The Journal of the American Osteopathic Association, 2013/08, 113(8):e3-e4. doi: 10.7556/jaoa.2013.026, type of study: ,rct,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2013.026/html)

Keywords:

fatigue [47]
medical students [694]
OMT [3924]
osteopathic manipulative treatment [3945]
osteopathic medicine [2109]
pilot study [215]
randomized controlled trial [947]
USA [1752]

Abstract:

Background: The rigors of medical school often induce fatigue, which can negatively impact academic performance and mental health. The psycho-behavioral model of osteopathic manipulative treatment (OMT) suggests utility to reduce fatigue; however, no prior studies have assessed this treatment modality. Hypothesis: The hypothesis of this study was that OMT would reduce self-reported medical student fatigue. Methods: This was an institutional review board–approved blinded longitudinal pilot study. First-year medical students from Lake Erie College of Osteopathic Medicine-Bradenton were recruited by general interest survey. Participants with psychiatric condition, contraindicated health concern, or prior exposure to OMT were excluded prior to enrollment. Thirty students were randomly selected, deidentified, and assigned to 1 of 3 groups: control, nondirected treatment (NDT), or OMT. All participants reported as white and single, with average age of 24 years, and both sexes equally represented. Those in the OMT and NDT groups received 20 minutes of therapy weekly for 4 weeks. Somatic dysfunction related to fatigue is assumed to be primarily in the core. The OMT group treatment focused on the core and included rib raising, anterior cervical fascia release, sternocleidomastoid and levator scapulae inhibition, and occipitoatlantal release. The NDT group treatment included upper and lower extremity balanced ligamentous tension and unwinding, as well as pelvic neuromuscular release. After treatment, groups rested for 10 minutes. The control group received no treatment. Participants completed an electronic Epworth Sleepiness Scale survey at weeks 0, 2, and 4. Data were analyzed retrospectively. Results: There was a significant difference in average Epworth Sleepiness Score (ESS) in the OMT group compared with the control group between surveys 1 and 2 (2.4 and −1.1, P=.01) and surveys 1 and 3 (2.8 and −1.2, P<.01). A significant difference was noted in ESS in the OMT group compared with the NDT group between surveys 1 and 2 (2.4 and −0.56, P=.07) and surveys 1 and 3 (2.8 and −0.1, P=.02). There was no significant difference among any groups between surveys 2 and 3 or between NDT and control groups. Conclusions: This pilot study demonstrates a significant decrease in ESS for the OMT group compared with the control and NTD groups, indicating the potential use of OMT to reduce self-perceived fatigue in medical students. Because of this study's small sample size and lack of participant diversity, further studies are warranted.