Physical Medicine / OMM

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    Analysis of Approach and Motion Velocities in Dominant Hands While Performing Daily Activities
    (2015-03) Juarez, Jessica K.; Young, Carolyn; Bugnariu, Nicoleta L.; Patterson, Rita M.
    Analysis of Approach and Motion Velocities in Dominant Hands While Performing Daily Activities Previous studies have shown individual force sensors to be a simple means of providing feedback about the environment to a robot. Combining the data of velocity in two phases (approach and motion) from a touch sensitive surface glove can provide insight into the neural processes that govern muscle movements during approach, pushing, and pulling of an object. The analysis of these interactions may be used to streamline the motions of a robot to simulate the average adult human’s movement while performing simple tasks. Data from dominant hand positions and velocities from ten people was collected using a motion capture system (Motion Analysis Corp, Santa Rosa, CA). There were five females and five males with ages 23-51. Quantitative data of both motion and velocity was collected on five trials and averaged across the cohort for analysis. The ‎ average minimum velocity during approach for a push movement was 0.546 meters/second, 0.579 meters/second, and 0.632 meters/second for a cylinder weight of three, five, ten pounds respectively. Trends show that as weight increases, so does the minimum velocity of approach in the palm position. Future analysis of these data will include providing information for building simulated and eventually physical human-robot interaction systems to aid in daily activities.
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    The Effects of Osteopathic Manipulative Treatment on GI Motility
    (2015-03) Liganor, Roselle E.; Watters, Jacob W.; Jouett, Noah P.; Hensel, Kendi L.; Smith, Michael L.
    Introduction Since its inception, osteopathic manipulative treatment (OMT) has been used for a variety of clinical conditions. Studies have shown that OMT can affect the autonomic nervous system as measured by heart rate variability, thereby demonstrating somatovisceral effects, and are theorized to affect gastrointestinal (GI) function by altering autonomic balance and GI motility. We hypothesize that OMT will demonstrably affect GI activity as measured by electrogastrography (EGG), a non-invasive measure of GI motility. Materials and Methods This is an IRB-approved randomized controlled trial. EGG was used to measure gastric motility before, during and after either an OMT protocol or a time control (TC). The OMT protocol included specific techniques. Results 15 subjects have enrolled to date. Five subjects’ data were eliminated due to motion artifact. The OMT group (n=5) exhibited a 22 ± 4 % change in EGG % 2-4 cycles per minute (CPM), compared with 10 ± 0.40 % change in the TC group (n=5) (p=0.014). Further, OMT shifted the dominant power of the EGG spectrum significantly greater than TC (p=0.037). OMT did not appear to alter the dominant frequency of the gastric motility (p=0.841). Conclusion OMT appears to either (a) increase the power of the EGG spectra within 2-4 CPM or (b) shift power away from 2-4 CPM to more tachygastric frequencies. This indicates an increase in gastric electrical activity in response to OMT, but more study is needed to determine the significance and relevance of these findings.
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    Evaluation of a Physical Exam Test for Determination of Leg Length Discrepancy Versus the Standard Postural X-ray Series in Low Back Pain Patients
    (2015-03) Picciotti, Brett; Crow, William; Liganor, Roselle E.; Laniewicz, Natalie; Boone, Aaron
    Objective: To determine if the hip (pelvic) swing test for short leg is equivalent to the postural x-ray series for determination of leg length discrepancy in patients with low back pain. Methods: Patients between the ages of 18 and 65 years who presented to the UNTHSC Department of OM with low back pain and a short leg on clinical exam were enrolled in the study. A hip swing test was performed with the patient barefoot. The test was repeated with heel lifts of various heights to determine which lift allowed for equal rotational motion of the hips. The height of the correct heel lift was recorded in the patient’s chart. Each patient was then referred to Radiology Associates for a postural standing x-ray series. The measure of sacral base unleveling was recorded. The correlation between physical exam test and postural x-ray results was analyzed using a kappa correlation. Results: 30 subjects participated in the study. All subjects underwent the hip swing test and postural standing x-rays. There was a positive correlation (P value) between heel lift height, as determined by physical exam test, and sacral base unleveling measured with imaging. Conclusion: The study shows that the hip swing test may be as reliable and clinically applicable as postural standing x-rays in the evaluation of leg length discrepancy in patients with low back pain. These findings have the potential to alleviate the need for x-rays in the future, thus saving money and reducing the risk of radiation exposure to patients.
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    A Case Report on Low Back Pain in the Third Trimester of Pregnancy addressed with Osteopathic Treatment
    (2015-03) Stanley, Russell F.; Smith-Barbaro, Peggy
    Purpose: The objective of this case report is to document the use of osteopathic manipulative articulatory, myofascial, soft tissue, and muscle energy techniques as safe adjunctive treatments for low back pain in the third trimester of pregnancy. The author describes a case of worsening low back pain in an obstetrical patient who was a G1P0 33 year old female in the 36th week of gestation and constantly on her feet at her workplace. The patient complained of stiffness in her lumbar spine as well as pain in the area of the round ligaments in the anterior pelvis. Following two osteopathic manipulative treatment sessions in addition to the patient stretching at home and using a massage therapist, the patient gained increased pain relief in her lumbar spine and sacrum as well as her anterior pelvis along the pubic symphysis. This enabled the patient to continue working her regular job up until the time of a full term vaginal delivery at 39 weeks. Methods: The author employed the use of the PROMOTE study OMT protocol developed by Dr. Kendi Hensel in order to address the patient with third trimester low back pain in this case report. The patient was treated twice using a series of techniques found in the PROMOTE study with great overall improvement in the patient’s pain. The author used seated thoracic articulation, cervical soft tissue, occipito-atlantal decompression, thoracic inlet myofascial release, lateral recumbent scapulothoracic soft tissue, lateral recumbent lumbar soft tissue, abdominal diaphragm myofascial release, pelvic diaphragm myofascial release, sacroiliac articulation, pubic symphysis decompression, and frog-leg sacral release. These OMT techniques were used in sequence to address the patient with third trimester low back pain. Results: In this case report, a multimodal approach was taken to address the patient’s back pain in the third trimester. The patient utilized home stretches and also attended massage therapy in addition to undergoing OMT treatments twice at the doctor’s office. The techniques from the PROMOTE study were utilized with great success in the patient and greatly relieved the patient’s low back pain in the weeks leading up to delivery. Through the treatments the patient was able to continue working and also was able to improve her ability to stay active in an exercise program in the weeks leading up to delivery. Conclusion: This case study does not prove that osteopathic treatment is the sole factor responsible for the improvement in low back pain within the third trimester of pregnancy. However, the case study does show that osteopathic manipulation was a vital component to the improvement that was shown in the pain and function of the patient in this particular case study. Further studies are indicated to focus more on the aspects of preparing the pelvis for the labor and delivery process as well as addressing other postural factors and improving overall hemodynamic functioning.
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    Use of Yoga in Children with Autism: A Systematic Review of Literature
    (2015-03) Martel, Rebecca K.; Fugler, Joseph; Yarbrough, Kaitlyn; Wheeler, Allison; Salem, Yasser; Liu, Howe; Young, Amanda
    Use of Yoga in Children with Autism: A Systematic Review of Literature Purpose and Hypothesis Research examining the use of yoga in children has suggested benefits related to a variety of outcomes; however, there is no review that synthesized research findings for children with autism. The purpose of this review was to examine the evidence concerning the use of yoga exercises for children with autism. Safety concerns, potential benefits and practical application are discussed. Materials/Methods: The databases searched included PubMed, PsychINFO, CINAHL, Cochrane, OVID, PEDro, ProQuest, Access Physiotherapy, and Hooked on Evidence. The search was conducted using the following keywords: ‘yoga’, ‘autism’, and ‘autism spectrum disorder’. Titles and abstracts were assessed manually according to the following criteria: (1) children with autism spectrum disorder, and (2) intervention (yoga program). An additional search, the reference lists of the relevant articles, was explored manually. We screened those articles for duplicate and selection criteria. Results: Seven of the 107 articles that were retrieved met the inclusion criteria. Across all studies, a total of 153 children (age range 13 to 16 years old) with autism were investigated. All studies reported improvements following participation in yoga exercises. Conclusion The result of this review suggests positive effects of yoga exercises in children with autism. The results should be interpreted with caution given the strength of evidence and the quality of reviewed studies and that the number of studies that examined the effects of yoga exercise in children with autism is low.
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    One OMT Session Lowers Cortisol and Brings Sustained Pain Relief: A Prospective Treatment Trial
    (2015-03) King, Andrew P.; Talari, Deepika; Nejtek, Vicki; Sivoravong DO, Jon C.; Budhani, Atiq
    Hypothesis: In acute pain patients, one treatment of osteopathic manipulative therapy (OMT) will increase range-of-motion (ROM), decrease pain, reduce stress, and lower inflammation as measured by salivary cortisol. Methods: A prospective, open-label, longitudinal, proof-of-concept treatment intervention trial was designed to test the hypotheses. Institutional Review Board approval and patient consent to participate in the study were obtained prior to recruitment. Inclusion criteria: Subjects with acute pain lasting Results: One session of OMT significantly reduced stress, pain and increased overall neck ROM (p Conclusion: Brief OMT was effective for increasing neck ROM, reducing pain-related stress and alleviating physical pain measured at the immediate post-OMT and 2-week conditions. Changes in salivary cortisol levels may also be a viable biomarker of OMT efficacy.
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    Effect of Whole Body Vibration on stroke patients: A Systematic Review
    (2015-03) Bao, Yi; Master, Hiral; Salem, Yasser; Holmes, Clayton; Du, Qing; Howe, Liu
    Introduction and Purpose: Stroke is one of the major medical disorders that affect patients’ daily functional mobility. From last decade, whole-body vibration therapy (WBV) has been introduced and getting more used for patients with stroke. However, up to date, about using the WBV, the following questions are still uncertain: which stage of patients with stroke can really benefit from the WBV, what WBV intervention parameters should be provided, and what assessment instruments could be applied to evaluate the WBV effectiveness. Therefore, the purpose of this review is aimed to answer these questions by analyzing relevant articles. The purpose of this study was to identify what benefits could stroke patient receive from WBV, Methods: Two researchers performed literature search by using Ovid Medline, Scopus, Medline, Cochrane and PubMed independently. Eligible studies published from 2000 through April 2014 were selected. The keywords for search were whole body vibration, stroke, cardiovascular accident, hemiplegia, hemiparalysis, hemiparesis, functional performance, posture, balance, strength, and rehabilitation. Result: Eleven articles were qualified for the purpose of this review. WBV could be used alone, or combined with therapeutic exercise. It seemed that patients with subacute and chronic stroke could benefit more from the WBV, while the acute one does not. The intervention parameters in these studies are: once per week to five times per week, duration from 3 to 12 weeks, frequency of vibration from 5 to 45 Hz, amplitude from 0.44 to 8 mm. More than ten measurements had been described for outcome assessment in these articles. It demonstrated that the WBV could improve activity of daily living (measured by Barthel’s index), and functional mobility (measured by timed up & go - TUG 10-MWT, 6-MWT, walk speed and cadence and Tinetti Gait Test). However, it is controversial if the WBV is able to improve 1) balance in term of Berg Balance Scale (1 study said yes while other two said no), 2) muscle strength and flexibility (3 said yes, while other three said no), and 3) spasticity (one with yes and two with no in term of Modified Ashworth Scale showed improvement in lower extremity). Conclusion: Whole body vibration therapy is an effective therapy that can be used independently or combined with others. It demonstrated that patients with subcase and chronic stroke can benefit more. People with strike used the WBV varies. Its main effects are on improvement of ADL and functional mobility, but its effect on balance, strength, flexibility and spasticity is uncertain, further study may be needed. Key Words: whole-body vibration, WBV, stroke, rehabilitation
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    Brief OMT Improves Range of Motion, Reduces Pain & Anxiety As Shown by Interleukin 1-Beta Levels
    (2015-03) Budhani, Atiq; Sivoravong, Jon; nejtek, vicki; Talari, Deepika; King, Andrew P.
    Hypothesis: Brief osteopathic manipulative therapy (OMT) will improve range-of-motion (ROM), reduce pain-related anxiety and self-reported somatic pain perceptions as indicated by salivary Interleukin 1- Beta levels (IL-1B). Methods: A prospective 2-week longitudinal treatment intervention trial was designed to examine treatment efficacy of one brief OMT session to improve trunk ROM while reducing anxiety and pain perceptions in 25 acute pain patients for up to 2-weeks later. Salivary IL-1B was analyzed as a biomarker of pre- and post-OMT inflammation, psychosomatic pain and anxiety. Results: Brief OMT delivered one time was significantly related to improved ROM in trunk flexion (t = 2.84, p = 0.009), reduced anxiety as measured by the Generalized Anxiety Disorder questionnaire (F=11.20, p=0.0000). A statistical trend in reduced pain perceptions was evident 2-weeks later (F=23.07, p=0.0000). Levels of IL-1B were significantly correlated to mood and anxiety (r =-0.47, p = 0.05) in the 2-week follow- up condition. Improvement in trunk side bending (right side) after OMT was significantly correlated to reduction in pain related anxiety (r=-0.43, p=0.04). Conclusion: These results suggest that one brief session of OMT effectively increased ROM, reduced pain and anxiety that lasted up to 2-weeks. These OMT benefits were associated with increased post-OMT levels of the inflammatory biomarker, IL-1B. OMT seemed to provide physical pain relief benefits while also reducing psychological pain perceptions and pain-related anxiety.