Band 103, Heft 12

The use of osteopathic manipulative treatment (OMT) during pregnancy has a long tradition in osteopathic medicine. A retrospective study was designed to compare a group of women who received prenatal OMT with a matched group that did not receive prenatal OMT. The medical records of 160 women from four cities who received prenatal OMT were reviewed for the occurrence of meconium-stained amniotic fluid, preterm delivery, use of forceps, and cesarean delivery. The randomly selected records of 161 women who were from the same cities, but who did not receive prenatal OMT, were reviewed for the same outcomes. The results of a logistic regression analysis were statistically reliable, chi2 (4, N = 321) = 26.55; P < .001, indicating that the labor and delivery outcomes, as a set, were associated with whether OMT was administered during pregnancy. According to the Wald criterion, prenatal OMT was significantly associated with meconium-stained amniotic fluid (Z = 13.20, P < .001) and preterm delivery (Z = 9.91; P < .01), while the use of forceps was found to be marginally significant (Z = 3.28; P = .07). The case control study found evidence of improved outcomes in labor and delivery for women who received prenatal OMT, compared with women who did not. A prospective study is proposed as the next step in evaluating the effects of prenatal OMT.

Integrated neuromusculoskeletal release (INR) using a segmental anterior/posterior approach is an osteopathic manipulative treatment technique that is easily learned and applied. The segmental anterior/posterior approach to INR was developed as a practical osteopathic manipulative treatment procedure for the inpatient setting, but also has equal efficacy in the outpatient setting. It builds on the principles of INR and myofascial release techniques, as well as other techniques. This approach focuses on both the anterior and posterior connectivity of the body through the neuromusculoskeletal system and uses this connectivity to effectively treat somatic dysfunctions. The principles of INR are discussed, as well as the role of INR in the diagnosis and treatment of somatic dysfunctions in the thoracic, lumbar, and sacral regions.

Data were gathered from 423 osteopathic primary care physicians who are members of the Michigan Osteopathic Association, assessing their attitudes and practices regarding complementary and alternative medicine (CAM). Family physicians and general internists were more likely than pediatricians to talk to their patients about CAM. Similarly, female physicians were more likely than male physicians to talk to their patients about CAM or refer their patients for CAM. Finally, physicians aged 35 years and younger were more likely than those 60 years and older to use CAM for themselves or their families. Predominant among the conditions for which the physicians would refer for CAM were long-term problems, traditional therapy failures, psychiatric disorders, and behavioral problems. Results reveal wide variations in the way osteopathic primary care physicians view and use complementary and alternative care.

Medical practice changes that limit patient availability, instructor time, and advances in technology have led to a greater use of simulators and multimedia computers in medical education. These systems address the problem of inadequate bedside skills training and poor proficiency among all health care providers. While studies have shown their effectiveness among medical students, residents, and practicing physicians, none has focused on the osteopathic internist population--one that is becoming more responsible for conducting initial and follow-up physical examinations. This report describes the use of "Harvey," the cardiology patient simulator, and the UMedic Multimedia Computer System at a workshop conducted at the American College of Osteopathic Internists' 61st Annual Convention and Scientific Sessions. Participants in this study significantly improved their ability to identify common cardiac auscultatory events, as indicated by pretest-to-posttest scores. Workshop participants were nearly unanimous in their belief that they would like to use these tools for learning and assessment.