The biology of manual therapies.

Each year, more than 18 million adults in the United States receive manual therapies, at a total annual out-of-pocket cost of $3.9 billion. Although there is growing evidence supporting the efficacy of manual therapies, little is known about the mechanisms underlying these treatments.

A stiffness discrimination experiment including analysis of palpation forces and velocities.

Introduction: The incorporation of haptics, the sense of touch, into medical simulations increases their capabilities by enabling the users to "feel" the virtual environment. We are involved with haptics-augmented virtual reality training for palpatory diagnosis. We have developed a stiffness discrimination program to train and test users in finding subtle differences in human tissue stiffness for medical diagnoses.

Muscle functional magnetic resonance imaging and acute low back pain: a pilot study to characterize lumbar muscle activity asymmetries and examine the effects of osteopathic manipulative treatment.

Background: Muscle functional magnetic resonance imaging (mfMRI) measures transverse relaxation time (T2), and allows for determination of the spatial pattern of muscle activation. The purposes of this pilot study were to examine whether MRI-derived T2 or side-to-side differences in T2 (asymmetries) differ in low back muscles between subjects with acute low back pain (LBP) compared to asymptomatic controls, and to determine if a single osteopathic manipulative treatment (OMT) session alters these T2 properties immediately and 48-hours after treatment.

Methods: Subjects with non-specific acute LBP (mean score on 110 visual analog score = 3.

Repeated palpatory training of medical students on the Virtual Haptic Back.

The effectiveness of simulation-based training has been accepted with great success in many fields including medicine. Most of the simulation research and development in medicine has focused on surgery. There has been some development of hardware based biomechanical models of sections of human anatomy, such as pelvic exam simulators.

The virtual haptic back: a simulation for training in palpatory diagnosis.

Background: Models and simulations are finding increased roles in medical education. The Virtual Haptic Back (VHB) is a virtual reality simulation of the mechanical properties of the human back designed as an aid to teaching clinical palpatory diagnosis.

Methods: Eighty-nine first year medical students of the Ohio University College of Osteopathic Medicine carried out six, 15-minute practice sessions with the VHB, plus tests before and after the sessions in order to monitor progress in identifying regions of simulated abnormal tissue compliance.

Palpatory diagnosis training on the virtual haptic back: performance improvement and user evaluations.

Context: Learning palpatory diagnosis is a challenge for many osteopathic medical students. The Virtual Haptic Back (VHB) is an aid in teaching and learning these skills. The device simulates the contours and surface compliances of the human back and allows these to be felt through haptic interfaces.

Effect of counterstrain on stretch reflexes, hoffmann reflexes, and clinical outcomes in subjects with plantar fasciitis.

Context: Previous research indicates that osteopathic manipulative treatment based on counterstrain produces a decrease in the stretch reflex of the calf muscles in subjects with Achilles tendinitis.

Objectives: To study the effects of counterstrain on stretch reflex activity and clinical outcomes in subjects with plantar fasciitis.

Methods: In a single-blind, randomized controlled trial of crossover design, the effects of counterstrain were compared with those of placebo in adult subjects (N=20) with plantar fasciitis.

Stretch reflex and Hoffmann reflex responses to osteopathic manipulative treatment in subjects with Achilles tendinitis.

Context: Irvin M. Korr, PhD, hypothesized that sensitivity of the monosynaptic stretch reflex (ie, deep tendon reflex) plays a major role in the restriction-of-motion characteristic of somatic dysfunction, and that restoration of range of motion through osteopathic manipulative treatment (OMT) could be achieved by resetting of the stretch receptor gain.

Objective: To test Korr's hypothesis in the context of Achilles tendinitis, examining whether OMT applied to patients with Achilles tendinitis reduces the strength of the stretch reflex.

The "iliacus test": new information for the evaluation of hip extension dysfunction.

This study confirms the clinical value of investigating the "iliacus complex" during evaluations of the low back. A new "iliacus test" isolates this iliacus complex component of limited hip extension. Designed for a single joint, the test isolates motion across the hip joint.

The relationship between elbow flexor volume and angular stiffness at the elbow.

OBJECTIVE: The purpose of this experiment was to determine if a correlation exists between the volume of the elbow flexors and angular stiffness at the elbow, and to determine the contribution of the biceps brachii and the brachialis muscles to angular stiffness. DESIGN: This study is a descriptive, correlational study and presents a graphical model of the passive properties of muscle. BACKGROUND: The correlation between arm volume and angular stiffness has been shown, but the measurement of arm volume was not specific to the structures being strained.