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Clinical Considerations for Positional Release Therapy with Special Populations

• Positional Release Therapy (PRT) can be used to treat somatic dysfunction in diverse patient populations, but special considerations are necessary for certain groups.

• Youth and elderly patients tend to be receptive to PRT and may heal faster, possibly due to differences in cellular senescence signaling and lower levels of physical and psychological stress.

• Cellular senescence signaling may explain why tissues and cellular responses to stress decline with age, leading to delayed healing and increased risk for disease.

• Psychological and physiological stress can impair healing, and supportive social networks can improve it.

• Elderly patients with low bone mass and osteoarthritis are particularly prone to somatic dysfunction and require caution when applying PRT.

• Nearly 50% of people over 50 have low bone mass, and roughly 10% have osteoporosis, making PRT's non-forceful nature ideal for this population.

• Osteoarthritis is a common cause of knee pain in people over 50 and may require caution when applying PRT due to pain and limited range of motion.

• Children with osteopathic lesions should be treated immediately to prevent central sensitization and functional movement impairments.

• Chronic myofascial pain with trigger areas is common in childhood and can be treated successfully with physiotherapy.

• Little is known about the prevalence of trigger points in children or the long-term consequences of osteopathic lesions in this population.

• Therapists should adjust evaluation and treatment approaches to ensure patient safety and effectiveness of therapeutic interventions with special populations.

• PRT can be an effective modality for treating somatic dysfunction in special populations, but caution and individualized approaches are necessary.Clinical Guide to Positional Release Therapy: Considerations for Special Populations

• Osteopathic lesions in children require attention and quick treatment to avoid central sensitization.

• Breast cancer is the most frequently diagnosed cancer in women, and complications from classical treatments can persist for several years.

• Postmastectomy patients often experience shoulder and chest wall pain, somatic dysfunction, and rotator cuff disease.

• Positional Release Therapy (PRT) is an effective tool to address postmastectomy pain and dysfunction.

• Competitive athletes are prone to developing osteopathic lesions due to the nature of athletic activity.

• PRT can prevent central sensitization and normalize muscle activation patterns in athletes with acute and chronic injuries.

• Low back and pelvic pain are prevalent in pregnant women due to anatomical and physiological changes.

• There is no clear consensus on why women develop low back and pelvic girdle pain during pregnancy.

• No therapeutic intervention to date has demonstrated a superior effect on pregnancy-related low back and pelvic pain and disability.

• Therapists should consider additional triggers that may propagate the development and persistence of osteopathic lesions in athletes.

• Therapists should keep in mind that PRT may produce marked soreness, particularly among chronic pain patients.

• Therapists should educate young patients and their caregivers about other therapeutic measures to optimize their treatment and healing.Therapeutic Interventions for Pregnancy-Related Low Back and Pelvic Girdle Pain

• Various therapeutic interventions have been examined for the treatment of pregnancy-related low back and pelvic girdle pain.

• The primary interventions studied include traditional physical therapy, aquatic exercise, osteopathic manipulative therapy (OMT), acupuncture, and physical and manual therapy combined.

• No intervention was found to be more effective than any other for relieving pregnancy-related low back and pelvic pain.

• Evidence suggests that exercise and acupuncture tailored to the stage of pregnancy can reduce lumbopelvic pain.

• A low level of evidence exists for using exercise alone to reduce low back and pelvic pain during pregnancy or postpartum.

• The study by Lillios and Young (2012) and T. Speicher examined the efficacy of using positional release therapy for pregnancy-related low back and pelvic girdle pain.

• Evidence suggests that exercise and acupuncture tailored to the stage of pregnancy can reduce lumbopelvic pain.

• OMT has been found to be effective in reducing pain and improving function in women with pregnancy-related low back and pelvic pain.

• Acupuncture has been found to be effective in reducing pain and disability in pregnant women with low back and pelvic pain.

• Physical therapy and manual therapy combined have been found to be effective in reducing pain and disability in pregnant women with low back and pelvic pain.

• No significant adverse events have been reported for any of the therapeutic interventions studied.

• Further research is needed to determine the most effective therapeutic interventions for pregnancy-related low back and pelvic girdle pain.