The AAO Journal, 2024/06, 34(2):13. doi: 10.53702/i2375-5717-34.2.7, type of study: ,ppt,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://meridian.allenpress.com/aaoj/article/34/2/7/500955/LBORC-NUFA-Poster-Abstracts-2024-Clinician-amp)

Keywords:

diaphragm [99]
motion [204]
OMT [3924]
osteopathic manipulative treatment [3945]
pilot study [215]
pretest posttest design [240]
ultrasound [56]

Abstract:

Background: No research has been published quantifying OMT’s effect on diaphragm motion. Improved diaphragmatic function is a frequent OMT goal. In 2023, our group presented a pilot study of healthy patients documenting increased diaphragm motion on ultrasound. Objective/Hypothesis: This follow-up, prospective, pilot-study compared how OMT may affect diaphragm motion measured by ultrasound in a group of unhealthy participants versus healthy. We hypothesized OMT would have a greater effect in increasing diaphragm motion in unhealthy participants. Methods: A convenience sample of 9 healthy and 8 unhealthy volunteers ages >18 were recruited. Unhealthy participants included subjects with a history of chronic pain or systemic disease. Ultrasound assessment was completed by a trained ONMM3 resident including measurements of the bilateral zone of apposition (ZOA) and right diaphragm dome. Subjects underwent a principle-based osteopathic approach, by a second ONMM3 resident, using area of greatest restriction screening and a modified MOPSE protocol. Repeated measures ANOVA was used to evaluate differences between group means, pre-treatment and post-treatment means, and interaction effect between treatment and group. Results: Post-OMT measurements demonstrated a statistically significant increase in left-sided ZOA excursion on maximum inhalation in the unhealthy group (1.249 cm) compared to healthy group (-0.687 cm) yielding a p-value=0.0384. Discussion/Conclusion: Our results suggest a principle-based OMT sequence can increase diaphragm motion more in unhealthy subjects than in healthy. Project limitations include size, nonrandomization, non-homologous unhealthy group, and unblinded. A larger follow-up study including a more homologous unhealthy group may resolve a sampling error which may have led to the discordant decrease in left ZOA excursion in the healthy group and allow for finding right-sided statistically significant effects as right hemidiaphragm motion is smaller than left.