Osteopathy Dissertations and Theses

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    Assessing the feasibility and preliminary effectiveness of a telehealth psychoeducation and progressive muscle relaxation programme over three weeks in adult females
    (2023) Taylor, Hannah Letitia Colcomb; Unitec, Te Pūkenga
    INTRODUCTION AND AIM Chronic stress is associated with a broad range of adverse health outcomes, and there is a particularly high incidence of stress among women. The covid-19 pandemic has accelerated the rise in global stress levels and contributed to increased utilisation of telehealth in place of, or as an adjunct to, face-to-face healthcare. As stress is complex and multidimensional, there is a need for a multi-modal approach to stress management. Psychoeducation (PE) and progression muscle relaxation (PMR) are effective stress management tools; however, there is limited research on online multi-modal stress management programmes that incorporate PE and PMR. Therefore, the aim of this project was to conduct a pilot study assessing the feasibility of an online combined PE and PMR therapy programme on reducing stress in women. METHOD An uncontrolled, nonrandomised, feasibility (pilot) interventional trial with a mixed pragmatic and exploratory design and a mixed-methodological approach was conducted. A therapy programme consisting of brief PE and guided PMR was delivered using videoconferencing over three sessions on three consecutive weeks. Participants completed psychometric questionnaires to assess perceived stress and mood, and participant and researcher feedback was collected via semi-structured questions and informal discussions. Feasibility data underwent qualitative analysis using a descriptive method and psychometric data underwent t-test analysis. RESULTS A total of eight female participants (age range 26 to 64, mean age 45) were enrolled, with a 100% retention rate. All aspects of the therapy programme (recruitment and retention; application of PE and PMR; duration and period of programme application; use of psychometric tools; application of programme via telehealth; and data collection) were feasible and participants felt “relaxed” after the sessions with no reported adverse effects. Significant decreases were observed across participants in all measures of perceived stress (all p = <.005) and all measures of negative mood (e.g., anger, confusion, depression, fatigue, tension, all p = <.03). CONCLUSIONS The application of the online therapy programme was feasible, and preliminary evidence may indicate the programme’s potential effectiveness on perceived stress. Future studies may benefit by employing a randomised controlled study design with a larger sample size that serves a broader population demographic, including Māori. The addition of objective measures such as heart rate variability may help to strengthen the interpretation of any future findings.
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    An exploration of the experience of osteopaths managing individuals with endometriosis
    (2023) Zeigler, Zena Lauren; Unitec, Te Pūkenga
    AIM This study aimed to investigate the theories, approaches, experiences, qualifications, and future recommendations of osteopaths regarding the management of individuals with physical symptoms associated with endometriosis. This study will contribute to the literature on the osteopathic management and treatment for women living with endometriosis. DESIGN Qualitative, descriptive, exploratory study. METHODS A sample of six registered osteopaths from New Zealand and Australia participated in semi-structured interviews over Zoom between April 2022 to July 2022. The recordings of interviews were transcribed verbatim and coded. Thematic analysis was conducted which identified three main themes and several subthemes. FINDINGS Thematic analysis of osteopath’s interviews identified three main themes: osteopathic management and treatment, osteopath's experiences, and perspectives and thirdly, recommendations and qualifications of participants. The study captured several subthemes linked to each theme. CONCLUSION This study provides in depth, unique, valuable insights on the experiences, clinical practices, perspectives of participants on their osteopathic management and treatment for women with endometriosis-related physical symptoms (low back pain, abdomen pain, and pelvic girdle pain). Endometriosis is a complex disease, and each individual may need unique treatment and management, including how an osteopath may manage an individual with endometriosis. In this study, participants preferred indirect techniques such as myofascial release (MFR), balanced ligament tension (BLT), over direct techniques such as inhibition techniques on muscles that surround the pelvis. Other techniques included visceral manipulation, iliopsoas and diaphragm release, articulation, muscle energy techniques (MET) and oscillation to the lumber spine and hips. Many osteopathic techniques, aims, and recommendations were aimed to decrease the sympathetic nervous system (SNS), reduce inflammation, improve lymphatic drainage, and improve immunity in individuals. Management also included advice on exercise and home recommendations, nutrition, pacing, transcutaneous electrical nerve stimulation (TENS), supplementation or diet advice, stretching, yoga, diaphragmatic breathing, pacing, mindfulness, pain education and appropriate referrals. Participants in this study highlighted the experiences and perspectives, regarding osteopathic treatment for women with endometriosis. The study contributes to the endometriosis management literature and provides perspectives and experiences and directions for future research.
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    Sleep abnormalities as potential early diagnostic biomarkers for Alzheimer’s disease: A scoping review examining the extent of empirical evidence
    (2023) Baxter, Lucas; Unitec, Te Pūkenga
    Alzheimer’s disease is the most common type of dementia, and its prevalence is increasing world-wide. This disease incurs a wide range of complications for individuals and society. No current therapies exist to cure or stop the progression of the disease once diagnosed within an individual. Many risk factors for Alzheimer’s disease are known, although one which has recently emerged within the scientific literature is sleep disturbance. The true implications of the research are at present, incomplete, yet the studies available have shown promise of the potential diagnostic and therapeutic value of sleep. Therefore, this study aimed to examine the extent and nature of research available discussing the role of sleep in Alzheimer’s disease development, as well as the potential utility of specific sleep disturbances to be diagnostic biomarkers for Alzheimer’s disease. A five-stage scoping review framework developed by Arksey and O’Malley was utilised to ensure an in-depth review of the relevant literature was achieved. From a total of 2,821 studies, 199 were included into this scoping review and classified into four primary themes: 1) Mechanistic links between sleep disturbance and Alzheimer’s disease, 2) Sleep disturbance as a biomarker for Alzheimer’s disease, 3) Sleep as a therapeutic target for Alzheimer’s disease, and 4) Preclinical Alzheimer’s disease definition. This review has covered a range of studies that discussed links between sleep disturbance and Alzheimer’s disease pathogenesis. The findings suggests that certain sleep patterns may have diagnostic and therapeutic uses in Alzheimer’s disease; however, further experimental research is indicated to substantiate these hypotheses. The term preclinical Alzheimer’s disease requires a relevant and concise consensus regarding its definition in order for the aforementioned hypotheses to fully be explored for their respective potential
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    The reported use of musculoskeletal rehabilitative ultrasound: A scoping review
    (2023) Faulkner-Gilmour, Suzanna; Unitec, Te Pūkenga
    BACKGROUND Rehabilitative ultrasound imaging (RUSI) has been a progressively growing area of interest for rehabilitation providers. The origins of ultrasound imaging were founded in its utility for diagnosing organs and soft tissue structures, but it has become apparent that it may have clinical utility for rehabilitation providers by providing real time images that can be used to guide assessment and clinical outcomes in musculoskeletal disorders. RUSI is an established and reliable tool however the current literature is sparse and heterogenous, prompting the need for further investigation and synthesis. OBJECTIVES The objectives of this study were to examine and synthesis the nature, range and extent of the current literature available on the topic of RUSI. In addition, to report the ways in which RUSI is being used and for what purpose. It also aimed to outline any implications and limitations to its integration into clinical practice for rehabilitation providers. METHOD The six-stage scoping review design developed by Arksey & O’Malley was used as the methodological framework for this review. Reporting was guided by the PRISMA extension for scoping reviews and Joanna Briggs Institute (JBI). EBSCO, Scopus and PubMed electronic databases were used to identify articles with no date restrictions and included grey literature such as conference proceedings and theses. A thematic and descriptive analysis was then conducted. RESULTS A total of 84 articles were included in this review of which a cross-sectional design represented the highest proportion of articles. Four main findings were reported which included: the nature of articles included, and the main categories of use were for musculoskeletal measurements, biofeedback and other which primarily consisted of literature reviews and expert opinion articles. CONCLUSION The findings of this study indicated the main limitations to integration of RUSI into clinical practice was the nebulous nature and lack of consensus-based definition for RUSI as well as the apparent absence of guidelines from regulatory bodies on if or how RUSI falls into the scope of practice of rehabilitation provider.
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    Exploring the quality of life of New Zealand adults who practise intermittent fasting: A cross-sectional survey study
    (2023) Reader, Karis Jaden; Unitec, Te Pūkenga
    INTRODUCTION Intermittent fasting (IF) has been investigated for its potential ability to improve aspects of quality of life (QoL). Current findings suggest that IF may be able to positively affect QoL. Additionally, only one study on IF has taken place in New Zealand, however, QoL was not their primary focus. Therefore, this study aimed to explore the QoL of New Zealand adults who practise IF. METHODS A cross-sectional study on New Zealand adults who practise intermittent fasting was conducted using a self-administered online survey. The survey asked respondents about demographic information, QoL using Short-Form 36, and questions about their IF practice. Frequency and percentages were calculated for ordinal and ratio data. Spearman's rank correlation coefficient tests were conducted between each QoL’s domain and age, education level, perceived level of challenge adhering to IF protocols and length of time practising IF. Data from open-ended questions was analysed using a truncated version of a manifest content analysis was employed. RESULTS 153 respondents completed the survey. The majority were females (93%) between the ages of 45-54 (37%) who lived in Auckland (36%). Mean scores for six of the eight QoL’s domains were 80% or greater. Time-Restricted Eating was the most common intermittent fasting regime (87%). Most respondents thought IF was easy to adhere to and effective for helping them reach their health goals. Benefits such as reduced hunger, improved energy, mood, and overall happiness were commonly reported. The most common challenges associated with practising IF were social and environmental temptations, followed by hunger and cravings. Over half of the statistically significant correlations were associated with respondents’ perceived level of challenge adhering to IF. CONCLUSION This retrospective cross-sectional survey explored the QoL of New Zealand adults who practise IF. Respondents thought that IF, specifically Time-Restricted Eating, is often easy to adhere to and effective for helping them reach their health goals. Additionally, people who thought IF was easy to adhere to, were positively correlated with greater scores in several QoL’s domains. These findings provide exploratory data on the QoL of people who practice IF in New Zealand. Future research should employ control groups to facilitate comparisons of QoL between fasters and non-fasters.