Movement Disorders, 2024/09, 39(S1):S853–S854. doi: 10.1002/mds.29956, type of study: ,cct,,,,,,,,,,,,,,,,,,,

Full text    (https://movementdisorders.onlinelibrary.wiley.com/doi/10.1002/mds.29956)

Keywords:

conference abstract [127]
controlled clinical trial [324]
lower extremities [27]
muscle characteristics [1]
OMT [3924]
osteopathic manipulative treatment [3945]
Parkinsons disease [1]

Abstract:

Objective: To define the mechanism of Osteopathic Manipulative Treatment (OMT) in decreasing symptomology and improving gait in Parkinson's disease (PD) patients. Background: A key symptom of Parkinson's disease (PD) is muscle rigidity, believed to contribute to the pain that patients experience. Therefore, it is imperative to treat this to manage PD. OMT uses the relationship between the neuromusculoskeletal system and the rest of the body to restore functionality, remove barriers to motion, decrease muscle stiffness and promote healing. Prior studies have shown improved motor function and gait performance after OMT. Methods: Subjects with Parkinson's disease (PD) with lower extremity pain were recruited and assigned to OMT or sham group. Muscle properties, joint ROM, and gait were assessed pre and immediately post treatment. The lower extremity functionality scale (LEFS) was used to measure difficulty with activities of daily living. The OMT group (n=6) received muscle energy technique (MET) to the hip, knee, and ankle bilaterally. MET involves active participation by engaging specific muscles while the practitioner applies a counterforce. The goal of MET is to correct biomechanical dysfunction, improve joint mobility, and reduce muscle tightness or spasm. The sham group (n=5) underwent ROM of identical joints without reaching the physiologic barrier. One week post session, participants were reassessed via the LEFS and a post-study survey. Results: OMT group had significantly higher stiffness in the left gastrocnemius lateral (p=0.042) and lower relaxation in the left gastrocnemius medial (p=0.045) compared to sham group. There were no significant changes in ROM. Timed-up and go (TUG) showed a significant decrease in the OMT group (p=0.012). 5 subjects (2 OMM; 3 sham) had a significant change in their LEFS score. Conclusions: The observed trends in muscle properties may stem from the lower extremity muscles being immediately activated after MET while passive ROM allows for less rigor. The improvement in TUG demonstrates an improvement in functional mobility following OMT. These findings establish a foundation for the potential avenues that MET may have in reducing muscle stiffness, alleviating pain, enhancing functionality, and reducing neuromusculoskeletal symptoms in individuals with PD.