Mazzeo S, Silverberg C, Oommen T, Moya D, Angelo N, Zwibel H, Mancini J, Leder A, Yao SC. Effects of Osteopathic Manipulative Treatment on Sleep Quality in Student Athletes After Concussion: A Pilot Study. J Am Osteopath Assoc 2020;120(9):615–622. doi: https://doi.org/10.7556/jaoa.2020.100.
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Impaired sleep quality is among many symptoms observed in patients with a concussion and may predispose a patient to a prolonged recovery course and a later return to their daily activities. Studies have suggested that osteopathic manipulative treatment (OMT) may play a role in improving sleep quality.
To investigate how OMT may play a role in the management and overall healing process in patients with a concussion by improving sleep quality.
Data were collected from a randomized, controlled study on OMT and concussion (of which this study represents 1 arm) to investigate the effects of OMT vs concussion education counseling on sleep quality in student athletes with a concussion. Student athletes with no medical history of neurodegenerative disease who presented to the New York Institute of Technology College of Osteopathic Medicine Academic Healthcare Center with a concussion following a sport-related injury were enrolled in the study. Participants received OMT intervention or standard counseling on how to care for a concussion during their first and second visits. Participants rated their symptoms, including sleep quality, on the validated scale Sport Concussion Assessment Tool 5th Edition at 3 consecutive visits during 1 week. The mean sleep quality score within and between the OMT and education groups before each of 2 interventions and at the third visit were compared and analyzed using the Mann-Whitney U test.
Thirty participants were enrolled in the study. Total symptom data showed a stronger, significant correlation with sleep scores than with other symptoms. Participants receiving OMT (n=16) reported overall 80% and 76% improvement in sleep quality from pre-OMT values to their second and third visits, respectively. Participants who had an educational intervention (n=14) reported a 36% and 46% improvement from pre-OMT values to their second and third visits, respectively.
The beneficial relationship trend between OMT and sleep quality in patients with a concussion was not statistically significant. Owing to the limitations of this study, further research with a larger population and sham control participants is warranted. (Clinicaltrials.gov No. NCT02750566)
Abbreviations: BLT, balanced ligamentous tension; BMT, balanced membranous tension; CV4, compression of the fourth ventricle; FPR, facilitated positional release; HVLA, high-velocity low-amplitude; MET, muscle energy technique; OA, occipitoatlantal; OM, occipitomastoid; OMT, osteopathic manipulative treatment.
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