Effectiveness of Osteopathic Manipulative Medicine vs Concussion Education in Treating Student Athletes With Acute Concussion Symptoms.

Sheldon C Yao, Hallie Zwibel, Nicole Angelo, Adena Leder, Jayme Mancini
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Abstract

Context: Concussion, a type of mild traumatic brain injury, is a disruption in normal brain function due to head injury. New-onset symptoms from concussion vary, likely depending on the areas of the head and neck affected; they can be severe and debilitating. Current treatment options are limited and difficult to individualize. Osteopathic manipulative medicine (OMM) can aid musculoskeletal restrictions that can potentially improve concussion symptoms.

Objective: To assess concussion symptom number and severity in participants with concussion who received either OMM or an educational intervention.

Methods: A randomized controlled trial was conducted at the New York Institute of Technology Academic Health Care Center. Patients presenting to the center with concussion-like symptoms due to recent head injury within the previous 7 days provided consent and were randomized into 2 intervention groups, receiving either 1 OMM treatment (n=16) or 1 concussion education intervention (n=15). Participants were assessed before and after the intervention with the validated Symptom Concussion Assessment Tool fifth edition (SCAT-5) for quantification of number of symptoms and their severity. Collected data were analyzed using the Mann-Whitney U test and the repeated-measures analysis of variance.

Results: Thirty-one participants were enrolled in the study; after 1 control participant was excluded due to incomplete data, 30 patient records were analyzed. The OMM intervention group had a significant decrease in symptom number (P=.002) and symptom severity (P=.001) compared with the concussion education group.

Conclusion: When used in the acute setting, OMM significantly decreased concussion symptom number and severity compared with concussion education. This study demonstrates that integration of OMM using a physical examination-guided, individualized approach is safe and effective in the management of new-onset symptoms of uncomplicated concussions. (Clinicaltrials.gov No. NCT02750566).

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骨科手法治疗与脑震荡教育在治疗有急性脑震荡症状的学生运动员方面的效果对比。
背景:脑震荡是轻度脑外伤的一种,是由于头部受伤导致的大脑正常功能紊乱。脑震荡引起的新发症状各不相同,可能取决于头部和颈部受影响的部位;这些症状可能很严重,会使人衰弱。目前的治疗方案有限,而且难以个性化。整骨疗法(OMM)可以帮助肌肉骨骼限制,从而有可能改善脑震荡症状:评估接受整骨疗法或教育干预的脑震荡患者的脑震荡症状数量和严重程度:纽约理工学院学术医疗保健中心进行了一项随机对照试验。因最近7天内头部受伤而出现类似脑震荡症状的患者在征得同意后被随机分为2个干预组,分别接受1次OMM治疗(16人)或1次脑震荡教育干预(15人)。参与者在干预前后均接受了有效的症状脑震荡评估工具第五版(SCAT-5)评估,以量化症状数量及其严重程度。收集的数据采用曼-惠特尼 U 检验和重复测量方差分析进行分析:31名参与者参加了研究;由于数据不完整,1名对照组参与者被排除在外,之后对30份病历进行了分析。与脑震荡教育组相比,OMM干预组的症状数量(P=.002)和症状严重程度(P=.001)均有显著下降:结论:与脑震荡教育相比,在急性期使用 OMM 可显著减少脑震荡症状的数量和严重程度。这项研究表明,在治疗无并发症脑震荡的新发症状时,采用体格检查指导的个性化方法整合 OMM 是安全有效的。(Clinicaltrials.gov编号:NCT02750566)。
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JOURNAL OF THE AMERICAN OSTEOPATHIC ASSOCIATION
JOURNAL OF THE AMERICAN OSTEOPATHIC ASSOCIATION MEDICINE, GENERAL & INTERNAL-
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期刊介绍: JAOA—The Journal of the American Osteopathic Association is the official scientific publication of the American Osteopathic Association, as well as the premier scholarly, peer-reviewed publication of the osteopathic medical profession. The JAOA"s mission is to advance medicine through the scholarly publication of peer-reviewed osteopathic medical research. The JAOA"s goals are: 1. To be the authoritative scholarly publication of the osteopathic medical profession 2. To advance the traditional tenets of osteopathic medicine while encouraging the development of emerging concepts relevant to the profession"s distinctiveness
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