomedical understanding of pain is problematic as it inaccurately endorses a linear relationship between noxious stimuli and pain, and is often dualist or reductionist. From a Cartesian dualist perspective, pain occurs in an immaterial mind. From a reductionist perspective, pain is often considered to be “in the brain.” The biopsychosocial conceptualization of pain has been adopted to combat these problematic views. However, when considering pain research advancements, paired with the work of phenomenologists’ and cognitive scientists’ advanced understanding of perception, the biopsychosocial model is inadequate in many ways. The boundaries between the biological, psychological, and social are artificial, and the model is often applied in a fragmented manner. The model has a limited theoretical foundation, resulting in the perpetuation of dualistic and reductionist beliefs. A new framework may serve to better understand and treat pain. In this paper, we conceptualize pain as a 5E process, arguing that it is: Embodied, Embedded, Enacted, Emotive, and Extended. This perspective is applied using back pain as an exemplar and we explore potential clinical applications. With enactivism at the core of this approach, pain does not reside in a mysterious immaterial mind, nor is it an entity to be found in the blood, brain, or other bodily tissues. Instead, pain is a relational and emergent process of sense-making through a lived body that is inseparable from the world that we shape and that shapes us.

@article{guillaud_reliability_2018,
	title = {Reliability of diagnosis and clinical efficacy of visceral osteopathy: a systematic review},
	volume = {18},
	issn = {1472-6882},
	shorttitle = {Reliability of diagnosis and clinical efficacy of visceral osteopathy},
	url = {https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-018-2098-8},
	doi = {10.1186/s12906-018-2098-8},
	language = {en},
	number = {1},
	urldate = {2024-03-13},
	journal = {BMC Complementary and Alternative Medicine},
	author = {Guillaud, Albin and Darbois, Nelly and Monvoisin, Richard and Pinsault, Nicolas},
	month = dec,
	year = {2018},
	pages = {65},
}

@article{engel_osteopathie_2018,
	title = {Östeopathie – ein {Bericht} aus dem südlichen {Nachbarland}},
	volume = {16},
	issn = {1610-5044, 1613-3781},
	url = {http://www.thieme-connect.de/DOI/DOI?10.1055/a-0651-8579},
	doi = {10.1055/a-0651-8579},
	language = {de},
	number = {04},
	urldate = {2024-01-28},
	journal = {DO - Deutsche Zeitschrift für Osteopathie},
	author = {Engel, Raimund},
	month = oct,
	year = {2018},
	pages = {42--44},
}

@article{collins_central_2018,
	title = {The {Central} {Role} of {Theory} in {Qualitative} {Research}},
	volume = {17},
	issn = {1609-4069, 1609-4069},
	url = {http://journals.sagepub.com/doi/10.1177/1609406918797475},
	doi = {10.1177/1609406918797475},
	abstract = {The use of theory in science is an ongoing debate in the production of knowledge. Related to qualitative research methods, a variety of approaches have been set forth in the literature using the terms conceptual framework, theoretical framework, paradigm, and epistemology. While these approaches are helpful in their own context, we summarize and distill them in order to build upon the case that a balanced and centered use of the theoretical framework can bolster the qualitative approach. Our project builds on the arguments that epistemology and methodological rigor are essential by adding the notion that the influence of theory permeates almost every aspect of the study—even if the author does not recognize this influence. Compilers of methodological approaches have referred to the use of theory as analogous to a coat closet in which different items can be housed or a lens through which the literature and data in the study are viewed. In this article, we offer an evaluative quadrant for determining the appropriate use of theory in qualitative research and a diagram of the qualitative project that points to the central role of a theoretical framework. We also caution against the overreliance on theory in the event that it begins to limit the ability to see emergent findings in the data.},
	language = {en},
	number = {1},
	urldate = {2023-12-22},
	journal = {International Journal of Qualitative Methods},
	author = {Collins, Christopher S. and Stockton, Carrie M.},
	month = dec,
	year = {2018},
	pages = {160940691879747},
}

The use of theory in science is an ongoing debate in the production of knowledge. Related to qualitative research methods, a variety of approaches have been set forth in the literature using the terms conceptual framework, theoretical framework, paradigm, and epistemology. While these approaches are helpful in their own context, we summarize and distill them in order to build upon the case that a balanced and centered use of the theoretical framework can bolster the qualitative approach. Our project builds on the arguments that epistemology and methodological rigor are essential by adding the notion that the influence of theory permeates almost every aspect of the study—even if the author does not recognize this influence. Compilers of methodological approaches have referred to the use of theory as analogous to a coat closet in which different items can be housed or a lens through which the literature and data in the study are viewed. In this article, we offer an evaluative quadrant for determining the appropriate use of theory in qualitative research and a diagram of the qualitative project that points to the central role of a theoretical framework. We also caution against the overreliance on theory in the event that it begins to limit the ability to see emergent findings in the data.

@article{murad_new_2016,
	title = {New evidence pyramid},
	volume = {21},
	issn = {1356-5524, 1473-6810},
	url = {https://ebm.bmj.com/lookup/doi/10.1136/ebmed-2016-110401},
	doi = {10.1136/ebmed-2016-110401},
	language = {en},
	number = {4},
	urldate = {2024-02-17},
	journal = {Evidence Based Medicine},
	author = {Murad, M Hassan and Asi, Noor and Alsawas, Mouaz and Alahdab, Fares},
	month = aug,
	year = {2016},
	pages = {125--127},
}

@article{garcia-moya_utility_2016,
	title = {The utility of salutogenesis for guiding health promotion: the case for young people's well-being},
	issn = {0957-4824, 1460-2245},
	shorttitle = {The utility of salutogenesis for guiding health promotion},
	url = {https://academic.oup.com/heapro/article-lookup/doi/10.1093/heapro/daw008},
	doi = {10.1093/heapro/daw008},
	language = {en},
	urldate = {2024-02-11},
	journal = {Health Promotion International},
	author = {García-Moya, Irene and Morgan, Antony},
	month = feb,
	year = {2016},
	pages = {daw008},
}

@article{blum_cervical_2015,
	title = {Cervical {Artery} {Dissection}: {A} {Review} of the {Epidemiology}, {Pathophysiology}, {Treatment}, and {Outcome}},
	volume = {2},
	issn = {2322-3944, 2322-5769},
	shorttitle = {Cervical {Artery} {Dissection}},
	url = {https://brieflands.com/articles/ans-20557.html},
	doi = {10.5812/archneurosci.26670},
	number = {4},
	urldate = {2024-03-18},
	journal = {Archives of Neuroscience},
	author = {Blum, Christina A. and Yaghi, Shadi},
	month = oct,
	year = {2015},
}

@article{bolton_varieties_2015,
	title = {Varieties of clinical reasoning},
	volume = {21},
	issn = {1356-1294, 1365-2753},
	url = {https://onlinelibrary.wiley.com/doi/10.1111/jep.12309},
	doi = {10.1111/jep.12309},
	abstract = {Abstract
            
              Rationale, aims and objectives
              Clinical reasoning comprises a variety of different modes of inference. The modes that are practiced will be influenced by the sociological characteristics of the clinical settings and the tasks to be performed by the clinician.
            
            
              Methods
              
                This article presents
                C.S. P
                eirce's typology of modes of inference: deduction, induction and abduction. It describes their differences and their roles as stages in scientific argument. The article applies the typology to reasoning in clinical settings.
              
            
            
              Results
              The article describes their differences, and their roles as stages in scientific argument. It then applies the typology to reasoning in typical clinical settings.
            
            
              Conclusions
              Abduction is less commonly taught or discussed than induction and deduction. However, it is a common mode of inference in clinical settings, especially when the clinician must try to make sense of a surprising phenomenon. Whether abduction is followed up with deductive and inductive verification is strongly influenced by situational constraints and the cognitive and psychological stamina of the clinician. Recognizing the inevitability of abduction in clinical practice and its value to discovery is important to an accurate understanding of clinical reasoning.},
	language = {en},
	number = {3},
	urldate = {2024-01-21},
	journal = {Journal of Evaluation in Clinical Practice},
	author = {Bolton, Jonathan W.},
	month = jun,
	year = {2015},
	pages = {486--489},
}

Abstract Rationale, aims and objectives Clinical reasoning comprises a variety of different modes of inference. The modes that are practiced will be influenced by the sociological characteristics of the clinical settings and the tasks to be performed by the clinician. Methods This article presents C.S. P eirce's typology of modes of inference: deduction, induction and abduction. It describes their differences and their roles as stages in scientific argument. The article applies the typology to reasoning in clinical settings. Results The article describes their differences, and their roles as stages in scientific argument. It then applies the typology to reasoning in typical clinical settings. Conclusions Abduction is less commonly taught or discussed than induction and deduction. However, it is a common mode of inference in clinical settings, especially when the clinician must try to make sense of a surprising phenomenon. Whether abduction is followed up with deductive and inductive verification is strongly influenced by situational constraints and the cognitive and psychological stamina of the clinician. Recognizing the inevitability of abduction in clinical practice and its value to discovery is important to an accurate understanding of clinical reasoning.

@article{reader_patient_2014,
	title = {Patient complaints in healthcare systems: a systematic review and coding taxonomy},
	volume = {23},
	issn = {2044-5415, 2044-5423},
	shorttitle = {Patient complaints in healthcare systems},
	url = {https://qualitysafety.bmj.com/lookup/doi/10.1136/bmjqs-2013-002437},
	doi = {10.1136/bmjqs-2013-002437},
	language = {en},
	number = {8},
	urldate = {2023-12-13},
	journal = {BMJ Quality \& Safety},
	author = {Reader, Tom W and Gillespie, Alex and Roberts, Jane},
	month = aug,
	year = {2014},
	pages = {678--689},
}

@article{rosner_evidence-based_2012,
	title = {Evidence-based medicine: {Revisiting} the pyramid of priorities},
	volume = {16},
	issn = {13608592},
	shorttitle = {Evidence-based medicine},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1360859211000751},
	doi = {10.1016/j.jbmt.2011.05.003},
	language = {en},
	number = {1},
	urldate = {2024-02-17},
	journal = {Journal of Bodywork and Movement Therapies},
	author = {Rosner, Anthony L.},
	month = jan,
	year = {2012},
	pages = {42--49},
}

@article{liebenson_musculoskeletal_2012,
	title = {Musculoskeletal myths},
	volume = {16},
	issn = {1532-9283},
	doi = {10.1016/j.jbmt.2011.11.003},
	abstract = {This paper discusses a number of common myths in the musculoskeletal pain management and rehabilitation/athletic development fields. The origins or rationale for these beliefs are reviewed. New scientific evidence disputing or refuting the myth is then presented followed by and explanation and evidence for an updated perspective.},
	language = {eng},
	number = {2},
	journal = {Journal of Bodywork and Movement Therapies},
	author = {Liebenson, Craig},
	month = apr,
	year = {2012},
	pmid = {22464114},
	keywords = {Attitude to Health, Back Pain, Chronic Pain, Fear, Health Knowledge, Attitudes, Practice, Humans, Intervertebral Disc Displacement},
	pages = {165--182},
}

This paper discusses a number of common myths in the musculoskeletal pain management and rehabilitation/athletic development fields. The origins or rationale for these beliefs are reviewed. New scientific evidence disputing or refuting the myth is then presented followed by and explanation and evidence for an updated perspective.

@article{tomlin_research_2011,
	title = {Research {Pyramid}: {A} {New} {Evidence}-{Based} {Practice} {Model} for {Occupational} {Therapy}},
	volume = {65},
	issn = {0272-9490, 1943-7676},
	shorttitle = {Research {Pyramid}},
	url = {https://research.aota.org/ajot/article/65/2/189/5478/Research-Pyramid-A-New-Evidence-Based-Practice},
	doi = {10.5014/ajot.2011.000828},
	abstract = {Abstract
            In the campaign to implement evidence-based practice, the current single-hierarchy model of levels of evidence fails to incorporate at parity all types of research evidence that are valuable in the practice of occupational therapy. A new model, originally developed by Borgetto et al. (2007) and modified and expanded, is presented. By separating the evidence-level criteria of internal and external validity, by incorporating explicitly the evidence provided by qualitative studies, and by retaining the critical notion of rigor, a pyramidal evidence model emerges. This model, the Research Pyramid, aligns itself with the revised model of evidence-based medicine and, more important, with the basic modes of clinical reasoning in occupational therapy. It constitutes a beginning attempt to order evidence-based practice in accordance with the epistemology of the profession. It may better guide occupational therapy research and meta-synthesis and their incorporation into practice decisions.},
	language = {en},
	number = {2},
	urldate = {2024-02-17},
	journal = {The American Journal of Occupational Therapy},
	author = {Tomlin, George and Borgetto, Bernhard},
	month = mar,
	year = {2011},
	pages = {189--196},
}

Abstract In the campaign to implement evidence-based practice, the current single-hierarchy model of levels of evidence fails to incorporate at parity all types of research evidence that are valuable in the practice of occupational therapy. A new model, originally developed by Borgetto et al. (2007) and modified and expanded, is presented. By separating the evidence-level criteria of internal and external validity, by incorporating explicitly the evidence provided by qualitative studies, and by retaining the critical notion of rigor, a pyramidal evidence model emerges. This model, the Research Pyramid, aligns itself with the revised model of evidence-based medicine and, more important, with the basic modes of clinical reasoning in occupational therapy. It constitutes a beginning attempt to order evidence-based practice in accordance with the epistemology of the profession. It may better guide occupational therapy research and meta-synthesis and their incorporation into practice decisions.

@article{engel_interview_2011,
	title = {Interview mit {Raimund} {Engel} zur {Osteopathie} in {Europa}},
	volume = {12},
	issn = {16159071},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1615907111000268},
	doi = {10.1016/j.ostmed.2011.01.025},
	language = {en},
	number = {1},
	urldate = {2024-01-28},
	journal = {Osteopathische Medizin},
	author = {Engel, Raimund},
	month = mar,
	year = {2011},
	pages = {29--30},
}

@article{becker_salutogenesis_2010,
	title = {Salutogenesis 30 {Years} {Later}: {Where} do we go from here?},
	volume = {13},
	url = {https://files.eric.ed.gov/fulltext/EJ895721.pdf},
	abstract = {In 1979 Aaron Antonovsky introduced the concept of salutogenesis as the study of health development. This
approach contrasted with the concept of pathogenesis or the study of disease development. Pathogenesis works
retrospectively from disease to determine how individuals can avoid, manage, and/or eliminate that disease.
Salutogenesis works prospectively by considering how to create, enhance, and improve physical, mental, and social
well-being. Salutogenesis provides a framework for researchers and practitioners to help individuals, organizations,
and society move toward optimal well-being. This article reviews the development and benefits of the salutogenic
approach to health, how it complements pathogenesis, and suggests how to use the salutogenic model to develop a
science for positive health. The article also suggests using salutogenesis as a basis for the new health care system in
America.},
	journal = {International Electronic Journal of Health Education},
	author = {Becker, Craig and Glascoff, Mary Alice and Felts, Michael},
	year = {2010},
	pages = {25--32},
}

In 1979 Aaron Antonovsky introduced the concept of salutogenesis as the study of health development. This approach contrasted with the concept of pathogenesis or the study of disease development. Pathogenesis works retrospectively from disease to determine how individuals can avoid, manage, and/or eliminate that disease. Salutogenesis works prospectively by considering how to create, enhance, and improve physical, mental, and social well-being. Salutogenesis provides a framework for researchers and practitioners to help individuals, organizations, and society move toward optimal well-being. This article reviews the development and benefits of the salutogenic approach to health, how it complements pathogenesis, and suggests how to use the salutogenic model to develop a science for positive health. The article also suggests using salutogenesis as a basis for the new health care system in America.

@article{debette_cervical-artery_2009,
	title = {Cervical-artery dissections: predisposing factors, diagnosis, and outcome},
	volume = {8},
	issn = {14744422},
	shorttitle = {Cervical-artery dissections},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1474442209700845},
	doi = {10.1016/S1474-4422(09)70084-5},
	language = {en},
	number = {7},
	urldate = {2024-03-18},
	journal = {The Lancet Neurology},
	author = {Debette, Stéphanie and Leys, Didier},
	month = jul,
	year = {2009},
	pages = {668--678},
}

@article{walach_circular_2006,
	title = {Circular instead of hierarchical: methodological principles for the evaluation of complex interventions},
	volume = {6},
	issn = {1471-2288},
	shorttitle = {Circular instead of hierarchical},
	url = {https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/1471-2288-6-29},
	doi = {10.1186/1471-2288-6-29},
	language = {en},
	number = {1},
	urldate = {2024-02-17},
	journal = {BMC Medical Research Methodology},
	author = {Walach, Harald and Falkenberg, Torkel and Fønnebø, Vinjar and Lewith, George and Jonas, Wayne B},
	month = dec,
	year = {2006},
	pages = {29},
}

@article{sales_models_2006,
	title = {Models, strategies, and tools: {Theory} in implementing evidence-based findings into health care practice},
	volume = {21},
	issn = {0884-8734, 1525-1497},
	shorttitle = {Models, strategies, and tools},
	url = {http://link.springer.com/10.1007/s11606-006-0274-x},
	doi = {10.1007/s11606-006-0274-x},
	language = {en},
	number = {S2},
	urldate = {2024-01-28},
	journal = {Journal of General Internal Medicine},
	author = {Sales, Anne and Smith, Jeffrey and Curran, Geoffrey and Kochevar, Laura},
	month = feb,
	year = {2006},
	pages = {S43--S49},
}

@article{cacioppo_realism_2004,
	title = {Realism, instrumentalism, and scientific symbiosis: psychological theory as a search for truth and the discovery of solutions},
	volume = {59},
	issn = {0003-066X},
	shorttitle = {Realism, instrumentalism, and scientific symbiosis},
	doi = {10.1037/0003-066X.59.4.214},
	abstract = {Scientific realism holds that scientific theories are approximations of universal truths about reality, whereas scientific instrumentalism posits that scientific theories are intellectual structures that provide adequate predictions of what is observed and useful frameworks for answering questions and solving problems in a given domain. These philosophical perspectives have different strengths and weaknesses and have been regarded as incommensurate: Scientific realism fosters theoretical rigor, verifiability, parsimony, and debate, whereas scientific instrumentalism fosters theoretical innovation, synthesis, generativeness, and scope. The authors review the evolution of scientific realism and instrumentalism in psychology and propose that the categorical distinction between the 2 is overstated as a prescription for scientific practice. The authors propose that the iterative deployment of these 2 perspectives, just as the iterative application of inductive and deductive reasoning in science, may promote more rigorous, integrative, cumulative, and useful scientific theories.},
	language = {eng},
	number = {4},
	journal = {The American Psychologist},
	author = {Cacioppo, John T. and Semin, Gün R. and Berntson, Gary G.},
	year = {2004},
	pmid = {15149262},
	keywords = {Humans, Philosophy, Psychological Theory, Science},
	pages = {214--223},
}

Scientific realism holds that scientific theories are approximations of universal truths about reality, whereas scientific instrumentalism posits that scientific theories are intellectual structures that provide adequate predictions of what is observed and useful frameworks for answering questions and solving problems in a given domain. These philosophical perspectives have different strengths and weaknesses and have been regarded as incommensurate: Scientific realism fosters theoretical rigor, verifiability, parsimony, and debate, whereas scientific instrumentalism fosters theoretical innovation, synthesis, generativeness, and scope. The authors review the evolution of scientific realism and instrumentalism in psychology and propose that the categorical distinction between the 2 is overstated as a prescription for scientific practice. The authors propose that the iterative deployment of these 2 perspectives, just as the iterative application of inductive and deductive reasoning in science, may promote more rigorous, integrative, cumulative, and useful scientific theories.

@article{mead_impact_2002,
	title = {The impact of general practitioners’ patient-centredness on patients’ post-consultation satisfaction and enablement},
	volume = {55},
	issn = {02779536},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S027795360100171X},
	doi = {10.1016/S0277-9536(01)00171-X},
	language = {en},
	number = {2},
	urldate = {2023-11-28},
	journal = {Social Science \& Medicine},
	author = {Mead, Nicola and Bower, Peter and Hann, Mark},
	month = jul,
	year = {2002},
	pages = {283--299},
}

@book{sackett_evidence-based_1999,
	address = {New York},
	edition = {Repr},
	title = {Evidence-based medicine: how to practice and teach {EBM}},
	isbn = {978-0-443-05686-4},
	shorttitle = {Evidence-based medicine},
	language = {eng},
	publisher = {Churchill Livingstone},
	editor = {Sackett, David L.},
	year = {1999},
}

@article{kaptchuk_chiropractic_1998,
	title = {Chiropractic: origins, controversies, and contributions},
	volume = {158},
	issn = {0003-9926},
	shorttitle = {Chiropractic},
	doi = {10.1001/archinte.158.20.2215},
	abstract = {Chiropractic is an important component of the US health care system and the largest alternative medical profession. In this overview of chiropractic, we examine its history, theory, and development; its scientific evidence; and its approach to the art of medicine. Chiropractic's position in society is contradictory, and we reveal a complex dynamic of conflict and diversity. Internally, chiropractic has a dramatic legacy of strife and factionalism. Externally, it has defended itself from vigorous opposition by conventional medicine. Despite such tensions, chiropractors have maintained a unified profession with an uninterrupted commitment to clinical care. While the core chiropractic belief that the correction of spinal abnormality is a critical health care intervention is open to debate, chiropractic's most important contribution may have to do with the patient-physician relationship.},
	language = {eng},
	number = {20},
	journal = {Archives of Internal Medicine},
	author = {Kaptchuk, T. J. and Eisenberg, D. M.},
	month = nov,
	year = {1998},
	pmid = {9818801},
	keywords = {Chiropractic, Humans, Randomized Controlled Trials as Topic, United States},
	pages = {2215--2224},
}

Chiropractic is an important component of the US health care system and the largest alternative medical profession. In this overview of chiropractic, we examine its history, theory, and development; its scientific evidence; and its approach to the art of medicine. Chiropractic's position in society is contradictory, and we reveal a complex dynamic of conflict and diversity. Internally, chiropractic has a dramatic legacy of strife and factionalism. Externally, it has defended itself from vigorous opposition by conventional medicine. Despite such tensions, chiropractors have maintained a unified profession with an uninterrupted commitment to clinical care. While the core chiropractic belief that the correction of spinal abnormality is a critical health care intervention is open to debate, chiropractic's most important contribution may have to do with the patient-physician relationship.

@article{whitman_review_1993,
	title = {A review of constructivism: understanding and using a relatively new theory},
	volume = {25},
	issn = {0742-3225},
	shorttitle = {A review of constructivism},
	abstract = {The purpose of this review paper is to familiarize family medicine educators with a relatively new educational theory, "constructivism." This theory is derived from the philosophical proposition that reality is constructed by the individual. According to the more traditional theory of "objectivism," knowledge exists in the world external to personal experience. Constructivist theory postulates that personal experience cannot be separated from knowledge. In analyzing the literature, the author found that constructivism can be viewed at the cognitive (individual) and social (community) levels. Cognitive constructivism maintains that individuals develop their own models of reality using personal experience and research-based data. Two key elements of cognitive constructivism with implications for family medicine educators are promoting student independence and active learning. Social constructivism maintains that individuals use their membership in a community to continually refine and shape their models of reality. By communicating with each other (for physicians, in the "conversation of medicine"), we test our constructs. Two key elements of social constructivism with implications for application by family medicine educators are promoting collaboration and peer teaching.},
	language = {eng},
	number = {8},
	journal = {Family Medicine},
	author = {Whitman, N.},
	month = sep,
	year = {1993},
	pmid = {8405799},
	keywords = {Cognition, Education, Medical, Family Practice, Group Processes, Humans, Models, Educational, Students, Medical},
	pages = {517--521},
}

The purpose of this review paper is to familiarize family medicine educators with a relatively new educational theory, "constructivism." This theory is derived from the philosophical proposition that reality is constructed by the individual. According to the more traditional theory of "objectivism," knowledge exists in the world external to personal experience. Constructivist theory postulates that personal experience cannot be separated from knowledge. In analyzing the literature, the author found that constructivism can be viewed at the cognitive (individual) and social (community) levels. Cognitive constructivism maintains that individuals develop their own models of reality using personal experience and research-based data. Two key elements of cognitive constructivism with implications for family medicine educators are promoting student independence and active learning. Social constructivism maintains that individuals use their membership in a community to continually refine and shape their models of reality. By communicating with each other (for physicians, in the "conversation of medicine"), we test our constructs. Two key elements of social constructivism with implications for application by family medicine educators are promoting collaboration and peer teaching.

@article{whitman_review_1993-1,
	title = {A review of constructivism: understanding and using a relatively new theory},
	volume = {25},
	issn = {0742-3225},
	shorttitle = {A review of constructivism},
	abstract = {The purpose of this review paper is to familiarize family medicine educators with a relatively new educational theory, "constructivism." This theory is derived from the philosophical proposition that reality is constructed by the individual. According to the more traditional theory of "objectivism," knowledge exists in the world external to personal experience. Constructivist theory postulates that personal experience cannot be separated from knowledge. In analyzing the literature, the author found that constructivism can be viewed at the cognitive (individual) and social (community) levels. Cognitive constructivism maintains that individuals develop their own models of reality using personal experience and research-based data. Two key elements of cognitive constructivism with implications for family medicine educators are promoting student independence and active learning. Social constructivism maintains that individuals use their membership in a community to continually refine and shape their models of reality. By communicating with each other (for physicians, in the "conversation of medicine"), we test our constructs. Two key elements of social constructivism with implications for application by family medicine educators are promoting collaboration and peer teaching.},
	language = {eng},
	number = {8},
	journal = {Family Medicine},
	author = {Whitman, N.},
	month = sep,
	year = {1993},
	pmid = {8405799},
	keywords = {Cognition, Education, Medical, Family Practice, Group Processes, Humans, Models, Educational, Students, Medical},
	pages = {517--521},
}

The purpose of this review paper is to familiarize family medicine educators with a relatively new educational theory, "constructivism." This theory is derived from the philosophical proposition that reality is constructed by the individual. According to the more traditional theory of "objectivism," knowledge exists in the world external to personal experience. Constructivist theory postulates that personal experience cannot be separated from knowledge. In analyzing the literature, the author found that constructivism can be viewed at the cognitive (individual) and social (community) levels. Cognitive constructivism maintains that individuals develop their own models of reality using personal experience and research-based data. Two key elements of cognitive constructivism with implications for family medicine educators are promoting student independence and active learning. Social constructivism maintains that individuals use their membership in a community to continually refine and shape their models of reality. By communicating with each other (for physicians, in the "conversation of medicine"), we test our constructs. Two key elements of social constructivism with implications for application by family medicine educators are promoting collaboration and peer teaching.

@article{maxwell_osteopaths_1993,
	title = {The {Osteopaths} {Bill}},
	volume = {306},
	issn = {0959-8138},
	doi = {10.1136/bmj.306.6892.1556},
	language = {eng},
	number = {6892},
	journal = {BMJ (Clinical research ed.)},
	author = {Maxwell, R. J.},
	month = jun,
	year = {1993},
	pmid = {8329908},
	pmcid = {PMC1677981},
	keywords = {Humans, Osteopathic Medicine, United Kingdom},
	pages = {1556--1557},
}

@article{ahn_heart_1989,
	title = {Heart rate response to breath-holding during supramaximal exercise},
	volume = {59},
	issn = {0301-5548},
	doi = {10.1007/BF02396593},
	abstract = {The cardiovascular responses to breath-holding (BH) during short-lasting supramaximal exercise (415 W) on a cycle ergometer were investigated in 15 healthy male subjects. The arterial oxygen saturation, heart rate (HR), endtidal PO2 and PCO2 were continuously monitored. Firstly, 15 subjects performed exercise during BH, preceded by air breathing (air-BH test), and secondly, exercise without BH. Then 9 of the subjects performed the same procedure as in the air-BH test, except that all subjects breathed 100\% O2 for 1 min before apnoea (O2-BH test). In 2 of these subjects, the systemic arterial blood pressure was continuously measured via a catheter in the radial artery and plasma catecholamine concentration [CA] was also measured both during the air-BH and the O2-BH tests. In the later period of the air-BH test, the high HR level became progressively depressed. This response, however, was absent in the O2-BH test. There was a late increase in the arterial blood pressure in both tests, and both tests produced hypercapnia. Only the air-BH test resulted in hypoxia, substantial hypertension and HR-depression. The increase in plasma CA was similar in both tests. The marked HR-depression demonstrated here is ascribed mainly to activation of the peripheral arterial chemoreceptors by asphyxia, and partially to baroreceptor activity due to elevated blood pressure.},
	language = {eng},
	number = {1-2},
	journal = {European Journal of Applied Physiology and Occupational Physiology},
	author = {Ahn, B. and Nishibayashi, Y. and Okita, S. and Masuda, A. and Takaishi, S. and Paulev, P. E. and Honda, Y.},
	year = {1989},
	pmid = {2583143},
	keywords = {Adolescent, Adult, Breathing Exercises, Exercise, Heart, Heart Rate, Humans, Lung, Male},
	pages = {146--151},
}

The cardiovascular responses to breath-holding (BH) during short-lasting supramaximal exercise (415 W) on a cycle ergometer were investigated in 15 healthy male subjects. The arterial oxygen saturation, heart rate (HR), endtidal PO2 and PCO2 were continuously monitored. Firstly, 15 subjects performed exercise during BH, preceded by air breathing (air-BH test), and secondly, exercise without BH. Then 9 of the subjects performed the same procedure as in the air-BH test, except that all subjects breathed 100% O2 for 1 min before apnoea (O2-BH test). In 2 of these subjects, the systemic arterial blood pressure was continuously measured via a catheter in the radial artery and plasma catecholamine concentration [CA] was also measured both during the air-BH and the O2-BH tests. In the later period of the air-BH test, the high HR level became progressively depressed. This response, however, was absent in the O2-BH test. There was a late increase in the arterial blood pressure in both tests, and both tests produced hypercapnia. Only the air-BH test resulted in hypoxia, substantial hypertension and HR-depression. The increase in plasma CA was similar in both tests. The marked HR-depression demonstrated here is ascribed mainly to activation of the peripheral arterial chemoreceptors by asphyxia, and partially to baroreceptor activity due to elevated blood pressure.

@article{dillon_osteopaths_1935,
	title = {The {Osteopaths} {Bill} {Inquiry}},
	volume = {1},
	url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2460192},
	number = {3878},
	journal = {The British Medical Journal},
	author = {Dillon, Frederick},
	month = apr,
	year = {1935},
	pages = {947--948},
}

@article{noauthor_american_1935,
	title = {American {Comment} on the {Osteopaths} {Bill} {Inquiry} in {England}},
	volume = {33},
	issn = {0008-4409},
	language = {eng},
	number = {2},
	journal = {Canadian Medical Association Journal},
	month = aug,
	year = {1935},
	pmid = {20319989},
	pmcid = {PMC1561292},
	pages = {215--216},
}