The AAO

48 Pages·2014·4.65 MB·English

The AAO
F o t
orum For steopathic hought
JOURNAL
Official Publication of the American Academy of Osteopathy
®
tradition shapes the Future Volume 24 number 2 June 2014
Lebanon, Oregon
4250 miles
Lobitos, Peru
Health Status Comparison of Lebanon,
Oregon, and Lobitos, Peru...page 31
The American Academy of Osteopathy is your voice . . .
in teaching, advocating, and researching the science, art, and philosophy of osteopathic medicine, emphasizing the integration of
osteopathic principles, practices, and manipulative treatment in patient care.
The AAO Membership Committee invites you to join the • Access to the members only section of the AAO website,
American Academy of Osteopathy as a 2014-2015 member. which will be enhanced in the coming months to include
The AAO is your professional organization. It fosters the core new features such as resource links, a job bank, and much
principles that led you to become a doctor of osteopathic more.
medicine. • Discounts on advertising in AAO publications, on the AAO
website, and at the AAO’s Convocation.
For just $5.27 a week (less than the price of a large specialty
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of the professional specialty organization dedicated to the core
for manual medicine in the medical world today.
principles of your profession.
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Your membership dues provide you with: DOs for promoting OMM through teaching, writing, and
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(including appropriate reimbursement for OMM services) • Promotion of research on the efficacy of osteopathic
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West Virginia School of Osteopathic Medicine
Osteopathic Principles and Practices Faculty Position
www.wvsom.edu/employment
Summary Responsibilities: For the last three years, WVSOM has been
consistently recognized as A Great College to
: WVSOM is seeking to fill a full-time OPP Department
Work For by the Chronicle of Higher Education.
tenure track faculty position in Osteopathic Prin- duties include training first- and
The school's campus is located in Lewisburg, West
ciples & Practices (OPP) Medicine. The primary second-year medical students in the
Virginia a picturesque community nestled in the
job of this faculty position is to provide education classroom. Academic responsibilities
Appalachian Mountains. In addition to being
in osteopathic principles and practices and assist may include preparing and delivering
named America's Coolest Small Town in 2011,
in providing OPP integration to all phases of the lectures, instruction in OPP labs,
Lewisburg has an array of eclectic restaurants,
WVSOM pre and post doctoral curriculum. development of test questions and
outdoor activities, antique shops, art galleries, a
Research opportunities are available if desired. small group activities. Research is
Carnegie Hall performing art center, and a live
This position provides an opportunity for a supported and encouraged but not
equity theater that is supported by varied local
clinical practice. Successful candidates must have r equired.
artists and benefactors. The community is also
a D.O. degree from an accredited college/school of Benefits:
supported by a regional medical center and
osteopathic medicine and be residency trained
Salary and faculty rank will excellent educational opportunities for students of
and board certified or board eligible by AOBNMM
be commensurate with experience all ages. To get a glimpse of this charming
(CSPOMM and/or NMM) or other osteopathic
and includes an excellent benefits community, please visit www.greenbrierwv.com
specialty board. The successful candidate must
package including medical malpractice
also be eligible for licensure in the state of West
insurance, educational loan reimburse-
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Interest candidates should contact Leslie Bicksler, Associamtee Vnitc ea Pnrde sriedelonct aotf iHounm eaxnp Reenssoeusrc. e s at 304.647.6279; 800.356.7836; or [email protected]
WVSOM is an equal opportunity employer. Applications accepted until the position is filled.
Page 2 The American Academy of Osteopathy Journal • Vol. 24, No. 2, June 2014
The AAO Forum for Osteopathic Thought
J
OURNAL
Official Publication of the American Academy of Osteopathy®
TRADITION SHAPES THE FUTURE • VOLUME 24 • NUMBER 2 • JUNE 2014
The mission of the American Academy of Osteopathy is to teach,
3500 DePauw Boulevard, Suite 1100
advocate, and research the science, art, and philosophy of osteopathic
Indianapolis, IN 46268-1136
medicine, emphasizing the integration of osteopathic principles,
[phone] • Fax: [phone]
practices, and manipulative treatment in patient care.
www.academyofosteopathy.org
In ThIs Issue:
The AAO Journal AAO Calendar of Events...............................................................4
Kate McCaffrey, DO .........................Scientific editor
CME Certification of Home Study Forms ..................................46
Katherine A. Worden, DO, MS .................Associate editor
Michael E. Fitzgerald .......................Supervising editor Component Society Calendar of Events. .....................................48
Lauren Good ..............................Managing editor
edITorIals:
Editorial Advisory Board
View From the Pyramids: The Gamification of Medical Schools ..5
Denise K. Burns, DO, FAAO Brian E. Kaufman, DO Kate McCaffrey, DO
Eric J. Dolgin, DO Hollis H. King, DO, PhD,
Millenials, Cranial Courses, and the Death of the Slide Projector ..6
Claire M. Galin, DO FAAO
Janice U. Blumer, DO
William J. Garrity, DO David C. Mason, DO
Stephen I. Goldman, DO, FAAO Kate McCaffrey, DO Book revIews:
Stefan Hagopian, DO, FAAO Hallie J. Robbins, DO
At the Still Point of the Turning World by Robert Lever .................7
Raymond J. Hruby, DO, MS, Mark E. Rosen, DO
Hollis H. King, DO, PhD, FAAO
FAAO Katherine A. Worden, DO, MS
Why Does It Hurt? by Todd Capistrant, DO, MHA,
American Academy of Osteopathy With Steve LeBeau........................................................................8
Kenneth J. Lossing, DO............................President Claire M. Galin, DO
Doris B. Newman, DO, FAAO ..................President-elect
Michael E. Fitzgerald ....................... Executive director orIgInal ConTrIBuTIons:
Sherri L. Quarles ...................Associate executive director The Bioenegetic Model in Osteopathic Diagnosis and Treatment:
An FAAO Thesis, Part 2 ...............................................................9
The AAO Journal is the official publication of the American Academy Jan T. Hendryx, DO, FAAO
of Osteopathy. Issues are published in March, June, September, and
Osteopathic Manipulative Treatment in Vestibular Neuritis ......27
December each year.
Brendan S. Ross, DO, MS;
The AAO Journal is not responsible for statements made by any
Virginia M. Johnson, DO, C-NMM/OMM
contributor. Although all advertising is expected to conform to
Health Status Comparison of Lebanon, Oregon, and Lobitos,
ethical medical standards, acceptance does not imply endorsement by
Peru: A Pilot Study Using a Novel Investigative Study Tool .......31
this journal or by the American Academy of Osteopathy.
Kathryn Kimes, OMS III; David Goldman, OMS III; Megan
Opinions expressed in The AAO Journal are those of the authors and
Aabo, OMS III; Dave Aabo, MS; Katherine Peters, OMS III;
do not necessarily reflect viewpoints of the editors or official policy of
Katie Zeiner, MAg; Kate McCaffrey, DO; John T. Pham, DO;
the American Academy of Osteopathy or the institutions with which
Robyn Dreibelbis, DO; John Mata, PhD
the authors are affiliated, unless specified.
Introducing MAAP: The Modified ASIA Examination
Please send all address changes to [email protected].
for Ambulatory Patients ..............................................................40
Drew D. Lewis, DO; Jose S. Figueroa, DO; Garth K. Summer,
ON THE COVER: ©iStock.com/pop_jop
OMS II; J.D. Polk DO
Continued on page 4
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The American Academy of Osteopathy Journal • Vol. 24, No. 2, June 2014 Page 3
Table of Contents (Continued from page 3) Treatment of Common Fibular Nerve Palsy With OMM ...........23
Bradley M. Jahnke, OMS V; Puanani Hopson, OMS V; Katherine
aBsTraCTs:
Worden, DO, MS
Neural Prolotherapy Can Resolve Neuralgia ...............................19
Application of OMT in a Pediatric Postoperative Ileus Case.......24
Eileen Conaway, DO; Brian Browning, DO
Rebecca S. Domlski, OMS III; Laura Nimkoff, MD; Sheldon C.
Management of Levator Ani Syndrome With Osteopathic
Yao, DO; Patricia Kooyman, DO
Manipulative Treatment: A Case Study ......................................20
Role of Osteopathic Manipulative Medicine in the Treatment
Miho Yoshida, DO, NMM+1; Dominic Derenge, OMS IV;
of Dacrystenosis ..........................................................................25
Katherine Worden, DO, MS
Theresa E. Apoznanski, OMS III; Reem Abu-Sbaib, DO;
Comparison of Patient Records From the Still-Hildreth
Sheldon C. Yao, DO
Sanitorium With Published Reports ...........................................21
Is There a Place for Osteopathy in Parkinson Disease
Leslie Ching, DO, OGME 4; Harriet Shaw, DO
Management? A Retrospective Case Control Study ....................26
Traumatic Groin Injury in a Football Player: A Case Study ........22
Michael P. Catanzaro, OMS III; Kathleen M.
Daniel Tsukanov, DO; Dennis Dowling, DO, FAAO;
Vazzana, OMS IV; Annie Chen, OMS II; Jayme Mancini, DO,
Lyn Weiss, MD
PhD; Sheldon C. Yao, DO
AAO Calendar of Events
Mark your calendar for these upcoming Academy meetings and educational courses.
2014
July 4 Independence Day—AAO office closed Aug. 6 Birthday of Andrew Taylor Still, MD, DO
July 11 Committee on Fellowship teleconference, Aug. 8–9 AAO Education Committee meeting—
8:30 p.m. Eastern time Indianapolis
July 12–13 AAO Board of Trustees meeting— Aug. 8–9 SAAO Council meeting—Indianapolis
Indianapolis
July 18–19 “Ultrasound-Guided Injections”—Sajid A.
Surve, DO—University of North Texas
Health Science Center—Texas College of
Osteopathic Medicine, Fort Worth
Page 4 The American Academy of Osteopathy Journal • Vol. 24, No. 2, June 2014
View From the Pyramids
The Gamification of Medical School
Kate McCaffrey, DO
Playing games at school? You bet! medical school can sometimes mean giving up, whereas
failure in video games translates into persistence.
Luminosity is an example of a game interface with which
you may already be familiar. A few of the more popular If you take students or residents for clerkships or if
medical games are www.prognosisapp.com, www. you teach them at the medical school level, keep an
scrubwars.com and www.picmonic.com. These apps are open mind to integrating creative ways of teaching like
widely used by medical trainees.1 gaming and quizzes. I am all for preserving our trainees’
self-esteem and producing intact healers when they
Several studies now support the video game model as
finally get through their grueling medical training.
an effective tool for studying medicine. A wise mentor
told me, “If we want to effectively teach the millennial References
generation, then we need to play in their sandbox.” And 1. Stevenson V. The gamification of medical training. 2013;
KevinMD.com; http://www.kevinmd.com/blog/2013/12/
we need to find out what they are using to build sand
gamification-medical-training.html. Accessed May 10, 2014.
castles. Staying culturally sensitive is another reason to
2. Culture; Merriam Webster Online; http://www.merriam-webster.
explore the crossover of using their “toys” in medical
com/dictionary/culture. Accessed May 10, 2014.
education and training. The definition of culture is 3. Morris BJ, Croker S, Zimmerman C, Gill D, Romig C. Gaming
to “maintain…conditions for growth.”2 Culture can science: the “Gamification” of scientific thinking. Frontiers in
Psychology. 2013;4:607.
also be defined as “the beliefs, customs, arts, etc., of
a particular society, group, place or time,”2 and the
millennial generation fits this definition of a group in
time with a particular set of beliefs and customs. As Follow the American Academy of
medical educators, we will want to get out our passports
Osteopathy online.
and explore this foreign culture and learn its customs
if we want to make a significant impact on the next
generation of osteopathic physicians. They will be caring
@
for us, after all.
So how does gaming work to enhance learning? Gaming www.facebook.com/American.
increases comprehension and keeps a learner’s interest
Academy.Osteopathy
using a multilayered approach. Morris et al, propose
that gaming uses motivational scaffolding such as feedback,
rewards, and flow states to keep learners engaged.3 A
flow state is a heightened state of focus and engagement
coupled with low anxiety. Also used is cognitive scaffolding,
such as simulations and reasoning skills. Gaming may
also change attitudes toward failure. In a game, errors are
@AmAcadOsteo
experienced as constructive feedback instead of failure.
This small change may alter the anxiety that failure
produces, especially in medical school where the threat
of failing can be emotionally devastating. Failure in
The American Academy of Osteopathy Journal • Vol. 24, No. 2, June 2014 Page 5
Millennials, Cranial Courses,
and the Death of the Slide Projector
Janice U. Blumer, DO
For the first time, incoming osteopathic medical students, interact with this generation of students. Today’s students
members of the millennial generation, have had computer struggle with slowing down enough to feel the subtle rhythms
technology and Internet access for their entire lives. This and strain patterns. They are skeptical and go to the Internet
has changed the way this cohort learns and interacts with to validate ideas before the lecture is done. In the blink of an
material. Labeled the “me, me, me generation” by Time eye or flash of the keyboard, they are already dismissing the
magazine, they have been told they are special, and they have entire concept before even a chance to defend it arises.
been given awards just for showing up. They expect as much
Of course I am not in the typical cranial course, as I am an
in training. These are multidevice users, and they are not
assistant professor in one of the few medical schools that still
without one to three devices in hand, often interacting in
offers a 40-hour course to students. My students come to pass
different ways on each device or seemingly “multitasking.”
the course and their national boards, not necessarily because
So how is this changing the way we teach osteopathic cranial they embrace the idea. Still, I wonder whether we are losing
manipulative medicine? How do we interact with this some because we missed the memo that what worked before
generation’s “edutainment” needs to make teaching cranial isn’t working with this generation.
“sexy”? How do we slow down these fast-paced students
Is it time to “flip” the cranial course, ditch the slide projector,
enough so they are able to feel the cranial rhythmic impulse
and meet the technology generation somewhere in the
and so they actually take the time to learn the palpation
middle? Some would say technology itself is a hindrance
involved in cranial? The answer is we don’t.
to teaching cranial, but how do we know unless we test it?
For generations, osteopathic cranial manipulative medicine I don’t have the answers to these questions, but I can say,
has been taught in the exact same way: at tableside with if these courses don’t evolve in some way, we will lose this
interspersed lectures, usually involving a slide projector. This generation in the “lack of technology” void.
model, though it worked for the previous generations, is
challenging the teachers of osteopathy in the cranial field who
Make plans now to join us
for the 2015 AAO Convocation.
“Life in Motion”
Louisville, Kentucky
March 11-15, 2015
Photos courtesy of Louisville Convention & Visitors Bureau
Page 6 The American Academy of Osteopathy Journal • Vol. 24, No. 2, June 2014
Book Review—At the Still Point of the Turning World:
The Art and Philosophy of Osteopathy by Robert Lever
© 2013 Handspring Publishing
Hollis H. King, DO, PhD, FAAO
No matter where you are in the world, if you are an Juicy and thought-provoking
osteopathic physician, an osteopath, a patient of one of the discussions develop throughout
foregoing, or a faculty member at an osteopathic training the book. One of my favorites is
institution, the philosophy of osteopathy has confronted in the chapter titled “Reciprocity,
you at some point. For those involved in the professions of Relationship, Spaces.” Lever states:
osteopathic medicine and osteopathy, Robert Lever’s book
“…the concept of
At the Still Point of the Turning World is most helpful in
interconnectedness, or
refining and developing your thoughts about osteopathic
reciprocity of function, is not
philosophy. As one who has taken a crack at writing about
anathema to conventional
osteopathic philosophy, I am impressed with how well the
medical theorists. It is simply
author expresses complex ideas, and I found myself looking
that so often, the therapeutic
at ideas from new angles. Readers will be rewarded with an
approach that is implemented is
enriched database and perspective on osteopathic philosophy.
extremely targeted and linear, and in this sense, the body
In the foreword, R. Paul Lee, DO, FAAO, FCA, observes that is not always treated with respect to its unity.”
Lever writes from a “British perspective,” but I found that
Lever holds that osteopathy—and I maintain, osteopathic
Lever’s is a truly universal osteopathic perspective. Regardless
medicine—contributes the necessary professional service to
of the degree or initials following one’s name or on which
improve health care in any context and should be allowed,
side of the Atlantic Ocean one resides, this book provides a
even encouraged, to be taught widely in all venues or
critical contribution to osteopathic philosophy and to the
professions that purport to treat the human condition.
understanding of the cranial concept in osteopathic medicine.
It is not a fast read, as the integration of relevant philosophical This reviewer recommends At the Still Point of the Turning
ideas from quantum physics to the five phenomena of World to any physician or other health care professional
W. G. Sutherland’s primary respiratory mechanism are placed anywhere in the world, especially if that professional uses
alongside and melded into each other. his or her hands to deliver health care. For the discerning
American Academy of Osteopathy member or subscriber who
already may be conversant with international osteopathic
publications, this book already may be in his or her library.
The American Academy of Osteopathy Journal • Vol. 24, No. 2, June 2014 Page 7
Book Review—Why Does It Hurt? by Todd Capistrant,
DO, MHA, With Steve LeBeau
Copyright © 2014 Beaver’s Pond Press
Claire M. Galin, DO
Todd Capistrant, DO, MHA, with the help of Steve LeBeau about the osteopathic medical
has written Why Does It Hurt? The Fascial Distortion Model: profession, including that it does
A New Paradigm for Pain Relief and Restored Movement. This not offer anything but conventional
book is specifically written for lay people experiencing pain. medicine for a patient with tennis
It is easy to read and well illustrated, and it is well balanced elbow (page 24) and a brief history
between being just scientific enough to explain the fascial of the profession that tends toward
distortion model yet not so scientific to be confusing to mythology. Dr Capistrant also makes
people outside the medical profession. The stories told and unsubstantiated comments such as
the explanations given become a compelling invitation to a in the old model of medicine, the
person suffering pain to seek out treatment in this model. doctor did all the talking (page 41).
And it is always useful to get material into the hands of the
I can recommend this book for
public that leads people to seek out DOs who do osteopathic
members of the public who are
manipulative medicine in any form.
seeking information on treatment of pain, but I hope that
However, Why Does It Hurt? has some obvious flaws. Multiple in his next edition, Dr Capistrant will support his claims
claims are made with no supporting data: All of the evidence with data and, therefore, show the true value of the fascial
is purely anecdotal. There are some confusing points made distortion model.
Sutherland Cranial Teaching Foundation
Upcoming Courses For more information on osteopathic
terminology used in The American
SCTF Basic Course:
Academy of Osteopathy Journal, see the
Osteopathy in the Cranial Field
June 6–10, 2014
Portland, Oregon
Course Director: Dr. Duncan Soule
40 hrs 1A CME anticipated
Glossary of Osteopathic
At The Double Tree Hotel at the Lloyd Center
1000 NE Multnomah Terminology
Portland, Oregon
direct link from the airport to the hotel via the
Max Light Rail Line
2 restaurants and a fitness center available
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Visit our website for enrollment Council on Osteopathic Medicine.
forms and course details: www.sctf.com
Contact: Joy Cunningham 509-758-8090
Email: [email protected]
Page 8 The American Academy of Osteopathy Journal • Vol. 24, No. 2, June 2014
Ultrasound-Guided Injections
July 18–19, 2014 • University of North Texas Health Science Center—
Texas College of Osteopathic Medicine in Fort Worth
Course Description Course Director
This course is designed for physicians who are novices at Sajid A. Surve, DO, is a 2005 graduate of
sonographic guidance for injections. Under the direction of what is now the Rowan University School
physiatrist Sajid A. Surve, DO, course participants will be of Osteopathic Medicine (RowanSOM) in
introduced to the basic principles of ultrasound, they will Stratford, NJ. After completing a traditional
learn proper injection techniques with ultrasound guidance, rotating internship at Delaware County
and they will learn proper billing and coding for ultrasound Memorial Hospital in Drexel Hill, Pa., he
injections. Cadavers will be available for practice, and became an inaugural resident and the fi rst
table trainers will ensure a low faculty-to-participant ratio. chief resident of the physical medicine and rehabilitation
The course will focus on the injection of the major joints: residency at Long Beach (New York) Medical Center. He
glenohumeral, sacroiliac, hip and knee. joined the faculty of RowanSOM in 2009 and completed
a neuromuscular medicine and osteopathic manipulative
Course Objectives medicine residency in 2010.
Upon completing this course, participants will be able to:
• apply the basic principles of musculoskeletal ultrasound; Course Location
• comfortably navigate the necessary equipment required University of North Texas Health Science Center—
for sonographic guidance of injections; Texas College of Osteopathic Medicine
• use proper injection techniques under sonographic 3500 Camp Bowie Blvd.
guidance for the glenohumeral, sacroiliac, hip and knee Fort Worth, TX 76107
joints;
• bill, code and document correctly for ultrasound-guided Course Times
injections; and Friday and Saturday: 8 am - 5:30 pm
• avoid common pitfalls associated with ultrasound Breakfast and lunch provided. Please contact the AAO’s
injections. Sherrie Warner with special dietary needs: [phone] or
[email protected].
CME
16 credits of AOA Category 1-A continuing medical Travel Arrangements
education is anticipated. Contact Tina Callahan of Globally Yours Travel at
[phone] or [email protected].
Registration Form Registration Rates
Ultrasound-Guided Injections On or before June 18 After June 18
July 18–19, 2014
AAO member $ 1,500 $ 1,600
AAO nonmember $ 1,600 $ 1,700
Name: AOA No.:
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Register online at www.academyofosteopathy.org, or submit the registration form and payment by
email to [email protected], by mail to the American Academy of Osteopathy,®
3500 DePauw Blvd., Suite 1100, Indianapolis, IN 46268-1136, or by fax to [phone].
The American Academy of Osteopathy Journal • Vol. 24, No. 2, June 2014 Page 9
The Bioenergetic Model in Osteopathic Diagnosis and
Treatment: An FAAO Thesis, Part 2
Jan T. Hendryx, DO, FAAO
O’Connell82 has described fascial architecture of the body
Click here to read Part 1 of “The Bioenergetic Model in Osteopathic as consisting of two functional subdivisions. Horizontal
Diagnosis and Treatment,” published in the March 2014 issue of diaphragms are myofascial or fibrous partitions that act as
The AAO Journal. Part 2 concludes Dr Hendryx’s thesis.
tension-countertension sheets. They include the tentorium
cerebelli, thoracic inlet/outlet, respiratory diaphragm, pelvic
Fascia and the Extracellular Matrix
diaphragm and plantar fascia. Longitudinal cables run superior
Andrew Taylor Still, MD, DO, placed much emphasis on to inferior in the body and include various muscles (psoas
the fascia and its relationship to health. He wrote, “I know of major, abdominals, quadratus lumborum), spinal dura and
no other part of the body that equals the fascia as a hunting longitudinal ligaments (occiput to S2), fascia (prevertebral,
ground [sic for health and disease].… By its action we live, alar, buccopharyneal, pericardial, investing of lower extremity)
and by its failure, we die.”75 and organs (trachea, esophagus).
Anatomically, fascia is defined as a sheet of fibrous tissue that The ECM has been referred to as part of the “living matrix”
envelops the body beneath the skin that encloses the muscles by Oschman.58,60 He calls it “living” because it is much more
and groups of muscles separating them into several layers.76 than a passive network of fibers and ground substance holding
Willard et al77,78 have classified the ubiquitous fascia into the body and its organs together. The ECM is dynamically
four basic divisions: pannicular (superficial, subcutaneous); active and connects to the most intimate reaches of cells
investing (deep, axial, appendicular); visceral (pleural, through the cell surface, cytoskeleton, and nuclear matrix.
pericardial, peritoneal); and meningeal (dural). Investing The dynamic nature of the living matrix can be palpated as
fascia not only covers the surface of skeletal muscles but also rhythmic inherent motion that can be influenced by various
branches deeply into the muscle interior in which case it is forms of osteopathic manipulation and bioenergetic fields.
termed myofascia. Inherent motion is defined as the “spontaneous motion of
every cell, organ, system and their component units within
Depending on the type and location of fascia, one finds
the body.”67
various structures (vascular, lymphatic, neurological)
traversing through it, as well as acellular and cellular Lee has elegantly synthesized information from numerous
components. Fascia is composed of three basic fiber types— sources to describe possible origins of the oscillatory
collagen, elastic, and reticular—immersed in a sea of colloidal animation of this life force in the fascia, ie, the primary
proteinaminoglycans. It is this acellular fiber-colloid part respiratory mechanism (PRM).52,83 First described by
of the fascia that is referred to as the extracellular matrix, or Sutherland, the source, or “initiative spark,” of the PRM was
ECM.58 what he termed the “Breath of Life.”84 He referred to the fluid
fluctuation of the inherent motion palpated in the tissues as
Cellular fascial components include various leukocytes,
the “Tide.”85 Recent scientific research suggests that the source
plasma cells, mast cells, macrophages, pluripotential cells,
of the inherent motion of the cranial rhythmic impulse may
fibroblasts and myofibroblasts. Interestingly, myofibroblasts
be due to or related to the Traube-Hering baroreflex.86,87
contain actin and myosin filaments and can provide a
contractile force to fascia.79 Myofibroblast contraction within Through the biophysical principles of tensegrity and
the fascia has been theorized to be contributory to tissue piezoelectricity, fascia influences cell physiology and
stiffness.80,81 pathophysiology. It provides for instantaneous holographic
access and communication outside the nervous system that
Fascia performs numerous functions in the body, including
extends all the way down to the level of the cell nucleus and
structural support, compartmentalization, nutritional
DNA. It serves as a large source of the bioenergetic fields that
support, immunity, tissue repair and communication.79 As
traverse through and extend outside the body.60
we shall see later, the extracellular matrix can modulate cell
function and pathophysiology.60 Continued on page 11
Page 10 The American Academy of Osteopathy Journal • Vol. 24, No. 2, June 2014