Which category of evidence sits highest on the evidence hierarchy pyramid?
Meta-analysis
According to Michael Patterson who were the main contributors to each phase of osteo research?
Phase 1: 1874-1939 - AT Still and the early American Osteopaths
- Phase 2: 1940-1969 - Kirksville College of Osteopathic Medicine
- Phase 3: 1969-2000 - Michigan State University
- Phase 4: 2001-2016 - Osteopathic Research Centre at the University of North Texas
What is the lowest stage of osteopathic research?
background information & expert opnion
What investigation was Louisa Burn’s first research article in 1907 primarily concerned with?
Viscero-somatic and somato-visceral spinal reflexes
What were the key findings of … Louisa Burns’ first research article published in 1907?
where viscerosensory impulses affect visceromotor nerves - in the sympathetic ganglia or spinal cord?- the ganglia
used electrode stinulation of visceral pleura under anaesthesia
- observed contraction of intercostal, diaphragm, QL
destruction of symp ganglia = no response
- “considerable difference in reaction time” across individuals
viscerosensory impulses enter the spinal cord through its posterior roots
somato-visceral reflexes are much less circumscribed and direct than are viscero-somatic reflexes
somato-sensory nerve stimulation plays a key role in normal visceral activity
Using irritating stimulus at segments or inhbiitoru pressure at segments
BP changed more sig with stim near lower splanhncis nerves
In what year was the AT Still Research Institute established in Chicago?
1913
Who debuted a physical spinal model at the AOA convention in 1919?
Halladay
What was the focus of J.S. Denslow’s research published in the journal of neurophysiology in 1914?
neurological aspects of the lesion
studied through electromyography EMG
sites of lesions would exhibit abnormal reflexes contractions in relation to tissue texture changes
lesioned areas showed high degrees of muscle contraction- action potentials firing
normal areas had low contraction- no action potentials firing
-used pressure meters - inserted needle into spine- D4, 6, 8, 10
areas that were lesioned- insertion potentials would last ways longer
-sympathetic osteopathic centres
lesioned areas require way less pressure to instigate a muscle to contraction
different threshold potentials on either side of spine
(Denslow- how lesioned areas make the nerves “Go”)
found
abnormal muscles activity in upset patients
impulses coming from brain- thoughts affect soma
fascilitated segments produced motor and sensory effects- fascilitated
What did Denslow leave out of his research article in 1914?
(he left out the word Osteopathy) published under the radar
What term did J. Denslow coin to describe the enduring hyper-irritable condition of motor cells in the anterior horn in the sub-threshold state of excitation?
Facilitation
ACCORDING TO IRVIN KORR’S 1951 ADDRESS. ‘ THE THREE FUNDAMENTAL PROBLEMS IN OSTEOPATHIC RESEARCH’ WHICH 3 categories could be used to describe ‘all observed and possible manifestations of the osteopathic lesion?
1 - Sensory and suprasegmental
2 - motor or neuromuscular
3 - autonomic or vegetative
What did william johnston D.O’s research on palpatory reliability demonstrate?
Demonstrating palpatory reliability between operators was inconsistent
A lot of the research showing this inconsistency came from cranial research.
Conditions for low agreement between operators
Examiners with variable skill levels
No preparatory calibration of palpatory refinement occurred
Poor definition of palpatory procedure
Recording methods unwieldy
What is Phase 1: 1874-1939 Research by Still & Early Osteopaths?
“I quote no authors but God and experience […]” - AT Still, Philosophy of Osteopathy
- Still’s research: clinical trials on his patients shared through his writings
- 1898 JM Littlejohn research on the impact of spinal manipulations (stimulation and inhibition)
- William Smith angiograms of cadavers (mercury in tallow/beeswax); 70min X-rays; radiography to study treatment effects on circulation
Who is Louisa Burns DO 1870-1958?
1903: graduate of Pacific College of Osteopathy
1906: taught physiology
1914: joined the AT Still Research Institute in Chicago
1917: directs the AT Still Research Institute in California
5 books; numerous articles
What is the summary of Burns’ first article (1907)?
- Interest was specifically related to clarifying exactly where viscero-sensory impulses affect viscero-motor nerves - in the sympathetic ganglia or spinal cord?
- Methods: human and animal (cats and dogs) experiments; “young and healthy” human participants were blinded, reactions described were verified in minimum of 5 individuals (usually 10-12)
- Animal viscero-somatic reflexes: electrode stimulation of visceral pleura under anaesthesia
- Observed contractions of intercostals, diaphragm, QL
- Destruction of sympathetic ganglia = no response
- Vagal sectioning did not alter somatic contractions
What were the factors of the experiments by Burns on the somato-visceral effects on animals?
- short, sharp forceful pinching
- using cutaneous receptors effects on viscera were inconspicuous and inconsistent
- D4-5 stimulated: observed lung colour change (lightening with vasoconstriction)
- cut out cardiac nerves to rule out viscero-viscero influence; same results with lungs collapsed
- reactions also remained when vagi above superior cervical ganglion were cut, but when vagi below SCG cut reaction was faint or absent
- paraspinal tissue at D5-12 stimulated stomach secretions and motility, but when the splanchnic nerves were directly stimulated action was inhibited
What were the inferences and conclusions made by Burns’ experiments?
- “considerable difference in reaction time” across individuals
- “a very important, if not only pathway of viscero-sensory impulses enter the spinal cord through its posterior roots”
- somato-visceral reflexes are much less circumscribed and direct than are viscero-somatic reflexes
- somato-sensory nerve stimulation plays a key role in normal visceral activity
Who was successful in reproducing Burns’ experiments and data?
Wilbur Cole DO
When did the Halladay Spine debut and where?
The AOA Convention in Chicago 1919
What did AG Walmsley DO say about the Halladay Spine in the preface to “Applied Anatomy of the Spine” in 1920?
To say that the exhibit at Chicago made a profound impression upon the profession is putting it mildly. The movements of the spine were so closely demonstrated that one could see just what happened at a given articulation, thus affording a means of criticizing methods of spinal adjustment long in vogue and enabling the practician to visualize the lesion and to determine better the proper procedure for correction.
Who were the two major players of Phase 2: 1940-1969 at Kirksville College of Osteopathic Medicine (KCOM)?
- John Stedman Denslow DO
- Irvin M. (Kim) Korr, PhD
Who is John Stedman Denslow DO?
- graduate of KCOM 1929
- internship at Massachusetts Osteopathic Hospital
- 1930-38: Director of Clinics, Chicago College of Osteopathy
- 1938-63: Professor and Chair of Department of Osteopathic Theory and Methods, KCOM
- 1965-77: Vice-President of KCOM
Who is Irvin M. (Kim) Korr PhD?
- 1930-31: BA, MA University of Pennsylvania
- 1935: PhD Princeton
- 1936: Department of Physiology NYU College of Medicine
- 1942-45: Research under War Department at Columbia
- 1945-75: KCOM
- 1975-78: Michigan State University, College of Osteopathic Medicine
- 1970-90s: TCOM (University of North Texas)
When was Korr working with Denslow?
1945-75 at KCOM
