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The Somatic Connection  |   May 2016
Postural Balance and Gait Improved With an Osteopathic Intervention in a Special Needs Population
Author Notes
  • University of California, San Diego School of Medicine 
Article Information
The Somatic Connection   |   May 2016
Postural Balance and Gait Improved With an Osteopathic Intervention in a Special Needs Population
The Journal of the American Osteopathic Association, May 2016, Vol. 116, 325-326. doi:10.7556/jaoa.2016.065
The Journal of the American Osteopathic Association, May 2016, Vol. 116, 325-326. doi:10.7556/jaoa.2016.065
Vismara L, Cimolin V, Galli M, Grugni G, Ancillao A, Capodaglio P. Osteopathic manipulative treatment improves gait pattern and posture in adult patients with Prader-Willi syndrome [published online September 12, 2015]. Int J Osteopath Med. 2016;19:35-43. doi:10.1016/j.ijosm.2015.09.001. 
Researchers at the Istituto Auxologico Italiano in Piancavallo, Italy, evaluated the effects of a single application of osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) on patients with Prader-Willi syndrome (PWS). This condition is a relatively rare genetic disorder affecting a part of chromosome 15. Major clinical features of PWS are short stature, obesity, scoliosis, developmental delay, muscular hypotonia, reduced physical activity, and gait and postural disorders. Study participants were 10 patients with genetically confirmed PWS. Two control groups were used: one of 15 obese individuals and another of 20 normal-weight healthy participants. Obese participants were recruited among other inpatients in rehabilitation, and healthy participants were recruited from the institute staff. Exclusion criteria included history of cardiovascular and neurologic conditions or musculoskeletal complaints, vision loss, vestibular impairments, symptoms related to intracranial hypertension or use of neuro-active drugs, pregnancy, and substance abuse. 
The outcome measures were 3-dimensional gait analysis and static posturography. The PWS participants were assessed on admission and 24 hours after OMTh. One-time assessments were made with the control participants. 
Participants in the PWS and obese groups received conventional treatment, but the PWS participants additionally received OMTh, which was delivered in a single 45-minute session. This was a pragmatic OMTh session delivered before any other intervention or rehabilitation by a registered osteopath. Somatic dysfunction was assessed, and the major sites addressed by OMTh were the spine, legs, dural system, and thoracic respiratory diaphragm. Procedures used included “thrust,” muscle energy, strain-counterstrain, and myofascial release. 
Before treatment, the PWS group had a significantly slower walk, shorter stride length, reduced cadence, and reduced postural stability compared with both control groups. After treatment, the PWS participants showed significant improvement in knee and ankle kinematics with greater ground push-off force. Postural stability also improved significantly, with reduced anteroposterior and mediolateral sway. The authors noted the small sample size as a limitation, and they suggested that if verified by further research, OMTh would show benefit and reduced cost in a comprehensive rehabilitation program. 
This study was selected for review as demonstrating a possible benefit of OMTh in patients with a genetic disorder and to highlight the further use of gait analysis and posturography in osteopathic research.