Davis SE, Hendryx J, Menezes C, Bouwer S, Menezes H, Patel V, Bostick Smith CA, Speelman DL. Weekly Osteopathic Manipulative Treatment to Improve Measures of Sympathetic Tone in Women With Polycystic Ovary Syndrome: A Randomized, Controlled Pilot Study. J Am Osteopath Assoc 2020;120(5):310–321. doi: https://doi.org/10.7556/jaoa.2020.051.
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Polycystic ovary syndrome (PCOS), a common hormone disorder affecting reproductive and metabolic health of reproductive-age women, was shown in a previous study from these authors to be associated with increased sympathetic tone. Increased sympathetic tone contributes to long-term health risks for cardiovascular disease and promotes PCOS pathogenesis.
To determine whether weekly osteopathic manipulative treatment (OMT) improves physiologic measures of sympathetic tone in women with PCOS.
In the second phase of a larger study from this author group, 25 women with PCOS, aged 22 to 43 years, living in Erie, Pennsylvania, were recruited to participate in a randomized, controlled evaluation of OMT intervention. Participants were randomly assigned to either an OMT intervention or control group. The OMT group received weekly manipulation of Chapman points and rib-raising for viscerosomatic reflexes associated with the ovaries, adrenal glands, and heart for 12 consecutive weeks. Physiologic measures of sympathetic tone were collected, along with metabolic, endocrine, and reproductive measurements, both before the 3-month intervention and within 1 week of completing the intervention. Measurements included heart rate and blood pressure at rest and after 15 minutes of aerobic exercise, heart rate recovery after exercise, resting heart rate variability, serum androgen levels, body mass index, fasting blood glucose and insulin levels, and menstrual cycle length.
Nineteen women completed the study. Comparing pre- and postintervention parameters, women with PCOS in the OMT intervention group experienced an improvement in postexercise systolic blood pressure (135.8 vs 129.1 mm Hg) and a trend toward heart rate recovery (23.2 vs 29.4 seconds). No significant improvements were found in the control group or in any other physiologic parameters measured. No significant improvements were found in the endocrine, metabolic, or reproductive parameters measured, although free testosterone was slightly lower after 3 months of weekly OMT (5.69 vs 4.64 pg/mL).
Improvements in sympathetic tone after OMT suggest that weekly manipulation of Chapman points and viscerosomatic reflexes can be a useful adjunctive therapeutic option for women with PCOS. (ClinicalTrials.gov No. NCT03383484)
a Statistical significance was set at P<.05, with P values between .05 and .10 considered trending.
Abbreviations: BMI, body mass index; PCOS, polycystic ovary syndrome.
a Data are given as mean (SD) unless otherwise indicated.
b Statistical significance was set at P<.05, with P values between .05 and .10 considered trending.
Abbreviations: bpm, beats/min; EKG, electrocardiogram; HR, heart rate; HRR, heart rate recovery; NN, normal-to-normal intervals on QRS complexes during heart examination; PCOS, polycystic ovary syndrome; SBP, systolic blood pressure.
Abbreviations: A4, androstenedione; DHEA, dehydroepiandrosterone; mFG, modified Ferriman-Gallwey; BAI, Beck Anxiety Index; BDI-II, Beck Depression Index II; BG, blood glucose; BMI, body mass index; HOMA-IR, homeostatic model assessment of insulin resistance; PCOS, polycystic ovary syndrome; T, testosterone.
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