Patient Active Approaches in Osteopathic Practice: A Scoping Review

Abstract

Background: In the field of manual therapies there is a growing interest in moving from passive hands-on approaches to patient active approaches. In the osteopathic field there are both active and passive methods described as integrated in the process of care. However, this prospective linkage has not been formally explored and is not well shared in the community of practice. The present review aims to appraise the relevant literature on the functioning and principles of Patient active osteopathic approaches (PAOAs) and explore a prospective model for selecting the different types of PAOA, highlighting their integration into patient management strategies. Methods: A scoping review was conducted to analyze the relevant literature on the functioning and the different principles of PAOA and to obtain a comprehensive perspective on the phenomenon. Results: The eligible articles provide insights into the mechanisms of functioning and principles of application of active approaches to be integrated with hands-on approaches. These results provide new insights into the relevance of PAOA to clinical practice. Conclusions: The proposal, emerging from the review, may promote discussions in the community of practice and provide a road map for research towards achieving an evidence-based structure for PAOA.

Epistemological Flexibility in Person-Centered Care: The Cynefin Framework for (Re)Integrating Indigenous Body Representations in Manual Therapy

“…Personalized tailored treatment with primary, secondary, and tertiary prevention roles encompasses a comprehensive approach to healthcare delivery. Moreover, this personalized treatment approach includes functional bio-psychosocial preventive and health maintenance objectives that are tailored to an individual’s specific needs and circumstances [ 87 ]. These objectives were formulated based on the results of the osteopathic evaluation, which assessed the patient’s physical, psychological, and social well-being.…”

“…Ultimately, this process improves the patient’s agency and function [ 41 ]. Emergent osteopathic practices integrate various types of minimalist manipulative and patient-active osteopathic approaches (PAOAs) as potential tools for personalized patient management strategies [ 87 ].…”

“…Different osteopathic manipulative techniques can be proposed to patients as manual procedures that influence their bodily perceptions within a specific epistemological framework shaped by their primary sociocultural health assumptions [ 24 ]. Along with these passive manual therapies, various types of PAOAs have been described as potential tools within maximalist management strategies [ 87 ].…”

“…The patient, being aware of the different reasoning that can be applied, makes sense of precedent treatments and shares with the osteopathic practitioner the decisions regarding the proposed osteopathic treatment planning. The progressive sequence of the overall physiotherapeutic and psychotherapeutic treatment plan is centered on the clinical context, based on available guidelines [ 95 ], and is indicated by the circled numbers 1 and 2; the subsequent personalized osteopathic treatment plan defined by shared decision-making [ 41 , 51 ] to promote participative-active osteopathic treatment [ 71 , 87 ] with a combination of touch-based and mindfulness-oriented strategies [ 97 , 98 , 99 ] and synchronized music listening [ 100 ], as well as self-management counseling [ 101 ] and is marked by the numbers 3 and 4. Abbreviations: symptom-oriented physical examination (SPE), functional physical examination (FPE), familial symptoms (FS), osteopathic palpatory findings (OPF), structure-function test (SFCT), manual assessment tests of central sensitization (CS), two-point discrimination test (TPD), and Waddell’s sign (WS).…”

The effect of water exercise and sand exercise training methods on agility in basketball athletes

“…Sand exercise is another method to improve the leg muscles' ability [38]. Training on sand can reduce the stress placed on the skeletal muscle system during exercise, limit the degree of exercise-induced muscle damage, and associated negative side effects such as increased muscle soreness and reduced performance capacity [39,40,41,43]. When the footsteps are on the sand, the athlete will receive a more significant stimulus through the resistance pressure generated during training.…”