Safety of Osteopathic Cranial Manipulative Medicine as an Adjunct to Conventional Postconcussion Symptom Management: A Pilot Study

Patel, Komal G.; Sabini, Rosanna C.

doi:10.7556/jaoa.2018.061

Cited by 12 publications

(8 citation statements)

References 17 publications

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“…In a follow-up study by Dreyer et al, these techniques again found favorable trends in ICP, CPP, and outcomes when using OMT [ 29 ]. Patel and Sabini demonstrated that cranial OMT was a safe and effective adjunct in the treatment of concussions [ 30 ].…”

Section: Reviewmentioning

confidence: 99%

A Review of Glymphatics and the Impact of Osteopathic Manipulative Treatment in Alzheimer's Disease, Concussions, and Beyond

Marino¹,

Petrova²,

Sweiss³

et al. 2022

Cureus

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Glymph is a fluid that circulates in the brain interstitium and, under pathological conditions, unusually accumulates and enhances the buildup of other noxious molecules. The study of this process of circulation, accumulation, and clearance is called glymphatics. We review the physiology of glymphatics and then dive into recent innovative research surrounding this neurological field of study and how it has applied to mainstream pathological processes, including Alzheimer's disease and spectrums of traumatic brain injury that range from a concussion to chronic traumatic encephalopathy (CTE). Furthermore, we explore the implications of glymphatics and a new and developing frontier of healthcare in space travel; with the advent of a Space Force and the introduction of space travel to consumer markets, this is an exciting time to develop novel techniques in enhancing its safety and optimizing human physiology for best outcomes. Therefore, we also propose that osteopathic manipulative treatment (OMT) plays an intuitive role in the treatment of abnormal glymphatics, as adjunctive therapy in Alzheimer's and CTE, and as a future staple before, during, and after space travel for the benefit of both enhancing healthcare in chronic conditions and advancing the capabilities of the human race in its shining new endeavor.

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Section: Reviewmentioning

confidence: 99%

A Review of Glymphatics and the Impact of Osteopathic Manipulative Treatment in Alzheimer's Disease, Concussions, and Beyond

Marino¹,

Petrova²,

Sweiss³

et al. 2022

Cureus

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show abstract

“…Neither study mentioned the duration of OMT. Patel and Sabini demonstrated that cranial OMT administered for four weeks was a safe and effective adjunct that reduces post concussive symptoms and accelerates recovery [21]. OMT-induced reduction in ICPs is thought to occur via increased CSF outflow from the cranial cavity in addition to improving glymphatic flow and decreasing interstitial brain edema [21].…”

Section: Osteopathic Manipulative Treatment To Improve Glymphatic Funmentioning

confidence: 99%

“…Concussion, which by definition meets the criteria as a minor TBI, can similarly be treated using these OMT techniques. As concussions have been linked to increased brain edema, improving glymphatic function may similarly decrease edema, and promote clearance of toxic metabolites actively being investigated as markers for TBI [9,21]. Being relatively quick and effective, OMT can supplement the treatment of concussions to great effect.…”

Section: Osteopathic Manipulative Treatment In Post Concussive Treatmentmentioning

confidence: 99%

Osteopathic Manipulative Treatment to Optimize the Glymphatic Environment in Severe Traumatic Brain Injury Measured With Optic Nerve Sheath Diameter, Intracranial Pressure Monitoring, and Neurological Pupil Index

Kashyap¹,

Brazdzionis²,

Savla³

et al. 2021

Cureus

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Background Traumatic brain injury (TBI) has a complex pathophysiology that has historically been poorly understood. New evidence on the pathophysiology, molecular biology, and diagnostic studies involved in TBI have shed new light on optimizing rehabilitation and recovery. The goal of this study was to assess the effect of osteopathic manipulative treatment (OMT) on peripheral and central glial lymphatics in patients with severe TBI, brain edema, and elevated intracranial pressure (ICP) by measuring changes in several parameters regularly used in management. Methodology This was a retrospective study at a level II trauma center that occurred in 2018. The study enrolled patients with TBI, increased ICP, or brain edema who had an external ventricular drain placed. Patients previously underwent a 51-minute treatment with OMT with an established protocol. Patients received 51 minutes of OMT to the head, neck, and peripheral lymphatics. The ICP, cerebrospinal fluid (CSF) drainage, optic nerve sheath diameter (ONSD) measured by ultrasonography, and Neurological Pupil Index (NPi) measured by pupillometer were recorded before, during, and after receiving OMT. Results A total of 11 patients were included in the study, and 21 points of data were collected from the patients meeting inclusion criteria who received OMT. There was a mean decrease in the ONSD of 0.62 mm from 6.24 mm to 5.62 mm (P = 0.0001). The mean increase in NPi was 0.18 (P = 0.01). The mean decrease in ICP was 3.33 mmHg (P = 0.0001). There was a significant decrease in CSF output after treatment (P = 0.0001). Each measurement of ICP, ONSD, and NPi demonstrated a decrease in overall CSF volume and pressure after OMT compared to CSF output and ICP prior to OMT. Conclusions This study demonstrates that OMT may help optimize glial lymphatic clearance of CSF and improve brain edema, interstitial waste product removal, NPi, ICP, CSF volume, and ONSD. A holistic approach including OMT may be considered to enhance management in TBI patients. As TBI is a spectrum of disease, utilizing similar techniques may be considered for all forms of TBI including concussions and other diseases with brain edema. The results of this study can better inform future trials to specifically study the effectiveness of OMT in post-concussive treatment and in those with mild-to-moderate TBI.

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“…18 Osteopathic manipulative treatment has been shown to yield significant improvement in symptoms associated with concussion, such as headache and vertigo. 18,19 Additionally, craniosacral therapy and visceral and neural manipulation have produced significant improvement in pain, cervical range of motion, and memory in former professional football players. 20 Recent research also demonstrates the safety of osteopathic cranial manipulative medicine in the treatment of patients with concussion.…”

Section: Osteopathic Structural Examinationmentioning

confidence: 99%

“…20 Recent research also demonstrates the safety of osteopathic cranial manipulative medicine in the treatment of patients with concussion. 19…”

Section: Osteopathic Structural Examinationmentioning

confidence: 99%

Concussion Evaluation and Management: An Osteopathic Perspective

Zwibel¹,

Leder²,

Yao³

et al. 2018

J Am Osteopath Assoc

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Concussions have been increasingly reported over the past decade, but the reported incidence likely minimizes the actual numbers of people affected. Associated symptoms include emotional, somatic, and cognitive complaints, which may be prolonged in patients with certain risk factors. Neurologic examination is necessary to exclude upper motor neuron lesions and thus the need for brain imaging. Cervical conditions are often found concurrently with head injury and displays a similar presentation to concussions. Therefore, determining symptom origin can be problematic. Neuropsychological, oculomotor, and balance evaluations expose specific deficits that can be successfully managed with rehabilitation. Osteopathic assessment of the cranium, spine, sacrum, and thorax for somatic dysfunctions allows for prudent interventions. Patients involved in sports may begin an established graduated return-to-play protocol once cleared by their physician. Concurrently, a parallel return-to-learn program, with applicable academic accommodations, is recommended.

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Safety of Osteopathic Cranial Manipulative Medicine as an Adjunct to Conventional Postconcussion Symptom Management: A Pilot Study

Abstract: Osteopathic cranial manipulative medicine was considered a safe adjunctive treatment option to improve concussion-related symptoms and recovery.

Cited by 12 publications

References 17 publications

A Review of Glymphatics and the Impact of Osteopathic Manipulative Treatment in Alzheimer's Disease, Concussions, and Beyond

A Review of Glymphatics and the Impact of Osteopathic Manipulative Treatment in Alzheimer's Disease, Concussions, and Beyond

Osteopathic Manipulative Treatment to Optimize the Glymphatic Environment in Severe Traumatic Brain Injury Measured With Optic Nerve Sheath Diameter, Intracranial Pressure Monitoring, and Neurological Pupil Index

Concussion Evaluation and Management: An Osteopathic Perspective

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