The AAO Journal, 2022/06, 32(2):8. doi: 10.53702/2375-5717-32.2.8, type of study: ,cr,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Free full text   (https://meridian.allenpress.com/aaoj/article/32/2/8/482676/LBORC-NUFA-Poster-Abstracts-2022-Residents)

Keywords:

ALS [130]
amyotrophic lateral sclerosis [6]
case report [736]
dysphagia [10]
motor neuron disease [1]
OMT [3925]
osteopathic manipulative treatment [3946]

Abstract:

Introduction/Background: Amyotrophic Lateral Sclerosis (ALS), the most common form of acquired motor neuron disease, is characterized by insidiously progressive neurodegeneration of motor neurons. There is currently no cure. Treatment is focused on symptomatic management and end-of-life comfort care. Dysphagia is a major disease complication and can lead to death by asphyxiation, aspiration pneumonia, nutrient deficiency, or dehydration. One pilot study has found potential benefit of using Osteopathic Manipulative Treatment (OMT) in ALS, but results were inconclusive due to small sample size. Case: WG, a 72M with medical history of atrial fibrillation and newly diagnosed ALS (with symptoms starting 5-10 years ago), presented to outpatient OMT clinic at NYITCOM. He is a newly retired critical care physician, retiring due to worsening, debilitating, full-body pain (worse in lower extremities), headaches, weakness, altered gait and dysphagia. He was prescribed a Combivent inhaler for daily tussive episodes following aspiration of food or water. Osteopathic Structural Exam (OSE) was notable for restrictions in the atlanto-occipital joint, hyoid bone, sacral base, and diaphragm. OMT was performed with Osteopathic Cranial Manipulative Medicine, Myofascial release and Balanced Ligamentous Tension. Results: After 10 OMT visits, patient had observable improvements in OSE. He reported significant symptomatic relief, including decreased dysphagia and Combivent use. Headaches and lower extremity pain were decreased in frequency and intensity, allowing him to wear socks and pants again after two years. Discussion: OMT was safely used in this patient, showing significant improvements in dysphagia, pain, OSE and quality of life (QOL). Use of OMT in ALS patients to reduce dysphagia is a compelling area of research to explore, as reducing dysphagia can increase QOL and lifespan in this patient population.