A Comparative Study of Cervical Hysteresis Characteristics after Various Osteopathic Manipulative Treatment (OMT) Modalities

Date of Award


Degree Type


Degree Name

Master of Science in Biomedical Sciences

First Advisor

Michael Kuchera, DO, FAAO

Second Advisor

Alexander Nicholas, DO, FAAO

Third Advisor

Charlotte Greene, PhD


Background: Despite apparent clinical benefits, few objective tissue texture measurements exist documenting change after osteopathic manipulative treatment (OMT). A durometer instrument (Spineliner®, Sigma Instruments, Pittsburgh, PA USA) was used to analyze a portion of the cervical hysteresis curve to measure each segment in Durometers. There are four components used to calculate a Durometer measurement; motoricity (overall dysfunction of a segment), mobility (range of motion), frequency (time to meet either a restrictive or physiologic barrier), and fixation (tissue resistance).

Hypothesis: Cervical tissues will show a quantifiable change in durometer measurements after OMT and no change in the Sham group.

Materials & Methods: A total of 240 subjects were enrolled in this study. The first 200 subjects were equally and randomly assigned to receive Sham, Muscle Energy (ME), Counterstrain (CS), Balanced Ligamentous Tension (BLT), or High-Velocity Low- Amplitude (HVLA) OMT. Subjects were objectively measured using the Spineliner®, diagnosed for somatic dysfunction via palpation, treated with cervical OMT, and finally remeasured with the Spineliner®. An additional 40 subjects were later randomized into the ME and HVLA groups only, using pressure sensitive palpation monitors during the diagnosis and treatment portion.

Results:Statistically significant (p-values

Conclusion: When comparing treated to untreated cervical spines, an appreciable objective change is noted in all four Spineliner® components post OMT and no change in Sham. Although there was a slight change in the Sham arm in regards to mobility; overall, it is evident that not only does a subjective change in the fascia occur post-OMT, but a quantifiable objective change transpires as well

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