Somatic dysfunctions in newborns:

prevalence and correlation inter-

operator

8th International Conference on Advance in Osteopathic Research.

Milan, Italy. May 29, 2010

Francesco Cerritelli MS DOEuropean Institute for Evidence Based Osteopathic Medicine

(EBOM)AIOT Research Institute

Pescara, Italy

francesco.cerritelli@ebom.it

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Definition of Somatic Dysfunction (SD)

Introduction

• impaired or altered function of related components of the somatic (body framework) system: skeletal, arthrodial, and myofascial structures, and their related vascular, lymphatic, and neural elements

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Glossary of Osteopathic Terminology, 2009

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SD as marker of:

Introduction

•bodily changing

•clinical condition

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Licciardone JC, Fulda KG, Stoll ST, Gamber RG, Cage AC. A case-control study of osteopathic palpatory findings in type 2 diabetes mellitus. Osteopath Med Prim Care. 2007 Feb 8;1:6.

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Measuring SD: TART paramters

Introduction

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SD and newborns

Introduction

RegionCerritelli

(’09)Carreiro (’03)

Frymann (’65)

SBS 36,77 40

Torsion 28,50

Compression 17,49

Occiput

Condyles 60,65 45,97

Temporal bone 5,79 32,58

Column 70

Dorsal tract 18,71

Lumbar/sacral tract

39,35

Sacrum

Extension 36,76

Intraosseum 36,77

Diaphragm 16,77Number in table are in percentage

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Aim of the study

•Evaluate the AREA and SUBJECT prevalence of SD in a population of newborns

•Evaluate the inter-operator reliability

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Population

Methods

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newborns N= newborns N= 220220

excluded excluded N=46N=46

eligible N= 174eligible N= 174

pre-terms pre-terms group N= 101group N= 101

terms group terms group N= 73N= 73

study group study group N= 47N= 47

control control group N= group N=

5454

study group study group N= 34N= 34

control control group N= group N=

3939

28≤ga<38

ga≥38

ga = gestational age

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Methods

•Baseline measurements of osteopathic characteristics (TART)

•Osteopathic Evaluations: 2/week

•Study period: 20 months

•Outcomes:

•prevalence of SD

• inter-reliability between operators

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Statistical Analysis

•Arithmetic means and SD for the general characteristics of study population

•Univariate statistical tests for all differences between study and control group

•Pearson’s test for correlation between operators

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Pre-terms population

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Study group Control group p value

N* 47 (46.5) 54 (53.5)

Gender Male 24 (51.1) 27 (50.0) 0,92 Female 23 (49.8) 27 (50.0)

Gestational Age

Overall34.1 (2.4)

34.1 (2.5)

> 32* 36 (76.6) 39 (72.2) 0,79

≤ 32 11 (23.4) 15 (27.8)

Weight (gr)

At birth2088 (498.6) 2234 (730.9)

0,24

≤ 1500* 7 (14.9) 10 (18.5) 0,26

> 1500* 40 (85.1) 44 (81.5)

At recovery 1893 (496.7) 1926 (713.8) 0,59

Numbers in table are mean±s.d.; p value from t test *n(%);p value from χ2 test

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Dysfunction per area

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Dysfunction per subject

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Terms population

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Study group Control group p value

N* 34 (46.6) 39 (53.4)

Gender

Male 17 (50.0) 18 (46.2) 0,75

Female 17 (50.0) 21 (53.8)

Gestational Age (w) 40 (0.9) 40 (1.0) 0,82

Weight (gr)

At birth 3375 (472.9) 3361 (561.6) 0,92

At recovery 3300 (445.8) 3268 (516.1) 0,66

Numbers in table are mean±s.d.; p value from t test *n(%);p value from χ2 test

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Dysfunction per area

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Dysfunction per subject

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Correlation inter-operator

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Arear

value*p value†

Cranium 0.44 0.001

Column 0.24 0.01

Pelvis 0.38 0.001

Thorax 0.15 0.03

* r value from Pearson’s test† p value from Pearson’s test

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Discussion

•Cranial and pelvic areas highest percentage of SD

•Supposed etiology:

- type of labor;

- absence of delivery;

- fetal condition;

- mother condition.

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Discussion

•How we should consider the SDs?

•Are the SDs related to an improvement of the clinical condition?

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Fractal system?

Discussion

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http://upload.wikimedia.org/wikipedia/commons/2/21/Mandel_zoom_00_mandelbrot_set.jpg

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Conclusion

•The study shows a significant r inter-reliability score as well as an high percentage of SD in cranial and pelvic areas.

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...A second... Thank you for your

attentionFrancesco Cerritelli MS DO

European Institute for Evidence Based Osteopathic Medicine (EBOM)

AIOT Research InstitutePescara, Italy

francesco.cerritelli@ebom.it

8th International Conference on Advance in Osteopathic Research.

Milan, Italy. May 29, 2010