ResearchPad - osteopathic-medicine Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[The Five Diaphragms in Osteopathic Manipulative Medicine: Myofascial Relationships, Part 2]]> The article continues the anatomical review of the anterolateral myofascial connections of the five diaphragms in osteopathic manipulative medicine (OMM), with the most up-to-date scientific information. The postero-lateral myofascial relationships have been illustrated previously in the first part. The article emphasizes some key OMM concepts; the attention of the clinician must not stop at the symptom or local pain but, rather, verify where the cause that leads to the symptom arises, thanks to the myofascial systems. Furthermore, it is important to remember that the human body is a unity and we should observe the patient not as a series of disconnected segments but as multiple and different elements that work in unison; a dysfunction of tissue will adversely affect neighboring and distant tissues. The goal of the work is to lay solid foundations for the OMM and the five-diaphragm approach showing the myofascial continuity of the human body.

<![CDATA[A Review of the Theoretical Fascial Models: Biotensegrity, Fascintegrity, and Myofascial Chains]]>

The fascial tissue includes solid and liquid fascia (body fluids such as blood and lymph). The fascia's nomenclature is the subject of debate in the academic world, as it is classified starting from different scientific perspectives. This disagreement is not a brake but is, in reality, the real wealth of research, the multidisciplinarity of thought and knowledge that leads to a deeper understanding of the topic. Another topic of discussion is the fascial model to conceptualize the human body, that is, how the fascial tissue fits into the living. Currently, there are some models: biotensegrity, fascintegrity, and myofascial chains. Biotensegrity is a mechanical model, which takes into consideration the solid fascia; fascintegrity considers the solid and the liquid fascia. Myofascial chains converge attention on the movement and transmission of force in the muscle continuum. The article is a reflection on fascial models and how these are theoretical-scientific visions that need to be further investigated.

<![CDATA[Estimating the Mobility of the Michaelis Sacral Rhombus in Pregnant Women]]>

Pelvic mobility is the cornerstone of an adequate birth canal for safe childbirth, and midwives invite pregnant women to assume loading positions to facilitate delivery. Biomechanics asserts that pelvic space changes in shifting positions from erect to the squat position. The current standard practice in obstetrics and osteopathy provides a qualitative observational assessment of the dimension of Michaelis sacral rhombus in shifting positions; a previous report presented a clinical method and instrument to estimate the pelvic range of motion through finger contact on bone landmarks. The present study aims to match the measurement of the diameters of the sacral area of Michaelis from skin marks with the amount from bone landmarks. Methods estimate the sacral area from 100 pregnant women in the late trimester, considering the dimension of the diameters, the range of motion, and the patterns of mobility. Differences resulted in the methods: measuring the skin marks in shifting positions revealed a not significant difference between starting position and squat position. The measurements through the finger contact on the bone landmarks seem to be adequate to estimate pelvic mobility fulfilling the expectation from biomechanics literature.

<![CDATA[The Intraosseous Dysfunction in the Osteopathic Perspective: Mechanisms Implicating the Bone Tissue]]>

The somatic dysfunction (SD) is a protagonist in the context of theories and practices involving osteopathy and various other manual therapy methods. It is considered an obstacle to the body's inherent self-regulatory capabilities, and several tissues may be involved in this dysfunctional process, including the bone. The so-called intraosseous dysfunction refers to the restriction of natural flexibility of the fibrous components of the bone tissue matrix, or of the nonossified cartilaginous or membranous areas. Bone is a connective tissue composed of inorganic material and specialized cells organized in a hydrated extracellular matrix that provides the mechanical qualities to the tissue. The development of the bone tissue is a continuous process throughout life, and some bones fuse only years or decades after birth. It has microanatomical continuity with other adjacent structures and its different compartments are supplied by fluids, as well as somatic and autonomic innervation. Several studies show the phenomenon of bone tissue sensitization under traumatic, pathological conditions and also movement restriction. The purpose of the article is to review well-established knowledge and recent scientific findings regarding bone tissue anatomy and physiology, in an attempt to offer insights that could be applied to better understand the mechanisms implicating the intraosseus dysfunctions and its local and global repercussions.

<![CDATA[Comparison of Bone Turnover Markers between Young Adult Male Smokers and Nonsmokers]]>


This study aims to compare the differences in the means of bone formation and resorption markers between young adult male smokers and nonsmokers.


This study employed a cross-sectional, descriptive design. Thirty-five smokers and 38 nonsmokers were recruited. All participants completed self-reported questionnaires about demographics, physical activity, and smoking status. In addition, blood specimens were collected to determine serum levels of bone turnover markers.


Regarding bone formation markers, the least square means (LSM) for osteoprotegerin (OPG) and procollagen type I N-terminal propeptide (PINP) were similar for smoking and nonsmoking groups. Regarding bone resorption markers, the LSM serum carboxyl-terminal telopeptide of collagen type I (CTXI) level was found to be significantly lower in smokers than nonsmokers [0.82 ± 0.83 vs. 1.30 ± 0.82 ng/mL, F (1, 66) = 5.73, p = 0.020]. The LSM for soluble-receptor activator of nuclear factor-kappa B ligand (sRANKL) [1.64 ± 0.60 vs. 1.69 ± 0.62 ng/mL, F (1,64) = 10.74, p = 0.002] and RANKL/OPG [2.62 ± 1.09 vs. 2.81 ± 1.10 ng/mL, F (1,65) = 5.88, p = 0.018] were different for smoking and nonsmoking groups. Exploration of the moderating influence of physical activity on smoking effects revealed significant effect for the interaction between smoking status and physical activity on sRANKL [F (2, 64) = 8.63, p = 0.001] and RANKL/OPG ratio [F (2, 65) = 5.49, p = 0.006].


Our study provides evidence for the effect of smoking on bone resorption markers in young adult males. Such effects should be carefully considered side by side with other lifestyles that may lead to poor bone health and increased risk for osteoporosis.