{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T02:42:51Z","timestamp":1775184171438,"version":"3.50.1"},"reference-count":15,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2018,12,17]],"date-time":"2018-12-17T00:00:00Z","timestamp":1545004800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jaoa.2019.003_s_001\">\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Rib raising is an osteopathic manipulative treatment modality that can help patients with various respiratory conditions to improve their work of breathing. However, the tolerance of this technique in hospitalized patients has not been assessed in a systematic manner. We hypothesized that rib raising would be a well-tolerated treatment modality for hospitalized patients admitted for asthma, pneumonia, chronic obstructive pulmonary disease, and\/or congestive heart failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jaoa.2019.003_s_002\">\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine hospitalized patients\u2019 tolerance of rib raising through a prospective pilot study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jaoa.2019.003_s_003\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The study included patients at University Hospitals\u2013Richmond Medical Center and University Hospitals\u2013Bedford Medical Center who were admitted for asthma, pneumonia, chronic obstructive pulmonary disease, and\/or congestive heart failure between November 1, 2016, and October 31, 2017. Each patient was treated with rib raising, which was performed in a standardized fashion. Immediately after treatment, patients were asked to rate their tolerance of the procedure on a scale of 0 to 10, where 0 represented no discomfort and 10 represented maximum discomfort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jaoa.2019.003_s_004\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The study population consisted of 87 hospitalized, non\u2013intensive care unit patients. The mean tolerance score for rib raising was 1.18, and the median score was 0. The score was between 0 and 3 in 80 patients (92.0%), between 4 and 6 in 6 patients (6.9%), and between 7 and 10 in 1 patient (1.1%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jaoa.2019.003_s_005\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Rib raising was shown to be well tolerated by the majority of the patients in the study population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.7556\/jaoa.2019.003","type":"journal-article","created":{"date-parts":[[2018,12,17]],"date-time":"2018-12-17T19:59:36Z","timestamp":1545076776000},"page":"19-23","source":"Crossref","is-referenced-by-count":3,"title":["Tolerance of Rib Raising Among Hospitalized Patients: A Pilot Study"],"prefix":"10.1515","volume":"119","author":[{"given":"Andrew J.","family":"Chin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea D.","family":"Fischione","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Shilian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren M.","family":"Walter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan M.","family":"Ratay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamar Y.","family":"Bejanishvili","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan H.","family":"Wynbrandt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P.","family":"Rowane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2018,12,17]]},"reference":[{"issue":"3","key":"2022022617382919008_j_jaoa.2019.003_ref_001","doi-asserted-by":"publisher","first-page":"156","DOI":"10.7556\/jaoa.2016.032","article-title":"Targeting patient subgroups with chronic low back pain for osteopathic manipulative treatment: responder analyses from a randomized controlled trial","volume":"116","author":"Licciardone","year":"2016","journal-title":"J Am Osteopath Assoc"},{"issue":"3","key":"2022022617382919008_j_jaoa.2019.003_ref_002","doi-asserted-by":"publisher","first-page":"144","DOI":"10.7556\/jaoa.2016.031","article-title":"Recovery from chronic low back pain after osteopathic manipulative treatment: a randomized controlled trial","volume":"116","author":"Licciardone","year":"2016","journal-title":"J Am Osteopath 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Treatment.","author":"DiGiovanna","year":"2005","edition":"3rd"},{"key":"2022022617382919008_j_jaoa.2019.003_ref_006","first-page":"42","volume-title":"Osteopathic Considerations in Systemic Dysfunction.","author":"Kuchera","year":"1994","edition":"2nd"},{"issue":"5","key":"2022022617382919008_j_jaoa.2019.003_ref_007","first-page":"251","article-title":"Immediate effects of osteopathic manipulative treatment in elderly patients with chronic obstructive pulmonary disease","volume":"108","author":"Noll","year":"2008","journal-title":"J Am Osteopath Assoc"},{"issue":"4","key":"2022022617382919008_j_jaoa.2019.003_ref_008","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.jphys.2015.08.009","article-title":"The manual diaphragm release technique improves diaphragmatic mobility, inspiratory capacity and exercise capacity in people with chronic obstructive pulmonary disease: a randomised trial","volume":"61","author":"Rocha","year":"2015","journal-title":"J Physiother"},{"issue":"87","key":"2022022617382919008_j_jaoa.2019.003_ref_009","doi-asserted-by":"publisher","DOI":"10.3791\/50687","article-title":"Osteopathic manipulative treatment as a useful adjunctive tool for pneumonia.","author":"Yao","year":"2014","journal-title":"J Vis Exp"},{"key":"2022022617382919008_j_jaoa.2019.003_ref_010","first-page":"46","volume-title":"Greenman\u2019s Principles of Manual Medicine.","author":"DeStefano","year":"2017","edition":"5th"},{"key":"2022022617382919008_j_jaoa.2019.003_ref_011","volume-title":"Foundations of Osteopathic Medicine.","author":"Chila","year":"2011","edition":"3rd"},{"issue":"1-2","key":"2022022617382919008_j_jaoa.2019.003_ref_012","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0034-5687(00)00209-7","article-title":"Motor control of airway goblet cells and glands","volume":"125","author":"Rogers","year":"2001","journal-title":"Respir 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