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Utilization of Osteopathic Structural Examinations by Osteopathic Physicians During A Routine Adult Physical Examination: A Systematic Review

Journal: The AAO Journal Date: 2023/06, 33(2):Pages: 31-32. doi: Subito , type of study: systematic review

Full text    (https://meridian.allenpress.com/aaoj/article/33/2/20/493544/LBORC-NUFA-Poster-Abstracts-2023-Students)

Keywords:

diagnosis [263]
structural examination [6]
systematic review [297]

Abstract:

Introduction/Background: Osteopathic Structural Examinations (OSE) should be an integral part of a full body assessment during a routine physical examination. Spinal Alignment, Mobility, Posture and Localizing Effects (SAMPLE) such as tenderness, asymmetry, restriction of motion, tissue texture (TART) changes, Viscero-Somatic Reflexes (VSR), or Chapman’s Points (CP) are some constituents of the OSE. To our knowledge, a SAMPLE-OSE has not been previously utilized as part of a holistic approach during routine physical examination. Objective: The primary objective of this study is to evaluate the utilization of OSE in routine physical examination by osteopathic physicians and determine the techniques used, areas examined, and specific SAMPLE-OSE constituents assessed. Methods: A systematic review was conducted utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format. Results: 466 articles met the screening criteria, and 27 articles were included in the final analysis. Utilization of OSE appears to be driven more by specific conditions or complaints instead of the traditional, holistic, “patientas-a-unit” approach. Additionally, assessments appear to be directed to a specific area of concern or complaint, with CP(s) and TART changes assessed more frequently compared to spinal alignment, mobility, posture, and localizing effects such as VSR. Conclusion: There is paucity of literature on the utility of OSE during routine physical examinations. The utilization of OSE in the assessment of somatic dysfunction appears to be more segmental and localized than holistic in approach. There is an apparent need to develop a SAMPLE-OSE incorporating the various tenets of osteopathy. Our study has limitations akin to the systematic reviews. Future studies should develop and incorporate a novel SAMPLE-OSE and test for its feasibility and outcomes.


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