Advance Articles

This study focused on investigating the incidence of sacral dysfunctions in recently postpartum patients by assessing the type of sacral somatic dysfunction present in postpartum patients and investigating the correlation between various demographic factors and sacral somatic dysfunctions.

Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide, and its intersection with cancer has emerged as a significant clinical concern. This comprehensive review synthesizes the current evidence on the association between AF and cancer, focusing on incidence and relative risk, biological mechanisms, temporal patterns, clinical outcomes, guideline recommendations, and research gaps.

Chronic low back pain (CLBP) remains a leading cause of disability and healthcare spending, with roughly 1 in 10 adults reporting persistent pain that limits activity and work participation. Contemporary guidelines emphasize multimodal, nonpharmacologic care and caution against early pharmacologic escalation given modest average benefits and dose-related harms. The objective of this study is to deliver precise, clinically interpretable short-term estimates of OMT’s benefits and harms for CLBP to inform guideline-concordant care and to guide future comparative-effectiveness trials.

Parental leave policies for physicians in the United States remain inconsistent and inadequate, despite growing recognition of their critical role in supporting families’ well-being and retention in the workplace. This review and policy proposal highlights the unique challenges faced by physicians and the urgent need for targeted federal and state-level policy interventions to advance paid parental leave and improve the physician workforce sustainability in the United States.

While medications have their place in the treatment of pain, incorporating osteopathic manipulative treatment (OMT) into pain treatment protocols may be beneficial. OMT has been administered with positive results in the reduction of pain, but it has been difficult to quantify palpable somatic changes, post-OMT. However, with technological advancement, adding objective documentation could potentially support the many published subjective studies demonstrating OMT effectiveness, reproducibility of OMT techniques, and the effect of OMT in pain reduction. This study documented objective changes in cervical hysteresis, consistent reproducible palpatory diagnosis, and treatment pressures with associated pain levels.

The National Board of Osteopathic Medical Examiners (NBOME) provides the Foundational Biomedical Sciences (FBS) examinations – FBS-Comprehensive and FBS-Targeted – to support the evaluation of osteopathic medical knowledge. However, the relationship between FBS performance and performance on the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) Level 1 has not been fully explored. The purpose of this study is to investigate the relationship between performance on Comprehensive Osteopathic Medical Achievement Test (COMAT) FBS assessments and COMLEX-USA Level 1 scores.

Depression and other mood disorders have a significant impact on patients, affecting their daily functioning, physical health, and emotional well-being. This systematic review contributes to the existing literature by evaluating published studies on the effectiveness of various manual-therapy modalities in reducing depression symptoms, and it provides a comparative examination of these modalities as complementary treatment options for depression and related mood disorders.

In 2020, the Accreditation Council on Graduate Medical Education (ACGME) became the sole accrediting body for osteopathic and allopathic residency programs. The objective of this study was to examine the demographic changes in osteopathic residents, faculty, and program directors in ACGME family medicine programs over the 5-year period of transition to single accreditation.

Cocaine-associated cardiovascular events pose significant challenges in primary care settings, where outpatient physicians often serve as the first point of contact for patients with both acute and chronic cardiovascular complications. This review aimed to systematically evaluate the evidence of unopposed alpha stimulation when prescribing beta blockers in people who utilize cocaine, as well as the safety and efficacy of beta blockers in managing heart failure in this population.

Cervicogenic headache (CeH) is a common secondary headache type arising from a disorder or lesion of the cervical spine and its soft tissues. This study aimed to evaluate the effect of osteopathic manipulative treatment (OMT) in patients with CeH.

This Letter to the Editor underscores the importance of integrating contemporary scientific advances and ethical imperatives into the future of osteopathic medicine.

Intractable hiccups is a rare medical condition defined as daily hiccups continuing for more than 30 days and is recognized by the National Organization for Rare Disorders and NIH Genetic and Rare Diseases Information Center. Hiccups are spasmodic contractions of the respiratory muscles, triggered by activation of the hiccup reflex arc, and intractable hiccups can occur if this arc is chronically or aberrantly activated. The objective of this case series is to determine whether one session of OMT can reduce the severity of intractable hiccups.

Chronic venous insufficiency (CVI) and peripheral arterial disease (PAD) are associated with significant morbidity, often manifesting as edema, pain, and nonhealing ulcers. The objective of this study is to systematically evaluate the evidence regarding the effectiveness of osteopathic manipulative medicine lymphatic drainage techniques on wound healing, symptoms, and quality of life in patients with CVI and PAD.

Osteopathic manipulative treatment (OMT) has been recognized as a conservative management option for patients with carpal tunnel syndrome (CTS), although limited research exists to validate its ability to effect posttreatment changes in the median nerve or the surrounding soft tissues. The objectives of this study are to evaluate and quantify changes in the elasticity of the median nerve, transverse carpal ligament, and intracarpal tunnel soft tissues in patients treated for CTS with traditional conservative therapy (e.g., steroid injection and splinting), OMT, or OMT plus conservative therapy.

Shortages in medical subspecialty care, particularly endocrinology, present a growing challenge in the United States. In Ohio, structural inequities in the rural and Appalachian regions, including fewer healthcare providers, limited facilities, and barriers to transportation and broadband connectivity, contribute to delayed diabetes diagnoses, increased complications, and a higher mortality rate. This study aimed to examine the distribution of endocrinology subspecialists in Ohio and the corresponding prevalence of diabetes.

The purpose of this paper is to present a self-assessment rubric for colleges of osteopathic medicine (COMs) that encompasses all aspects of the academic medical enterprise. This work endeavors to capture the extent to which a COM creates an institutional culture of professional behavior, from the first touchpoints of interaction with the COM, through all aspects of the educational experience as well as provision of care, education, and service toward the COM’s mission.

Child maltreatment impacts an estimated 7.4 per 1,000 children in the United States. Given the severity of some abusive injuries, children may present to emergency departments (EDs). As such, EDs are primary screening locations for early identification of maltreatment. The objective of this study was to assess rates of maltreatment among pediatric patients presenting to the ED.

Heart failure affects 6.7 million American adults. The gold standard for heart failure assessment is echocardiography to determine the ejection fraction (EF). Evaluating the cardiac apex angle may be a possible way to estimate EF; however, there is a lack of investigation into this relationship. This study aimed to evaluate whether a correlation exists between the cardiac apex angle and EF.

The United States is facing a persistent physician shortage, particularly in rural and tribal regions. Oklahoma ranks 43rd nationally for primary care provider availability, with rural and tribal communities experiencing some of the most severe health workforce shortages. This study aimed to evaluate the geographic distribution and practice outcomes of graduates from three family medicine residency programs located in tribal healthcare systems in Oklahoma and to assess their contributions to addressing physician shortages in rural and underserved areas.

Burnout is a critical issue, with prevalence as high as 76 % among medical students. Associated with decreased empathy, cheating, withdrawal from medical school, and suboptimal patient care, burnout correlates with work hours (WH) and self-harm thoughts (SHT). This study analyzes the correlations of burnout, WH, SHT, and various socioeconomic, demographic, experiential, and behavioral factors among medical students.

Acute neck and low back pain are common emergency department presentations, generally treated with nonsteroidal anti-inflammatory drugs. Osteopathic manipulative treatment (OMT) is a hands-on treatment modality utilized to treat a variety of musculoskeletal conditions. The authors sought to evaluate the relative efficacies and side effects of hands-on OMT vs. one dose of oral ibuprofen, in the treatment of adult patients presenting with acute neck or back pain.

Concerns about differences in medical training between DO and MD students may lead to biases against DOs as applicants for entry into residency or fellowship programs. This study aimed to compare Milestone assessments across ACGME competencies of residents who attended US allopathic vs. osteopathic medical schools, hypothesizing that there would be no differences throughout residency.

Kinesiology tape (KT) is a common adjunct in the management of patellofemoral pain syndrome (PFPS), with the intention to alleviate pain and facilitate microcirculation by providing positional stimuli to the surrounding musculature. The purpose of this systematic review and meta-analysis is to analyze the effectiveness of KT in pain reduction for individuals with PFPS.

The pediatric surgical workforce in the United States faces increasing strain due to a limited supply of specialists, geographic maldistribution, and rising complexity in pediatric cases. This review analyzes current gaps in the pediatric surgical workforce and propose actionable solutions through an osteopathic lens, including the integration of osteopathic principles such as whole-person care, preventive health, and OMT.

Whiplash is common after road traffic accidents and affects millions of people worldwide. The incidence of whiplash-associated disorders has risen to at least 300 per 100,000 in Western countries, with global emergency room visits estimated at 235–300 per 100,000 annually. The aim of this study was to evaluate an osteopathic intervention for whiplash and determine whether pain, mobility, and quality of life improve with respect to conventional treatment.

Interprofessional education in health professions training strives to create a future collaborative healthcare workforce for the betterment of patient care. This study aimed to critically analyze the discourse of an interprofessional team of healthcare students following a simulated patient encounter to assess the power dynamic among the professions present.

Overhead throwing in elite baseball pitchers is a rapid, highly coordinated motion that culminates in extreme action from the upper extremity. Injuries to throwing athletes stereotypically occur to the shoulder and elbow; however, throwing is not solely an upper-extremity task. Previous studies have sought to improve pitch performance and shoulder function utilizing the Muscle Energy Technique or Spencer’s technique. This study is the first to measure the effects of OMT among key points of the kinetic chain, measuring range of motion of the shoulder and the hip, as well as pitch metrics beyond release velocity.

Acute lateral ankle sprain (ALAS) is responsible for short-term disability, increased risk for future acute ankle sprain, and chronic ankle instability. The objectives of this study were to evaluate the effectiveness of osteopathic care in ALAS, to assess pain, edema, and functional stability of the injured ankle, and to assess and comparing mobility between the injured and noninjured ankle.

Osteopathic manipulative treatment (OMT) encompasses a wide range of diagnostic and treatment techniques for many conditions, but few studies have evaluated OMT use on injured patients. The authors aimed to describe the use of OMT on injured patients from a nationwide sample of emergency department encounters.

The clinical relationship between cardiovascular disease and deleterious surgical outcomes has been extensively examined; however, the relationship between cardiovascular risk and the association with major surgical interventions has yet to be examined at the population level. This study attempts to quantify the relationships between cardiovascular risk factors and the history of open-chest or abdominal surgery.

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a life-sustaining therapy for severe refractory cardiogenic shock. Although VA-ECMO provides various degrees of cardiopulmonary support, mortality rates remain high. Serum biomarkers have potential to identify the rising risk of mortality in patients receiving ECMO, but evidence supporting their prognostic value is inconsistent. This study aims to systematically investigate existing evidence on the relationship between biomarkers and mortality in adult patients with refractory cardiogenic shock undergoing VA-ECMO support.

The purpose of this study was to evaluate formerly American Osteopathic Association (AOA) - accredited orthopaedic surgery programs to identify the prevalence of DO degrees among program directors and residents, and stratify the association of program geography, program director degree, and osteopathic recognition status on resident composition.

The Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) is a three-level national standardized licensure examination designed for the practice of osteopathic medicine. The purpose of this study is to investigate the differences in student Level 1 self-reported stress levels, test preparation, and performance following the transition to pass/fail score reporting.

The primary objective of this study was to assess the current rates of UTIs among perinatal women and to identify associations with sociodemographic and comorbid factors. Findings from this study should allow for more comprehensive screening and preventive measures to be addressed, and potentially identify current barriers to accessing treatment during this critical time frame.

Since healthcare workers and medical students are at higher exposure risk to the hepatitis B virus (HBV), immunity status is important to assess and maintain. The objective of this study is to evaluate whether various factors, including the interval between vaccination and antibody titer measurement and the timing of first vaccination, contribute to a reduction in HBV immunity among medical students with a history of HBV vaccination.

Randomized controlled trials (RCTs) are essential for developing effective treatments, but when trials are discontinued or unpublished, valuable data are lost. This study aims to evaluate the rates and characteristics of discontinuation and nonpublication among US-registered phase 3 and 4 RCTs investigating osteoporosis therapies from 2000 to 2022.

The benefits of breastfeeding are well established, from reduced incidence of common childhood infections to decreased incidence of sudden infant death syndrome and infant mortality. The purpose of this study was to evaluate whether utilization of a standardized OMT protocol as an adjunct to lactation support improves feeding dysfunction in breastfed newborns.

This study was undertaken to build upon the work of J. Gordon Zink, DO, FAAO, by developing a novel screening examination (Expanded Zink screen) that can correlate with proper identification of somatic dysfunction, the area of greatest restriction, and effective treatment in soccer players,

This study aims to assess the reliability of a novel, systematic musculoskeletal examination model — called the Functional Pathology of the Musculoskeletal System (FPMSS) model, which assesses the musculoskeletal system as an integrated organ system — to identify somatic dysfunction after stroke or transient ischemic attack in healthy participants.

Experimental evidence supporting the existence of the viscerosomatic reflex highlights an involvement of multiple vertebral levels when renal pathology is present. Further exploration of this reflex, particularly in the context of nephrolithiasis, could offer valuable insights for osteopathic treatments related to this pathology. This study aimed to compare the rotation of vertebrae at levels associated with the viscerosomatic reflex in renal pathology in patients with nephrolithiasis vs. those without kidney stones.