Osteopathic Care as (En)active Inference: A Theoretical Framework for Developing an Integrative Hypothesis in Osteopathy

Frontiers in Psychology, Journal Year: 2022, Volume and Issue: 13

Published: Feb. 18, 2022

Osteopathy is a person-centred healthcare discipline that emphasizes the body’s structure-function interrelationship—and its self-regulatory mechanisms—to inform whole-person approach to health and wellbeing. This paper aims provide theoretical framework for developing an integrative hypothesis in osteopathy, which based on enactivist active inference accounts. We propose osteopathic care can be reconceptualised under (En)active as unifying framework. Active suggests action-perception cycles operate minimize uncertainty optimize individual’s internal model of lived world and, crucially, consequences their behaviour. argue offers evince mechanisms underlying dyadic triadic (e.g., paediatric care) exchanges outcomes. this underpin across lifespan, from preterm infants elderly those with persistent pain other physical symptoms. In situations chronicity, ecological niche, patient-practitioner dyad provides osteopath patient set affordances, i.e., possibilities action provided by environment, through shared intentionally, promote adaptations restoration productive agency. Through therapeutic relationship, they engage niche’s affordances—a structured affordances agents—osteopath actively construct sense-making narrative realise generative relation niche. general, touch plays critical role robust alliance, mental state alignment, biobehavioural synchrony between practitioner. However, particularly crucial fields neonatology paediatrics, where it becomes central regulating allostasis restoring homeostasis. standpoint, niche underwrites effectiveness care. Considerations implications model—to clinical practice research, both within- outside osteopathy—are critically discussed.

Language: Английский

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Touch medicine: bridging the gap between recent insights from touch research and clinical medicine and its special significance for the treatment of affective disorders

Frontiers in Psychiatry, Journal Year: 2024, Volume and Issue: 15

Published: May 22, 2024

Interpersonal touch represents the primal sensory experience between humans, fostering social bonding from cradle to death bed. In recent decades “affective touch” has been intensely studied, stimulated by discovery of a population mechanosensitive unmyelinated C-tactile afferents in mammalian skin. A lack childhood is associated with negative consequences for psychosocial and physical health benefits professional techniques prevention treatment various diseases have shown over again clinical studies. However, its application mainstream applications remains limited. To bridge gap discoveries research medicine, we propose establishment new discipline: ‘Touch Medicine’. Here, unfold potential Touch Medicine focusing on depression, which our view primarily disorder lived body. Controlled studies systematic reviews demonstrated antidepressant, anxiolytic analgesic effects specific massage techniques. Underlying mechanisms action are currently under investigation, ranging interoceptive, endocrinological, stress-related or psychological underpinnings. novel interdisciplinary field connected medical specialities such as neonatology, pediatrics, pain neurology, psychiatry, geriatrics – but also psychology psychosomatic medicine might benefit integration these findings into their daily practice.

Language: Английский

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An Enactive–Ecological Model to Guide Patient-Centered Osteopathic Care

Healthcare, Journal Year: 2022, Volume and Issue: 10(6), P. 1092 - 1092

Published: June 12, 2022

Osteopaths commonly face complexity and clinical uncertainty in their daily professional practice as primary contact practitioners. In order to effectively deal with complex presentations, osteopaths need possess well-developed reasoning understand the individual patient's lived experience of pain other symptoms how problem impacts personhood ability engage world. We have recently proposed (En)active inference an integrative framework for osteopathic care. The enactivist active frameworks underpin our hypothesis. Here, we present a clinically based interpretation hypothesis by considering ecological niche which care occurs. Active enables patients practitioners disambiguate each other's mental states. patients' states are unobservable must be inferred on perceptual cues such posture, body language, gaze direction response touch hands-on A robust therapeutic alliance centred cooperative communication shared narratives appropriate effective use enable contextualize experiences. Touch enhance alliance, state alignment, biobehavioural synchrony between patient practitioner. Therefore, osteopath-patient dyad provides alignment opportunities construction. Arguably, this can produce experiences reduce prominence given high-level prediction errors-and consequently, top-down attentional focus bottom-up sensory errors, thus minimizing free energy. This commentary paper primarily aims critically consider value appreciating complexities delivering person-centred

Language: Английский

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An Active Inference Account of Touch and Verbal Communication in Therapy

Frontiers in Psychology, Journal Year: 2022, Volume and Issue: 13

Published: May 20, 2022

This paper offers theoretical explanations for why “guided touch” or manual touch with verbal communication can be an effective way of treating the body (e.g., chronic pain) and mind emotional disorders). The active inference theory suggests that pain disorders attributed to distorted exaggerated patterns interoceptive proprioceptive inference. We propose nature is abductive. As such, rectify aberrant processes, we should change “Rule” abduction, “prior beliefs” entailed by a patient’s generative model. means pre-existing models replaced new models. To facilitate such replacement—or updating—the present treatment proposes weaken prior beliefs, especially one at top level hierarchical models, thereby altering sense agency, redeploying attention. Then, belief installed through inner along touch. several hypotheses possible experimental studies. If guidance proven effective, this would demonstrate relevance implicit prediction model behavioral level. Furthermore, it open possibilities employing interventions, including self-talk training, wide range psychological physical therapies.

Language: Английский

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Reconceptualizing the therapeutic alliance in osteopathic practice: Integrating insights from phenomenology, psychology and enactive inference

International journal of osteopathic medicine, Journal Year: 2022, Volume and Issue: 46, P. 36 - 44

Published: June 24, 2022

Language: Английский

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Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Biobehavioural Synchrony in Musculoskeletal Care

Frontiers in Behavioral Neuroscience, Journal Year: 2022, Volume and Issue: 16

Published: June 30, 2022

Touch is recognised as crucial for survival, fostering cooperative communication, accelerating recovery, reducing hospital stays, and promoting overall wellness the therapeutic alliance. In this hypothesis theory paper, we present an entwined model that combines touch alignment active inference to explain how brain develops “priors” necessary health care provider engage with patient effectively. We appeal empirically integrative neurophysiological behavioural mechanisms underwrite synchronous relationships through touch. Specifically, offer a formal framework understanding – explaining role of hands-on in developing alliance synchrony between providers their patients musculoskeletal care. first review importance its clinical facilitating formation solid regulating allostasis. then consider used clinically promote demonstrate empathy, overcome uncertainty, infer mental states others lens inference. conclude plays achieving successful outcomes adapting previous priors create intertwined beliefs. The ensuing may help healthcare field use strengthen alliance, minimise prediction errors (a.k.a., free energy), thereby recovery from physical psychological impairments.

Language: Английский

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Reconceptualizing Somatic Dysfunction in the Light of a Neuroaesthetic Enactive Paradigm

Healthcare, Journal Year: 2023, Volume and Issue: 11(4), P. 479 - 479

Published: Feb. 7, 2023

Background: Palpatory findings are considered a central element of osteopathic practice, especially when associated with patient's altered regulative functions than named somatic dysfunctions. Although theories for dysfunction could be plausible, the clinical applicability concept is debated, because it largely related to simple cause-effect models care. In contrast linear kind diagnosis "tissue as producer symptoms", this perspective article aims provide conceptual and operational framework in which evaluation process seen neuroaesthetic (en)active encounter between osteopath patient. Subsections relevant subject: To summarize all concepts hypothesis, enactive neuroaesthetics principles proposed critical foundation assessment treatment person, specifically addressing new paradigm dysfunction. Conclusions, future directions: The present represents proposition blend technical rationality informed by neurocognitive social sciences, professional artistry experience traditional tenets, overcome controversy around dysfunction, rather dismissing concept.

Language: Английский

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Effects of manual osteopathic interventions on psychometric and psychophysiological indicators of anxiety, depression and stress in adults: a systematic review and meta-analysis of randomised controlled trials

BMJ Open, Journal Year: 2025, Volume and Issue: 15(2), P. e095933 - e095933

Published: Feb. 1, 2025

Objectives To evaluate whether osteopathic and related manual interventions improve adult mental health (depression, anxiety, stress) psychophysiological measures (eg, heart rate variability, skin conductance). Design Systematic review meta-analysis of randomised controlled trials (RCTs). Data sources PubMed, MEDLINE (Ovid), Scopus, Cochrane, AMED, searched through September 2024. Eligibility criteria English-language RCTs with ≥30 participants investigating or therapies myofascial release, high-velocity low-amplitude thrusts) delivered by qualified practitioners, compared no treatment sham, reporting immediate postintervention outcomes. extraction synthesis Full-text screening, risk-of-bias assessment data were conducted independently multiple reviewers using a standardised Joanna Briggs Institute (JBI) Extraction Form. Risk bias was assessed the JBI Critical Appraisal Checklist. For meta-analyses, Hedges’ g (with 95% CIs) calculated from means SD. Random-effects models accounted for heterogeneity, prediction intervals to assess uncertainty in effect estimates. Results 20 included. Osteopathic reduced depression (Hedges’ =−0.47, CI: −0.86 –0.09, p=0.02) increased conductance =0.67, 0.00 1.34, p=0.05). Depression improvements greater pain populations =−0.61, –1.06 –0.17, p=0.01). However, wide moderate heterogeneity indicate true sizes, limited studies sample sizes restrict publication bias. Conclusions may reduce influence certain markers, particularly populations, but limit confidence. More rigorous, larger, longitudinal are needed. Trial registration number This not formally registered, though protocol search strategy can be found at Open Science Framework, identification: https://osf.io/jrtpx/ .

Language: Английский

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Autonomic correlates of osteopathic manipulative treatment on facial functional mapping: an innovative approach based on thermal imaging

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: March 2, 2025

Osteopathic manipulative treatment (OMT) has shown efficacy in various clinical conditions and age groups. Understanding its neurobiological, particularly autonomic, mechanisms of action remain limited. Preliminary studies suggested a parasympathetic effect OMT, evidenced by heart-rate-variability analysis. A cross-over RCT on healthy adults was conducted to compare OMT with sham therapy. Thirty-seven participants underwent two sessions (OMT sham), comprising baseline, tactile treatment, post-touch. Novel thermal imaging data analyses combination seed correlation (SCA) were employed explore the effects autonomic parameters. Particularly, group exhibited an elevated warming cheeks, nose, chin. Inversely, for conspicuous cooling trend but not cheeks chin observed. Considering SCA maps, intensity nose tip, glabella GSR seeds showed higher values compared group. The comparative analysis maps results represents significant advancement our understanding physiological underlying OMT's functions. By elucidating specific patterns temperature change, clusters, this research provides valuable insights optimizing practice refining theoretical models manual

Language: Английский

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Osteopathic diagnosis and treatment of the spine in patients with chronic back pain through the lens of medical infrared thermography: A randomised controlled pilot study

Complementary Therapies in Clinical Practice, Journal Year: 2025, Volume and Issue: unknown, P. 101999 - 101999

Published: May 1, 2025

Language: Английский

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