Title:Reliability and validity of the Diagnostic Thinking Inventory in qualified osteopaths and osteopathic students at the British School of OsteopathyAuthor:Clare AdamsBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:DIAGNOSTIC THINKING INVENTORY OSTEOPATHY PRACTITIONERS OSTEOPATHIC STUDENTS Type of Publication:DissertationLevel of academic award:MScResearch design:ExperimentPublication Date:2015Language:EnglishAbstract:Objectives: The aim of this study is to explore the validity of the Diagnostic Thinking Inventory (DTI) questionnaire to assess diagnostic reasoning in an osteopathic population of students and qualified practitioners. The DTI has been previously used in medicine and physiotherapy, it contains two subscales 1) Flexibility in thinking, and; 2) Evidence for structure in memory. This paper also aims to investigate the test-retest reliability in the identical population to understand if the participant will replicate the same answers they gave in the first response. It is with the intent that the DTI could be utilised to aid students reflect on their reasoning skills and identify areas for development.Method: 43 participants took part in the test and retest component of the research. 10 3rd year students. 33 4th year students. Zero experienced clinic tutors participated.Reliability was measured via test-retest method using paired sample t-test and Wilcoxon signed-rank test. Internal consistency measured using Cronbach’s Alpha calculation for the subscales. Construct validity measured using independent T-test. Comparing mean and medians of scores between gender and year group using independent sample t-test and Mann-Whitney U tests.Results: Test-Retest: Alpha score: 1st response: 0.691; 2nd response: 0.707; Construct validity; Year level: Flexibility in thinking: 0.126; Evidence for structure in memory: 0.028; Gender: Flexibility in thinking: 0.640; Evidence for structure in memory: 0.054.Conclusion: The Diagnostic Thinking Inventory may have limited value assessing the diagnostic reasoning in a student osteopathic population. Adapting the questionnaire to increase its relevance to osteopathy would potentially gain more insight to the participants reasoning skills.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Adams.pdf

Title:The Clinical Reasoning processes of Osteopaths in relation to Psychosomatic and Somatoform Disorders: A qualitative studyAuthor:Annabelle AgyapongBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Osteopathy, somatoform disorders, psychosomatic disorder, clinical reasoning, manual therapy Type of Publication:DissertationLevel of academic award:MScResearch design:qualitative studyPublication Date:2015Language:EnglishAbstract:Background: Somatoform and psychosomatic disorders are two categories of diseases that can be very similar in their clinical manifestations, but differ according to pathogenesis and psychology.Objective: To explore the clinical reasoning processes and experiences of Osteopaths in Relation to psychosomatic and somatoform disorders.Method: Seven semi-structured interviews were carried with a purposeful sample of UK registered osteopaths. Data was transcribed verbatim and content analysis and elements of grounded theory was used as a framework for analysis.Results: Participants indicated no specific alteration to their clinical reasoning processes. There is a lack of understanding of the term Somatoform disorders; however, osteopaths tend to treat the somatic complaints associated with these conditions which they find challenging and problematic. Osteopaths are aware of their limitations and the need of psychiatric intervention as psychological treatment is beyond their scope of practice. Due to the complexity of these conditions, practitioners could adapt their therapeutic approach in response to the patients' responses, expectations and outcomes of treatments.Conclusion: This is the first study exploring the clinical reasoning processes of Osteopaths in relation to Psychosomatic and Somatoform disorders. This study identifies the importance of exploring the way osteopaths assess these patients. It highlights their experiences and opinions on Somatoform disorders which suggests that their knowledge and understanding of somatoform disorders is limited and therefore needs to be improved to enhance patient management. Understanding where osteopathic management can fit within primary healthcare to support these patients is an important area for future research.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Agyapong.pdf

Title:Osteopathic perspective on the pathophysiology of Irritable Bowel Syndrome – critical narrative review.Author:Sofia Almeida.British School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:irritable bowel syndrome, inflammation, genetics, microbiota-gut-brain axis, biopsychosocial.Type of Publication:DissertationLevel of academic award:MScResearch design:critical narrative reviewPublication Date:2015Language:EnglishAbstract:Background: Irritable bowel syndrome (IBS) is a common chronic gastrointestinal (GI) disorder with uncertainty surrounding its pathophysiology. Recent advances in research indicate a multifactorial aetiology for IBS.Objective: To review the most globally accepted theories about IBS pathophysiology and infer the mechanisms by which the manual treatment can influence IBS.Design: Critical literature review.Methods: A systematic search of online databases and hand search of literature for up to date and relevant primary research using appropriate methodological quality criteria.Results: From the 61 full text articles retrieved, 27 reviews met the inclusion criteria, and from those 16 were considered to be of strong or moderate quality and included in the discussion. Evidence was found for the role of inflammation, alteration in gut microbiota, immunity, genetics, and enteroendocrine cells in the pathophysiology of IBS.Conclusions: The current body of knowledge supports a multifactorial aetiology of IBS, with biopsychosocial influences playing a role in its development. Further research is suggested regarding osteopathy and manual treatment techniques, focusing more specifically on a particular pathophysiological mechanism of IBS.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Almeida.pdf

Title:What is the strength of current research evidence suggesting links between manual therapy and the regulation of haemodynamics?Author:Beatrice AmetowanouBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Haemodynamics, Nervous system, Manual Therapy, Osteopathy, Physical Therapy Type of Publication:DissertationLevel of academic award:MScResearch design:Systematic ReviewPublication Date:2015Language:EnglishAbstract:Objective: To synthesise and appraise the evidence on the effect of manual therapy on the regulation of haemodynamics in order to understand blood flow mechanisms and how manual therapy may play a role in their regulation. To identify the best available evidence and any inconsistencies or limitations, with the aim of promoting evidence-based practice among manual therapists.Methods: A computerised and hand literature search for Randomised Control Trial (RCTs) as well as other quantitative experimental and observational studies in which manual therapy was used to regulate factors of haemodynamics. Studies meeting the inclusion criteria were evaluated for methodological quality and risk of bias using the validated assessment tools.Results: Out of the 25 studies assessed (11 RCTs, 12 experimental non RCT studies and 2 case control studies), 19 were identified as having high methodological quality and low risk of bias. Significant differences were generally high but varied across objective physiological outcome measures and technique used.Conclusion: High quality studies found mild or no significant difference between manual techniques and haemodynamic regulation within their control group and this suggests that changes observed in the treatment group are worth considering.The principles on the body fluid movements have gained validity within research however some limitations and gaps still need to be solved in terms of treatment protocol, population and experiment conditions.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Ametowanou.pdf

Title:A qualitative study of reassurance in the Initial consultation of physiotherapy with patients presenting with low back pain and back related leg pain. Author:Fatimah AyoadeBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Reassurance, low back pain, physiotherapy, initial consultation.Type of Publication:DissertationLevel of academic award:MScResearch design:qualitativePublication Date:2015Language:EnglishAbstract:Background: Low back pain (LBP) is the most common single diagnosis for long term sick leave in several European countries including the UK, affecting at least 80% of the population at some point. Reassuring patient with LBP and back related leg pain in one of the communist recommended interventions via the newest guidelines.Objectives & aims: Explore and describe the nature and process associated with reassurance used by physiotherapists and osteopaths in the initial consultations with patients suffering from back related leg pain, and the possibility of creating an initial model of frameworkMethod: Fourteen initial consultations with physiotherapist were audio recorded with a purposeful sample of LBP that were recommended by NHS general practitioners. The data was transcribed verbatim, initial analysis used grounded theory and then later comprised of content analysis.Results: Practitioners reassured patients in a variety of methods, predominately described as cognitive or affective reassurance in nature. Management, education and patient summaries were important in the delivery of reassurance whilst creating rapport.Conclusion: This is one of the first studies to investigate reassurance as a framework with regards to LBP and physiotherapy practitioners. Limited research is still present with regards to reassurance and how it can exclusively be used for LBP patients.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Ayoade.pdf

Title:Effectiveness of manual therapies, electrotherapy and physical agent therapy in treating and managing adults presenting with chronic low back pain: A critical narrative review followed by a systematic approach.Author:Antonino BalistreriBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Chronic low back pain, manual therapy, stretching, massage, ultrasoundType of Publication:DissertationLevel of academic award:MScResearch design:critical narrative review/systematicPublication Date:2015Language:EnglishAbstract:Background: Chronic Low Back Pain (CLBP) is a common, complex and disabling condition caused by a heterogeneous number of mechanical and non-mechanical causes. A variety of treatments for LBP have been introduced into clinical practice.Objectives: The proposed research aimed to provide an objective evaluation of the evidence on manual therapy interventions and machine aided intervention in treating and managing CLBP.Design: Critical narrative review followed by a systematic approach.Methods: Computerised literature was conducted between March and June 2014. Databases used were PubMed, The Cochrane Database of Systematic Reviews and Clinical Trials, AMED, CINAHL and Ovid Medline. The quality of papers was assessed using the method guidelines for systematic reviews in the Cochrane Back Review Group.Results:Twenty five RCTs met the selection criteria (TENS = 5; UST = 4; Man Ther = 16). There was low evidence that UST is effective in treating and managing people with CLBP. There is moderate level of evidence for using TENS as electrotherapy for treating CLBP in the short term. Heterogeneity of intervention duration/frequency, co-interventions and samples potentially contributed to some inconsistency and poor quality results for manual therapy interventions.Conclusion: There is moderate evidence that TENS interventions reduce pain and disability in people with CLBP in the short term. There is no evidence that UST reduce pain and disability. Moderate evidence of short term duration is also reported for HVT interventions. Further valid and methodologically robust research is required for meaningful interpretation of relevance of other manual therapy interventions.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Balistreri.pdf

Title:Criteria leading to undertake a Buteyko Technique course regarding the treatment and the management of asthmatic patients – a questionnaire studyAuthor:Pierre BarillecBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Osteopathy, Asthma, Buteyko Breathing Technique, HyperventilationType of Publication:DissertationLevel of academic award:MScResearch design:QuestionnairePublication Date:2015Language:EnglishAbstract:Objectives: The aim is to assess via a questionnaire what led healthcare professionals and non healthcare professionals to take a Buteyko Breathing Technique course in UK, despite conclusions of current literature which have weak evidence to support its use.Method: A web-based questionnaire was sent to 202 Buteyko practitioners via the databases of different Buteyko practitionners association’s UK websites.Results: the response rate was 29% (n=59) with 39% (n=23) of the respondents healthcare practitioners (HP). The HP group claimed that undertaking a Buteyko Breathing Technique (BBT) course was in relation to research, for personal development and that they hear of it within the health environment. The non HP group denied any link between research and undertaking a BBT course and most decided to attend following recommendations from friends. Both groups had strong beliefs about BBT efficiency and most of them agreed on the mechanisms of hypoventilation on the CO_ levels in the blood on which BBT bases its theory.Conclusions: HP and non HP have mainly the same views regarding BBT theories towards asthma and hyperventilation-linked conditions. However, future qualitative research on beliefs towards BBT is needed.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Barillec.pdf

Title:Is milk an effective supplementation for preventing delayed onset muscle soreness (DOMS) compared to vitamins – A systematic reviewAuthor:Paige BarnardBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Delayed onset muscle soreness, supplementation, muscle fatigue, muscle ache, nutritionType of Publication:DissertationLevel of academic award:MScResearch design:Systematic ReviewPublication Date:2015Language:EnglishAbstract:Background - Delayed onset muscle soreness (DOMS) is caused by exercise involving eccentric muscle contractions which causes protein leakage from muscle fibres into the circulation, resulting in inflammation and soreness post exercise.Objective - To assess the effects of supplementation when preventing the severity and/or duration of delayed onset muscle soreness post exercise.Methods - A systematic review was completed to compare and contrast the effects of milk and vitamins on DOMS. A computerised literature search was conducted between September and November 2014. Papers were refined using an adapted version of Prisma (2009) until relevant papers were gathered. Critical appraisal skills programme (CASP) checklist (2013) and an appraisal criteria developed by Furlan et al (2009) were used to assess the appropriateness of papers. Tests were completed to ensure bias was reduced.Results - 371 papers were retrieved comparing different supplements and their effects on DOMS which was reduced to 94 once duplicates were removed. All human research was included in the review however due to volume of papers the research question was adapted to compare the effects of vitamins and milk on DOMS. This left 17 papers that were eligible to be reviewed. One paper was unavailable and so 16 papers were reviewed.Conclusion - Out of the two supplements milk looks most promising to having a beneficial effect on DOMS, however additional research is required to see if results can be replicated. A more in depth review should also be completed including all supplementation to determine if any prove to be effective.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Barnard.pdf

Title:Student osteopaths' awareness and management of non-traumatic injuries in cycling. A quantitative survey study.Author:Daniel BeckBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Bicycling, Cumulative Trauma Disorders, Knee, Low Back Pain, Neck PainType of Publication:DissertationLevel of academic award:MScResearch design:quantitative surveyPublication Date:2015Language:EnglishAbstract:Objectives: The main objectives of this study were to explore the awareness and management of cycling overuse injuries by student osteopaths. The study also explored whether a students year or frequency that they cycled had an influence on the patient questioning and management.Methods: An online questionnaire containing 12 closed questions was sent to all students from the British School of Osteopathy who are active in clinic. Responses were analysed using SPSS software.Results:290 participants were invited to participant to which 121 responded. 46 participants cycled at east once per week with 32 cycling between 5 and 7 days per week. Overuse injuries in cycling are thought to be common by 67.2% of participants. A students' year groups was found to be significantly related to them asking about how much time a patient cycled. Also identifying cycling as a predisposing or maintaining factor in a patients presentation, modifying a patient cycling behaviour through changes to bicycle fit and equipment were significantly related to a students' year groups. The frequency that a student cycled per week was significantly related to them asking if a patient cycled and how often.Conclusion: Osteopathic students are aware of the common overuse injuries in cycling. Only a quarter of participants ask if a patient cycles if not mentioned by the patient, with students who cycle more frequently more likely to ask. However follow up questions regarding a patients cycling activity are more likely to be asked by students in higher year groups. Over half of students have modified a patient’s cycling behaviour, with those in higher year groups more likely.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Beck.pdf

Title:Utilisation of Eyes Closed and Gaze Fixation Palpation Methods and Mental Imagery by Student Osteopaths._Author:Diego BertoldoBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Mental imagery, diagnostic palpation, osteopathy, haptic, students.Type of Publication:DissertationLevel of academic award:MScResearch design:cross-sectional surveyPublication Date:2015Language:EnglishAbstract:Background: Studies in tactile discrimination with eyes closed highlighted the activation of the visual cortex (Facchini and Aglioti, 2003) and suggested that mental imagery plays a role in this (Shore and Dhanoah, 2008).Objectives: The aim of the study is to explore the use of one’s eyes closed and fixation of gaze during palpation in penultimate and ultimate year osteopathic students, and the related use of mental imagery.Methods: A cross-sectional design was used on 212 penultimate and ultimate year osteopathic students at the British School of Osteopathy (BSO). Participants were asked to complete a web-based questionnaire which included a combination of yes-no answers and a five point Likert scales indicating level of agreement with a statement (Strongly Agree-Strongly Disagree) and frequency of use (Always-Never).Results: Results show the practice of eyes closed diagnostic palpation is widely used by osteopathic students, 69% (N=41). There is no significance association between the academic year and the closure of the eyes during palpation X2 (1, N=59) = 1.612, p =0.204. In addition, the fixation of gaze during palpation is a practice adopted by 83.8% (N= 52) of the total population. Over 80% (N=49) students reported using mental imagery during palpation, with visual and kinaesthetic mental imagery being favoured over tactile mental imagery.Conclusion: Closed eyes palpation and fixation of gaze are widely used practices amongst student osteopaths. Mental imagery is shown to play a key role in palpation with visual and kinaesthetic being the most predominantly used. Training that is focused on developing skills in the use of mental imagery during palpation might provide a valuable tool to further aid the formation of osteopathic students.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Bertoldo.pdf

Title:A qualitative study exploring how an HIV positive diagnosis changes attitudes towards Complementary and Alternative MedicineAuthor:James Birkett.British School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:HIV; CAM; Attitudes; Integrative Health; HAART.Type of Publication:DissertationLevel of academic award:MScResearch design:qualitativePublication Date:2015Language:EnglishAbstract:Objectives: To explore how an HIV positive diagnosis changes attitudes towards complementary & alternative medicine (CAM), how this affects their use and what factors are involved in these changes.Methods: Semi-structured interviews were carried out with a purposive sample of six people living with HIV infection, who had current or past experience of CAM therapiesResults: Three themes were constructed from the data: 1) attitude towards personal health, 2) attitude towards CAM 3) attitude towards healthcare interactionsConclusion: The role of CAM within HIV healthcare has evolved since the introduction of highly active antiretroviral therapy (HAART). Higher survival rates and a higher proportion of new infections in the over 50’s age group have resulted in an ageing HIV+ population. A new paradigm is needed in HIV Healthcare with more emphasis on treating the side-effects of HAART medication and the symptoms of age-related co-morbidities. An integrative healthcare model is needed with open discussions regarding the use of CAM to treat quality of life issues, as well as possible interactions and contraindications of concurrent HAART and CAM use.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Birkett.pdf

Title:Osteopaths' experiences of barriers to treating patient with life-limiting illnesses: an interview studyAuthor:Georgina BonniciBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Osteopathy, manual therapy, life-limiting illness, barriers.Type of Publication:DissertationLevel of academic award:MScResearch design:InterviewPublication Date:2015Language:EnglishAbstract:Background: The need for palliative care has grown in recent years and it is clear that there is a need for improvements in the management and treatment of patients with life-limiting illnesses (LLIs) by all professionals, as osteopathic barriers to care have been under-explored. Therefore, investigating the barriers experienced by osteopaths may help to develop future strategies for the improvement of services to these patients.Objective: To investigate osteopaths’ opinions and experiences of barriers in treating patients with LLIs.Design: Semi-structured qualitative interviews with osteopaths who teach at the British School of Osteopathy (BSO).Method: Five osteopaths were interviewed who had treated at least one patient with a LLI in the past two years. Interview data was analysed using thematic analysis in a manner consistent with elements of Grounded Theory. Two participants took part in an additional follow-up interview in order to clarify the interpretations of the key concepts developed by the researcher.Results: The results of the study showed that barriers to treating patients with LLIs were perceived in four main areas: Resources, including financial and accessibility barriers; communication with patients; knowledge limitations, involving training and experience; and perceptions about osteopathy creating barriers.Conclusion: The most important barriers preventing patients from receiving osteopathic care were perceived to be resource barriers and the perceptions of osteopathy from outside the profession, especially by patients who regard osteopathy as a potential cure for LLIs. Further research into the cost-effectiveness of integrating osteopathy and/or complementary and alternative medicine (CAM) services into the National Health Service and the private healthcare sector is required before further integration can occur. In addition, further research is required in order to determine the demand for osteopathy amongst this patient group.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Bonnici.pdf

Title:Comorbidities, pain, depression and their links with health related quality of life in an ageing HIV population: A cross-sectional surveyAuthor:Matt BrabnerBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:HIV, health related quality of life, chronic back pain, peripheral neuropathy, depressionType of Publication:DissertationLevel of academic award:MScResearch design:cross-sectionalPublication Date:2015Language:EnglishAbstract:Objectives: To establish the most prevalent comorbidities and any relationships between these conditions, age and health related quality of life (HRQoL) in a cohort of people living with HIV (PLWH) and receiving osteopathic treatment.Method: A cross-sectional, self-administered survey (n=42) that captured basic demographics, a list of HIV and non-HIV related comorbidities and HRQoL scores.Results:The most prevalent comorbidities were chronic back pain (n=17), lipodystrophy (n=16), peripheral neuropathy (n=13) and depression (n=12). There was a significant relationship between lipodystrophy and peripheral neuropathy (p=0.005).The mean HRQoL scores for the cohort were below the standard norm, with a significant negative correlation (_=0.000) between the number of comorbidities and the Physical Component Summary (PCS). The relationship between the number of comorbidities and Mental Component Summary (MCS) was also significant (_=0.007), although there was no significant relationship between self-reported depression and the comorbidity burden.Conclusions: The composite burden of HIV and age-related comorbidities have a significant impact on HRQoL in a cohort of PLWH receiving osteopathic care. Osteopaths need to be aware of the specific risk factors for both mental and physical HRQoL to enable the highest quality primary care for PLWH. Further research is however indicated to compare the comorbidity burden with a matched cohort of HIV-uninfected participants.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Brabner.pdf

Title:The clinical reasoning of osteopaths in relation to cervical arterial dysfunction.Author:Christopher BrooksBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:CERVICAL ARTERIAL DYSFUNCTION CLINICAL REASONING OSTEOPATHY Type of Publication:DissertationLevel of academic award:MScResearch design:InterviewPublication Date:2015Language:EnglishAbstract:Background: Cervical arterial dysfunction (CAD) fully represents the anatomical and pathological spectrum of possible events by including all of the arteries of the neck. Clinical reasoning of this condition may increase our understanding of how osteopaths arrive at conclusions in a clinical setting and how they generate and interpret cues in complex patient presentations.Objective: The objective was to investigate the clinical reasoning of osteopaths in relation to CAD. This involved gaining an understanding of their diagnostic framework, their narrative reasoning in relation to the lifestyle and health of the patient and their assessment strategies.Methods: A qualitative research framework was used, which took the form of semi-structured interviews of eight osteopaths in relation to a vignette depicting a cervical spine disorder. The vignette was broken into four stages and participants were questioned as to their clinical reasoning processes. Interviews were audio recorded and transcripts were subsequently analysed with elements of grounded theory.Results: Four key themes were constructed from the data. These included osteopathic focus during the diagnostic process, interpretation of cues and symptoms, factors raising the level of suspicion and the importance of the underlying health of the patient.Conclusions: This study shows the importance of the case history in any hypothesis creation relating to CAD. Individual symptoms such as dizziness and headache did not by themselves increase the index of suspicion of CAD for most participants. Instead most participants looked to use a more contextual approach to the patient, by generating cues from the patient’s lifestyle, systemic health and history. Lastly, participants highlighted the importance of a clear timeline for the onset of symptoms and revealed a lack of confidence in the objective examination due to its transience and irreproducibility.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Brooks.pdf

Title:The perceived and potential roles of osteopathy in professional football.Author:Nick CastleBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:sports osteopathy, professional football, soccer, sports medicine, and injury preventionType of Publication:DissertationLevel of academic award:MScResearch design:InterviewPublication Date:2015Language:EnglishAbstract:Objectives: Over the years osteopathy has been integrated into the multidisciplinary medical teams of several professional football clubs. It is not commonplace however and the aim of this study is to research the reasons why and gain the perspectives and experiences of therapists that have experience of osteopaths working within professional football.Methods: A qualitative study utilising semi-structured interviews. Data collection and analysis occurred concurrently with constant comparative analysis with elements of grounded theory from 7 medical professionals involved in professional football.Results: 5 themes were generated which related to the perceived and potential role for osteopathy in professional football. These were: biomechanical holistic approach, osteopathic role, osteopath stereotypes, benefits and acceptance of osteopathy and finally the barriers to osteopathic integration.Conclusions: Medical professionals within football had contrasting opinions on osteopathy; but it was apparent that if the finances were available, most would recommend utilising an osteopath within their club. Due to the FA guidelines the priority and necessity would always be for a physiotherapist and doctor, however if finances were available an osteopath may then be employed after, or as well as a soft tissue therapist. It was also evident that potential benefits are available to integrating osteopaths into the medical team of a professional football club, however communication is key.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Castle.pdf

Title:Osteopaths’ Opinions on the Benefits and Challenges of Treating Expectant Mothers Prior to LabourAuthor:Natalie ChallinorBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Benefits, Challenges, Manual therapy, Pregnancy, Prenatal.Type of Publication:DissertationLevel of academic award:MScResearch design:InterviewPublication Date:2015Language:EnglishAbstract:Background: Osteopaths’ experiences and opinions when treating expectant mothers in the lead up to labour has been significantly under-researched. Although osteopathic treatment during pregnancy has been reported as successful, the evidence-based research supporting this notion remains insufficient.Objectives: Exploring osteopaths’ opinions and experiences of the benefits and challenges of treating expectant mothers prior to labour. Whilst also obtaining their thoughts on treating this type of patient in collaboration with other healthcare professionals.Method: A qualitative interview study was conducted on a small purposeful sample of osteopaths who had been in practise for at least five years and had experience in treating expectant mothers. Interviews were transcribed verbatim and analysed using Thematic Framework Analysis, consistent with elements of Grounded Theory.Results: Five main themes were developed. The participants discussed their opinions on their roles in preparing expectant mothers for labour, treatment approaches utilised, benefits and challenges experienced when treating expectant mothers and multi-professional relationships.Conclusion: The results obtained from this study outline osteopaths’ opinions about the benefits and challenges of treating expectant mothers and preparing them for labour. This sample reported treating the musculoskeletal system in pregnant patients, but also providing information and support for expectant mothers.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Challinor.pdf

Title:A study to investigate injury in flat-water kayakingAuthor:Mark ChilderstoneBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Kayak Injury Sport Canoeing TreatmentType of Publication:DissertationLevel of academic award:MScResearch design:QuestionnairePublication Date:2015Language:EnglishAbstract:Objective: To investigate the most common sites of injury within the sport of flat-water kayaking, and to establish which means of treatment a paddler chooses when injured.Method: Self designed questionnaire modeled on the Nordic Musculoskeletal Questionnaire (Crawford, 2007), hand distributed to members of the Wey Kayak Club. Subjects: A total of 96 active members of the Wey Kayak Club. Outcome measure: Self designed questionnaire adapted from the Nordic Musculoskeletal Questionnaire (Crawford, 2007) .Results:Overall, 65% of participants reported at least one site of injury. Shoulder injury was the most commonly recorded, as 35 out of a total of 104 total injuries were to the shoulder. There was significant correlation between distance kayaked and the incidence of injury (p=0.009). A trend was found between distance kayaked and shoulder injury (p=0.051) but this was not significant. Self-treatment was the most common treatment. No significance was found between any area of injury and type of treatment chosen.Conclusion: The findings of this study suggest that the shoulder is the most common site of injury and that distance paddled directly correlates to injury. The study only involved 96 participants from one location (the Wey Kayak Club), and therefore further research needs to be undertaken, to confirm and extend these findings.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Childerstone.pdf

Title:Osteopathic treatment of the Sacroiliac Joint on dynamic balance performance in asymptomatic individuals: an experimental investigation with a student population.Author:Hugo Fernandez ChinchillaBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Postural stability, dynamic balance tests, sacroiliac joint manipulation, sacroiliac joint dysfunction, measurement.Type of Publication:DissertationLevel of academic award:MScResearch design:ExperimentPublication Date:2015Language:EnglishAbstract:Objective: To investigate the immediate and lasting effects of bilateral manipulation of the sacroiliac joints (SIJs) on dynamic balance performance in asymptomatic participants.Design: Randomised, controlled, double-blind pilot study.Background: Although manipulation of the SIJs has shown postural balance improvements, further investigation on dynamic balance was needed.Interventions: The experimental group underwent a bilateral high-velocity, low-amplitude manipulation in the SIJs. The control group underwent mobilisation of the hips without tension in the supine position.Methods and measures: The anterior, posterior-medial and posterior-lateral SEBT distances and limb lengths were measured bilaterally, pre-, post- and 5-min after intervention. After normalising for lower limb length, right-left distance differences were examined within and between the two groups. Normality of data was tested with the Saphiro Wilk Test, and significant was set at 0.05.Results: SEBT performance showed statistically significant differences in the three directions, standing on the right leg in the experimental group, after and 5-min after the intervention (p<0.05). In addition, the existence of cavitation corroborated greater and significant numerical SEBT differences in the posterior-medial and posterior-lateral directions 5-min after the intervention (p<0.05). SEBT score differences in the left leg showed equal significant improvement within the two groups in the posterior-medial and posterior-lateral direction, after and 5-min after intervention. However, inter-group differences were not statistically significant (p>0.05) in any direction, either after or 5-min after the intervention.Conclusion: Sacroiliac joint manipulation applied bilaterally in asymptomatic individuals resulted in immediate and lasting dynamic balance score changes during SEBT. Study limitations and suggestions for future studies are discussed.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Chinchilla.pdf

Title:Osteopath’s views on effective concordance with GPs within a general clinic: A qualitative studyAuthor:Yvan Cormier-ScottBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:“National Health Service”, “integrative medicine”, “Complementary and Alternative Medicine”, “inter-practitioner communication/collaboration”, “manual therapy”.Type of Publication:DissertationLevel of academic award:MScResearch design:QualitativePublication Date:2015Language:EnglishAbstract:Background: There increased patient demand for osteopathy and other CAM therapies availability on the NHS. Some studies have shown benefits to integration however there remains limited integration.Objectives: This study aimed to investigate osteopath's views on integration with GPs in the NHS in order to find out ways to improve provision of osteopathy on the NHS.Method: Semi-structured interviews were conducted with 5 osteopaths working in London NHS practices. Two of the osteopaths were hiring rooms in NHS. Transcripts were coded and analysed using thematic analysis and OSOP (one-sheet-of-paper) technique.Results: There were many benefits to having osteopathy on the NHS such as improved patient care, inter-practitioner collaboration on patient management, GP understanding of osteopathy, faster referral times and sharing of patient notes. Barriers considered to having osteopathy provision on the NHS and effective inter-practitioner collaboration included lack of GP understanding of osteopathy and what it can treat, lack of funding, overly busy NHS workers, and competition with physiotherapy.Conclusions: There are many benefits to osteopaths working with the NHS, and in order to increase it's provision on it there needs to be increased education to the public and GPs about osteopathy, increased funding, updated referral guidelines and more time for inter-practitioner collaboration.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Cormier.pdf

Title:A qualitative study of osteopaths’ opinions about the use of neurophysiological education in practise.Author:Mandy Cuttica.British School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Neurophysiological Education, Neurophysiological, Neuroscience, Chronic Pain, Osteopaths.Type of Publication:DissertationLevel of academic award:MScResearch design:QualitativePublication Date:2015Language:EnglishAbstract:Background: The use of neuroscience education (NE) as part of a treatment plan by manual therapists for chronic pain patients has increased. Unlike traditional education, NE focuses on the neurophysiology and neurobiology of pain in the hope that it will reconceptualise the patients’ understanding of their pain and the role that central sensitisation plays in it. It is aimed at increasing patient knowledge and understanding of their pain, thus reducing the fear associated with musculoskeletal injury.The implementation of NE as part of a treatment plan has shown some potential for improving the prognosis for chronic pain patients. With 31 million lost working days attributed to musculoskeletal pain in 2013 and, according to the General Osteopathic Council, osteopaths already regularly treating this demographic, an evaluation of current practise in this field is important.Objectives: The objective of this research project was to explore the use of neurophysiological education (NE) in osteopathic practice.Methods: Semi-structured interviews were conducted with a purposive sample of eight BSO tutors who were also practising osteopaths. These were transcribed and analysed using Thematic Analysis and elements of Grounded Theory.Results:Although promising, the results highlighted two important frustrations; the first was an inconsistency of NE knowledge and use throughout the medical profession, which left patients confused, and the second was that effective delivery of NE was instrumental to its’ success.Conclusions: The sample of osteopaths in this study reported that the use of NE as part of osteopathic treatment was beneficial with chronic pain patients as it helped to reconceptualise their understanding of pain and reduce the fear associated with it. However it also highlighted some important frustrations. Further investigations in a wider context are recommended.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Cuttica.pdf

Title:Osteopathy Use Among Women with Breast Cancer: Prevalence, Patterns, Motives and Patient Perceived BenefitsAuthor:Christoph DatlerBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:breast cancer management, osteopathy, disclosure rates, lymphedema, iatrogenic effects of cancerType of Publication:DissertationLevel of academic award:MScResearch design:QuestionnairePublication Date:2015Language:EnglishAbstract:OBJECTIVES: Complementary and alternative medicine is used as an adjunct to conventional medical treatment by cancer patients to alleviate cancer related or iatrogenic symptoms. This survey study explores the prevalence, determinants of use patterns, motives, patient perceived benefits/side effects and disclosure rates of osteopathy use in the UK female breast cancer population.METHODS: Online questionnaires were distributed to breast cancer patients affiliated with cancer support networks and responses analysed quantitatively and qualitatively.RESULTS: Prevalence of osteopathy use decreased significantly post breast cancer diagnosis with 15% accessing osteopathic care post compared to 22% pre diagnosis. Determinants of use were previous use, previous surgical interventions and lower concurrent medical treatment intensity. Taking up osteopathy post diagnosis correlated with high past medical treatment intensity, especially surgery and chemotherapy. Dropping osteopathic care correlated with high concurrent and low past medical treatment intensity. Inversely, consistent use correlated with low concurrent and high past medical treatment intensity, in particular surgery. The majority of osteopath consultations were cancer related, significantly more so in patients undergoing medical intervention(s). The most prevalent reasons for seeking osteopathic care included general musculoskeletal wellbeing, trunk/shoulder mobility impairments post surgery and pain relief. Motives for use significantly changed with concurrent medical treatment. Patient perceived efficacy was 95% and users experienced benefits in significantly and consistently more categories than reported as “primary” reasons for seeing an osteopath. Contrarily, only a minority of users (3%) reported adverse effects of osteopathic care which were mild and short-lived. Less than half of the users disclosed use to the treating medical team; this increased significantly with concurrent medical treatment or when complaints were cancer related. After not knowing osteopathy, the most prevalent reasons for non-use were safety concerns, financial restraints and the lack of anticipated benefits. Safety concerns as well as financial correlated with concurrent medical treatment.CONCLUSION: Osteopathy plays a substantial role in the management of deleterious cancer related, iatrogenic as well as non-cancer related symptoms in the female breast cancer population in the UK. The

patient perceived efficacy and risk/benefit ratio is extremely favourable. The lack of expert guidance on safety and efficacy of osteopathy in the cancer setting alienates patients and osteopathic practitioners, and needs to be urgently addressed to establish a safe integrative medical approach for cancer survivors.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Datler.pdf

Title:A comparative study of the effects of different protocols of Muscle Energy Technique directed at the hip flexors.Author:Maxime DescacqBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Muscle energy technique, Hip extension, Illiopsoas muscle, Modified Thomas Test, Isometric Contraction.Type of Publication:DissertationLevel of academic award:MScResearch design:ComparativePublication Date:2015Language:EnglishAbstract:Objective: The purpose of this study was to compare the effects of isometric contraction durations and isometric contraction repetitions on the efficacy of muscle energy technique directed at the hip flexors.Design: This study was a randomised, controlled, pre-post experiment intervention with 2 independent variables, contraction duration and contraction repetitions. The dependent variable was the increase in degrees of hip extension.Methods: 45 asymptomatic participants, aged between 18 and 60, recruited on a voluntary basis from the British School of Osteopathy, were randomly assigned to 9 different groups all receiving the muscle energy technique, varying in contraction durations (3s, 6s or 9 seconds) and contraction repetitions (2, 4 or 6 times). Measurements of passive hip extension were taken pre and post intervention in a Modified Thomas Test. Means was compared using SPSS.Results: There was a significant change when testing Repetition, F(2,36) = 8.4, p = 0.001, partial _2 = 0.32. There was slight change when testing Duration but this was not shown to be statistically significant, F(2,36) = 1.3, p = 0.273, partial _2 = 0.07. There was a trend towards an interaction of Duration and Repetition, F(4,36) = 2.5, p = 0.063 , partial _2 = 0.21, which is apparent in the plot of the marginal means (Figure X). A plot of the standardised residual and predicted values presented, appeared to show no association.Conclusion: Results demonstrate the immediate success of muscle energy technique in increasing hip extension when directed at the hip flexors. Significant changes was shown between each repetitions groups suggesting that greater number of isometric contraction lead to greater change in flexibility. This study however failed to show any correlation between efficacy of MET and isometric contraction duration. There were no benefits in holding the isometric contraction for more than 3 seconds.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Descacq.pdf

Title:The most frequently used diagnostic criteria of Cervicogenic headaches and the justification for its use- A critical narrative review.Author:Joe DowlingBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:cervicogenic headache; diagnostic criteria; cervical spine; neck pain; headache.Type of Publication:DissertationLevel of academic award:MScResearch design:critical narrative reviewPublication Date:2015Language:EnglishAbstract:Background: Cervicogenic headache (CEH) is a type of secondary headache caused by primary cervical spine dysfunction. Diagnostic criteria for CEH are disputed by various research organisations.Objective: The primary objective of this critical narrative literature review is to systematically identify and appraise literature on the derivation of the most frequently used diagnostic criteria for CEH. Furthermore, this study aims to identify trends in the justification for the use of such criteria and its implications on clinicians.Methods: A computerised literature search was conducted between November 2014 and January 2015 to gather published research concerning CEH and the justification for the use of particular diagnostic criteria. Databases used included PubMed, Trip database, Plos one database and the Cochrane Library. Relevant literature was selected and outlined using an adapted PRISMA flow diagram (2009). Selected literature was ordered according to the hierarchy of evidence (NICE, n.d.), grouped by study design and critically appraised using relevant appraisal criteria by the critical appraisal skills program (CASP) and Greenhalgh (2014).Results: A total of 13 items of relevant literature was found containing a justification for the use of particular diagnostic criteria for CEH. 13 items of literature were found appropriate for use in this review with regards to the hierarchy of evidence.Conclusion: Further objective studies on the symptoms of CEH and refinement of the existing diagnostic criteria are required in order for the development of a greater understanding of CEH and its origins.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Dowling.pdf

Title:Development and Trial of a Protocol for the Diagnosis of Early Presentation Rheumatoid Arthritis in Osteopathic PracticeAuthor:Samantha DoxfordBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Rheumatoid Arthritis, Early presentation, Diagnosis, Protocol, Referral.Type of Publication:DissertationLevel of academic award:MScResearch design:ProtocolPublication Date:2015Language:EnglishAbstract:Background: Current diagnostic criteria for early Rheumatoid Arthritis (RA) tend to focus on blood tests and x-ray results making them clinically time consuming and inconvenient. Developing a protocol with the inclusion of clinical signs and symptoms could shorten the referral times to GP’s and specialists, minimising the lag time for treatment.Objective: The aim of this study is to develop and trial a protocol to enhance osteopathic students’ ability to recognise a patient with early onset RA and perform appropriate referral action.Methods: A two stage questionnaire was developed and piloted, it consisted of two nearly identical questionnaires to be completed pre and post reading the protocol. It was electronically sent to all SPYr3/4 and MMYr4/5 students at the British School of Osteopathy. Results: 99 questionnaires were started and 72 were fully completed. Significant improvements were found in the sign/symptom selection post questionnaire, and additionally in the selection of the appropriate referral action. Participants indicated increased awareness of the benefits of early diagnosis and treatment in relation to disease progression, and felt more confident identifying suspect patients post questionnaire. The majority of students found the protocol easy to use and would find it useful to have in clinic. Conclusion: Further research is needed to determine whether the improvement in diagnostic capability from using the protocol is temporary and if, explore ways to amplify such advances in knowledge.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Doxford.pdf

Title:Patient perceptions of the relevance of Osteopathic treatment in the management of lipodystrophic body changes associated with Highly Active Antiretroviral Therapy.Author:Joseph DuffBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:AIDS/HIV, Biopsychosocial, HAART, Lipodystrophy, Osteopathy.Type of Publication:DissertationLevel of academic award:MScResearch design:InterviewPublication Date:2015Language:EnglishAbstract:Objectives: This paper aims to gain an insight into BSO Chapman Clinic patients’ perceptions and experiences of lipodystrophy syndrome (LS), in order to:Explore the effect of LS on their wellbeing and identify their resulting needsHighlight the effectiveness of Osteopathic treatment in addressing their needsHighlight any potential aspects of the clinic and student education that may benefit from further development, in order to better address their needsMethods: Interviews were conducted with BSO Chapman clinic patients who had experience of LS. Interviews were analysed using elements of Grounded Theory. Inter-rater reliability analysis was conducted, with 90% agreement after discussion.Results: Participants were seen to have extensive experience of trauma, associated with LS, affecting their physical, psychological and social wellbeing. Participants dealt with this trauma through self-care strategies, involving: avoidance, pro-active personal healthcare and acceptance. Care from external entities (including Osteopaths) was seen to be relevant and valued although somewhat inadequate. Improvements to Osteopathic care were suggested.Conclusion: Participants experiences and perceptions highlighted the unique needs of people living with LS. Osteopathic care is highly relevant and beneficial in addressing these needs. However, further student education and resource provision is necessary to more thoroughly meet patient needs. Further research is necessary in order to elucidate the needs of other sub-groups within the HIV positive population.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Duff.pdf

Title:The relationship between chronic musculoskeletal pain and alcohol consumption: a critical literature review.Author:Gregory DurandBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Manual therapy, alcoholic neuropathy, alcoholic myopathy, alcohol withdrawal syndrome, musculoskeletal manipulation.Type of Publication:DissertationLevel of academic award:MScResearch design:critical literature reviewPublication Date:2015Language:EnglishAbstract:Background: Understanding a patient, as a whole is the keystone of an osteopathic treatment. Alcohol dependency affects behaviours, mental health, environment and relatives, but also many physiological aspects. It is important that manual therapists integrate these factors, to be able to deal with each patient as an individual.Objective: Understanding the physiological mechanisms that occur in the body when alcohol is consumed on short-term and long –term periodsMethod: A literature search was performed using a variety of computer-based databases as well as manual searches for relevant articles fulfilling the inclusion criteria, which were sorted by study designs, ranked according to the hierarchy of evidence and appraised with criteria appropriate to each study.Results: 13 research papers were identified as having high methodological quality and low risk of bias. The studies meeting our inclusion criteria encompassed a variety of manual therapy interventions and an even more diverse group of subjects. The studies reviewed revealed a variety of methodological shortcomings.Conclusion: Future research efforts to examine the effectiveness of manual therapy in easing physiological symptoms of excessive alcohol consumption should employ methodological rigour and integrity so as to increase public and scientific confidence in the published results.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Durand.pdf

Title:The Challenges Osteopaths Face In Treating Patients with Medically Unexplained Symptoms (MUS)Author:Danielle DwyerBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:MUS (Medically Unexplained Symptoms), Functional Syndromes, biopsychosocial, therapeutic relationship, self-management.Type of Publication:DissertationLevel of academic award:MScResearch design:InterviewPublication Date:2015Language:EnglishAbstract:Background: Medically Unexplained Symptoms (MUS) is a blanket term used to describe a large group of functional somatic syndromes, which have persistent somatic symptoms predominantly based around a system but are often multi-systemic in nature. Lack of tissue pathology and biological evidence means that these conditions are poorly understood and treatment is often ineffective. Patients often become dissatisfied with conventional medicine and seek complementary and alternative therapy; however, the role of osteopathy in the care of these patients is largely under-researched.Objectives: To explore the challenges faced by osteopaths in diagnosing, treating and managing patients with MUS, including the techniques and management strategies they employ to meet these challenges. Method: Six semi-structured interviews were carried out on a purposeful sample of osteopaths with expertise in treating patients with MUS / functional syndromes. Data was transcribed verbatim and thematic analysis was used as a framework.Findings: Three main themes emerged: (1) challenges osteopaths’ face when dealing with patients with medically unexplained symptoms (MUS) i.e., diagnosis, the application of labels and patient management; (2) approaches to treatment and management ie., individualised treatment plans, manual treatment, communication and self-management; (3) a barrier to treatment was patient passivity.Conclusions: Participants use a biopsychosocial approach to assess patients with MUS, placing great emphasis on the therapeutic relationship to provide a supportive role that encourages patients to address psychosocial issues. Moreover, treatment is aimed at enabling patients to develop appropriate coping strategies and to regain their sense of agency in spite of ongoing pain. However, lack of patient engagement can negatively affect outcomes.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Dwyer.pdf

Title:An investigation into the conservative treatment for Adolescent Idiopathic Scoliosis (AIS) : critical review of the current literature.Author:Audrey EngleBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Adolescent idiopathic scoliosis, manual therapy, conservative therapy, osteopathy. Type of Publication:DissertationLevel of academic award:MScResearch design:critical reviewPublication Date:2015Language:EnglishAbstract:Background: Adolescent Idiopathic Scoliosis (AIS) is a three dimensional (3D) deformity of a growing spine with uncertainty surrounding its conservative treatments.Objective: The aim of this study is initially to provide a comprehensive analysis of the available literature on non-surgical treatment for AIS, excluding brace management. It will also underline pre-existing weak areas in previous papers that are limiting the quality and restricting the progress in the field of conservative treatment of AIS.Design: Literature reviewMethods: A computerised literature research has been done among different databases including papers from the past 14 years.Results: 12 papers were saved and included in the discussion. Scientific exercises approach to scoliosis (SEAS), side-shift, Schorth 3D and manual therapy are the therapies that have been saved and discussed.Discussion / Conclusion: The demand of conservative treatments for AIS is on the rise, unfortunately, the quality of the studies, up to date, is poor and progress need to be done within the methods of assessment and other areas.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Engel.pdf

Title:Short-term effects of an osteopathic intervention on respiratory function and quality of life of patients with chronic obstructive pulmonary disease-a randomized clinical trial.Author:Karim Taha Arabi GadElRabBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:COPD, manual therapy, Quality of Life, anxiety, chronic conditions.Type of Publication:DissertationLevel of academic award:MScResearch design:randomised clinical trialPublication Date:2015Language:EnglishAbstract:Background: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease estimated to become the third most common cause of death and fifth cause of disability by 2020.Objectives: The aims of this study were firstly to investigate, via a Randomized Controlled Trial (RCT), the short-term effects of OMT and massage as an adjunctive therapy on respiratory function and quality of life (QoL) of patients diagnosed with COPD. It also, examined whether OMT presented any adverse effects to the patients suffering from COPD.Method: 30 patients diagnosed with COPD for more than one year were selected by the chief Respiratory consultant of Egyptair in Cairo, Egypt. Pulmonary function was assessed via a 6 minute-walk test, spirometry and blood gases whilst QoL was assessed via a validated questionnaire (SF-36 short form). Participants received two sessions of either osteopathic treatment (OMT) or massage within a four- day interval.Results: Other than two elements of the QoL questionnaire none of the other variables tested displayed a p value ≤0.05. Therefore, neither OMT nor massage had a significant effect on pulmonary function or QoL.Conclusion: Although the results of this study did not appear to be statistically significant, the treatment might still have had a positive impact on the patients’ condition. Attention should be given to understanding the patients’ experience of the condition and further research is needed to offer an effective multidisciplinary treatment protocol.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/GadElRab.pdf

Title:The Effect of a Single Session of Osteopathic Treatment on Patients with Low Back Pain on Anxiety, Features of Body Awareness, Pain Intensity and Pain Self-Efficacy: An Observational Study.Author:Emily GalloneBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Low Back Pain, Anxiety, Body Awareness, Pain Self Efficacy, Osteopathy Type of Publication:DissertationLevel of academic award:MScResearch design:ObservationalPublication Date:2015Language:EnglishAbstract:Objective: The objectives of this study are two-fold. Firstly, it investigated the effects of a single session of osteopathic treatment on patients with low back pain (LBP) on anxiety, Features of Body Awareness (FBA), pain intensity and Pain Self-Efficacy (PSE); and explored whether differences between Acute LBP (ALBP) and Chronic LBP (CLBP) existed. Secondly, it investigated differences and associations between CLBP and ALBP patients in four baseline measurements: anxiety, FBA, pain intensity and PSE.Design: The study used a pre- and post- observational design. Dependent Variables (DV) were: anxiety, FBA, pain intensity and PSE. The Independent Variable (IV) was time: pre- and post- intervention.Participants: 30 new patients with LBP presenting at The British School of Osteopathy’s (BSO) outpatient clinic for treatment took part in this study.Results: The study found that osteopathic treatment reduced: pain intensity in LBP patients; PSE in ALBP patients and pain intensity in CLBP patients. A negative correlation between anxiety and ‘self-regulation’ (FBA) in all LBP and CLBP patients was found. In ALBP patients, a negative correlation was found between pain with ‘noticing’ (FBA) and ‘not worrying’ (FBA).Conclusion: This study was limited by a small sample but provided evidence to suggest that a single osteopathic consultation of a patient presenting with LBP has immediate modulatory effects on pain perception, i.e., can reduce its intensity; it also modulates PSE in those presenting with ALBP. Further research using a prospective cohort study into the effects of osteopathic treatment on ALBP and CLBP patients using psychological parameters such as pain, PSE, FBA and anxiety is suggested.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Gallone.pdf

Title:The prevalence of signs and symptoms of myogenous temporomandibular disorders in patients with chronic non- specific neck pain: A cross-sectional study.Author:Javier GascónBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Temporomandibular Joint Disorders; Neck Pain; Masticatory Muscles; Myalgia; Myofascial Pain Syndrome.Type of Publication:DissertationLevel of academic award:MScResearch design:cross-sectionalPublication Date:2015Language:EnglishAbstract:Objectives: This study was performed to assess the relationship between neck disability and the prevalence of signs and symptoms of myogenous temporomandibular disorders (TMD) in patients with chronic non-specific neck pain.Method: A group of 15 patients with chronic neck pain and a group of 15 matched asymptomatic controls (aged 21-50 years) were recruited. Subjects in the symptomatic group completed a Neck Disability Index (NDI) questionnaire while participants in both groups were examined by measuring active maximal mouth opening (MMO) and the presence of myofascial tender points in the masticatory system.Results: The results showed that symptomatic patients reported pain on palpation more often than those in the control group (p= 0.02). No differences were found on MMO when comparing both groups. Within group analysis showed no significant correlation between NDI and MMO or the presence of myofascial pain.Conclusions: It was concluded that although the causality of cervical pain remains unclear, the masticatory system should be evaluated in patients with chronic non-specific neck pain.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Gascon.pdf

Title:Interoceptive awareness, pain awareness and vigilance to pain in chronic low back pain. A case-control survey study.Author:Anji GopalBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Chronic Pain, Interoception, Low Back Pain, Manual Therapy, Meditation.Type of Publication:DissertationLevel of academic award:MScResearch design:Case-control surveyPublication Date:2015Language:EnglishAbstract:Objectives: Chronic low back pain (CLBP) is a common and costly condition which defies treatment approaches despite considerable research. Alterations in interoceptive awareness (IA) may be one of several factors involved in the creation and longevity of chronic pain (CP) as the sense of interoception shares neural correlates and may also drive attentional behaviour. This study examines self-reported IA in a CLBP population compared to those with no pain; as well as relationships between pain and attentional behaviour.Methods: A case-control study, employing validated questionnaires, was used to measure IA and attentional pain behaviour in a sample of 74 adults, divided into CLBP and Control groups.Results: The findings did not reveal a significant relationship in IA between groups, nor an association between IA and attention to pain, however CLBP patients trust their bodies less. A significant link between levels of vigilance to pain changes and worrying was also found. A meditative practice was found to have a positive effect on attentional behaviours to pain.Conclusions: Several limitations of the study suggest scope for further research investigating changes in IA and associated attentional behaviours. Applying the skills gained in meditative practice, such as using IA as a training tool by focusing on breathing cues, may offer scope to alter attention to and focus on pain and somatic signals. The combination of interoceptive skills, attitudinal changes and manual therapy, may provide new opportunities to treat CLBP patients in clinical settings. Further research in these areas is warranted. Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Gopal.pdf

Title:A qualitative exploration into osteopaths’ perceptions of their patients’ transition from acute to chronic painAuthor:Hannah GordonBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:“chronic”, “pain”, “biopsychosocial”, “transition”, “acute”Type of Publication:DissertationLevel of academic award:MScResearch design:qualitativePublication Date:2015Language:EnglishAbstract:Background: Once established, chronic pain is challenging and costly to treat. Patients with musculoskeletal pain will often present to osteopaths independently from the National Health Service (NHS), putting responsibility on osteopaths to manage acute patients effectively to prevent their transition to chronic pain (chronification).Objectives: To explore general practice osteopaths’ perceptions of patients’ transition from acute to chronic pain (CP) and whether these perceptions inform their patient management plan in terms of predicting and preventing chronicity.Methods: Semi-structured interviews explored seven London osteopaths’ perceptions of the transition from acute to CP. Interviews were audio recorded, transcribed verbatim, member validated and then analysed using thematic analysis with elements of grounded theory.Results: Participants found the multifactorial nature of CP made these patients challenging to manage. Biopsychosocial risk factors of chronicity were identified and at times addressed but participants were not systematically triaging patients to predict and prevent chronification. Conclusions: Patient management should focus on attempting to prevent chronification with use of prognostic tools, prompt analgesia advice plus measured communication and management. Further research on osteopathic usage, experiences and potential for a prognostic approach is recommended alongside exploring osteopaths’ experiences of NHS referrals. Widespread pain Continued Professional Development (CPD) is recommended within the osteopathic community to aid effective patient management.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Gordon.pdf

Title:The Effect of High-Heeled Shoe Wearing on Breathing Mechanics: an Experimental Investigation with a Healthy Student Population.Author:Colette GoveiaBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Breathing, High-Heels, Shoes, FVC, FEV1. Type of Publication:DissertationLevel of academic award:MScResearch design:randomised cross-overPublication Date:2015Language:EnglishAbstract:Objective: To investigate whether wearing high-heeled shoes has an effect on breathing mechanics in healthy subjects. Methods: A randomised cross-over study was conducted on 56 healthy students. Participants were randomised into two groups with both groups providing spirometer readings whilst wearing high-heeled shoes (the intervention) and also whilst wearing no footwear (control). The random allocation determined the order in which participants would receive intervention or control. Forced Vital Capacity (FVC) and the forced expiratory volume in one second (FEV1) readings were measured by the spirometer, as indicators of overall respiratory function (Barrett et al., 2009, pp.593), to determine efficiency of breathing mechanics.Results: Data from 56 subjects were analysed. Spirometer measurements of FVC and FEV1 pre and post-intervention showed no significant differences (p>0.05) within the groups when compared with the control measurement.Conclusion: From this study (n=56), there is no evidence to suggest the use of high-heeled shoes has an immediate effect on breathing mechanics, as measured by FVC and FEV1 in healthy students. Further research is recommended to address limitations of the study.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Goveia.pdf

Title:Support for new osteopathic graduates and the potential role for mentorship.Author:Olwen Grindley.British School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:support, new graduates, osteopathy, mentorship Type of Publication:DissertationLevel of academic award:MScResearch design:InterviewPublication Date:2015Language:EnglishAbstract:Background: This qualitative research explores new osteopathic graduates’ views on the support needed in the initial years after graduation as well as their views on mentorship as a potential mechanism for providing that support.Objectives: This study aimed to identify the challenges faced by new osteopathic graduates, the support recent graduates feel is necessary to deal with these challenges and where this support was found. It also researched attitudes towards mentorship amongst this group.Methods: Five semi-structured interviews were carried out with osteopaths who had registered with the General Osteopathic Council between 2011 and 2013. The interviews were analysed with elements of Grounded Theory.Results: The findings of this small-scale study correspond strongly with the findings of the much larger-scale report compiled on new graduates’ preparedness to practice by Freeth et al in 2012. The main difference was the reported lack of business and marketing skills on graduation.Conclusions: Informal support exists within osteopathy, however new graduates feel strongly that this should be formalised. All participants were very willing to contribute to supporting those entering the profession after them and this enthusiasm and sense of duty needs to be harnessed. Support needs to be an integral part of osteopathy, thus enhancing the profession by giving it more unity within its inherent diversity. A mentorship programme is already being piloted by the Osteopathic Development Group and it will be interesting to observe how this will operate. Monitoring the progress of this programme and reporting on its effectiveness could also be valuable in order to inform further development in the future.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Grindley.pdf

Title:The clinical reasoning of osteopaths in the assessment of femoroacetabular impingement: A qualitative study.Author:Dale HardimanBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:FEMOROACETABULAR IMPINGEMENT OSTEOPATHS Type of Publication:DissertationLevel of academic award:MScResearch design:qualitativePublication Date:2015Language:EnglishAbstract:Background: Femoroacetabular Impingement (FAI) is a common but poorly managed clinical condition which osteopaths may experience in practice. Previously no research has been carried out identifying the clinical reasoning processes of osteopaths in relation to FAI.Objectives: This study explores the clinical reasoning of osteopaths in relation to the assessment of patients with Femoroacetabular Impingement describing the osteopaths’ social and cognitive processes and describing how osteopaths make decision in practice regarding patients presenting with FAI.Method: Six qualitative semi structured interviews were conducted with osteopaths of various experience levels using a vignette to guide the interview. Elements of grounded theory were used to analyse data and construct themes.Results: Five common themes emerged from data analysis; precautionary screening, hypothesis generation, clinical assessment, limitations of practice, treatment and management.Conclusions: Despite absence of FAI education at OEI, osteopaths were able to recognise signs and symptoms related to hip joint pathology and refer patients for necessary investigations. Clinical reasoning of osteopaths in relation to FAI varied dependant on experience levels encompassing hypothetico-deductive and pattern recognition reasoning strategies. Further research using focus groups or qualitative questionnaires is required to explore findings. Guidelines for diagnosis, treatment and rehabilitation for FAI need to be established.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Hardiman.pdf

Title:An observational study into osteopathy: Communication and the exchange of information during the process of obtaining consent in first consultations. Author:Laura HazellBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Consent, understanding, permission, risks, benefitsType of Publication:DissertationLevel of academic award:MScResearch design:ObservationalPublication Date:2015Language:EnglishAbstract:Background: Various studies have looked into consent within primary health care but little has been done specifically focusing on the profession of osteopathy. Existing results show a discrepancy between what practitioners and patients are reporting.Objective: This study aimed to explore and describe communication related to receiving consent in osteopathic consultations.Design: This qualitative observational study used transcriptions of initial consultations for a newly presented problem.Method: One osteopathic practice was recruited using purposeful sampling, data was collected by audio recording consultations, these recordings were transcribed and then analysed using aspects of thematic and content analysis.Findings: Eight practitioners were involved in the study and twenty consultations were recorded. Data analysis revealed six major themes that fed into the concept of informed consent; permission to act, running commentary, outcomes, alternatives, patient comprehension and presumed knowledge.Conclusion: Findings show that osteopaths are gaining permission for examination and treatment but elements of the process as by the Standards of Practice (General Osteopathic Council 2012) are being omitted. The method by which they obtain permission has shown to be complex and involves a variety of methods throughout the whole consultation.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Hazell.pdf

Title:Clinical Considerations and Challenges Treating Dyslexic/Dyspraxic Children: A Qualitative Study with Paediatric OsteopathsAuthor:Gillian HindBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Children and Osteopathy, Dyslexia, Dyspraxia.Type of Publication:DissertationLevel of academic award:MScResearch design:QualitativePublication Date:2015Language:EnglishAbstract:Background: In the UK dyslexia affects up to 10% of school aged children (Stein, 2001; Bull, 2009; BDA, 2015) and dyspraxia between 5 and 19% (Martin et al, 2010; Dyspraxia Foundation, 2014). The aetiology is multifactorial and being a spectrum disorder the boundaries of symptoms are not clearly defined or understood (Handler and Fierson et al, 2011). The mainstream approach has focussed on phonological interventions but up to 25% of children do not respond to these special education measures (Reynolds, Nicolson and Hamby, 2003; Bull, 2007).Limited non-conclusive research (Bull, 2007) have utilised aspects of manual therapy but the outcome measures have been more strongly aligned to phonological progress. Objectives: The objective of this study was to explore with paediatric osteopaths the aims of treatment, the clinical considerations and the challenges that these conditions presented.Methods: The study adopted a qualitative research framework using semi-structured interviews with eleven paediatric osteopaths. Analysis was conducted using Thematic Analysis with elements of Grounded Theory.Results: Two themes were constructed from the data: understanding the patient and the challenges that these conditions presented to osteopaths. Within these main themes there were 6 inter-related subcategories.Conclusions: This study provided insight into how paediatric osteopaths used a patient centred approach to address some of the complexities of treating children with dyslexia and dyspraxia and the challenges these conditions presented. These findings may explain why measuring outcomes in phonological terms do not capture the depth and breadth of influencing factors on these conditions.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Hind.pdf

Title:Exploring the informed consent process in new patient consultations with UK osteopaths: A cross-sectional observational study.Author:Alexander HooperBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Informed Consent, Osteopathy, Examination, Diagnosis, Treatment.Type of Publication:DissertationLevel of academic award:MScResearch design:Qualitative cross-sectionalPublication Date:2015Language:EnglishAbstract:Background: Much has been written about the need to obtain informed consent because it has been shown that poor communication is at the root of most complaints made by patients against osteopaths. However there are limited studies that describe how clinicians gained it in practice. To date there is no literature that has explicitly seeks to explore how informed consent is obtained within osteopathy by observing new patient consultations.Objective: To observe how UK osteopaths navigate the informed consent process within new patient consultations.Method: A qualitative cross-sectional study observing 20 new patient consultations at one private osteopathic practice. Data was analysed using thematic analysis with combined inductive and deductive approaches.Findings: The themes that were deciphered by the researcher were: Directing, explaining and educating.Conclusion: The act of obtaining consent is largely a dynamic, continuous process interwoven throughout the consultation. Three distinct methodological behaviours were identified. These methodologies could not be distinctly attributed to a particular practitioner; rather they were better reflected on a spectrum of behaviour ranging from low to high competency. The behavioural themes identified in this study closely resemble the findings of other recently published literature.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Hooper.pdf

Title:Rheumatoid arthritis: A systematic review of the effects of physical exercise on the cardiorespiratory systems of adult patients diagnosed with Rheumatoid ArthritisAuthor:Aleksandra IvanovaBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Rheumatoid arthritis; strength and endurance training; exercise; aerobic capacity; muscle strength.Type of Publication:DissertationLevel of academic award:MScResearch design:Systematic ReviewPublication Date:2015Language:EnglishAbstract:Background: Rheumatoid Arthritis (RA) is a chronic disorder characterized by systemic inflammation leading to numerous respiratory and cardiovascular complications. The reduced cardiorespiratory capacity may be further affected by the decreased muscle mass and increased adipose activity characteristic for RA patients. The positive effects of exercise on healthy adults is widely accepted however, its effects on the cardiorespiratory systems of RA patients still remains unclear.Objective: The main objective of this review is to investigate the impact of physical exercise on the cardiorespiratory systems of adults diagnosed with RA. Methods: A literature search of a number of databases was conducted. The search was limited to randomized controlled trials (RCTs) published after 1999. The methodological quality of the studies was assessed by Jadad and Furland checklists.Results: Eight RCTs which conducted strength and endurance training were selected. They recruited 898 adults with mean age 53.88 years who were diagnosed with RA. The intervention groups from all the studies were supervised during training and the outcome assessors were blinded. The RCTs reported statistically significant improvement of patients’ aerobic capacity and muscle strength. The values of health assessment questionnaire (HAQ), diseases activity score (DAS) and levels of pain perception (VAS) were statistically insignificant.Conclusions: The findings indicate positive impact of strength and endurance training on the aerobic capacity and muscle strength. The HAQ, DAS, VAS reached statistically insignificant values.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Ivanova.pdf

Title:The epidemiology of squash injuries, and awareness/attitudes amongst squash players of osteopathy as a model of health care.Author:Paddy Joyce.British School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:INJURIES OSTEOPATHY SPORT SPORTS INJURIES SQUASH Type of Publication:DissertationLevel of academic award:MScResearch design:QuestionnairePublication Date:2015Language:EnglishAbstract:Aims: The main aim of this quantitative survey of squash players was to investigate the epidemiology of squash injuries. We also aimed to explore the current awareness of osteopathy among squash players.Methods: 152 questionnaires were completed via an online squash forum, and members of a local squash club. Different definitions of injury were reported to provide more reliable data regarding injury incidence. We predominantly report substantive injuries, those defined as an injury that prevented squash participation for longer than 6 days.Results: Substantive injury incidence rate in squash was 5.0 injuries/1000 times of play. Lower extremity injuries accounted for at least 47% of all squash injuries. Injury duration was generally short with 63% of injuries lasting less than a month. 64% of those injured sought medical attention, with 58% opting for physiotherapy. Osteopathy was generally well thought of from those who had previously sought treatment, however only 46% of squash players were aware of osteopathy as a mode of healthcare. 87% of squash players were aware of physiotherapists treating sports injuries compared to just 45% aware of osteopaths doing so.Conclusions: The major findings of this survey were that squash is a relatively safe sport for people of different age, gender and ability, with substantive injuries occurring infrequently, and lasting a short duration. Physiotherapists were the main medical practitioners sought for squash injuries. The majority of squash players were unaware of osteopathy, however those squash players who had previously sought osteopathic treatment, were by in large satisfied with there treatment.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Joyce.pdf

Title:An experiment investigating the accuracy of palpation by osteopathy students at different stages of their pre-registration education at the British School of Osteopathy.Author:Jonathan JuvilerBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Palpation, accuracy, haptic development, experiment.Type of Publication:DissertationLevel of academic award:MScResearch design:experimentPublication Date:2015Language:EnglishAbstract:Objectives: To investigate the accuracy of palpation in Osteopathy students at The British School of Osteopathy (BSO) on the full time M.Ost degree course. A comparison was made between 1st year and 4th year students to test their abilities to differentiate between different Braille letters. The students fine touch skills were being assessed. Change between the 2 groups was inferred only.Participants: The pilot study recruited three participants, two 4th year students and one 1st year student form the BSO in order to test the proposed methods. The main study used ten 1st year and ten 4th year full time students on the M.Ost degree course at the BSO.Methods: An experimental study was carried out to compare the accuracy of palpation between 1st year and 4th year M.ost degree course students at the BSO. Each participant was asked to haptically explore a series of 20 plastic Braille imprinted tiles through a curtain. After each tile was explored manually using touch the participants were requested to respond as to whether it was “the same” or “different” to the previously explored tile. This method is a one back design. The proposed measurement outcome is Palpatory accuracy.Results: The study found no significant difference in palpatory accuracy between the 1st year (n=10) and 4th year (n=10) degree level students that took part. (p = .377)Conclusion: This study found that the accuracy of palpation in regards to fine touch between 1st and 4th year osteopathic students studying on an M.Ost course at the BSO was not significantly different. This study is purely suggestive and further research into the development of accuracy of palpation is recommended. Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Juviler.pdf

Title:Rheumatoid arthritis and gluten sensitivity: a critical narrative review.Author:Milosz Kalotka.British School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:systematic review, rheumatoid arthritis, gluten sensitivity and vegan gluten free diet.Type of Publication:DissertationLevel of academic award:MScResearch design:critical narrative reviewPublication Date:2015Language:EnglishAbstract:Objective: The aim of this review was to deliver an objective analysis of the evidence suggesting that diet, particularly grains containing gluten, could possibly play a role in appearance of rheumatoid arthritis (RA). It could also said to be one of the contributing factors and to exacerbate and prolong symptoms.Methods: Critical narrative review to deliver an objective analysis on published research, with standardised appraisal criteria of the evidence on gluten sensitivity and development of RA and the influence on gluten free and non-gluten free diet on patients with RA.Results: A total of 19 papers were suitable for the review, which consisted of 3 systematic reviews, 4 randomized control trials, 2 non- randomized control trials and 10 non- systematic reviews.Conclusions: RA might be linked with food consumption, especially cereal grains, leading to increased permeability of the intestinal wall and production of cross-reactive antibodies. The food related problems might reflect an adverse effect of multiple modest hypersensitivity reactions, mediated by immune complex promoting autoimmune reaction in the joint. Therefore, altering and adopting diet and lifestyle that imitate the beneficial characteristics of the pre-agricultural environment could be an effective strategy to reduce the risk of chronic degenerative disease.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Kalotka.pdf

Title:Mechanotransduction and Manual Medicine – Exploring Mechanobiology: A qualitative study.Author:Thomas KathrinerBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Qualitative Research, Manual Medicine (MM), Connective Tissues (CT), Extracellular matrix (ECM), PiezoelectricityType of Publication:DissertationLevel of academic award:MScResearch design:QualitativePublication Date:2015Language:EnglishAbstract:Background: Mechanotransduction has been proposed as a unifying cellular mechanism in mechanobiology that provides a more comprehensive understanding of the affect of biomechanical forces at the cellular, tissue and organ level. Mechanotransduction is evident in numerous tissues including fascia and has received increasing attention in manual medicine (MM) literature. Despite the large body of research the actual clinical evidence for MM is limited but suggests promising insights for MM practice.Objectives: To investigate the experiences and opinions of scientists and manual practitioners regarding the implications of mechanotransduction for manual medicine.Method: A semi-structured interview was conducted with seven scientists and manual practitioners, and was analysed using qualitative research methods with elements of grounded theory (GT).Results:The obtained data from this study indicates that mechanotransduction is important for human physiology/pathophysiology and is relevant to manual medicine. This study indicates that mechanotransduction offers a conceptual framework for MM practitioners to explore cellular mechanisms relevant to their practice. Three different approaches to mechanotransduction were identified and elaborated on. Furthermore, data suggests that mechanotransduction may positively contribute to MM research, in particular in the context of sham intervention.Conclusion: This study suggests that mechatransduction is a scientific approach not only important in the field of mechanobiology and engineering, but may also be applicable to MM. Further research should investigate both MM practitioners’ perception of the model and its practical applicability.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Kathriner.pdf

Title:Non-chemical non-contact cell signalling in the neuro-musculoskeletal system – A critical narrative review.Author:Sarah LalBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Cell signalling; electromagnet*; biophoton; non-contact; tensegrityType of Publication:DissertationLevel of academic award:MScResearch design:critical narrative reviewPublication Date:2015Language:EnglishAbstract:Background: Non-chemical non-contact (NCNC) cell signaling encompasses a means of cell communication independent of messenger molecules or direct cellular contact.Objective: To systematically appraise the methodological quality of existing published research on potential origins, behaviour and purposes of NCNC occurrences within the neuro-musculoskeletal system (NMS). This study aims to identify the potential relevance of NCNC communication to manual therapists who work primarily with the NMS, and to identify areas for further research.Methods: A computerised literature search was conducted between August and December 2014 to retrieve and critically appraise published research on NCNC phenomena. Databases included Pubmed, Cochrane Library, Trip database and Plos One database. Literature selection was guided by an adapted Prisma flow diagram (2009). Selected literature was ranked according to the hierarchy of evidence (NICE, n.d.) and grouped by study design. Critical appraisal was conducted using appropriate review checklists, including CASP checklists, Greenhalgh (2014) and Furlan (2009).Results: 202 studies were found on NCNC communication and the neuro-musculoskeletal system. 18 studies were identified as appropriate for this literature review based on their rank in the hierarchy of evidence (NICE, n.d.).Conclusion: Current research demonstrates the existence and outlines the behaviour of NCNC phenomena within single tissues of the neuro-musculoskeletal system (Seo et al., 2012; Chaban et al., 2012; Kataoka et al., 2001), however does not explain its physiological mechanisms. Further clinical studies on the effects of manual therapy on NCNC communication are needed as current research is limited and inconclusive.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Lal.pdf

Title:How much do healthcare practitioners’ characteristics and intervention styles impact on patient treatment outcomes? A narrative literature review.Author:Kate Lanaway.British School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:patient-practitioner relationship; therapeutic relationship; empathy; patient outcomes.Type of Publication:DissertationLevel of academic award:MScResearch design:Narrative reviewPublication Date:2015Language:EnglishAbstract:Background: The notion of ‘Empathy’ and ‘Positive Therapeutic relationship’ has seen a recent increase of interest with studies conducted in medicine, psychology, affective neuroscience and even economics. However, research tends to focus on definitions, evolutionary origin and the neurobiological basis. This critical literature review aims to analyse the evidence that links practitioner characteristics and intervention styles with objective improvements in patient outcomes.Objective: To appraise the quantity and methodological quality and strength of the most recent research evidence regarding the patient-practitioner relationship as a contextual variable and influence on patient outcomes in primary healthcare. To find out if there are specific therapeutic interactional styles that consistently demonstrate significant influences on patient treatment outcomes, such as pain relief and subjective treatment experiences.Method: A systematically conducted critical literature review based on computerised search of healthcare databases on the influence of the patient-practitioner relationship on treatment outcomes for relevant articles that met the inclusion criteria, which were sorted by study design, ranked according to the hierarchy of evidence and appraised with appropriate criteria.Results: 16 out of 89 research papers were identified as relevant and included 14 systematic reviews and 2 qualitative studies. All were identified as having high methodological quality and low risk of bias. The strongest evidence showed that a “soft skill’ like empathy has its effectiveness on wide ranging areas such as patient satisfaction, adherence, decrease of anxiety and stress, better diagnostics and outcomesConclusion: The clinical implications are that practitioners’ awareness of the impact of their own attitudes, and their informed use of particular intervention styles could be enhanced to promote more positive patient outcomes in osteopathic practice.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Lanaway.pdf

Title:Professional collaboration between osteopaths and physiotherapists: a qualitative study.Author:Karen LemonBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Interprofessional collaboration, osteopathy, physiotherapy, professional identity, qualitative research.Type of Publication:DissertationLevel of academic award:MScResearch design:qualitativePublication Date:2015Language:EnglishAbstract:Background: Osteopaths and physiotherapists in private practice often see similar musculoskeletal patient presentations and often have the same treatment aims. Despite the difference in origin and training of the professions, their distinction is becoming less clear with the advancement of evidence-based practice. A growing number of multi-therapy clinics now exist in the UK, many with osteopaths and physiotherapists as part of a multi-professional team, but there is no research into how the professions collaborate.Objectives: To investigate the experiences and nature of professional collaboration between osteopaths and physiotherapists, and to understand their views and perceptions of further opportunities for collaboration.Methods: Eight participants working in private practice, consisting of five registered osteopaths and three registered physiotherapists, took part in the study. Purposive and snowball sampling was used to identify potential participants. Data collection involved audio-recorded semi-structured interviews being carried out with participants either face-to-face or by telephone. Interviews were transcribed verbatim. Data collection and analysis occurred concurrently to identify developing categories using thematic analysis and elements of grounded theory.Results: There was variation in the ways that osteopaths and physiotherapists collaborated and how they perceived the benefits and challenges of professional collaboration. Four main categories were constructed from the data: Professional Identity, Conception of Collaboration, Opportunity to Learn, and Inter-professional Challenges.Conclusion: This study helps to identify some of the factors that influence the collaborative experience between osteopathy and physiotherapy and shows that there may be further opportunities for inter-professional collaboration. More research is required into the experiences of the patient and how collaboration impacts treatment outcomes.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Lemon.pdf

Title:The effectiveness of exercise vs. manual therapy in treating plantar heel painAuthor:Vladimir LevachyovBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Plantar fasciitis, plantar heel pain, plantar fasciopathy, manual therapy, exercise therapy.Type of Publication:DissertationLevel of academic award:MScResearch design:critical narrative review/ systematicPublication Date:2015Language:EnglishAbstract:Background: Plantar fasciitis is an enthesopathy of the plantar fascia and a commonly presenting complaint in musculoskeletal clinics. It is a degenerative process and the more recent research states that it should be renamed to plantar heel pain or plantar fasciopathy. A variety of treatment modalities are employed to help with recovery which include manual therapy to lower extremity muscles, home exercises, orthotics as well as electrophysical agents.Objectives: The proposed research aims to provide an objective evaluation of the evidence on the addition of exercises (home stretches) to manual therapy and standard intervention for patients with the condition.Design: Critical narrative review aligned as close as possible with systematic review guidelines.Methods: Computerised literature was conducted between March and June 2015. Databases used were PubMed, The Cochrane Database of Systematic Reviews and Clinical Trials, and CINAHL. The quality of papers was assessed using the method guidelines for systematic reviews in the Cochrane Back Review Group.Results: Three RCTs met the selection criteria which analysed the addition of exercises and contrasted it to other treatment modalities such as electrophysical agents, orthoses and standard intervention (such as a take home informational guide). Two RCTs had high (6, 8) methodological quality score whilst one RCT had a moderate (5) methodological quality score.Conclusion: The addition of take-home exercises (specific stretches) to manual therapy leads to an improved outcome for patients with plantar fasciopathy at 1 month and 6 month follow-up. The addition of stretches to custom orthoses or the use of stretches alone does not lead to improved outcomes for patients with plantar fasciopathy, as measured at 4 and 12 month follow-up.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Levachyov.pdf

Title:The frequency of Smartphone usage amongst the BSO population and its potential as a risk factor in the development of musculoskeletal symptoms - A questionnaire based studyAuthor:Addison Levens British School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Participants, Smartphones, Musculoskeletal (MSK), Symptoms, Usage.Type of Publication:DissertationLevel of academic award:MScResearch design:Quantitative questionnairePublication Date:2015Language:EnglishAbstract:Objective: To assess how much participants use and positon themselves when in possession of a smartphone. It was then the intension to explore whether there were relationships between the use of smartphones and the incidence of musculoskeletal symptoms expressed by students and staff at the BSO.Method: An online cross-sectional self-administered, quantitative questionnaire was distributed via in-house emailing system to a sample size of 652 participants within the BSO.Results: 137 questionnaires were completed (response rate = 20%). Smartphones were used by all 137 participants with the majority of participants (35%) spending 1-2 hours on their smartphones per day. The posture of participants held more frequently when using smartphones were, sitting hunched over (39%), and holding the neck in a downward position 92%. Participant’s common areas of musculoskeletal pain when using a smartphone were reported at a low frequency of 14% experiencing pain in the neck and 8% in the shoulders. Those who experienced pain when using their smartphone reported symptoms described as a dull ache 29%. The main area of significance was between whether the participant’s pain was increased when using a smartphone in relation to their pain location in general.Conclusion: There was significant correlation with previous studies in a way that participants self-reported having musculoskeletal pain in the upper extremity whilst using their smartphone. Despite there being some evidence to support existing research (mobile devices and computers) that smartphone use could be a risk to the development of musculoskeletal symptoms, the methodological limitation of this self-report survey means these results require further validation to support this research.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Levens.pdf

Title:A qualitative study to explore osteopaths' opinions about the role of the commonly cited set of osteopathic principals in clinical practice.Author:Lee LewisBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Osteopathic principles, evidence, clinical reasoning.Type of Publication:DissertationLevel of academic award:MScResearch design:QualitativePublication Date:2015Language:EnglishAbstract:Background: Previous research has identified conflicting opinions within the osteopathic profession about the role of commonly cited historical principles in the current evidence-based environment of healthcare practice.Objective: This aim of this qualitative study was to explore areas of agreement and diversity in the opinions of osteopaths about core principles and how the principles influence clinical decision-making in practice.Design: Semi structured interviews were conducted with a convenience sample of practicing osteopaths with more than five years’ experience. They were recruited via invitation emails to osteopaths practicing in an area accessible to the researcher and interviews were with four osteopaths conducted at convenient locations.Results: The findings confirmed there are still diverse opinions about the value of historical principles in contemporary osteopathic practice. Some participants believed the principles are a useful, unique basis for providing individualised patient care, where others felt it was difficult to specify how these principles were distinct from those used in other healthcare professions.Conclusion: Although some participants talked about osteopathic principles being integral to patient care, they found it harder to describe how they actively applied the principles in practice. This study concludes that data obtained from qualitative interviews may be inadequate to explore professional activity which is guided by tacit beliefs, implicit knowledge or unconscious competence. Observational studies using video recordings and participant de-briefing may be a more effective method of exploring how osteopaths use principles-based approaches in practice in the UK today.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/LewisL.pdf

Title:Parkour: Injury Prevalence and Types, and the Relationship with FearAuthor:Richard LewisBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Parkour; fear; injuries; adrenalin, risk;Type of Publication:DissertationLevel of academic award:MScResearch design:quantitative cross-sectional questionnairePublication Date:2015Language:EnglishAbstract:Objectives: Parkour has rapidly gained popularity and media attention. Often labelled an extreme sport, research into parkour injuries is limited. The objectives of this study therefore, are to research the common types of injuries, mechanisms involved, and to examine practitioners’ relationships with fear. This potentially will allow for injury prevention methods to be established and inform healthcare professionals of common injury presentations associated with parkour.Methods: A bespoke quantitative cross-sectional questionnaire was designed using SurveyMonkey, and distributed via social media.Results: 785 responses were received from 54 countries across 6 continents. The majority of injuries occurred to joints and tendons of the lower extremities from jumping and landing manoeuvres, followed by wrist and shoulder injuries from pull up movements. 77% did not view parkour as an adrenaline seeking activity and 90% believe experiencing fear within parkour correlates positively to their lives outside of parkour.Conclusions: Parkour is not an extreme sport. Although some choose to practice it in this way, adrenaline seeking is not a primary motivating factor. Severe injury in parkour is uncommon and parkour training is an effective form of injury prevention, aiming to improve efficient movement and reduce impact to the body.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/LewisR.pdf

Title:Ex-military amputees’ experiences of osteopathy as a treatment for musculoskeletal disorders.Author:Caroline LovettBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Amputation, Osteopathy, Patient-practitioner relationship, Body awareness, Self-identity.Type of Publication:DissertationLevel of academic award:MScResearch design:Semi-structured qualitative interviewPublication Date:2015Language:EnglishAbstract:Background: Amputations sustained by service personnel following traumatic injury have increased following the recent conflicts in Iraq and Afghanistan. Despite this, osteopathy, a manual therapy, is not a treatment option available in the military medical care system.Objective: To explore ex-military amputees’ awareness, perception and experiences of osteopathy in order to ascertain any benefits and factors that may help or hinder effective care.Design: Semi-structured qualitative interviewsSubjects: Five ex-military amputees.Analysis: Thematic analysis with elements of grounded theory.Results: The majority of participants had positive experiences with osteopathy. Awareness was through referrals from friends. Understanding of osteopathy is limited and variable. Osteopathy was viewed either as a necessity to maintain optimal function or as a last resort if self-maintenance failed. In both situations it seemed to return control and autonomy to the participants. There is increased body awareness and a change in self-identity amongst people who suffer an amputation. Conclusion: Osteopathy was found to be beneficial to ex-military amputees in relieving pain and maintaining function. Awareness of osteopathy is similar to the rest of the population and is mostly though referrals from friends. Osteopaths need to take into account body awareness and self-identity changes when communicating with patients.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Lovett.pdf

Title:How and why do osteopaths use Exercise Therapy for patients with CNLBP: A qualitative study.Author:Kieran Lowe.British School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:“Exercise therapy”, “Chronic low back pain”, “Core stability”, “Flexibility”, “Biopsychosocial”Type of Publication:DissertationLevel of academic award:MScResearch design:QualitativePublication Date:2015Language:EnglishAbstract:Background: The management of chronic non-specific lower back pain (CNLBP) has been explored in depth in healthcare. Guidelines from a UK national health policy organisation advocate the use of exercise therapy (ET) but there is limited research about how this is being implemented in osteopathic practice.Objective: To investigate how and why osteopaths use ET for the management of CNLBP.Method: Semi-structured interviews with a purposive sample of eight practicing osteopaths who use ET were conducted. Verbatim transcripts were analysed using Thematic Analysis in a manner consistent with elements of Grounded Theory.Results: Participant’s use of ET is supported by current research but ambiguity exists in reasoning and prescription. Three key themes influenced osteopaths approach to ET: (1) health benefits, (2) rationale to ET use, (3) patient well-being. The fourth theme captured methods and consideration for ET prescription.Conclusion: Participants use ET to promote a biopsychosocial approach to managing CNLBP, with a focus on self-care and accessibility. Knowledge of ET has developed from non-osteopathic institutions leading to recommendations to review and develop current learning.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Lowe.pdf

Title:“I did feel as if I was in a cage, locked up in a cage.” Narrative Analysis of Chronic Pain Patients’ Experiences.Author:Joanna LuftBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Narrative analysis, chronic pain, patient narratives, osteopathy.Type of Publication:DissertationLevel of academic award:MScResearch design:Narrative AnalysisPublication Date:2015Language:EnglishAbstract:Background: Patient narratives of a range of health conditions analysed using various qualitative methodologies have shown value in; understanding the patient story; promoting patient agency; exploring pain beliefs; and reflective learning. To date within osteopathy there have been no studies into chronic pain patients’ narratives analysed with Narrative Analysis. Objectives: To investigate a small sample of chronic pain patients’ narratives to explore their role in enhancing osteopathic understanding of patient’s experiences.Methods: 5 semi-structured interviews of patients with chronic pain took place. Participants were asked to talk about their experiences of having chronic pain. The interviews were transcribed and individual stories told within the discourse were analysed using Narrative Analysis. All interviews were analysed in equal depth and results were drawn from all participants. For deeper illustrative purposes the discussion focuses on three stories from one participant.Results: All narratives were examples of a never ending 'Quest' story. Five character types were identified: The Concealer, The Captive, The Pragmatist, The Believer and The Thinker. All characters described a sense of loss between their past and present selves.Conclusions: Narrative analysis is valuable to osteopaths because of their role in co-authoring patients’ stories about pain, their position in shaping medical discourses, and in understanding the individual experiences faced by each patient.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Luft.pdf

Title:A quantitative questionnaire into the use of Osteopathy in the Cranial Field (OCF) as a treatment modality for children with special needs.Author:Marion LynchBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Quantitative Osteopathy Cranial OCF Special Needs.Type of Publication:DissertationLevel of academic award:MScResearch design:Quantitative questionnairePublication Date:2015Language:EnglishAbstract:Aim: This study aimed to generate more knowledge about the treatment approaches used by osteopaths in their treatment of children with special needs.Method: 1000 UK GOsC registered osteopaths were randomly selected to complete an online questionnaire using a five-point Likert scale and multiple choice questions as well as three open questions generating qualitative data. The questionnaire was designed and piloted by the author.Results: From the 1000 questionnaires sent out, 58 responses were received generating a response of 5.8%. Female participants used OCF in their treatment of children with special needs more than male practitioners in private practice.Conclusion: Due to a low response rate no conclusions can be drawn from this sample but 50% of osteopaths surveyed had no postgraduate qualification in cranial and/or paediatric field, but were treating children with special needs using OCF primarily for behavioural problems.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Lynch.pdf

Title:A qualitative study to explore the beliefs and attitudes of manual therapists who additionally have expertise in the field of equine manual therapy on the combined evaluation of horse and rider.Author:Sara MagernBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Horse, rider, treatment, osteopathy, integrated assessment.Type of Publication:DissertationLevel of academic award:MScResearch design:QualitativePublication Date:2015Language:EnglishAbstract:Background: Although there are separate research papers on manual therapy for horses and for humans, none have so far considered the combined assessment and treatment of horse and rider as a functional unit.Objectives: The aim of the study was to gather the opinions from manual therapists who provide combined treatment of horse and rider and establish the possibility of further areas of research or study that would be of benefit.Methods: Five manual therapists were interviewed using qualitative semi-structured interview techniques. Interviews were transcribed verbatim and analysed by Thematic Analysis consistent with elements of Grounded Theory, such as using memo writing.Results: Three key themes were identified which included functional assessment and management, benefits of combined treatment and challenges faced by osteopaths.Conclusions: The manual therapists highlighted several areas otherwise not considered by the researcher and identified scope for further research into a combined approach to treatment of the horse and rider.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Magern.pdf

Title:Evaluating aspects of non-surgical and non-pharmacological treatment methods available for manual therapists to use in the treatment of tendinopathies. A narrative review.Author:Huw Mars-JonesBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Tendinopathy, rehabilitation, manual therapy, therapeutic ultrasound, cryotherapy.Type of Publication:DissertationLevel of academic award:MScResearch design:Narrative reviewPublication Date:2015Language:EnglishAbstract:Objective: The purpose of this project is to compare and contrast aspects of non-surgical and non-pharmacological treatment methods available for manual therapists to use in the treatment of tendinopathies. The treatment methods that will be evaluated will include Transverse Friction Massage, Eccentric Contraction, Therapeutic Ultrasound, Extracorporeal Shock Wave Therapy (ESWT), Cryotherapy and Kinesiology Taping.Methods: A literature search was conducted online using online databases such as PubMed, Google Scholar and Chochrane using Medical subject headings (MeSH) and key terms.Results: A total of 52 papers were read and analysed, including 17 randomised control trials, 7 pilot studies, 1 controlled trial, 1 single blind study and 1 case study.Conclusion: Following this review, the treatment chosen to treat the tendinopathies is dependent upon the type of pathology within the tendinopathic tendon. Eccentric contraction has been shown to have the more beneficial effects and more reliable results than transverse friction massage in the treatment of non-calcific tendinopathies, however larger sample sized are required to provide more reliable results. ESWT and therapeutic ultrasound have shown to be the most effective treatment for calcific tendinopathies with ESWT showing greater results; however the efficacy of these techniques in treating non-calcific tendinopathies is speculative. Cryotherapy has shown evidence of significantly reducing the blood flow to the tendon and thus may be effective in inflammatory tendinopathies, but may not have effects on degenerative tendinopathies. Kinesiology taping demonstrated beneficial effects on muscular and tendon pain, however this research is limited and further research is required to draw reliable conclusions regarding this treatment method.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Mars-Jones.pdf

Title:Comparing short-term effects of two talocrural mobilisation interventions on dynamic balance in healthy individualsAuthor:Paul MarsatBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:BALANCE HEALTH TALOCRURAL MANIPULATION TALOCRURAL MOBILISATION INTERVENTIONS Type of Publication:DissertationLevel of academic award:MScResearch design:randomised controlled trialPublication Date:2015Language:EnglishAbstract:Objectives: This study investigated the effects of talocrural manipulation on immediate and short-term dynamic standing balance. The study also observed if the presence of a cavitation, or ROM changes, were in part responsible for balance changes.Methods: This RCT compared SEBT performance of subjects immediately (t1), and 10-minutes after manipulation (t2), with an active-control Maitland mobilisation group. SEBT performance with and without cavitation in the manipulation group was also compared. Finally, the relationship between WBLT changes and SEBT performance changes was examined.Results: The manipulation group improved SEBT reach (cm) performance both t1 and t2 in the anterior, t1: 24.1(12.9) vs t2: 20.8(9.8), postero-lateral 4.7(6.6) vs 2.7(5.4) and postero-medial 3.8(6.3) vs 2.2(40.6) directions.SEBT improvements were non-significantly greater in the manipulation group compared to the mobilisation group. No cavitation induced significantly greater improvements in the anterior direction at t2: 17.2(34.0) vs0.9(29.7). In all other directions, cavitation led to numerically but not significantly greater SEBT performance. Finally, in the manipulation group, SEBT differences did not correlate with ROM differences.Conclusions: This pilot RCT showed that talocrural manipulation is an effective approach to improve immediate and short-term dynamic balance in healthy individuals. The improvements were not linked to the presence of a cavitation or an increase in ROM.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Marsat.pdf

Title:The effects of osteopathic diaphragm techniques on respiratory function in asymptomatic subjects: A randomised controlled trial.Author:Francesca MasonBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:ASYMPTOMATIC SUBJECTS DIAPHRAGM OSTEOPATHY RESPIRATORY FUNCTIONS Type of Publication:DissertationLevel of academic award:MScResearch design:randomised controlled trial.Publication Date:2015Language:EnglishAbstract:Objective: To investigate the effects of two osteopathic diaphragmatic techniques on respiratory function in asymptomatic subjects.Method: A single-blind, randomized controlled pre and post-test experimental design was conducted on 21 healthy individuals who were randomly allocated to a soft tissue release (STR) or diaphragmatic muscle energy technique (MET) group. Two rib cage measurements and two lung function spirometry readings were taken before and after the intervention. Participants: Asymptomatic BSO student population according to study exclusion criteria.Results: Analysis showed no significant changes in breathing mechanics or lung function for STR or MET. No significant difference was detected between the two interventions for breathing mechanics or lung function.Conclusion: The results of this study showed no evidence of STR or MET diaphragm techniques affecting breathing mechanics or lung function in a small sample of asymptomatic BSO students. Methodological limitations and small sample size may have been the confounding restraints. Future studies should utilise a control or sham group for comparison and a larger sample size. The use of a symptomatic population may also allow techniques to be more effective.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Mason.pdf

Title:Investigating osteopathy students' levels of emotional intelligence and their ability to haptically (touch and proprioception) recognise 3-D familiar and unfamiliar objects; a cross-sectional study.Author:Marlene MaurerBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Osteopathy; Emotional Intelligence; Palpation; Haptic recognitionType of Publication:DissertationLevel of academic award:MScResearch design:cross-sectionalPublication Date:2015Language:EnglishAbstract:Objectives: The aim of this experimental research study was to explore links between osteopathy students' levels of emotional intelligence (EI) and their ability to haptically recognize 3-D familiar and unfamiliar objects. The statistical null hypothesis was that there would be no relation between EI and object recognition skills.Methods: An associative observational cross-sectional study was conducted with a convenience sample (n=50) recruited from the full-time student body of a UK osteopathy school via e-mail. Students’ participation was voluntary including completion of the Edinburgh Handedness Inventory (EHI), Trait Emotional Intelligence Questionnaire Short Form (TEIQueSF) and an object recognition test. Descriptive statistics were calculated and differences between groups evaluated using non-parametric tests.Results: No significant correlation was found between EI and palpatory capabilities or EI and gender. No relationship was found between accuracy and gender or accuracy and age. First year students scored highest in accuracy levels whereas fourth year students scored highest in EI. Conclusions: No statistical correlation was found between EI and haptic recognition skills. No significant between-year group differences in mean palpatory accuracy could be found, which might be due to previous degrees of students. This study has provided baseline data for haptic recognition skills and EI scores among osteopathy students but further research in form of longitudinal studies and more objective EI measuring tools is recommended. Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Maurer.pdf

Title:Important characteristics that improve access to osteopathy for D/deaf people and people with hearing loss: a pilot structured survey.Author:Nia MayBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:deafness, health services accessibility, healthcare, osteopathy, complementary therapies.Type of Publication:DissertationLevel of academic award:MScResearch design:Pilot structured survey.Publication Date:2015Language:EnglishAbstract:Background: Research has found that D/deaf people and people with hearing loss experience poor accessibility to conventional healthcare, and are negatively affected by this. Accessibility to complementary and physical therapies has not been researched. This pilot study aimed to investigate whether the access barriers identified in conventional healthcare were important to people with hearing loss when attending an osteopathy appointment, and whether there was a hierarchy of importance within these characteristics. Method: A structured questionnaire was developed from a literature review and administered online. Participants were recruited via self-selection from the online networks of four organisations/groups for D/deaf people. The main outcome measures were scores of importance for characteristics via 10-point Likert scales, and the perceived three characteristics of highest importance via a multiple choice question. A feedback section was included at the end of the questionnaire.Results:11 participants responded to the questionnaire. All characteristics scored a majority of 10/10 on the score for importance. A hierarchy of importance was identified and found to be significant via statistical analysis. Feedback was 100% positive.Conclusion: Participants in this study identified all ten characteristics as highly important during an osteopathy appointment. Improvements to practice could follow a sequence of priority following an order of importance. The low participation rate requires support from larger studies to begin to generalise these findings to the wider D/deaf population. The questionnaire is a resource for future research.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/May.pdf

Title:How do Osteopaths practising different modalities of osteopathy perceive the profession and their professional identity?Author:Elisabeth McGirlBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Professional identity; Osteopathy; Modality; Collective identityType of Publication:DissertationLevel of academic award:MScResearch design:InterviewPublication Date:2015Language:EnglishAbstract:Background: If osteopathy is to be prominent in a competitive healthcare market it is necessary for it to be clear about its professional identity and distinctiveness.Objective: To explore how Osteopaths practising different modalities of osteopathy perceive their professional identity and the profession as a distinctive form of healthcare.Method: Semi structured interviewers were conducted with a purposive sample of eight osteopaths who predominantly practiced one of the following: Structural, Classical, Cranial or Mixed Approach OsteopathyResults: Three subordinate themes emerged; 1) Internal Conflict & Challenges to the Growth of the Profession, 2) Individual and Collective Professional Identity, 3) Evidence Base & the Future of the ProfessionConclusion: The professional identity of ‘Osteopath’ encompasses a range of practitioner roles, values and agendas. Osteopathy is well positioned to meet the future healthcare needs of the population. However, intra-professional tribalism represents a significant barrier to the profession establishing itself in a competitive market place.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/McGirl.pdf

Title:Modulation of spatial perception and autonomic function in individuals with chronic upper extremity pain: An experimental study.Author:Zoe McParlinBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Chronic arm pain, spatial perception, prism adaptation, thermoregulation, autonomic nervous system.Type of Publication:DissertationLevel of academic award:MScResearch design:ExperimentPublication Date:2015Language:EnglishAbstract:Objectives: To investigate the effect of spatial perception and its effects on thermoregulation (autonomics) in individuals with chronic upper extremity pain, building on a similar study by Moseley et al (2013).Method: Quasi-experimental controlled trial consisting of 10 control and 10 individuals with unilateral chronic upper extremity pain. Participants wore prism glasses that altered their visual field by 20° both medially and laterally. Skin temperature was measured at baseline, i.e. before intervention, and then again at 5 minutes periods with the prism glasses.Results: The overall effect of the prism glasses and differences of 20° medially were higher than scores compared to the control. The study results partially reflect the trend found in Moseley et al (2013) in CRPS patients; however, observed differences were not statistically significant.Conclusion: Despite suggesting a possible link with spatial perception of a painful limb, influencing cortical reorganization and thermoregulation of the symptomatic hand. However more research would need to be done to confirm these results. The results imply that it is plausible to predict a similar development in spatial perception for chronic arm pain compared to CRPS patients; however, more research into the mechanism in CP would need to be carried out to confirm a possible link.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/McParlin.pdf

Title:An investigation into the epidemiology of rugby related injuries and attitudes and awareness of osteopathy as a form of treatment.Author:Alex MillarBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:OSTEOPATHY, RUGBY, RUGBY INJURIES, SPORTS INJURIES, TREATMENT Type of Publication:DissertationLevel of academic award:MScResearch design:Quantitative questionnairePublication Date:2015Language:EnglishAbstract:Objectives: To explore the prevalence and epidemiology of injuries in amateur men’s rugby union and explore awareness of treatment options and attitudes towards osteopathy among players.Design: A quantitative questionnaire aimed at rugby players in southeast and southwest England.Methods: An online questionnaire was designed on survey monkey and distributed to clubs around the south of England via email. The questionnaire was also set up at Newbury RFC and was advertised in the clubhouse by the managers to current players and visiting teams.Results: High incidence rates were discovered at a rate of 210 injuries per 1000 hours. The shoulder was found to have the highest risk of injury compared to all other joints and muscles with the knee being most common. There was no significant link between whether forwards or backs received the most injuries however. Specific positions at highest risk were front row forwards and centres. Awareness of osteopathy was high as well as success of treatment being deemed effective. However most players chose to go to physiotherapists and GPs for their rugby related injuries.Conclusion: Injury rates were high however the research was unable to discover significant links between position and location of injury due to a small sample size. Awareness of osteopathy was high among players, however physiotherapist where the preferred choice for players rugby related injuries. More promotion of osteopathy as a form of treatment for sports related injuries is needed and would be beneficial for osteopathy as a profession.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Millar.pdf

Title:Osteopathic education and the challenges of constant change: An investigation into the education experiences facing students at the British School of OsteopathyAuthor:Catherine MorrittBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Osteopathy, mature students, funding, motivations, higher education.Type of Publication:DissertationLevel of academic award:MScResearch design:Qualitative focus groupPublication Date:2015Language:EnglishAbstract:Background: There have been changes over recent years affecting osteopathic education, in particular governmental policy changes to student funding in 2013. Osteopathic Educational Institutions (OEIs) such as Oxford Brookes and Leeds Metropolitan University have closed entry to their osteopathic courses whilst the British School of Osteopathy (BSO) changed its course structure.Objectives: To explore the main issues facing students undertaking osteopathic degree courses at the BSO in order to understand the main concerns faced in their endeavours to qualify as osteopaths. Design: Participants were students currently enrolled on an M.Ost degree course. Qualitative focus group discussions were used to gather their views about osteopathic education. Discussions were semi-structured in nature using cue cards based around the main study questions. Meetings were recorded, transcribed verbatim and analysed using thematic coding with elements of grounded theory to identify key themes.Results: Influences to study osteopathy included the desire to help people and a hands-on therapy. Choice of BSO was due to its reputation and recommendations by BSO graduate osteopaths. Students expected the course to be ‘hard work’, with high levels of academia and this remained unchanged. Disappointment and frustration expressed with communication and timetabling structure. Modernisation of current technology recommended for benefit both facilitators and students. This demanding course impacted highly on lifestyle with both positive and negative views of student funding.Conclusion: Choice to study osteopathy appeared non-discriminatory with mature students re-educating themselves due to either wishing to expand their knowledge/skill base or leave unfulfilling careers as opportunities arose. The BSOs’ reputation remains strong with many prior students recommending it as an OEI. Students were pleased with the variety the courses available and ease of entry expecting a demanding masters level degree course providing a high level of academic study. It was felt distribution of academic and practical studies could be improved to include a more consistent and even mix of both. IT modernisation was recommended with organisation of administration specifically communication and timetabling. It was felt improvement in these areas would bolster the financial outlay required by current students.

Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Morritt.pdf

Title:Autism and Osteopathy- A qualitative exploration of parent’s experiencesAuthor:Maxime NeillBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:autism, parental experiences, motivations, osteopathy, CAMType of Publication:DissertationLevel of academic award:MScResearch design:QualitativePublication Date:2015Language:EnglishAbstract:Objectives: To explore parent’s views and opinions of the factors that influences their decision to use osteopathic treatment, as well as their perceptions of the effects of treatment.Method: Four semi-structured interviews were carried out with four parents whom have a child diagnosed with an ASD. Interviews were transcribed verbatim and analysed using a thematic analysis framework consistent with elements of grounded theory.Results: The findings identified a multitude of factors reported in influencing parents’ use of osteopathic treatment for their children. Such factors reported mainly stemmed from pre-existing expectations which were built through beliefs surrounding the cause of the child’s disorder, personal experiences and external sources.Parents described benefits of osteopathy within the domains of social interaction and physical relationships with children; however this was inconclusive amongst participants. Some parents questioned whether osteopathic treatment had any influence whatsoever.Conclusion: Influences for seeking osteopathic care amongst this group of parents varied massively. The factors reported had ultimately led to parents expectations of osteopathic treatment. Some parents looked to osteopathy to help with certain symptoms, whilst others looked for treatment to intervene with the underlying cause. Osteopathic care was perceived by the majority of parents as beneficial and felt to have some role in treating children with ASDs; however these opinions were inconsistent from parent to parent. In order to inform the profession, as well as other parents looking for intervention, further research is warranted using a larger and more diverse sample and exploring whether there are correlations, differences or additional findings within a bigger population. Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Neill.pdf

Title:Osteopathy and Yoga: A Complementary Approach to Treatment?Author:Aimee NewtonBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:yoga, patient centred care, dual-trained practitioners, biopsychosocial, integrative healthcareType of Publication:DissertationLevel of academic award:MScResearch design:InterviewPublication Date:2015Language:EnglishAbstract:Background: Yoga is an increasingly popular activity with a growing amount of evidence based research. It has areas of a shared philosophical base with osteopathy and may potentially work well as an adjunct tool for treatment. There is the possibility it is already been used by many osteopaths as part of a treatment plan the scope of which has not been explored.Objectives: To explore dual-trained practitioners’ feelings and beliefs about a complementary approach to treatment using both osteopathy and yoga.Method: Eight semi-structured interviews were carried out with a snowball sample of dual trained osteopaths and yoga teachers. Data was transcribed verbatim and elements of grounded theory were used as a framework for analysis.Findings: Four Key Themes were constructed which helped provide an understanding of dual trained practitioners conceptions of a complementary treatment approach; Clinical Synergy; Therapeutic Boundaries; Person-Centred Care and Identifying ObstaclesConclusions: Due to both yoga and osteopathy’s biopsychosocial philosophy’s this study identified several ways in which yoga is currently being used in a complementary way with osteopathy such as prescriptive exercises and for the management of stress and chronic patients. Dual trained practitioners work either by combining the two approaches or via a referral process.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Newton.pdf

Title:A quantitative survey of attitudes towards rehabilitative exercise and patient autonomy.Author:Ryan NortonBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Rehabilitative exercises; patient autonomy; effectiveness; treatment plan; patient management.Type of Publication:DissertationLevel of academic award:MScResearch design:Quantitative SurveyPublication Date:2015Language:EnglishAbstract:Objective: To examine the relationship between rehabilitative exercises (RE), its validity and role in patient autonomy (PA) as perceived by Osteopathic students (OS) at the British school of Osteopathy (BSO).Method: An online survey of third and fourth year Osteopathy students at the British School of Osteopathy. Split into four sections, Demographics, professional experience, rehabilitative exercise and patient autonomy section. This was conducted between September-December 2014. Participants: A total of 21questionnaires completed.Results: Descriptive statistics of RE suggest agreement between the effectiveness of RE and its relevance within the osteopathic treatment plan. Students “often” agree RE has an influence on patient management (PM), although the data was spread as to the frequency and consistency of prescribing and revaluating RE.Descriptive statistics of PA indicate that PA is valuable in the clinical setting, considered in the treatment plan while being aware of PA while suggesting RE to patients.Conclusions: RE should be used with PA in mind and is significant in the treatment and management plan of patients. Students consider RE an effective tool in encouraging patient autonomy.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Norton.pdf

Title:Diaphragm to internal oblique muscle activity and its relation to thoracic kyphosis during quiet and forced breathingAuthor:Hania OgrodzinskiBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Diaphragm; internal oblique; intra-abdominal pressure; ventilation; electromyography (EMG)Type of Publication:DissertationLevel of academic award:MScResearch design:ExperimentPublication Date:2015Language:EnglishAbstract:Objectives: To measure the ratio of diaphragm to internal oblique electromyographic (EMG) activity, under different breathing conditions (normal and forced breathing). The influence of thoracic kyphosis, age and gender on this ratio were also observed.Method: Nineteen participants were recruited from the British School of Osteopathy (BSO). Cobb angle was obtained by fitting circles through digitised points using the least squares procedure. Diaphragm and internal oblique electromyographic (EMG) activity was recorded continuously using surface electrodes through a period of normal breathing and forced breathing.Results: Male subjects log diaphragm:internal oblique was ~0.96 less than that of female subjects and was significant (p<0.05); meaning that, in this sample, women use their diaphragm more relative to the internal oblique. Age showed no relationship with diaphragm/internal oblique ratio. The mean cobb angle was 40.4 degrees (9.8 degrees standard deviation). Males, in the sample, were observed to be on average 11.4 degrees more kyphotic than women.Conclusion: Differences in diaphragm:internal oblique activity may be due to either gender or degree of kyphosis.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Ogrodzinski.pdf

Title:The effects of Kinesio Taping® application on chronic mechanical neck pain: a comparative experimental study with traditional osteopathic careAuthor:Gianmarco OlivieroBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:chronic neck pain, osteopathy, Kinesio taping® method, manual therapy. Type of Publication:DissertationLevel of academic award:MScResearch design:comparative experimentPublication Date:2015Language:EnglishAbstract:Context: Despite preliminary evidence indicating that the application of Kinesio taping® (KT®) is effective for chronic low back pain and neck pain, no evidence have been found suggesting the potential use of this technique in combination or in alternative to the traditional care.Objectives: To investigate the effects of KT® method combined with osteopathic treatment on pain perception, quality of life and disability in patients with chronic neck pain (CNP) compared to osteopathy alone.Methods: A pilot randomised controlled trial (RCT) was carried out at the British School of Osteopathy (BSO) outpatient clinic, recruiting 14 patients complaining of CNP. The patient were randomly assigned to either the intervention group or the control group, to start a six-weeks program. The outcome measurements were represented by the Visual Analogue Scale (VAS), Euro Quality of Life (EuroQoL) and Neck Disability Index (NDI). Data were collected twice, at baseline and at the end of the intervention.Results: 13 patients completed the study. In both the groups there was a significant reduction in the pre-post intervention values, with a greater reduction of the NDI (p=0.022) and VAS for pain (p=0.035) for the intervention group (KT®).Conclusions: The combination of KT® method and osteopathy showed a significant improvement in patient suffering from CNP in comparison to osteopathy alone. This pilot study demonstrated the study methodology to be feasible and the positive trends shown can be considered a first basis on which to undertake a further larger research project.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Oliviero.pdf

Title:Recognition of hereditary haemochromatosis in osteopathic clinical practice. What are the early symptoms? A critical narrative reviewAuthor:Rebecca ParkBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Arthropathy; Diagnosis; Fatigue; Headache; Hereditary haemochromatosisType of Publication:DissertationLevel of academic award:MScResearch design:critical narrative reviewPublication Date:2015Language:EnglishAbstract:Background: Hereditary hemochromatosis (HH) is a life-threatening genetic condition. Early diagnosis can improve prognosis but late diagnosis is common. Since 1996 genetic screening has allowed earlier diagnosis and a different symptomatic profile may be emerging.Objectives: This study aims to identify literature published since 1996 describing symptoms at the time of genetic diagnosis, and review the quality of that evidence to determine the earliest symptoms.Methods: Papers were identified electronically and scored on methodological quality using risk of bias appraisal tools. Locations and descriptions of symptoms were recorded and significant findings identified.Results: Research is hampered by lack of consensus on definitions and thresholds, and lack of open questioning regarding symptoms. Evidence is emerging of a gender difference in presentation. A possible association with headaches, particularly in females, has been identified. Ankle/foot arthropathy may be an important early symptom in males.Conclusions: Osteopaths should consider HH as a differential diagnosis in males presenting with fatigue and joint pain, particularly of the MCP joints and ankles / feet, and in females presenting with MCP pain and headaches. Skin discolouration is now rarely seen. A negative test for abnormal iron levels does not indicate absence of HH genotype.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Park.pdf

Title:Patients' nutritional knowledge and expectations about receiving dietary advice: a cross-sectional surveyAuthor:Rose ParkerBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Therapy, Soft Tissue Musculoskeletal Manipulations Manipulation, Osteopathic Nutritional Sciences, Dietetics Type of Publication:DissertationLevel of academic award:MScResearch design:cross-sectionalPublication Date:2015Language:EnglishAbstract:Objectives: This study aims to explore patients' nutritional knowledge and expectations about receiving dietary advice at an osteopathic teaching clinic.Methods: A cross-sectional quantitative questionnaire was used to provide a description of knowledge and attitudes of patients at the BSO clinic. Over a four week period, 91 adult patients collected and completed the survey on nutritional knowledge and expectations. Participants were selected by convenience sample.Results: Most patients at the BSO clinic were not offered dietary advice. Women were more likely to report being offered dietary advice than men and women scored higher in nutritional knowledge. Although most participants (99%) were able to associate illnesses with inappropriate nutrition, the cohort neither agreed nor disagreed that nutritional advice is within the remit of osteopathy. Participants also remained neutral as to whether or not they expected to be offered dietary advice at the BSO clinic.Conclusions: This survey shows that although knowledgeable about nutrition and the effects of inappropriate nutrition on general health, the participants do not particularly associate nutritional advice and osteopathy. The wide ranging responses suggest that further research is required to explore patient associations between nutrition, osteopathy and health, and the potential effects of including a nutritional module in the core BSO syllabus.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Parker.pdf

Title:Manual/Physical therapy for Chronic Pelvic Pain in women – a critical narrative review of evidence for its effectiveness.Author:Minatsu de Penanster.British School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Chronic pelvic pain; pelvic adhesion; endometriosis; dysmenorrhea; Irritable Bowel SyndromeType of Publication:DissertationLevel of academic award:MScResearch design:critical narrative reviewPublication Date:2015Language:EnglishAbstract:Background: Chronic Pelvic Pain (CPP) is common condition among the women with various causes. In addition to gynecologic/urologic causes, recent researches are suggestive of musculoskeletal dysfunction being involved in the complex etiological picture. The ability of manual therapy to improving musculoskeletal dysfunction therefore contributing CPP treatment has been strongly suggested in literature; however, there is currently little clear evidence. Objective: To provide a critical overview of published research and an interpretation of the relevance of findings, to further awareness and understanding, and to stimulate discussion on the treatment of CPP within the field of osteopathy.Methods: Systematic computerised and hand literature searches for relevant up to date research and evaluation using methodological quality criteria.Results: The sixteen highest quality studies have demonstrated that certain types of manual therapy interventions have a positive effect on the pain reduction and improved quality of life in female patient with Chronic Pelvic Pain.Conclusion: There are evidences of certain manual therapy may contribute into the reduction pain and other CPP associated symptoms; however, many studies reviewed were not blinded or randomised, with relatively small sample size and require to be further powered to improve external validity. Further research using improved methodology with long term follow up and larger populations is recommended.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Penanster.pdf

Title:The effects of a 40g Pin Prick stimulus on pain processing and Wind-Up in two comparable groups.Author:David Platten.British School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Quantitative Sensory Testing (QST), hyperalgesia, allodynia, Pin Prick, Pain Processing. Type of Publication:DissertationLevel of academic award:MScResearch design:ExperimentPublication Date:2015Language:EnglishAbstract:Objective: The purpose of this study was to investigate the effects of altered pain processing (APP) of a 40g repetitive pinprick stimulus to the hands and feet in two comparable groups.Subjects: 2 groups of a total of 27 participants. Group 1 consisted of 12 subjects with no history of pain. Group 2 consisted of 15 subjects with history of a significant pain event (6 or more weeks). Both groups at the time of the study were asymptomatic for the previous 3 months. Subjects came from the student faculty of the British School of Osteopathy and members of Slim Jims Health Club.Method: APP was tested using a repetitive pinprick stimulus of a force of 40g over a duration of 1 stimulus per second over 10 seconds. This was repeated two times on the bilateral palmar and dorsum surfaces of the hand and bilateral plantar and dorsal surfaces of the feet giving a total of 16 test sites.Results: The analysis demonstrated a significant increase in APP between the lower extremity and pain group.Conclusion: APP was significantly higher in the pain group with wind-up being achieved in 73 sites (34%) to the lower extremity. It can be suggested that after a significant pain event the potential of increased sensitivity causing hyperalgesia needs to be considered. However, further research is required in this field.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Platten.pdf

Title:Barriers to exercise during pregnancy: a critical narrative review of the qualitative literature. Author:Elizabeth PowellBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Pregnancy, exercise, physical activity, barriers, qualitative.Type of Publication:DissertationLevel of academic award:MScResearch design:critical narrative review (qualitative literature)Publication Date:2015Language:EnglishAbstract:Background: Quantitative studies have shown that incidence of obesity in pregnancy is rising. Maternal obesity is associated with increased risk of miscarriage, gestational hypertension, gestational diabetes and pre-eclampsia. Several studies have linked exercise during pregnancy with reduced risk of pre-eclampsia, gestational diabetes, preterm delivery, high birth weight, and gestational hypertension. As holistic primary healthcare practitioners, osteopaths provide both manual therapy and self-care advice. In the case of pregnant patients this should include an exercise component, and may require osteopaths to help women overcome their individual barriers to exercise.Objectives: To analyse the quality of studies that used a qualitative design to discern women’s attitudes, beliefs and personal barriers to exercise, and bring together common themes for discussion in the context of osteopathic management of pregnant patients.Method: Internet searching and hand searching of the literature was carried out. Eligible papers were assessed against standardised checklists of criteria for methodological quality and risk of bias. Best evidence was explored and findings were discussed thematically under the headings of “physical and medical barriers”, “social and environmental barriers”, and “cognitive barriers”, and in the context of osteopathic management of pregnant patients.Results: Twelve papers were eligible for discussion. The most common barriers were physical followed by social and cognitive barriers respectively. Two specific barriers were pervasive: health-related changes/challenges and lack of time. Other barriers were significant but less common.Conclusions: Some physical barriers can be modified by manual treatment by an osteopath. Since osteopathic management should also include a self-care component, osteopaths can help to modify non-physical barriers to exercise through tailored advice based on best evidence for safe exercise in pregnancy. In all instances, osteopaths should be familiar with ACOG and RCOG guidelines relating to exercise during pregnancy.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Powell.pdf

Title:A qualitative investigation into the effects of mindfulness on osteopaths.Author:Justin RedpathBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Mindfulness, Self-care, Manual Therapy, OsteopathyType of Publication:DissertationLevel of academic award:MScResearch design:qualitativePublication Date:2015Language:EnglishAbstract:Background: Mindfulness has been a topic of a large amount of research, primarily as an intervention on patients in healthcare settings and shows promising results. There is less research investigating the effects of mindfulness on practitioners, and a distinct lack involving manual therapists.Objective: To explore and investigate the effects a mindfulness practice has on osteopaths across personal and professional domains, including positive and negative outcomes.Design:A qualitative research framework was used in the form of eight semi-structured interviews of osteopaths who practise mindfulness. Verbatim transcribed material was analysed using Thematic Analysis with elements of Grounded Theory.Results:Three key themes; relationship to self, relationship to patient, and relationship to higher meaning. and seven sub-themes were constructed from the data which illustrated the effects of mindfulness.Conclusion: This small sample shows promising benefits of mindfulness on osteopaths’ personal and professional domains, and may help to connect to a deeper sense of meaning and values.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Redpath.pdf

Title:Osteopaths’ Opinions toward Adult Sleep Disturbances and their Effect on Patient Health.Author:Caroline ReevesBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Osteopathy, sleep disturbance, chronic pain, Rheumatoid Arthritis and Gluten SensitivityType of Publication:DissertationLevel of academic award:MScResearch design:Cross-sectional questionnairePublication Date:2015Language:EnglishAbstract:Objective: The aim of this study was to explore the current beliefs of GOsC registered osteopaths regarding sleep disturbances (SD) in the adult population, their impact on patients’ health and to investigate whether osteopaths believe osteopathy can improve a patient’s sleep pattern.Method: A cross-sectional questionnaire survey was emailed to 1072 GOsC registered osteopaths using Survey Monkey. Data was then analysed using SPSSv21 software.Results: Response rate was 11%. Results showed that the majority of osteopaths recognised key characteristics and causes of SD, and considered emotional and environmental factors to be as much a cause of SD as physical aspects. All participants considered sleep to be important to a patient’s general health and the majority consider osteopathy to be a somewhat effective treatment method for SD. Disparity exists between the number of patients who suffer with SD and those who presented with SD as a primary complaint. Treatment plans for SD include cognitive behavioural therapy, cranio-sacral techniques, education regarding sleep hygiene and relaxation advice. However, osteopaths who considered osteopathy effective as a treatment for SD reported that they treat only a patient’s presenting complaint, or, treat the presenting complaint and refer the patient to another healthcare practitioner for the SD.Conclusions: This study concludes that osteopaths have a working knowledge of SD, their characteristics and causes, and appreciate the important role sleep plays on a patient’s general health and in persistent pain. The large disparity between sufferers of SD, and those that present with SD to an osteopath, highlights the need for thorough questioning on this aspect of a patients history, in order to best treat all the patients symptoms. This study indicates that the best method for the treatment of SD includes behavioural techniques, education regarding sleep hygiene and relaxation advice as adjunct to the treatment of comorbid pain.There is a need for further research into the effectiveness of osteopathy for the treatment of SD.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Reeves.pdf

Title:Narrative Literature review: Looking at the effects of kinesio tape on Fascia and its role in increasing Muscle activityAuthor:Alex RoganBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Kinesio tape, Fascia, Muscle Contraction, Joint ROM, Physiotherapy.Type of Publication:DissertationLevel of academic award:MScResearch design:Narrative reviewPublication Date:2015Language:EnglishAbstract:Narrative review looking at the effects of kinesio tape on fascia and its role in increasing muscle activity exploring the limitation of tapping in muscle activation and that of proprioception. Taking these results into consideration and how they can be applied to osteopathy and improving the patient experience, levels of pain and ongoing management. A literature search was carried out using the keywords below looking at randomised controlled studies.Conclusion: There is limited research into supporting the theories surrounding kenisio tape and its effects on proprioception, joint position sense and activation. Research suggests that there needs to be more research carried out to understand the mechanism of kinesio taping with standardised procedures on application of the tape depending on the joint and chronicity of the patient.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Rogan.pdf

Title:A questionnaire survey of patients’ experience of 3rd year students' empathy in the BSO clinicAuthor:Joe RudlandBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Empathy, Osteopathy, Gender, Stress, Patients Type of Publication:DissertationLevel of academic award:MScResearch design:questionnaire surveyPublication Date:2015Language:EnglishAbstract:Background: Empathy has been shown to improve patient outcomes and forms an important part of osteopathic treatment. Previous undergraduate work at the British School of Osteopathy (BSO) has shown an apparent disparity in empathy between male and female third year students.Objective: To determine if patients perceived female patients as more empathetic than male students in the 3rd year and to examine any trends of perceived empathy based on gender and ages of students and patients.Method: A quantitative, cross-sectional questionnaire was used. The first part of the questionnaire collect demographic information about patients the students treating them, followed by the Jefferson Scale of Patient’s Perceptions of Physician Empathy questionnaire. Participants were patients who had been treated for three or more sessions by students at the British School of Osteopathy Clinic.Results: 79 completed questionnaires were analysed. Patients generally perceived high levels of empathy in the BSO students treating them and reported few problems relating to lack of empathy. Older patients and those who had attended the clinic more often recorded higher student empathy scores. Female students were perceived as being significantly more empathetic than males and the highest levels were reported by female patients treated by female studentsConclusion: The patients in this study were generally happy with the levels of empathy they perceived in the students treating them. The potential influences of gender bias in the patient’s empathy ratings and perceptions of empathy may benefit from further, larger scale studies, to assess whether there are issues affecting patient care which could be addressed through student education or support.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Rudland.pdf

Title:Exploring the process of the combining of osteopathy and traditional acupuncture by practitioners who use a combination of both in their clinical practice.Author:Peidaei, SamadBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Osteopathy, Acupuncture, Traditional Chinese Medicine, integration, holism.Type of Publication:DissertationLevel of academic award:MScResearch design:InterviewPublication Date:2015Language:EnglishAbstract:Introduction: There is an increasing number of patients requesting acupuncture and also of osteopaths who combine acupuncture into their practice. There are limited studies investigating the effect of integrating manual therapies and acupuncture, or why practitioners choose to combine these two methods. This study aims to explore the experiences and clinical decision-making process of healthcare practitioners who are qualified as both osteopaths and acupuncturists and how they integrate osteopathy and acupuncture in practice.Methods: Eight osteopath acupuncturists participated in a qualitative semi-structured interview study, which was digitally recorded then transcribed and were coded and analysed using Thematic Analysis with elements of Grounded Theory.Results: Six themes were identified from the data, which interconnected to form a rationale of how and why practitioners combined osteopathy and acupuncture. Justification for combining practices were: theories and philosophies about health and illness; characteristics such as condition types and patient types; and outcomes from application in practice. Other important factors were research evidence, practitioner training and experience, and the perceived limitations of each approach.Conclusions: Osteopathy was used as the primary method of evaluation, acupuncture methods were added as an adjunct. There are practitioners who believe that the underlying theories are compatible and aim to combine the treatment approaches equally, and those who believe that there are conflicting philosophies which make full integration impracticable. The reasons for choosing to do either osteopathy or acupuncture or both seem to be related to presenting conditions, patient factors and practitioner clinical expertise and preference but this interview study was unable to clearly identify the clinical reasoning processes itself. Future observational video studies are recommended in order to explore process of decision making process of dual practitioners.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Peidaei.pdf

Title:A questionnaire survey to evaluate whether qualified osteopaths believe the use of placebo language has a place in osteopathic patient care.Author:Ben SayerBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Osteopathy, placebo language, expectations.Type of Publication:DissertationLevel of academic award:MScResearch design:questionnaire surveyPublication Date:2015Language:EnglishAbstract:Objective: The purpose of this study was to evaluate whether qualified osteopaths believe the use of placebo language has a place in osteopathic patient care.Methods: The design was a cross sectional survey using a questionnaire created specifically for this project. Questionnaires were emailed to a randomised sample of osteopaths registered with the General Osteopathic Council (GOsC).Results: 106 questionnaires were completed out of 1064 distributed (11% response rate). 83% of participants agreed that placebo language was an effective form of treatment in general healthcare and 77% of the participants also agreed that it was ethical. 93% of participants who believed that placebo language was an effective part of osteopathic healthcare, overlapped with 88% who reported positive outcomes from using it. A number of participants, however, were unclear what ‘placebo language’ meant, which means these results should be interpreted cautiously. Conclusion: The majority of osteopaths who responded to this survey reported using some form of ‘placebo language’ to promote positive patient outcomes. Despite the major limitation of an unclear definition, further studies are recommended to explore what language osteopaths are using in clinical practice and how this might relate to theories of cognitive reassurance or patient expectations. Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Sayer.pdf

Title:What expectations do BSO patients have of student osteopaths regarding professional expertise?Author:Matthew Schofield_British School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:OSTEOPATHY PATIENTS PATIENTS' EXPECTATIONS PROFESSIONALISM Type of Publication:DissertationLevel of academic award:MScResearch design:cross-sectional surveyPublication Date:2015Language:EnglishAbstract:Background: The United Kingdom regulator of osteopathy has previously highlighted the importance of patient expectations and information regarding whether expectations were met.Objective: To determine what expectations were important to patients at the British School of Osteopathy Clinic, and to establish if there were differences based on gender or age. These expectations were based on previous research regarding the term “professional expertise”.Method: A cross sectional survey.Subjects: Patients at the British School of Osteopathy Clinic who had seen a student osteopath at least once.Results: There were statistically significant findings in gender based responses to expectations of professionalism and privacy (P=<0.05) following Mann-Whitney U and Chi Square test of independence. Furthermore, Spearman’s test found significant correlations between expectations and age bracket concerning effects of treatments and return to activities of daily living (P=.003). Also, many aspects of care are positively expected of students by patients who attend the British School of Osteopathy clinic.Conclusions: Patients at the British School of Osteopathy Clinic have many positive expectations about student osteopaths. These expectations are diverse and are similar to those of fully qualified osteopaths. More research is needed into whether student osteopaths meet these expectations to draw more meaningful conclusions.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Schofield.pdf

Title:EMOTIONAL PROCESSING AND ITS RELATIONSHIP TO TRAINING THROUGH INJURY IN ELITE TAEKWONDO ATHLETESAuthor:Prit SidhuBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:EMOTIONAL PROCESSING RELATIONSHIPS SPORTS INJURIES TAEKWONDO TRAINING Type of Publication:DissertationLevel of academic award:MScResearch design:Case-controlPublication Date:2015Language:EnglishAbstract:Objective: To explore how elite Taekwondo athletes training through injury process their emotions using the Emotional Processing Scale (EPS-25) compared with athletes free from injury.Method: A case control study. The cases were the elite injured Taekwondo athletes and the control cases were the non-injured Taekwondo athletes. Both groups of elite Taekwondo athletes were training for the ITF World Taekwondo Championships.Results: At the 5% level the scores between the pain and the pain free group were not significant.Conclusion: The results are not consistent with the study conducted by Esteves et al (2013) on chronic low back sufferers, and suggested that altered emotional processing does not influence athletes decisions to train through pain and/or injury. Further research into this area may help expand on psychosocial factors regarding athletes and training through injury.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Sidhu.pdf

Title:A study into the attitudes and behaviours of osteopaths towards HIV patientsAuthor:Anuvrat SinghBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:HIV/AIDS, attitudes, stigma, healthcare professionals, fears.Type of Publication:DissertationLevel of academic award:MScResearch design:cross-sectional questionnairePublication Date:2015Language:EnglishAbstract:Introduction: Aim of this study is to explore the attitudes and behaviours of osteopaths in the UK towards HIV positive patients.Method: 600 United Kingdom osteopaths, willing to participate in online osteopathic questionnaire were invited to complete a cross- sectional Survey Monkey© questionnaire.Result: The response rate of the survey was 11%. Out of the total 66 replies, 28 items were almost unanimous, by responding strongly agree and strongly disagree. 36 responses showed limited variation and were collapsed into 12 response categories to evaluate significance values. The impression of poor response was noticed due to quality of the questionnaire; however this may be as a result of the design, format or its layout.Conclusion: Respondent osteopaths appear to have a biased attitude towards HIV-positive patients; however this may be because of the design or layout of the questionnaire. Valid results couldn’t be drawn due to several limitations in the study.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Singh.pdf

Title:A qualitative study to explore the reasoning why qualified physiotherapists choose to study osteopathy and the influence this has on their approach to clinical practice.Author:Rachel StanleyBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:“osteopathy”, “physiotherapy”, “integration” “collaboration”, “clinical expertise” Type of Publication:DissertationLevel of academic award:MScResearch design:QualitativePublication Date:2015Language:EnglishAbstract:Objectives: This paper aims to explore the following three things; firstly why qualified physiotherapists choose to study osteopathy and the ways in which it has influenced their clinical practice, secondly what relationship there is between their decision to study osteopathy and the influence their studies have had on their clinical practice, thirdly could the findings inform educational delivery of pre-registration education and future recruitment of qualified physiotherapists?Methods: The British School of Osteopathy (BSO) student database was used to identify students previously trained as physiotherapists who were on one of the BSO’s pre-registration osteopathy courses. 24 students were identified and invited to take part, 8 participated in semi-structured interviews by replying to an email invitation. All interviews were analysed using thematic analysis with elements of grounded theory.Results: The drive towards personal and professional autonomy directed qualified physiotherapists decision to study osteopathy, and influenced their clinical practice. This was facilitated by interactive learning; direct observation and feedback on practice from both peers and tutors in a clinical setting. Participant’s opinions on the roles of physiotherapy and osteopathy varied but almost all highlighted the benefits and complexities of integrative and collaborative practice between the different healthcare modalities.Conclusions: This study offers the first documented exploration of why qualified physiotherapists undertake an osteopathy degree and the influence this has had on their clinical practice. This exploration may be of value for educational programmes to inform educational delivery of pre-registration education and future recruitment of qualified physiotherapists; to facilitate inter-disciplinary learning and development of clinical expertise.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Stanley.pdf

Title:Manual therapy combined with exercise for the treatment of rotator cuff tendinopathy: A systematic review.Author:Katy StoneBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:rotator cuff tendinopathy; shoulder impingement syndrome; exercise; manual therapy; physical therapyType of Publication:DissertationLevel of academic award:MScResearch design:Systematic ReviewPublication Date:2015Language:EnglishAbstract:Objective: To review and appraise the methodological quality of existing research regarding the efficacy of manual therapy (MT) combined with exercise for the treatment of rotator cuff (RC) tendinopathy.Design: Systematic ReviewMethods: A systematic computerised and hand literature search for randomised control trials (RCTs) in which MT and exercise were used to treat RC tendinopathy. RCTs meeting the inclusion criteria were evaluated for methodological quality and risk of bias using validated assessment tools.Results: 10 randomised controlled trials (RCT) were identified as having high/medium methodological quality and low risk of bias. Significant differences were low between group interventions. Population characteristics, intervention and outcome measures were highly heterogeneous making reliable conclusions on the efficacy of MT and exercise combined difficult to draw.Conclusions: Reviewed trials lacked homeogenity making a conclusion difficult to reach. Results seem to support that MT with exercise can significantly decrease pain and increase function however, is no more effective than other interventions included. Further research is warranted for the effects for eccentric exercise in conjunction with MT and on scapular dysfunction and focused treatment.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Stone.pdf

Title:UK Osteopath’s knowledge of pre-manipulative clinical testing procedures for craniovertebral instabilityAuthor:Hans-Heinrich SturmBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:CERVICAL SPINE CLINICAL TESTING CRANIOVERTEBRAL INSTABILITY MANIPULATION OSTEOPATHY Type of Publication:DissertationLevel of academic award:MScResearch design:QuestionnairePublication Date:2015Language:EnglishAbstract:Objective: To inquire into osteopaths knowledge and use of pre-manipulative tests to assess the stability of the upper cervical spine and their attitudes towards recommendations from the national regulating body in the UKMethods: A questionnaire adopted from Osmotherly and Rivestt was sent out to 1800 osteopaths in the UK. It had been pre validated when it was sent out to manipulative physical therapists in Australia and New ZealandResults: Of the 100 responses received 12 had to be discarded as the participants had not answered more than 2 of the 22 questions. There seems to be no statistical difference between either having post graduate qualification or extra experience in the profession. Whilst nearly half (48.3%) clearly disagreed with mandatory stress testing the other half would welcome some kind of recommendation on clinical testing, be it prior manipulation or even just articulation. 65% of participants supposed they would comply if guidelines were issued. Conclusion: There was confusion about the stress tests mentioned in this study. The majority of participants (51.7%) were in favour of some kind mandatory testing although there is no consensus as to when. Those who objected to them question their clinical effectiveness. Nearly all of them (98%) are happy to manage and treat patients with cervical spine issues because they feel they have enough treatment options available already. 93% of practitioners test necks on patients at least once a week. There are too few responses collected to make an assumption about the greater osteopathic profession, further work is needed.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Sturm.pdf

Title:The experience and attitudes of musicians with performance-related musculoskeletal disorders (PRMD) towards manual therapy care.Author:Heather ThomasBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Musician, performance-related, musculoskeletal, disorder, manual-therapy care.Type of Publication:DissertationLevel of academic award:MScResearch design:critical narrative reviewPublication Date:2015Language:EnglishAbstract:Objective: To critically assess research literature relevant to practise behaviours, performance-related musculoskeletal disorders (PRMD), and the exposure and attitudes of professional musicians towards manual therapy care.Methods: A critical narrative review using standardised assessment criteria to assess the methodological quality of a variety of relevant studies.Results: Manual therapy, chiropractic, massage and physiotherapy were commonly utilised. Self-help methods were frequently discussed. Female professional musicians tend to experience PRMD and consult health practitioners more frequently than their male colleagues. Negative attitudes exist toward treatment due to lack of practitioner understanding of musicians and little musician-specific healthcare knowledge, leading to unsatisfactory PRMD treatment and management. There is a culture of silence surrounding PRMD presence and pursuing treatment. There are positive attributes to treatment including satisfaction with some of the treatment received.Conclusion: Research presented mixed attitudes towards manual therapy, negativity was expressed when the musicians were faced with practitioners whom were lacking musician-specific experience. There are many different methods of interventions utilised by the music community. Manual therapy is not discussed exclusively. There is a suggestion for a multidisciplinary care as the most beneficial for the musician.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Thomas.pdf

Title:Exploring osteopaths’ aims and rationale for the use of Visceral Osteopathic TreatmentAuthor:Freyah TidswellBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Visceral osteopathy, Visceral Osteopathic Technique, Concepts Type of Publication:DissertationLevel of academic award:MScResearch design:InterviewPublication Date:2015Language:EnglishAbstract:Introduction: ‘Around 40% of people have at least one digestive symptom at any one time’. Visceral Osteopathic Techniques (VOTs) are actively used as treatment in the UK; for digestive conditions and musculoskeletal complaints. Due to the lack of research into VOT, the initial priority is to improve our understanding of the concepts and rationale that lead osteopaths to use these techniques.Methods: A qualitative study with semi-structured interviews was performed. Selective, then purposive samples of 597 osteopaths were invited to take part. Three chose to participate. A thematic analysis with elements of Grounded Theory was completed.Results: Six themes were drawn from the data. All themes were inter-related aims and reasons for the use of VOT. ‘Theories of integration’, the idea that the theories used were combined justify VOT, fed into ‘Accepting limitations’, ‘Simplistic holism’ and ‘Anecdotal evidence’, whilst these continued to feed into ‘Clinical reasoning’ along with ‘Patient orientation’. A model was developed to display these result.Conclusions: Osteopaths considered that visceral dysfunction plays a part in both abdominal complaints and more distal presentations. Three main theoretical models based on knowledge of the body and influenced by osteopathic concepts, were found to inform the decision to perform VOT. This was further informed by the interaction between the osteopaths’ beliefs of limitations to VOT use, patient orientation and the osteopath’s belief that using VOT displayed an improvement in patient symptoms.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Tidswell.pdf

Title:What are BSO students’ perceptions of the Hypermobility Syndrome?Author:Elly VanderplankBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:hypermobility, ehlers-danlos, chronic pain, osteopathy.Type of Publication:DissertationLevel of academic award:MScResearch design:QuestionnairePublication Date:2015Language:EnglishAbstract:OBJECTIVES: Discover British School of Osteopathy (BSO) students’ perceptions of Hypermobility Syndrome (HMS), and identify any discrepancies in knowledge base between year groups. Discover how BSO students rate their education on the subject of HMS.METHOD: 96 BSO students responded to a self-administered paper questionnaire concerning their perceptions of HMS. The first series of questions covered diagnostic criteria, treatment modalities and the nature of HMS itself .The second section focused on musculoskeletal symptoms, diagnosis, biopsychosocial issues, and forms of treatment. Students were also asked to rate how well they felt they had been educated in the subject.RESULTS: 70% of participants believed that HMS was a distinct entity, and 73% believed that Osteopathy/Acupuncture/Homeopathy was the best treatment method. There was no consensus on features required for diagnosis. Regarding their education on the subject, 95% of students reported that they had either been taught ‘Not very well’ or ‘Not taught at all.’CONCLUSION: Results indicated that more time should be allocated to the education on HMS, diagnosis and treatment. Student’s current knowledge of HMS seems to have come from hands-on clinical experience rather than lecture based study.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Vanderplank.pdf

Title:An exploration of the reasons influencing healthcare professionals to take a Kinesio Taping course, using a self-designed questionnaire in a purposive sample of Kinesio UK trainees.Author:Oliver Vimal de Saint PalBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Kinesio Taping, research, reasons, beliefs, knowledgeType of Publication:DissertationLevel of academic award:MScResearch design:QuestionnairePublication Date:2015Language:EnglishAbstract:Objectives: The aim of this study was to understand the influences on healthcare professionals choosing to take a Kinesio Taping (KT) course. A secondary aim was to find out if they were more strongly influenced by their own beliefs or knowledge of research in that decision.Methods: A self-designed questionnaire was distributed via hard copy to a purposive sample of 64 Kinesio UK trainees.Results: This study achieved a 91% response rate (n=58). 53 participants had a positive attitude towards KT’s effectiveness. The sample’s involvement in sporting activities was preponderant (n=47). 35 participants had positive feedback from their entourage concerning KT’s effectiveness and 34 reported personal interest as a reason to take the course. 36 participants were not aware of current research regarding KT and 34 had negative answers concerning the influence of research on their decision to take the course. However, a statistically significant association was found between the number of articles read regarding KT in the past year and the influence of current research on participants’ decision to take the course X_(2, N = 53) = 10.165, p<0.05.Conclusion: The results indicated that Kinesio UK trainees appeared to have been more strongly influenced by beliefs, interest in the topic and positive feedback from their entourage than by knowledge of research regarding KT. However, it seemed that despite insufficient evidence from current literature to incorporate the use of KT in practice, of those participants who were acquainted with KT literature, the greater their claimed knowledge of research, the more likely they were to take a course.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Vimal.pdf

Title:Assessment of the impact of recreational resistance training using free or machine weights on low back pain in a cross section of gym usersAuthor:Matthew WalkerBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:free and machine weights, core strengthening, resistance training, muscle strengthening, aetiology of low back painType of Publication:DissertationLevel of academic award:MScResearch design:cross-sectional surveyPublication Date:2015Language:EnglishAbstract:Background: The National Institute for Health and Care Excellence (NICE) clinical guidelines suggest inclusion of muscle strengthening activities for the early management of non-specific low back pain (LBP). Literature searches have indicated a lack of research into the effects of different forms of recreational resistance training (RRT) and their relationship with LBP.Method: A questionnaire was devised to query LBP features (pain severity/ duration, causal factors) together with other information including age, gender, nature of occupation, time spent in gym and other gym activities which aggravate LBP. Using these data a cross-sectional analysis was performed to investigate LBP problems experienced by gym members participating in RRT using either free (n=67) or machine weights (n=47). Results: RRT using machine weights showed a statistically significant difference in both the severity of LBP and duration of LBP when compared to the free weight group. In the machine weight group levels of job physicality and time spent in gym were associated with increased severity of LBP also a prolonged duration of LBP correlated with increasing age. These finding were not replicated in the free weight group. Conversely, free weight use appeared to be beneficial, a statistically significant correlation between time spent in gym and duration of LBP was observed. Specific forms of RRT activity were identified as aggravating LBP in participants from both RRT groups. Trends were noted but these differed between free and machine weight groups.Conclusion: This study has provided statistically significant evidence that RRT, in the form of machine weights, has a greater influence on LBP severity and duration, than has free weight activity. Although statistically significant, the observed findings do not allow for causal inferences to be made. The question as to whether specific forms of RRT are causative, or simply an aggravating factor to LBP, remains to be established.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Walker.pdf

Title:The relationship between tissue tenderness and pressure pain sensitivity measured by a digital algometer. A normative study of BSO students in the context of cervicogenic headache diagnosis.Author:Fredrick WellerBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:DIGITAL ALGOMETER HEADACHE STUDENTS STUDENTS AT BSO TISSUE TENDERNESS Type of Publication:DissertationLevel of academic award:MScResearch design:ExperimentPublication Date:2015Language:EnglishAbstract:Background: Cervicogenic headache is a secondary headache caused by dysfunction in the neck referring to the head, it is a common condition. Diagnosis is notoriously difficult. This study looks at one aspect of the physical examination used in diagnosis; the palpatory scanning for abnormal tissue texture and local tenderness. The prevalence of this key diagnostic signs in asymptomatic persons is not well studied; therefore this study looks at students at the British School of Osteopathy not suffering headaches.Methods: Thirty-three BSO students were included in the study (male n=15, female n=18). Three practitioners were used 2 >5 years clinical experience 1 = 4th year student. The practitioner assessed the neck searching in 4 quadrants of the neck of the candidate (supine) and noted any abnormal tenderness, a sign of dysfunction. The pressure pain threshold (PPT) was then measured (prone) for each candidate in each quadrant.Results: There was not a significant difference between the measured PPT of palpated abnormal tissue tenderness and palpated normal tissue tenderness. Using an adapted scoring system the more experienced practitioners performed better at locating areas that would have lower PPT. The prevalence of palpated abnormal tenderness was found in 50% of the quadrants (66 out of 132).Conclusion: Presence of tenderness in key areas of the neck should not be used as a stand alone criterion of cervicogenic headache due to the questionable accuracy and the high prevalence of tenderness in asymptomatic participants.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Weller.pdf

Title:Osteopaths’ attitudes to steroid injections to treat sports injuries and the role of osteopathic treatment and management.Author:David Wells.British School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Corticosteroids; Sport; Soft tissue injuries; Intra-articular injections; Treatment.Type of Publication:DissertationLevel of academic award:MScResearch design:cross-sectional surveyPublication Date:2015Language:EnglishAbstract:Objective: The aim of this cross-sectional survey was to analyse osteopaths’ opinions about the role of steroid injections in osteopathic treatment and patient management.Method: A random sample of 1,000 registered osteopaths were invited to complete an on-line questionnaire.Results: The majority of participants (91%) thought steroid injections could play a useful role in sports injury treatment and when other treatments were ineffective.A low prevalence of one to five referrals within the last six months was reported, with the main reasons being to decrease pain and inflammation. The most common sites for injection were the shoulder (94%), foot (36%), and lumbar spine (34%). Participants agreed that repeated injections were harmful and that there was a need to adapt osteopathic treatment appropriately. Participants who were also members of the Osteopathic Sports Care Association (OSCA) reported more positive views about the use of injections, which may be associated with treating more sports injuries.Conclusion: A high proportion of osteopaths in this study thought steroid injections can play a role in sports injury management, although referral rates were modest. Surprisingly few participants believed they were inconsistent with the principle of the body’s self-healing capacity but this may be due to response bias. There were some differing opinions between male and female osteopaths, which may warrant further investigation to assess the impact of practitioner beliefs on patient care choices.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Wells.pdf

Title:Osteopathic treatment for Headache: Patient expectations and experiences of treatment and management.Author:Gabrielle WhiteBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:“expectations”, “headaches”, “management”, “locus of control”, “diagnosis”Type of Publication:DissertationLevel of academic award:MScResearch design:InterviewPublication Date:2015Language:EnglishAbstract:Background: Headaches have been estimated to affect 47% of the world’s population (WHO, 2012). More and more patients are seeking osteopathic care for the treatment for their headaches (I.O., 2014). However there has been little research into the expectations of these patients concerning their osteopathic treatment.Objectives: This research aimed to investigate the expectations of headache patients who are under osteopathic care. The additionally goal was to assess whether these expectations changed due to patients treatment experience.Methods: This qualitative study conducted nine semi-structured interviews of patients at the British School of Osteopathy’s clinic who suffered from chronic headaches (intermittently headaches for more than three months). These interviews were analysed using Thematic Analysis with aspects of Grounded Theory.Results: Themes such as: expectations before and after treatment, expectation of diagnosis, management attitudes, importance of the practitioner and the time available in appointments were all developed from the data. Conclusions: This research suggests that patients expect their osteopaths to discuss: diagnosis of their headaches and management strategies in their appointment as well as hands on treatment. Therefore time accessible within the appointment is very important as it enables the practitioner the opportunity to fulfil all these expectations. Moreover participants recognised the importance of the patient practitioner relationship.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/White.pdf

Title:Exploring the potential for osteopathic intervention in the conservative management of haemophiliac arthropathy: A systematic narrative review.Author:Michael WilliamsBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Haemophilia; Von Willebrands; Manual Therapy; Conservative Management; Arthropathy.Type of Publication:DissertationLevel of academic award:MScResearch design:Systematic Narrative ReviewPublication Date:2015Language:EnglishAbstract:Background: The term Manual Therapy encompasses multiple hands-on therapeutic disciplines including physiotherapy and osteopathy. Manual therapy is commonly used alongside medical practices to assist human coagulopathy patients in the management of arthropathy (joint pathology). Juxtaposed with this is the prevailing advice that coagulopathy is an absolute contraindication to treatment for osteopaths.Objectives: Review the effectiveness of manual therapy interventions within haemophiliac patient populations relating to arthropathy.Design: Systematic narrative reviewMethods: PubMed, UoB databases and JOAO, Haemophilia and Blood journals were electronically searched (terms: table 4) between 01/02/2004 and 31/01/2014 following the PRISMA (Moher et al., 2009) guidelines. 285 articles were retrieved and exclusion criteria (table 5) applied. Validated tools were used to establish evidence of methodological quality, clinical relevance and strength of outcome.Results: Extracted data was analysed and synthesised with the results indicating a strong correlation between patient recovery, pain reduction, improved quality of life and manual therapy intervention.Conclusion: While data indicated patient benefit through manual therapy intervention the scope of intervention was significantly limited. Further research into other types of manual therapy intervention including osteopathy is recommended along with a clearer distinction between appropriate and inappropriate manual therapy techniques for haemophiliac patients.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Williams.pdf

Title:The effectiveness of prolotherapy as a treatment modality for knee osteoarthritis: A systematic reviewAuthor:Anna WylieBritish School of Osteopathy http://intranet.bso.ac.uk/library_info/ Will Podmore library@bso.ac.ukCountry:UKKeywords:Prolotherapy, Knee Osteoarthritis, Dextrose solution, Platelet Rich Plasma, treatmentType of Publication:DissertationLevel of academic award:MScResearch design:systematic reviewPublication Date:2015Language:EnglishAbstract:Objective: To review and appraise the methodological quality of existing research regarding the efficacy of prolotherapy (PT), including dextrose solution injections and PRP, in the treatment of knee osteoarthritis (OA). The intention is to determine recommendations based on best available evidence, which can be used by osteopathic practitioners.Design: Systematic ReviewMethods: A systematic computerised and hand literature search for randomised control trials (RCTs) in which prolotherapy was used as a treatment modality for knee OA. RCTs that met the inclusion criteria were evaluated for methodological quality and risk of bias using two validated assessment tools.Results: Eleven RCTs were identified as having met the inclusion criteria. The methodological quality ranged from high to low. Trends suggest that PT can improve symptoms associated with knee OA. However highly heterogeneous study design, outcome measures and intervention protocol make it very difficult to draw any sound conclusions of the efficacy of PT.Conclusion: The potential use of PT as a treatment modality for knee OA is of interest to any medical practitioner due to its theoretical regenerative capacity. Currently, without further trials to confirm standardised injection protocol, the use of PT should not be considered or clinically administrated.Hyperlink:http://opac.bso.ac.uk/library-e-stack/PROJECTS_2015_files/Wylie.pdf