Measuring the effects of Osteopathic Manipulative Treatment on range of motion in subjects with postural asymmetries in the posterior view: A potential implication for people with lateral spinal curvatures

Philadelphia

Poor posture is a part of most people’s lives whether they are aware of it or not. While correcting a postural asymmetry has options, many interventions are painful, inconvenient, and/or socially stigmatized. For instance, back braces and surgery are typical ways in which to improve posture when the underlying problem is a spinal lateral curvature. However, Osteopathic Manipulative Treatment (OMT) may be a potential noninvasive treatment for spinal lateral curvatures, and my thesis research is centered on testing whether or not OMT improves range of motion and/or changes the overall shape of subjects with spinal lateral curvatures or postural asymmetries. The research I am conducting studies the efficacy of OMT on postural asymmetries using morphometric shape analysis. Morphometrics is able to detect differences in shape and pieces out the principle components of the shape; therefore it has the potential to determine whether OMT changes the shape of an individual’s back and increases range of motion. In my project, I am analyzing pre and post OMT treatment digital photographs taken of patients who received treatment in 2014 as part of joint study with the Department of Bio-Medical Sciences and the Department of Osteopathic Manipulative Medicine at PCOM. Photographs were prepared by placing landmarks on specific loci on their backs, which are then interpreted by the morphometrics programs. The morphometric shape analysis program enables us to visualize treatment progression through graph and statistical analysis. I present the results here on subjects who have completed nine treatments, specifically analyzing range of motion indicated by side bending to the left. The results for Bony landmark palpations showed the greatest change in shape when comparing groups of patients from a sham protocol and a treatment protocol, before the first day of treatments and after the ninth treatment. The first five Principle Component Analysis (PCA) Eigenvalues accounted for 84.674% indicating that landmarks five, six, seven, and ten had the most variation. In addition to PCA analysis, a warp analysis was done which shows the energy bends in the data and the same landmarks were indicated to shift the greatest amount. Furthermore, and analysis of shape as a function of the treatments was performed using the Canonical Variates Analysis (CVA). Results of the CVA for subjects as a function of treatment group, indicated that the treatment group had the largest change shift in morphospace on the graph, while sham did not shift as much. The same analyses were performed for semi-landmarks which traced the silhouette of the patients. Results indicate the semi data show that a majority of the shape change occurred around semi landmarks 31-41. These semi landmarks were on the left interior trunk of the subject. Landmark 31 was located on the left hip and 41 was under the left armpit region. These results may present an increase in range of motion for side bending to the left since these semi landmarks where indicative of the left side of the subjects. The CVA also showed a large shift in morphospace for OMT treated patients as opposed to sham patients.