Research Project
6192143
DESCRIPTION: (adapted from Investigator's abstract) The specific aims for this project are: 1) to evaluate the relationship between impaired segmental vertebral mobility and locally altered bone mineral density (BMD); 2) to define a clinical significance of palpatory diagnosis of segmental mobility; and 3) to develop methodology for defining outcomes of spinal manipulation. The major hypotheses to be tested are: 1) Impairment of segmental vertebral mobility is associated with localized decreases in BMD in the lumbar spine. 2) Persistent somatic dysfunction results in measurable changes within the bony skeleton. and 3) Palpatory diagnosis can be used to identify levels/vertebrae of the spine at risk for decreased BMD. Men and women ages 20-40, within the age range when peak bone mass is attained, will be recruited. Eligible subjects will receive a focused osteopathic musculoskeletal exam on the initial visit, at four weeks and at eight weeks. Motion testing of the lumbar spine (L1-L4) will be defined in terms of the limitations or severity of mobility and tenderness. Each segment will be rated according to overall severity of restriction, as defined by the American Osteopathic Association, on a scale of 1-4. The study group will consist of those subjects who demonstrate persistent somatic dysfunction, defined as a severity of restriction score of 2 or higher present at the same segment during all three OME's. Subjects in the study group will receive a bone density DEXA scan following their eight-week osteopathic musculoskeletal exam. The severity of restriction will be correlated with the BMD T-scores from the DEXA scan. This research intends to demonstrate that persistent impairment of segmental vertebral mobility results in locally decreased BMD and that palpatory diagnosis is capable of predicting the location of such changes. The ability to identify a potentially reversible cause of localized decreased BMD and the development of methodology to measure outcomes of osteopathic manipulative treatments (OMT) will enable the investigators to proceed with a full-scale randomized clinical trial on the use of OMT to effectively restore vertebral mobility and to determine whether this restoration of mobility results in increased BMD.
