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1.  ACUTE IMPROVEMENT IN HEMODYNAMIC CONTROL AFTER OSTEOPATHIC MANIPULATIVE TREATMENT IN THE THIRD TRIMESTER OF PREGNANCY 
Objectives
The physiological changes that occur during pregnancy, including increased blood volume and cardiac output, can affect hemodynamic control, most profoundly with positional changes that affect venous return to the heart. By using Osteopathic Manipulative Treatment (OMT), a body-based modality theorized to affect somatic structures related to nervous and circulatory systems, we hypothesized that OMT acutely improves both autonomic and hemodynamic control during head-up tilt and heel raise in women at 30 weeks gestation.
Design
One hundred subjects were recruited at 30 weeks gestation.
Setting
The obstetric clinics of UNTHealth in Fort Worth, Texas.
Intervention
Subjects were randomized into one of three treatment groups: OMT, placebo ultrasound, or time control. Ninety subjects had complete data (N=25, 31 and 34 in each group respectively).
Main outcome measures
Blood pressure and heart rate were recorded during 5 min of head-up tilt followed by 4 min of intermittent heel raising.
Results
No significant differences in blood pressure, heart rate or heart rate variability were observed between groups with tilt before or after treatment (p>0.36), and heart rate variability was not different between treatment groups (p>0.55). However, blood pressure increased significantly (p=0.02) and heart rate decreased (p<0.01) during heel raise after OMT compared to placebo or time control.
Conclusions
These data suggest that OMT can acutely improve hemodynamic control during engagement of the skeletal muscle pump and this was most likely due to improvement of structural restrictions to venous return.
doi:10.1016/j.ctim.2013.08.008
PMCID: PMC3893141  PMID: 24280470
Blood pressure; hypotension; tilt; muscle pump; osteopathic manipulation
2.  Suboccipital Decompression Enhances Heart Rate Variability Indices of Cardiac Control in Healthy Subjects 
Abstract
Objectives
Osteopathic manipulative treatment (OMT) focused on the upper cervical spine is theorized to affect the function of the vagus nerve and thereby influence the parasympathetic branch of the autonomic nervous system. This study was designed to determine the acute effect of upper cervical spine manipulation on cardiac autonomic control as measured by heart rate variability.
Design
Nineteen healthy, young adult subjects underwent three different experimental interventions administered in random order: cervical OMT, sham manipulation, and time control. Six minutes of electrocardiographic data were collected before and after each intervention, and heart rate variability was assessed by both time-domain and frequency-domain measures.
Results
No differences in resting heart rate or any measure of heart rate variability were observed between the baseline periods prior to each intervention. The OMT protocol resulted in an increase in the standard deviation of the normal-to-normal intervals (0.12±0.082 seconds, p<0.01), an increase in the high frequency spectral power (p=0.03), and a decrease in the low/high frequency spectral ratio (p=0.01) relative to the sham and time control conditions. No significant differences between sham and time control were observed (p>0.11 for all variables).
Conclusions
These data support the hypothesis that upper cervical spine manipulation can acutely affect measures of heart rate variability in healthy individuals.
doi:10.1089/acm.2011.0031
PMCID: PMC3576914  PMID: 22994907
3.  Osteopathic Manipulative Treatment of Back Pain and Related Symptoms during Pregnancy: A Randomized Controlled Trial 
Objective:
To study osteopathic manipulative treatment (OMT) of back pain and related symptoms during the third trimester of pregnancy.
Study design:
A randomized, placebo-controlled trial was conducted to compare usual obstetrical care (UOBC) and OMT (UOBC+OMT), UOBC and sham ultrasound treatment (UOBC+SUT), and UOBC only. Outcomes included average pain levels and the Roland Morris-Disability Questionnaire (RMDQ) to assess back-specific functioning.
Results:
Intention-to-treat analyses included 144 subjects. The RMDQ scores worsened during pregnancy; however, back-specific functioning deteriorated significantly less in the UOBC+OMT group (effect size, 0.72; 95% CI, 0.31-1.14; P=.001 vs. UOBC only; and effect size, 0.35; 95% CI, −0.06-0.76; P=.09 vs. UOBC+SUT). During pregnancy, back pain decreased in the UOBC+OMT group, remained unchanged in the UOBC+SUT group, and increased in the UOBC only group, although no between-group difference achieved statistical significance.
Conclusion:
Osteopathic manipulative treatment slows or halts the deterioration of back-specific functioning during the third trimester of pregnancy.
doi:10.1016/j.ajog.2009.07.057
PMCID: PMC2811218  PMID: 19766977
osteopathic manipulative treatment; pregnancy; back pain; physical functioning; randomized controlled trial
4.  OSTEOPAThic Health outcomes In Chronic low back pain: The OSTEOPATHIC Trial 
Background
Osteopathic manipulative treatment (OMT) and ultrasound physical therapy (UPT) are commonly used for chronic low back pain. Although there is evidence from a systematic review and meta-analysis that OMT generally reduces low back pain, there are no large clinical trials that specifically assess OMT efficacy in chronic low back pain. Similarly, there is a lack of evidence involving UPT for chronic low back pain.
Methods
The OSTEOPAThic Health outcomes In Chronic low back pain (OSTEOPATHIC) Trial is a Phase III randomized controlled trial that seeks to study 488 subjects between August 2006 and June 2010. It uses a 2 × 2 factorial design to independently assess the efficacy of OMT and UPT for chronic low back pain. The primary outcome is a visual analogue scale score for pain. Secondary outcomes include back-specific functioning, generic health, work disability, and satisfaction with back care.
Conclusion
This randomized controlled trial will potentially be the largest involving OMT. It will provide long awaited data on the efficacy of OMT and UPT for chronic low back pain.
Trial registration
, NCT00315120
doi:10.1186/1750-4732-2-5
PMCID: PMC2386783  PMID: 18439282

Results 1-4 (4)