Gazzetta Medica Italiana Archivio per le Scienze Mediche, 2021/07, 180(7-8):349-354. doi: 10.23736/S0393-3660.20.04305-3, type of study: ,rct,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.minervamedica.it/en/journals/gazzetta-medica-italiana/article.php?cod=R22Y2021N07A0349)

Keywords:

vestibulo-ocular reflex [2]
head impulse test [2]
osteopathic manipulative treatment [3945]
OMT [3924]
proprioception [19]
randomized controlled trial [947]
vertigo [34]
vestibular disorder [4]
vestibuloocular reflex [1]

Abstract:

BACKGROUND: The vestibulo-ocular reflex (VOR) gain-symmetry is fundamental for gaze control. VOR is a multisensorial integrated reflex that combines vestibular, visual, and proprioceptive inputs. Osteopathic manipulative treatment (OMT) approaches fascial system for the treatment of somatic dysfunction. Fascial system was recently described as body-wide proprioceptive organ. Hence, we performed a single-blinded, with third rater-blinded, three-arm randomized controlled trial to investigate the OMT interaction with VOR-gain-symmetry (VGS) of young healthy subjects, with the aim to evaluate the interaction between: Proprioception, VOR and osteopathic manipulations on fascial-system. METHODS: Participants were treated and examined in the SOMA institute outpatient clinic. According to the randomization list, the subjects received a sham OMT, an OMT and no interventions. The primary endpoint was the VGS variation (VGS01), assessed by video head impulse test, after 30 minutes from the interventions. Besides, VGS after 1 week from the interventions was the secondary endpoint. RESULTS: One-hundred and eighty subjects were randomized; of those, 171 subjects completed the trial. Subjects who underwent OMT reduced them VGS01 asymmetry about 3.89% with a significant difference between groups (P=0.002). At follow-up, subjects who receive OMT maintained a 2.29% asymmetry reduction in contrast to the other groups that presented no delta with baseline (P=0.011). CONCLUSIONS: OMT compared to placebo and time control demonstrated a plausible modulatory effect on VOR asymmetry of healthy subjects, which it might be mediated by proprioceptive inputs and multisensorial integration of vestibular system. A proof-of-concept trial should be performed to test the OMT in chronic dizzy patients.