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Counterstrain Point Frequency and Treatment in Osteopathic Medical Students

Journal: The AAO Journal Date: 2024/06, 34(2):Pages: 27-28. doi: Subito , type of study: pretest posttest design

Full text    (https://meridian.allenpress.com/aaoj/article/34/2/16/500954/LBORC-NUFA-Poster-Abstracts-2024-Students)

Keywords:

cervical spine [302]
counterstrain [60]
levator scapulae [1]
medical students [659]
osteopathic medicine [2055]
pretest posttest design [221]
shoulder [128]
USA [1707]

Abstract:

Introduction/Background: Counterstrain technique is widely taught in osteopathic medical schools and has been proven to be efficacious for patients treated with the modality despite the lack of literature outlining the physiology of its effects. Objective: The Levator Scapulae is hypothesized to be the most frequent counterstrain point (CSP) among OMS I and OMS II medical students and counterstrain treatment is predicted to reset gamma gain, decreasing muscle stiffness. Methods: 61 first and second year osteopathic medical students were screened by an OMS II CO-PI for identification of 52 common counterstain points whose locations were approximated by the RVU OPP I and II Manual. 41 students were identified as having the levator scapulae CSP. The MyotonPro was used to measure muscle tone, dynamic stiffness, elasticity, mechanical stress relaxation time, and ratio of relaxation and deformation before and after treatment. Results were compared to the contralateral unaffected limb. The contralateral CSP received a placebo treatment via ultrasound (US) scan, while the identified CSP received counterstrain treatment by an OPP Fellow. The student’s dominant hand side was preferentially treated with counterstrain while the nondominant hand received US treatment if bilateral tender points were identified. Results: The 2 most common CSPs identified were the levator scapulae (positive in 41/61 medical students) and the radial head (37/61). Muscle stiffness saw a significant decrease post CSP treatment, going from a mean of 206 N/m pre-treatment to 197 N/m post-treatment (p= 0.01, paired t-test). Conclusion: Our conclusions will provide a more systematic screening for counterstrain points in populations found to sit for many hours and quantitative data to support the efficacy of resetting gamma gain with counterstrain treatment.


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