Department of Physical Medicine and Rehabilitation, New York Presbyterian 12295 , Weill Cornell Medicine and Columbia University , New York, USA.
College of Osteopathic Medicine, 155229 Touro University California , Vallejo, CA, USA.
J Osteopath Med. 2024 Apr 24;124(7):321-332. doi: 10.1515/jom-2022-0081. eCollection 2024 Jul 1.
Interoceptive bodily awareness (IBA) is one's attentional focus on and relationship with comfortable and uncomfortable (e.g., pain) internal body sensations. Integrating IBA into research on osteopathic manipulative treatment (OMT) is growing, both as an outcome and predictor of treatment outcomes; however, it has yet to be studied in a clinical setting.
We aimed to conduct a pilot study to measure IBA, with the Multidimensional Assessment of Interoceptive Awareness (MAIA), in patients seeking OMT for pain, and to test if OMT exposure may be associated with higher IBA as measured by the MAIA. The primary outcome was the change in MAIA scores, and the secondary outcomes were reduction in pain intensity, reduction in pain interference, and increase in participants' perception of change post-OMT.
A convenience sample was recruited from individuals presenting for OMT appointments at a College of Osteopathic Medicine OMT teaching clinic. Participants were recruited into our single-arm observational cohort study (n=36), and categorized into one of two groups, OMT-naïve (n=19) or OMT-experienced (n=17), based on prior exposure to OMT. We measured MAIA scores and clinical pain-related outcomes prior to, immediately after, and at 1 and 3 weeks after a usual-care OMT session in the clinic. Covariates including experience with mind-body activities, non-OMT body work, and physical and emotional trauma were also collected to explore potential relationships. We utilized t tests to compare MAIA scores and pain outcomes between groups and across time points. Stepwise regression models were utilized to explore potential relationships with covariates.
The OMT-experienced group scored higher on the MAIA scales "Not-worrying" (p=0.002) and "Trusting" (p=0.028) at baseline. There were no significant changes in the MAIA scores before and after the single OMT session. Analysis of secondary outcomes revealed that all pain outcomes significantly decreased post-OMT (p<0.05), with the largest relative improvements in the acute pain and OMT-naïve subgroups, with diminishing effects over time.
Assessing IBA with MAIA in a clinical OMT setting is feasible. There were significant positive correlations between OMT exposure and two of the eight MAIA scales. Future studies are justified to further explore this relationship.
内感受身体意识（IBA）是指个体对舒适和不适（例如疼痛）内部身体感觉的注意力焦点和关系。将 IBA 整合到整骨治疗（OMT）的研究中正在不断发展，无论是作为治疗结果的指标还是预测治疗结果的指标；然而，它尚未在临床环境中进行研究。
我们旨在进行一项试点研究，使用多维内感受意识评估量表（MAIA）测量接受 OMT 治疗疼痛的患者的 IBA，并测试 OMT 暴露是否与 MAIA 测量的更高 IBA 相关。主要结果是 MAIA 评分的变化，次要结果是疼痛强度的降低、疼痛干扰的降低以及参与者对 OMT 后变化的感知的增加。
从一所骨医学院 OMT 教学诊所就诊的接受 OMT 预约的个体中招募了方便样本。参与者被招募到我们的单臂观察队列研究（n=36）中，并根据先前接受 OMT 的情况分为 OMT 新手组（n=19）和 OMT 经验丰富组（n=17）。我们在诊所的一次常规 OMT 治疗前后立即以及 1 周和 3 周测量 MAIA 评分和临床疼痛相关结果。还收集了包括身心活动、非 OMT 身体工作以及身体和情绪创伤在内的协变量，以探索潜在的关系。我们使用 t 检验比较了组间和时间点的 MAIA 评分和疼痛结果。使用逐步回归模型探索与协变量的潜在关系。
OMT 经验丰富组在“不担忧”（p=0.002）和“信任”（p=0.028）量表上的 MAIA 评分更高。单次 OMT 治疗前后 MAIA 评分没有明显变化。对次要结果的分析表明，所有疼痛结果在 OMT 后均显著降低（p<0.05），在急性疼痛和 OMT 新手亚组中相对改善最大，随着时间的推移效果逐渐减弱。
在临床 OMT 环境中使用 MAIA 评估 IBA 是可行的。OMT 暴露与 MAIA 的八个量表中的两个量表之间存在显著的正相关。有理由进行进一步研究以探索这种关系。
