Topic
Lumbar Somatic Dysfunction
About: Lumbar Somatic Dysfunction is a research topic. Over the lifetime, 4 publications have been published within this topic receiving 7 citations.
Papers
TL;DR: Study results suggest that somatic dysfunction was more significant in chronic LBP participants and segmental BMD T scores were higher for vertebrae demonstrating moderate/severe rotational asymmetry and tenderness.
Abstract: Context: Somatic dysfunction as diagnosed by palpation should be associated with an objective measure. Bone mineral density (BMD) has been shown to be elevated in lumbar vertebrae with somatic dysfunction and in the lumbar region of individuals with chronic low back pain (LBP). Objective: To investigate the association of lumbar somatic dysfunction and BMD T-score variability in participants with chronic LBP and without LBP (non-LBP) and to determine the reproducibility of previously published results. Methods: Two examiners, blinded to symptom history, evaluated participants for tissue texture abnormalities, rotational asymmetry, anterior motion restriction, and tenderness at vertebral levels L1 to L4. Participants also underwent dual-energy xray absorptiometry of vertebral levels L1 to L4 for the assessment of BMD T scores. Generalized linear models were used to compare the chronic LBP and non-LBP groups on the presence and severity of somatic dysfunction and to test whether group and the presence and severity of somatic dysfunction were related to BMD T scores. Results: Forty-three chronic LBP (54%) and 36 non-LBP participants (46%) completed the study. Although the presence of somatic dysfunction in the 2 groups was not significantly different, the presence of tenderness was significantly more common in the chronic LBP group (P<.001), as was the severity for tissue texture abnormalities (P=.03), motion restriction (P=.04), and tenderness (P<.001). Of the 316 vertebrae assessed, 31 (10%, all in the chronic LBP group) had moderate/ severe tenderness. The vertebral somatic dysfunction burden score, the total somatic dysfunction burden score, the vertebral somatic dysfunction severity score, and the total somatic dysfunction severity score were higher in the chronic LBP group (all P<.001). The vertebral BMD T score was significantly higher for vertebrae demon strating moderate/severe rotational asymmetry compared with those demonstrating mild or no rotational asymmetry (P=.01) and for vertebrae demonstrating moderate/ severe tenderness compared with those demonstrating no tenderness (P=.04). Conclusion: Study results suggest that somatic dysfunction was more significant in chronic LBP participants. Although the correlation between the presence of somatic dysfunction and segmental BMD T scores was not reproduced, BMD T scores were higher for vertebrae demonstrating moderate/severe rotational asymmetry and tenderness.
7 citations
TL;DR: Persistent vertebral motion restriction was shown to have an association with final lumbar BMD T scores, and persistent TTA and tenderness were associated with changes in the B MD T scores over 8 weeks.
Abstract: CONTEXT Clinically meaningful somatic dysfunction, if left untreated, should persist over time and be associated with objective measurable findings OBJECTIVE To investigate the persistence of lumbar somatic dysfunction over 8 weeks and the association of that persistence with lumbar bone mineral density (BMD) T scores METHODS Individuals were assessed at 0, 4, and 8 weeks for the presence and severity of paraspinal tissue texture abnormalities (TTA), vertebral rotational asymmetry, anterior motion restriction, and tenderness from L1 to L4 Participants underwent dual-energy x-ray absorptiometry of the lumbar spine at 0 and 8 weeks Persistent somatic dysfunction findings from all 3 examinations were compared with BMD T scores obtained at 8 weeks and to changes in the BMD T scores from 0 to 8 weeks RESULTS Forty-eight individuals (38 women [79%] and 10 men [21%]) participated in the study The mean (standard deviation [SD]) age was 301 (64) years (range, 200-408 years), and the mean (SD) body mass index was 263 (52) The percentage of vertebrae with persistent somatic dysfunction varied by vertebral level and ranged from 44% to 83% for TTA, 63% to 79% for rotational asymmetry, 10% to 56% for motion restriction, and 2% to 10% for tenderness Vertebral segments with persistent motion restriction had higher mean BMD T scores (95% confidence interval [CI]) than those without persistent motion restriction (06 [04 to 08] vs 02 [01 to 04], respectively; P=02) There was a significant increase in the vertebral BMD T scores for those vertebrae that demonstrated persistent TTA (P=02) and for those vertebrae that demonstrated persistent moderate/severe TTA (P=02) A significant difference was found in the initial to final vertebral BMD T-score change between vertebrae that demonstrated persistent tenderness and those that did not (mean [95% CI] change, -02 [-04 to 01] vs 01 [00 to 01], respectively; P=04) CONCLUSION A persistence of predominantly left lumbar rotation was observed Persistent vertebral motion restriction was shown to have an association with final lumbar BMD T scores, and persistent TTA and tenderness were associated with changes in the BMD T scores over 8 weeks
2 citations
18 Aug 2021
TL;DR: There are a variety of Osteopathic Manipulative Treatments (OMT) aimed at reducing lower back pain, two of which include counterstrain (CS) and facilitated positional release (FPR) techniques.
Abstract: The lumbar spine is involved in a myriad of duties, including weight-bearing, providing a sound structure that allows for locomotion, and upholding the spinal neural structures. With constant motion and close proximity to a network of nerves, the lumbar spine is a common source of low back pain. Low back pain is common in the adult population. Some estimates show that 84% of the adults in the United States will experience low back pain at some point in their life. A metanalysis has found that Osteopathic Manipulative Treatment (OMT) can significantly reduce lower back pain. There are a variety of Osteopathic Manipulative Treatments (OMT) aimed at reducing lower back pain, two of which include counterstrain (CS) and facilitated positional release (FPR) techniques. Both of these techniques are considered to be indirect techniques, meaning they take the patient away from the restrictive barrier. The basis of the CS technique is identifying the inappropriately hypertonic, or shortened muscle belly, which causes an excessive amount of discomfort during activation or palpation. CS aims to relieve the muscle’s tension indirectly. To achieve this, the muscle is placed in a position of ease for a sustained period. FPR is a similar indirect technique that places the somatic dysfunction in a neutral position and adds an activating compressive or rotational force.While focusing treatment on the lumbar musculature, it is important to evaluate and treat the adjacent axial skeleton and spinal segments. A full osteopathic treatment should consist of evaluating the surrounding structures such as the thoracic spine, sacrum, and the pelvis for alleviating and preventing further lumbar somatic dysfunction and associated back pain. This educational paper aims to educate on these two osteopathic treatment modalities for lumbar somatic dysfunctions: counterstrain and facilitated positional release.
TL;DR: It is observed that using equal pressures in both hands while palpating a lumbar segment correlates to more accurate somatic dysfunction diagnoses.
Abstract: Context There is no consensus on the correlation between clinical experience and accuracy in diagnosing somatic dysfunctions, which makes it difficult to justify the use of more subjective measures to evaluate this important association. To better understand this relationship, palpatory forces can be observed while diagnosing a somatic dysfunction. Objective To quantify the pressure applied in diagnosing lumbar somatic dysfunction, find a correlation between accuracy of diagnosis and palpation pressure, set the standards for palpation, and develop precise palpatory skills for osteopathic medical students. Methods The palpatory forces were evaluated between participants with varying experience levels (osteopathic medical students and attending physicians from the New York Institute of Technology College of Osteopathic Medicine). Two osteopathic physicians confirmed an L5 somatic dysfunction diagnosis in a volunteer standardized patient (SP), who served as the control. Participants then palpated the lumbar segment of the SP in a prone position with F-Scan System (TekScan) sensors, which recorded the amount of pressure and time used to reach a full diagnosis. Results Participants (11 osteopathic medical students and 10 attending physicians) who diagnosed an L5 somatic dysfunction consistent with the SP's diagnosis had less of a difference in peak force (mean [SD] difference, 62.50 [325.7] g/cm2) between the contact points (right hand vs left hand). In contrast, participants with a dissimilar L5 diagnosis from the SP's had a mean (SD) difference in peak force of 319.38 (703.1) g/cm2. Similarly, the difference in the mean (SD) force of palpation between the contact points was lower in participants who made the correct diagnosis (16.81 [117.4] g/cm2) vs those who made an incorrect diagnosis (123.92 [210.3] g/cm2). No statistical significance was found between the diagnostic accuracy of the students and physicians (P=.387) or the time taken to reach a diagnosis (P=.199). Conclusion We observed that using equal pressures in both hands while palpating a lumbar segment correlates to more accurate somatic dysfunction diagnoses.
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2021 | 1 |
| 2020 | 1 |
| 2014 | 2 |