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神经肌肉骨骼医学/整骨疗法门诊的孕妇的特点和管理。

Characteristics and Management of Pregnant Patients From a Neuromusculoskeletal Medicine/Osteopathic Manipulative Medicine Clinic.

出版信息

J Am Osteopath Assoc. 2020 Dec 1;120(12):913-920. doi: 10.7556/jaoa.2020.151.

Abstract

CONTEXT

Osteopathic manipulative medicine (OMM) is considered beneficial in the treatment of pregnant women, but few studies have outlined the presenting complaints and diagnoses that warrant consideration and utilization of osteopathic manipulative treatment (OMT) in this population.

OBJECTIVE

To describe the characteristics of pregnant patients receiving OMM at a neuromusculoskeletal medicine (NMM)/OMM specialty outpatient clinic, for the purpose of identifying patients who would benefit from referral to NMM specialty clinics or to be considered for treatment by DOs in non-NMM specialty clinics.

METHODS

Electronic health records were reviewed from a single clinic for a 3-year period from October 2015 through September 2018 for patient encounters involving patients with an International Classification of Diseases 10th Revision code for pregnancy. Data regarding patient demographics, payment methods, presenting complaints, treatment modalities, regions treated, and assessment diagnoses were collected and analyzed.

RESULTS

Records showed 465 clinical encounters with 194 pregnant patients (mean [SD] number of encounters per patient, 2.4 [2.0]). The most common presenting complaints involved the back (371; 55.4%), hip and pelvis (99; 14.8%), neck (62; 9.3%), and head (54; 8.1%). The most common clinical assessments were lumbar and thoracic spine neuromusculoskeletal diagnoses (420; 53.0%). There were 2604 somatic dysfunction assessments documented; lumbar (409; 15.7%) and sacral (396; 15.2%) somatic dysfunction were most commonly assessed. There were 2518 OMT techniques documented, and muscle energy was most frequently used (406; 16.1%).

CONCLUSIONS

This data, which documents the most frequent presenting complaints of pregnant patients in an NMM/OMM clinic, may be used by clinicians to better understand the role of OMM as an obstetric adjunctive treatment approach and to identify conditions to investigate in future outcome studies.

摘要

背景

整骨手法医学(OMM)被认为对孕妇治疗有益,但很少有研究概述在该人群中考虑和使用整骨手法治疗(OMT)的指征和诊断。

目的

描述在神经肌肉骨骼医学(NMM)/OMM 专科门诊接受 OMM 的孕妇患者的特征,目的是确定哪些患者受益于转诊至 NMM 专科诊所,或被考虑在非 NMM 专科诊所由 DO 进行治疗。

方法

从 2015 年 10 月至 2018 年 9 月的 3 年期间,对一家诊所的电子健康记录进行了回顾,患者就诊时的国际疾病分类第 10 版编码为妊娠。收集并分析了患者人口统计学、支付方式、就诊主诉、治疗方式、治疗部位和评估诊断的数据。

结果

记录显示,465 次临床就诊中有 194 名孕妇(每位患者平均就诊次数为 2.4[2.0])。最常见的就诊主诉涉及背部(371 例;55.4%)、臀部和骨盆(99 例;14.8%)、颈部(62 例;9.3%)和头部(54 例;8.1%)。最常见的临床评估是腰椎和胸椎脊柱的神经肌肉骨骼诊断(420 例;53.0%)。记录了 2604 次躯体功能障碍评估;最常评估的是腰椎(409 例;15.7%)和骶骨(396 例;15.2%)躯体功能障碍。记录了 2518 次 OMT 技术,肌肉能量技术使用最频繁(406 例;16.1%)。

结论

本数据记录了 NMM/OMM 诊所中孕妇最常见的就诊主诉,临床医生可以据此更好地理解 OMM 作为产科辅助治疗方法的作用,并确定未来结局研究中需要调查的病症。

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