Avoiding nocebo and other undesirable effects in chiropractic, osteopathy and physiotherapy: An invitation to reflect

Musculoskeletal Science and Practice, Год журнала: 2022, Номер 62, С. 102677 - 102677

Опубликована: Окт. 21, 2022

While the placebo effect is increasingly recognised as a contributor to treatment effects in clinical practice, nocebo and other undesirable are less well explored likely underestimated. In chiropractic, osteopathy physiotherapy professions, some aspects of historical models care may arguably increase risk effects. this masterclass article, clinicians, researchers, educators invited reflect on such possibilities, an attempt stimulate research raise awareness for mitigation This briefly introduces its underlying mechanisms. It then traces development osteopathy, physiotherapy, arguing that there was continues be excessive focus patient's body. Next, including communication, therapeutic relationship, rituals, wider social economic context practice examined their potential generate To aid reflection, model individual professions through ‘prism’ introduced illustrated. Finally, steps proposed how educators, practitioners can maximise positive minimise negative context.

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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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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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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Homeostasis After Injury: How Intertwined Inference and Control Underpin Post-Injury Pain and Behaviour

bioRxiv (Cold Spring Harbor Laboratory), Год журнала: 2025, Номер unknown

Опубликована: Фев. 6, 2025

Abstract Injuries are an unfortunate but inevitable fact of life, leading to evolutionary mandate for powerful homeostatic processes recovery and recuperation. The physiological responses the body immune system must be coordinated with behaviour allow protected time this happen, prevent further damage affected bodily parts. Reacting appropriately requires internal control that represents nature state injury specifies withholds actions accordingly. We bring formal uncertainties embodied in into framework a partially observable Markov decision process (POMDP). discuss nociceptive phenomena light analysis, noting particularly paradoxical behaviours associated investigation, propensity transitions from normative, tonic, pathological, chronic, pain states. Importantly, these simulation results provide quantitative account enable us sketch much needed roadmap future theoretical experimental studies on injury, tonic pain, transition chronic pain. Ultimately, we seek novel ways target

Язык: Английский

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The importance of constructing an osteopathic profession around modern common academic values and avoiding pseudoscience: The Spanish experience

Advances in Integrative Medicine, Год журнала: 2023, Номер 10(3), С. 139 - 144

Опубликована: Сен. 1, 2023

Язык: Английский

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Enactivism: a contemporary perspective of a reconceptualization of Osteopathy

Advances in Integrative Medicine, Год журнала: 2024, Номер unknown

Опубликована: Сен. 1, 2024

Язык: Английский

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The osteopath-parent-child triad in osteopathic care in the first 2 years of life: a qualitative study

Frontiers in Psychology, Год журнала: 2023, Номер 14

Опубликована: Окт. 2, 2023

Background Enactivism and active inference are two important concepts in the field of osteopathy. While enactivism emphasizes role body environment shaping our experiences understanding world, action perception world. Together, these frameworks provide a unique perspective on practice osteopathy, how it can be used to facilitate positive change patients. Since neonatal period is crucial time for development, osteopaths should aim create therapeutic relationship. Arguably, through participatory sense-making, help baby build generative model (with priors) deal with stress needs throughout their life. Aim literature considers that interactions environment, which enact patients’ experiences, depending contextual factors communication between patient caregiver, this research explored whether there correspondence indications clinical management mother/parent–child dyad during osteopathic care children aged 0 2 years old. Methods Semi-structured interviews were conducted purposive sample nine experience pediatrics. Interviews transcribed verbatim, constructivist grounded theory was conceptualize, collect analyze data. Codes categories actively constructed an interpretive/constructionist paradigm. Results The core category idea pediatric osteopath as support family, not only child. Four additional identified: (1) Preparing safe both parents, (2) Communication, (3) Attachment synchrony, (4) Synchronization. Conclusion Through manage establish effective alliance osteopath-parent–child triad construction child’s internal promote healthy development. encounter considered embodied subjects, occurring within affordances (ecological niche) allows interlocutors participate creating new meanings interpersonal synchronization. Participatory sense-making establishment development

Язык: Английский

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Active Inference in Psychology and Psychiatry: Progress to Date?

Entropy, Год журнала: 2024, Номер 26(10), С. 833 - 833

Опубликована: Сен. 30, 2024

The free energy principle is a formal theory of adaptive self-organising systems that emerged from statistical thermodynamics, machine learning and theoretical neuroscience has since been translated into biologically plausible ‘process theories’ cognition behaviour, which fall under the banner ‘active inference’. Despite promise this holds for theorising, research practical applications in psychology psychiatry, its impact on these disciplines only now begun to bear fruit. aim treatment consider extent active inference informed progress psychology, before exploring contributions our understanding psychopathology. facing persistent translational obstacles, suggests potential become new paradigm promises unite psychology’s subdisciplines, while readily incorporating traditionally competing paradigms evolutionary developmental psychology. To date, however, towards end slow. Meanwhile, main outstanding question whether will make positive difference through clinical sister discipline psychiatry.

Язык: Английский

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