Preventative Osteopathic Manipulative Treatment (OMT) and the Nursing Home Patient
Condition: General Health Status
Study type: Interventional

Summary: 
      This pilot research study will investigate the possible benefit that elderly nursing home
      patients may receive from regular Osteopathic Manipulative Medicine (OMM) care during the
      winter months. The study is based on the osteopathic philosophies that structure and function
      are interrelated and that the body has self-healing mechanisms. The body is expected to have
      optimized ability to heal itself "when all its parts are in place" (AT Still). This study is
      looking at subject population for whom their ability to take care of themselves is diminished
      by their underlying diseases. Based on the osteopathic philosophies, optimization of the
      nursing home patient's physical structure through osteopathic manipulative treatment (OMT)
      should enhance their body's homeostatic mechanisms. This study is assessing the validity of
      these philosophies by looking at the effect of OMT on the global health of these individuals.
    

Detailed description: 
      This study will randomly assign 36 nursing home patients from two Kirksville nursing homes
      into three groups of twelve subjects: 1) treatment as usual (TAU) control group; 2) light
      touch (LT) group, and 3) standard OMT group.

      This study will begin with rolling admission of volunteer nursing home patients starting in
      October 2009. Subjects in the LT and OMT group would receive focused musculoskeletal
      evaluations twice a month for 5 months (10 visits). The OMT group would also receive an OMT
      protocol each visit that would specifically address optimization of homeostatic mechanisms -
      balancing autonomic nervous system and improving lymphatic drainage- along with OMT that
      would specifically target somatic dysfunction found on that day's evaluation. The LT group
      subjects would receive a light touch protocol meant to simulate OMT. The TAU group will
      receive no intervention. The protocol period will end for all subjects by March 2010. All
      osteopathic examinations, assessments, and treatments will be performed at the participating
      nursing homes.

      Throughout the protocol period, at the end of the winter (March 2010), and three months later
      (June 2010), retrospective chart reviews will be conducted on all subjects. All cause
      morbidity and mortality for all subjects will be assessed by monitoring their medications,
      health history changes, and hospitalizations.
    

Intervention name(s): Osteopathic Manipulative Treatment; Light Touch
Intervention type(s): Procedure; Procedure
Intervention description(s): Focused osteopathic musculoskeletal exam; paraspinal muscle inhibition and/or soft tissue kneading or stretching; rib raising and or rib mobilization; abdominal diaphragm release technique; abdominal mesenteric/colon release; thoracic inlet release technique; hip flexion/extension range of motion; shoulder range of motion with pectoral traction; cervical paraspinal muscle inhibition and/or soft tissue kneading or stretching; suboccipital release technique; specific OMT of significant somatic dysfunction (variable).; Focused osteopathic musculoskeletal exam; contact ribs to simulate rib raising and paraspinal muscle inhibition; contact lower rib margin to simulate abdominal diaphragm release; palpate the four quadrants of the abdomen to simulate abdominal mesenteric/colon release; contact shoulders to simulate thoracic inlet release; contact suboccipital region to simulate thoracic inlet release.
Other intervention name(s): OMT; OMM; Osteopathic Manipulative Medicine; Manipulation; Sham manipulation; Placebo manipulation
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Osteopathic; Manipulation; Preventative; Elderly; Nursing Home; Prevention: General Health Status