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Utilizing Osteopathic Manipulative Technique to Alleviate Restriction at the Hip from the Tibio-Fibular Joint

Journal: Journal of Osteopathic Medicine Date: 2025/12, 125(12):Pages: A693–694. doi: Subito , type of study: clinical trial

Full text    (https://www.degruyterbrill.com/document/doi/10.1515/jom-2025-2000/html)

Keywords:

clinical trial [659]
hip [382]
OMT [3746]
osteopathic manipulative treatment [3766]
range of motion [110]
tibiofibular joint [4]

Abstract:

Context: This study aims to analyze the correlation of hip joint ROM associated with a finding of an ipsilateral tibio-fibular joint restriction. The study will assess an innovative manual technique of correcting the tibio-fibular joint restriction to facilitate a simultaneous improvement of restricted hip internal and external rotation. Objective: A dysfunctional joint in the lower extremity, the tibio-fibular joint with resulting restricted range of motion, may directly cause a restricted range of motion of its more proximal ipsilateral hip joint. Utilizing a manual retraction technique, this study will assess whether the corrective alignment of this tibio-fibular joint also provides a corrective restoration of the ipsilateral hip joint range of motion. Methods: A group of 20 healthy adult volunteers (10 male and 10 female) were selected based on the exclusion criteria of being over 65 years of age without previous surgical hip or knee procedures. They were recruited either in person, over institutional email or through their class group-me. Inclusion criteria included range of motion restriction that was lacking in hip flexion, determined as less than 90 degrees in passive range of motion. In the first phase of the study, a goniometer (GM) was used to measure the passive range of motion (ROM) of the internal and external hip joint, followed by an assessment of the ipsilateral tibio-fibular joint. The participants that were found to have a tibio-fibular shift with associated loss of lower leg and ankle range of motion were provided the manual technique after their consent. The manual treatment performed in this study was the controlled lower leg thrust with the participant placed in a supine position. This manual method consisted of securing the lateral and medial malleolus and applying a brief, forceful retraction release to the subtalar complex and calcaneus while having the participant perform an extended exhalation. This manual release method was performed in three precise positions: neutral extension, 30-degree lower limb abduction, and 15-degree lower limb adduction. Results: All results were found to be clinically significant regardless of gender or age using a standard p-value of P<0.05, with the significance in this study p<0.00001. In hip flexion, male participants improved a mean of 12.1 degrees, while female participants improved a mean of 18.2 degrees following the technique completion. A paired samples t-test was used through Microsoft excel using an alpha value of 0.05 to determine significance. Conclusion: The results found that an ipsilateral manual retraction of the lower leg technique significantly improved tibio-fibular joint mobility, which, in turn, contributed to improved ipsilateral hip joint ROM.


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