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The Effects of Osteopathic Manipulative Treatment on Climbing Performance
Beyer, B. R. [1]
Sheppard, C. [1]
Bolig, J. [1]
Muvvala, M. [1]

Journal: Journal of Osteopathic Medicine Date: 2024/12, 124(12):Pages: A41-A42. doi: Subito , type of study: randomized controlled trial

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2024-2000/html)

Keywords:

athletes [37]
climbing [2]
endurance [2]
grip strength [4]
OMT [3730]
osteopathic manipulative treatment [3750]
randomized controlled trial [880]
sports [140]

Abstract:

Context: Rock climbing has surged in popularity recently, driven by media attention and major motion pictures, resulting in increased public participation. Climbers place excessive strain on their upper extremities and fingers due to abnormal body positioning and intense finger grip use, raising the risk of injuries. Grip strength, essential for climbing performance, is also associated with various health outcomes, including better cardiovascular health, lower mortality rates, and improved functional independence in daily activities among older adults (1). However, factors such as aging, sedentary lifestyles, and certain medical conditions can compromise grip strength. Therefore, understanding ways to enhance grip strength is of significant interest both within the sporting community and in the broader context of public health. Previous studies have explored the effectiveness of manual therapies, including the pre-treatment of Osteopathic Manipulative Treatment (OMT), in enhancing musculoskeletal function and performance in athletes (2,3). Research indicates that manual therapy targeting specific anatomical structures can improve joint mobility, reduce pain, and enhance overall performance (4-6). Meta-analyses suggest that reduced grip strength is linked to a higher risk of injury in both the general population and climbers (7-9). Despite the recognized importance of grip strength and its implications for health and performance, research on interventions to enhance it, particularly in athletes, is lacking. Therefore, research on objective performance enhancement and injury prevention through pre-treatment of OMT in athletes is needed. This research aims to fill this gap by examining the efficacy of OMT in improving grip strength and endurance among climbers, contributing valuable insights to both the sporting community and the field of manual therapy. Objective: Evaluate the immediate and long-term benefits of OMT to the upper extremities in climbing athletes, specifically assessing grip strength and endurance. Methods: The study was a randomized, placebo-controlled, crossover study. Ten participants, aged 18-35 years with at least 3 months of climbing experience, were recruited through local climbing gyms in Albuquerque and Las Cruces, New Mexico. Inclusion criteria: generally healthy young adults, regardless of gender or biological sex. Exclusion criteria: acute injuries (e.g., ruptured finger tendons, tendonitis), chronic conditions (e.g., arthritis), contraindications to OMT, and pregnancy. Participants were randomly assigned to treatment or sham groups using a random number generator in Microsoft Excel. The OMT intervention targeted the upper extremities with 2 sessions/week over 4 weeks, followed by a 1-week washout, then a sham intervention with the same frequency and duration. The OMT included Spencer’s Technique, Radial Head Muscle Energy Technique (MET), Ulnar Olecranon High-Velocity Low-Amplitude (HVLA), Myofascial Release (MFR) of the interosseous membrane and forearm muscles, and carpal bone mobilization through MFR. The sham intervention involved holding the participant in a neutral position reflecting the OMT technique without active treatment. Grip strength and endurance were measured using a dynamometer and overall hang time on a 20mm edge, respectively, before and after the OMT and sham interventions. Results were analyzed using statistical analysis with one-way ANOVA comparing changes in performance metrics over the first, third, and sixth sessions, and paired t-tests comparing pre- and post-intervention measurements for each session. Trials ended if a participant experienced pain, and the data was excluded. The study question underscores the osteopathic significance by exploring the potential impact of targeted OMT on neurovascular and lymphatic flow. By focusing on the upper extremity, the study aims to show how previously mentioned treatments could enhance grip strength, endurance, and climbing performance, thereby emphasizing the practical applications and benefits of osteopathic principles. Results: The study indicated no significant differences between the OMT and sham treatments for performance metrics when analyzed longitudinally: hang time (F(2,12) = 0.47, p = 0.64), right grip strength (F(2,12) = 0.13, p = 0.88), and left grip strength (F(2,12) = 0.26, p = 0.78). The OMT protocol significantly increased performance metrics post-treatment compared to pre-treatment: hang time increased by 4.06 seconds (t(31) = 3.79, p = 0.001, 95% CI [1.88, 6.24]), right grip strength by 4.51 pounds (t(28) = 2.95, p = 0.01, 95% CI [1.38, 7.64]), and left grip strength by 2.81 pounds (t(23) = 2.14, p = 0.04, 95% CI [0.10, 5.53]). The sham protocol resulted in significant decreased performance metrics post-treatment compared to pre-treatment with hang time by -3.42 seconds (t(34) = -3.14, p = 0.003, 95% CI [-5.63, -1.21]) and left grip strength by -3.86 pounds (t(33) = -2.94, p = 0.01, 95% CI [-6.53, -1.20]), with no significant change in right grip strength (mean difference = -1.47 pounds, t(33) = -1.10, p = 0.3, 95% CI [-4.17, 1.24]). Conclusion: While OMT demonstrates significant short-term improvements in grip strength and endurance for climbing athletes compared to sham treatment, the study found that these effects did not persist over the long term. Further investigation is necessary to understand the factors contributing to this discrepancy, including intervention duration, participant compliance, and controlling for confounding variables. Despite the lack of sustained long-term effects, the observed significant improvement over sham treatment supports the efficacy of OMT as a valuable intervention for enhancing athletic performance in the short term. Future research should delve deeper into these findings, exploring potential mechanisms underlying the short-term benefits of OMT and addressing methodological limitations to enhance our understanding of its role in performance enhancement in athletes and healthcare. Moreover, the potential benefits of OMT extend beyond the realm of athletic performance. This includes its application to populations such as the elderly, where grip strength has significant implications for fall risk, hospitalizations, and all-cause mortality. By broadening the scope of OMT to encompass diverse populations, we can potentially improve overall health outcomes and quality of life.

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