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Merge it. Donaldal 18:20, 19 May 2006 (UTC)
OMM its its own treatment modality, like "radiation therapy" or "acupuncture." What would you merge it with? Touro Osteopathic Freak T 03:50, 26 July 2007 (UTC)
That's not what they teach at Texas College of Osteopathic Medicine... citation? I'm changing to DO, MD without further proof. Reid Sullivan ( talk) 23:24, 18 November 2008 (UTC)
I added the reference for this problem and changed the order of degrees to the way it is listed in all other literature. Redrok84 ( talk) 19:46, 15 April 2009 (UTC)
Traditionally, OMM has stood for "osteopathic manipulative medicine." However, it is becoming more fashionable by some institutions (my own, Des Moines University, being one of them) to begin referring to it as "Osteopathic MANUAL medicine," merely to avoid the connotations associated with the word "manipulative." A simple Google search of the term should demonstrate its prevalence. I would like to propose that this term supplant the old term in this article, if anyone else would agree to its usefulness? —Preceding unsigned comment added by 71.61.204.168 ( talk) 05:59, 25 May 2010 (UTC)
As an allopathic medical student who is not well-versed in this discipline, I am curious to see how much of OMM is backed up by randomized clinical trials and other solid evidence. Can anyone provide some content on specifics of therapy and what has been demonstrated to work vs. sham OMM as a control? Bobsagat ( talk) 20:07, 30 March 2011 (UTC)
Look into the August 2005 issue of the BMC Musculoskeletal Disorders, which features an article entitled "Osteopathic Manipulative Treatment for Low Back Pain: a Systematic Review and Meta-Analysis of Randomized Controlled Trials," by John C. Licciardone, DO, and colleagues. This article summarizes the results of clinical trials suggesting the potential utility of OMT in both acute and chronic low back pain. Another article of note is "Nonpharmacologic Therapies for Acute and Chronic Low Back Pain: A Review of the Evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline," by Roger Chou, MD, and Laurie Hoyt Huffman, MS. This article from the October 2007 issue of Annals of Internal Medicine cites evidence for efficacy of spinal manipulation in treating low back pain. In addition, a 1999 study in The New England Journal of Medicine shows OMT to be an effective form of medical treatment for low back pain. In this study, participants were divided into 2 groups: 1 treated with standard care for low back pain and the other treated with standard care and OMT. While both groups showed improvement over a 12-week period, the patients who received OMT required significantly less medication and used less therapy. — Preceding unsigned comment added by 65.28.249.2 ( talk) 22:26, 25 July 2011 (UTC)
A list of commonly used OMM techniques and accompanying descriptions of each respective technique as well as the body of evidence for each technique, whether absent, limited, or substantial would make this article more complete and would be a great addition. — Preceding unsigned comment added by DoctorK88 ( talk • contribs) 17:42, 2 September 2011 (UTC)
Myofascial release isn't limited to D.O. practitioners. Hands-on Physiatrist MDs proably utilize the technique and I know for sure that Physical Therapists do. Since it isn't limited to DOs, why is mentioned here with no reference to other, non-DO practitioners? What techniques ARE limited to DOs? Yours, Wordreader ( talk) 21:09, 19 November 2011 (UTC)
There are far more OMM techniques than the ones currently explained on this page. More of them should be added with accurate citations to make this article more complete. — Preceding unsigned comment added by DoctorK88 ( talk • contribs) 06:39, 9 January 2012 (UTC)
A section that briefly explains when OMM/OMT techniques are not indicated would be a useful addition to this article and would make it more complete. TylerDurden8823 ( talk) 06:03, 14 March 2012 (UTC)
The introduction to this article should probably be re-written. I might do it myself at some point in the future, but at the moment I don't feel well versed enough with OMM to do so.
The introduction is confusing, potentially biased, and contains citations that don't prove the assertions they are cited as evidence for. OMM is classified as a "generally ineffective" therapy, with two citations listed as evidence. However, one of those citations makes no determinations, and rather concludes that the evidence and sample size limits any conclusions about effectiveness (the review contained references to studies that found OMM effective as well as ineffective). The second citation about OMM's ineffectiveness is a single study examining OMM's effect on a single respiratory disorder. Additionally, OMM has been found to be effective for treating back pain, and a citation is listed for that as well. Is OMM a "generally ineffective" therapy if it is found to be effective for one ailment and ineffective for another? I wouldn't suggest antidepressants are a "generally ineffective" therapy because they have limited effectiveness when treating things other than depression. Furthermore, can research ever find anything to be "ineffective?" You can't prove a negative. Researchers have failed to find significant evidence to merit OMM's use as a therapy for certain disorders. This might be splitting hairs, but I feel like this article is ripe of pre-med sniping (med students and docs are probably too busy to make poorly worded passive aggressive edits.
The intro also concludes by saying "some critics call OMM pseudoscience." Well who are these critics? Why do we care? There's a link, but it's to a 15 year old pub-med article that isn't even there. Maybe it's behind a paywall. But again, why do we care what critics have said? Who are these critics? Critics of conventional medicine call MDs corporate tools who exist solely as an arm of the pharmaceutical companies. But those critics are crazy hippies, so we ignore them. You can find critics of anything, and the existence of critics alone proves nothing. It's just a way for a lazy editor to take a swipe at OMM without sifting through scientific literature.
This intro is probably the first thing most internet users will see when researching OMM and deciding whether its right for them. And it should be honest about the pros and cons of the therapy. Readers should understand D.O.s aren't idiots - OMM is definitely effective for some disorders - but at the same time, as with any alternative therapy, practitioners often make ridiculous claims about the extent of OMM's effectiveness.
I made a couple edits that I think makes the intro slightly better, I hope nobody objects. Really, it should probably say something like:
"Although studies have demonstrated OMM's effectiveness for treating back pain, (citation) practitioners often claim OMM can treat a variety of ailments that conventional medicine does not generally associate with manual therapies (citation). Studies into OMM's effect on respiratory disorders, viral infections, and asthma (etc) have failed to find significant evidence that OMM is effective for treating these ailments (Citation). The discrepancies between these studies and the claims made by certain practitioners have led critics to call OMM a pseudoscience" (citation that actually works).
TL;DR: This article sucks. We should fix it in a way devoid of broken links and internet douchebaggery, and just present the facts as currently understood by science. If I've got persistent back pain, OMM might be a good alternative to painkillers. If I have allergies, OMM is probably a stupid idea. This should come across immediately, without any MD/DO politicking or unnecessary swipes. — Preceding unsigned comment added by 67.164.210.210 ( talk) 04:03, 5 November 2013 (UTC)
I don't necessarily disagree about mentioning pseudoscience, but I think it could be done more effectively, or at least be better cited. I think that ideally it would be clear that elements of OMM have been demonstrated to be effective. However, practitioners make unreasonable claims about the scope of its effectiveness, and this is why it is considered pseudo-scientific. I tried to convey that with my minor edits, but I didn't add or remove any thoughts, I just reworded the existing view. (I would want to do research before I actually change anything). What I don't know is if there are other conditions that OMM has been found to alleviate. If it's effective for back pain, is it effective for neck pain? Is it effective for shoulder pain? For headaches caused by neck or shoulder pain? The way it's written now (before and after my edit) says it's ineffective for everything other than back pain, but our citations don't really support such a broad condemnation.
Thanks for replying so quickly and constructively. A rarity on the internet, it seems. Especially to non-user editors. I wonder if the "reception" category should be changed to "criticism?" The Chiropractic article has a section entitled "Controversy and Criticism" as the last section on the page. Since everything currently listed in the "reception" section is negative, that might make it more clear. 67.164.210.210 ( talk) 10:09, 5 November 2013 (UTC)
Alexbrn talk| contribs| COI 10:19, 5 November 2013 (UTC)
Oh, no problem with the links. I need them, thanks, I'm not an experienced wiki editor. And we may not need tons of sources in the intro, but the main citation that states OMM is pseudoscience in the body of the article is the same dead link as the introduction. It's referenced about five times. The page you linked me to regarding fringe theories states "And for writers and editors of Wikipedia articles to write about controversial ideas in a neutral manner, it is of vital importance that they simply restate what is said by independent secondary sources of reasonable reliability and quality." But there's no way to verify the reliability or quality of the source material if we can't check it. I'll defer to your judgement for now. In the future if I do the research, I might suggest some rewrites. I think in a perfect world we'd have a bunch of journal reviews of OMM research to cite. It looks like there are already a couple. I think I would like to see an expanded research section, so that the majority of criticism in the article is directly sourced to research, as opposed to secondary sources complaining.
I'm pretty busy right now though, I'll run any change ideas by the "talk" page, once I have some new sources. Thanks for the links. Why are the chiro articles renown for terribleness? — Preceding unsigned comment added by 67.164.210.210 ( talk) 23:44, 5 November 2013 (UTC)
I would like to hear from others if they think the section heading currently labeled as effectiveness is better that way or if research was a better section heading. Please weigh in, thanks. Alex, I already know where you stand on this issue obviously since it was your edit. It's definitely okay if you want to add your opinion, but I'm curious to hear from others. TylerDurden8823 ( talk) 06:19, 7 February 2014 (UTC)
Osteopathic manual therapy is claimed to be useful for treating a wide range of conditions, from pancreatitis to Parkinson's disease, sinusitis, and asthma
What else has OMT been claimed to treat? Alexbrn talk| contribs| COI 02:05, 8 February 2014 (UTC)
It's as fringe as it gets, and WP:FRINGE applies (as well as discretionary sanctions since we're editing a pseudoscience topic). We have many sources in agreement on that. It's certainly startling that practitioners claims that prodding the body can treat things like cerebral palsy, isn't it? Ernst seems to think so ...
A lede is meant to summarize the body. That's what we have, without the source misrepresentation your edit introduced (see my response at WT:MED). For the Ernst blog post, I was engaging in the conversation here on Talk - particularly the idea the OMT is merely "unproven". Alexbrn talk| contribs| COI 21:54, 9 February 2014 (UTC)
Now, moving on to the actual topic of importance at hand-saying the sentence has a plain meaning is missing the point. That's your interpretation, not everyone's. It can be interpreted in multiple ways. My point is that it is ambiguous to a general reader and therefore needs to be more specific. Given that you have displayed a staunch anti-OMT bias on numerous occasions (in my opinion your treatment of the subject has not seemed neutral), the way the sentence is currently written sounds like you were attempting to use it to imply what I mentioned earlier-that OMT being characterized as pseudoscience is not just a past view-but the prominent one today. Whether that's true today, I cannot say with absolute certainty. What I can say is that the referenced articles after the sentence do not say that in any way, shape, or form. If my assumptions about what you were trying to imply were unfounded or incorrect and that's not what you're trying to say (or not for that reason), then you should be amenable to rephrasing the sentence so it is clearer for all. If there are any objections to my following proposal, please explain what the precise objection(s) would be to rephrasing the sentence in the following way. Just as a rough example, saying something to the effect of: "Critics of OMT characterized it as pseudoscience for decades after its creation (or OMT was characterized as pseudoscience for many decades after its creation). Today, certain critics such as Stephen Barrett and Bryan Bledsoe have echoed such criticisms. In recent years, skepticism about the use of OMT for non-musculoskeletal conditions has persisted and has often been cited as a major obstacle preventing more widespread acceptance of the techniques. (Referring to Jordan Cohen's statement which is quoted in the body). Etc. etc. You get the idea. It's still a brief summary, faithful to the sources (if not, show me precisely how this deviates from them), and discusses what is in the body of the article. Such a revision, from my perspective, makes the perception of OMT clearer by separately specifying past views and current views. TylerDurden8823 ( talk) 08:12, 10 February 2014 (UTC)
Added Template:dubious to sentence in lede "(OMM)...is the core technique of osteopathic medicine." This is certainly not the whole truth, since North American DO's study (in addition to OMM) the exact same things as MD's & have same scope of practice in all 50 states. We can't just rely on the one source given; that's highly misleading and a bit POINT-y. -- Middle 8 ( leave me alone • talk to me • COI) 23:00, 20 February 2014 (UTC)
Okay, so if "osteopathic medicine" confuses Americans, let's call it "osteopathy" to be less ambiguous (done). I don't think we should dwell on DOs here, OMT training of DOs is covered in the DO article. Alexbrn talk| contribs| COI 04:56, 22 February 2014 (UTC)
I have moved here text that was recently added to the article:
A 2014 systematic review and meta-analysis found low quality evidence to support the use of strain/counterstrain for short-term relief of tender point palpation pain.
sourced to
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)Is this a WP:FRIND? I note too the journal doesn't appear to have an impact factor and the article used is not (yet anyway) MEDLINE indexed. Alexbrn talk| contribs| COI 09:28, 27 April 2014 (UTC)
I see nothing on the WP:MEDRS page at all that says a journal must be (or should be) high impact to be considered for inclusion on Wikipedia as a reliable source. Where are you getting this criterion from exactly? The only mention of anything even close to this statement is that ideal sources are from "reputable medical journals" and as far as I can see this journal doesn't have a substantial reputation, but I have not come across any materials referencing this journal as "fringe". As for the WP:FRIND part, this certainly seems like an independent source, not sure where the doubt about that is coming from. The lead author is a PhD, PT, OCS from Columbia University while the other authors are from the physical therapy program also at Columbia University. Study was funded by the NIH and National Center for Advancing Translational Sciences and this information is readily visible in the acknowledgements section of the paper. TylerDurden8823 ( talk) 18:12, 27 April 2014 (UTC)
I attempted to add reasonable information (one sentence) from a 2014 secondary source (systematic review and meta-analysis) from a PubMed source, from a journal that is MEDLINE indexed (if we must wait for the article itself to be MEDLINE indexed, as I said earlier, there is no objection to that), and reasonably restated their findings in the evidence section. You seem determined to prove that OMT does not work, but I have added information that shows positive, neutral, and negative results showing that I have approached this in a balanced/neutral way. I have often said (when there was disagreement) that we should directly quote the article in question to sidestep the issue of disagreements in interpretation, but you have rebuffed such offers in favor of your own view. Much of the content that you have added that I do not agree with remains, but it is unreasonable that each and every single edit that I put on here must be discussed on the talk page first. Even minor edits that I do seem to be reflexively objected to or reverted. I do not have any WP:OWN issues, I do not prevent other editors from writing on this page nor have I claimed anyone is "ruining my work" or anything to that effect. So, I will have to say no to WP:KETTLE. You're comparing apples to oranges. I think what you are correct about is that we need more eyes on this article. TylerDurden8823 ( talk) 19:13, 27 April 2014 (UTC)
Unless and until you are prepared to declare all surgery (or oncology, or physics, or whatever else) journals to be non-independent with respect to their specialization, then you cannot declare that all altmed journals are non-independent with respect to their specializationbut is that not the very embodiment of the WP:GEVAL fallacy? There is an essential difference between the top physics journal and the top homeopathy journal, precisely because of the field in which they publish: one is not mainstream, and so is where WP:FRINGE guidance applies. So far as I can see, the field of Bodywork (alternative medicine) is a umbrella term for a area which contains a number of nonsensical things (e.g. Bates method and reflexology). Any claimed health benefits deriving from these things is extraordinary and needs strong sourcing. Sure we can use potentially biased sources, but we would make that potential bias clear and take weight into account. Alexbrn talk| contribs| COI 05:16, 28 April 2014 (UTC)
According to our content guideline on identifying reliable sources, a reliable source has the following characteristics:
- It has a reputation for fact-checking and accuracy.
- It is published by a reputable publishing house, rather than by the author(s).
- It is "appropriate for the material in question", i.e., the source is directly about the subject, rather than mentioning something unrelated in passing.
- It is a third-party or independent source, with no significant financial or other conflict of interest.
- It has a professional structure in place for deciding whether to publish something, such as editorial oversight or peer review processes.
The sources used in the lede are of poor quality and seem to characterizing the entirety of OMT/CMT as pseudoscience. Are these really the type of sources that we use to label a whole therapeutic intervention? That seems like a sweeping generalization to me, and it seems like there's a better categorization out there. DVMt ( talk) 21:22, 16 May 2014 (UTC)
INTRO _________
"Research into OMM has generally not found it to be an effective therapy.[3][4][5] Some critics have characterized it as pseudoscience.[6][7][8]"
?Research into OMM has generally not been able to prove with certainty whether or not it is an effective therapy since it is very difficult to study manual therapies. Some research studies have found OMM to be effective while others have not. Some critics have characterized it as pseudoscience but OMM has many advocates in the medical community"
The old text is very misleading. Research hasn't generally found it to be an effective therapy but it also has not proved it to be an ineffective therapy. This is a technicality in the way scientific reviews are written and the wording of the original text will lead visitors to believe that OMM is ineffective. The new text is a much more accurate way of descriving the current state of the research. This can be verified at http://www.med.nyu.edu/content?ChunkIID=37409#evidence.
EFFECTIVENESS ____________ Added this additional research information on OMM. The original text includes only studies that are outdated and only one view of a topic with two sides.
"In a study of 183 people with neck pain, use of osteopathic methods provided greater benefits than standard physical therapy or general medical care. Participants receiving OMT showed faster recovery and experienced fewer days off work. OMT appeared to be less expensive overall than the other two approaches; however, researchers strictly limited the allowed OMT sessions, making direct cost comparisons questionable. Another study evaluated a rather ambitious combined therapy for the treatment of chronic pain resulting from whiplash injury (craniosacral therapy along with Rosen Bodywork and Gestalt psychotherapy). The results failed to find this assembly of treatments more effective than no treatment. [2] [3]
In a 14-week, single-blind study of 29 elderly people with shoulder pain, real OMT proved more effective than placebo OMT. Although participants in both groups improved, those in the treated group showed relatively greater increase in range of motion in the shoulder. And, in a larger study of 150 adults with shoulder complaints, researchers found that adding manipulative therapy to usual care improved shoulder and neck pain at 12 weeks. [4]
In a small randomized, placebo-controlled trial researchers used oscillating-energy manual therapy, an osteopathic technique based on the principle of craniosacral therapy, to treat 23 subjects with chronic tendonitis of the elbow (tennis elbow or lateral epicondylitis). Subjects in the treatment group showed significant improvement in grip strength, pain intensity, function, and activity limitation due to pain. These results however, are limited by the small size of the study and the fact that the therapist delivering the treatment could not be blinded. [5]
Twenty-four women with fibromyalgia were divided into five groups: standard care, standard care plus OMT, standard care plus an educational approach, standard care plus moist heat, and standard care plus moist heat and OMT. The results indicate that OMT plus standard care is better than standard care alone, and that OMT is more effective than less specific treatments, such as moist heat or general education. However, because this was not a blinded study (participants knew which group they were in), the results can’t be taken as reliable. In another study, 93 women (average age 53) with fibromyalgia were randomized to receive sham treatment or craniosacral therapy (one-hour sessions twice a week for 20 weeks). The women in the craniosacral therapy group experienced a decrease in pain at 20 weeks, which persisted for at least one year. In another randomized trial, 94 people with fibromyalgia received either myofascial release or sham therapy for 40 sessions (20 weeks). 21 At the 6-month follow-up, the people in the treatment group reported less pain and more physical ability. But, only some of these results lasted until the 1-year follow-up. [6]
A study of 28 people with tension headaches compared one session of OMT against two forms of sham treatment and found evidence that real treatment provided a greater improvement in headache pain. A small randomized controlled trial with 63 patients compared two myofascial release techniques to a control group. Myofascial release treatments resulted in fewer headaches for the 4-week trial period compared to the control group. [7] [8]
OMT has shown some promise for the treatment of back pain, including a randomized trial of 455 patients. The trial assessed the effects of 6 OMT sessions over 8 weeks compared to sham treatments. At 12 weeks, OMT was associated with moderate or substantial pain reduction compared to sham OMT. OMT also reduced the use of prescription pain medications. However, one of the best-designed trials failed to find it a superior alternative to conventional medical care. In this 12-week study of 178 people, OMT proved no more effective than standard treatment for back pain.6 Another study, this one enrolling 199 people and following them for 6 months, failed to find OMT more effective than fake OMT. This study also included a no-treatment group; both real and fake OMT were more effective than no treatment. A much smaller study reportedly found that muscle energy technique enhances recovery from back pain, but this study does not appear to have used a meaningful placebo treatment. [9] [10] [11]
Researchers analyzed 4 studies investigating the benefits of manual therapy (including massage therapy, joint mobilization, and manipulation) for osteoarthritis of the hip or knee. The results were inconclusive. Although one of the studies (involving 68 people) did find that massage therapy helped to improve pain and function, it was compared to no intervention rather than another treatment or a placebo. [12]
Some studies have evaluated the potential benefits of OMT for speeding healing in people recovering from surgery or serious illness. The best of these studies compared OMT against light touch in 58 elderly people hospitalized for pneumonia. The results indicate that use of osteopathy aided recovery. [13]
OMT showed improvement in 6-minute walk test distance in a small randomized trial of 20 patients with stable chronic obstructive pulmonary disease. Distance in patients in the OMT group improved on average by 72.5 meters compared to 23.7 meters for patients in the sham OMT group. [14]
In 2013, a Cochrane Review reviewed six randomized controlled trials which investigated the effect of four types of chest physiotherapy (including OMT) as adjunctive treatments for pneumonia in adults and concluded that "based on current limited evidence, chest physiotherapy might not be recommended as routine additional treatment for pneumonia in adults." [15] A 2013 systematic review of the use of OMT for treating pediatric conditions concluded that its effectiveness was unproven. [16]
A small study found some evidence that OMT might be helpful for childhood asthma. [17]?
201.229.95.34 ( talk) 03:00, 22 June 2014 (UTC) 6/21 - Stephen F., D.O.
References
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cite journal}}
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Alexbrn, please explain the grounds for your revert. Your objection to the rewrite seems to be nothing more than stylistic and I don't think that's adequate cause for the revert (especially without a constructive counterproposal and just a simple revert). I left a very clear edit summary explaining the reason for the change: "More accurate-should not generalize and instead specifically state that some/certain practitioners use it for conditions such as asthma or PD." The point of this edit was to clarify that not all practitioners of OMT use it in this manner and that the application of OMT in this manner is likely done by a small minority.
Your objection to this initial edit per your edit summary (here [3]) was about tense. I responded by correcting the tense in my original edit while maintaining the wording correction. Therefore, I see no grounds for your reversion unless you're changing your tune about why you objected. This feels extremely nitpicky and like you are unable to collaborate with me on the simplest/most minor of changes and that's rather disheartening. The meaning has not been changed at all except to be more specific in saying that only certain practitioners apply OMT in this way. Can you seriously say that's not a fair statement? If so, please explain how so with specific quantitative evidence to support your position. Additionally, the claim of "clunky" seems rather absurd since it's only a few words. It's really more helpful to suggest alternate wording instead of what's already there (I think it can be improved upon though perhaps you don't think so). As written, this sentence can be interpreted to mean that all OMT practitioners "sometimes" use these techniques in this way and that is an inaccurate statement. Only certain practitioners use it in this way (in reality this is likely a rather small minority). Do you have suggestions for alternate wording to avoid this issue? If so, I am open to a dialogue and I hope you are open to a collaborative dialogue as well. TylerDurden8823 ( talk) 06:26, 18 December 2014 (UTC)
This is the
talk page for discussing improvements to the
Osteopathic manipulation redirect. This is not a forum for general discussion of the article's subject. |
Article policies
|
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
This redirect does not require a rating on Wikipedia's
content assessment scale. It is of interest to the following WikiProjects: | ||||||||||||||||||||||||||||
|
Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Osteopathic manipulation.
|
The
contentious topics procedure applies to this page. This page is related to
pseudoscience and
fringe science, which has been
designated as a contentious topic. Editors who repeatedly or seriously fail to adhere to the purpose of Wikipedia, any expected standards of behaviour, or any normal editorial process may be blocked or restricted by an administrator. Editors are advised to familiarise themselves with the contentious topics procedures before editing this page. |
Arbitration Ruling on the Treatment of Pseudoscience In December of 2006 the Arbitration Committee ruled on guidelines for the presentation of topics as pseudoscience in Wikipedia:Requests for arbitration/Pseudoscience. The final decision was as follows:
|
Merge it. Donaldal 18:20, 19 May 2006 (UTC)
OMM its its own treatment modality, like "radiation therapy" or "acupuncture." What would you merge it with? Touro Osteopathic Freak T 03:50, 26 July 2007 (UTC)
That's not what they teach at Texas College of Osteopathic Medicine... citation? I'm changing to DO, MD without further proof. Reid Sullivan ( talk) 23:24, 18 November 2008 (UTC)
I added the reference for this problem and changed the order of degrees to the way it is listed in all other literature. Redrok84 ( talk) 19:46, 15 April 2009 (UTC)
Traditionally, OMM has stood for "osteopathic manipulative medicine." However, it is becoming more fashionable by some institutions (my own, Des Moines University, being one of them) to begin referring to it as "Osteopathic MANUAL medicine," merely to avoid the connotations associated with the word "manipulative." A simple Google search of the term should demonstrate its prevalence. I would like to propose that this term supplant the old term in this article, if anyone else would agree to its usefulness? —Preceding unsigned comment added by 71.61.204.168 ( talk) 05:59, 25 May 2010 (UTC)
As an allopathic medical student who is not well-versed in this discipline, I am curious to see how much of OMM is backed up by randomized clinical trials and other solid evidence. Can anyone provide some content on specifics of therapy and what has been demonstrated to work vs. sham OMM as a control? Bobsagat ( talk) 20:07, 30 March 2011 (UTC)
Look into the August 2005 issue of the BMC Musculoskeletal Disorders, which features an article entitled "Osteopathic Manipulative Treatment for Low Back Pain: a Systematic Review and Meta-Analysis of Randomized Controlled Trials," by John C. Licciardone, DO, and colleagues. This article summarizes the results of clinical trials suggesting the potential utility of OMT in both acute and chronic low back pain. Another article of note is "Nonpharmacologic Therapies for Acute and Chronic Low Back Pain: A Review of the Evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline," by Roger Chou, MD, and Laurie Hoyt Huffman, MS. This article from the October 2007 issue of Annals of Internal Medicine cites evidence for efficacy of spinal manipulation in treating low back pain. In addition, a 1999 study in The New England Journal of Medicine shows OMT to be an effective form of medical treatment for low back pain. In this study, participants were divided into 2 groups: 1 treated with standard care for low back pain and the other treated with standard care and OMT. While both groups showed improvement over a 12-week period, the patients who received OMT required significantly less medication and used less therapy. — Preceding unsigned comment added by 65.28.249.2 ( talk) 22:26, 25 July 2011 (UTC)
A list of commonly used OMM techniques and accompanying descriptions of each respective technique as well as the body of evidence for each technique, whether absent, limited, or substantial would make this article more complete and would be a great addition. — Preceding unsigned comment added by DoctorK88 ( talk • contribs) 17:42, 2 September 2011 (UTC)
Myofascial release isn't limited to D.O. practitioners. Hands-on Physiatrist MDs proably utilize the technique and I know for sure that Physical Therapists do. Since it isn't limited to DOs, why is mentioned here with no reference to other, non-DO practitioners? What techniques ARE limited to DOs? Yours, Wordreader ( talk) 21:09, 19 November 2011 (UTC)
There are far more OMM techniques than the ones currently explained on this page. More of them should be added with accurate citations to make this article more complete. — Preceding unsigned comment added by DoctorK88 ( talk • contribs) 06:39, 9 January 2012 (UTC)
A section that briefly explains when OMM/OMT techniques are not indicated would be a useful addition to this article and would make it more complete. TylerDurden8823 ( talk) 06:03, 14 March 2012 (UTC)
The introduction to this article should probably be re-written. I might do it myself at some point in the future, but at the moment I don't feel well versed enough with OMM to do so.
The introduction is confusing, potentially biased, and contains citations that don't prove the assertions they are cited as evidence for. OMM is classified as a "generally ineffective" therapy, with two citations listed as evidence. However, one of those citations makes no determinations, and rather concludes that the evidence and sample size limits any conclusions about effectiveness (the review contained references to studies that found OMM effective as well as ineffective). The second citation about OMM's ineffectiveness is a single study examining OMM's effect on a single respiratory disorder. Additionally, OMM has been found to be effective for treating back pain, and a citation is listed for that as well. Is OMM a "generally ineffective" therapy if it is found to be effective for one ailment and ineffective for another? I wouldn't suggest antidepressants are a "generally ineffective" therapy because they have limited effectiveness when treating things other than depression. Furthermore, can research ever find anything to be "ineffective?" You can't prove a negative. Researchers have failed to find significant evidence to merit OMM's use as a therapy for certain disorders. This might be splitting hairs, but I feel like this article is ripe of pre-med sniping (med students and docs are probably too busy to make poorly worded passive aggressive edits.
The intro also concludes by saying "some critics call OMM pseudoscience." Well who are these critics? Why do we care? There's a link, but it's to a 15 year old pub-med article that isn't even there. Maybe it's behind a paywall. But again, why do we care what critics have said? Who are these critics? Critics of conventional medicine call MDs corporate tools who exist solely as an arm of the pharmaceutical companies. But those critics are crazy hippies, so we ignore them. You can find critics of anything, and the existence of critics alone proves nothing. It's just a way for a lazy editor to take a swipe at OMM without sifting through scientific literature.
This intro is probably the first thing most internet users will see when researching OMM and deciding whether its right for them. And it should be honest about the pros and cons of the therapy. Readers should understand D.O.s aren't idiots - OMM is definitely effective for some disorders - but at the same time, as with any alternative therapy, practitioners often make ridiculous claims about the extent of OMM's effectiveness.
I made a couple edits that I think makes the intro slightly better, I hope nobody objects. Really, it should probably say something like:
"Although studies have demonstrated OMM's effectiveness for treating back pain, (citation) practitioners often claim OMM can treat a variety of ailments that conventional medicine does not generally associate with manual therapies (citation). Studies into OMM's effect on respiratory disorders, viral infections, and asthma (etc) have failed to find significant evidence that OMM is effective for treating these ailments (Citation). The discrepancies between these studies and the claims made by certain practitioners have led critics to call OMM a pseudoscience" (citation that actually works).
TL;DR: This article sucks. We should fix it in a way devoid of broken links and internet douchebaggery, and just present the facts as currently understood by science. If I've got persistent back pain, OMM might be a good alternative to painkillers. If I have allergies, OMM is probably a stupid idea. This should come across immediately, without any MD/DO politicking or unnecessary swipes. — Preceding unsigned comment added by 67.164.210.210 ( talk) 04:03, 5 November 2013 (UTC)
I don't necessarily disagree about mentioning pseudoscience, but I think it could be done more effectively, or at least be better cited. I think that ideally it would be clear that elements of OMM have been demonstrated to be effective. However, practitioners make unreasonable claims about the scope of its effectiveness, and this is why it is considered pseudo-scientific. I tried to convey that with my minor edits, but I didn't add or remove any thoughts, I just reworded the existing view. (I would want to do research before I actually change anything). What I don't know is if there are other conditions that OMM has been found to alleviate. If it's effective for back pain, is it effective for neck pain? Is it effective for shoulder pain? For headaches caused by neck or shoulder pain? The way it's written now (before and after my edit) says it's ineffective for everything other than back pain, but our citations don't really support such a broad condemnation.
Thanks for replying so quickly and constructively. A rarity on the internet, it seems. Especially to non-user editors. I wonder if the "reception" category should be changed to "criticism?" The Chiropractic article has a section entitled "Controversy and Criticism" as the last section on the page. Since everything currently listed in the "reception" section is negative, that might make it more clear. 67.164.210.210 ( talk) 10:09, 5 November 2013 (UTC)
Alexbrn talk| contribs| COI 10:19, 5 November 2013 (UTC)
Oh, no problem with the links. I need them, thanks, I'm not an experienced wiki editor. And we may not need tons of sources in the intro, but the main citation that states OMM is pseudoscience in the body of the article is the same dead link as the introduction. It's referenced about five times. The page you linked me to regarding fringe theories states "And for writers and editors of Wikipedia articles to write about controversial ideas in a neutral manner, it is of vital importance that they simply restate what is said by independent secondary sources of reasonable reliability and quality." But there's no way to verify the reliability or quality of the source material if we can't check it. I'll defer to your judgement for now. In the future if I do the research, I might suggest some rewrites. I think in a perfect world we'd have a bunch of journal reviews of OMM research to cite. It looks like there are already a couple. I think I would like to see an expanded research section, so that the majority of criticism in the article is directly sourced to research, as opposed to secondary sources complaining.
I'm pretty busy right now though, I'll run any change ideas by the "talk" page, once I have some new sources. Thanks for the links. Why are the chiro articles renown for terribleness? — Preceding unsigned comment added by 67.164.210.210 ( talk) 23:44, 5 November 2013 (UTC)
I would like to hear from others if they think the section heading currently labeled as effectiveness is better that way or if research was a better section heading. Please weigh in, thanks. Alex, I already know where you stand on this issue obviously since it was your edit. It's definitely okay if you want to add your opinion, but I'm curious to hear from others. TylerDurden8823 ( talk) 06:19, 7 February 2014 (UTC)
Osteopathic manual therapy is claimed to be useful for treating a wide range of conditions, from pancreatitis to Parkinson's disease, sinusitis, and asthma
What else has OMT been claimed to treat? Alexbrn talk| contribs| COI 02:05, 8 February 2014 (UTC)
It's as fringe as it gets, and WP:FRINGE applies (as well as discretionary sanctions since we're editing a pseudoscience topic). We have many sources in agreement on that. It's certainly startling that practitioners claims that prodding the body can treat things like cerebral palsy, isn't it? Ernst seems to think so ...
A lede is meant to summarize the body. That's what we have, without the source misrepresentation your edit introduced (see my response at WT:MED). For the Ernst blog post, I was engaging in the conversation here on Talk - particularly the idea the OMT is merely "unproven". Alexbrn talk| contribs| COI 21:54, 9 February 2014 (UTC)
Now, moving on to the actual topic of importance at hand-saying the sentence has a plain meaning is missing the point. That's your interpretation, not everyone's. It can be interpreted in multiple ways. My point is that it is ambiguous to a general reader and therefore needs to be more specific. Given that you have displayed a staunch anti-OMT bias on numerous occasions (in my opinion your treatment of the subject has not seemed neutral), the way the sentence is currently written sounds like you were attempting to use it to imply what I mentioned earlier-that OMT being characterized as pseudoscience is not just a past view-but the prominent one today. Whether that's true today, I cannot say with absolute certainty. What I can say is that the referenced articles after the sentence do not say that in any way, shape, or form. If my assumptions about what you were trying to imply were unfounded or incorrect and that's not what you're trying to say (or not for that reason), then you should be amenable to rephrasing the sentence so it is clearer for all. If there are any objections to my following proposal, please explain what the precise objection(s) would be to rephrasing the sentence in the following way. Just as a rough example, saying something to the effect of: "Critics of OMT characterized it as pseudoscience for decades after its creation (or OMT was characterized as pseudoscience for many decades after its creation). Today, certain critics such as Stephen Barrett and Bryan Bledsoe have echoed such criticisms. In recent years, skepticism about the use of OMT for non-musculoskeletal conditions has persisted and has often been cited as a major obstacle preventing more widespread acceptance of the techniques. (Referring to Jordan Cohen's statement which is quoted in the body). Etc. etc. You get the idea. It's still a brief summary, faithful to the sources (if not, show me precisely how this deviates from them), and discusses what is in the body of the article. Such a revision, from my perspective, makes the perception of OMT clearer by separately specifying past views and current views. TylerDurden8823 ( talk) 08:12, 10 February 2014 (UTC)
Added Template:dubious to sentence in lede "(OMM)...is the core technique of osteopathic medicine." This is certainly not the whole truth, since North American DO's study (in addition to OMM) the exact same things as MD's & have same scope of practice in all 50 states. We can't just rely on the one source given; that's highly misleading and a bit POINT-y. -- Middle 8 ( leave me alone • talk to me • COI) 23:00, 20 February 2014 (UTC)
Okay, so if "osteopathic medicine" confuses Americans, let's call it "osteopathy" to be less ambiguous (done). I don't think we should dwell on DOs here, OMT training of DOs is covered in the DO article. Alexbrn talk| contribs| COI 04:56, 22 February 2014 (UTC)
I have moved here text that was recently added to the article:
A 2014 systematic review and meta-analysis found low quality evidence to support the use of strain/counterstrain for short-term relief of tender point palpation pain.
sourced to
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)Is this a WP:FRIND? I note too the journal doesn't appear to have an impact factor and the article used is not (yet anyway) MEDLINE indexed. Alexbrn talk| contribs| COI 09:28, 27 April 2014 (UTC)
I see nothing on the WP:MEDRS page at all that says a journal must be (or should be) high impact to be considered for inclusion on Wikipedia as a reliable source. Where are you getting this criterion from exactly? The only mention of anything even close to this statement is that ideal sources are from "reputable medical journals" and as far as I can see this journal doesn't have a substantial reputation, but I have not come across any materials referencing this journal as "fringe". As for the WP:FRIND part, this certainly seems like an independent source, not sure where the doubt about that is coming from. The lead author is a PhD, PT, OCS from Columbia University while the other authors are from the physical therapy program also at Columbia University. Study was funded by the NIH and National Center for Advancing Translational Sciences and this information is readily visible in the acknowledgements section of the paper. TylerDurden8823 ( talk) 18:12, 27 April 2014 (UTC)
I attempted to add reasonable information (one sentence) from a 2014 secondary source (systematic review and meta-analysis) from a PubMed source, from a journal that is MEDLINE indexed (if we must wait for the article itself to be MEDLINE indexed, as I said earlier, there is no objection to that), and reasonably restated their findings in the evidence section. You seem determined to prove that OMT does not work, but I have added information that shows positive, neutral, and negative results showing that I have approached this in a balanced/neutral way. I have often said (when there was disagreement) that we should directly quote the article in question to sidestep the issue of disagreements in interpretation, but you have rebuffed such offers in favor of your own view. Much of the content that you have added that I do not agree with remains, but it is unreasonable that each and every single edit that I put on here must be discussed on the talk page first. Even minor edits that I do seem to be reflexively objected to or reverted. I do not have any WP:OWN issues, I do not prevent other editors from writing on this page nor have I claimed anyone is "ruining my work" or anything to that effect. So, I will have to say no to WP:KETTLE. You're comparing apples to oranges. I think what you are correct about is that we need more eyes on this article. TylerDurden8823 ( talk) 19:13, 27 April 2014 (UTC)
Unless and until you are prepared to declare all surgery (or oncology, or physics, or whatever else) journals to be non-independent with respect to their specialization, then you cannot declare that all altmed journals are non-independent with respect to their specializationbut is that not the very embodiment of the WP:GEVAL fallacy? There is an essential difference between the top physics journal and the top homeopathy journal, precisely because of the field in which they publish: one is not mainstream, and so is where WP:FRINGE guidance applies. So far as I can see, the field of Bodywork (alternative medicine) is a umbrella term for a area which contains a number of nonsensical things (e.g. Bates method and reflexology). Any claimed health benefits deriving from these things is extraordinary and needs strong sourcing. Sure we can use potentially biased sources, but we would make that potential bias clear and take weight into account. Alexbrn talk| contribs| COI 05:16, 28 April 2014 (UTC)
According to our content guideline on identifying reliable sources, a reliable source has the following characteristics:
- It has a reputation for fact-checking and accuracy.
- It is published by a reputable publishing house, rather than by the author(s).
- It is "appropriate for the material in question", i.e., the source is directly about the subject, rather than mentioning something unrelated in passing.
- It is a third-party or independent source, with no significant financial or other conflict of interest.
- It has a professional structure in place for deciding whether to publish something, such as editorial oversight or peer review processes.
The sources used in the lede are of poor quality and seem to characterizing the entirety of OMT/CMT as pseudoscience. Are these really the type of sources that we use to label a whole therapeutic intervention? That seems like a sweeping generalization to me, and it seems like there's a better categorization out there. DVMt ( talk) 21:22, 16 May 2014 (UTC)
INTRO _________
"Research into OMM has generally not found it to be an effective therapy.[3][4][5] Some critics have characterized it as pseudoscience.[6][7][8]"
?Research into OMM has generally not been able to prove with certainty whether or not it is an effective therapy since it is very difficult to study manual therapies. Some research studies have found OMM to be effective while others have not. Some critics have characterized it as pseudoscience but OMM has many advocates in the medical community"
The old text is very misleading. Research hasn't generally found it to be an effective therapy but it also has not proved it to be an ineffective therapy. This is a technicality in the way scientific reviews are written and the wording of the original text will lead visitors to believe that OMM is ineffective. The new text is a much more accurate way of descriving the current state of the research. This can be verified at http://www.med.nyu.edu/content?ChunkIID=37409#evidence.
EFFECTIVENESS ____________ Added this additional research information on OMM. The original text includes only studies that are outdated and only one view of a topic with two sides.
"In a study of 183 people with neck pain, use of osteopathic methods provided greater benefits than standard physical therapy or general medical care. Participants receiving OMT showed faster recovery and experienced fewer days off work. OMT appeared to be less expensive overall than the other two approaches; however, researchers strictly limited the allowed OMT sessions, making direct cost comparisons questionable. Another study evaluated a rather ambitious combined therapy for the treatment of chronic pain resulting from whiplash injury (craniosacral therapy along with Rosen Bodywork and Gestalt psychotherapy). The results failed to find this assembly of treatments more effective than no treatment. [2] [3]
In a 14-week, single-blind study of 29 elderly people with shoulder pain, real OMT proved more effective than placebo OMT. Although participants in both groups improved, those in the treated group showed relatively greater increase in range of motion in the shoulder. And, in a larger study of 150 adults with shoulder complaints, researchers found that adding manipulative therapy to usual care improved shoulder and neck pain at 12 weeks. [4]
In a small randomized, placebo-controlled trial researchers used oscillating-energy manual therapy, an osteopathic technique based on the principle of craniosacral therapy, to treat 23 subjects with chronic tendonitis of the elbow (tennis elbow or lateral epicondylitis). Subjects in the treatment group showed significant improvement in grip strength, pain intensity, function, and activity limitation due to pain. These results however, are limited by the small size of the study and the fact that the therapist delivering the treatment could not be blinded. [5]
Twenty-four women with fibromyalgia were divided into five groups: standard care, standard care plus OMT, standard care plus an educational approach, standard care plus moist heat, and standard care plus moist heat and OMT. The results indicate that OMT plus standard care is better than standard care alone, and that OMT is more effective than less specific treatments, such as moist heat or general education. However, because this was not a blinded study (participants knew which group they were in), the results can’t be taken as reliable. In another study, 93 women (average age 53) with fibromyalgia were randomized to receive sham treatment or craniosacral therapy (one-hour sessions twice a week for 20 weeks). The women in the craniosacral therapy group experienced a decrease in pain at 20 weeks, which persisted for at least one year. In another randomized trial, 94 people with fibromyalgia received either myofascial release or sham therapy for 40 sessions (20 weeks). 21 At the 6-month follow-up, the people in the treatment group reported less pain and more physical ability. But, only some of these results lasted until the 1-year follow-up. [6]
A study of 28 people with tension headaches compared one session of OMT against two forms of sham treatment and found evidence that real treatment provided a greater improvement in headache pain. A small randomized controlled trial with 63 patients compared two myofascial release techniques to a control group. Myofascial release treatments resulted in fewer headaches for the 4-week trial period compared to the control group. [7] [8]
OMT has shown some promise for the treatment of back pain, including a randomized trial of 455 patients. The trial assessed the effects of 6 OMT sessions over 8 weeks compared to sham treatments. At 12 weeks, OMT was associated with moderate or substantial pain reduction compared to sham OMT. OMT also reduced the use of prescription pain medications. However, one of the best-designed trials failed to find it a superior alternative to conventional medical care. In this 12-week study of 178 people, OMT proved no more effective than standard treatment for back pain.6 Another study, this one enrolling 199 people and following them for 6 months, failed to find OMT more effective than fake OMT. This study also included a no-treatment group; both real and fake OMT were more effective than no treatment. A much smaller study reportedly found that muscle energy technique enhances recovery from back pain, but this study does not appear to have used a meaningful placebo treatment. [9] [10] [11]
Researchers analyzed 4 studies investigating the benefits of manual therapy (including massage therapy, joint mobilization, and manipulation) for osteoarthritis of the hip or knee. The results were inconclusive. Although one of the studies (involving 68 people) did find that massage therapy helped to improve pain and function, it was compared to no intervention rather than another treatment or a placebo. [12]
Some studies have evaluated the potential benefits of OMT for speeding healing in people recovering from surgery or serious illness. The best of these studies compared OMT against light touch in 58 elderly people hospitalized for pneumonia. The results indicate that use of osteopathy aided recovery. [13]
OMT showed improvement in 6-minute walk test distance in a small randomized trial of 20 patients with stable chronic obstructive pulmonary disease. Distance in patients in the OMT group improved on average by 72.5 meters compared to 23.7 meters for patients in the sham OMT group. [14]
In 2013, a Cochrane Review reviewed six randomized controlled trials which investigated the effect of four types of chest physiotherapy (including OMT) as adjunctive treatments for pneumonia in adults and concluded that "based on current limited evidence, chest physiotherapy might not be recommended as routine additional treatment for pneumonia in adults." [15] A 2013 systematic review of the use of OMT for treating pediatric conditions concluded that its effectiveness was unproven. [16]
A small study found some evidence that OMT might be helpful for childhood asthma. [17]?
201.229.95.34 ( talk) 03:00, 22 June 2014 (UTC) 6/21 - Stephen F., D.O.
References
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Alexbrn, please explain the grounds for your revert. Your objection to the rewrite seems to be nothing more than stylistic and I don't think that's adequate cause for the revert (especially without a constructive counterproposal and just a simple revert). I left a very clear edit summary explaining the reason for the change: "More accurate-should not generalize and instead specifically state that some/certain practitioners use it for conditions such as asthma or PD." The point of this edit was to clarify that not all practitioners of OMT use it in this manner and that the application of OMT in this manner is likely done by a small minority.
Your objection to this initial edit per your edit summary (here [3]) was about tense. I responded by correcting the tense in my original edit while maintaining the wording correction. Therefore, I see no grounds for your reversion unless you're changing your tune about why you objected. This feels extremely nitpicky and like you are unable to collaborate with me on the simplest/most minor of changes and that's rather disheartening. The meaning has not been changed at all except to be more specific in saying that only certain practitioners apply OMT in this way. Can you seriously say that's not a fair statement? If so, please explain how so with specific quantitative evidence to support your position. Additionally, the claim of "clunky" seems rather absurd since it's only a few words. It's really more helpful to suggest alternate wording instead of what's already there (I think it can be improved upon though perhaps you don't think so). As written, this sentence can be interpreted to mean that all OMT practitioners "sometimes" use these techniques in this way and that is an inaccurate statement. Only certain practitioners use it in this way (in reality this is likely a rather small minority). Do you have suggestions for alternate wording to avoid this issue? If so, I am open to a dialogue and I hope you are open to a collaborative dialogue as well. TylerDurden8823 ( talk) 06:26, 18 December 2014 (UTC)