Browsing by Subject "Osteopathic Manipulative Treatment"
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Item Determination of Genetic Factors Associated with Response to Osteopathic Manipulative Treatment (OMT) in Individuals with Chronic Lower Back Pain (CLBP).(2014-05-01) Richardson, Kayla K.; Deanna CrossOMT is a treatment for patients with CLBP. It is underutilized partially because there is still skepticism regarding efficacy and no clear mechanism of action has been defined. Data previously collected from a CLBP clinical study was used to investigate genotypic and/or phenotypic characteristics associated with OMT pain reduction. Polymorphisms in IL-8 (rs2227543), GCH1 (rs998259), and LARGE (rs240070) were associated with treatment response defined as at least 30% pain reduction (α≤0.05). An intergenic interaction was observed in GCH1 (rs998259/rs3783641). A multivariate model which included the GCH1 polymorphisms was able to account for ~76% of variability in response to OMT. This study successfully demonstrated an association between genetics and response to OMT.Item DETERMINATION OF GENETIC FACTORS ASSOCIATED WITH RESPONSE TO OSTEOPATHIC MANIPULATIVE TREATMENT IN INDIVIDUALS WITH CHRONIC LOWER BACK PAIN(2014-03) Richardson, Kayla; Cross, Deanna; Kearns, Cathy; Planz, John; Licciardone, John C.OMT (Osteopathic Manipulative Treatment) is an often overlooked, low risk treatment option for management of (Chronic Lower Back Pain) CLBP. My overarching hypothesis is that genetics contributes to OMT response. The study used 216 samples consisting of 111 individuals who received OMT, and a placebo group of 105 individuals who received a sham treatment. Genetic differences between subjects who benefited from OMT (responders) and those who did not benefit from OMT (non-responders) were compared. We found an association between 3 genes (IL-8, GCH1, and LARGE) and response to OMT in individuals who suffer from CLBP. Purpose (a): OMT (Osteopathic Manipulative Treatment) is an often overlooked, low risk treatment option for management of (Chronic Lower Back Pain) CLBP. Underutilization of OMT is partially due to an undefined mechanism of action for the therapy. Our overarching hypothesis is through analysis of genotypic attributes; it is possible to determine which individuals are more likely to respond to OMT leading to insights into mechanisms of action. The current study investigated potential polymorphisms associated with OMT and pain reduction using data previously collected from a CLBP clinical study, which was part of The OSTEOPATHIC Trials. Methods (b): We performed a candidate gene study using single nucleotide polymorphisms (SNPs) within genes previously associated with pain: Catechol-o-methyltransferase (COMT), beta 2 adrenergic receptor (ADRB2), GTP cyclohydrolase GCH1, Interleukin 1 alpha (IL1A), interleukin 1 beta (IL1B), interleukin 1 receptor antagonist (IL1RN), Interleukin 8 (IL8), and like- glycosyltransferase (LARGE). Genotypes from subjects who benefited from OMT (responders) were compared to subjects who did not benefit from OMT (non-responders) using a chi-square analysis to test for associations. For SNPs that showed significance (α=0.05) an odds ratio (O.R.) was calculated. The study utilized 216 samples consisting of 111 individuals who received OMT, and a placebo group of 105 individuals who received a sham treatment. Results (c): SNPs in IL-8, GCH1, and LARGE showed significance (α=0.05) in the OMT group only: IL-8 SNP rs2227543 (O.R. 2.2824 CT, confidence interval (C.I.) 1.0053-5.1818), LARGE SNP rs240070 (O.R. 2.8546 TA, 1.0508-7.7548), and GCH1 SNP rs998259 (O.R. 0.4016 GA, C.I. 0.1600-1.0080). A SNP by SNP interaction was detected within GCH1 between rs998259 and rs3783641. When the rs998259 genotype is GG, rs3783641 is associated with response to OMT (α=0.05, O.R. 2.9630 TA, C.I. 1.1269-7.7907). Conclusions (d): There is an association between genetics and response to OMT in individuals who suffer from CLBP. Individuals with genotype CT in rs2227543 or TA in rs240070 are more likely to respond to OMT whereas individuals with genotype GA in rs998259 are less likely to respond to OMT. Furthermore, if an individual has genotype GG in rs998259 and TA in rs3783641 they are more likely to respond to OMT. Genes in neuronal, immunological, and muscular pathways affect OMT response.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 OSTEOPATHIC MANAGEMENT OF LEG LENGTH INEQUALITY WITH HEEL LIFT THERAPY: ANALYSIS OF ALTERED GAIT KINETICS & KINEMATICS(2013-04-12) Bens, Sebastiaan M.Purpose: The overall hypothesis of this research is that leg length inequality (LLI) of 5-20 mm has deleterious effects on musculoskeletal function and gait, which can be minimized with heel lift therapy (HLT) and Osteopathic Manipulative Treatment (OMT) adjunctively to correct somatic dysfunction. Methods: Our pilot participant was asked to wear a fitted shirt, fitted shorts or pants, and comfortable walking shoes. 49 reflective markers were placed on the body. Three dimensional motion data were collected using a 12 camera system that tracked the reflective markers, allowing precise calculation of kinematics, gait parameters, and joint range of motion during movements. A dual belt instrumented treadmill with force plates mounted underneath each treadmill belt recorded ground reaction force (GRF) data. A virtual reality environment was delivered by a 180° cylindrical screen enveloping the participant's field of vision during the walking trials. Results: Analysis of the Center of Mass of the participant was measured by a center pelvis marker, before and after HLT. There was a reduction in the medio-lateral (ML) displacement, 235.89 mm before and 148.87 mm after therapy. GRFs measured at heel strike during the gait cycle were averaged for the Long and Short leg. The participant walked with a speed of 3km/h in two conditions: a "simple walk" exploring a flat path in the virtual forest and a more challenging task "complex walk" in which large arms movements were required to avoid virtual birds while walking in the forest. The shorter leg had a larger GRF at heel strike. Before HLT, there was a difference of 34 N and 30 N between the average values of GRF for the Long and Short leg, respectively, during "simple walk" and "complex walk." After HLT, the difference in GRF at heel strike between the Long and Short sides decreased to 27 N and 23 N. Symmetry was also evaluated. A perfect symmetry between the two legs would be a value of zero. In our pilot participant, the symmetry in the simple walk, prior to HLT, was -0.3 and post HLT was 0.2. Conclusions: The decrease in difference of GRF at heel strike between the Long and Short legs after HLT indicates a tendency towards symmetry. The reduction in ML sway indicates reduced energy expenditure and increased stability during walking. By including the repeat radiographs at the end of therapy to reassess sacral declination, the proposed study will help us determine the best approach for intervention.