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Is There a Place for Osteopathy in Parkinson Disease Management? A Retrospective Case Control Study

Journal: The AAO Journal Date: 2014/06, 24(2):Pages: 26, type of study: case control study

Free full text   (https://www.academyofosteopathy.org/aaoj)

Keywords:

osteopathic manipulative treatment [2973]
OMT [2951]
Parkinson disease [10]
retrospective analysis [2]
case control study [36]
conference abstract [108]

Abstract:

Context: Parkinson disease (PD) is a severe neurodegenerative disease whose treatment involves a multifaceted approach. Osteopathic manipulation medicine (OMM) may play an important role in PD management. Objectives: This study was designed to determine the difference in the presence of somatic dysfunctions and the treatment approach with OMM between PD cases and matched control cases. Methods: This retrospective case control study was conducted at the Academic Health Care Center at the New York Institute of Technology College of Osteopathic Medicine (NYITCOM) using charts of patients seen from January 1, 2010, to August 1, 2013. A search of the electronic medical record system eClinicalWorks© was performed using International Classification of Disease 9th (ICD-9) codes. The ICD-9 codes for PD (332.0) and thoracic somatic dysfunction (739.2) were searched, yielding 322 charts of patients with Parkinson disease. Of these, 80 met our inclusion criteria. The control group was identified by ICD-9 codes for thoracic somatic dysfunction (739.2) and a musculoskeletal complaint: low back pain (724.2), back pain (724.5), thoracic back pain (724.1), cervicalgia (723.1), and sacrococcygeal disorders (724.6). The cases were matched to controls by age, gender, and treating physician. Outcomes were measured by comparing the presence of somatic dysfunctions of each body region between the groups using McNemar’s test with alpha set at 0.05. The number of body regions treated in each group and the frequency of use of active and passive techniques were also recorded, and they were compared using paired t-tests. Results: Parkinson disease cases had significantly more head/cranial (p < 0.01, or = 0.21) and cervical somatic dysfunctions (p = 0.01, or = 0.28). The control cases had significantly more pelvic somatic dysfunctions (p < 0.01, or = 3.14). PD cases received OMM treatments in significantly more body regions than the matched control cases (p < 0.01, CI [-1.184, 1.466]). There was no significant difference between the frequency of use of different passive (p = 0.148, CI [-0.0690, 0.4487]) and active (p = 0.242, CI [-0.0516, 2016]) treatment techniques between PD cases and control cases. Conclusion: Head/cranial and cervical somatic dysfunctions were significantly greater in the Parkinson disease cases, indicating that patients with PD may be more susceptible to dysfunctions in these regions. PD cases also received treatment in significantly more body regions than the control cases. These findings can help to establish a PhD OMM protocol. Additional studies should be aimed at correlating successful treatment of these regions with improved quality of life in patients with PD.


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