Scientific articles on effects of Osteopathic treatments on stroke patients' rehabilitation ?

Hi,

I'm making research on the effectiveness of osteopathic treatments on stroke patients' rehabilitation. Do you have any references I could use ?

Thanks,

Aurore Barea.

Treatments: 364

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Permalink Reply by Roger Kingston on February 18, 2012 at 11:21pm

I have never seen any specific ones and suspect only the JAOA is the only place to look.

Prof Eyal Lederman would know, but he will probably tell you osteopathy has no role or a minimal role in affecting motor function.

Prof Kolar at the Prague School, using his DNS approach, does treat stroke with good results and is worth contacting via Dr Kobesova.  www.rehabps.com   As this is being taught in post grad osteopathy settings (ESO) it could now be classified as coming into the osteopathic remit.

Permalink Reply by Aurore Barea on February 24, 2012 at 2:28pm

Hi Roger,

Thank you for your answer ! I have searched the JAOA articles but unfortunately there is no specific articles on the effectiveness of stroke rehabilitation by Osteopathy.

As for Pr Kolar, DNS seems really interesting but it doesn't fit in my research as i want it to be centered on osteopathy and not other therapies. Anyway, it was really interesting for me to discover Pr Kolar approach and I will probably take time after this research to have more information on DNS.

I have found some of Pr. Lederman articles. I have to analyse them as english is not my mother tongue it takes some time. But as you have mentioned, Pr. Lederman doesn't think that Osteopathic treatment can improve motor function. I'm surprise about that result...

Did you already treat these kinds of patients ?

Thank you,

Aurore.

Permalink Reply by Small Fry on February 24, 2012 at 3:52pm

I would say that depends on what is meant by 'osteopathic treatment' and 'improve' in this context.  Also what we mean by rehabilitation and what would be deemed a good outcome.  However, the original question was what research is available about osteopathy in stroke rehabilitation, and there probably isn't a great deal more specifically on that.  That's not to say there won't be practitioners using osteopathy to good effect, just to say that to find out more probably means redefining the search.

Aurore Barea said:

I have found some of Pr. Lederman articles. I have to analyse them as english is not my mother tongue it takes some time. But as you have mentioned, Pr. Lederman doesn't think that Osteopathic treatment can improve motor function. I'm surprise about that result...

Permalink Reply by Roger Kingston on February 24, 2012 at 10:27pm

In context of stroke rehabilitation I suspect most of us mean return / rehabilitation of motor control.

From my understanding of Lederman - he says that passive osteopathic techniques will have no effect on motor function. He advocates that only active technique will have any effect - see his version of Neural Re"abilitation" technique.

I can not say I totally agree with him, but he has all the figures and references at his finger tips so arguing with him is pointless, but passive technique does have "in my humble opinion" massive effects upon physiology and function.

Kolar and most of Eastern Europe use the DNS protocols for stroke and neurological rehab and get good results but it is not a miracle cure and needs lots of hard work.

Permalink Reply by indikate on February 25, 2012 at 10:19pm

I regard stroke patients from an osteopathic perspective as I am comforted that they will not be suffering a deficit of medical attention.

This is vascular disease. They need vit C and D3 (familiar song?) This helps with the adventitia media and collagen formation.

They will be suffering systemic shock (palpable in the tissues)

They will have aberrent patterns to the norm on palpation of the field-like effect around the cranium which to my imagination may be something to do with brain physiology.

Different post grad courses teach very well a variation on what i am about to nutshell. Some refer to it as the spark in the motor, ignition, the breath of life (realists will argue that these are different) but what it boils down to for written purposes is the sense of something like a light moving from the ccx to lamina terminalis and vitalising all the fluids and tissues as it goes.

This can work alongside any other physical therapy the ptn may choose inc neuro-rehab etc and just requires mentoring to learn once you have a sense of subtle motion. It is useful for lots of patients esp. those presenting with CNS sympt.

 

Permalink Reply by Small Fry on February 26, 2012 at 2:07pm

If we're trying to 'make them better' - by using a favourite technique in which you have embedded your osteopathic identity - then no, there's not a lot that can be done.  On the other hand, if we're trying to promote the conditions for an optimum recovery, then there's loads.  Just stop thinking about the rocket science and a world of opportunity unfolds.

If a person is static in a chair due to impairment, and you offer passive movement to stir the circulation, how can that not improve the situation?  Have you seen what people in an NHS rehab centre are given to eat and drink?  Do something about that.  What about initiation and motivation?  Sometimes that needs to come from outside to keep the person from giving up.

Remember that recovery from a stroke is not just about reprogramming a computer, there is also spontaneous physical recovery of affected tissues as well.  But recovery can be working against incredible odds at times, and that is something we may be able to change.  The requirement for all the basic necessities of health are not in any way reduced following a stroke, but they may become even more unobtainable for the patient.

Simple things like a call-buzzer always out of reach, dehydration, uncomfortable clothing, a personal interest not fulfilled, or being catheterised instead of toileted, may be enough to turn success into failure.  Do you want to deal with these things?  Maybe not, but they are certainly 'osteopathic' considerations.

And if the conditions that led to the stroke remain, then nerves and blood vessels will be slow to heal, immunity will be compromised, inflammation will be inefficient, etc etc.  The chances are that there will be a high dependency on pharmaceuticals.  And on top of all that, repeat episodes will always be a possiblity.

D.O. means DO what you can to make the situation better.

Permalink Reply by Patrick Morgan on February 27, 2012 at 2:43pm

Hi Aurore

I work for a stroke charity and I am also an osteopath, I agree with Roger and Prof Lederman that you will have to widen your search to beyond the current scope of osteopathic concepts and techniques, stroke rehabilitation is post graduate health professional specialists work. There are 1 million stroke survivors in the UK and it is the 2nd largest cause of disability. The best outcomes for stroke survivor's require a multidisciplinary approach including medics, physiotherapists, speech therapists, occupational therapists, social services, community services, family support etc...Many of the services used by stroke survivors in the community are patient led so if an individual feels that osteopathy could or has improved their well-being then that practitioner can become a part of their management but only within this multidisciplinary context. You might consider doing a survey of osteopaths who have treated stroke survivors to find out how they feel they have improved the health of their patient? what approaches they used? and how they measured the outcome? Go to http://www.stroke.org.uk/ for lots of information about stroke...

Permalink Reply by Small Fry on February 27, 2012 at 3:06pm

Alternatively, you could elect not to narrow your scope of concepts and techniques to what Prof Lederman thinks makes for good research.

Permalink Reply by indikate on February 27, 2012 at 3:39pm

Hi Patrick
Where do you think osteopathy's limitations lie in regard to stroke patients?
Patrick Morgan said:

Hi Aurore

I work for a stroke charity and I am also an osteopath, I agree with Roger and Prof Lederman that you will have to widen your search to beyond the current scope of osteopathic concepts and techniques, stroke rehabilitation is post graduate health professional specialists work. ...

Permalink Reply by Patrick Morgan on February 27, 2012 at 5:42pm

Hi Indikate

I fully respect your invitation to debate with the question you have posed but I tend to not to think within that type of conceptual framework. But as I have already said with stroke patient's improved health outcomes come from a multidisciplinary approach (medical / allied health professionals) there will also be patient led multi-agency approaches which, could include community stroke services, osteopathy, acupuncture etc...Certainly if an osteopath has an interest in specifically rehabilitating neurological and motor function in stroke patient's then they can always attend the relevant further post graduate training.

Permalink Reply by indikate on February 27, 2012 at 7:24pm

Hi Patrick
So sorry to have phrased my question in a different type of conceptual framework.

 I was interested in your assertion that stroke patients rehab. is "beyond the current scope of osteopathic concepts and techniques". I would be interested to read your opinion regarding this statement
Patrick Morgan said:

Hi Indikate

I fully respect your invitation to debate with the question you have posed but I tend to not to think within that type of conceptual framework. But as I have already said with stroke patient's improved health outcomes come from a multidisciplinary approach (medical / allied health professionals) there will also be patient led multi-agency approaches which, could include community stroke services, osteopathy, acupuncture etc...Certainly if an osteopath has an interest in specifically rehabilitating neurological and motor function in stroke patient's then they can always attend the relevant further post graduate training.

Permalink Reply by Patrick Morgan on February 27, 2012 at 8:14pm

Hi Indikate

Stroke and its immediate rehabilitation where response time, surgery, pharmaceuticals and expensive rehab apparatus are crucial is treated very successfully under the medical model and this has led to thousands of stroke survivors. Stroke and cardiovascular disease prevention at the moment is a high priority and many Public Health local and national initiatives have been rolled out using health promotion theory, community outreach programs bring together a number of services to improve the health and well-being of stroke survivors, stroke incidence has declined although it remains stubbornly high in some populations. This demonstrates to me at least that a wide range of health and social welfare models and practices are required to successfully manage stroke patients. Certainly IMO osteopathic health models have a place but just like any another health model it has both conceptual and practical limitations, a practitioner would need to address those limitations and or become part of a multidisciplinary effort to safely practice among some patient demographics. So if I had a stroke I hope someone dials 999 pronto but when I leave hospital and go back into the community I would be delighted to have the services of an osteopath I wouldn't mind if my neu

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