title: The use of osteopathic manipulative treatment as adjuvant therapy in patients with peripheral arterial disease.
abstract: Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis associated with impaired endothelial function and intermittent claudication is the hallmark symptom. Hypothesizing that osteopathic manipulative treatment (OMT) may represent a non-pharmacological therapeutic option in PAD, we examined endothelial function and lifestyle modifications in 15 intermittent claudication patients receiving osteopathic treatment (OMT group) and 15 intermittent claudication patients matched for age, sex and medical treatment (control group). Compared to the control group, the OMT group had a significant increase in brachial flow-mediated vasodilation, ankle/brachial pressure index, treadmill testing and physical health component of life quality (all p<0.05) from the beginning to the end of the study. At univariate analysis in the OMT group there was a negative correlation between changes in brachial flow-mediated vasodilation and IL-6 levels (r=-0.30; p=0.04) and a positive one between claudication pain time and physical function score (r=0.50; p=0.05). In conclusion, despite the relatively few patients in our study, these results suggest that OMT significantly improves endothelial function and functional performance in intermittent claudication patients along with benefits in quality of life. This novel treatment combined with drug and lifestyle modification might be an effective alternative to traditional training based on exercise.
authors.affiliation: Internal Medicine, Angiology and Atherosclerosis, University of Perugia, Italy. rlomba@unipg.it
authors.forename: Rita
authors.initials: R
authors.lastname: Lombardini
authors.forename: Simona
authors.initials: S
authors.lastname: Marchesi
authors.forename: Luca
authors.initials: L
authors.lastname: Collebrusco
authors.forename: Gaetano
authors.initials: G
authors.lastname: Vaudo
authors.forename: Leonella
authors.initials: L
authors.lastname: Pasqualini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ciuffetti
authors.forename: Matteo
authors.initials: M
authors.lastname: Brozzetti
authors.forename: Graziana
authors.initials: G
authors.lastname: Lupattelli
authors.forename: Elmo
authors.initials: E
authors.lastname: Mannarino
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D004730:Endothelium, Vascular; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy / Q000534:rehabilitation*; D008297:Male; D016555:Matched-Pair Analysis; D026201:Musculoskeletal Manipulations; D016491:Peripheral Vascular Diseases / Q000534:rehabilitation*; D010807:Physical Endurance; D010865:Pilot Projects; D011788:Quality of Life