Perspectives on tissue adaptation related to allostatic load: Scoping review and integrative hypothesis with a focus on osteopathic palpation

Osteopathic care may support an individual's adaptive capacity, including allostatic regulation and tissue changes in both health and disease. The palpatory findings which osteopaths claim are related to tissue changes may be linked to allostatic load. However, this putative link has not been f...

Full description

Saved in:
Bibliographic Details
Published in:Journal of bodywork and movement therapies 2020-07, Vol.24 (3), p.212-220
Main Authors: Lunghi, Christian, Consorti, Giacomo, Tramontano, Marco, Esteves, Jorge E., Cerritelli, Francesco
Format: Article
Language:English
Subjects:
Allostatic load
Osteopathic care
Salutogenesis
Tissue adaptation
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Osteopathic care may support an individual's adaptive capacity, including allostatic regulation and tissue changes in both health and disease. The palpatory findings which osteopaths claim are related to tissue changes may be linked to allostatic load. However, this putative link has not been formally investigated. We conducted a scoping review to critically appraise the relevant literature on the relationship between allostatic processes and tissue alterations. This review evaluates the use and relevance of palpatory findings in osteopathic care. We searched on PubMed, EMBASE, Cochrane library for research exploring the links between tissue adaptation, allostasis and osteopathic palpatory findings (OPF). Recent studies provide insights into the role of allostatic regulation on body systems' responses related to tissue alterations. These results provide new insights into the relevance of OPF to clinical practice. We build upon the findings of our review to propose a putative model for OPF in clinical practice. Although the clinical phenomena associated with OPF may be biologically plausible, it lacks the necessary underpinning research evidence. Arguably, the classical focus on the diagnosis of palpable tissue changes fails to integrate biological, social and neuropsychological aspects such as stress responses. Tissue alterations related to stress and allostatic load markers have been less studied. Tissue changes involved in the adaptive process may be useful to practitioners in the field of manual therapy, particularly in osteopathy. We propose that OPF are one of the multidimensional aspects that may inform osteopathic decision-making. However, they should be considered within a biopsychosocial perspective and taking into account concepts of allostatic load and regulation. •Processes associated with allostatic load and regulation are related to tissue alterations.•Tissue changes, allostasis, and psychosocial factors merged into a model to clarify the role of OPF in clinical practice.•Bio-psycho-life-markers and patient experience related to musculoskeletal clinical findings integrated into decision-making.•Future research is needed to develop a robust osteopathic clinical reasoning framework.
ISSN:1360-8592
1532-9283
DOI:10.1016/j.jbmt.2020.03.006