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Effect of Osteopathic Manipulative Medicine Thoracic Cage Techniques on Parkinson Disease Patients

Journal: The Journal of the American Osteopathic Association Date: 2014/01, 114(1):Pages: e7-e8. doi: Subito , type of study: randomized controlled trial


Keywords:

lung function [15]
OMT [3102]
osteopathic manipulative treatment [3124]
pilot study [134]
randomized controlled trial [766]
thoracic spine [66]

Abstract:

Introduction: Parkinson disease (PD) is the second most prevalent progressive neurodegenerative disorder. It is a disabling disease frequently associated with pulmonary dysfunction. Pulmonary function test (PFT) and maximal voluntary ventilation (MVV), which has been associated with PD severity, are used to assess respiratory status. Osteopathic Manipulative Medicine (OMM) on the thoracic cage and diaphragm is used clinically to address myofascial imbalances to improve thoracic cage excursion. Prior research has demonstrated that manual approaches to the thoracic cage yield improvements in lung function. These findings have not been applied to the treatment of PD patients. Hypothesis: Performing thoracic cage OMM on PD subjects will improve PFT, MVV, and chest expansion. Methods: 22 subjects with PD were randomly assigned to an OMM protocol (N=10) or light touch (LT) control (N=12) group for 1 session. The OMM protocol consisted of 5 techniques (thoracic spine/rib articulation, diaphragm doming, thoracic outlet release, and pectoral traction). Maximal and minimal chest circumferences, PFTs, and MVV were measured pre and post OMM/LT protocol. Statistical analysis was performed using analysis of covariance to assess the changes in each of the measured variables. Results: The 3-way interaction effect of time, protocol, and PD severity found a significant difference for lower chest expansion (P=.02) with a large effect size. The change in MVV pre/post treatment was significant in the OMM and LT groups (P=.004). The difference between the groups was marginally significant (P=.06). No significant difference between OMT and LT was found for the PFTs. Conclusion: This pilot study suggests the potential benefit of utilizing OMM for PD patients. Significant improvements were found in MVV for both groups. This could be attributed to the effort-dependent nature of the MVV. Future studies need to be performed to further assess the potential benefit of OMM in PD patients.


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