The Journal of the American Osteopathic Association
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J Am Osteopath Assoc · Dec 2015
Comparative StudyFemoral Nerve Block vs Periarticular Bupivacaine Liposome Injection After Primary Total Knee Arthroplasty: Effect on Patient Outcomes.
Patients receiving femoral nerve blocks for total knee arthroplasty (TKA) have been shown to have a high incidence of postoperative falls, which has been attributed to weakening of the quadriceps muscles. Local injection of analgesic medication that allows for full motor function of the quadriceps and, therefore, better progress through inpatient physical therapy and decreased hospital stay, has been suggested as an option for postoperative pain relief. ⋯ Compared with femoral nerve block, periarticular injection of analgesia was found to quicken postoperative recovery in patients hospitalized for TKA. The use of periarticular injections in patients undergoing TKA could yield substantial cost savings given the high frequency of this procedure.
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J Am Osteopath Assoc · Dec 2015
ReviewPosterolateral Corner Knee Injuries: Review of Anatomy and Clinical Evaluation.
The structures in the posterolateral corner of the knee, which stabilize the joint, are often involved in injuries to the posterior cruciate ligament. Familiar structures include the anterior cruciate ligament, posterior cruciate ligament, tibial collateral ligament, and menisci. ⋯ The purpose of this review is to highlight the posterolateral corner of the knee and injuries to its structures so that physicians can more accurately diagnose these injuries and provide appropriate treatment. Management focuses on restoring the fibular collateral ligament, popliteofibular ligament, and, in certain cases, the popliteus tendon.
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J Am Osteopath Assoc · Sep 2015
Effect of Table Trainer-to-Student Ratios on Outcome in Student Assessments of Cervical Muscle Energy Techniques.
Improving the acquisition of osteopathic manipulative treatment (OMT) skills may increase student confidence and later use of OMT. A first step in this process is determining the optimal table trainer-to-student ratio (TTR). ⋯ The TRR had no significant effect on written or practical assessment scores. Practical assessment scores for the 1:4 and 1:8 TTRs declined significantly between postworkshop and retention assessments. Future studies with more statistical power will be necessary to determine the effect of TTRs on student learning. The current study also found that student order in paired demonstrations may affect practical assessment scores, because the second-demonstrating student scored higher than the first; colleges of osteopathic medicine should therefore consider randomizing student order during practical assessments.
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J Am Osteopath Assoc · Jul 2015
Randomized Controlled Trial Multicenter Study Pragmatic Clinical TrialOsteopathic Manipulative Therapy in Women With Postpartum Low Back Pain and Disability: A Pragmatic Randomized Controlled Trial.
Persistent low back pain (LBP) is a common complaint among women during and after pregnancy, and its effects on quality of life can be disabling. ⋯ During 8 weeks, OMTh applied 4 times led to clinically relevant positive changes in pain intensity and functional disability in women with postpartum LBP. Further studies that include prolonged follow-up periods are warranted. (German Clinical Trials Register: DRKS00006280.).
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J Am Osteopath Assoc · Jun 2015
Observational StudyAge-related decline in chest wall mobility: a cross-sectional study among community-dwelling elderly women.
Chest wall mobility is strongly related to respiratory function; however, the effect of aging on chest wall mobility-and the level at which this mobility is most affected-remains unclear. ⋯ Chest wall mobility at the axillary level and respiratory function decreased with age in community-dwelling women aged 65 years or older. Further longitudinal studies are required to clarify the effects of aging on chest wall mobility and respiratory function.