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OsteoNews

Statistics


ReportS by the General Osteopathic Council

  • In 2016 the majority of osteopaths were aged between 31 and 50 with 4,381 practicing in England, 158 are in Scotland, 135 Wales, 24 Northern Ireland, and 424 outside the UK. In Jully 2013 the 41- 50 age group were the largest (approximately 37%), followed by the 31-40 age group (approximately 28%, with the smallest being the 61+ age group  (approximately 7%). In March 2014 the majority of osteopaths were aged between 31and 50. In July 2013 the greatest number of osteopaths were located within Greater London at 1,341 and the South east (excluding London) at 1,430 and the lowest numbers located within Scotland, Wales and Northern Ireland. In March 2014 the greatest number of osteopaths (4,130) were located in England.
  • In February 2016 there were 5,122 osteopaths on the Statutory RegisterIn March 2014 there were 4,815 and in July 2013 there were 4,689. 

 

  • There are 2,550 male and 2,572 female registrants. In March 2014 the gap between male and female registrants had almost closed with 2,418 male osteopaths and 2,397 female osteopaths.

 

  • Each year, there are approximately up to 300 new osteopaths joining the GOsC register.

 

  • Each year, approximately 2.5-3% (approximately 150-170 per annum) of registrants leave the register due to retirement, moving overseas or ceasing to practice for other reasons.

 

  • Around 30,000 people currently consult osteopaths every working day.

 

Diary Dates


January    
26th -30th Cancertalk week  
     
FEBRUARY  
 
February National Reynaud's Awareness Month  
4th World Cancer Day    
28th Rare Disease Day  
     
MARCH
 
March National Prostate Awareness Month  
March National Ovarian Cancer Aareness Month  
8th International Women’s Day  
3th - 9th Endometriosis Awareness Week  
10 -16th National Brain Awareness Week  
12th National No Smoking Day  
17th -20th National Nutrition and Hydration week  
20th International Day of Happiness   
20th World Head Injury Awareness DAY  
21st   World Down Syndrome Day   
24th World Tuberculosis Day  
     
APRIL
 
April National Bowel Cancer Awareness Month  
  IBS Awareness Month  
  National Autism Awareness Month  
7th World Health Day  
28th World Day for Safety and Health at Work  
     
MAY
 
  Cystic Fibrosis Month  
May National Walking Month  
3rd World Ankylosing Spondylitis Day  
5th World Asthma Day  
4th - 10th Deaf Awareness Week  
10th World Lupus Day  
12th World Chronic Fatigue and Immune Dysfunction Syndrome  
12th International Fibromyalgia Awareness Day  
15th International Day of Families    
     
JUNE
 
9th-15th National Mens Health Week  
19th World Sickle Cell Day  
     
JULY
 
  Group Strep B Awareness Month  
  Sickle Cell Awareness Month  
25th World Patient Safety Day  
     
AUGUST
 
12th International Youth Day  
     
SEPTEMBER
 
5th International Day of Charity     
8th World Cystic Fibrosis Day   
29th World Heart Day  
     
OCTOBER
 
  Breast Cancer Awareness Month  
  Lupus Awareness Month  
1st International Day of Older Persons  
12th World Arthritis Day    
7th-13th National Arthritis Week  
12-20th World Bone and Joint week   
16th World Spine Day   
17th World Trauma Day  
20th World Osteoporosis Day  
26th National Make A Difference Day  
     
NOVEMBER
 
4th National Stress Awareness Day (NSAD)  
14th World Diabetes Day  
     
DECEMBER
 
1st World AIDS Day  
3rd International Day of Persons with Disabilities  

                                                                                                                                                                                                                                                                                                                         
                                                                                                

 

 Articles


Acupuncture for (sub)acute non-specific low-back pain

Abstract

This is the protocol for a review and there is no abstract. The objectives are as follows:

The objectives of this systematic review are to determine the effects of acupuncture for (sub)acute non-specific low-back pain compared to no treatment, placebo/sham acupuncture or other sham procedures, other therapies, the addition of acupuncture to other therapies, and between various techniques of acupuncture. www.onlinelibrary.wiley.com

 

Adjunts to Osteopathic Treatment

  • The use of exercise in the management of osteoarthritic pain - a brief summary of current evidence.
  • Contrast bathing - a brief summary of the evidence.
  • The use of ice in patient management.
  • Glucosamine - a brief summary of the evidence.
  • Pharmacological pain management.

www.ncor.org.uk
 

 

Assessing age-related ossification of the petro-occipital fissure: Laying the foundation for understanding the clinicopathologies of the cranial base

Keywords

Human anatomy, cranial base, petro-occipital fissure, petro-occipital synchondrosis, petro-occipital complex, hearing loss, myxoid chondrosarcoma.

Abstract

The petro-occitpital fissure (POF) lies within a critical interface of cranial growth and development in the posterior cranial fossa. The relationships between skeletal and soft tissues make this region especially important for examining biomechanical and basic biologic forces that may mold the cranial base and contribute to significant clinicopathologies associated with the structures located near the POF. Therefore, this study investigates the POF in adults in both preserved human cadavers and dried crania in order to determine if developmental changes can be observed and, if so, their value in age assessment as a model system for describing normal morphogenesis of the POF. This study demonstrates that tissue within the POF undergoes characteristic changes in ossification with age, the onset of which is considerably later than that of other synchondroses of the cranial base. Statistically, there is a moderate to strong correlation between age and stage of ossification within the POF. Further, male crania were observed to reach greater degrees of ossification at a younger age than female crania and that individual asymmetry in ossification of the tissue within the POF was not uncommon. An understanding of the basic temporal biological processes of the POF may yield insight into the development of clinicopathologies in this region of the cranial base. www.onlinelibrary.wiley.com

 

Children at risk for developmental coordination disorder: judgement of changes in action capabilities

Abstract

In three separate manipulations, a group of children at risk for developmental coordination disorder (DCD; five males, seven females; mean age 11y 6mo [SD 6.8mo]who were at or below the 15th centile on the Movement ABC) and a group of typically developing children (TDC; seven males, five females; mean age 11y 3mo [SD 6.8mo]) judged the limit of their standing horizontal reach (HRmax) under two conditions in which actual HRmax differed. The manipulations were: (1) one-hand versus two-hand reach; and (2) standard versus short effective foot-length; and (3) rigid versus compliant support surface. For the foot-length and support surface manipulations (but not for the hand manipulation), children correctly judged that their actual HRmax differed in the two conditions (p<.05). On all three manipulations, TDC made significantly larger adjustments in their judgements than did children at risk for DCD (p<0.05). The TDC group adjusted their judgements in the appropriate direction on all three manipulations, whereas the DCD group adjusted in the appropriate direction for the foot-length manipulation only. The results suggest that children at risk for DCD are less adept at detecting changes in the limits of their action capabilities. www.onlinelibrary.wiley.com

 

Complementary and alternative methods in cerebral palsy

There are no published studies specifically addressing complementary and alternative treatments in adults with cerebral palsy (CP). However, national surveys of adults with chronic disabilities document that a majority of them use such treatments, that they are willing to pay out of pocket, if necessary, and that they believe that pursuing such treatment relieves pain, reduces stress and anxiety, and leads to improved feelings of fitness and well-being. Individuals enjoy taking charge of their own health care decisions, and frequently feel more in control with these therapies than with more traditional methods. In contrast to adults, there is some information on complementary and alternative methods (CAM) in children with CP. This article discusses some of the CAM used in children that may be carried over into adulthood, as well as the pitfalls for patients and conventional physicians as they try to sort out what might be helpful and what might be harmful in this arena. Practitioners of both conventional and CAM therapies believe that exercise can be beneficial; accordingly, activities such as recreational sports, yoga, and hippotherapy may be continued from childhood into adulthood. General treatments for stress and anxiety, through such activities as yoga and meditation, though not directed at CP per se, may be more popular for adults than children. Research in this area should first identify what methods are being utilized and then subject these methods to well-designed outcome studies that take into account any associated risks. www.onlinelibrary.wiley.com

 

Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: A randomized clinical trial

Keywords

Osteoarthritis, Hip, Rehabilitation, Musculoskeletal manipulations, Exercise therapy.

Objective

To determine the effectiveness of a manual therapy program compared with an exercise therapy program in patients with osteoarthritis (OA) of the hip.

Methods

A single-blind, randomized clinical trial of 109 hip OA patients was carried out in the outpatient clinic for physical therapy of a large hospital. The manual therapy program focused on specific manipulations and mobilization of the hip joint. The exercise therapy program focused on active exercises to improve muscle function and joint motion. The treatment period was 5 weeks (9 sessions). The primary outcome was general perceived improvement after treatment. Secondary outcomes included pain, hip function, walking speed, range of motion, and quality of life.

Results

Of 109 patients included in the study, 56 were allocated to manual therapy and 53 to exercise therapy. No major differences were found on baseline characteristics between groups. Success rates (primary outcome) after 5 weeks were 81% in the manual therapy group and 50% in the exercise group (odds ratio 1.92, 95% confidence interval 1.30, 2.60). Furthermore, patients in the manual therapy group had significantly better outcomes on pain, stiffness, hip function, and range of motion. Effects of manual therapy on the improvement of pain, hip function, and range of motion endured after 29 weeks.

Conclusion

The effect of the manual therapy program on hip function is superior to the exercise therapy program in patients with OA of the hip. www.onlinelibrary.wiley.com

 

Craniofacial levels and the morphological maturation of the human skull

Keywords

Basicranium, cranial base, craniofacial ontogeny, Denver Growth Study, modularity, Procrustes, sliding semilandmarks.

Abstract

It is well known that the human skull achieves adult size through a superior–inferior gradient of maturation. Because the basicranium matures in size before the face, it has been suggested that the form of the basicranium might have ontogenetic knock-on effects on that of the face. However, although sequential spatially organized maturation of size is well described in the cranium, the maturation of skull shape is not. Knowledge of the maturation of shape is important, nevertheless, because it is claimed that the early determination of the spatial configuration of basicranial components, where the facial skeleton attaches, is relevant in the spatio-temporal ontogenetic cascade from basicranium to face. This paper examines the ontogeny of various components of the human skull in 28 individuals from the longitudinal Denver Growth Study. Sixty-six landmarks and semilandmarks were digitized on 228 X-rays and analysed using geometric morphometric methods. Bootstrapped confidence intervals for centroid size support previous studies suggesting a supero-inferior gradient of growth maturation (size over time), while developmental maturation (shape over time) is more complex. A sequence of shape maturation is described, in which the earliest structure to mature in shape was the midline cranial base (7–8 years), followed by the lateral cranial floor (11–12), midline neurocranium (9–10) and facial and mandibular structures (15–16). The absolute ages of shape maturation of the latter three depended on the criterion of maturity used, which was not the case for the basicranial components. Additionally, ontogenetic dissociations were found between the maturation of size and shape of the midline cranial base and lateral floor, possibly underlining its role as structural ‘interface’ between brain and facial ontogeny. These findings imply potential for bidirectional developmental influences between the lateral cranial floor and the face until about 11–12 years. The findings are discussed with regard to their relevance for palaeoanthropology and especially the evolutionary and developmental bases of skull morphological variation. www.onlinelibrary.wiley.com

 

Derivative benefits: exploring the body through complementary and alternative medicine

Keywords

Agency, CAM, health practices, responsibility, sociology of the body.

Abstract

Since the 1960s, in Western societies, there has been a striking growth of consumer interest in complementary or alternative medicine (CAM). In order to make this increased popularity intelligible this paper challenges stereotypical images of users’ motives and the results of clinical studies of CAM by exploring bodily experiences of acupuncture, reflexology treatments, and mindfulness training. The study draws on 138 in-depth interviews with 46 clients, client diaries and observations of 92 clinical treatments in order to identify bodily experiences of health and care: experiences that are contested between forces of mastery, control and resistance. We discuss why clients continue to use CAM even when the treatments do not help or even after they have been relieved of their physiological or mental problems. The encounter between the client and CAM produces derivative benefits such as a fresh and sustained sense of bodily responsibility that induces new health practices. www.onlinelibrary.wiley.com

 

Impact of head rotation on the individualized common carotid flow and carotid bifurcation hemodynamics.

Abstract

This paper aims at evaluating the changes that head rotation poses on morphological and flow characteristics of the carotid bifurcation (CB) and on the distribution of parameters that are regarded as important in atherosclerosis development, such as relative particle residence time (RRT), normalized oscillatory shear index (nOSI), and helicity (HL). Using a subject-specific approach, six healthy volunteers were MR-scanned in two head postures: supine neutral and prone with rightward head rotation. Cross-sectional flow velocity distribution was obtained using phase-contrast MRI at the common carotid artery (CCA). Our results indicate that peak systolic flow rate is reduced at the prone position in most cases for both CCAs. Morphological MR images are used to segment and construct the CB models. Numerical simulations are performed and areas exposed to high helicity or unfavorable hemodynamics are calculated. Head rotation affects the instantaneous spatial extent of high helicity regions. Posture-related observed differences in the distribution of nOSI and RRT suggest that inlet flow waveform tends to moderate geometry-induced changes in the qualitative and quantitative distribution of atherosclerosis-susceptible wall regions. Overall, presented results indicate that an individualized approach is required to fully assess the postural role in atherosclerosis development and in complications arising in stenotic and stented vessels. www.ncbi.nlm.nih.gov/pubmed

 

Manipulative therapies for infantile colic

Abstract

Infantile colic is a common disorder, affecting around one in six families, and in 2001 was reported to cost the UK National Health Service in excess of £65 million per year (Morris 2001). Although it usually remits by six months of age, there is some evidence of longer-term sequelae for both children and parents.

Manipulative therapies, such as chiropractic and osteopathy, have been suggested as interventions to reduce the severity of symptoms.

To evaluate the results of studies designed to address efficacy or effectiveness of manipulative therapies (specifically, chiropractic, osteopathy and cranial manipulation) for infantile colic in infants less than six months of age.

Randomised trials evaluating the effect of chiropractic, osteopathy or cranial osteopathy alone or in conjunction with other interventions for the treatment of infantile colic.

Authors Conclusions

The studies included in this meta-analysis were generally small and methodologically prone to bias, which makes it impossible to arrive at a definitive conclusion about the effectiveness of manipulative therapies for infantile colic.

The majority of the included trials appeared to indicate that the parents of infants receiving manipulative therapies reported fewer hours crying per day than parents whose infants did not, based on contemporaneous crying diaries, and this difference was statistically significant. The trials also indicate that a greater proportion of those parents reported improvements that were clinically significant. However, most studies had a high risk of performance bias due to the fact that the assessors (parents) were not blind to who had received the intervention. When combining only those trials with a low risk of such performance bias, the results did not reach statistical significance. Further research is required where those assessing the treatment outcomes do not know whether or not the infant has received a manipulative therapy.

There are inadequate data to reach any definitive conclusions about the safety of these interventions.www.onlinelibrary.wiley.com

 

Diversity of intervertebral disc cells: phenotype and function

Keywords

Annulus fibrosus, cartilaginous endplate, disc cell phenotype, intervertebral disc function, notochordal cells, nucleus pulposus.

Abstract

The intervertebral disc (IVD) is a moderately moving joint that is located between the bony vertebrae and provides flexibility and load transmission throughout the spinal column. The disc is composed of different but interrelated tissues, including the central highly hydrated nucleus pulposus (NP), the surrounding elastic and fibrous annulus fibrosus (AF), and the cartilaginous endplate (CEP), which provides the connection to the vertebral bodies. Each of these tissues has a different function and consists of a specific matrix structure that is maintained by a cell population with distinct phenotype. Although the healthy IVD is able to balance the slow matrix turnover of synthesis and degradation, this balance is often disturbed, leading to degenerative disorders. Successful therapeutic management of IVD degeneration requires a profound understanding of the cellular and molecular characteristics of the functional IVD. Hence, the phenotype of IVD cells has been of significant interest from multiple perspectives, including development, growth, remodelling, degeneration and repair. One major challenge that complicates our understanding of the disc cells is that both the cellular phenotype and the extracellular matrix strongly depend on disc maturity and health and as a consequence are continuously evolving. This review delineates the diversity of the cell types found in the intervertebral disc, with emphasis on human, but with reference to other species. The cells of the NP appear rounded and express a proteoglycan-rich matrix, whereas the more elongated AF cells are embedded in a collagen fibre matrix and the CEPs represent a layer of cartilage. Even though all disc cells have often been referred to as ‘intervertebral disc chondrocytes’, distinct phenotypical differences in comparison with articular chondrocytes exist and have been reported recently. The availability of more specific markers has also improved our understanding of progenitor cell differentiation towards an IVD cell phenotype. Ultimately, new cell- and tissue-engineering approaches to regenerative therapies will only be successful if the specific characteristics of the individual tissues and their context in the function of the whole organ, are taken into consideration. www.onlinelibrary.wiley.com

 

Evidence for the Influence of Diet on Cranial Form and Robusticity

Keywords

Cranial vault thickness, cranial globularity, dietary properties, masticatory stresses/loads, plasticity, rabbits.

Abstract

The evolutionary significance of cranial form and robusticity in early Homo has been variously attributed to allometry, encephalization, metabolic factors, locomotor activity, and masticatory forces. However, the influence of such factors is variably understood. To evaluate the effect of masticatory loading on neurocranial form, sibling groups of weanling white rabbits were divided into two cohorts of 10 individuals each and raised on either a soft diet or a hard/tough diet for 16 weeks until subadulthood. Micro-CT was used to quantify and visualize morphological variation between treatment groups. Results reveal trends (P < 0.10) for greater outer table thickness of the frontal bones, zygomatic height, and cranial globularity in rabbits raised on a hard/tough diet. Furthermore, analyses of three-dimensional coordinate landmark data indicate that the basicrania of hard/tough diet rabbits exhibit more robust middle cranial fossae and pterygoid plates, as well as altered overall morphology of the caudal cranial fossa. Thus, long term increases in masticatory loads may result in thickening of the bones of the neurocranial vault and/or altering the curvature of the walls. Differences in cranial regions not directly associated with the generation or resistance of masticatory forces (i.e., frontal bone, basicranium) may be indirectly correlated with diet-induced variation in maxillomandibular morphology. These findings also suggest that long-term variation in masticatory forces associated with differences in dietary properties can contribute to the complex and multifactorial development of neurocranial morphology. Anat Rec, 293:630–641, 2010. © 2010 Wiley-Liss, Inc. www.onlinelibrary.wiley.com

 

Interventions for preventing and treating pelvic and back pain in pregnancy

Summary

Many women experience low-back (LBP) or pelvic pain during pregnancy. Pain usually increases as pregnancy advances, interfering with work, daily activities, and sleep.

We included 26 randomised trials (RCTs) involving 4093 women. Eleven examined LBP (1312 women); four examined pelvic pain (661 women); 11 examined both conditions together (lumbo-pelvic pain) (2120 women). Unless noted, interventions were added and compared to usual prenatal care.

Moderate-quality evidence showed that acupuncture or exercise, tailored to the stage of pregnancy, significantly reduced evening pelvic or lumbo-pelvic pain. Acupuncture was significantly more effective than exercise for reducing evening pelvic pain. A 16- to 20-week training program was no more successful than usual care in preventing pelvic or LBP. Low-quality evidence suggested that exercise reduced pain and disability from LBP. Reported adverse effects were minor and transient. Further research is likely to change the estimates of effect of these interventions. An agreed classification system for categorising women is overdue.

LBP: there was low-quality evidence that exercise significantly reduced pain (six RCTs) and disability (two RCTs). From single trials; exercise in water significantly reduced LBP-related sick leave; pain and physical function were similar when wearing pelvic support belts or having osteo-manipulative therapy (OMT) compared with usual care or sham ultrasound. Very low-quality evidence suggested that a specially-designed pillow may relieve night pain better than a regular pillow.

Pelvic pain: there was moderate-quality evidence that acupuncture reduced evening pain better than exercise; both were better than usual care (one RCT). From single trials: exercise plus a rigid belt improved average pain but not function; acupuncture was better than sham acupuncture for evening pain and function, but not average pain. There was no difference in evening pain after either deep or superficial acupuncture.

Lumbo-pelvic pain: there was moderate-quality evidence that an eight- to 20-week exercise program reduced the risk of lumbo-pelvic pain; but a 16- to 20-week training program was no better than usual care for preventing pain (four RCTs). From single trials: exercise significantly reduced lumbo-pelvic-related sick leave and improved function; OMT significantly improved pain and function; a combination of manual therapy, exercise and education improved pain and function; acupuncture improved these outcomes more than usual care or physiotherapy; pain and function improved more when acupuncture was started at 26- rather than 20-weeks' gestation. Ear acupuncture significantly improved these outcomes more than sham acupuncture. www.onlinelibrary.wiley.com

 

Manipulation or Mobilisation for Neck Pain

Main Results

We included 27 trials (1522 participants).

Cervical Manipulation for subacute/chronic neck pain : Moderate quality evidence suggested manipulation and mobilisation produced similar effects on pain, function and patient satisfaction at intermediate-term follow-up. Low quality evidence showed manipulation alone compared to a control may provide short- term relief following one to four sessions (SMD pooled -0.90 (95%CI: -1.78 to -0.02)) and that nine or 12 sessions were superior to three for pain and disability in cervicogenic headache. Optimal technique and dose need to be determined.

Thoracic Manipulation for acute/chronic neck pain : Low quality evidence supported thoracic manipulation as an additional therapy for pain reduction (NNT 7; 46.6% treatment advantage) and increased function (NNT 5; 40.6% treatment advantage) in acute pain and favoured a single session of thoracic manipulation for immediate pain reduction compared to placebo for chronic neck pain (NNT 5, 29% treatment advantage).

Mobilisation for subacute/chronic neck pain: In addition to the evidence noted above, low quality evidence for subacute and chronic neck pain indicated that 1) a combination of Maitland mobilisation techniques was similar to acupuncture for immediate pain relief and increased function; 2) there was no difference between mobilisation and acupuncture as additional treatments for immediate pain relief and improved function; and 3) neural dynamic mobilisations may produce clinically important reduction of pain immediately post-treatment. Certain mobilisation techniques were superior. www.onlinelibrary.wiley.com

 

Intervertebral disc degeneration: evidence for two distinct phenotypes

Keywords

Ageing, biomechanics, degeneration, intervertebral disc, phenotype.

Abstract

We review the evidence that there are two types of disc degeneration. ‘Endplate-driven’ disc degeneration involves endplate defects and inwards collapse of the annulus, has a high heritability, mostly affects discs in the upper lumbar and thoracic spine, often starts to develop before age 30 years, usually leads to moderate back pain, and is associated with compressive injuries such as a fall on the buttocks. ‘Annulus-driven’ disc degeneration involves a radial fissure and/or a disc prolapse, has a low heritability, mostly affects discs in the lower lumbar spine, develops progressively after age 30 years, usually leads to severe back pain and sciatica, and is associated with repetitive bending and lifting. The structural defects which initiate the two processes both act to decompress the disc nucleus, making it less likely that the other defect could occur subsequently, and in this sense the two disc degeneration phenotypes can be viewed as distinct. www.onlinelibrary.wiley.com

 

1m Britons have headaches from overusing painkillers

Experts say pills people take to relieve headaches and migraines may be making things much worse. More than one million people in Britain may be suffering from constant, crippling headaches because they are taking too many painkillers, experts say. www.theguardian.com
 
 

Morphological and morphometric study on sphenoid and basioccipital ossification in normal human fetuses

Keywords

Cranial base, fetus, human, morphometry, ossification.

Abstract

Congenital anomalies of the brain frequently correspond to cranial base anomalies, and a detailed description of morphology and individual variations in the developing cranial base is of clinical importance for diagnosing anomalies. Development of the human cranial base has been studied using dissection, computed tomography, and magnetic resonance imaging, each of which has advantages and disadvantages. We here examined development of the normal human fetal cranial base using bone staining, which allows for direct observation of the ossification centers and precise three-dimensional measurements. We observed alizarin red S-stained sphenoids and basiocciputs of 22 normal formalin-fixed human fetuses with crown-rump lengths (CRL) of 115–175 mm. We defined landmarks and measured sphenoids and basiocciputs using a fine caliper. Growth patterns of these ossifying bones were obtained, and we found similarities and differences among the growth patterns. We also observed individual variations in the ossification patterns, in particular, single- or double-ossification center patterns for the basisphenoid. The orbitosphenoid and basisphenoid widths and ratios of the widths to the total cranial base width were significantly different between the two pattern groups, whereas the other measurements and their ratios to the total cranial base did not differ between the groups. We measured the cerebrum and pons in different sets of 22 human fetuses with CRLs of 105–186 mm and found close relationships with the development of corresponding parts of the cranial base. The results contribute to the quantitative and qualitative information about the growth patterns and variations during human fetal cranial base development. www.onlinelibrary.wiley.com

 

Morphological integration between the cranial base and the face in children and adults

Keywords

Covariation, development, geometric morphometrics, malocclusion.

Abstract

The primary aim of the present study was to assess morphological covariation between the face and the basicranium (midline and lateral), and to evaluate patterns of integration at two specific developmental stages. A group of 71 children (6–10 years) was compared with a group of 71 adults (20–35 years). Lateral cephalometric radiographs were digitized and a total of 28 landmarks were placed on three areas; the midline cranial base, the lateral cranial base and the face. Geometric morphometric methods were applied and partial least squares analysis was used to evaluate correlation between the three shape blocks. Morphological integration was tested both with and without removing the effect of allometry. In children, mainly the midline and, to a lesser extent, the lateral cranial base were moderately correlated to the face. In adults, the correlation between the face and the midline cranial base, which ceases development earlier than the lateral base, was reduced. However, the lateral cranial base retained and even strengthened its correlation to the face. This suggests that the duration of common developmental timing is an important factor that influences integration between craniofacial structures. However, despite the apparent switch of primary roles between the cranial bases during development, the patterns of integration remained stable, thereby supporting the role of genetics over function in the establishment and development of craniofacial shape. www.onlinelibrary.wiley.com

 

The sacroiliac joint: an overview of its anatomy, function and potential clinical implications

Keywords

Ankylosing spondylitis, pelvic girdle pain, pelvis, sacroiliac joint, sacrum, thoracolumbar fascia.

Abstract

This article focuses on the (functional) anatomy and biomechanics of the pelvic girdle and specifically the sacroiliac joints (SIJs). The SIJs are essential for effective load transfer between the spine and legs. The sacrum, pelvis and spine, and the connections to the arms, legs and head, are functionally interrelated through muscular, fascial and ligamentous interconnections. A historical overview is presented on pelvic and especially SIJ research, followed by a general functional anatomical overview of the pelvis. In specific sections, the development and maturation of the SIJ is discussed, and a description of the bony anatomy and sexual morphism of the pelvis and SIJ is debated. The literature on the SIJ ligaments and innervation is discussed, followed by a section on the pathology of the SIJ. Pelvic movement studies are investigated and biomechanical models for SIJ stability analyzed, including examples of insufficient versus excessive sacroiliac force closure. www.onlinelibrary.wiley.com

 

Spinal manipulative therapy for acute low-back pain

Summary

Low-back pain is a common and disabling disorder, representing a great burden both to the individual and society. It often results in reduced quality of life, time lost from work, and substantial medical expense. Spinal manipulative therapy (SMT) is widely practised by a variety of healthcare professionals worldwide and is a common choice for the treatment of low-back pain. The effectiveness of this form of therapy for the management of acute low-back pain is, however, not without dispute.

For this review, acute low-back pain was defined as pain lasting less than six weeks. Only cases of low-back pain not caused by a known underlying condition, for example, infection, tumour, or fracture, were included. Also included were patients whose pain was predominantly in the lower back but may also have radiated (spread) into the buttocks and legs.

SMT is known as a 'hands-on' treatment directed towards the spine, which includes both manipulation and mobilization. The therapist applies manual mobilization by passively moving the spinal joints within the patient’s range of motion using slow, passive movements, beginning with a small range and gradually increasing to a larger range of motion. Manipulation is a passive technique whereby the therapist applies a specifically directed manual impulse, or thrust, to a joint at or near the end of the passive (or physiological) range of motion. This is often accompanied by an audible ‘crack’.

In this review, a total of 20 randomized controlled trials (RCTs) (representing 2674 participants) assessing the effects of SMT in patients with acute low-back pain were identified. Treatment was delivered by a variety of practitioners, including chiropractors, manual therapists, and osteopaths. Approximately one-third of the trials were considered to be of high methodological quality, meaning these studies provided a high level of confidence in the outcome of SMT.

Overall, we found generally low to very low quality evidence suggesting that SMT is no more effective in the treatment of patients with acute low-back pain than inert interventions, sham (or fake) SMT, or when added to another treatment such as standard medical care. SMT also appears to be no more effective than other recommended therapies. SMT appears to be safe when compared to other treatment options but other considerations include costs of care. www.onlinelibrary.wiley.com

 

Spinal manipulative therapy for chronic low-back pain

Summary

Spinal manipulative therapy (SMT) is an intervention that is widely practiced by a variety of health care professionals worldwide. The effectiveness of this form of therapy for the management of chronic low-back pain has come under dispute.

Low-back pain is a common and disabling disorder, which represents a great burden to the individual and society. It often results in reduced quality of life, time lost from work and substantial medical expense. In this review, chronic low-back pain is defined as low-back pain lasting longer than 12 weeks. For this review, we only included cases of low-back pain that were not caused by known underlying conditions, for example, infection, tumour, or fracture. We also included patients whose pain was predominantly in the lower back, but may also have radiated (spread) into the buttocks and legs.

SMT is known as a "hands-on" treatment of the spine, which includes both manipulation and mobilisation. In manual mobilisations, the therapist moves the patient’s spine within their range of motion. They use slow, passive movements, starting with a small range and gradually increasing to a larger range of motion. Manipulation is a passive technique where the therapist applies a specifically directed manual impulse, or thrust, to a joint, at or near the end of the passive (or physiological) range of motion. This is of

 
 
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