Segmental definition: Part II. Application of an indirect method in osteopathic manipulative treatment

Abstract

Part I of this series showed how somatic function is examined by application of a series of passive gross motion tests. In osteopathic manipulative treatment of somatic dysfunction, diagnosis of the asymmetries in resistance to segmental motion tests provides a basis for the methods the physician applies and criteria for posttreatment evaluation. Successful use of the method described produces a return to symmetry in posttreatment motion tests not only at the specific segmental asymmetry being addressed, but also at the adjacent segments where mirror image asymmetries had once prevailed. It appears that, within this three-segment dysfunctional unit, a sensory input of somatic origin from the primary central dysfunction accounts for the mirror image asymmetries at adjacent segments. This behavior implies an adaptive reflex basis that is somatosomatic. Experience in comparing responses to motion tests throughout the three-segment unit can provide greater accuracy in segmental diagnosis and internal validation of the location of the primary dysfunctional segment where osteopathic manipulative treatment is more effective.