What's wrong with osteopathy?

Thomson, Oliver P.; MacMillan, Andrew

doi:10.1016/j.ijosm.2023.100659

Cited by 15 publications

(9 citation statements)

References 87 publications

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“…The process of classification, hierarchization, marginalization, and rejection of different epistemologies is termed epistemicide [ 4 ]. In the context of manual therapy, colonial legacies may still manifest in various ways, including the dominance of Western models of assessment and treatment, marginalization of holistic and culturally responsive approaches, and lack of representation and recognition of diverse practitioners and patients [ 8 , 62 , 63 ]. Additionally, educational institutions and professional organizations supporting this ideology should become more responsible for ethically addressing these legacies within manual therapy curricula and standards of practice, promoting genuine diversity, equity, and social justice.…”

Section: Resultsmentioning

confidence: 99%

“…Some authors in the COP professions advocate breaking down professional boundaries in manual therapy which would be artificially upheld by professional ideologies, and instead promote a form of ‘agnostic’ person-centered and evidence-informed MSK care [ 8 , 62 , 63 ]. We feel that such a Eurocentric view of knowledge production to guide patient care, which openly dismisses any other origin of knowledge, such as Indigenous, aligns perfectly with an epistemicide agenda reported in other areas of healthcare [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

“…Non-medical professionals outside the United States, such as chiropractic, osteopathy, and physiotherapy (COP), have historically employed passive hands-on procedures aligned with their guiding principles. Non-medical COP research advocates evidence-informed, patient-centered musculoskeletal (MSK) care, emphasizing hands-off approaches such as education and exercise therapy [ 7 , 8 , 9 ]. Native American medicine has been practiced for at least 12,000 years in America.…”

Section: Introductionmentioning

confidence: 99%

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

Zegarra-Parodi,

D’Alessandro,

Baroni

et al. 2024

Healthcare

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Background: Chiropractic, osteopathy, and physiotherapy (COP) professionals regulated outside the United States traditionally incorporate hands-on procedures aligned with their historical principles to guide patient care. However, some authors in COP research advocate a pan-professional, evidence-informed, patient-centered approach to musculoskeletal care, emphasizing hands-off management of patients through education and exercise therapy. The extent to which non-Western sociocultural beliefs about body representations in health and disease, including Indigenous beliefs, could influence the patient–practitioner dyad and affect the interpretation of pillars of evidence-informed practice, such as patient-centered care and patient expectations, remains unknown. Methods: our perspective paper combines the best available evidence with expert insights and unique viewpoints to address gaps in the scientific literature and inform an interdisciplinary readership. Results: A COP pan-professional approach tends to marginalize approaches, such as prevention-oriented clinical scenarios traditionally advocated by osteopathic practitioners for patients with non-Western sociocultural health assumptions. The Cynefin framework was introduced as a decision-making tool to aid clinicians in managing complex clinical scenarios and promoting evidence-informed, patient-centered, and culturally sensitive care. Conclusion: Epistemological flexibility is historically rooted in osteopathic care, due to his Indigenous roots. It is imperative to reintroduce conceptual and operative clinical frameworks that better address contemporary health needs, promote inclusion and equality in healthcare, and enhance the quality of manual therapy services beyond COP’s Western-centered perspective.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Zegarra-Parodi,

D’Alessandro,

Baroni

et al. 2024

Healthcare

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“…Post-professional theorising has now been documented in relation to physiotherapy (Nicholls, 2021) and osteopathy (Nicholls, 2023;Thomson & MacMillan, 2023), however it is yet to fully emerge within chiropractic. Our results showed that the way COPs in co-located settings identify themselves and each other in different ways, sometimes more strongly identifying with their profession and at other times more as a unique person with distinct beliefs, knowledge and skills.…”

Section: Discussionmentioning

confidence: 99%

Fluid Boundaries: Ethnographic observations of co-located physiotherapists, chiropractors, and osteopaths

Toloui-Wallace,

Forbes,

Thomson

et al. 2023

Preprint

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Background: Chiropractors, osteopaths and physiotherapists (COPs) assess and manage musculoskeletal conditions with similar manual or physical therapy techniques. This overlap in scope of practice raises questions about the boundaries between the three professions. Clinical settings where they are co-located may provide insight into the nature of these boundaries and how they are managed by clinicians themselves. Objectives: To understand the nature of professional boundaries between COPs within a co-located clinical environment and describe the ways in which professional boundaries may be reinforced, weakened, or navigated in these environments. Methods: Drawing from an interpretivist paradigm, we used ethnographic observations to observe interactions between 15 COPs across two clinics. Data were analysed using reflexive thematic analysis principles. Results: We identified various physical and non-physical ‘boundary objects’ that influenced the nature of the professional boundaries between the COPs that participated in the study. These boundary objects overall seemed to increase the fluidity of the professional boundaries, at times simultaneously reinforcing and weakening them. The boundary objects were categorised into three themes: physical, including the clinic’s floor plan, large and small objects; social, including identities and discourse; and organisational, including appointment durations and fees, remuneration policies and insurance benefits. Conclusions: Physical, social, organisational related factors made the nature of professional boundaries between COPs in these settings fluid. These findings may challenge consumers, clinicians and administrators to appreciate that traditional beliefs of distinct boundaries between COPs may not be so in practice. Both clinical practice and future research on professional boundaries between COPs may need to further consider some of these broader factors.

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“…Tanto la osteopatía, como la quiropraxia y la acupuntura, se consideran terapias alternativas en la actualidad debido a que siguen siendo objeto de controversia. Sus conceptos primigenios son anteriores a la medicina contemporánea y, aun hoy en día, hay una división entre aquellos que las practican siguiendo religiosamente los principios empíricos originales, y los que están tratando de adaptarlas a los métodos científico actuales [23][24][25] . Sin embargo, a pesar de ser polémicas, muchos pacientes con dolor crónico optan por manejar sus condiciones mediante estas al no encontrar alivio en los establecimientos de salud convencionales.…”

Section: Segmentaria ¿Qué Abarca?unclassified

Sensibilización espinal segmentaria: un síndrome doloroso neuromusculoesquelético desconcertante

Nakazato Nakamine,

Romero Ventosill

2023

Rev. Colomb. Med. Fis. Rehabil.

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El síndrome de sensibilización espinal segmentaria es un cuadro clínico de dolor regional crónico muy frecuente en la consulta fisiátrica cotidiana. Se caracteriza por la presencia de fenómenos de sensibilización periférica y central las cuales son producidas por el bombardeo persistente de impulsos nociceptivos que provienen de una articulación inestable y/o una lesión de los tejidos, e involucran a uno o más segmentos adyacentes de la columna vertebral, sus correspondientes nervios espinales (raíces nerviosas) y a todas las metámeras que estas inervan, con predominio de los sistemas tegumentario y musculoesquelético. musculoesquelético. Este cuadro clínico, que tiene características de un dolor mixto (nociceptivo y nociplástico), causa desconcierto en la mayoría de médicos porque corresponde a una disfunción neuromusculoesquelética que se presenta sin una lesión definida (no se aprecia en los estudios de imágenes ni de electromiografía), o cuando la hay, esta no es proporcional al dolor que manifiesta el paciente. En este sentido, la compresión de su neurofisiopatología es fundamental para establecer un diagnóstico oportuno e iniciar un tratamiento de rehabilitación adecuado, lo cual beneficiará a un gran número de pacientes que sufren de dolor crónico discapacitante a causa de esta condición.

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What's wrong with osteopathy?

Cited by 15 publications

References 87 publications

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

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

Fluid Boundaries: Ethnographic observations of co-located physiotherapists, chiropractors, and osteopaths

Sensibilización espinal segmentaria: un síndrome doloroso neuromusculoesquelético desconcertante

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