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Kirksville, Mo

To the Editor: I enjoyed reading the May 2005 review of The DOs: Osteopathic Medicine in America by Norman Gevitz, PhD¹ (D'Alonzo GE Jr. J Am Osteopath Assoc. 2005;105:240).

In his history of osteopathic medicine, Dr Gevitz¹ wrote something that, in my opinion, should be an outstanding and motivating paragraph for the profession's researchers:

Remarkably, though, in the past two decades, no articles have been published in the JAOA that empirically test whether somatic dysfunction as specifically and objectively identified along the spinal column can be eliminated through the use of osteopathic manipulation and whether such treatments are correlated in any way with demonstrable physiological changes elsewhere in the body. Such studies are absolutely essential to testing the fundamental premises upon which the profession rests.

In a workshop I designed and have been teaching for several years, we attempt to rise to Dr Gevitz's serious challenge. In the course, titled "Evidence-Based Osteopathic Manipulation," we not only correlate physiologic changes with spinal somatic dysfunctions, we also quantify the points of physiologic change for each patient.²

To accomplish this goal, workshop attendees learn to integrate direct craniofacial osteopathic manipulative treatment with making, fitting, and balancing an acrylic template (also known as an "acrylic oral appliance" or an "osteopathic oral appliance") for each patient.²

Workshop attendees are amazed when they sense the almost total relaxation of the patient's spinal somatic dysfunctions as the patient lies down on the table. The moment of recognition shows on attendees' faces and is striking to me. Then I say, "Okay, just put the patient through a gentle range of motion and maybe use some gentle hand pressure to make sure the somatic dysfunctions disappear." When workshop attendees note this improvement in patient symptoms, they know that they are experiencing "proof-of-concept learning." After completing the course, workshop attendees learn quicker and have more confidence in their use of osteopathic manipulative treatment as a treatment modality.

Dr Gevitz's statement on the paucity of empiric evidence in the osteopathic medical literature has also motivated me to write a research proposal for review by the American Osteopathic Association's Council on Research. The clinical procedure described above can be used in a college of osteopathic medicine as well as in solo practitioners' offices. The procedure uses a clinical quantifying system³ that has been approved by the National Institutes of Health.

References
1. Gevitz N. The DOs: Osteopathic Medicine in America. 2nd ed. Baltimore, Md: Johns Hopkins University Press;2004 .

2. White JE, White JS, White WK. Criteria for direct measurement of the effect of osteopathic manipulative treatment using an acrylic template balanced to prevent the Cl, C2 somatic dysfunction palpatory findings [abstract]. J Am Osteopath Assoc.1984; 84:80 –81.

3. Baker EG. Alteration in width of maxillary arch and its relation to sutural movement of cranial bones. J Am Osteopath Assoc. 1971;70:559 –564.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by WHITE, J. E. Search for Related Content PubMed PubMed Citation Articles by WHITE, J. E.