Advanced search

Search results      


Osteopathic Manipulation Increases Cognitive Ability in Patients With Chronic Pain: A Rationale for a New Approach

Journal: Journal of Osteopathic Medicine Date: 2018/11, 118(11):Pages: e181-e182. doi: Subito , type of study: clinical trial

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2018.163/html)

Keywords:

clinical trial [612]
chronic pain [204]
cognitive ability [1]
geriatrics [48]
OMT [2951]
osteopathic manipulative treatment [2973]

Abstract:

Research Question: Elderly patients frequently complain of a decline in cognitive ability and pain. A recent systematic review and meta-analysis suggest that chronic pain is associated with memory deficits. Osteopathic Manipulative Treatment (OMT) has been shown to alleviate pain. Therefore, does OMT have the potential to improve cognitive function in patients with chronic pain? Hypothesis: Patients receiving OMT for pain will demonstrate improvements in cognitive function and reductions in pain and inflammatory biomarkers. Clinical and Osteopathic Significance: The health care system is faced with an increase in the elderly patient population. This unique patient population frequently experiences cognitive decline and has chronic pain. Because these patients require greater care, they can deplete medical and financial resources. As osteopathic physicians, we understand the interconnectedness of body systems and how to diagnose and treat somatic dysfunction. Identifying the source of pain and treating it with OMT may reduce the prescription of opioids and facilitate the body's ability to heal itself. Most importantly, if OMT can improve cognitive function in these patients, it will increase their quality of life and reduce health care costs. Methods: Midwestern University Institutional Review Board approval was obtained (MWU #2761). Patients were recruited and consented at our Multi-Specialty Clinic. Self-identified pain scores, neurocognitive function tests, and salivary biomarkers were measured at admission and after approximately 6 weeks of standardized OMT. These parameters were re-measured after 4 weeks without OMT (washout). Inflammatory biomarkers (tumor necrosis factor α [TNF-α], interleukin-1 [IL-1], IL-6, IL-8, and cortisol) were measured with high sensitivity enzyme-linked immunoassay kits (Millipore Sigma). Data Analysis: Primary outcomes included neuropsychological, clinical, and physiological domains. Nonparametric repeated measures and correlations were used to index the effect of OMT over consecutive assessments with SPSS software. Results: In this preliminary study, 15 patients received an average of 4 OMT sessions over 5.7 weeks. With each office visit, OMT significantly reduced patient-assessed pain (10-point scale) supporting previous literature. After an average of 6 weeks of OMT, pain was significantly reduced from 5.3 to 3.4 (P<.05), which was durable at follow-up (P<.05, average of 4 weeks without OMT). Significant gains in attention (measured by the number of seconds it takes to connect random numbers in numerical order) decreased from an average of 36 seconds to 26 seconds (P<.05). Verbal memory (recall of word list) increased significantly from 18 to 25 words (P<.05), which was durable at follow-up (P<.05). Similar gains were observed in executive function (Stroop Test, P<.01). Biomarkers for inflammation had significant patient-to-patient variation illustrating the diversity of the patient population, pain duration, and pharmacologic treatments. There was a trend for OMT to reduce IL-1 (530±517 to 96±66pg/mL) and cortisol (0.16±0.06 to 0.12±0.03ug/dL), but not IL-6 or TNF-α concentrations. Conclusion: This proof-of-concept study suggests OMT improves neurocognitive parameters and reduces pain acutely and up to 4 weeks after treatment (washout). Study limitations include small sample size and lack of control groups. Ongoing research is incorporating osteopathic physician controls (osteopathic philosophy, no OMT) and allopathic physician controls to strengthen conclusion validity.


Search results      

 
 
 






  • ImpressumLegal noticeDatenschutz


ostlib.de/data_qyfrxzhbcnvetdpakwuj



Supported by

OSTLIB recommends