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Clinically significant lung function improvement for collegiate soccer players after OMT with restrictive ribcage motion correlated with Expanded Zink screen
Leung, D. Y. [1]
Stiles, E. G. [5]

Journal: Journal of Osteopathic Medicine Date: 2025/12, (online 2025/12/08):. doi: Subito , type of study: case series

Free full text   (https://www.degruyterbrill.com/document/doi/10.1515/jom-2025-0011/html)

Keywords:

case series [55]
female [597]
lung function [17]
OMT [3750]
osteopathic manipulative treatment [3770]
ribcage [1]
soccer [5]
women [553]
Zink screen [1]

Abstract:

Context This study was undertaken to build upon the work of J. Gordon Zink, DO, FAAO, by developing a novel screening examination (Expanded Zink screen) that can correlate with proper identification of somatic dysfunction, the area of greatest restriction (AGR), and effective treatment in soccer players, which would elevate the osteopathic profession and advance the field of medicine. Objectives The objectives of this study are to determine whether the Expanded Zink screen can accurately correlate with the somatic dysfunctions found in soccer players, with what ended up being treated, and with effectiveness of treatment as measured by spirometry. Methods We performed a correlational study that involves female collegiate soccer players during the season who signed up to receive osteopathic manipulative treatment (OMT) after providing written informed consent. We screened 8 University of Pikeville (UPIKE) women’s soccer players; exclusion criteria included any pre-existing health problems, such as bleeding disorders, congenital malformations, and spinal cord injuries. Each soccer player underwent pre-OMT spirometry measurements. Next, each soccer player received a screening examination (“Traditional Zink” screen or “Expanded Zink screen”) from Operator 1. The soccer player then received the same screening examination from Operator 2. Operator 2 then found somatic dysfunctions and performed OMT. Finally, Operator 1 completed a re-screen of the soccer player utilizing the initial screen and noted any changes in findings. The soccer player then completed post-OMT spirometry measurements. Results We find that all players in both groups after receiving OMT have a normal lung function pattern or one that improved from an obstructive pattern to a normal pattern as measured by spirometry. All eight soccer players had lumbar somatic dysfunction, innominate somatic dysfunction, and lower extremity somatic dysfunction. All players had all four junctions equalized post-OMT. Seven out of the eight players had cranial somatic dysfunction, and five of them had their cranial somatic dysfunction treated first, including Player 5, who showed clinically significant improvement in lung function post-OMT. Player 5’s ribs were treated second in the treatment sequence. A novel Expanded Zink screen accurately correlated OMT of exhaled ribs to lateral asymmetry in rotation at the cervicothoracic junction in Player 5. Spirometry measurement post-OMT in Player 5 revealed clinically significant improvement in lung function showing 32 % change from obstruction to a normal pattern, which we attribute to correction of restrictive ribcage motion/dysfunction utilizing OMT. Both cranium and rib treatments accurately correlate with Expanded Zink screen findings of cranial and rib somatic dysfunctions in Player 5. Conclusions The Expanded Zink screen can be utilized as a screening model for the hypothesized correlating body regions to identify significant somatic dysfunction and to augment the physician’s ability to detect key body regions that need OMT. Through the use of the Expanded Zink screen, we discovered an out-of-pattern rib somatic dysfunction, which may have led to what we call a “restrictive ribcage motion/dysfunction.” This type of rib motion may have been the cause of the obstructive pattern on pre-OMT spirometry seen in Player 5. Once the rib was treated, the restrictive ribcage motion resolved, which allowed lung function to be restored to normal.

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