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Evaluation of Osteopathic Manipulative Medicine Pretreatment for the Prevention of Acute Mountain Sickness

Journal: The Journal of the American Osteopathic Association Date: 2011/08, 111(8):Pages: 487-488. doi: Subito , type of study: randomized controlled trial

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2011.111.8.487/html)

Keywords:

mountain sickness [2]
OMT [3746]
osteopathic manipulative treatment [3766]
preventive medicine [18]
randomized controlled trial [889]

Abstract:

Context: Acute mountain sickness (AMS) is seen in unacclimatized persons shortly after ascent to high altitude. Its pathogenesis is still unclear but appears multifactoral, arising from inadequate response to hypoxia. Hypothesis: We hypothesized that somatic dysfunction (SD) via increased allostatic load hampers the body's ability to respond, and that osteopathic manipulative treatment (OMT) would improve it. Methods: The TUCCOM institutional review board approved this double-blind, randomized, sham-controlled trial. Sixteen healthy volunteers were randomly assigned to receive OMT or sham therapy. Four subjects served as their own control (half received sham first). Heart rate (HR), respiratory frequency (f), tidal volume (Vt), and hemoglobin O2 saturation (SaO2) were monitored pre- and post-OMT/Sham 48 hours before acclimatization. Subjects were evaluated for location and severity of SD (utilizing the American Academy of Osteopathy's SOAP note), received sham or OMT, and then was reevaluated by 1 DO. No one in the sham group had improvement in their SD. During a 2-day/2-night stay at 12,500 feet (White Mountain Research Station, California); HR, f, Vt, and SaO2 were monitored, and AMS symptoms were evaluated using the Lake Louise Scoring system (LLS). Results: At high altitude, no significant differences were seen in HR, f, Vt, or SaO2 between groups at any time point. At day 2, LLS scores were higher (P<.05) in the OMT group vs sham group (mainly headache and difficulty sleeping). Separate analysis for the 4 repeating subjects showed no significant difference in any parameters, but a trend was noted toward more rapid acclimatization after OMT as measured by the rate of increase in SaO2 (P=.068, day 3). Conclusions: The data obtained from the 4 repeat subjects support our hypothesis that by treating SD, OMT might better prepare the body to adjust to this hypoxic environment. However when compiled with the other subjects, the positive effect of OMT became questionable. Possible explanations include: The inequality in SD severity between groups, while there was no significant difference in SD severity for each of the 4 compared to themselves, the mean SD severity score was significantly higher in the OMT group compared to sham (P<.05); 48 hours may be an insufficient length of recovery time after OMT. There is large individual variability in high altitude response and AMS susceptibility. Further study and a larger number of repeating subjects are needed to evaluate the use of OMT for prevention of AMS and to better understand its effects on the ventilatory response to high altitude.


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