somatic dysfunctions in newborns: prevalence and correlation inter-operator
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Somatic dysfunctions in newborns: prevalence and correlation inter-operator. Francesco Cerritelli MS DO European Institute for Evidence Based Osteopathic Medicine (EBOM) AIOT Research Institute Pescara, Italy [email protected]. - PowerPoint PPT PresentationTRANSCRIPT
Somatic dysfunctions in newborns:
prevalence and correlation inter-
operator
8th International Conference on Advance in Osteopathic Research.
Milan, Italy. May 29, 2010
Francesco Cerritelli MS DOEuropean Institute for Evidence Based Osteopathic Medicine
(EBOM)AIOT Research Institute
Pescara, Italy
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Definition of Somatic Dysfunction (SD)
Introduction
• impaired or altered function of related components of the somatic (body framework) system: skeletal, arthrodial, and myofascial structures, and their related vascular, lymphatic, and neural elements
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Glossary of Osteopathic Terminology, 2009
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SD as marker of:
Introduction
•bodily changing
•clinical condition
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Licciardone JC, Fulda KG, Stoll ST, Gamber RG, Cage AC. A case-control study of osteopathic palpatory findings in type 2 diabetes mellitus. Osteopath Med Prim Care. 2007 Feb 8;1:6.
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Measuring SD: TART paramters
Introduction
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SD and newborns
Introduction
RegionCerritelli
(’09)Carreiro (’03)
Frymann (’65)
SBS 36,77 40
Torsion 28,50
Compression 17,49
Occiput
Condyles 60,65 45,97
Temporal bone 5,79 32,58
Column 70
Dorsal tract 18,71
Lumbar/sacral tract
39,35
Sacrum
Extension 36,76
Intraosseum 36,77
Diaphragm 16,77Number in table are in percentage
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Aim of the study
•Evaluate the AREA and SUBJECT prevalence of SD in a population of newborns
•Evaluate the inter-operator reliability
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Population
Methods
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newborns N= newborns N= 220220
excluded excluded N=46N=46
eligible N= 174eligible N= 174
pre-terms pre-terms group N= 101group N= 101
terms group terms group N= 73N= 73
study group study group N= 47N= 47
control control group N= group N=
5454
study group study group N= 34N= 34
control control group N= group N=
3939
28≤ga<38
ga≥38
ga = gestational age
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Methods
•Baseline measurements of osteopathic characteristics (TART)
•Osteopathic Evaluations: 2/week
•Study period: 20 months
•Outcomes:
•prevalence of SD
• inter-reliability between operators
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Statistical Analysis
•Arithmetic means and SD for the general characteristics of study population
•Univariate statistical tests for all differences between study and control group
•Pearson’s test for correlation between operators
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Pre-terms population
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Study group Control group p value
N* 47 (46.5) 54 (53.5)
Gender Male 24 (51.1) 27 (50.0) 0,92 Female 23 (49.8) 27 (50.0)
Gestational Age
Overall34.1 (2.4)
34.1 (2.5)
> 32* 36 (76.6) 39 (72.2) 0,79
≤ 32 11 (23.4) 15 (27.8)
Weight (gr)
At birth2088 (498.6) 2234 (730.9)
0,24
≤ 1500* 7 (14.9) 10 (18.5) 0,26
> 1500* 40 (85.1) 44 (81.5)
At recovery 1893 (496.7) 1926 (713.8) 0,59
Numbers in table are mean±s.d.; p value from t test *n(%);p value from χ2 test
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Dysfunction per area
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Dysfunction per subject
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Terms population
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Study group Control group p value
N* 34 (46.6) 39 (53.4)
Gender
Male 17 (50.0) 18 (46.2) 0,75
Female 17 (50.0) 21 (53.8)
Gestational Age (w) 40 (0.9) 40 (1.0) 0,82
Weight (gr)
At birth 3375 (472.9) 3361 (561.6) 0,92
At recovery 3300 (445.8) 3268 (516.1) 0,66
Numbers in table are mean±s.d.; p value from t test *n(%);p value from χ2 test
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Dysfunction per area
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Dysfunction per subject
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Correlation inter-operator
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Arear
value*p value†
Cranium 0.44 0.001
Column 0.24 0.01
Pelvis 0.38 0.001
Thorax 0.15 0.03
* r value from Pearson’s test† p value from Pearson’s test
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Discussion
•Cranial and pelvic areas highest percentage of SD
•Supposed etiology:
- type of labor;
- absence of delivery;
- fetal condition;
- mother condition.
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Discussion
•How we should consider the SDs?
•Are the SDs related to an improvement of the clinical condition?
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Fractal system?
Discussion
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http://upload.wikimedia.org/wikipedia/commons/2/21/Mandel_zoom_00_mandelbrot_set.jpg
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Conclusion
•The study shows a significant r inter-reliability score as well as an high percentage of SD in cranial and pelvic areas.
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...A second... Thank you for your
attentionFrancesco Cerritelli MS DO
European Institute for Evidence Based Osteopathic Medicine (EBOM)
AIOT Research InstitutePescara, Italy
8th International Conference on Advance in Osteopathic Research.
Milan, Italy. May 29, 2010