NMM/OMTOriginal Article

Characteristics and treatment of geriatric patients in an osteopathic neuromusculoskeletal medicine clinic

Alicia A. King, DO, MPH; Jayme Cox, BS, OMS III; Shalini Bhatia, MS; and Karen T. Snider, DO
Notes and Affiliations
Notes and Affiliations

Received: August 24, 2020

Accepted: November 19, 2020

Published: February 18, 2021

  • Alicia A. King, DO, MPH, 

    Private practice, Sikeston, MO, USA

  • Jayme Cox, BS, OMS III, 

    Kirksville College of Osteopathic Medicine, A.T. Still University, Kirksville, MO, USA

  • Shalini Bhatia, MS, 

    Department of Research Support, A.T. Still University, Kirksville, MO, USA

  • Karen T. Snider, DO, 

    Department of Family Medicine, Preventive Medicine, and Community Health, Kirksville College of Osteopathic Medicine, A.T. Still University, Kirksville, MO, USA

Abstract

Context: Osteopathic manipulative medicine (OMM) is an adjunctive treatment approach available to geriatric patients, but few studies provide details about presenting conditions, treatments, and response to osteopathic manipulative treatment (OMT) in that patient population.

Objectives: To provide descriptive data on the presentation and management of geriatric patients receiving OMT at an outpatient osteopathic neuromusculoskeletal medicine (ONMM) clinic.

Methods: Data were retrospectively collected from electronic health records (EHR) at a single outpatient clinic for clinical encounters with patients over 60 years of age who were treated with OMT between July 1, 2016, and June 30, 2019. Records were reviewed for demographic information, insurance type, presenting concerns, assessments, regions treated, OMT techniques used, and treatment response.

Results: There were 9,155 total clinical encounters with 1,238 unique patients found during the study period. More women than men were represented for overall encounters (6,910 [75.4%] vs. 2,254 [24.6%]) and unique patients (850 [68.7%] vs. 388 [31.3%]; both p<0.001). The mean (standard deviation, SD) number of encounters per patient per year was 4.5 (4.0) and increased with increasing age by decade (p<0.001). Medicare was the most common primary insurance (7,246 [79.2%]), with private insurance the most common secondary insurance (8,440 [92.2%]). The total number of presenting concerns was 12,020, and back concerns were most common (6,406 [53.3%]). The total number of assessments was 18,290; most were neuromusculoskeletal (17,271 [94.5%]) and in the thoracolumbar region (7,109 [38.9%]). The mean (SD) number of somatic dysfunction assessments per encounter was 5 (1.7); the thoracic region was the most documented and treated (7,263 [15.8%]). With up to 19 technique types per encounter, the total number of OMT techniques documented across all encounters was 43,862, and muscle energy (7,203 [16.4%]) was the most documented. The use of high-velocity, low-amplitude (HVLA) declined as age increased (p<0.001). The overall treatment response was documented in 7,316 (79.9%) encounters, and most indicated improvement (7,290 [99.6%]).

Conclusions: Our results showed that geriatric patients receiving OMT at our clinic were predominately presenting for neuromusculoskeletal concerns associated with back, neck, and extremity conditions, consistent with national epidemiological data for this population. The most common OMT techniques were also consistent with those used nationally by osteopathic medical students and practicing physicians. Future longitudinal studies are needed to determine the length of time improvement persists and the overall health impact experienced by geriatric patients receiving OMT.

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