Advance Articles

Whiplash type injuries resulting from a rear end motor vehicle accident are thought to be caused by excessive loading and displacement of structural components of the cervical spine. On impact, the seat propels the driver’s torso forward relative to the head, resulting in forced flexion of the occipitoatlantal (OA) joint, accompanied by forced stretching of the rectus capitis posterior minor (RCPm) muscles. To quantify the relationships among flexion of the OA joint, RCPm muscle stretch, and backset - and to quantify the biomechanical response of RCPm muscles to increasing levels of axial load due to stretching - the authors assessed the results of hydrauclic stretching of RCPm muscles from unembalmed head and neck specimens from three elderly White female cadavers.

In this Commentary, based on the results of a literature review, the authors propose a model to provide a focused osteopathic assessment for the purposes of maintaining Osteopathic Recognition within residency training programs based on the Accreditation Council for Graduate Medical Education’s six core competencies. Examples of multiple choice and essay questions are provided, as is a rubric for grading. The model is applied to the field of dermatology in this article but proposed as a blueprint for other subspecialties.

To determine whether third year and fourth year students receiving a new online curricula during core clerkship at A.T. Still University’s School of Osteopathic Medicine in Arizona performed better overall on national standardized examinations than students from previous years who had not received the curricula, the authors conducted a retrospective cohort study of 713 students from the classes of 2017-2020 (curriculum group) and 2014-2016 (precurriculum group).

In this Editorial, Journal of Osteopathic Medicine’s Section Editor for Behavioral Health discusses the “thorny questions” around what contributes to and helps sustain medical student and physician wellbeing, and conversely, what contributes to physicians’ dissatisfaction and unhappiness with their work.

Previous studies have indicated that the muscle energy technique (MET) and the positional release technique (PRT) are effective in the management of piriformis syndrome (PS); however, evidence is scarce regarding the combination of these techniques in the form of an integrated neuromuscular inhibition technique (INIT) in the management of individuals with PS. The authors conducted a single blind, randomized clinical trial of 48 patients to examine the effects of INIT with integrated RRAF compared with PRT in the management of patients diagnosed with PS.

The authors assessed 256 articles published in the “top 5” urology journals according to h5 index, appraising how often previous systematic reviews were appropriately used as justification for conducting a new randomized controlled trial.

The Comprehensive Osteopathic Medical Licensing Examination of the United States of America (COMLEX-USA) is a three level examination used as a pathway to licensure for students in osteopathic medical education programs; COMLEX-USA Level 2 includes a written assessment (Level 2-Cognitive Evaluation [L2-CE]) and separate performance evaluation (Level 2-Performance Evaluation [L2-PE]) administered through live encounters with standardized patients. L2-PE was designed to augment L2-CE. To assess concurrent validity between the two parts, the authors compared first attempt test scores from the National Board of Osteopathic Medical Examiners database for 6,639 candidates who took L2-CE between June 2019 and May 2020 and matched them to the students’ L2-PE scores.

Each year, approximately 53,200 people die in the U.S. from colorectal cancer (CRC), indicating a need to increase screening efforts. To analyze CRC screening rates in patients with comorbidities compared with healthy patients, and to assess whether the number of comorbid diagnoses impacted screening rates, the authors performed cross sectional analysis of 279,784 patients who received CRC screening using the 2018 and 2019 Behavioral Risk Factor Surveillance System (BRFSS).

To examine how involvement in extracurricular activities and attendance at burnout lectures can impact burnout among medical students, the authors assessed the anonymous responses of 597 students at Rowan School of Osteopathic Medicine to a survey that included the Maslach Burnout Inventory alongside questions regarding the number of burnout/wellness lectures respondents had attended, the number of clubs in which the respondents participated, the number of hours spent in these clubs, and any leadership positions held by the respondents.

Chronic low back pain (cLBP) is the second leading cause of disability in the United States, with significant physical and financial implications. Development of a multifaceted treatment plan that is cost effective and optimizes patients’ ability to function on a daily basis requires data; among the needed data points is a cost comparison of osteopathic manipulative treatment vs standard care for patients with cLBP. To that end, the authors conducted a prospective, observational study of 146 patients over 4 months with either standard care or standard care plus osteopathic manipulative treatment, quantifying patients’ pain scale responses as well as cost data for all associated interventions during the study period.

To investigate how the COMSAE Phase 1 examination was used by candidates and how completing Phase 1 impacted their performance on the COMLEX-USA Level 1 examination, the authors assessed Level 1 data from 7,120 first time candidates who took the 2018-2019 COMSAE administration between May 2018 and April 2019, counting the frequency of the unique Phase 1 forms taken by the candidates and calculating the correlations between first attempt Phase 1 scores and the number of Phase 1 forms taken as well as Level 1 scores and Phase 1 scores.

Previous studies have demonstrated the effectiveness of osteopathic manipulative treatment (OMT) for various headache types, with limited evidence of its use for headaches related to mild traumatic brain injury (MTBI). To evaluate the efficacy of OMT for headaches in patients with postconcussion syndrome (PCS) - defined as symptom persistence for longer than 3 months after MTBI – the authors performed a pilot study of 26 patients (13 in an OMT group and 13 in a control group), comparing headache scores on a Visual Analog Scale or Headache Impact Test (HIT-6) at baseline, posttreatment, and 4 to 6 week follow up.

The authors collected voluntary responses from 200 residents at the True Worth Place Homeless Shelter in Fort Worth, Texas – where the University of North Texas Health Science Center (UNTHSC) offers a Homeless Outreach through Medical Education (HOME) Clinic – to assess the past and current use of complementary and alternative treatments for chronic pain among people experiencing homelessness, as well as their awareness and perception of osteopathic manipulative treatment (OMT) as a complementary treatment.

In this pre-post study of 476 participants enrolled in a pain registry, the author measured changes in utilization of nonpharmacological and pharmacological treatments for chronic low back pain and related outcomes during the COVID-19 pandemic to help quantify how the pandemic has impacted the delivery of health care services throughout the United States.