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The Efficacy of Treating Thoracic Cage Counterstrain Tender Points With Varied Mobile Point Time Durations in a Classroom Setting
Smith, J. M. [1]
Docherty, J. [10]
Kooyman, P. [5]
Yao, S. C. [54]

Journal: Journal of Osteopathic Medicine Date: 2019/12, 119(12):Pages: e123-e124. doi: Subito , type of study: clinical trial

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2019.128/html)

Keywords:

clinical trial [612]
counterstrain [34]
medical students [402]
osteopathic medicine [1540]
rib [48]
tender points [9]
thoracic spine [56]
time durations [1]

Abstract:

Statement of Significance: Using Osteopathic Manipulative Treatment (OMT) in the clinical setting is often limited by time constraints of each patient visit. If CS for 90 seconds is as effective as CS for 120 seconds, this information is important for physicians to be aware of to increase efficiency at each visit. Furthermore, physicians that may have previously been reluctant to utilize CS of rib and thoracic regions given time constraints may feel more compelled to use this treatment option knowing the shorter duration is effective. Research Methods: Participants were second year medical students from the New York Institute of Technology College of Osteopathic Medicine (NYITCOM) who treated their fellow student partner, whom they had diagnosed with an anterior or posterior thoracic or rib tender point. Different laboratory sessions were randomized to hold the mobile point for either 90 or 120 seconds. The entire class was asked to complete an online form that documented the point, the duration of holding the point, and the pre- and post pain level (on a scale of 0-10) of the tender point if there was a true tender point present. In total, there were 392 entries for treatment of a rib tender point (209 treated for 90 seconds and 183 treated for 120 seconds) and 170 entries for treatment of a thoracic tender point (134 treated for 90 seconds and 36 treated for 120 seconds). Data Analysis: Data was gathered via an online questionnaire and analyzed with Excel. Data was collected from 688 students throughout laboratory days during the period of 8/22/2018 - 9/20/2018. Data from 562 students was used for this study and CS treatments that used different durations of time outside the 90 or 120 second intervals were excluded. Paired Sample t tests were used to compare pain before and after CS was used. A simple linear regression model was used to find a possible correlation between pain relief and time. Results: CS was found to be effective at relieving pain when treatment was held for 90 or 120 seconds at either ribs or thoracic tender points (P<.0001). No correlations were found between pain relief for rib CS and time held (P=.295). Furthermore, the same was true when comparing time held of the thoracic tender point location (P=.886). Conclusion: CS was highly effective in reducing pain of both thoracic and rib tender points when treated for 90 or 120 seconds. The difference in duration of treatment, time held, for each tender point was not statistically significant. Limitations of this study include that this was a classroom setting and the rib and thoracic tender points were diagnosed on non-symptomatic students. These findings suggest that CS for rib, as well as thoracic, tender points can be held for 90 seconds instead of 120 seconds. Further research is needed to correlate these findings in the clinical setting.

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