Advance Articles

Concussions are some of the most common sports-related injuries in US high school athletes, yet concussions have a wide range of symptoms and stigma that lead to underreporting of symptoms to healthcare professionals and coaches. Previous studies have linked sleep disturbances to increased head injury risk in collegiate athletes, but less is known about this relationship in younger populations. With thousands of high school athletes sustaining concussions annually, this study aimed to explore associations between sleep quantity/quality and concussion history in high school athletes and if these vary by sex or other sociodemographic factors.

Severe asthma affects 3–10 % of all asthma patients but accounts for disproportionately high morbidity and mortality. These patients tend to experience more frequent hospitalization compared to mild-to-moderate controlled asthmatics or the general population. Despite optimized inhaler therapy, many patients experience persistent symptoms and impaired lung function. Biologics targeting type-2 inflammation, including benralizumab, dupilumab, and tezepelumab, have emerged as add-on treatments that improve lung function and quality of life. The objective of this meta-analysis was to evaluate the efficacy of benralizumab, dupilumab, and tezepelumab in adults with severe asthma.

Patients recovering from trauma frequently experience persistent pain and functional limitations requiring ongoing healthcare utilization. To address this need, the authors established a novel OMT for trauma program to complement interventions for patients with subacute and chronic postinjury pain and mobility impairments. This study aims to evaluate the growth and effectiveness of the program over its first 3 years.

The future of osteopathic institutions depends not on preserving traditional structures, but on adapting while clearly articulating the profession’s distinct value. Osteopathic medicine combines whole-person principles, prevention, and care tailored to individual patient needs. As these principles increasingly enter mainstream healthcare, osteopathic institutions must decide whether to lead that transformation or be left behind.

Team physicians play a critical role in professional sports, providing medical care for athletes under high-pressure conditions. These positions are highly competitive, influenced by previous affiliations, training pedigree, and institutional connections, with fellowship training increasingly essential. The objective of this study is to compare the training and demographic characteristics of DO and MD team physicians in professional sports leagues.

This study aims to develop a Doppler ultrasonography protocol to assess blood flow changes in the subclavian artery before and after osteopathic manipulative treatment that was intended to address musculoskeletal dysfunction associated with vascular thoracic outlet syndrome.

While the change to a Pass/Fail designation was meant to improve medical students’ mental health during their first-level licensure examination period, it is also critical to consider how this may affect students during their second-level licensure examination period. This study aims to investigate the quality of life of osteopathic medical students during their designated study periods for COMLEX-USA Level 1 and Level 2 after the transition of COMLEX-USA Level 1 to a Pass/Fail designation.

The brain is highly vulnerable to circulatory disruptions, including cerebrovascular accident (CVA or stroke), and stroke survivors can benefit from cardiac rehabilitation (CR). This systematic review evaluated the safety and efficacy of CR in stroke survivors.

Clinical assessment of vertebral segment motion in the horizontal plane relies on applying anterior force to the tissues overlying transverse processes (TPs). Although current osteopathic principles suggest that this force induces vertebral rotation around a vertical axis, this mechanism has not been verified. The objective of this study was to assess whether anterior force applied to the TP of the seventh thoracic vertebra (T7) induced vertebral rotation about a vertical axis.

Postural balance is essential for daily activities, injury prevention, and rehabilitation, and it can be objectively assessed through stabilometric analysis of center-of-pressure oscillations. This study examined whether a biodynamic osteopathic approach characterized by a light, attentive touch could enhance postural stability in asymptomatic adults compared to a sham nonattentive touch and a no-treatment control.

Students at medical schools without home residency programs face barriers such as limited research opportunities, lack of faculty mentorship, and minimal specialty exposure that result in lower match rates in competitive fields like neurosurgery and reduce workforce diversity. The purpose of this study was to design and implement a structured, year-long research curriculum as a proof-of-concept model to explore whether such programming may improve specialty match outcomes for students from underresourced institutions.

Gestational diabetes mellitus has been associated with increased infectious morbidity antenatally. However, it is unclear whether the risk of infections in this population remains elevated postpartum. The objective of this study was to evaluate whether medication-controlled gestational diabetes mellitus increases the risk for infectious morbidity in the postpartum period.

Quality mentorship for medical students and resident physicians throughout their medical education has been shown to be beneficial in supporting students in their academic and professional endeavors. This review aims to evaluate the quality and availability of osteopathic mentorship in medical education and to identify areas of improvement and barriers for implementing structured mentorship programs across institutions.

Breast cancer is the second leading cause of cancer death among women in the United States. Screening mammograms reduce mortality overall, but they present unique challenges in patients with cognitive impairments. The primary objective of this study was to determine whether rates of screening mammography differ between women with and without subjective cognitive decline (SCD). The authors also examined whether sociodemographic factors (including urbanicity, income, and insurance status) are associated with differential screening rates among those with and without SCD.

Osteopathic manipulative treatment has been shown to have a mild to moderate treatment effect on reducing low back pain and disability. This study aims to determine the efficacy of OMT in the treatment of mechanical low back pain with regard to pain, disability, and quality of life.

Since its inception, osteopathic medicine has included pediatric patients within its clinical scope, addressing a wide range of congenital, postural, respiratory, neurological, and musculoskeletal conditions. This study aimed to review historical osteopathic literature for the analysis of osteopathic manipulative treatment utilized for the management of pediatric patients.

Vaginismus is a condition characterized by involuntary vaginal muscle contraction leading to pain and distress that significantly impacts sexual health, psychological well-being, and quality of life. This review highlights the importance of a multidisciplinary, patient-centered approach to managing vaginismus and underscores the need for further research to refine and expand therapeutic options.

Early detection of colon cancer through screening is critical for improving long-term survival outcomes; however, only 54% of the US population that is eligible to have a colon cancer screening receive one. Previous research found that people who participate in physical activity are less likely to get screened due perception of having low risk. This study aimed to examine the association between colon cancer screening and self-reported health status for individuals meeting aerobic physical activity guidelines among individuals aged 45–54.

Osteopathic medical care has been associated with better long-term outcomes in an intention-to-treat analysis of data from a retrospective cohort study involving chronic low back pain. This study utilized data from the previously reported study to conduct a per-protocol analysis to determine the outcomes of osteopathic medical care utilizing a pragmatic research design in which patients consistently received osteopathic or allopathic medical care during long-term follow-up.

Nonpharmacologic treatments are recommended for the treatment of pain including osteopathic manipulative treatment (OMT). It has been shown there is low utilization of OMT and disparities in access in patient with pain conditions. The objective of this study is to describe the current landscape of OMT receipt as an adjunct in adult patients prescribed opioids. Through the exploration of a national outpatient database, this study will discern if there are disparities to receiving OMT.

Ehlers-Danlos syndrome and hypermobility spectrum disorder (HSD) are connective tissue disorders associated with musculoskeletal manifestations and significant psychiatric comorbidities. Psychoactive medications commonly utilized in these populations raise concerns regarding potential cardiac effects. This study explores associations between psychoactive medication utilization and electrocardiogram parameters in patients with hypermobile Ehlers-Danlos syndrome and HSD to provide insight into potential cardiac considerations in this population.

Access to mobile recording devices and the prevalence of telehealth encounters have increased dramatically in recent years. These circumstances create opportunities for patients to record their clinical encounters, and some states do not require permission from the physician to do so. State laws that define requirements to record conversations vary significantly, and clinicians may be unaware of their own states’ policies. This commentary explores the legislation governing recording laws, describes several cases involving recorded healthcare information, and reviews studies examining the risks and benefits of recording encounters.

Currently, there is no strong evidence or guideline recommendations for utilizing OMM when treating patients with postacute sequelae of SARS-CoV-2 (PASC). In this article, the authors describe a protocol for a large-scale prospective study to determine the effectiveness of OMM in treating PASC-related symptoms, to assess its impact on functional outcomes, and to monitor for adverse events related to OMT.

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.

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.

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.