Hospital OMM

Philadelphia

Hospital OMM

 

Roxborough Hospital Osteopathic Manipulative Medicine Service

The PCOM OMM Department provides consultation service at Roxborough Hospital Monday through Friday.

Our mission is to enhance the health and promote the recovery from illness for patients at Roxborough Hospital by providing care from an osteopathic manipulative medicine perspective and approach.

Our scope of care includes all ages and all severity of illness – from infants and pediatrics to adults and geriatric patients, including those with mild, moderate, and severe levels of illness, even patients in critical care settings.

Problems addressed include patients with a wide range of medical and surgical illnesses as well as specific neuromusculoskeletal problems.

Areas where the osteopathic manipulative medicine approach can be particularly helpful are in treating patients with pneumonia and other respiratory infections, post-operative ileus (best results are obtained when OMM treatment is started soon after surgery), as well as patients with acute coronary problems that have stabilized or those status-post chest surgery.

Osteopathic manipulative medicine can be a very useful adjunctive treatment in hospitalized patients with a wide variety of problems. The Roxborough OMM physicians are available and happy to work with any of the patients at Roxborough Hospital.

The Roxborough OMM service is available five days a week, Monday through Friday, for OMM consults.

Faculty

The current staff providing OMM services at Roxborough Hospital consists of a group of three physicians, all of whom are board certified in Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine. They are all members of the PCOM OMM Department, who teach students, interns, and residents, and who see out-patients at the Philadelphia campus OMM office.

There is also an OMM resident who sees patients at Roxborough Hospital along with the attending physicians several days each week.

OMM Roxborough faculty:

 

Osteopathic Manipulative Medicine

Tenets of Osteopathic Medicine

The osteopathic manipulative medicine approach began in 1874 and has continued to develop since that time.

Certain principles have remained consistent, which include:

  • Each person has an inherent ability to heal and the role of the physician is to facilitate this process.
  • Structure and function are integrally related.
  • Each individual consists of a body, mind, and spirit. While we focus on the body, we recognize there is more to than that to each patient.
  • A hands-on approach using osteopathic manipulative medical diagnosis and treatment can be an appropriate and effective part of well-rounded patient care. In the hospital setting, OMM can serve a complementary role with conventional medical and surgical care of patients.

An Osteopathic Approach

A simple model used in the osteopathic approach is to look at patients and their problems from the perspective of neurological, fluid, and biomechanical points of view.

The neurologic perspective in the care of hospitalized patients includes addressing imbalances in the autonomic nervous system, as well as any specific somatic nerve involvement. Many acutely ill patients have an increased sympathetic tone and can benefit from hands-on osteopathic treatment to reduce this facilitated state, such as patients post-op abdominal surgery, who are at high risk of developing ileus. Other patients might need to have their parasympathetic tone addressed.

While the fluid perspective can include arterial and venous components, the lymphatics are an area of great importance in hospitalized patients, especially when inflammation or edema is involved. Removing restrictions to flow and using alternating pressure techniques can be helpful to improve lymphatic flow and drainage in patients – whether visceral, such as pulmonary congestion with pneumonia, or extremity-related, such as with wounds of the lower extremity.

A biomechanical approach can be used in many ways, improving rib motion to improve thoracic respiratory mechanics, and improving motion of extremities, pelvis, and spine.

Types of Osteopathic Manipulative Treatment

The OMM faculty use all types of osteopathic manipulative treatment (OMT). These range from gentle articulation and soft tissue techniques, to myofascial release techniques, from release by position techniques such as counterstrain, to balancing techniques, such as balanced ligamentous tension and ligamentous articular strain. Very gentle techniques, such as osteopathic manipulation in the cranial field can used, as well as more direct techniques, such as high-velocity low-amplitude techniques. There are other types of OMT as well.

Evidence Supporting OMM in the Hospitalized Patients

OMM diagnosis and treatment has been shown to help in treatment of patients with a variety of problems. Studies have shown benefit in patients with pneumonia as well as asthma, even localized problems such as children with otitis media. OMM has been shown to be effective in preventing post-operative ileus and atelectasis as well as improving the hemodynamic status of patients immediately following cardiothoracic surgery.

References

Noll, DR et al. "Efficacy of osteopathic manipulation as an adjunctive treatment for hospitalized patients with pneumonia: a randomized controlled trial." Osteopath Med Prim Care, vol. 4: 2, (2010).

Baltazar et al. "Effect of osteopathic manipulative treatment on Incidence of postoperative ileus and hospital length of stay in general surgical patients." J Am Osteopath Assoc, vol. 113, no. 3, (March 1, 2013): 204-209.

O-Yuvati et al. "Hemodynamic effects of osteopathic manipulative treatment immediately after coronary artery bypass graft surgery." J Am Osteopath Assoc, vol. 105, no 10, (October, 2005): 475-481.

SL Sleszynski, Kelso, AF. "Comparison of thoracic manipulation with incentive spirometry in preventing postoperative atelectasis." J Am Osteopath Assoc, vol 93, no 8, (August, 1993): 834-8, 843-5.

Guiney et al. "Effects of osteopathic manipulative treatment on pediatric patients with asthma: a randomized controlled trial." J Am Osteopath Assoc, vol. 105, no. 1, (January 1, 2005): 7-12

Hodge, L., Downey, H. "Lymphatic pump treatment enhances the lymphatic and immune systems." Experimental Biology and Medicine, vol. 236, (2011):1109-1115

Mills, MV et al. "The use of osteopathic manipulative treatment as adjuvant therapy in children with recurrent acute otitis media." Arch Pediatr Adolesc Med, vol. 157, no. 9 (2003):861-866.