the end of craniosacral teaching??

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•••quote:•••Originally posted by osteodoc13:
Try to have an open mind and develop your hands so you can feel the CRI •••••This is a major part of what bothers me about cranial, Osteodoc. It is this notion that you must "develop your hands," or suspend your disbelief (that quasi-religious thing again), in order to feel this supposed primary respiratory mechanism (i believe that is what it is called?).

You see, I've been palpating things for many years - ever since I was born, in fact. We all have. I feel that I have a pretty well developed tactile sense.

I place my hands on my wrist - I feel a pulse.

I place my hands on my chest - I feel the rhythmic movement of breathing.

I place my hands on my skull - I feel no primary respiratory mechanism pulse.

the same goes for the average joe on the street. you don't need to "develop" your hands to feel a pulse or sense the movements of breathing. Someone may have to explain to you the significance of the sensations - but they are unmistakable.

"You can't feel it? Your hands must need developing." What a great way to prove something exists.

It's like the emperor who gets a new set of invisible clothes. Only the tailor can "see" them, but he assures us they are magnificent!

Unfortunately, the emperor was not actually wearing any clothes.

Now I know you are just going to tell me that this "pulse" is really subtle. (if so, please re-read above) But, let's consider - where is the primary respiratory pulse monitor? A machine that you can sit down next to, place on your head and - whoah! - there's that primary respiratory pulse on the monitor that the osteopathic guy is talking about.

Where is it?

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•••quote:•••Originally posted by Dr. Nick:

The writings of Dr. Still are....well, the writings of Dr. Still. Speaking of which, is it true he claims in his autobiography, osteopathy's "definitive text," that he could, "shake a child and stop scarlet fever, croup, diphtheria, and cure whooping cough in three days by a wring of its neck.[1]"

Cheers,
Dr. Nick•••••Yes, the above quote is reasonably accurate. You have to understand, however, that Still wrote the above text in the late 19th century, and he was using the simple language of a farmer in 19th century Missouri. His infirmary in Kirksville, MO, had a tremendous record of "cures" with patients coming from far and wide to be treated by Still or one of his students.

I have agreed over and over again that the research in OMM is lacking, but I think the proof that it works is in the thousands of patients who have been successfully treated. Look at the influenza epidemic if the early 1900s, and compare the success rates achieved by DOs who were only using their hands, coupled with their knowledge of anatomy and physiology.

Allopathic medicine has a long history of using treatments which do not have a firm scientific basis solely on the fact that they work. Anyone who has spent time in the office of an Osteopath sees that the treatment works. Yes, the research needs to be done, but that doesn't alter the fact that OMM helps patients heal themselves.

As far as a CRI detector, I was laughing at the obvious sarcasm in that statement. The human hands are our CRI detectors. It may make you even more incredulous to know that the CRI can be palpated anywhere on the body, as the CSF flows through the perineural lymphatic spaces which are contiguous with the subdural space. <img border="0" title="" alt="[Eek!]" src="eek.gif" />

You are right, the CRI is subtle. Have you done an orthopedic rotation yet? Have you noticed how the doctor is able to notice subtle changes in range or fluidity of motion which you did not detect, yet by the end of the rotation you were able to diagnose? Have you felt the difference between a negative anterior drawer and a slightly positive one? The ability to notice subtle (and sometimes not so subtle) differences in tissue texture and mobility is the basis of Osteopathic diagnosis and treatment, and yes, it takes time to "develop your hands."

Spend some time with your hands on your patients and you just might see what I mean.

:wink:
 
•••quote:•••Originally posted by osteodoc13:
[QB]
Yes, the above quote is reasonably accurate. ••••I believe it is verbatim.

"I have agreed over and over again that the research in OMM is lacking, but I think the proof that it works is in the thousands of patients who have been successfully treated."

Testimonials and anecdotes are not proof. And you are wrong to assume that they have been "successfully treated" without such proof.

"Allopathic medicine has a long history of using treatments which do not have a firm scientific basis solely on the fact that they work."

What specifically are you referring to, Osteodoc. Hopefully, something more than the already oft-beaten argument about psychiatric drugs.

"Yes, the research needs to be done, but that doesn't alter the fact that OMM helps patients heal themselves."

I think you are "putting the cart before the horses," so to speak. According to you, the research needs to be done but it is already a fact that it is effective. Interesting.

"As far as a CRI detector, I was laughing at the obvious sarcasm in that statement. The human hands are our CRI detectors. It may make you even more incredulous to know that the CRI can be palpated anywhere on the body, as the CSF flows through the perineural lymphatic spaces which are contiguous with the subdural space. <img border="0" title="" alt="[Eek!]" src="eek.gif" /> "

Yes, I am even more incredulous! Cranial is bunk, sorry.
 
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There is one point that I did not make clear early in out discussion.
Osteopathy is not reductionist. It looks at the entire bio-psycho-social-spiritual person as an integrated whole. When one is palpating cranial motion it is no just across one suture.

The operator is palpating the movement patterns of the entire skull and by extension the whole body. It is a little absurd to feel simple lateral movement of a few microns across a single suture.

However, there are 29 bones in the adult human skull (8 cranial, 14 facial, 7 miscellaneous) and there are literally dozens of lines of articulation at the sutures. Each surface is oriented along a slightly different directional plane; motion is in 3 dimensions not just lateral.

In the OCF literature this motion is described as phases of flexion and extension.

In flexion the midline bones (sphenoid, occiput, ethmoid, and vormer) move into flexion around their respective transverse axes. And the paired temporals and paired parietals externally rotate. During extension the opposite happens.

In the crainum, the CRI is felt as a widening and shortening and then a narrowing and lengthening of the whole skull.
 
I have been quite hesitant to do this. However, some things must be experienced in order to be understood.

I take no responsibility for any injury that might result if you choose to follow this exercise. It could be potentially dangerous.

I would not undertake this exercise if I had a serious illness, a history of major trauma (physical or psychological), participated extensively in contact sports or soccer, had significant orthodontia or if my mother had a difficult labor or delivery including C-section.

If you are really interested in OCF contact the Cranial Academy for a for physician referral, look for someone who is a Fellow of the Cranial Academy or at least an instructor. Send a self addressed, stamped, business size envelope ($0.57 postage) to the address below. Please include the city and state of the referral:

The Cranial Academy
Referrals
8202 Clearvista Parkway #9-D
Indianapolis, IN 46256

Get treatments, shadow a practice, and take the basic course.

In an earlier thread someone suggested have someone ?squeeze? their head to feel the sutural motion.

MANIPULATING THIS SYSTEM IS SERIOUS MEDICINCE. PLAYING WITH IT IS AKIN TO PLAYING WITH A SCALPEL.

What follows is an exercise to learn to palpate the cranial rhythmic impulse on oneself. It will probably take more than one sitting, maybe days, weeks or even months of consistent practice.

It has been culled from multiple sources.

This exercise will probably will not come easily however, be assured that you feel the cranial rhythmic impulse all the time. You are just not aware of it.

It is like (METAPHOR ALERT) the background noise that a city dweller experiences.. One cannot hear it unless one ?changes? the way one hears. When city dwellers go to a more rural area they are often struck by the silence. Or, if the city dweller slows down and listens for it all the noise of the city is there. The background can become the center of attention if one changes their usual frame of mind.

For example, the first time I was aware of it came quite by accident. It was during yoga practice and I was coming out of Bridge pose and I used a block to isolated my low back. As I rested with my sacrum balanced on the block, I became aware of waves of motion rhythmically moving through my body. When I held my breath, it was there. When I slowed done and felt my heartbeat, it was there, distinct and independent.

The styles of yoga that I have practiced teach students to adopted the attitude of the ?Beginner?s mind.? It is based on mindfulness meditation or ?Insight meditation? techniques (see Jon Kabat-Zinn and Thich Nhat Hanh). One attempts to adopt an attitude that sees each moment as something new. One attempts to approach each breathe as a very young child might approach something new. It is savored, experienced and then let go of without regret.

If you have a regular meditation, or mindful movement practice (such as yoga or Tai Chi) do it before you begin this exercise.

To start, you need three raisins, a dime and quite, private space where you will not be interrupted.

Take off your shoes, loosen restrictive clothing, adjust the room temperature and lighting and sit comfortably at a table or desk in chair with good back support.

Put the raisins on the table in front of you and adopt an attitude of nonjudgmental mindfulness. Pretend that you have never seen a raisin before. Engage and experience each raisin with all your senses. Touch the raisin; roll it between your thumb and forefinger, note texture, temperature, stickiness. Really look at it as if you had never seen it before. Roll it close to your ears so you can hear the sounds that the raisin makes with your fingers. Smell it. When you put it in your mouth feel it with your tongue, cheeks and gums. As you taste and chew it note the flavors and sensations as if they were all unique and new. Experience the raisin as something unique and new even if you normally find raisins distasteful.

Repeat with at least two more raisins, more if you still are not in a nonjudgmental mindful frame of mind. Many people such as Dr. Nick and myself who tend to have an over inflated sense of self importance struggle with adopting an attitude of nonjudgmental and mindfulness. It takes time. Engage your frustration mindfully.

Now hold a hand out in front of you. Put the dime on a finger and experience the weight of the dime. Try this with each of your fingers and get comfortable with this amount of weight and pressure. This is how much pressure you will apply to your cranium.

I assume that you have undertaken a highly detailed study of the anatomy and physiologic motion of each of the bones in the body including the face and the cranium and that you can very clearly visualize all the structures beneath your hands when you touch a persons body. If you have not, you are simply wasting your time with this exercise.

One important note, your touch is with your finger pads; they have many more nerve endings

Now, sit comfortably. Raise your arms, bend your elbows and place your hands gently on your head with your fingers spread. Suspend your wrists like slings from your elbows. With a dimes worth of pressure place your thumb pads under your occipital base and your fifth finger pads at the sides of your temporal. Let your other finger pads mold your skull. Relax as you mindfully move into the experience of your skull. Begin to visualize all the anatomy and physiologic motion under your fingers.

Bring your mindful attention to your thoracic respiration. Experience your breath; feel each inhalation and exhalation as if it were something new and wonderful. Feel your whole body move as you breathe. Feel your head subtly nod.

Now, move into the sensations beneath your finger pads. Feel the arterial pulsation in your scalp. Be with it.

Now, feel the entrainment between your breath, the arterial pulse and the more subtle impulses. Feel your whole body moving as your sit in poised stillness.

The CRI is felt as a widening and shortening and then a narrowing and lengthening of the whole skull.

It can be deduced from the pendular motion in your elbows as the subtly rock back and forth. Bring your attention to your scapulae as they float in and out of synch with your elbows. Use your joint proprioception to amplify your tactile proprioceptive pathways. You can try holding your breath for a cycle to make the CRI more clear.

Each phase of flexion and each phase of extension takes about 3 seconds; some people have faster rate, some have a slower rate.

When you have become aware of the rhythm practice being with it without judgment for a time, begin to note its qualities such as amplitude and symmetry.

Move back and forth between all thoracic respiration, arterial pulse, and the CRI.

Feel your whole body moving as your sit in poised stillness.

DO NOT TRY THIS ON ANOTHER PERSON WITHOUT ADEQUATE INSTRUCTION.
 
With a dimes worth of pressure place your thumb pads under your occipital base and your fifth finger pads at the sides of your temporal.

I meant frontal instead of temporal!!!!!!!!!

Sorry
 
I am tired of this back and forth with Dr. Nick, because it is obvious that he is too closed-minded to even begin to contemplate that OCF is valid. See his last post:

"Cranial is bunk!"

There have been other posts by DO students who have been exposed to cranial in their classes. I would love to continue the discussion of whether or not it is important to learn cranial in school. Let's keep this thread moving forward.
 
"Many people such as Dr. Nick and myself who tend to have an over inflated sense of self importance struggle with adopting an attitude of nonjudgmental and mindfulness."

Hey now! Who says my sense of self-importance in over-inflated, LOL?!

"I am tired of this back and forth with Dr. Nick, because it is obvious that he is too closed-minded to even begin to contemplate that OCF is valid. See his last post:
'Cranial is bunk!'"


Perhaps, we can agree to disagree on cranial if you are tired of the argument.

I don't think I am "close-minded" though - I've only been picking it apart in minute detail on this board for the last couple of weeks - that seems like due consideration to me.

In the interests of collegiality i'll rephrase the above statement to say that, "the current 'science' of cranial is bunk."

Cheers!
 
Dr. Nick,

What has really irked me about your last several comments has been your rather sloppy intellectual attitude.

From your posts, I have gathered that you are genuinely intrigued by Osteopathy, at least as a cultural specimen. And, that you seem to honestly care about patients.

However, you do not seem to have exerted even the slightest effort to a gain command of the primary osteopathic literature. In fact, you seem to disdain it and dismiss its study as cultist.

Furthermore, you do not seem to have read the literature on the culture of osteopathy (Gevitz, Trowbridge, and Gallagher and Humphrey). If had you would not have castigated the Cranial Academy, one of the most venerable organizations in this profession, as "snake oil" salesmen. You are so unaware of this professions history that you have no idea how insulting that sounds to some people here.

In addition, you early in the discussion you were offered a document that included 100s of research references supporting the concepts in OCF and you declined.

You do not seem to do your own research. Instead, you read other students posts and make snide comments while occasionally making a reference to quackwatch.com. You do not seemed to have made an effort to learn fro yourself. This is at best nothing more than intellectual laziness and a poor excuse for scholarship.

I am willing to discuss this topic with you, but you have to contribute.

What medical setting are you in where you do not have a library with ready access to NEMJ? Virtually every public library in the country has it. And, how can such a strong proponent of EBM lack a subscription to the world?s most authoritative medical journal?
 
Stillfocused, please take a deep breath, and give all the personal comments a rest, will ya? Honestly, I don't care. It wastes your time. It wastes my time. It gets us nowhere.

I already told you that I have chosen to agree to disagree with you on cranial. I'm sorry if you find that "sloppy" or overly "self-important" - I really don't care. I'm willing to leave it at that.

The simple fact of the matter is that I have no intention of spending my time meditating with raisins, reading the complete works of still, or doing a complete review of all papers ever published on the subject. I've researched it enough to understand that the evidence simply isn't there.

That's enough for me. What works for you, is, naturally, up to you.

Look, cranial is scientifically unproven. I know it. You know it. Most of the scientific world seems to know it. If you're OK with that, great! Up to you! I, personally, wouldn't touch it with a 10 foot pole. That, however, is just one man's opinion.

We can banter back and forth about the microscopic movements of sutures under tension and compression, how many thousands of people that you claim have been "successfully treated" with it, etc., etc. ad nauseum.

However, at the end of the day there is:

#1: no evidence that any cranial movements are actually palpable (for me that's pretty much end of story already...)

#2: ASSUMING that such movements were palpable (i don't believe so) - there is no evidence to support claims that palpation of such movements has any affect on disease in the human body

#3: Moreover, there is no evidence as to how such theoretical manipulations might work to improve health, other than to "get the juices flowing" or to bring "balance" to the body. Nothing.

Why then, waste more time on this? If you wish to believe in cranial - more power to you. I would only hope, were you ever to practice it, that you would be a bit more candid with your patients about the available evidence.

~cranial rant over~

Cheers!
Dr. Nick
Hollywood Upstairs Medical College
 
I agree that we can agree to disagree, but I have to take exception with your statement that there is no evidence when you haven't even attempted to look at the evidence yourself. I have tried to give you at least a starting point, but you refuse.

Given the amount of time you have put into posting on this subject over the past few weeks, you should at least take the time to look at the list of relevant articles. I guess you prefer to be reactionary instead of proactive.

You can continue to trash OCF all you want, but until you have reviewed at least some of the literature, I will lump your opinions in with those of Dr. Barret of Quackwatch fame and call you an underinformed town crier.
 
You are welcome to post your evidence for points 1-3 from my previous post below. I think article abstracts would be good.

Let's see this vaunted evidence - clearly, it is the medical world's best kept secret :rolleyes:

OK, looking forward to reading them (i'm holding my breath).

Goodbye,

Informed Town Crier
 
As I've posted previously, and as Stillfocused will attest, the bibliography is too large to post on SDN. If you give me an e-mail address, even a free one like yahoo if you don't want me spamming you, I will be glad to send it to you or anyone else.
 
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As a future osteopathic physician I will quote an old Wendy's advertisement that was very popular when I was younger..."where's the beef?"

I don't doubt that OCF is diff than Cranio-sacral as upledger teaches it. However, the fact remains that much of "science" on which the theory is based is flawed. Much of the research into cranial manip, therapy, treatments, diagnosis, and success of the above items is flawed or misinterepreted using sub-standard methods of data analysis.

I would like someone to post access to legitimate studies showing any efficacy of OCF. I have admitted that the literature pointed that the cranial bones do move...I had to eat my words on that (despite the fact that the movement is very small). I am not unwilling to change my opinion, however, citing the Cranial Academy webpage as a source of information is a little like letting the fox into the henhouse.

Obviously I disagree with cranial, OCF. I don't think that enough scientific (read not anecdotal) evidence exists to be teaching it in regular OTM courses. OTM can be a real helpful adjunct, however, courses like cranial/OCF only delegitimize the benefits of other proven manipulative therapies and, in my opinion, cast dispersions on the rest of the field.

The above said, I have a proposition (it should wait till after boards in a week):

Perhaps we can, as a group (Osteodoc, stillfocused, Dr. Nick blondarb, John DO), pick ONE therapy that cranial is alleged to be effective. Then, we can each of us who have been involved with this thread do a little research looking for data concerning that particular therapy, and discuss the results of our own research and what the others find. This can mean a couple of things, that in the end we agree that OCF works/doesn't work, that more research needs to be done, or we will agree to disagree; but we will have investigated the topic with some degree of thouroughness and approached the topic with thoughtful and logical consideration.

Let me know what you kids think.

Sweaty
 
I feel like we are often talking past each other in this discussion. Perhaps we need to have a discussion of what ?proof? and ?validity? and ?evidence? mean in the context of clinical medicine. Someone just started a thread on the validity of anecdotal evidence.

Another part of the problem with this discussion is that some of us are literally entering it on the 64th floor.

For example, using OCF to treat anything but a tension headache would sound utterly loony unless one was familiar with concepts like connective tissue continuity.

As I posted on the first day of this discussion, the most official introduction to OCF is in Chapter 64 ?Cranial Field? by Edna Lay in ?Foundations for Osteopathic Medicine? by Ward et al. This is the AOA?s official introductory text for Osteopathic Medicine.

<a href="http://www.amazon.com/exec/obidos/ASIN/0683087924/qid=1022006318/sr=1-1/ref=sr_1_1/103-9201794-6869421" target="_blank">http://www.amazon.com/exec/obidos/ASIN/0683087924/qid=1022006318/sr=1-1/ref=sr_1_1/103-9201794-6869421</a>

Although it is a less than ideal text, if one is really interested in Osteopathic Medicine this is the best place to gain an introduction. If you have better things to spend $120 on, it is available in many medical school libraries. If your school does not have it, you can get it through inter-library loan. Obviously, you do not read the whole thing but perusing it a bit might give us some more common ground.
 
I like Sweaty Paul's idea...I'm in.

Last night I threw together a web page so you all can look at the Cranial Bibliography. I am especially interested in what Dr. Nick thinks of the "non-existent" research on OCF. Here's the link:

<a href="http://home.earthlink.net/~bloveless/biblio.html" target="_blank">http://home.earthlink.net/~bloveless/biblio.html</a>

Good luck!
 
Stillfocused,

If you paid $120 for the FOM you got taken, mine cost me $5.00 and two beers when I bought it from a second year med-student last year (After the beer he forgot about $5.00) LOL

Sweaty

By the way, are you in our experiment?
 
I got mine for $80 and I was was ripped. If could have waited a couple weeks I would have gotten a free copy.

Sure, I'll try it.

What do you can to look at?

Otitis Media is probably easiest.

<a href="http://www.healthsciences.okstate.edu/college/fammed/mills-omt/overview.htm" target="_blank">http://www.healthsciences.okstate.edu/college/fammed/mills-omt/overview.htm</a>

However, I like the case study I saw in AAO Journal where someone used OCF to fix urinary incontince in a male bagpipper. LOL.
 
In all seriousness, there is a paucity of good outcome based research concerning OMT in general.

Perhaps our time would be better spent reviewing the evidence that Osteodoc posted.

Maybe a more effective question would be, given unlimited funding, how might one demonstrate the validity of OCF?

If we were to focus on research on treatment, I think that we would mostly find case studies and theoretical notions about how x, y or z symptom was resolved.

I can't give you my outcome data, yet. Hopefully we will have a review of the retrospective stuff done and a grant proposal submitted by the end of the summer though.

Have you guys seen Nelson's CRI palpation/Traube-Hering-Mayer oscillation article in JAOA 101(3)163-173?

I am pretty psyched about these studies that are in progress:

F01-07 - Brian J. Lenahan, MS-II; The THM Oscillation Correlated with the CRI: Multiexaminer Reliability; Chicago College of Osteopathic Medicine/Midwestern University -$5,000

F01-01 - Michael J. Cutler, MS-IV; The Effect of Cranial-Sacral CV-4 on Sleep Latency and Sympathetic Nerve Activity; UNTHSCFW/ TCOM - $5,000

01-11-526 - John C. Licciardone, D.O., The Role of Osteopathic Manipulative Treatment in Diabetes Mellitus; UNTHSCFW/TCOM; 2 yr. $89,346

F01-10- Christine M. Skand, D.O.; Prophylactic Osteopathic Manipulative Therapy to Decrease Infections in the Nursing Home; UMDNJSOM -$5,000
 
Hey Sweaty,

If you are studying in the KCOM libary to today look at paragraphs 485 - 492 in Still's Research and Practice for a protocol for the treament of excessive sweating with OMM. I am not making this up........
 
This is a good resource for writings on early American manual therapy. It includes Still's Autobiography and the Philosophy of Osteopathy.

<a href="http://www.meridianinstitute.com/eamt/files/contents.htm" target="_blank">http://www.meridianinstitute.com/eamt/files/contents.htm</a>

Do not read this stuff without knowing something of the historical context that they was working in. I recommend Trowbridge's Biography of A.T. Still for an introduction to his intellectual milieu. This is a quick but messier introduction:

<a href="http://www.connective.org/Burning%20brain.doc" target="_blank">http://www.connective.org/Burning%20brain.doc</a>

The EAMT collection is a bit mixed. There is some excellent stuff here and some real garbage. Remember that in the early days there were plenty of people running around claiming to be "Osteopaths" that had no formal training at all. Some of these documents reflect this. Writings by Still, Littlejohn, and Hazzard are worth your time.

The Meridian Institute, the organization that maintains this site, is kind of weird. They are dedicated to researching Edgar Cayce "readings" on health..........

Although, this article was published the AAO Journal last fall and its not awful.

<a href="http://www.meridianinstitute.com/ceu/ceu23aao.html" target="_blank">http://www.meridianinstitute.com/ceu/ceu23aao.html</a>
 
I agree with stillfocused, or was it osteodoc,

lets check out otitis media and the research on ocf in its treatment.

Sweaty
 
Hi Osteodoc,

I looked at your bibliography briefly - initially, I must say that I am not too impressed but am willing to approach this with an open-mind.

However, it is a massive amount of noise for me to sift through - sorry I do not have the time to sort the articles on, "Developmental screening tests in achondroplastic children." and "Voltage-dependent ion channels in glial cells." That is your job :D

How about you try this:

Pick out 2 or 3 articles each on the two topics below (from your bibliography if you wish) and we can then consider them. Choose the few articles that represent your BEST EVIDENCE and we can discuss further. That will be much easier than looking at dozens and dozens of tangentially related article titles.

#1: Cranial movements occur and they are reliably palpable

#2: Manipulation of such movements effectively treats disease

Cheers.

P.S. We will need the article texts for this exercise.
 
DR NICK:where is the primary respiratory pulse monitor? A machine that you can sit down next to, place on your head and - whoah! - there's that primary respiratory pulse on the monitor that the osteopathic guy is talking about.

Where is it?[/QB][/QUOTE]

CCOM has such a machine, some sort of doppler. They just published research using it. I was a test subject and the machine readings did indeed correspond with the operators palpation.

One of the main authors is a Dr. Nelson.

By the way, I find it sad that you need a machine to "prove" your reality to you.

Read the book "Descarte's Error," it may help you.
 
yes, this is Dr. Nelson's research I was speaking of:

Have you guys seen Nelson's CRI palpation/Traube-Hering-Mayer oscillation article in JAOA 101(3)163-173?
 
I am up for reviewing and discussing any articles that people think are pertinent dealing with how cranial manipulation is legit.

I have read the article about the THM testing. I do not remember much about it. For those of you whose great institutions don't subscribe to the JAOA <img border="0" title="" alt="[Eek!]" src="eek.gif" /> here is an abstract in case you want to order it via ILL.

J Am Osteopath Assoc 2001 Mar;101(3):163-73

Cranial rhythmic impulse related to the Traube-Hering-Mayer oscillation: comparing laser-Doppler flowmetry and palpation.

Nelson KE, Sergueef N, Lipinski CM, Chapman AR, Glonek T.

Department of Osteopathic Manipulative Medicine, Chicago College of Osteopathic Medicine of Midwestern University, USA.

The primary respiratory mechanism (PRM) as manifested by the cranial rhythmic impulse (CRI), a fundamental concept to cranial osteopathy, and the Traube-Hering-Mayer (THM) oscillation bear a striking resemblance to one another. Because of this, the authors developed a protocol to simultaneously measure both phenomena. Statistical comparisons demonstrated that the CRI is palpably concomitant with the low-frequency fluctuations of the THM oscillation as measured with the Transonic Systems BLF 21 Perfusion Monitor laser-Doppler flowmeter. This opens new potential explanations for the basic theoretical concepts of the physiologic mechanism of the PRM/CRI and cranial therapy. Comparison of the PRM/CRI with current understanding of the physiology of the THM oscillation is therefore warranted. Additionally, the recognition that these phenomena can be simultaneously monitored and recorded creates a new opportunity for further research into what is distinctive about the science and practice of osteopathic medicine.
 
is the primary respiratory pulse monitor? A machine that you can sit down next to, place on your head and - whoah! - there's that primary respiratory pulse on the monitor that the osteopathic guy is talking about

Fryman actually attempted something like this in the early 1970's (JAOA 1971;70:928-945). However, the study was really a poilot and it was poorly controlled. There are no published attempts at replication.

The THM/CRI study comes closer to this. The rate and rhythm of the CRI and THM osscillations seem to related. Yet, quoting Nelson, "It does not yet explain the complex patterns of motion observed when palpating the CRI, and it offers no explanation of membranous strain dysfunctions."
 
Hi Dr. Nick,

A few comments

However, it is a massive amount of noise for me to sift through - sorry I do not have the time to sort the articles

That will be much easier than looking at dozens and dozens of tangentially related article titles

Remember that there are 5 classic components to the PRM.

1.Inherent mobility of the brain and spinal cord.
2. Fluctuation of the cerebral spinal fluid.
3. Mobility of the intracranial and the intraspinal membranes.
4. Articular mobility of cranial bones.
5. Involuntary mobility of the sacrum between the illia.

Osteopathic Philosophy does not easily separated out structure/function or parts from wholes. Each component is seen as interrelated and functionally interdependent. Studies like "Voltage-dependent ion channels in glial cells" are really important if you want to understand what is going on here.

Earlier I posted this:

Another good place to start on the web is the RESEARCH section of <a href="http://www.osteohome.com/" target="_blank">http://www.osteohome.com/</a>
It?s about 3 or 4 years out of date but it references are a good starting place to start.

Have you seen it? Jones does a competent job of synthesizing the research that was available 3 or 4 years ago.

You have ?thrown down the gauntlet? a couple of time when you stated:

#1: Cranial movements occur and they are reliably palpable

#2: Manipulation of such movements effectively treats disease

As of today, there is no definitive controlled evidence to answer your questions. This work has simply not been done yet, but is it in progress.

However, there is a heap of experimental evidence to support many of its underlying physiological principles.

Moreover, there is a mountain of clinical evidence that supports its use. OCF has been a part of Osteopathy for over 60 years. There are literally dozens of case studies in the literature. Obviously, these lack the methodological rigor that you are focused on. Yet, the case study is a valid piece of clinical science. The case study is both a starting point for further research and a limited demonstration of its subject.

This clinical evidence suggests that OCF is 1) an effective treatment for a number of conditions 2) a safe treatment in trained hands 3) based on a fascinating set of anatomical-physiological postulates 4) a treatment that fits with the values of osteopathic physicians and osteopathic patients.

OCF is now an integral part of Osteopathy. It is not like this is a new, unproven potentially dangerous drug therapy. It is a method of treatment that 1000s of physicians and patients have found to be helpful.

To demand its removal from the Osteopathic curriculum until there is definitive research to demonstrate its claims is putting the cart before the horse.

The research is being done.

If it is consistently shown to be ineffective, dangerous or scientifically untenable then throw it out. Besides, how can anyone understand it claims and begin to test it unless it is taught?
 
Also,

What does "proof" mean for you in science?

What does "proof" mean for you in the context of clinical medicine?
 
•••quote:•••Originally posted by Dr. Nick:
•However, it is a massive amount of noise for me to sift through - sorry I do not have the time to sort the articles on, "Developmental screening tests in achondroplastic children." and "Voltage-dependent ion channels in glial cells." That is your job :D

How about you try this:

Pick out 2 or 3 articles each on the two topics below (from your bibliography if you wish) and we can then consider them. Choose the few articles that represent your BEST EVIDENCE and we can discuss further. That will be much easier than looking at dozens and dozens of tangentially related article titles.

#1: Cranial movements occur and they are reliably palpable

#2: Manipulation of such movements effectively treats disease
•••••I don't see where this is MY job. I use OCF, I understand the underlying anatomy and physiology, and I consistently get good results. I don't need to prove anything to myself or to you. I posted the bibliography to allow YOU to understand the basic research behind OCF. It is now YOUR job to sift through it and try to learn the anatomy and physiology behind the work.

As far as sorting articles, it seems to me that they are already sorted by topic. Dr. King spent quite a lot of energy explaining the organization of the list. If you want to look for a certain topic, just use the FIND feature on your browser.

I graduated yesterday, and I'm not going to have much time in the next week or so to help on the Otitis stuff, but I will try to find whatever I can.

Good luck all!
 
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