Profile of members of the Australian Osteopathic Association: Part 2 – the patients
Orrock, PJ 2009, 'Profile of members of the Australian Osteopathic Association: Part 2 – the patients', International Journal of Osteopathic Medicine, vol. 12, no. 4, pp. 128-139.
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Objectives: The Research Council of the Australian Osteopathic Association (AOA) identified the need to gather data about the members of the professional association as well as ‘who' and ‘what' they treat in order to guide strategic planning and research.
Methods: A two part census was sent to members of the AOA (n=656). Part 1 focussed on the practitioners and Part 2 the patients. Surveys of members of osteopathic professional associations in New Zealand, all the registrants in the United Kingdom as well as earlier Australian surveys were obtained for comparative and temporal analysis.
Results: Part 2 had a response rate of 38.9% of the AOA membership. The respondents consulted an average of 8.7 patients on 11 May 2004, 18.9% of them new patients, and 62.5% of them female. Patients were mostly aged 30–49 years (46%), but there was a large range from 0 to 80+ years. They were 89% private paying patients. These people predominantly presented to the practitioners with low back (27.3%) or neck (24.5%) pain and immobility, with symptoms of pain and immobility in thorax (5%) and thoracic spine (7%) somewhat less. Headaches accounted for 10% of presenting symptoms and were also reported in the ‘other’ section as migraines. Only small numbers of patients (4% overall) presented other symptoms (e.g. general illness, paediatric, vertigo). Many of these patients could be classified as chronic, as 51% had 12 or more weeks of history of the presenting symptom(s). They were 66% self-referred, with a mixture of other practitioners referring, including General Practitioners (GPs) at 4.6%.
The practitioners diagnosed these patients with somatic dysfunction (74%), postural dysfunction (46%), trauma (29%) and organic disease (8.9%). Therapeutic techniques employed were soft tissue (71% of patients had this technique used on them), joint articulation (57%), high velocity thrust manipulation (51%), muscle energy (50%), exercise prescription (33%), cranial (23%), functional (21%), counterstrain (17%) and myofascial (16%).
Conclusion: The patients of members of the AOA predominantly present with pain of the lower back and neck, and both spinal immobility and headaches featured as concomitant symptoms. The majority of the patients had chronic conditions, were self-referred and paid for the service without subsidy from a third party. There was also evidence for primary care practice in the diagnostic data. The use of manual treatment modalities was eclectic and interventions also included lifestyle and dietary advice and exercise prescription.