Physical Medicine / OMM
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/31262
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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.Item CASE REPORT: ENHANCING ANKLE FUNCTIONALITY STATUS-POST ACUTE INVERSION INJURY UTILIZING OSTEOPATHIC MANIPULATIVE TREATMENT(2013-04-12) Strot, SarahPurpose: This case study evaluated the effectiveness of osteopathic manipulative treatment (OMT) in enhancing functionality in the ankle status post grade II lateral ankle sprain. Methods: AC is a 55 year old Caucasian male presenting to the UNT Health Bone & Joint Institute (BJI) after suffering an inversion injury to his right ankle two weeks prior. AC was diagnosed with grade II inversion ankle sprain, ankle effusion, and somatic dysfunction of the lower extremity. In addition to traditional conservative management, osteopathic manipulative treatment (OMT) was performed to the ankle and lower extremity. Results: There was a noted immediate decrease in the ankle effusion from 1.12cm to 0.54cm status-post treatment with OMT as seen on musculoskeletal ultrasound (MSK US). His pain decreased from 9/10 to 5/10 with increased range of motion (ROM) post-OMT. Conclusions: This case study demonstrated the benefit of utilizing OMT for acute inversion ankle injuries. This study can serve as a model for a clinical trial to demonstrate how OMT can be used to complement and improve upon the standard of care in an effort to decrease the morbidity of this frequently occurring injury.Item THE DEVELOPMENT OF A NOVEL OSTEOPATHIC ANIMAL MODALITY OF INFLAMMATORY BOWEL DISEASE: PRELIMINARY FINDINGS AND CLINICAL IMPLICATIONS(2013-04-12) Schander, ArturPurpose: Osteopathic clinicians have reported some success in the treatment of Inflammatory Bowel Disease (IBD) patients; however, objective evidence-based research exploring mechanisms and efficacy of OMT in IBD is lacking, in part due to the lack of an osteopathic IBD animal model. Therefore, the purpose of these experiments was to establish such a model and lay a foundation for future studies. Preliminary results can be used and expanded upon in future studies to evaluate the safety and efficacy of lymphatic pump techniques (LPT) in IBD, and to create treatment regimens and guidelines for the application of LPT. Methods: Colitis in male, Wistar rats, weighing around 275 grams, was induced by replacing normal drinking water with water containing 3.5% DSS for 10 days (days 0-9). Treatment was performed daily on days 3-8, which allowed for 3 days of IBD induction by DSS. To minimize stress to both animals and animal handlers, 2-5% isoflurane gas was administered to LPT or Sham rats prior to and during treatment. This was done daily for 6 days (days 3-8). Experiments included an LPT group, a Sham group , a disease control group , and a healthy control group . Results: Daily treatment with DSS decreased body weight in both DSS and DSS+ISO groups, with a statistically significant difference to the Control group on days 7-9. The Disease Activity Index (DAI)score increased over time, without any changes between DSS and DSS+ISO groups.We found a statistically significant increase in colonic tissue damage at days 6 and 9 in DSS and DSS+ISO groups when compared to the Control group at respective days. LPT significantly decreased DAI as compared to Sham and DSS+ISO controls. Of interest, application of LPT restored the weight of the colon still containing fecal contents similar to levels seen in the healthy control group. In addition, LPT also restored stool consistency similar to what was seen in the healthy control group. This is of significance because decreases in filled colon weight are indicative of colonic hypermotility; thus, colons from animals with severe colitis can be seen to be nearly devoid of fecal contents. Conclusions: The results shown in this presentation confirm that the proposed DSS induction model does in fact present a disease model with clinical measurable variables, such as weight changes and DAI. We further showed that LPT had a significant decrease on disease severity and was able to reverse clinical symptoms of IBD.Item OSTEOPATHIC MANIPULATIVE TREATMENT FOR LOW BACK PAIN DURING PREGNANCY: A CASE REPORT(2013-04-12) Hanley, KellyPurpose: In 2010 Licciardone et al. published the landmark paper "Osteopathic manipulative treatment of back pain and related symptoms during pregnancy: a randomized controlled trial" in the American Journal of Obstetrics and Gynecology. They found that osteopathic manipulative treatment (OMT) was effective at slowing or halting the deterioration of back-specific functioning during pregnancy. Since this publication there is been an increase in interest among physicians in the use of OMT as a treatment for back pain during pregnancy. The purpose of this case report is to demonstrate a pregnant patient with low back pain who was successfully treated with OMT. Methods: This case report consisted of a review of a patient's medical file. Results: A 19-year old G1P0 Caucasian female presented at an osteopathic manipulative medicine clinic at 21 weeks gestation for a three month history of low back pain. The patient was found to have somatic dysfunctions of the cervical, thoracic, and lumbar spine, as well as the pelvis and sacrum. She was treated with a variety of OMT techniques and reported reduced pain both immediately after treatment and at her 10 day follow-up appointment. Conclusions: Low back pain is a common complaint among pregnant women and can be treated with OMT to reduce pain and improve function. Osteopathic physicians should continue to offer OMT to their obstetric patients because of its proven effectiveness.