Browsing by Subject "OMT"
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Item Does Osteopathic Manipulative Treatment Improve Dyspnea and Exercise Tolerance Subjects with Stable Chronic Obstructive Pulmonary Disease?(2006-05-01) Pickett, Carolyn M.; Stoll, Scott; Cruser, des Anges; Licciardone, John C.Pickett, Carolyn M., D.O., M.S. Does Osteopathic Manipulative Treatment Improve Dyspnea and Exercise Tolerance in Subjects with Stable Chronic Obstructive Pulmonary Disease? Master of Science (Clinical Research and Education – OMM), May 2006, 54 pages, 10 tables, 4 figures, references 48 titles. Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death globally and is projected to increase. This highly prevalent and costly disease causes reduced physical and social functioning, and none of the existing medications for COPD seem to modify long-term decline in lung function. COPD patients with the severe dyspnea have more deficits in the health status and energy. Reduced functional status has been significantly correlated with health related quality of life. Osteopathic Manipulative Treatment (OMT) has been suggested for treatment of COPD as early as 1902, some research indicates that OMT may improve dyspnea and exercise tolerance, yet there are few published studies on OMT and COPD. Study goals were to increase scientific knowledge about how OMT may immediately improve dyspnea and exercise tolerance in stable COPD following exertion. This RCT was approved by the Institutional Review Board at the University of North Texas Health Science Center (UNTHSC) in Fort Worth and funded by the Osteopathic Research Center (ORC) at UNTHSC. –Hypothesis 1: A single intervention of OMT will improve dyspnea in a stable COPD subject, as measured by response to the Borg scale with exertion, when compared to no treatment. –Hypothesis: a single intervention of OMT will improve exercise tolerance in a stable COPD subject, as measured by distance walked during the six-minute walk test, when compared to no treatment. Twenty-one subjects completed the trial, 10 in the OMT group and 11 in the no-treatment group. No significant differences were found in the Borg scale or 6MWT following OMT. This study is limited by a small sample size and single OMT intervention design; however, it does demonstrate the feasibility of this research at this institution and may lead to a larger, more definitive and funded clinical trial.Item Effects of Cervical Manipulation on Cardiac Autonomic Control(2006-05-01) Giles, Paul David; Michael Smith; Scott Stoll; Walter WitryolGiles, Paul David, Effects of Cervical Manipulation on Cardiac Autonomic Control. Master of Science (Clinical Research and Education – OMM), May 2006, pp, 1 table, 8 figures, references. Objective: Osteopathic Manipulative Medicine treatment (OMT) regimes often focus on treating the Autonomic Nervous System (ANS) in addition to biomechanics. Techniques focused on the upper cervical spine are theorized to affect the function of the vagus nerve and thereby influence the parasympathetic branch of the ANS. This study was conducted to observe the effect of upper cervical spine manipulation on cardiac autonomic control as measured by heart rate variability (HRV). Methods: Nineteen healthy, young adult subjects were randomly assigned an order in which they would undergo three different experimental protocols: OMT, Sham, and a time control. Six minutes of electrocardiographic data was collected before and after each intervention to be analyzed by power spectral analysis. Results: All baseline data for each protocol and all parameters studied were the same. The OMT protocol and all parameters studied were the same. The OMT protocol caused a change in the standard deviation of the normal-to-normal (SDNN) intervals (0.121 +/- 0.0822 sec, p=0.005) and the change in the high frequency HRV was different from the changes caused by other interventions (p=0.038). Conclusions: This preliminary data supports the hypothesis that under cervical spine manipulation affects the parasympathetic nervous system; however, more data on more subjects needs to be collected in order to clarify some points, and to reach statistical significance in certain measures.Item Effects of Osteopathic Manipulative Treatment on Parkinsonian Gait: A Statistical Parametric Mapping Analysis(2021-05) Terrell, Zachary T.; Patterson, Rita M.; Moudy, Sarah; Hensel, KendiIntroduction/Background: Tens of thousands of people are diagnosed with Parkinson's disease (PD) each year, making it the second most common neurodegenerative disorder. PD results in a variety of gait disturbances that increase the fall risk of those afflicted. The overarching goal for this project is to examine the efficacy of Osteopathic Manipulative Treatment (OMT) and Osteopathic Cranial Manipulative Medicine (OCMM) in improving Parkinsonian gait. Objective: The purpose of this study was to compare joint range of motion (ROM) and joint angle waveforms before and after OMT to determine the effects of OMT and OCMM on Parkinsonian gait, as well as to compare the relative effects of each treatment protocol. We hypothesized that the application of a single OMT protocol on adults with PD will acutely increase joint ROM, and the addition of OCMM to the OMT treatment protocol will further improve gait kinematics. Methods: An 18-camera motion analysis system was used in conjunction with 54 reflective markers on the body to capture three-dimensional position data in a short treadmill walking trial before and after the application of a whole-body (OMT-WB), neck-down (OMTND), or sham OMT protocol. Ankle, knee, and hip joint ROM and waveforms in the sagittal plane during the gait cycle were compared before and after treatment, and across experimental groups. Results: No significant differences were found in baseline ROM and joint angle waveforms of the hip, knee, and ankle joints across experimental groups, or in post-treatment joint waveforms across experimental groups. Knee ROM increased significantly following OMT-ND and OMT-WB protocols (p=0.018, p=0.032). Waveform analysis revealed no significant differences at the hip, knee, or ankle joints. Discussion/Conclusion: Comparison of baseline measurements validates participant randomization and an increase in sagittal knee ROM in individuals with PD following OMT and OCMM may have important implications for decreasing potential fall risk. However, waveform analysis shows no significant change in gait pattern as evidenced by sagittal joint angles following OMT-WB, OMT-ND, or SHAM treatments.Item Effects of Osteopathic Manipulative Treatment on Symptom Severity and Functional Status in Carpal Tunnel Syndrome(2005-05-01) Meyer, Patricia M.Meyer, Patricia M, Effects of Osteopathic Manipulative Treatment on Symptom Severity and Functional Status in Carpal Tunnel Syndrome. Master of Science (Clinical Research and Education), May, 2005, 55pp., 7 tables, 54 figures, bibliography 44. Carpal tunnel syndrome (CTS) is symptoms like paresthesias and weakness caused by compression of the median nerve. It affects up to 10% of the adult population in the U.S. with medical costs exceeding $2 billion annually. The goal of this study is to evaluate the benefits of Osteopathic Manipulative Treatment (OMT) on the symptom severity and daily functioning of subjects with CTS. The OMT group was compared to a ultrasound placebo group. Outcome measures include symptom severity, functional status scores, and strength measures. Subjects receive six treatments with measures taken at three points in the study. Thirty-two subjects were used in the study analysis. The OMT group had significantly improved symptom severity and functional status scores over time. These scores were not significantly different from the changes in the ultrasound group. While outcome measures show trends toward improvement with OMT, they are not significantly different from placebo.Item Efficacy of Osteopathic Manipulative Treatment in Improving Clinical Outcomes in Patients with Orthopedic Diagnoses Admitted to a Hospital-Based Rehabilitation Unit(1997-06-01) Brittain, Paul D.; John LicciardoneBrittain, Paul D., Efficacy of Osteopathic Manipulative Treatment in Improving Clinical Outcomes in Patients with Orthopedic Diagnoses Admitted to a Hospital-Based Rehabilitation Unit Master of Public Health (Biomedical Sciences), June, 1997, 75 pp., 12 tables, bibliography, 16 titles. The primary purpose of this study was to determine the efficacy of osteopathic manipulative treatment (OMT) in improving clinical outcomes in patients who had undergone a surgical procedure for either a hip fracture or osteoarthritis affecting the hip or knee. OMT treatment subjects were recruited from an inpatient rehabilitation unit housed with an osteopathic hospital. OMT subjects received a standard course of OMT throughout their stay in the rehabilitation unit. Clinical outcomes were assessed principally through the administration of the Functional Independence Measure (FIM), a standard disability measure, to study subjects on admission to and discharge from the rehabilitation unit. Mean FIM score charges were compared between the OMT and a control group of similar patients. Receipt of OMT was associated with shorter length-of-stay, higher total FIM score change, and greater improvement on FIM locomotion items. These findings suggest that OMT is a beneficial therapy for this population of patients.Item Immediate Effects of Osteopathic Manipulative Treatments on Immune Function in a Healthy Population: A Pilot Study(2006-05-01) John, Janice Thomas; Scott Stoll; Jerry Simecka; Barbara AtkinsonJanice Thomas, D.O., M.S. Immediate Effects of Osteopathic Manipulative Treatments on Immune Function in a Healthy Population: A Pilot Study. Master of Science (Clinical Research and Education – OMM), May 2006, 75 pp, 3 tables, 5 figures, 66 references, 24 titles. Objectives: The purpose of this pilot study was to investigate the immediate effects of Osteopathic Manipulative Treatment (OMT) on immune function in a healthy population. Methods: This was a randomized, blinded and controlled clinical trial. 50 healthy individuals, ages 18 to 40, were recruited. Subjects were randomly assigned to one of two groups: OMT or Rest (control). Blood and saliva samples were collected pre and post-intervention (thirty minutes of OMT or Rest). Samples were analyzed for a CBC, salivary IgA, and various lymphocyte populations. Results: This study successfully demonstrated the feasibility of this protocol. No statistically significant differences in outcome measures were identified between the two groups, nor were any apparent trends identified. Conclusion: This study established a framework for future research investigating the effects OMT on acute and chronic infection, chronic pain, and immunocompromised populations in human and/or animal populations.Item Inhibitory Rib-Raising and Microneurographic Measurement of Sympathetic Nervous System Activity(2007-05-01) Kinzler, Damien W.; Michael Smith; Russell Gamber; Hollis KingThe clinical effectiveness of osteopathic manipulative therapy (OMT) techniques that are designed to address the autonomic nervous system (ANS) are untested to current research standards. As the concept of “autonomic imbalance” is frequently ascribed as the etiology of various pathologic conditions, it is paramount to undertake basic research into not only efficacy but also possible mechanistic actions and origins. Osteopathic physicians often utilize treatment regimens and techniques for which the given mechanism of action is simply attributed to “balancing the autonomics”. This intuitive concept may finally be at the threshold where enough basic science exists to justify clinical investigations. Osteopathic manual manipulative techniques have shown effectiveness in the treatment of various musculoskeletal conditions and have been shown to lower perceived pain; supporting the use of manual therapy as an effective treatment modality. A brief review yields the following within just the last four years: Eisenhart showed positive range-of-motion outcomes after ankle sprain in the emergency department. Biondi reviews the usefulness of cervical manipulation for tension headache and McReynolds demonstrated an equivalent decrease in acute neck with OMT versus intramuscular ketolac in an emergency department setting, although the dosing was not maximal. German researchers have shown effectiveness in chronic epicondylopathia humeri radialis and research has led to the demonstration of lowered post-operative pain in hip or knee arthroplasty. There has also been decreased post-operative pain medication reported in hysterectomy when compared with a control group. OMT has demonstrated a decrease in fibromyalgia symptoms when used with standard care over standard care alone. Low back pain, perhaps the most extensively studied diagnosis in which OMT has been evaluated, has reported numerous positive outcomes including lower levels of narcotic use and decreased pain in both double-blinded and meta-analysis studies, although there is still considerable debate within this area. There has also been favorable outcomes associated with the management of gain in Parkinson’s disease and preliminary work has shown the efficacy in treatment of carpal tunnel syndrome. Most of the aforementioned musculoskeletal conditions are not amenable to traditional therapies and have a high-cost burden on the economy. Traditional treatments generally have a “wait and see” approach combined with analgesics which may not cause harm, but hampers quality of life and income in the interim. The cost effectiveness of OMT is still in the preliminary stages, but there is evidence supporting a superior cost benefit ratio when compared to standard care and since many of these conditions have no other proven treatment modality available patients will often try anything over nothing. The evaluation of OMT addressing clear autonomic dysfunction is limited. This study closes a small part of that gap by examining the proposed physiologic mechanism of OMT and its’ interaction with the ANS. Small studies have documented changes, namely heart rate variability, in autonomic processes in healthy individuals while other, older studies have found benefit in clinical variables. With few exceptions however, most of these studies lacked a particular technique protocol. Operators were free to use whatever intervention that they chose and most of these studies were not performed under rigorous testing methods with a randomized design. The technique that was evaluated (inhibitory rib-raising) has a documented history from the origins of osteopathic medicine in the United States, and is currently taught to students in osteopathic medical schools as part of their medical education curriculum. Rib-raising is most often taught to enhance the mechanical motion of the ribs, but other paradigms utilize this technique to either enhance or inhibit sympathetic nervous system (SNS) activity. The evaluation of inhibitory rib-raising or its’ proposed mechanism of action has never been rigorously scrutinized to modern scientific standards. The current study was designed to address that gap with both direct and indirect measurement of SNS variable in healthy individuals with the hypothesis that there would be a time-dependent, graded reduction in measured sympathetic nervous system activity (MSNA) in healthy individuals undergoing cold-pressor stimulus.Item OMT IN THE MANAGEMENT OF CERVICAL RADICULOPATHY IN A PATIENT WITH CERVICAL SPONDYLOSIS(2013-04-12) Long, AliaPurpose: The purpose of this study is to present a unique case of a patient with cervical spondylosis and cervical fusion in whom osteopathic manipulative treatment was used in the management of the patient. Methods: The authors report the case of a 46-year-old man with cervical radiculopathy who received 6 trigger point steroid injections, in addition to a 20-minute session of osteopathic manipulative treatment that focused primarily on the cervical, upper thoracic spine and rib somatic dysfunctions. After treatment, the patient reported immediate improvement of symptoms. Results: A case of cervical radiculopathy in a patient with a past medical history of cervical spondylosis and cervical fusion was presented. The combination of OMT and trigger point steroid injections resulted in improvement of the patient's level of pain, cervical radiculopathy, and nausea. The treatment modalities, possible adverse sequelae as a result of manipulative treatment, review of literature, and discussion of cervical radiculopathy and management of cervical spondylosis are reviewed. Conclusions: Cervical radiculopathy is a common clinical entity that can be frustrating for patients and physicians as a result on the lack of effective treatment options. Because evidence has shown that cervical radiculopathy can be the result of a pathological process or may result from a somatic dysfunction of the spine or ribs, OMT may be an effective treatment modality - alone or combined with other methods.Item Physiologic and Anatomic Changes in Carpal Tunnel Syndrome: Is Osteopathic Manipulative Treatment an Effective Non-Surgical Alternative Therapy?(2005-05-01) White, Heath D.; Williams, Stuart; Cruser, des Anges; Stoll, ScottWhite, Heath D., D.O., M.S. Physiologic and Anatomic Changes in Carpal Tunnel Syndrome: Is Osteopathic Manipulative Treatment an Effective Non-surgical Alternative Therapy? Master of Science (Clinical Research and Education – OMM), May 2005, 110 pp., 4 tables, 5 figures, references, 46 titles. Objective: Carpal tunnel syndrome (CTS), caused by compression of the median nerve within the carpal tunnel, has a prevalence that ranges between 0.53 and 16.3 with medical costs exceeding $2 billion annually. The goal of this clinical trial was to assess for physiologic and anatomic changes in CTS in response to OMT. Physiologic changes were measured with nerve conduction studies (NCS). Anatomic changes were measured with magnetic resonance imaging. Methods: This prospective, randomized, controlled, blinded clinical trial phased to evaluate 50 subjects randomized between two treatment groups, OMT and placebo sub-therapeutic ultrasound. Eligibility criteria included adults between 21 and 70 with a clinical diagnosis of CTS and increased conduction latency of the median nerve. Outcome measures were median motor and sensory conduction distal latencies. Subjects received six treatments. NCS were conducted at entry to the study (baseline), midpoint, and endpoint. Results: Thirty-seven of a planned 50 subjects were randomized to groups. Thirty-one subjects were included in the final data analysis. Preliminary analysis found no significant difference in NCS values over the three testing intervals. Evaluation for effect(s) of multiple treatment providers by analyzing the single treatment provider with the greatest number of subjects found significant improvement in some NCS values for the OMT group. This study was funded by the Osteopathic Research Center, and approved by the UNTHSC Institutional Review Board. Conclusions: The results of this preliminary analysis indicate the possibility for improvement of CTS with OMT, but no conclusive statements about the efficacy of OMT can be made. This preliminary study enabled us to identify multiple areas in the research design and methodology that may be improved, and provides the framework for future studies.Item The Immedicate Effect of OMT on a COPD Population: A Pilot Study(2006-05-01) Som, Mousumi; Kimberly Fulda; John LicciardoneSom, Mousumi, M.S. The Immediate Effect of OMT on a COPD Population: A Pilot Study. Master of Science (Clinical Research and Education OMM), May 2006, 81 pages, 3 figures, references 45 titles. Objective: Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of morbidity and mortality in the United States costing approximately 32 billion dollars yearly. COPD cannot be cured, and existing modalities are limited. This study explored the use of Osteopathic Manipulative Treatment (OMT) on pulmonary function and alveolar ventilation. Methods: this prospective, randomized single blinded pilot study included 21 subjects with two interventions: OMT and no intervention. Subjects were 40 to 80 years of age with a clinical diagnosis of COPD. Primary outcome measures included pulmonary function values: FVC, FEV1, FEV1/FVC, RV, TLC. Secondary outcome measures included alveolar ventilation measured by pulse oximetry. Results: No statistically significant results were observed. Clinically relevant trends indicated a potential impact of OMT on COPD subjects. This study was funded by the Osteopathic Research Center (ORC) and approved by the UNTHSC Institutional Review Board. Conclusions: This study demonstrated the feasibility of conducting research on COPD subjects by the ORC. Because of the small sample size, no conclusive statements can be made determining the efficacy of OMT on pulmonary function and alveolar ventilation.