Giandomenico D'ALessandro

Background: Osteopathy’s integration into contemporary healthcare requires clear articulation of its theoretical and practical foundations and active engagement in interprofessional practice. Despite growing institutional recognition, conceptual ambiguity remains regarding foundational principles and their operationalization. Osteopathy is broadly described as a person-centered, evidence-informed discipline promoting health through manual and educational strategies within systemic and biopsychosocial contexts. Objectives: This Perspective critically examines osteopathic principles, proposes a shared conceptual model for interdisciplinary care, and outlines a structured research agenda for empirical validation, aiming to enhance person-centered, preventive, and sustainable practice. Methods: A narrative review synthesized historical, theoretical, and contemporary evidence. Records were thematically analyzed through expert collaborative brainstorming to achieve consensus, ensuring both conceptual and empirical rigor. Results: Twenty-two studies were included, forming two thematic areas: (1) historical evolution of osteopathic principles, encompassing foundational definitions, early interpretive divergences, codifications, and adaptations; and (2) contemporary reconceptualization for interdisciplinary care, integrating systems-oriented and biopsychosocial frameworks. Emphasis was placed on self-regulation, structure–function relationships, and holistic care. This synthesis bridges historical and modern insights, highlighting osteopathy’s relevance in integrative, pediatric, and preventive healthcare. Conclusions: Reconceptualizing osteopathic principles strengthens professional identity and supports sustainable, evidence-informed, person-centered practice. The proposed framework informs interprofessional collaboration and guides a research roadmap to validate and integrate osteopathy globally within contemporary healthcare systems.

Kimmerle anomaly is a congenital bony variant of the atlas vertebra that can, in rare cases, be associated with neurological and vascular symptoms. Although often asymptomatic, its clinical significance increases when presenting alongside persistent cranio-cervical pain and associated symptoms. This case report aims to describe the clinical presentation and osteopathic management of a young adult with symptoms potentially secondary to Kimmerle anomaly, highlighting the role of osteopathic manipulative treatment in a complex diagnostic context. A 19-year-old male presented with chronic cranio-cervical pain, right-sided neck and trapezius discomfort, tension-type headaches, dizziness, and episodic right-ear tinnitus and hypoacusis. Symptoms began at the age of 16 years and persisted despite various conservative interventions. Imaging revealed a complete Kimmerle anomaly. Neurological examination by the osteopath indicated altered sensation and sensory deficits. The patient underwent five osteopathic manipulative treatment sessions using a whole-body approach, focused on somatic dysfunctions, including, but not limited to, the upper cervical spine and its related fascial system connections. Techniques were chosen based on clinical evaluation and adapted to the patient’s individual dysfunction patterns. No adverse effects were reported. At follow-up, the patient reported a reduction in pain, improved quality of life, and resolution of vestibular and auditory symptoms. This case highlights the potential value of osteopathic assessment and treatment in patients with persistent symptoms potentially linked to Kimmerle anomaly. The integration of osteopathic care into interdisciplinary diagnostic pathways may enhance management and improve outcomes in complex cases where structural anomalies coexist with functional disturbances.

Background. A major goal for a significant portion of the osteopathic community is to update osteopathic principles, satisfying three needs: sourcing from the origin, proposing original and unique practical approaches, and describing the entire process in a scientifically updated way. On this line, several interprofessional proposals for healthcare providers have already been made by implementing patient-centered care and touch-based strategies informed by the enactive model. Enactivism principles can provide a foundation for rethinking osteopathic care by integrating environmental, psychological, social, and existential factors to facilitate the patient’s biobehavioral synchronization with the environment and social context, address health needs, and enhance the quality of multiprofessional healthcare services. However, there is a need to develop a conceptual model that offers a framework for organizing and interpreting disciplinary knowledge, guiding clinical observation and practical strategies, and defining both interprofessional collaboration and the unique focus of the profession. This scoping review and integrative hypothesis aim to fulfill the need for a more detailed and comprehensive understanding of the distinctive osteopathic care to biobehavioral synchrony, emphasizing both interprofessional collaboration and the profession’s unique competencies. Methods. The present article was developed in accordance with established guidelines for writing biomedical scoping reviews. Results. A total of 36 papers were considered for thematic and qualitative analyses, which supported the integrative hypothesis. Considering the current tenets for osteopathic rational practice, we propose an integrative hypothesis to focus on a practical framework for osteopathic patient biobehavioral synchronization. Patient–practitioner–environment synchronization could be promoted through a four-step process: (1) a narrative-based sense-making and decision-making process; (2) a touch-based shared sense-making and decision-making process; (3) hands-on, mindfulness-based osteopathic manipulative treatment; (4) patient active participatory osteopathic approaches to enhance person-centered care and rational practice. Conclusions and future directions: The proposed model fosters patient–practitioner synchronization by integrating updated traditional osteopathic narratives and body representations into practice, offering a culturally sensitive approach to promoting health, addressing contemporary health needs, and improving inclusive health services. Future studies are required to assess the transferability and applicability of this framework in modern settings worldwide.

Background: Musculoskeletal conditions with multisystem comorbidities present significant challenges in terms of prevention and rehabilitation. Despite advances in instrumental technologies for diagnosis and treatment, a gap remains between biomedical research and practical application. Strengthening the therapeutic alliance involves improving patients’ understanding of diagnostics and treatment, while emphasizing face-to-face interactions. A team of healthcare professionals, promoting an integrated approach combining manual and movement therapies—such as physiotherapy, chiropractic, and osteopathic care—can bridge this gap, promoting well-being through a person-centered framework. Emerging research highlights the role of cognitive, neurophysiological, and sociocultural factors in body perception and health, emphasizing the need for inclusive, culturally sensitive care within osteopathic practice. Methods: We synthesize the available evidence and expert insights to address gaps in the literature. Our approach integrates conceptual analysis with emerging research, applying Driscoll’s reflective model to generate a practical framework rooted in osteopathic principles and clinical experiences. Results: We propose an integrative model incorporating narrative-based sense-making, shared decision-making, mindfulness, and active participation. By blending historical osteopathic principles with modern evidence, the model aims to enhance health resilience, reduce unnecessary interventions, and establish a holistic framework for prevention and rehabilitation. Conclusions: Integrating diverse approaches within osteopathic care refines clinical practices, ensuring a more person-centered, culturally sensitive, and holistic approach to musculoskeletal rehabilitation. This model bridges the gap between tradition and modern evidence, enhancing therapeutic outcomes and fostering an inclusive healthcare system.

Background/Objectives: Indigenous perspectives, which emphasize non-materialistic dimensions of healing, such as the interconnectedness of the body, mind, and spirit, align with one foundational principle of osteopathic care. Integrating these perspectives into person-centered care may enhance therapeutic effectiveness by accommodating diverse understandings of health and well-being. This perspective paper explores how various epistemological frameworks, including Indigenous non-materialistic approaches, can inform manual therapy techniques and therapeutic alliances to advance person-centered care. Methods: We synthesized the best available evidence with expert insights and interdisciplinary viewpoints to address the gaps in the scientific literature. Our approach integrates conceptual analysis and emerging research to provide a comprehensive discussion for a broad professional audience. Results: We focused on detailing the existing sociocultural and experiential frameworks available to describe patients’ bodily perceptions rather than abstract intellectual constructs. Our findings were divided into two sections. The first examines the incorporation of diverse body representations that extend beyond purely biomechanical interpretations, emphasizing the role of non-materialistic components in therapeutic processes. The second explores recent neuroscientific research on self and consciousness, demonstrating how these insights intersect with Indigenous perspectives to enrich the theoretical and practical applications of osteopathic principles in different clinical contexts. Conclusions: Epistemological flexibility has the potential to refine clinical frameworks and ensure that they reflect the full scope of osteopathic practices beyond musculoskeletal care. By integrating diverse sociocultural perspectives without reinforcing stereotypes or rigid cultural constructs, this approach clarifies the diversity of body representations in osteopathic practices, addresses gaps in academic discourse, and promotes the integration of multiple worldviews as a foundation for truly person-centered care.

Background: Chiropractic, osteopathy, and physiotherapy (COP) professionals regulated outside the United States traditionally incorporate hands-on procedures aligned with their historical principles to guide patient care. However, some authors in COP research advocate a pan-professional, evidence-informed, patient-centered approach to musculoskeletal care, emphasizing hands-off management of patients through education and exercise therapy. The extent to which non-Western sociocultural beliefs about body representations in health and disease, including Indigenous beliefs, could influence the patient–practitioner dyad and affect the interpretation of pillars of evidence-informed practice, such as patient-centered care and patient expectations, remains unknown. Methods: our perspective paper combines the best available evidence with expert insights and unique viewpoints to address gaps in the scientific literature and inform an interdisciplinary readership. Results: A COP pan-professional approach tends to marginalize approaches, such as prevention-oriented clinical scenarios traditionally advocated by osteopathic practitioners for patients with non-Western sociocultural health assumptions. The Cynefin framework was introduced as a decision-making tool to aid clinicians in managing complex clinical scenarios and promoting evidence-informed, patient-centered, and culturally sensitive care. Conclusion: Epistemological flexibility is historically rooted in osteopathic care, due to his Indigenous roots. It is imperative to reintroduce conceptual and operative clinical frameworks that better address contemporary health needs, promote inclusion and equality in healthcare, and enhance the quality of manual therapy services beyond COP’s Western-centered perspective.

Introduction: Health professionals and bodyworkers may be pivotal in promoting prevention programs, providing tailored advice and guidance to patients’ adherence to self-care strategies, such as physical activity. Contemporary evidence encourages manual therapists to involve patients in decision-making and treatment procedures integrating passive and active approaches in treatment planning. This manuscript provides a definition and applications of neuromyofascial movement patterns, discusses the significance of functional assessment, and gives an example of clinical applications in the osteopathic field to highlight how this assessment can promote interdisciplinarity. Methods: The reporting framework used in the current manuscript followed guidelines for writing a commentary. Results: The manuscript highlights the crucial role that the neuromyofascial system plays in human movement and overall well-being and the importance of a functional neuromyofascial activity assessment in the context of person-centered participative care. Conclusions: Understanding individual neuromyofascial patterns could help healthcare practitioners, movement specialists, and bodyworkers in tailoring treatment plans, meeting patients’ unique needs, and promoting a more effective personalized approach to care. The current perspective could spark debates within the professional community and provide a research roadmap for developing an evidence-informed interprofessional framework.

Background: Many efforts are made to find safer and more feasible therapeutic strategies to improve gynaecological care. Non-pharmacological treatments, such as osteopathic interventions, could be used as complementary strategies to better manage different gynaecological conditions. This review aims to report the effectiveness of osteopathic treatment in the gynaecology and obstetrics field, updating the previous review published in 2016. The secondary aim was to elucidate the role of somatic dysfunction (SD) in osteopathic assessment and treatment procedures, as well as their health and economic implications. Methods: An electronic search was conducted in the following databases: Embase, MEDLINE (PubMed), and Science direct. All types of clinical studies published between May 2014 and December 2021 have been included: randomised controlled trial (RCT), controlled before/after, interrupted time series quasi RCT, case controls, case reports, case series, observational, clinical studies involving any type of osteopathic treatment, (standardised, semi-standardised or patients’ need-based treatment) performed alone or in combination with other treatments, were included). Results: A total of 76,750 were identified through database searching and other sources. After the removal of duplicates, 47,655 papers were screened based on title and A total of 131 full-text articles were consequently assessed for eligibility. Twenty-one new articles were included in the synthesis. A total of 2632 participants with a mean age of 28.9 ± 10.5 years were included in the review. Conclusions: Results showed an effectiveness of osteopathic care in gynaecology and obstetrics, but the studies were too heterogeneous to perform quantitative analysis and make clinical recommendations. Nevertheless, osteopathic care could be considered a safe complementary approach to traditional gynaecological care.

Background: Osteopathic manipulative treatment (OMT) is a patient-centred, whole-body intervention aimed at enhance the person’s self-regulation. OMT interventions are focused on somatic dysfunctions (SD) that can be defined as an altered regulative function associated with inflammatory signs palpable in the body framework in different body regions. The conceptual model that sustains SD, as well as its usefulness for the osteopathic profession, is still being discussed by the osteopathic community. Understanding the role and the application of SD is the aim of this scoping review. Methods: A literature search was carried out through the main biomedical databases: Pubmed (Medline), Cochrane, Central (Cochrane), Embase, PEDro and Scopus. Grey literature was considered via Google Scholar and the Osteopathic Research Web. The review was prepared by referring to the “Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews” (PRISMA-ScR). Results: A total of 37,279 records were identified through database searching and other sources. After the duplicates were removed, 27,023 titles and abstracts were screened. A total of 1495 full-text articles were assessed for eligibility. The qualitative synthesis included 280 studies. Conclusions: Treating SD is an important part of osteopathic practice that varies from country to country. SD should be considered as a clinical value that assists in the clinical assessment and guides the decision-making process of osteopathic practitioners. Further studies should be designed to better understand why and how to choose the different assessment and intervention modalities to approach SD and to evaluate new osteopathic models.

Background/Objective: The purpose of this study was to cross-culturally adapt the Body Perception Questionnaire Short Form (BPQ-SF) into Italian and to assess its psychometric properties in a sample of Italian subjects. Methods: A forward-backward method was used for translation. 493 adults were recruited for psychometric analysis. Structural validity was assessed with confirmatory factor analysis and a hypothesis testing approach. Internal consistency was assessed by Cronbach’s alpha and McDonald’s omega. Measurement invariance analysis was applied with an age-matched American sample. Results: The single-factor structure fit the awareness subscale (RMSEA = .036, CFI = .983, TLI = .982). Autonomic reactivity (ANSR) was well-described by supra- and sub-diaphragmatic subscales (RMSEA = .041, CFI = .984, TLI = .982). All subscales were positively correlated (r range: .50-.56) and had good internal consistency (McDonald’s Omega range: .86-.92, Cronbach’s alpha range: .88-.91). Measurement invariance analysis for the Awareness model showed significant results (p<0.001) in each step (weak, strong and strict) whereas the ANSR showed significant results (p<0.001) only for the strong and strict steps. Conclusions: Our results support the Italian version of the BPQ as having consistent psychometric properties in comparison with other languages.