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Palmer GM, Dominick N, Kane M, Bawek S, Burch B, Sanders T, Phrathep D, Myers N, Lorenzo S. Effect of osteopathic manipulative treatment and Bio-Electro-Magnetic Energy Regulation (BEMER) therapy on generalized musculoskeletal neck pain in adults. J Osteopath Med 2024; 124:153-161. [PMID: 38033194 DOI: 10.1515/jom-2023-0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023]
Abstract
CONTEXT General neck pain is a prevalent complaint made by patients to their physicians and is often of a suspected musculoskeletal origin. Osteopathic manipulative treatment (OMT) is a form of manual therapy utilized by osteopathic physicians and some allopathic physicians to treat a broad variety of musculoskeletal ailments, including neck pain. Bio-Electro-Magnetic Energy Regulation (BEMER) is an emerging therapeutic modality that deploys a biorhythmically defined stimulus through a pulsed electromagnetic field and has been shown to reduce musculoskeletal pain. Studies on these treatments have independently yielded promising results. Therefore, it is possible that the utility of OMT and BEMER can produce an additive improvement in the treatment of neck pain. OBJECTIVES The objectives of this study are to investigate the individual and combined effects of OMT and BEMER therapy on neck pain in adults. METHODS Adults with nonspecific neck pain were recruited for the study. A total of 44 participants met the study inclusion criteria and were randomized into one of four study groups: OMT-only, BEMER-only, OMT+BEMER, or CONTROL (light touch and sham). Forty subjects completed the study, and data for 38 participants were included in our analyses. An OMT and BEMER protocol were specifically designed for this study under the guidance of a licensed osteopathic physician. Participants underwent intervention for a duration of 3 weeks. Data were obtained through baseline and postintervention assessments utilizing three surveys: Neck Disability Index (NDI), Visual Analog Scale (VAS), and Short Form 12-item Health Survey (SF-12, divided into Mental and Physical). One-way analysis of variance (ANOVA) analysis was performed retrospectively on pre- and postintervention absolute means between study groups. Significance was set at p<0.05. RESULTS One-way ANOVA analysis demonstrated a statistically significant difference in pre- vs. postintervention mean scores between BEMER and CONTROL (p<0.05), BEMER compared to OMT (p<0.005), and BEMER compared to BEMER+OMT (p<0.05), in the NDI. The OMT+BEMER group reported an average reduction in pain on the VAS of 21.3 (±29.3) points, or a 65.0 % reduction of pain. A similarly substantial decrease in pain was reported in the BEMER study group, which showed a 46.2 % reduction in pain from baseline. The OMT and CONTROL study groups only reported a 2.9 and 23.9 % decrease, respectively. The BEMER and OMT+BEMER study groups also demonstrated a reduction in subjective reporting on the NDI, by 53.8 and 26.3 %, respectively. The BEMER study group also achieved the most substantial improvement in mental and physical well-being as reported by the SF-12. CONCLUSIONS Study arms that incorporated BEMER yielded improvements on the NDI, VAS, and SF-12, indicating benefits to BEMER regarding improved overall functionality in routine daily activities as well as a reduction in nonspecific neck pain. Perceived pain, as demonstrated on the VAS, was seemingly improved in an additive fashion from the BEMER group to the OMT+BEMER group, although the results did not achieve statistical significance. Further study with greater participation could provide additional insight.
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Affiliation(s)
- Genevieve M Palmer
- Osteopathic Research Department, Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA
| | - Nicholas Dominick
- Osteopathic Research Department, Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA
| | - Melissa Kane
- Osteopathic Research Department, Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA
| | - Sawyer Bawek
- Osteopathic Research Department, Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA
| | - Blake Burch
- Osteopathic Research Department, Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA
| | - Taylor Sanders
- Osteopathic Research Department, Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA
| | | | - Nicole Myers
- Assistant Professor, Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA
| | - Santiago Lorenzo
- Associate Professor, Physiology, Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA
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King HH, Mai J, Morelli Haskell MA, Wolf K, Sweeney M. Effects of osteopathic manipulative treatment on children with plagiocephaly in the context of current pediatric practice: a retrospective chart review study. J Osteopath Med 2024; 124:171-177. [PMID: 37999741 DOI: 10.1515/jom-2023-0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/17/2023] [Indexed: 11/25/2023]
Abstract
CONTEXT Deformational plagiocephaly (DP) is on the rise in pediatric patients. The current standard of care recommended for management is repositioning with possible addition of cranial orthoses. However, strong data are lacking to support these recommendations. Osteopathic manipulative treatment (OMT) is another treatment option for DP that is also lacking evidential support. OBJECTIVES This retrospective chart review study investigated the effects of OMT at restoring a more symmetrical cranial bone configuration in children with DP. METHODS A retrospective chart review was performed on medical records of patients with a diagnosis of DP from three private practices over a 4-year period from September 2017 to December 2021. Inclusion criteria were diagnoses of DP by a referring physician and aged 10 months or less at the time of initial evaluation and treatment. Patients were excluded if they had confounding diagnoses such as genetic syndromes or severe torticollis. A total of 26 patients met these criteria, and their records were reviewed. The main outcome reviewed was anthropometric assessment of the cranium, mainly the cranial vault asymmetry index (CVAI). RESULTS Participants demonstrated a mean CVAI - a measure that determines the severity of DP - of 6.809 (±3.335) (Grade 3 severity) at baseline, in contrast to 3.834 (±2.842) (Grade 2 severity) after a series of OMT treatments. CVAI assessment after OMT reveals statistically significant (p≤0.001) decreases in measurements of skull asymmetry and occipital flattening. No adverse events were reported throughout the study period. CONCLUSIONS The application of OMT has shown potential benefit for reducing cranial deformity in patients with DP.
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Affiliation(s)
- Hollis H King
- University of California San Diego School of Medicine, Center for Integrative Medicine, San Diego, CA, USA
| | - Julie Mai
- Osteopathy's Promise to Children, San Diego, CA, USA
| | | | - Kimberly Wolf
- Osteopathic Manipulative Medicine Department, Touro University California College of Osteopathic Medicine, Vallejo, CA, USA
| | - Megan Sweeney
- Osteopathy's Promise to Children, San Diego, CA, USA
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Sanchez J, Martinez ES, Loveless B, Sees JP, Zammuto J, Szurmant H, Fuchs S, Crone P, Hostoffer R. Augmentation of immune response to vaccinations through osteopathic manipulative treatment: a study of procedure. J Osteopath Med 2024; 124:163-170. [PMID: 38011280 DOI: 10.1515/jom-2023-0198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023]
Abstract
CONTEXT Anecdotal evidence suggested that osteopathic manipulative treatment (OMT) may have imparted survivability to patients in osteopathic hospitals during the 1918 influenza pandemic. In addition, previous OMT research publications throughout the past century have shown evidence of increased lymphatic movement, resulting in improved immunologic function qualitatively and quantitatively. OBJECTIVES The following is a description of a proposed protocol to evaluate OMT effects on antibody generation in the peripheral circulation in response to a vaccine and its possible use in the augmentation of various vaccines. This protocol will serve as a template for OMT vaccination studies, and by adhering to the gold standard of randomized controlled trials (RCTs), future studies utilizing this outline may contribute to the much-needed advancement of the scientific literature in this field. METHODS This manuscript intends to describe a protocol that will demonstrate increased antibody titers to a vaccine through OMT utilized in previous historical studies. Confirmation data will follow this manuscript validating the protocol. Study participants will be divided into groups with and without OMT with lymphatic pumps. Each group will receive the corresponding vaccine and have antibody titers measured against the specific vaccine pathogen drawn at determined intervals. RESULTS These results will be statistically evaluated. Our demonstration of a rational scientific OMT vaccine antibody augmentation will serve as the standard for such investigation that will be reported in the future. These vaccines could include COVID-19 mRNA, influenza, shingles, rabies, and various others. The antibody response to vaccines is the resulting conclusion of its administration. Osteopathic manipulative medicine (OMM) lymphatic pumps have, in the past through anecdotal reports and smaller pilot studies, shown effectiveness on peripheral immune augmentation to vaccines. CONCLUSIONS This described protocol will be the template for more extensive scientific studies supporting osteopathic medicine's benefit on vaccine response. The initial vaccine studies will include the COVID-19 mRNA, influenza, shingles, and rabies vaccines.
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Affiliation(s)
- Jesus Sanchez
- Department of Neuromusculoskeletal Medicine/Osteopathic Manipulative Medicine, College of Osteopathic Medicine of the Pacific at Western University of Health Sciences, Pomona, CA, USA
| | - Eric S Martinez
- Department of Neuromusculoskeletal Medicine/Osteopathic Manipulative Medicine, College of Osteopathic Medicine of the Pacific at Western University of Health Sciences, Pomona, CA, USA
| | - Brian Loveless
- Department of Neuromusculoskeletal Medicine/Osteopathic Manipulative Medicine, College of Osteopathic Medicine of the Pacific at Western University of Health Sciences, Pomona, CA, USA
| | - Julieanne P Sees
- Fellow Osteopathic Medicine, National Academy of Medicine, Washington, DC, USA
| | - Joseph Zammuto
- Associate Professor of Family Medicine, Western University of Health Sciences College of Osteopathic Medicine of the Pacific, Pomona, CA, USA
| | - Hendrik Szurmant
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific at Western University of Health Sciences, Pomona, CA, USA
| | - Sebastien Fuchs
- Department of Basic Sciences, College of Osteopathic Medicine of the Pacific at Western University of Health Sciences, Pomona, CA, USA
| | - Paula Crone
- Western University of Health Sciences, Pomona, CA, USA
| | - Robert Hostoffer
- University Hospitals, Cleveland Medical Center, Cleveland, OH, USA
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Cella M, Acella E, Aquino A, Pisa V. Cranial osteopathic techniques and electroencephalogram (EEG) alpha power: a controlled crossover trial. J Osteopath Med 2022; 122:401-409. [PMID: 35675898 DOI: 10.1515/jom-2021-0257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/23/2022] [Indexed: 11/15/2022]
Abstract
CONTEXT Osteopathic tradition in the cranial field (OCF) stated that the primary respiratory mechanism (PRM) relies on the anatomical links between the occiput and sacrum. Few studies investigated this relationship with inconsistent results. No studies investigated the occiput-sacrum connection from a neurophysiological perspective. OBJECTIVES This study aims to determine whether the sacral technique (ST), compared to the compression of the fourth ventricle (CV4) technique, can affect brain alpha-band power (AABP) as an indicator of a neurophysiological connection between the occiput and sacrum. METHODS Healthy students, 22-30 years old for men and 20-30 years old for women, were enrolled in the study and randomized into eight interventions groups. Each group received a combination of active techniques (CV4 or ST) and the corresponding sham techniques (sham compression of the fourth ventricle [sCV4] or sham sacral technique [sST] ), organized in two experimental sessions divided by a 4 h washout period. AABP was continuously recorded by electroencephalogram (EEG) of the occipital area in the first 10 min of resting state, during each intervention (active technique time) and after 10 min (post-active technique time), for a total of approximately 50 min per session. Analysis was carried out utilizing a repeated-measure ANOVA within the linear general model framework, consisting of a within-subject factor of time and a within-subject factor of treatment (CV4/ST). RESULTS Forty healthy volunteers (mean age ± SD, 23.73±1.43 years; range, 21-26 years; 16 male and 24 female) were enrolled in the study and completed the study protocol. ANOVA revealed a time × treatment interaction effect statistically significant (F=791.4; p<0.001). A particularly high increase in mean AABP magnitude was recorded during the 10 min post-CV4, compared to both the CV4 and post-sCV4 application (p<0.001). During all the times analyzed for ST and sST application, no statistically significant differences were registered with respect to the resting state. CONCLUSIONS The ST does not produce immediate changes on occipital AABP brain activity. CV4, as previous evidence supported, generates immediate effects, suggesting that a different biological basis for OCF therapy's connection between the head and sacrum should be explored.
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Affiliation(s)
- Mattia Cella
- Department of Osteopathic Manipulative Medicine, Istituto Superiore di Osteopatia, Milan, Italy
| | - Eric Acella
- Department of Osteopathic Research at Istituto Superiore di Osteopatia (ISO), Milan, Italy
| | - Alessandro Aquino
- Department of Osteopathic Research at Istituto Superiore di Osteopatia (ISO), Milan, Italy
- Department of Health Science, University of Milan, Milan, Italy
- Clinical-based Human Research Department, COME Collaboration, Pescara, Italy
| | - Viviana Pisa
- Department of Osteopathic Research at Istituto Superiore di Osteopatia (ISO), Milan, Italy
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Rehman Y, Ferguson H, Bozek A, Blair J, Allison A, Johnston R. Dropout associated with osteopathic manual treatment for chronic noncancerous pain in randomized controlled trials. J Osteopath Med 2021; 121:417-428. [PMID: 33721921 DOI: 10.1515/jom-2020-0240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 11/18/2020] [Indexed: 11/15/2022]
Abstract
CONTEXT Reviews exploring harm outcomes such as adverse effects (AE), all cause dropouts (ACD), dropouts due to inefficacy, and dropouts due to AE associated with osteopathic manipulative treatment (OMT) or osteopathic manual therapy (OMTh) are scant. OBJECTIVES To explore the overall AE, ACD, dropouts due to inefficacy, and AE in chronic noncancerous pain (CNCP) patients receiving OMTh through a systematic review of previous literature. METHODS For this systematic review and meta-analysis, the authors searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), EMCare, and Allied and Complementary Medicine Database (AMED), and Ostmed.Dr, as well as the bibliographical references of previous systematic reviews evaluating OMTh for pain severity, disability, quality of life, and return to work outcomes. Randomized controlled trials with CNCP patients 18 years or older with OMTh as an active or combination intervention and the presence of a control or combination group were eligible for inclusion. In this sub-study of a previous, larger systematic review, 11 studies (n=1,015) reported data that allowed the authors to perform meta-analyses on ACD and dropouts due to AE. The risk of bias (ROB) was assessed with the Cochrane ROB tool and the quality of evidence was determined with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS The pooled analysis showed that ACD was not significantly different for visceral OMTh (vOMTh) vs. OMTh control (odds ratio [OR]=2.66 [95% confidence interval [[CI]], 0.28, 24.93]) or for OMTh vs. standard care (OR=1.26 [95% CI, 0.84, 1.89]; I2=0%). Single study analysis showed that OMTh results were nonsignificant in comparison with chemonucleolysis, gabapentin, and exercise. OMTh in combination with gabapentin (vs. gabapentin alone) and OMTh in combination with exercise (vs. exercise alone) showed nonsignificant ACD. Dropouts due to AE were not significantly different, but the results could not be pooled due to an insufficient number of studies. CONCLUSIONS Most articles did not explicitly report AEs, ACD rates, or dropouts due to AEs and inefficacy. The limited data available on dropouts showed that OMTh was well tolerated compared with control interventions, and that the ACD and dropouts due to AEs were not significantly different than comparators. Future trials should focus on explicit reporting of dropouts along with beneficial outcomes to provide a better understanding of OMTh efficacy.
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Affiliation(s)
- Yasir Rehman
- Department of Health Research Methodology, Department of Health Research Methods, Evidence, and Impact, The Michael G. DeGroote Institute for Pain Research and Care, Hamilton, ON, Canada.,McMaster University, Hamilton, ON, Canada.,Department of Medical Sciences at Canadian Academy of Osteopathy, Hamilton, ON, Canada
| | - Hannah Ferguson
- Department of Medical Sciences at Canadian Academy of Osteopathy, Hamilton, ON, Canada
| | - Adelina Bozek
- Department of Medical Sciences at Canadian Academy of Osteopathy, Hamilton, ON, Canada
| | - Joshua Blair
- Department of Medical Sciences at Canadian Academy of Osteopathy, Hamilton, ON, Canada
| | - Ashley Allison
- Department of Medical Sciences at Canadian Academy of Osteopathy, Hamilton, ON, Canada
| | - Robert Johnston
- Department of Medical Sciences at Canadian Academy of Osteopathy, Hamilton, ON, Canada
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