Virginia Research Day 2021

Medical Student Research Cl inical

06 The “One” Approach: An Integrated Osteopathic-Neurological Examination Enhancing Patient Care

Michael P. Cargill, OMS III, Alyssa M Jackson, OMS III, Jessica K Morris, OMS III Charles R. Joseph, MD; Michael D. Lockwood, DO, FCA, FAAO Corresponding author: jmorris64@liberty.edu

Liberty University College of Osteopathic Medicine

Neurological disorders are a leading cause of disability and death worldwide. The global burden of neurological disease has increased the demand for treatments, rehabilitation, and other supportive services. By incorporating the osteopathic structural somatic examination with the traditional complete neurological examination, somatic dysfunction occurring as a consequence of neurologic injury or independently, can be identified and treated using osteopathic manipulative techniques at the time of the patient’s visit. Our proposed integrated osteopathic- neurological examination (ONE) approach provides the physician with more diagnostic and treatment modalities while allowing the physician to make a more tangible impact in patient care. Structural dysfunction can influence the neurological exam, and likewise, neurological conditions can influence structural exam findings. Utilizing the proposed

integrated examination, the physician can determine the interplay between structural and neurological findings to identify patterns of change that coincide with more specific diagnoses and the chronicity of a condition. To the degree somatic components exist, Osteopathic Manipulative Treatment (OMT) can be applied as a primary or adjunct treatment modality. Gentle techniques, such as direct inhibition, myofascial release, and muscle energy, have been shown to improve patient comfort and outcomes in a variety of neurological conditions and are easily mastered by uninitiated physicians through accredited skills workshops. OMT has been shown to improve musculoskeletal complaints, facilitate pain processing, and enhance activity of central neural centers related to perception of wellbeing, proprioception, balance, and gait. In addition, improvement in overall functionality for various patient populations is well

documented. With limited treatment options for many progressive neurological diseases often contributing to physician burnout, visible patient improvement post-treatment may provide more fulfillment in patient care. These tangible benefits from the “ONE” approach translate to enhanced patient and physician satisfaction.

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