NMM/OMTORIGINAL ARTICLE

Concussion-related visual memory and reaction time impairment in college athletes improved after osteopathic manipulative medicine: a randomized clinical trial

Jayme D. Mancini, DO, PhD; Nicole Angelo, DO, MS; Reem Abu-Sbaih, DO; Patricia Kooyman, DO; and Sheldon Yao, DO
Notes and Affiliations
Notes and Affiliations

Received: April 29, 2022

Accepted: August 29, 2022

Published: September 30, 2022

  • Jayme D. Mancini, DO, PhD, 

    Department of Osteopathic Manipulative Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA

  • Nicole Angelo, DO, MS, 

    Department of Osteopathic Manipulative Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA

  • Reem Abu-Sbaih, DO, 

    Department of Osteopathic Manipulative Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA

  • Patricia Kooyman, DO, 

    Department of Osteopathic Manipulative Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA

  • Sheldon Yao, DO, 

    Department of Osteopathic Manipulative Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA

Abstract

Context: Concussion is an acute, transient disruption in brain function due to head injury. Previous studies suggest osteopathic manipulative medicine (OMM) improved recovery from concussion.

Objectives: The hypothesis was that new-onset impairments (NOI) of neurological functions identified by Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) will improve more so after OMM than after concussion-education.

Methods: College athletes presenting to the outpatient academic healthcare center (AHCC) with concussion due to head injury within the preceding 2 weeks were recruited for this IRB-approved, randomized, single-blinded trial. Consented men and women were randomized into groups receiving two OMM treatments or two concussion-education sessions to control for social effects. Preseason, Baseline, ImPACT was compared to Post-Injury scores to determine NOI. Baseline, Post-Injury, and Post-Interventions ImPACTs were compared by analysis of variance (ANOVA, α≤0.05). Post-Injury correlations and mean changes in King-Devick (KD) scores were analyzed.

Results: Post-Injury NOI were found in 77.8% (14/18) men and 85.7% (6/7) women, including ImPACT subscore indices for verbal and visual memory, processing speed (PS), and reaction time (RT). Of those with NOI, mean visual memory recovered by 50.0% following one and by 104.9% (p=0.032) following two OMM treatments in men and by 82.8% (p=0.046) following one treatment in women. Following two interventions, the mean RT in men receiving OMM improved by 0.10 more than education (p=0.0496). The effect sizes of OMM were large (Cohen’s d=1.33) on visual memory and small (Cohen’s d=0.31) on RT.

Conclusions: The NOI in visual memory and RT following concussion significantly improved in the OMM group compared to the education group. Integrating OMM utilizing physical exam and this treatment was a safe individualized approach in athletes with acute uncomplicated concussions. Further research is warranted to improve the utilization of OMM for individuals with concussion.

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