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

Frontiers in Psychology, Год журнала: 2022, Номер 13

Опубликована: Фев. 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.

Язык: 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, Год журнала: 2024, Номер 15

Опубликована: Май 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.

Язык: Английский

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

Scientific Reports, Год журнала: 2025, Номер 15(1)

Опубликована: Март 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

Язык: Английский

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

Healthcare, Год журнала: 2022, Номер 10(6), С. 1092 - 1092

Опубликована: Июнь 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

Язык: Английский

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An Active Inference Account of Touch and Verbal Communication in Therapy

Frontiers in Psychology, Год журнала: 2022, Номер 13

Опубликована: Май 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.

Язык: 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, Год журнала: 2022, Номер 16

Опубликована: Июнь 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.

Язык: Английский

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Reconceptualizing Somatic Dysfunction in the Light of a Neuroaesthetic Enactive Paradigm

Healthcare, Год журнала: 2023, Номер 11(4), С. 479 - 479

Опубликована: Фев. 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.

Язык: 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, Год журнала: 2022, Номер 46, С. 36 - 44

Опубликована: Июнь 24, 2022

Язык: Английский

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“What you feel under your hands”: exploring professionals’ perspective of somatic dysfunction in osteopathic clinical practice—a qualitative study

Chiropractic & Manual Therapies, Год журнала: 2022, Номер 30(1)

Опубликована: Авг. 31, 2022

Despite controversy regarding its validity and clinical usefulness, manual examination findings still have an important role for manipulative therapies. As example, somatic dysfunction (SD) remains central to osteopathic practice.This study aims explore the experienced osteopaths' attitudes concerning SD in practice. This qualitative research could contribute building a consistent paradigm intervention all musculoskeletal manipulations.A thematic analysis with grounded theory elements was used. Data were collected through semi-structured interviews carried out between February April 2021. A purposive sample of twenty professional osteopaths past experience care chosen reflect phenomenon's variety. The data done inductively tandem recruiting keep track saturation.Eleven participated study. Three main themes emerged from analysis: (1) as safe tissue-touch-based communication tool operator person complex adaptive health system; (2) treatment is shareable osteopaths, other professionals, patients involved therapeutic pathway improving body awareness health; (3) development concept practice better clarify profession identity definition.A panel expert consider valuable integrated into evaluation process. shared application informed by person-centered concepts fields neuroscience, cognitive complexity science. Our reports common need among develop evidence-based framework allow best profession.

Язык: Английский

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Exploring the Role of Therapeutic Alliance and Biobehavioural Synchrony in Musculoskeletal Care: Insights from a Qualitative Study

Musculoskeletal Science and Practice, Год журнала: 2024, Номер 73, С. 103164 - 103164

Опубликована: Авг. 14, 2024

Person-centred care underscores the therapeutic alliance (TA) as fundamental, fostering positive treatment outcomes through collaborative patient-clinician interactions. Biobehavioural synchrony within TA, essential for effective care, reflects an adaptive process where organisms align responses during Enactivism and active inference provide profound insights into human perception, reshaping musculoskeletal understanding. Touch verbal communication, integral to foster alignment of personal beliefs.

Язык: Английский

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