At the University of Minnesota/St. Cloud Hospital Family Medicine Residency, we are very interested in keeping up-to-date on the current medical literature, including what’s new in osteopathic manipulation. There are so many new and exciting studies coming out on OMT! We have highlighted a recent study here for your information. -- Jennifer Holmes, DO, Osteopathic Program Director

Feature Article - Summer 2011
Falls are one of the most common causes of morbidity and mortality in elderly patients leading to fractures, intracranial bleeding, loss of independence, depression, and death. Elderly patients have less capability to maintain equilibrium than younger patients. Combine that inability to maintain equilibrium with presbyopia, peripheral neuropathy from diabetes, loss of muscle mass, and other age-related changes, the elderly are a great risk of having a life-changing fall.

Researchers in Texas have begun studying the effects of OMT in balance of healthy elderly patients. According to Dr. Lopez and et al., a person is felt to have poor balance if they have too much anterioposterior (AP) and mediolateral (ML) sway while standing. AP sway is particularly important because AP instability is thought to be associated with higher likelihood of falls. They conducted a pilot study of the amount of AP and ML sway in patients who have received osteopathic manipulation (n=20) compared to elderly patients who have not received the manipulation (n=20). The amount of sway was measured by a force platform while the patient did three balance tests.

Cervical manipulation was part of the protocol because cervical spine proprioceptors may be impacted by impingement from conditions like cervical stenosis. The temporal bone can impact the vestibular system greatly because of its close proximity. This is why craniosacral therapy was used to treat the patients. The protocol included soft tissue and myofascial release to T1-L5, sacral rock, myofascial release to the shoulders and scapula, correction of somatic dysfunction of the cervical spine using several different techniques, OA treatment, condylar decompression, venous sinus treatment, V-spread, frontal/parietal lifts, and CV4. The treatments were performed weekly by the same physician for four weeks.

Dr. Lopez and his team found that the ML and AP sway was less in the elderly patients who received the manipulation compared to the group of elderly patients who did not receive the manipulation. This study may open the door to further, more patient-oriented research of the effects of OMT on elderly falls.

Lopez, Daniel, DO; Hollis King, DO, PhD; Knebl, Janice, DO; et. al.; Effects of Comprehensive Osteopathic Manipuative Treatment on Balance in Elderly Patients: A Pilot Study; JAOA; June 2011, vol. 111, no. 6