Title:
Reliability and validity of the Diagnostic Thinking Inventory in qualified osteopaths and osteopathic students at the British School of Osteopathy
Author:
Clare Adams
British School of Osteopathy Will Podmore
Country:
UK
Keywords:
DIAGNOSTIC THINKING INVENTORY OSTEOPATHY PRACTITIONERS OSTEOPATHIC STUDENTS
Type of Publication:
Dissertation
Level of academic award:
MSc
Research design:
Experiment
Publication Date:
2015
Language:
English
Abstract:
Objectives: The aim of this study is to explore the validity of the Diagnostic Thinking Inventory (DTI) questionnaire to assess diagnostic reasoning in an osteopathic population of students and qualified practitioners. The DTI has been previously used in medicine and physiotherapy, it contains two subscales 1) Flexibility in thinking, and; 2) Evidence for structure in memory. This paper also aims to investigate the test-retest reliability in the identical population to understand if the participant will replicate the same answers they gave in the first response. It is with the intent that the DTI could be utilised to aid students reflect on their reasoning skills and identify areas for development.
Method: 43 participants took part in the test and retest component of the research. 10 3rd year students.33 4th year students. Zero experienced clinic tutors participated.
Reliability was measured via test-retest method using paired sample t-test and Wilcoxon signed-rank test. Internal consistency measured using Cronbach’s Alpha calculation for the subscales. Construct validity measured using independent T-test. Comparing mean and medians of scores between gender and year group using independent sample t-test and Mann-Whitney U tests.
Results: Test-Retest: Alpha score: 1st response: 0.691; 2nd response: 0.707; Construct validity; Year level: Flexibility in thinking: 0.126; Evidence for structure in memory: 0.028; Gender: Flexibility in thinking: 0.640; Evidence for structure in memory: 0.054.
Conclusion: The Diagnostic Thinking Inventory may have limited value assessing the diagnostic reasoning in a student osteopathic population. Adapting the questionnaire to increase its relevance to osteopathy would potentially gain more insight to the participants reasoning skills.
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Title:
The Clinical Reasoning processes of Osteopaths in relation to Psychosomatic and Somatoform Disorders: A qualitative study
Author:
Annabelle Agyapong
British School of Osteopathy Will Podmore
Country:
UK
Keywords:
Osteopathy, somatoform disorders, psychosomatic disorder, clinical reasoning, manual therapy
Type of Publication:
Dissertation
Level of academic award:
MSc
Research design:
qualitative study
Publication Date:
2015
Language:
English
Abstract:
Background: Somatoform and psychosomatic disorders are two categories of diseases that can be very similar in their clinical manifestations, but differ according to pathogenesis and psychology.
Objective: To explore the clinical reasoning processes and experiences of Osteopaths in Relation to psychosomatic and somatoform disorders.
Method: Seven semi-structured interviews were carried with a purposeful sample of UK registered osteopaths. Data was transcribed verbatim and content analysis and elements of grounded theory was used as a framework for analysis.
Results: Participants indicated no specific alteration to their clinical reasoning processes. There is a lack of understanding of the term Somatoform disorders; however, osteopaths tend to treat the somatic complaints associated with these conditions which they find challenging and problematic. Osteopaths are aware of their limitations and the need of psychiatric intervention as psychological treatment is beyond their scope of practice. Due to the complexity of these conditions, practitioners could adapt their therapeutic approach in response to the patients' responses, expectations and outcomes of treatments.
Conclusion: This is the first study exploring the clinical reasoning processes of Osteopaths in relation to Psychosomatic and Somatoform disorders. This study identifies the importance of exploring the way osteopaths assess these patients. It highlights their experiences and opinions on Somatoform disorders which suggests that their knowledge and understanding of somatoform disorders is limited and therefore needs to be improved to enhance patient management. Understanding where osteopathic management can fit within primary healthcare to support these patients is an important area for future research.
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Title:
Osteopathic perspective on the pathophysiology of Irritable Bowel Syndrome – critical narrative review.
Author:
Sofia Almeida.
British School of Osteopathy Will Podmore
Country:
UK
Keywords:
irritable bowel syndrome, inflammation, genetics, microbiota-gut-brain axis, biopsychosocial.
Type of Publication:
Dissertation
Level of academic award:
MSc
Research design:
critical narrative review
Publication Date:
2015
Language:
English
Abstract:
Background: Irritable bowel syndrome (IBS) is a common chronic gastrointestinal (GI) disorder with uncertainty surrounding its pathophysiology. Recent advances in research indicate a multifactorial aetiology for IBS.
Objective: To review the most globally accepted theories about IBS pathophysiology and infer the mechanisms by which the manual treatment can influence IBS.
Design: Critical literature review.
Methods: A systematic search of online databases and hand search of literature for up to date and relevant primary research using appropriate methodological quality criteria.
Results: From the 61 full text articles retrieved, 27 reviews met the inclusion criteria, and from those 16 were considered to be of strong or moderate quality and included in the discussion. Evidence was found for the role of inflammation, alteration in gut microbiota, immunity, genetics, and enteroendocrine cells in the pathophysiology of IBS.
Conclusions: The current body of knowledge supports a multifactorial aetiology of IBS, with biopsychosocial influences playing a role in its development. Further research is suggested regarding osteopathy and manual treatment techniques, focusing more specifically on a particular pathophysiological mechanism of IBS.
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Title:
What is the strength of current research evidence suggesting links between manual therapy and the regulation of haemodynamics?
Author:
Beatrice Ametowanou
British School of Osteopathy Will Podmore
Country:
UK
Keywords:
Haemodynamics, Nervous system, Manual Therapy, Osteopathy, Physical Therapy
Type of Publication:
Dissertation
Level of academic award:
MSc
Research design:
Systematic Review
Publication Date:
2015
Language:
English
Abstract:
Objective: To synthesise and appraise the evidence on the effect of manual therapy on the regulation of haemodynamics in order to understand blood flow mechanisms and how manual therapy may play a role in their regulation. To identify the best available evidence and any inconsistencies or limitations, with the aim of promoting evidence-based practice among manual therapists.
Methods: A computerised and hand literature search for Randomised Control Trial (RCTs) as well as other quantitative experimental and observational studies in which manual therapy was used to regulate factors of haemodynamics. Studies meeting the inclusion criteria were evaluated for methodological quality and risk of bias using the validated assessment tools.
Results: Out of the 25 studies assessed (11 RCTs, 12 experimental non RCT studies and 2 case control studies), 19 were identified as having high methodological quality and low risk of bias. Significant differences were generally high but varied across objective physiological outcome measures and technique used.
Conclusion: High quality studies found mild or no significant difference between manual techniques and haemodynamic regulation within their control group and this suggests that changes observed in the treatment group are worth considering.
The principles on the body fluid movements have gained validity within research however some limitations and gaps still need to be solved in terms of treatment protocol, population and experiment conditions.
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Title:
A qualitative study of reassurance in the Initial consultation of physiotherapy with patients presenting with low back pain and back related leg pain.
Author:
Fatimah Ayoade
British School of Osteopathy Will Podmore
Country:
UK
Keywords:
Reassurance, low back pain, physiotherapy, initial consultation.
Type of Publication:
Dissertation
Level of academic award:
MSc
Research design:
qualitative
Publication Date:
2015
Language:
English
Abstract:
Background: Low back pain (LBP) is the most common single diagnosis for long term sick leave in several European countries including the UK, affecting at least 80% of the population at some point. Reassuring patient with LBP and back related leg pain in one of the communist recommended interventions via the newest guidelines.
Objectives & aims: Explore and describe the nature and process associated with reassurance used by physiotherapists and osteopaths in the initial consultations with patients suffering from back related leg pain, and the possibility of creating an initial model of framework
Method: Fourteen initial consultations with physiotherapist were audio recorded with a purposeful sample of LBP that were recommended by NHS general practitioners. The data was transcribed verbatim, initial analysis used grounded theory and then later comprised of content analysis.
Results: Practitioners reassured patients in a variety of methods, predominately described as cognitive or affective reassurance in nature. Management, education and patient summaries were important in the delivery of reassurance whilst creating rapport.
Conclusion: This is one of the first studies to investigate reassurance as a framework with regards to LBP and physiotherapy practitioners. Limited research is still present with regards to reassurance and how it can exclusively be used for LBP patients.
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Title:
Effectiveness of manual therapies, electrotherapy and physical agent therapy in treating and managing adults presenting with chronic low back pain: A critical narrative review followed by a systematic approach.
Author:
Antonino Balistreri
British School of Osteopathy Will Podmore
Country:
UK
Keywords:
Chronic low back pain, manual therapy, stretching, massage, ultrasound
Type of Publication:
Dissertation
Level of academic award:
MSc
Research design:
critical narrative review/systematic
Publication Date:
2015
Language:
English
Abstract:
Background: Chronic Low Back Pain (CLBP) is a common, complex and disabling condition caused by a heterogeneous number of mechanical and non-mechanical causes. A variety of treatments for LBP have been introduced into clinical practice.
Objectives: The proposed research aimed to provide an objective evaluation of the evidence on manual therapy interventions and machine aided intervention in treating and managing CLBP.
Design: Critical narrative review followed by a systematic approach.
Methods: Computerised literature was conducted between March and June 2014. Databases used were PubMed, The Cochrane Database of Systematic Reviews and Clinical Trials, AMED, CINAHL and Ovid Medline. The quality of papers was assessed using the method guidelines for systematic reviews in the Cochrane Back Review Group.
Results:Twenty five RCTs met the selection criteria (TENS = 5; UST = 4; Man Ther = 16). There was low evidence that UST is effective in treating and managing people with CLBP. There is moderate level of evidence for using TENS as electrotherapy for treating CLBP in the short term. Heterogeneity of intervention duration/frequency, co-interventions and samples potentially contributed to some inconsistency and poor quality results for manual therapy interventions.
Conclusion: There is moderate evidence that TENS interventions reduce pain and disability in people with CLBP in the short term. There is no evidence that UST reduce pain and disability. Moderate evidence of short term duration is also reported for HVT interventions. Further valid and methodologically robust research is required for meaningful interpretation of relevance of other manual therapy interventions.
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Title:
Criteria leading to undertake a Buteyko Technique course regarding the treatment and the management of asthmatic patients – a questionnaire study
Author:
Pierre Barillec
British School of Osteopathy Will Podmore
Country:
UK
Keywords:
Osteopathy, Asthma, Buteyko Breathing Technique, Hyperventilation
Type of Publication:
Dissertation
Level of academic award:
MSc
Research design:
Questionnaire
Publication Date:
2015
Language:
English
Abstract:
Objectives: The aim is to assess via a questionnaire what led healthcare professionals and non healthcare professionals to take a Buteyko Breathing Technique course in UK, despite conclusions of current literature which have weak evidence to support its use.
Method: A web-based questionnaire was sent to 202 Buteyko practitioners via the databases of different Buteykopractitionners association’s UK websites.
Results: the response rate was 29% (n=59) with 39% (n=23) of the respondents healthcare practitioners (HP). The HP group claimed that undertaking a Buteyko Breathing Technique (BBT) course was in relation to research, for personal development and that they hear of it within the health environment. The non HP group denied any link between research and undertaking a BBT course and most decided to attend following recommendations from friends. Both groups had strong beliefs about BBT efficiency and most of them agreed on the mechanisms of hypoventilation on the CO_ levels in the blood on which BBT bases its theory.
Conclusions: HP and non HP have mainly the same views regarding BBT theories towards asthma and hyperventilation-linked conditions. However, future qualitative research on beliefs towards BBT is needed.
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Title:
Is milk an effective supplementation for preventing delayed onset muscle soreness (DOMS) compared to vitamins – A systematic review
Author:
Paige Barnard
British School of Osteopathy Will Podmore
Country:
UK
Keywords:
Delayed onset muscle soreness, supplementation, muscle fatigue, muscle ache, nutrition
Type of Publication:
Dissertation
Level of academic award:
MSc
Research design:
Systematic Review
Publication Date:
2015
Language:
English
Abstract:
Background - Delayed onset muscle soreness (DOMS) is caused by exercise involving eccentric muscle contractions which causes protein leakage from muscle fibres into the circulation, resulting in inflammation and soreness post exercise.
Objective - To assess the effects of supplementation when preventing the severity and/or duration of delayed onset muscle soreness post exercise.
Methods - A systematic review was completed to compare and contrast the effects of milk and vitamins on DOMS. A computerised literature search was conducted between September and November 2014. Papers were refined using an adapted version of Prisma (2009) until relevant papers were gathered. Critical appraisal skills programme (CASP) checklist (2013) and an appraisal criteria developed by Furlan et al (2009) were used to assess the appropriateness of papers. Tests were completed to ensure bias was reduced.
Results - 371 papers were retrieved comparing different supplements and their effects on DOMS which was reduced to 94 once duplicates were removed. All human research was included in the review however due to volume of papers the research question was adapted to compare the effects of vitamins and milk on DOMS. This left 17 papers that were eligible to be reviewed. One paper was unavailable and so 16 papers were reviewed.
Conclusion - Out of the two supplements milk looks most promising to having a beneficial effect on DOMS, however additional research is required to see if results can be replicated. A more in depth review should also be completed including all supplementation to determine if any prove to be effective.
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Title:
Student osteopaths' awareness and management of non-traumatic injuries in cycling.A quantitative survey study.
Author:
Daniel Beck
British School of Osteopathy Will Podmore
Country:
UK
Keywords:
Bicycling, Cumulative Trauma Disorders, Knee, Low Back Pain, Neck Pain
Type of Publication:
Dissertation
Level of academic award:
MSc
Research design:
quantitative survey
Publication Date:
2015
Language:
English
Abstract:
Objectives: The main objectives of this study were to explore the awareness and management of cycling overuse injuries by student osteopaths. The study also explored whether a students year or frequency that they cycled had an influence on the patient questioning and management.
Methods: An online questionnaire containing 12 closed questions was sent to all students from the British School of Osteopathy who are active in clinic. Responses were analysed using SPSS software.
Results:290 participants were invited to participant to which 121 responded. 46 participants cycled at east once per week with 32 cycling between 5 and 7 days per week. Overuse injuries in cycling are thought to be common by 67.2% of participants. A students' year groups was found to be significantly related to them asking about how much time a patient cycled. Also identifying cycling as a predisposing or maintaining factor in a patients presentation, modifying a patient cycling behaviour through changes to bicycle fit and equipment were significantly related to a students' year groups. The frequency that a student cycled per week was significantly related to them asking if a patient cycled and how often.
Conclusion: Osteopathic students are aware of the common overuse injuries in cycling. Only a quarter of participants ask if a patient cycles if not mentioned by the patient, with students who cycle more frequently more likely to ask. However follow up questions regarding a patients cycling activity are more likely to be asked by students in higher year groups. Over half of students have modified a patient’s cycling behaviour, with those in higher year groups more likely.
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Title:
Utilisation of Eyes Closed and Gaze Fixation Palpation Methods and Mental Imagery by Student Osteopaths._
Author:
Diego Bertoldo
British School of Osteopathy Will Podmore
Country:
UK
Keywords:
Mental imagery, diagnostic palpation, osteopathy, haptic, students.
Type of Publication:
Dissertation
Level of academic award:
MSc
Research design:
cross-sectional survey
Publication Date:
2015
Language:
English
Abstract:
Background: Studies in tactile discrimination with eyes closed highlighted the activation of the visual cortex (Facchini and Aglioti, 2003) and suggested that mental imagery plays a role in this (Shore and Dhanoah, 2008).
Objectives: The aim of the study is to explore the use of one’s eyes closed and fixation of gaze during palpation in penultimate and ultimate year osteopathic students, and the related use of mental imagery.
Methods: A cross-sectional design was used on 212 penultimate and ultimate year osteopathic students at the British School of Osteopathy (BSO). Participants were asked to complete a web-based questionnaire which included a combination of yes-no answers and a five point Likert scales indicating level of agreement with a statement (Strongly Agree-Strongly Disagree) and frequency of use (Always-Never).