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Purpose of Study: Previous Osteopathic manipulative treatment (OMT) research has shown evidence of increased lymphatic movement resulting in increased leukocyte and cytokine flow. One study even showed increased antibody titer response in patients when used in conjunction with the Hepatitis B vaccine. Given previous studies, our group conducted a year-long longitudinal randomized controlled clinical trial to evaluate the ability of OMT to improve the COVID-19 vaccine immune response. Methods Used: Subjects were randomized into either the control arm or OMT intervention arm. OMT consisted of myofascial release of the thoracic inlet, pectoral traction, diaphragm release with MFR, splenic pump, and thoracic pump applied the day of and the day following each vaccination session. All subjects in each group received the Pfizer mRNA COVID-19 vaccine. All subjects had blood drawn on day 0 (1st vaccine), day 7, day 21 (2nd vaccine), days 28, 90, 210, and 365. Anti-spike IgG immunoglobulin titers (AS IgG) were measured at all time points for all subjects. Side effects, adverse events, and medication usage in response to the vaccines or OMT was documented. Breakthrough cases with symptomology and medication usage was documented for both groups. The study was approved by the WesternU IRB committee, protocol #FB21/IRB026. Summary of Results: Data for 91 subjects were analyzed with 41 male (45.1%) and 50 female (54.9%). Age distribution was comparable between the two groups. Side effects and medication usage reported by the subjects was similar between groups (p>0.1). AS IgG measured at baseline distinguished between previously infected individuals and those naive to COVID-19, regardless of OMT treatment. For all time points measured, the average AS IgG in subjects trended higher in OMT group than control group. Two-way ANOVA analysis showed statistical significance at 1 week after 2nd injection (p<0.001) in the COVID-19 naive population. 13 symptomatic breakthrough infections were reported in the control group and 12 in the OMT group. Length of symptoms were reported as 8.36 +/- 4.60 days (control) and 4.62 +/- 2.60 days (OMT) (p<0.05). Length of medication usage was 3.64 +/- 3.58 days (control) and 1.23 +/- 1.24 days (OMT) (p<0.1). Conclusion(s): Both groups had comparable side effects after COVID-19 vaccination with no adverse events linked to OMT, indicating that OMT is a safe adjunct that can be used with COVID-19 vaccination. The data showed an enhanced immune response by OMT, as evidenced by increased levels of AS IgG in previously naive subjects. Although both control and OMT groups had similar rates of symptomatic breakthrough infection, the OMT data shows reduced length of symptoms and medication duration in this population when compared to control breakthrough infections. This study is underpowered for statistical significance at each time point and future vaccination studies should recruit more patients to confirm the trends seen here.
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As America continues to face the opioid epidemic, numerous people have made great strides in receiving formal treatment for their opioid use disorder (OUD). This research seeks to examine the effects of providing osteopathic manipulative treatment (OMT) along with traditional OUD pharmacological methods in providing results for patients. By using prior research on OMT techniques, we were able to uncover how effective OMT can be in reducing the time and discomfort associated with seeking opioid recovery. Osteopathic manipulative treatment, in combination with traditional pharmacology, was associated with reduction of somatic pain, higher success with medication-assisted treatment and lower costs. This research also highlights the importance of OMT in the era of COVID-19 social distancing, as well as special considerations when treating those with trauma histories associated with their disorder. We argue the benefit of OMT in combination with pharmacological methods can be successful at reducing the overall burden of prior OUDs.Copyright © 2023 by the American College of Osteopathic Family Physicians. All rights reserved.
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BACKGROUND: Falling is a major trauma that can occur with aging, leading to very significant psychological and physical health effects with financial and societal consequences. It is therefore essential to explore therapeutic treatments that can reduce this risk. Some recognized effective treatments exist, concerning in particular the re-education of the muscles of the lower limbs. However, to our knowledge, none of them focus on the cervical spine although the latter is located at an essential physiological crossroads. Manual therapy, which has already demonstrated its impact on pain and balance parameters in the elderly, could be a painless and non-invasive tool of choice in addressing this problem. METHODS: Interventional study (not related to a health product), monocentric, prospective, controlled, randomized double-blind (patient and evaluator performing the measurements). The experiment will take place over three measurement periods on D0, D7 and D21. On D0 subjects will be randomized in 2 groups: experimental and placebo group. Both groups will be assessed on: Short Physical Performance Battery test score, walking speed, lower limb strength, balance, heart rate variability and cervical spine strength and mobility. Then the experimental group will receive a myofascial release protocol applied to the cervical spine and the placebo group will receive a placebo light touch protocol. The intervention will be followed by the same measurements as before. This schedule will be reproduced on D7. On D21, only one assessment will be done. DISCUSSION: This study started in 2020 but could not go beyond the inclusion phase due to the COVID pandemic. It is envisaged that recruitment could resume during 2022. TRIAL REGISTRATION: Registered by the Comité de Protection des Personnes-Sud Méditerranée; under the title "Prévention des troubles de l'équilibre chez le senior: influence de la thérapie manuelle appliquée au rachis sur les paramètres statiques et dynamiques¼, n° 19.12.27.47.259 in date of February 4, 2020. Registered by ClinicalTrials.gov ID: NCT05475652; under the title « The Influence of Manual Therapy Applied to the Cervical Spine in the Prevention of Balance Disorders in the Elderly (ManEq)".
Subject(s)
COVID-19 , SARS-CoV-2 , Aged , Cervical Vertebrae , Humans , Pandemics/prevention & control , Prospective Studies , Randomized Controlled Trials as TopicABSTRACT
Introduction: The present study aimed to investigate the effects of Myofascial Release Therapy (MRT) on cardiorespiratory functions in patients with COVID-19. Materials and Methods: A total of 36 patients with COVID-19 (intervention group=20, controls=16) were included in the present study. The patients in the intervention group participated in a single session of suboccipital, anterior thoracic and sternal, anterior cervical, and diaphragm myofascial release techniques, plus respiratory physiotherapy. The controls just received respiratory physiotherapy. Before-after assessments included recording heart rate, systolic and diastolic blood pressure, respiratory rate, blood oxygen saturation, chest expansion, and breathing comfort. Results: There was a significant reduction in the heart rate and ease of breathing in the intervention group (P=0.04, P=0.02;respectively);also, the diastolic blood pressure increased significantly in the control group (P=0.02). Compared to the controls, the ease of breathing decreased significantly in the intervention group (P=0.03). Conclusion: Myofascial release techniques of the neck, thoracic, and diaphragm, along with respiratory physiotherapy, could immediately affect heart rate and ease of breathing and prevent increasing diastolic blood pressure. If a patient with COVID-19 is stable, pulmonary physiotherapists may consider using these techniques while monitoring cardiopulmonary function. © 2021 The Authors.
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Background: Many studies have shown that changes in lumbar flexion angle and the pelvic inclination angle can be affected by the shortening of the lumbar muscles, which can cause low back pain. Decreased lumbar flexion angle and pelvic inclination angle can cause or exacerbate low back pain by disrupting the lumbo-pelvic rhythm. Purpose: This study aimed to use myofascial release techniques as a specialized treatment on muscle tissue to cause muscles to reach the optimal length and improve lumbar flexion angle and pelvic inclination angle, and thus improve low-back pain. Setting: Non-specific low back pain patients, Tarbiat Modares University, Iran. Participants: 30 chronic non-specific low back pain participants were randomly assigned into two groups. Research Design: This is a randomized control trial. Interventions: The myofascial release group (n=15) underwent 4 sessions of myofascial release treatment based on Myer's techniques, and the control group (n=15) underwent 10 sessions of routine electrotherapy for two weeks. Main Outcome Measures: Before starting the intervention and after the last treatment session, both groups were evaluated by the lumbar flexion angle with a flexible ruler, calculating the pelvic inclination angle by a trigonometric formula, and VAS measured the pain score of the participants. Results: The results of the paired t test showed that, after treatment in both groups, the severity of pain and lumbar flexion angle changed significantly (p ≤ .001). However, the pelvic inclination angle was changed considerably only in the myofascial release group, and we did not see significant changes in the control group (p = .082). Also, the independent sample t test results to examine the between-group changes showed that changes in the myofascial release group were significantly different from the control group (p ≤ .000). Also, the effect size shows the large effect of the myofascial release technique compared to the control group (effect size ≥ 1.85). Conclusion: The present study results showed that myofascial release techniques in patients with low back pain could help decrease pain intensity and increase lumbar flexion and pelvic inclination angle. Based on the present study results, myofascial release can be a treatment to correct posture in patients with chronic non-specific, low back pain. Due to the prevalence of the COVID-19 pandemic, it was not possible to evaluate the long-term effects of treatment.
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Background: Respiratory involvement is a common consequence of COVID-19; changes in cardiorespiratory parameters of these patients during respiratory rehabilitation program are very important. Previous studies showed that myofascial release therapy (MFRT) could affect the respiratory muscle and adjunct fascia. Purpose: The aim of this study was to evaluate the effects of MFRT techniques and respiratory physiotherapy, in comparison with respiratory physiotherapy alone, on improving cardiorespiratory parameter in patients with COVID-19. Setting: A hospital affiliated to Tehran University of Medical Sciences in Tehran, Iran, from February to July 2021. Participants: Fifty patients with COVID-19 participated in this study. Research Design: A single-blind, randomized control design. Intervention: The patients with COVID-19 randomly assigned to an intervention group who received respiratory physiotherapy combined with MFRT or a control group receiving respiratory physiotherapy alone. Main Outcome Measures: Heart rate, systolic and diastolic blood pressure, respiration rate, oxygen saturation, chest expansion, and ease of breathing were assessed at baseline and after the first and third session of treatment. Dyspnea and fatigue perception and 6-minute walking were assessed at baseline and at the end of treatment. Patient's thoughts about the treatment were examined through the 4-point Likert scale. Results: The ANOVAs found significant time effect for ease of breathing, dyspnea perception (F = 32.33, p < .01 and F = 11.72, p < .01, respectively). Also significant time by group interaction was found for chest expansion at xiphoid level (F = 4.02, p = .02). Conclusions: The present study provided evidence that both programs could result in improving ease of breathing and dyspnea perception, although the inclusion of MFR techniques into a respiratory physiotherapy program did not result in better outcomes in cardiorespiratory function of patients with COVID-19.
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The proposed study was focused on the search for the effective method of post-COVID rehabilitation by means of Pilates training and myofascial release. Materials and methods. Fifteen females took part in the study in December 2020. Participants were divided into experimental (n = 9) and control (n = 6) groups. Severity of COVID infection varied within mild to severe stages. 7 participants had 5 to 25 % lung damage. Anthropometric measurements (body length, body weight, chest excursion) and spirometry data (vital capacity, forced vital capacity) were obtained, which demonstrated a decrease in external respiration in terms of expiratory force, maximal breathing capacity and the Tiffeneau index. For a month, the experimental group performed daily breathing exercises and exercises to improve chest mobility and respiratory muscles. These exercises were accompanied by myofascial release. Results. The proposed method of rehabilitation with the elements of Pilates training and myofascial release allowed to significantly improve pulmonary function (expiratory force, maximal breathing capacity and the Tiffeneau index) in the experimental group. No significant changes were recorded in the control group. Conclusion. Pilates training and myofascial release demonstrated their effectiveness and were recommended for post-COVID rehabilitation.