Original Contribution  |   May 2020
Weekly Osteopathic Manipulative Treatment to Improve Measures of Sympathetic Tone in Women With Polycystic Ovary Syndrome: A Randomized, Controlled Pilot Study
Author Notes
  • From the Lake Erie College of Osteopathic Medicine in Erie, Pennsylvania (Drs Davis, Hendryx, and Speelman, and Student Doctors Menezes, Bouwer, Menezes, and Patel) and Medical Associates of Erie (Drs Hendryx and Smith). 
  • Financial disclosures: None reported. 
  • Support: This work was funded by AOA Grant #181627705 to Diana Speelman, PhD. This trial was registered with ClinicalTrials.gov on December 25, 2017 (Trial number NCT03383484). 
  •  *Address correspondence to: Diana Speelman, PhD, Lake Erie College of Osteopathic Medicine, 2000 W Grandview Blvd, Erie, PA 16509-1029. Email: dspeelman@lecom.edu
     
Article Information
Endocrinology / Obstetrics and Gynecology / Osteopathic Manipulative Treatment
Original Contribution   |   May 2020
Weekly Osteopathic Manipulative Treatment to Improve Measures of Sympathetic Tone in Women With Polycystic Ovary Syndrome: A Randomized, Controlled Pilot Study
The Journal of the American Osteopathic Association, May 2020, Vol. 120, 310-321. doi:https://doi.org/10.7556/jaoa.2020.051
The Journal of the American Osteopathic Association, May 2020, Vol. 120, 310-321. doi:https://doi.org/10.7556/jaoa.2020.051
Web of Science® Times Cited: 1
Abstract

Background: 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.

Objective: To determine whether weekly osteopathic manipulative treatment (OMT) improves physiologic measures of sympathetic tone in women with PCOS.

Methods: 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.

Results: 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).

Conclusion: 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)

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