The AAO Journal, 2024/06, 34(2):12. 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:

lymphatic system [58]
OMT [3924]
osteopathic manipulative treatment [3945]
pilot study [215]
pretest posttest design [240]
thoracic duct [6]
ultrasound [56]

Abstract:

Background: Many OMT approaches target the body to create optimal function of the lymphatic system. One of the foundational principles of these treatments is the removal of restriction of the central lymphatic vessels. Hodges et al has shown increased lymphatic flow in animal models using lymphatic techniques; however, there is no human data if OMT changes the structure of lymphatic vessels. Recent studies have shown how to image the thoracic duct (TD) using ultrasound (US) with Hinton et al demonstrating a change in TD diameter with positional changes. These new protocols can allow us to measure the TD before and after OMT. Objectives: We propose that lymphatic directed OMT causes a significant change in the diameter of the TD as measured by US. Methods: This pilot study enrolled a convenience study of 7 healthy men and women aged 23-31. TD diameter was measured, using US protocols established in the literature. The Osteopathic assessment and treatment were performed by an ONMM3 resident using a principle-based protocol from the writings and teachings from Gordon Zink, DO. This included targeting the thoracic inlet, abdominal diaphragm, and major transition zones. Paired t-test were utilized to compare pre/post TD measurements. Results: We saw a 0.18 mm increase in TD diameter (p value 0.045, difference ranged from 0-0.6mm) after OMT. Discussion: We demonstrated that lymphatic directed OMT can change TD diameter in young healthy individuals. This data suggests that OMT is removing restrictions of terminal lymphatic vessels as part of its mechanism of action. Project limitations include participant number, nonrandomization, healthy subjects, and unblinded. This pilot attempt suggests a feasible measurement method and treatment approach for study expansion.