“The Dark Side of Musculoskeletal Care”: Why Do Ineffective Techniques Seem to Work? A Comprehensive Review of Complementary and Alternative Therapies

Biomedicines, Journal Year: 2025, Volume and Issue: 13(2), P. 392 - 392

Published: Feb. 6, 2025

The increasing interest in complementary and alternative medicines (CAMs) for musculoskeletal care has sparked significant debate, particularly regarding their biological plausibility clinical effectiveness. This comprehensive review critically examines the use of two most widely utilized CAMs-osteopathy chiropractic care-over past 25 years, focusing on plausibility, effectiveness, potential mechanisms action. Our analysis current research studies reveals that osteopathy are based concepts such as "somatic dysfunction" "vertebral subluxation", which lack robust empirical validation. While these therapies often presented credible treatment options, evaluating effectiveness frequently exhibit serious methodological flaws, providing insufficient support recommendation first-line treatments conditions. effects underlying remain poorly understood. However, placebo responses-mediated by interaction contextual, psychological, non-specific factors-appear to play a role observed outcomes. integration with limited whose may primarily rely effects, into healthcare systems raises important ethical dilemmas. highlights need rigorous adherence scientific principles calls more investigation biobehavioral, psychosocial factors interact specific interventions. Such efforts essential advancing our understanding CAMs, enhancing decision-making, promoting practices, guiding future aimed at improving patient disorders.

Language: Английский

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Pseudoscience: A skeleton in osteopathy's closet?

International journal of osteopathic medicine, Journal Year: 2024, Volume and Issue: 52, P. 100716 - 100716

Published: Feb. 19, 2024

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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Integrated manual therapies: IASP taskforce viewpoint

PAIN Reports, Journal Year: 2024, Volume and Issue: 9(6), P. e1192 - e1192

Published: Oct. 29, 2024

Abstract Introduction: Manual therapy refers to a range of hands-on interventions used by various clinical professionals, such as osteopaths, osteopathic physicians, chiropractors, massage therapists, physiotherapists, and physical treat patients experiencing pain. Objectives: To present existing evidence mechanisms effectiveness manual in Methods: This Clinical Update focuses on the 2023 International Association for Study Pain Global Year Integrative Care. Current models examples integrative are discussed. Results: The evolution concepts recent years presented current gaps knowledge guide future research highlighted. Mechanisms discussed, including specific contextual effects. Findings from animal humans inflammatory markers, fibrosis, behaviours. There is low moderate levels that effect sizes small large pain function tension headache, cervicogenic fibromyalgia, back pain, neck knee hip Conclusion: therapies appear be effective variety conditions with minimal safety concerns. opportunities integrate new its educational, clinical, models. also well-suited fostering person-centred approach care, requiring clinician relinquish some their power person consulting. Integrated have recently demonstrated fascinating illustrating adaptability capacity address contemporary societal challenges.

Language: Английский

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Insights into how manual therapists incorporate the biopsychosocial-enactive model in the care of individuals with CLBP: a qualitative study

Chiropractic & Manual Therapies, Journal Year: 2025, Volume and Issue: 33(1)

Published: Feb. 18, 2025

Abstract Background Chronic low back pain (CLBP) presents a significant challenge for manual therapists. Recent advancements in research have highlighted the limitations of traditional biomedical and biopsychosocial models, prompting exploration alternatives. The biopsychosocial-enactive (BPS-E) model has emerged as promising alternative. This study aims to explore application BPS-E by therapists managing CLBP initiate meaningful dialogue about its use. Methods adhered Standards Reporting Qualitative Research. Guided constructivist grounded theory, we conducted semi-structured interviews with ten who are experts model. Data collection, conceptualization, analysis were systematically carried out identify key themes insights. Results core theme identified was “The person-centred approach,” three subthemes: “Opportunities implementing model”, “Utilizing Integrating Diverse Skills Holistic Care”, “Challenges model”. Conclusion provides insights into how incorporate their practice, demonstrating advantages over findings highlight need further training effectively implement clinical settings. begins an essential discussion on potential enhance care patients.

Language: Английский

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Bayes meets Hegel: the dialectics of belief space and the active inference of suffering

Synthese, Journal Year: 2025, Volume and Issue: 205(3)

Published: Feb. 21, 2025

Language: Английский

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