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BLOG DE OSTEOPATIA E CIÊNCIA
18 fevereiro, 2019
16 fevereiro, 2019
Symptom perception, placebo effects, and the Bayesian brain
Artigo na íntegra sobre um tema muito interessante e que ilustra uma mudança de paradigma do modelo biomédico, na interpretação do efeito placebo e nocebo. Tanto um como outro são respostas de um sistema nervoso central ativo e são uma parte integrante na cura e nos sintomas do paciente. Entender estes importantes mecanismos e torná-los inclusivos na terapêutica e prognóstico (em vez de os considerar como uma resposta aberrante) é uma mudança de paradigma.
Boa leitura !
Giulio Ongaroa, Ted J. Kaptchukb
"...Conclusion: Symptoms without a physical cause and relief through placebo intervention are anomalies for the biomedical model of disease. The Bayesian approach to perception explains and accommodates these 2 phenomena. It exposes placebo and nocebo effects, not as aberrant events, but as facets of the overall modus operandi of the nervous system. It shows, also, that these act on the same inferential processes as “real” disease and “real” treatments do. The implication of this approach is that, to be truly patient-focused, medicine must attend to the predictive process that lies at the basis of symptom perception, and thereupon evaluate what efficient courses of action can lead the brain to predict the body’s health."
3http://eprints.lse.ac.uk/90458/1/Ongaro_Symptom%20perception_2018.pdf
Boa leitura !
Symptom perception, placebo effects, and the Bayesian brain
Giulio Ongaroa, Ted J. Kaptchukb
"...Conclusion: Symptoms without a physical cause and relief through placebo intervention are anomalies for the biomedical model of disease. The Bayesian approach to perception explains and accommodates these 2 phenomena. It exposes placebo and nocebo effects, not as aberrant events, but as facets of the overall modus operandi of the nervous system. It shows, also, that these act on the same inferential processes as “real” disease and “real” treatments do. The implication of this approach is that, to be truly patient-focused, medicine must attend to the predictive process that lies at the basis of symptom perception, and thereupon evaluate what efficient courses of action can lead the brain to predict the body’s health."
3http://eprints.lse.ac.uk/90458/1/Ongaro_Symptom%20perception_2018.pdf
04 fevereiro, 2019
Fascial tissue research in sports medicine: from molecules to tissue adaptation, injury and diagnostics: consensus statement
, et al. Fascial tissue research in sports medicine: from molecules to tissue adaptation, injury and diagnostics: consensus statement
Abstract
The fascial system builds a three-dimensional continuum of soft, collagen-containing, loose and dense fibrous connective tissue that permeates the body and enables all body systems to operate in an integrated manner. Injuries to the fascial system cause a significant loss of performance in recreational exercise as well as high-performance sports, and could have a potential role in the development and perpetuation of musculoskeletal disorders, including lower back pain. Fascial tissues deserve more detailed attention in the field of sports medicine. A better understanding of their adaptation dynamics to mechanical loading as well as to biochemical conditions promises valuable improvements in terms of injury prevention, athletic performance and sports-related rehabilitation. This consensus statement reflects the state of knowledge regarding the role of fascial tissues in the discipline of sports medicine. It aims to (1) provide an overview of the contemporary state of knowledge regarding the fascial system from the microlevel (molecular and cellular responses) to the macrolevel (mechanical properties), (2) summarise the responses of the fascial system to altered loading (physical exercise), to injury and other physiological challenges including ageing, (3) outline the methods available to study the fascial system, and (4) highlight the contemporary view of interventions that target fascial tissue in sport and exercise medicine. Advancing this field will require a coordinated effort of researchers and clinicians combining mechanobiology, exercise physiology and improved assessment technologies.
Chronic pain as a symptom or a disease the IASP Classification of Chronic Pain for the International Classification of Diseases
Abstract
Chronic pain is a major source of suffering. It interferes with daily functioning and often is accompanied by distress. Yet, in the International Classification of Diseases, chronic pain diagnoses are not represented systematically. The lack of appropriate codes renders accurate epidemiological investigations difficult and impedes health policy decisions regarding chronic pain such as adequate financing of access to multimodal pain management. In cooperation with the WHO, an IASP Working Group has developed a classification system that is applicable in a wide range of contexts, including pain medicine, primary care, and low-resource environments. Chronic pain is defined as pain that persists or recurs for more than 3 months. In chronic pain syndromes, pain can be the sole or a leading complaint and requires special treatment and care. In conditions such as fibromyalgia or nonspecific low-back pain, chronic pain may be conceived as a disease in its own right; in our proposal, we call this subgroup “chronic primary pain.” In 6 other subgroups, pain is secondary to an underlying disease: chronic cancer-related pain, chronic neuropathic pain, chronic secondary visceral pain, chronic posttraumatic and postsurgical pain, chronic secondary headache and orofacial pain, and chronic secondary musculoskeletal pain. These conditions are summarized as “chronic secondary pain” where pain may at least initially be conceived as a symptom. Implementation of these codes in the upcoming 11th edition of International Classification of Diseaseswill lead to improved classification and diagnostic coding, thereby advancing the recognition of chronic pain as a health condition in its own right.
Treede, Rolf-Detlefa; Rief, Winfriedb; Barke, Antoniab; Aziz, Qasimc; Bennett, Michael I.d; Benoliel, Rafaele; Cohen, Miltonf; Evers, Stefang; Finnerup, Nanna B.h,i; First, Michael B.j; Giamberardino, Maria Adelek; Kaasa, Steinl,m,n; Korwisi, Beatriceb; Kosek, Evao; Lavand'homme, Patriciap; Nicholas, Michaelq; Perrot, Serger; Scholz, Joachims; Schug, Stephant,u; Smith, Blair H.v; Svensson, Peterw,x; Vlaeyen, Johan W.S.y,z,aa; Wang, Shuu-Jiunbb,cc
PAIN: January 2019 - Volume 160 - Issue 1 - p 19–27doi: 10.1097/j.pain.0000000000001384
Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects: The PROMOTE Study A Randomized Controlled Trial
Kendi L. HENSEL, DO, PhD, Steve BUCHANAN, DO, FACOOG (Dist), Mayra RODRIGUEZ, MPH, des Anges CRUSER, PhD
Abstract
Objective—To evaluate the efficacy of Osteopathic Manipulative Treatment (OMT) to reduce low back pain and improve functioning during the third trimester in pregnancy and improve selected outcomes of labor and delivery.
Study Design—PROMOTE was a randomized, placebo-controlled trial of 400 women in their third trimester. Women were randomized to usual care only (UCO), usual care plus OMT (OMT), or usual care plus placebo ultrasound treatment (PUT). The study included seven treatments over nine weeks. The OMT protocol included specific techniques administered by board-certified OMT specialists. Outcomes were assessed using self-report measures for pain and back-related functioning, and medical records for delivery outcomes.
Results—There were 136 women in the OMT group, 131 in PUT, and 133 in UCO. Characteristics at baseline were similar across groups. Findings indicate significant treatment effects for pain and back related functioning (P<.001 for both), with outcomes for the OMT group. Similar to that of the PUT, but both groups were significantly improved compared to UCO. For secondary outcome of meconium- stained amniotic fluid there were no differences between the groups.
Published in final edited form as:
Am J Obstet Gynecol. 2015 January ; 212(1): 108.e1–108.e9. doi:10.1016/j.ajog.2014.07.043.
Abstract
Objective—To evaluate the efficacy of Osteopathic Manipulative Treatment (OMT) to reduce low back pain and improve functioning during the third trimester in pregnancy and improve selected outcomes of labor and delivery.
Study Design—PROMOTE was a randomized, placebo-controlled trial of 400 women in their third trimester. Women were randomized to usual care only (UCO), usual care plus OMT (OMT), or usual care plus placebo ultrasound treatment (PUT). The study included seven treatments over nine weeks. The OMT protocol included specific techniques administered by board-certified OMT specialists. Outcomes were assessed using self-report measures for pain and back-related functioning, and medical records for delivery outcomes.
Results—There were 136 women in the OMT group, 131 in PUT, and 133 in UCO. Characteristics at baseline were similar across groups. Findings indicate significant treatment effects for pain and back related functioning (P<.001 for both), with outcomes for the OMT group. Similar to that of the PUT, but both groups were significantly improved compared to UCO. For secondary outcome of meconium- stained amniotic fluid there were no differences between the groups.
Conclusion—OMT was effective for mitigating pain and functional deterioration compared to the UCO group; however OMT did not differ significantly from PUT. This may be attributed to PUT being a more active treatment than intended. There was no higher likelihood of conversion to high risk status based on treatment group. Therefore, OMT is a safe, effective adjunctive modality to improve pain and functioning during their third trimester.
Published in final edited form as:
Am J Obstet Gynecol. 2015 January ; 212(1): 108.e1–108.e9. doi:10.1016/j.ajog.2014.07.043.
02 fevereiro, 2019
Medo da dor e lesão
A Osteopatia é muito mais do que manipular articulações ou músculos. Na verdade está tudo, ou quase tudo no sistema nervoso central. Afinal tudo em nós está em permanente movimento e comunicação. Só 20% do nosso input/ output é nociceptivo e motor. O resto é proprioceptividade, memória, emoções, intimamente ligados ao SN autónomo e glândulas. Cabe ao Osteopata contemporâneo entender esta complexidade de informações aplicando a simplicidade do toque com a intenção de um novo "reset" no paciente cujo sintoma é a "dor".
Aqui fica um link de um trabalho cada vez mais multidisciplinar e transversal às áreas que atuam na dor e movimento.
-Fearing Pain and Injury-
https://www.facebook.com/
Aqui fica um link de um trabalho cada vez mais multidisciplinar e transversal às áreas que atuam na dor e movimento.
-Fearing Pain and Injury-
https://www.facebook.com/
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