title: Effects of comprehensive osteopathic manipulative treatment on balance in elderly patients: a pilot study.
abstract: BACKGROUND
  Falls, many of which are caused by balance problems, are a leading cause of injuries in elderly persons. Few studies have investigated osteopathic manipulative treatment (OMT) for patients with balance problems.
  
  
  OBJECTIVE
  To test whether an OMT protocol with an emphasis on cranial manipulation can improve vestibular balance control structures and postural stability in a healthy elderly population.
  
  
  METHODS
  A pilot prospective clinical trial.
  
  
  METHODS
  Research laboratories of the University of North Texas Health Science Center Texas College of Osteopathic Medicine in Fort Worth.
  
  
  METHODS
  Forty healthy elderly patients aged 65 or older were enrolled and separated into an OMT group and a control group. Owing to the recruitment process and limited time for the study, the first 20 patients to enroll were in the OMT group, and the next 20 were in the control group. Patients were excluded if they had a condition that could impair balance.
  
  
  METHODS
  The OMT protocol comprised 7 OMT techniques applied weekly by the same osteopathic physician before balance tests. Patients in the control group received no treatment.
  
  
  METHODS
  Patients were asked to stand on a force plate and to perform 3 balance tests: (1) eyes open, (2) eyes closed, and (3) a modified Romberg test. The center of pressure between their feet was recorded for 30 seconds. The average center of pressure displacement for each test was used to determine anteroposterior (AP) sway and mediolateral (ML) sway. Balance tests were performed each week for 4 weeks. Tests were performed at the same time of day as the first test.
  
  
  RESULTS
  Changes in AP sway values between visits 1 and 4 were as follows: eyes open, -0.72 and 0.75 mm for the control and OMT groups, respectively; eyes closed, -0.49 and 0.44 mm; and Romberg test, -0.17 and 0.52 mm. The changes in ML sway values between visits 1 and 4 were as follows: eyes open, -0.58 and 0.07 mm for the control and OMT groups, respectively; eyes closed, -0.21 and 0.03 mm; and Romberg test, -0.15 and 0.39 mm. The OMT group had significantly reduced sway for the eyes-open test after 4 visits (P=.001).
  
  
  CONCLUSIONS
  The OMT protocol used in the present study improved the postural stability of healthy elderly patients, as measured by changes in sway values. (ClinicalTrials.gov number NCT01153412).
authors.affiliation: Osteopathic Heritage Foundation, Physical Medicine Core Research Facility, University of North Texas Health Science Center, Fort Worth, TX 76107-2729, USA. ripatter@hsc.unt.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Lopez
authors.forename: Hollis H
authors.initials: HH
authors.lastname: King
authors.forename: Janice A
authors.initials: JA
authors.lastname: Knebl
authors.forename: Victor
authors.initials: V
authors.lastname: Kosmopoulos
authors.forename: Deraan
authors.initials: D
authors.lastname: Collins
authors.forename: Rita M
authors.initials: RM
authors.lastname: Patterson
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000367:Age Factors; D000368:Aged; D000375:Aging; D002985:Clinical Protocols; D006801:Humans; D026301:Manipulation, Osteopathic / Q000379:methods*; D010865:Pilot Projects; D004856:Postural Balance; D011446:Prospective Studies