International Journal of Osteopathic Medicine RSS feed: Current Issue. The International Journal of Osteopathic Medicine is a peer-reviewed journal that provides for the publication of high quality research articles and review papers that are as broad as the many disciplines that influence and underpin the principles and practice of osteopathic medicine. Particular emphasis is given to basic science research, clinical epidemiology and health social science in relation to osteopathy and neuromusculoskeletal medicine. The Editorial Board encourages submission of articles based on both quantitative and qualitative research designs. The Editorial Board also aims to provide a forum for discourse and debate on any aspect of osteopathy and neuromusculoskeletal medicine with the aim of critically evaluating existing practices in regard to the diagnosis, treatment and management of patients with neuromusculoskeletal disorders and somatic dysfunction. All manuscripts submitted to the IJOM are subject to a blinded review process. The categories currently available for publication include reports of original research, review papers, commentaries and articles related to clinical practice, including case reports. Further details can be found in the IJOM Instructions for Authors. Manuscripts are accepted for publication with the understanding that no substantial part has been, or will be published elsewhere. http://www.journalofosteopathicmedicine.com/?rss=yesElsevier Inc.en © 2011 Published by Elsevier Inc. All rights reserved. International Journal of Osteopathic Medicine1746-0689144December 2011 © 2011 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.journalofosteopathicmedicine.com/article/PIIS174606891100112X/abstract?rss=yesEditorial Board10.1016/S1746-0689(11)00112-XInternational Journal of Osteopathic Medicine 14, 4 (2011)2011-12-01International Journal of Osteopathic Medicine2011-12-01144S1746-0689(11)X0004-4iihttp://www.journalofosteopathicmedicine.com/article/PIIS1746068911001088/abstract?rss=yesThe media is fond of reminding us that we live in a ‘small world’, a world where your friends, colleagues and family are as close as the smart phone in your pocket. We communicate digitally on a daily basis and many of us connect across vast distances. Holidaying abroad is common; and air travel between countries only slightly more complicated than commuting by train (and sometimes less so). So then, in a society where we are being constantly reminded of the world beyond our own backyard, it’s hardly surprising that working in a different country is of considerable interest to many people. I write this from New Zealand where after completion of tertiary studies living and working abroad for a few years is almost regarded as a cultural ‘rite of passage’ – a time to experience the world and ‘expand one’s horizons’ before the obligations and responsibilities of a serious career become the focus. And it’s not just new graduates who are interested in working abroad, increasingly professionals are exploiting migration options in pursuit of improved economic conditions, career development and lifestyle opportunities. In countries where osteopathy is regulated, there can be substantial costs incurred by practitioners in the process of satisfying credentialing requirements for registration in a new jurisdiction. To date, the most common form of credentialing process for osteopaths moving between jurisdictions has been a ‘high-stakes’ clinical exam. This assessment approach is expensive to administer and of uncertain validity in demonstrating equivalency of standards. Furthermore, the utility of ‘high-stakes’ exams for predicting future safe and effective practice is largely unknown. Such isolated exams may not adequately reflect the realities of everyday practice and so there exists a need to develop clarity around overseas assessment pathways.Towards a more international community in osteopathyRobert Moran10.1016/j.ijosm.2011.11.002International Journal of Osteopathic Medicine 14, 4 (2011)2011-12-01International Journal of Osteopathic Medicine2011-12-01144S1746-0689(11)X0004-4Editorial127128http://www.journalofosteopathicmedicine.com/article/PIIS1746068911000861/abstract?rss=yesAbstract: A new approach to assessment design is considered through the process of developing a set of capabilities for osteopathic practice that starts from an understanding of a concept of ‘practice’ applicable to real, situated osteopathic healthcare. Appropriately framed capabilities inform a variety of assessment needs, allowing different tools to assess common standards across many credentialing, high stakes, summative and formative situations, and through work based practice. An argument is made for the inclusion of a work-based phase of assessment in high stakes examinations for overseas trained candidates as the best way to capture real/situated practice enabling the assessment process to contribute to on-going professional learning. The relationship of assessment to learning is regarded as vital to the development of many aspects of regulatory policy, programme accreditation, and continuing professional development, and needs to be considered by stakeholders concerned with maintaining and improving standards of practice.Assessment of osteopaths: Developing a capability-based approach to reviewing readiness to practiceCaroline Stone, David Boud, Paul Hager10.1016/j.ijosm.2011.09.001International Journal of Osteopathic Medicine 14, 4 (2011)2011-11-03International Journal of Osteopathic Medicine2011-11-03144S1746-0689(11)X0004-4Commentary129140http://www.journalofosteopathicmedicine.com/article/PIIS1746068911000824/abstract?rss=yesAbstract: Objectives: To investigate the effect of thoracic spine thrust manipulation on the EMG activity of posterior deltoid and lower trapezius during treadmill walking.Methods: Volunteers (n=40; 19 males and 21 females) were randomly assigned to a ‘sham ultrasound’ control group (n=20) or a thoracic spine high-velocity thrust (HVLAT) manipulation group (n=20). Surface EMG recordings were collected from the right posterior deltoid and lower trapezius muscles whilst participants walked on a treadmill for 2min, at 2.8mph, both prior to and immediately post-intervention. EMG recordings were analysed by evaluating the difference of integral values for pre and post data using repeated measures ANOVA.Results: Both control (sham ultrasound) and experimental groups (HVLAT) exhibited small non-significant reductions in post-intervention EMG activity of lower trapezius (p=0.201) and a significant reduction in posterior deltoid (p=0.003) during treadmill walking. No significant difference was found in the integrated EMG (IEMG) power between control and experimental group in either the ‘before’ or ‘after’ measurements for both target muscles.Conclusions: Manipulation of the thoracic spine does not significantly alter the myoelectric activity of lower trapezius and posterior deltoid muscles during treadmill walking.Highlights: ► This study investigated the effect of High Velocity Low Amplitude thrust technique (in thoracic spine) on the posterior deltoid and lower trapezius muscles during treadmill walking. ► Subjects had 2 minute recordings of target muscle EMG activity during treadmill walking before and after control (sham ultrasound) or experimental (HVLAT) interventions. ► No significant difference was found between groups, indicating that HVLAT had no effect on the target muscle EMG activity during this functional task. ► Further study examining different functional tasks within a similar experimental model is warranted.The effect of thoracic spine high-velocity low-amplitude thrust manipulation on myoelectric activity of the lower trapezius and posterior deltoid muscles during treadmill walkingBen D. McChesney, Lesley Haig, Conor Gissane10.1016/j.ijosm.2011.07.001International Journal of Osteopathic Medicine 14, 4 (2011)2011-11-14International Journal of Osteopathic Medicine2011-11-14144S1746-0689(11)X0004-4Research Report141148http://www.journalofosteopathicmedicine.com/article/PIIS1746068911000848/abstract?rss=yesAbstract: A hypothesis is proposed which suggests biomechanical changes affect physiological mechanisms that may explain the therapeutic effects and tissue changes palpated by practitioners of osteopathy in the cranial field (OCF). It is suggested that the subtle application of manual compression between a practitioner’s hands may cause a net negative charge in the collagen matrix resulting in a change of state from a gel to a sol. This is attributed to biochemical changes and the thixotropic properties of collagen.It is also hypothesized that ionic movement results in an electrochemical gradient which causes changes in the cellular/plasma membrane permeability. Altered cation (hydrogen and calcium ions) distribution, present in the extracellular fluid, results in 1) an electrochemical gradient which causes changes in the cellular/plasma membrane permeability and 2) the stimulation of a local vasomotive response. It is postulated that the stimulation of a local vasomotive response within the extracellular matrix (ECM) is perceived by the practitioner of OCF as feeling a change in the quality of the “primary respiratory mechanism” (PRM) and the “cranial rhythmic impulse” (CRI).Restoring a normal electrochemical/ionic gradient across the cellular/plasma membrane, equilibrium is reached and it is hypothesized that this is the point of balanced fluid interchange (BFI), a point practitioners of OCF refer to as a “still point”. Other physiological mechanisms and their implications are discussed to 1) explain other palpatory findings felt during the therapeutic response and 2) to explain the reported changes in the quality of the PRM/CRI, made by OCF practitioners, after a still point has been reached.Highlights: ► Hypotheses explaining the therapeutic claims made by osteopaths in the cranial field. ► It is suggested compression applied to the collagen matrix causes a state change. ► This is attributed to the thixotropic properties of collagen and biochemical changes. ► The biomechanical changes may account for the tissue change felt by OCF practitioners.A hypothesis to explain the palpatory experience and therapeutic claims in the practice of osteopathy in the cranial fieldDavid Hamm10.1016/j.ijosm.2011.07.003International Journal of Osteopathic Medicine 14, 4 (2011)2011-11-24International Journal of Osteopathic Medicine2011-11-24144S1746-0689(11)X0004-4Review149165http://www.journalofosteopathicmedicine.com/article/PIIS1746068911001076/abstract?rss=yesRafael Zegarra-Parodi, CEESO Paris & Lyon, France Woolf et al.1 have proposed a mechanism-based classification of pain to assist clinicians in the diagnosis and treatment of painful conditions. They described two broad categories: tissue injury pain (nociceptive) or nervous system injury pain (neuropathic). Freynhagen et al.2 developed and validated the painDETECT questionnaire (PD-Q), a neuropathic pain screening self-questionnaire to be used among low back pain (LBP) patients. This patient-based questionnaire comprises nine items that do not require a clinical examination. There are seven weighted sensory descriptor items (“never” to “very strongly”) and two items relating to the spatial (“radiating”) and temporal characteristics of the individual pain pattern. The PD-Q screens patients into 3 pain groups: likely nociceptive, unclear and possible neuropathic with a positive predictive value of 83%, a sensitivity of 85% and a specificity of 80%.Research and treatment bulletinPaul Blanchard10.1016/j.ijosm.2011.11.001International Journal of Osteopathic Medicine 14, 4 (2011)2011-12-01International Journal of Osteopathic Medicine2011-12-01144S1746-0689(11)X0004-4Research and treatment bulletin166172http://www.journalofosteopathicmedicine.com/article/PIIS1746068911000836/abstract?rss=yesAbstract: A case of pathological fracture of a thoracic vertebra in a 55-year-old male presenting with backache is reported.Highlights: ► Differential diagnosis of thoracic backache should include pathological fracture. ► Patients with primary biliary cirrhosis may be at risk of osteoporosis. ► Osteoporosis and vertebral fracture are complications of PBC.Pathological vertebra fracture in a man with primary biliary cirrhosisErdem Akbal, Ayla Akbal, Erdem Koçak, Adnan Taş, Seyfettin Köklü10.1016/j.ijosm.2011.07.002International Journal of Osteopathic Medicine 14, 4 (2011)2011-10-05International Journal of Osteopathic Medicine2011-10-05144S1746-0689(11)X0004-4Case Report173175