Journal of Osteopathic Medicine, 2024/12, 124(12):A32. doi: 10.1515/jom-2024-2000, type of study: ,css,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2024-2000/html)

Keywords:

anxiety [71]
cross sectional study [894]
diaphragm [99]
fascia [313]
thoracic spine [98]

Abstract:

Context: Multiple studies have discussed the fascia’s influence in regulating the hypothalamic-pituitary axis and the autonomic nervous system, ultimately affecting neuropsychiatric health (1). In the realm of osteopathic medicine, there is growing curiosity about the presence and severity of somatic dysfunctions (SDs) in fascia and its surrounding structures that can manifest in different clinical subtypes of anxiety–such as state and trait (2). State anxiety is the proclivity of one to perceive a situation as threatening and transiently experience apprehension, tension, and dread (3). Trait anxiety is the stable inclination to experience state anxiety to varying external stimuli (3). Objective: To examine how state-trait anxiety manifests in one’s SDs by comparing Osteopathic Structural Exam (OSE) findings to scores taken from the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) questionnaire. Methods: A cross-sectional study was performed with 200 Touro medical students across the Harlem, Middletown and Montana campuses. Participants were recruited by email, and the study excluded those with any clinically diagnosed psychiatric conditions. Each participant completed the STICSA and subsequently underwent an OSE conducted by student investigators. Tissue texture changes, asymmetries, and restricted ranges of motion within thoracic structures and fascia were quantified based on presence and severity. Numerical scores collected from the STICSA and the OSE were analyzed using Pearson’s coefficient. Data was later stratified to compare selected thoracic structures’ SDs with somatic and cognitive components of state and trait anxiety using a correlation matrix. Results: Significant positive correlations were found between thoracic inlet (R= 0.998, p= 0.038) and thoracic spine (R= 1, p= 0.003) SD totals and state anxiety STICSA totals. Similarly, positive correlations were found between thoracic inlet (R= 1, p= 0.013) and thoracic spine (R= 0.997, p= 0.048) SD totals and state-cognitive anxiety STICSA totals. There was no significant correlation found between any structure and trait anxiety STICSA totals. Conclusion: Though correlations between state-trait anxiety and osteopathic SDs varied among campuses, association of SDs from specific structures such as thoracic inlet, sternum, and thoracic vertebrae held significance across all three. By honing in on the impacts that fascia and its surrounding structures have on one’s physical and mental health, osteopathic physicians are better able to holistically treat their patients through more interpersonal, cost-effective, and sustainable modalities such as Osteopathic Manipulative Medicine.