title: The short-term effect of a lymphatic pump protocol on blood cell counts in nursing home residents with limited mobility: a pilot study.
abstract: BACKGROUND
  Lymphatic pump techniques have the potential to alter blood cell counts and thus enhance immune function in elderly adults with diminished mobility.
  
  
  OBJECTIVE
  To test whether an osteopathic manipulative treatment (OMT) protocol designed to enhance immune function will have an effect on lymphocyte and lymphocyte subset counts compared with a sham control group.
  
  
  METHODS
  The study design was a single-session, randomized, controlled clinical trial comparing a standardized lymphatic pump protocol with a light-touch protocol. Participants were assigned to 1 of 2 groups by using a 1:1 allocation ratio.
  
  
  METHODS
  The study was conducted in 2 rural long-term care facilities in Missouri.
  
  
  METHODS
  Residents in the long-term care facilities who were aged 60 years or older and who were confined to a bed or wheelchair for most of their waking hours. Twenty residents were recruited to participate in the study, and 10 were randomly assigned to each group.
  
  
  METHODS
  Baseline blood samples were obtained. Then each patient received a 6-minute study protocol treatment. Thirty minutes after completion, posttreatment blood samples were obtained. The OMT protocol consisted of 3 osteopathic techniques: myofascial release to the thoracic inlet, the splenic pump, and the pedal lymphatic pump. The light touch protocol was applied to the same body areas as the OMT protocol for 6 minutes.
  
  
  METHODS
  A pretreatment and posttreatment lymphocyte subset panel, complete blood cell count, and automated white blood cell count differential was obtained from each participant.
  
  
  RESULTS
  There was a statistically significant between-group difference in mean change for platelet counts: counts in the OMT group decreased by a mean (standard deviation) of 15,400 (7947) platelets per microliter and the light touch group increased by 4,700 (17,857) platelets per microliter (P=.004). The between-group differences for the mean (standard deviation) absolute lymphocyte cell count, red blood cell count, hemoglobin level, and hematocrit measures all decreased, but the changes were not statistically significant relative to the control group.
  
  
  CONCLUSIONS
  The OMT protocol used in this pilot study modestly reduced platelet counts in nursing home residents with limited mobility.
authors.affiliation: New Jersey Institute for Successful Aging at Rowan University-School of Osteopathic Medicine, Stratford, New Jersey, USA. nolldr@rowan.edu
authors.forename: Donald R
authors.initials: DR
authors.lastname: Noll
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities / Q000534:rehabilitation*; D004906:Erythrocyte Count; D005260:Female; D006801:Humans; D008208:Lymphatic System / Q000502:physiology; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000276:immunology*; D008297:Male; D026301:Manipulation, Osteopathic / Q000379:methods*; D009735:Nursing Homes; D010865:Pilot Projects