L'ostéopathie ne prend pas seulement en charge les adultes : elle est efficace aussi sur les bébés et utilise des techniques douces et adaptées au jeune âge des nourrissons. La prise en charge ostéopathique de votre bébé aura pour objectif de...
Avec le temps, certaines pathologies prennent place et perturbent l'équilibre du corps, le métabolisme ralenti et l'organisme a plus de difficulté à s'équilibrer, faire face aux aléas de la vie et compenser les pertes de mobilité. L'ostéopathie pourra aider à ....
News Santé Ostéopathie : le gouvernement a entendu les ostéopathes News Santé Le Ministère de la Santé (avec le ministère de l'Education Nationale) vient de publier au Journal Officiel un décret qui renforce notablement la réglementation des écoles...
Lifting at work is considered an important risk factor for low back pain (LBP). However, contradictory findings have been reported, partly because frequency, duration and intensity (ie, the weight of the load) of lifting have not been systematically considered. This has hampered developments of threshold values for lifting. The aims of this study were: to assess the effect of lifting during work (quantified in duration, frequency or intensity) on the incidence of LBP and to quantify the impact of these relationships on the occurrence of LBP in occupational populations exposed to lifting. We searched in PubMed and EMBASE.com for longitudinal studies assessing the effect of occupational lifting on LBP incidence. For each study, the exposure-response slope of the association was estimated by loglinear regression analysis. When possible, a meta-analysis on these slopes was conducted. In a health impact assessment, the effects of the pooled exposure-response relationships on LBP incidence was assessed. Eight longitudinal studies were included. Pooled estimates resulted in ORs of 1.11 (1.05 to 1.18) per 10 kg lifted and 1.09 (1.03 to 1.15) per 10 lifts/day. Duration of lifting could not be pooled. Using these ORs, we estimated that lifting loads over 25 kg and lifting at a frequency of over 25 lifts/day will increase the annual incidence of LBP by 4.32% and 3.50%, respectively, compared to the incidence of not being exposed to lifting. Intensity and frequency of lifting significantly predict the occurrence of LBP. Exposure-response relationships show that lifting heavy loads may have a substantial impact on musculoskeletal health of the working population. This information may direct the development of occupational lifting guidelines and workplace design for LBP prevention.
Ostéopathe Paris 15's insight:
Coenen P, et al. – L'objectif de cette étude a été d'évaluer l'effet du levage durant le travail (quantifié en termes de durée, de fréquence ou d'intensité) sur l'incidence de la lombalgie et de quantifier l'impact de ces relations sur la survenue de lombalgies dans les populations exposées professionnellement au levage. Ces informations sont susceptibles d'orienter l'élaboration de recommandations en matière de levage professionnel et la conception de postes de travail visant à prévenir la lombalgie.
Publics concernés : établissements de formation en ostéopathie, étudiants en formation en ostéopathie. Objet : procédure et conditions d’agrément des établissements de formation en ostéopathie, création d’une commission consultative nationale d’agrément des établissements de formation en ostéopathie. Entrée en vigueur : le texte entre en vigueur le lendemain de sa publication. Notice explicative : en application de l’article 75 de la loi no 2002-303 du 4 mars 2002 modifiée relative aux droits des malades et à la qualité du système de santé, ce projet de décret a pour objet de fixer les conditions d’agrément des établissements souhaitant délivrer une formation en ostéopathie. Il définit la procédure conduisant à la délivrance d’un agrément par le ministre chargé de la santé aux établissements de formation souhaitant dispenser une telle formation. Il précise la composition de la nouvelle commission consultative nationale d’agrément des établissements de formation en ostéopathie. Le présent décret fixe également les mesures en faveur des étudiants ayant effectué une période d’études non sanctionnée par un diplôme au sein d’un établissement de formation en ostéopathie dont l’agrément n’a pas été renouvelé ou a été retiré. Références : les dispositions du présent décret peuvent être consultées sur le site Légifrance (http://www. legifrance.gouv.fr). Il est pris pour l’application de l’article 75 de la loi no 2002-303 du 4 mars 2002 modifiée relative aux droits des malades et à la qualité du système de santé.
Fibromyalgia is a chronic pain syndrome associated with numerous somatic symptoms including gastrointestinal manifestations of nonspecific nature. Celiac disease and nongluten sensitivity frequently evolve in adults with gastrointestinal and extraintestinal symptoms similar to those found among patients with fibromyalgia. The objective of the present study was to evaluate the presence of celiac-type symptoms among patients with fibromyalgia in comparison with healthy subjects and with those experienced by adult celiac patients and subjects with gluten sensitivity. A list of typical celiac-type symptoms was developed, comparing the frequency of presentation of these symptoms between patients with fibromyalgia (N = 178) and healthy subjects (N = 131), in addition to those of celiac patients and gluten-sensitive patients reported in the literature. The frequency of presentation of every celiac-type symptom, excepting anemia, was significantly higher among patients with fibromyalgia compared to controls (p < 0.0001). Regarding the existing data in the literature, the prevalence of fatigue, depression, cognitive symptoms and cutaneous lesions predominated among patients with fibromyalgia, whereas the prevalence of gastrointestinal symptoms was higher among patients with fibromyalgia compared to gluten-sensitive patients and was similar among patients with fibromyalgia and celiac disease patient. The symptomatological similarity of both pathologies, especially gastrointestinal symptoms, suggests that at least a subgroup of patients with fibromyalgia could experience subclinical celiac disease or nonceliac gluten intolerance.
Ostéopathe Paris 15's insight:
García–Leiva JM, et al. – L'objectif de la présente étude a été d'évaluer la présence de symptômes de maladie cœliaque chez les patients souffrant de fibromyalgie en comparaison avec des sujets en bonne santé, et des symptômes présentés par des patients adultes atteints de maladie cœliaque et des sujets souffrant d'une sensibilité au gluten. Toutefois, les résultats montrent que la similarité symptomatologique des deux pathologies, notamment les symptômes gastro-intestinaux, indique qu'au moins un sous-groupe de patients souffrant de fibromyalgie pourrait présenter une maladie cœliaque de stade subclinique ou une intolérance au gluten non cœliaque.
Pneumonia, the inflammatory state of lung tissue primarily due to microbial infection, claimed 52,306 lives in the United States in 2007 (1) and resulted in the hospitalization of 1.1 million patients (2). With an average length of in-patient hospital stay of five days (2), pneumonia and influenza comprise significant financial burden costing the United States $40.2 billion in 2005 (3). Under the current Infectious Disease Society of America/American Thoracic Society guidelines, standard-of-care recommendations include the rapid administration of an appropriate antibiotic regiment, fluid replacement, and ventilation (if necessary). Non-standard therapies include the use of corticosteroids and statins; however, these therapies lack conclusive supporting evidence (4). (Figure 1) Osteopathic Manipulative Treatment (OMT) is a cost-effective adjunctive treatment of pneumonia that has been shown to reduce patients' length of hospital stay, duration of intravenous antibiotics, and incidence of respiratory failure or death when compared to subjects who received conventional care alone (5). The use of manual manipulation techniques for pneumonia was first recorded as early as the Spanish influenza pandemic of 1918, when patients treated with standard medical care had an estimated mortality rate of 33%, compared to a 10% mortality rate in patients treated by osteopathic physicians (6). When applied to the management of pneumonia, manual manipulation techniques bolster lymphatic flow, respiratory function, and immunological defense by targeting anatomical structures involved in the these systems(7,8, 9, 10). The objective of this review video-article is three-fold: a) summarize the findings of randomized controlled studies on the efficacy of OMT in adult patients with diagnosed pneumonia, b) demonstrate established protocols utilized by osteopathic physicians treating pneumonia, c) elucidate the physiological mechanisms behind manual manipulation of the respiratory and lymphatic systems. Specifically, we will discuss and demonstrate four routine techniques that address autonomics, lymph drainage, and rib cage mobility: (1) Rib Raising, (2) Thoracic Pump, (3) Doming of the Thoracic Diaphragm, and (4) Muscle Energy for Rib 1.
Osteopathic manipulative treatment (OMT) has been studied in patients with various respiratory diseases. However, to the authors' knowledge, no studies have assessed the efficacy of OMT in patients with cystic fibrosis (CF).
To evaluate pulmonary function and perceptions of breathing, anxiety, and pain of CF patients who receive OMT in addition to standard inpatient management of pulmonary exacerbation.
In a single-blind randomized controlled trial, we assessed adult patients with a history of CF who were admitted to the hospital because of pulmonary exacerbation. Participants were randomly assigned to receive a daily standardized protocol of OMT or sham therapy. Both groups also received standard treatment for CF. Spirometry and questionnaire data (self-assessment of breathing, pain, and anxiety level) were collected before the first OMT or sham therapy session and after the final session.
A total of 33 patients were included in the study: 16 in the OMT group and 17 in the sham therapy group. Improvements in spirometric parameters were observed in both the OMT and the sham therapy groups, with no statistically significant differences found between the groups. More patients in the OMT group than in the sham therapy group had questionnaire response patterns that indicated their breathing had improved during the study period (15 of 16 vs 8 of 16, respectively). No differences were found between groups for perceived improvement of pain and anxiety.
In the current study, CF patients who received OMT did not demonstrate statistically significant differences in pre- and posttreatment spirometry findings compared with CF patients who received sham therapy. Questionnaire findings suggest that OMT may affect CF patients' perception of overall quality of breathing. Additional studies are needed to assess the clinical use of OMT in patients with CF.
To evaluate the efficacy of Osteopathic Manipulative Treatment (OMT) to reduce low back pain and improve functioning during the third trimester in pregnancy and improve selected outcomes of labor and delivery.
PROMOTE was a randomized, placebo-controlled trial of 400 women in their third trimester. Women were randomized to usual care only (UCO), usual care plus OMT (OMT), or usual care plus placebo ultrasound treatment (PUT). The study included seven treatments over nine weeks. The OMT protocol included specific techniques administered by board-certified OMT specialists. Outcomes were assessed using self-report measures for pain and back-related functioning, and medical records for delivery outcomes.
There were 136 women in the OMT group, 131 in PUT, and 133 in UCO. Characteristics at baseline were similar across groups. Findings indicate significant treatment effects for pain and back related functioning (P<.001 for both), with outcomes for the OMT group similar to that of the PUT, but both groups were significantly improved compared to UCO. For secondary outcome of meconium- stained amniotic fluid there were no differences between the groups.
OMT was effective for mitigating pain and functional deterioration compared to the UCO group; however OMT did not differ significantly from PUT. This may be attributed to PUT being a more active treatment than intended. There was no higher likelihood of conversion to high risk status based on treatment group. Therefore, OMT is a safe, effective adjunctive modality to improve pain and functioning during their third trimester.
La grossesse est une période très particulière de la vie d'une femme. Durant 9 mois, le corps va changer et s'adapter pour finalement se préparer à l'accouchement. Des modifications importantes auront lieu, tant sur le plan physique quepsychique...
Le sport permet d'entretenir le corps, d'améliorer l'état de santé et de compenser une mauvaise ergonomie au travail. Cependant, la répétition de certains mouvements, les chocs itératifs voir les micro-traumatismes peuvent entraîner des pertes de mobilité et dysfonctions du corps amenant à des troubles fonctionnels et douleurs. La prise en charge ostéopathique du sportif aura pour but de ...
Hernie discale, canal lombaire étroit, troubles de la statique, lombalgie, scoliose…, pathologies tumorales, traumatiques, infectieuses ou complexes du rachis pourront être prises en charge dans ce nouvel Institut Universitaire du Rachis qui...
Osteoarthritis (OA) is a chronic disease, usually characterized by pain, which is associated with reduced muscle strength, disability and progressive loss of function. However, the pain influence over proprioception and motor behaviour remains unclear. Thus, the purpose of the study was to identify the levels of pain, the proprioceptive acuity and the pattern of muscle recruitment during stair ascent and descent in elderly patients with mild and moderate osteoarthritis (OA) compared to healthy subjects.
The study participants included 11 healthy elderly subjects (7 women and 4 men) and 31 elderly patients with knee OA (19 women and 12 men). The functional capacity was assessed by the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index; the pain was evaluated by Wong-Baker faces pain rating scale (WBS) and pressure pain threshold (PPT); the proprioceptive acuity was based on the joint position sense evaluated by electrogoniometer; and the electromyographic (EMG) activity of the major muscles of the lower limb were evaluated during a task of stair ascent and descent of 15 cm. For statistical analysis it was used Statistic for Windows software (StatSoft Inc., version 5.0). Data from the WOMAC index, WBS, the proprioceptive acuity and IEMG (for each muscle in each phase) were analyzed using the Mann–Whitney U test and data from PPT was used Kruskal-Wallis test.
Higher scores were found in the WOMAC index and WBS whereas lower scores were seen in PPT in patients with knee OA compared to healthy subjects. In contrast, there were no significant differences in the proprioceptive acuity and EMG results of most muscles analyzed between the groups.
The presence of pain does not influence the proprioception and the motor behavior of the thigh muscles during stair ascent and descent in subjects with mild and moderate knee OA.
Ostéopathe Paris 15's insight:
de Oliveira DC, et al. – L'arthrose est une maladie chronique, habituellement caractérisée par des douleurs et associée à une réduction de la force musculaire, un handicap et une perte de fonction progressive. Cependant, l'influence de la douleur sur la proprioception et le comportement moteur reste méconnue. L'objet de cette étude était donc d'identifier les niveaux de douleur, l'acuité proprioceptive et les schémas de mobilisation musculaire pendant la montée et la descente d'escalier chez les patients âgés atteints d'arthrose du genou légère à modérée par comparaison avec des sujets sains. La présence de douleur n'influence pas la proprioception ni le comportement moteur des muscles de la cuisse pendant la montée et la descente d'escalier chez les sujets atteints d'arthrose du genou légère à modérée.
Inflammatory bowel diseases (IBD) commonly affect young patients in the reproductive phase of their lives. The chronic and relapsing nature of IBD and the potential need for medical or surgical interventions raise concerns about family planning issues.
To review the current knowledge on IBD management in pregnant and nursing IBD patients.
A PubMed literature search was performed using the search terms 'reproduction' and 'inflammatory bowel disease' and using the headers and main subjects of each section of this article as search terms.
Male and female fertility are not impaired in the majority of IBD patients. In IBD patients with quiescent disease pregnancy outcomes are not impaired in comparison to the general population, however, an increased incidence of pregnancy complications is observed in active IBD patients. As methotrexate (MTX) has been demonstrated to be teratogenic, the use of MTX is contraindicated in patients, who wish to conceive, throughout pregnancy and when nursing. However, normal pregnancies following MTX treatment at conception and later have been reported. Most of the other currently approved IBD medications are not associated with adverse pregnancy outcomes and may be used to maintain quiescent disease or to induce a rapid remission in patients with flares and active disease. Breast-feeding in IBD patients is possible and recommended.
The overall outcome of pregnancies in IBD patients is favourable and not different to healthy controls, thus patients with IBD should not be discouraged from having children.
Ostéopathe Paris 15's insight:
Schulze H, et al. – Les auteurs ont pour objectif de passer en revue les connaissances actuelles sur la prise en charge des maladies intestinales inflammatoires (MII) chez les patientes atteintes de MII enceintes et allaitantes. L'issue globale des grossesses chez les patientes atteintes de MII est favorable and ne diffère pas de celle des contrôles sains. On ne devrait donc pas déconseiller aux patientes atteintes de MII d'avoir des enfants.
To investigate the efficacy of conservative dental treatment (occlusal splint and pharmacologic therapy) and invasive therapy (prosthetic restorations) in the treatment of tension-type headache (TTH).
METHOD AND MATERIALS:
The study sample was composed of 70 patients who presented with symptomatic TTH and were assigned to three treatment groups according to their treatment needs. Group A (30 patients): a conservative treatment protocol with a combination of an occlusal splint and analgesic and muscle relaxant medication. Group B (10 patients): invasive prosthodontic procedures. Group C (30 patients): patients who refused any type of treatment but consented to the study served as a control group. Pain quality was measured with the Headache Impact Test (HIT-6). The statistical analysis was performed with the Wilcoxon rank test (P ≤ .05).
Conservative treatment with splints and analgesic medication and invasive treatment by prosthetic rehabilitation relieved the TTH symptoms. The patients who received treatment experienced a significant reduction in their discomfort after 6 months (P ≤ .01), whereas the patients who refused therapy remained, on average, at the same pain level (P ≤ .117). In group A, the HIT-6 score was reduced for 26 patients, and in group B for 8 patients. In group C a reduction of HIT-6 scores was observed in 10 patients.
Conservative or invasive occlusal adjustments may serve as a useful tool in the treatment of TTH.
Ostéopathe Paris 15's insight:
Troeltzsch M, et al. – Les chercheurs ont évalué l'efficacité des traitements dentaires traditionnels (gouttière occlusale et thérapie pharmacologique) et de la thérapie invasive (restaurations prothétiques) dans le traitement de la céphalée de tension. Ils en ont conclu que les ajustements occlusaux traditionnels ou invasifs peuvent s'avérer utiles dans le traitement de la céphalée de tension.
On n’en finit pas de découvrir les dégâts des pesticides sur l’environnement et la santé. Cette fois, c’est une nouvelle « méta-analyse » qui dresse une synthèse très large. Elle décrit sur quelles espèces les pesticides étendent leurs néfastes influences. Autrement dit, c’est un tableau de l’impact des pesticides sur la biodiversité qui nous est proposé. Pas rassurant.
Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP is often termed nonspecific and may be due to multiple biologic and behavioral etiologies. Researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures, which impede comparisons and consensus. The purpose of this article is to disseminate the report of the National Institutes of Health (NIH) task force on research standards for cLBP.
The NIH Pain Consortium charged a research task force (RTF) to draft standards for research on cLBP. The resulting multidisciplinary panel developed a 3-stage process, each with a 2-day meeting.
The panel recommended using 2 questions to define cLBP; classifying cLBP by its impact (defined by pain intensity, pain interference, and physical function); use of a minimal data set to describe research subjects (drawing heavily on the Patient Reported Outcomes Measurement Information System methodology); reporting "responder analyses" in addition to mean outcome scores; and suggestions for future research and dissemination. The Pain Consortium has approved these recommendations, which investigators should incorporate into NIH grant proposals.
The RTF believes that these recommendations will advance the field, help to resolve controversies, and facilitate future research addressing the genomic, neurologic, and other mechanistic substrates of cLBP. Greater consistency in reporting should facilitate comparisons among studies and the development of phenotypes. We expect the RTF recommendations will become a dynamic document and undergo continual improvement.
Ostéopathe Paris 15's insight:
Deyo RA, et al. – L'objectif de cet article est de diffuser le rapport du groupe de travail des National Institutes of Health (NIH) concernant les normes de recherche relatives à la lombalgie chronique (LC). Le groupe de travail de recherche (GTR) estime que ces recommandations assureront des progrès dans ce domaine, permettront la résolution des controverses et aideront la recherche future relative aux substrats génomiques, neurologiques et autres substrats mécanistes de la LC. Une plus grande cohérence dans les rapports devrait faciliter les comparaisons entre les études et le développement de phénotypes. Les auteurs s'attendent à ce que les recommandations du GTR constituent un document évolutif et fassent l'objet d'améliorations continues.
Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral disorder most commonly affecting children and teenagers. It is characterized by the coexistence of attention problems and impulsivity and hyperactivity. Although several studies have been conducted on the efficacy of conventional and alternative therapies in children with ADHD, few studies have specifically investigated the efficacy of osteopathicmanipulative therapy (OMTh).
To evaluate the efficacy of OMTh in the treatment of children with ADHD.
Children aged 5 to 15 years with a primary diagnosis of ADHD who were admitted to a single neuropsychiatry unit from November 2008 to September 2009 were randomly assigned to an intervention group (OMTh + conventional care) or a control group (conventional care only). Biancardi-Stroppa Modified Bell Cancellation Test accuracy and rapidity scores were recorded for both groups at baseline and after 10 weeks. Statistical analyses included univariate tests and multivariate linear regressions.
A total of 28 participants were included in the study: 14 in the OMTh group and 14 in the control group. Univariate statistical analysis showed no statistically significant differences between the intervention and control groups in terms of characteristics measured at baseline, except for psychosocial intervention (P=.05). Multivariate linear regression showed that OMTh was positively associated with changes in the Biancardi-Stroppa Test accuracy (β=7.948 points; P=.04) and rapidity (β=9.089 points; P=.03) scores.
Participants who received OMTh had greater improvement in Biancardi-Stroppa Test scores than participants who received conventional care only, suggesting that OMTh can potentially increase performances of selective and sustained attention in children with ADHD. To confirm these findings, studies of larger and more diverse populations are warranted.
Childhood acute otitis media (AOM) is highly prevalent. Its usual sequela of middle ear effusion (MEE) can lead to conductive hearing loss, for which surgery is commonly used.
To evaluate the efficacy of an osteopathic manipulative treatment (OMT) protocol on MEE resolution following an episode of AOM. The authors hypothesized that OMT provided adjunctively to standard care for young children with AOM would reduce the duration of MEE following the onset of AOM.
We compared standard care only (SCO) and standard care plus OMT (SC+OMT) for the duration of MEE following AOM. Patients were aged 6 months to 2 years. The SC+OMT group received OMT during 3 weekly visits. Weekly tympanometric and acoustic reflectometer (AR) readings were obtained from all patients.
There were 52 patients enrolled, with 43 completing the study and 9 dropping out. No demographic differences were noted. Only ears from each patient with abnormal tympanograms at entry were included. There were 76 ears in the tympanogram analysis (38 from SCO; 38 from SC+OMT) and 61 ears in the AR data analysis (31 from SCO; 30 from SC+OMT). Dependence of bilateral ear disease noted in AR readings was accounted for in statistical analysis. Tympanogram data demonstrated a statistically significant improvement in MEE at visit 3 in patients in the SC+OMT group (odds ratio, 2.98; 95% confidence interval, 1.16, 7.62; χ(2) test for independence, P=.02). The AR data analysis showed statistically significant improvement at visit 3 for the SC+OMT group (z=2.05; P=.02). There was no statistically significant change in MEE before or immediately after the OMT protocol. Conclusion: A standardized OMT protocol administered adjunctively with standard care for patients with AOM may result in faster resolution of MEE following AOM than standard treatment alone. (ClinicalTrials.gov number NCT00520039.).
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