NMM/OMTORIGINAL ARTICLE
Abstract
Context: Fascia is a ubiquitous and continuous connective tissue containing receptors involved in nociception, proprioception, and the autonomic nervous system. In conjunction with muscle, the myofascial system plays an important role in body mechanics and connectivity. Beyond structure and function, research implicates the myofascial system in the pathophysiology of depression, anxiety, and stress. As understanding of these multidimensional conditions evolves, there is increasing emphasis on integrated treatment approaches such as osteopathic manipulative treatment (OMT). The myofascial system presents a promising target for standardized treatment that bridges the gap between physical and psychological.
Objectives: The objective of this study was to investigate the effects of a standardized myofascial and lymphatic OMT protocol on body awareness, dissociation, and mood symptoms related to anxiety, depression, and stress.
Methods: This was a prospective, randomized, parallel-assignment, open-label, interventional study with 31 volunteer students and staff from an osteopathic medical college. An external party randomly assigned volunteers to one of two groups: OMT intervention or control. Triplanar diagnoses of the occipitoatlantal (OA), cervicothoracic (CT), thoracolumbar (TL), and lumbosacral (LS) regions were obtained and recorded for all subjects for 4 consecutive weeks during a weekly scheduled session. The experimental group was treated with direct myofascial release and a lymphatic pedal pump. Primary outcome measures were scores on the State-Trait Anxiety Inventory (STAI Form Y2), Depression Anxiety Stress Scale (DASS), and Scale of Body Connection (SBC) at baseline (T1), after two treatments (T3), and after four treatments (T4). The effects of OMT on mood and body connection over time were modeled with generalized estimating equations (GEEs). Cohen’s d effect size was also determined for the between-group comparisons.
Results: A total of 31 participants volunteered for the study. Due to scheduling conflicts, 29 participants (21 females, 72.4 % and 8 males, 27.6 %), with ages ranging from 22 to 54 (M=30.9 years, SD=9.4) were randomly assigned to OMT intervention (n=14) or control (n=15). Medical students comprised 72.4 % (n=21) of the population, whereas the remaining 27.6 % (n=8) were faculty or staff employed by the medical school. The average BMI for female participants was 26.7 (SD=4.9), and 26.4 (SD=4.8) for males. The prevalence of the psychiatric conditions among the participants was high, with 17 (58.6 %) participants reporting a psychiatric diagnosis at some point in their life, with only 3 of the 17 (17.7 %) reporting remission. Significant improvements in trait anxiety (p<0.001), depression (p=0.028), body awareness (p=0.046), and body dissociation (p=0.003) occurred in the experimental group over all time periods. Experimental group improvements in DASS (T1–T4; MD=−9.87; p=0.005; 95 % CI [–16.69, −3.04]) and stress (T1–T4; MD=−3.93; p=0.020; 95 % CI [–7.24, −0.63]) were observed after four treatments.
Conclusions: A standardized myofascial and lymphatic OMT protocol may have a positive effect on trait anxiety, depression, stress, body awareness, and body dissociation.