Osteopathic Manipulative Treatment for Allostatic Load Lowering

Participants

• Number: 2 people (1 female and 1 male, age 22-23 years)

• Criteria of inclusion: MS students (stressful environment).

• Criteria of exclusion: past exposure to OMT, possible contraindications to OMT or delicate health situations (eg, pregnancy), planned to change habits such as exercise, diet, medication, meditation, yoga, taiji or supplement use within the last 4 months.
• Groups of study: participants were the control of each otehr in this before-after study

Interventions and evaluations

• The study included 4 visits 2-4 weeks apart, always at the same time the of day.
• Assessment of perceived stress via TICS and blood pressure at each visit, before and after treatment,
• Evaluation, at visits 1 and 4, of other biomarkers related to allostatic load: diurnal urine cortisol and catecholamines; glycated hemoglobin, DHEA, HDL, high sensitivity C-reactive protein; BMI, waist-to-hip ratio.
  • Participants were instructed to take urine samples 4 times over a 24-hour period (upon awakening, 2 hours after awakening, in the early evening, and at nighttime) both before and after treatment.
  • To evaluate the allostatic load, a score from 0 to 20 was defined, giving each biomarker a score between 0 (no risk) and 1 (at risk).
• 3 30-minutes sessions of OMT over 7 weeks, at visits 1, 2 and 3.
• OMT: personalized treatment based on autonomic, circulatory and biomechanical assessment
  • techniques used: suboccipital release, rib raising, high-velocity low-amplitude, myofascial release, balanced ligamentous tension and muscle energy, thoracic inlet myofascial release, thoraco-abdominal diaphragm myofascial release
• OMT performed by the same osteopathic physician, supported by an assistant to check the consistency of the techniques between treatments and the duration of the sessions.

Results

• Allostatic load: the score for allostatic load decreased in both participants: from 7 to 4, and from 9 to 7.
  The first participant saw a decrease in morning norepinephrine and evening and nighttime adrenaline and an increase in HDL, although there was an increase in cortisol.
  The second participant saw a decrease in nocturnal cortisol and diastolic and systolic blood pressure and an increase in HDL, although there was an increase in norepinephrine.
• Perceived stress: perceived stress decreased from 18 to 15 in the first participant and from 40 to 13 in the second participant.

Discussion

Given that OMT acts on the treatment of somatic dysfunctions to improve the body’s self-healing capabilities, it is conceivable that it has positive influences on the allostatic load, a model widely used in recent years to define the general state of health and the risk of developing systemic pathologies. In this study, OMT was shown to reduce allostatic load and perceived stress in two students in the first semester of an advanced college program.

The increase in HDL found in both participants was interesting given that the literature shows HDL as the single best lipid predictor of allostasis. The result was also interesting because it is the first study to detect such an effect of OMT. Given the high incidence of cardiovascular disease, it is a result that certainly needs to be investigated with more rigorous studies.

The decrease in perceived stress was in line with previous studies and, therefore, confirms the importance of OMT as a stress-regulating intervention and the need for more in-depth studies.

Obviously, the presence of only two participants and the lack of a sham-treated control group greatly limits the conclusions of the study. Furthermore, student participation was voluntary, which may have introduced an important bias into the research.

Therefore, more rigorous studies are needed from a methodological point of view, with decidedly larger samples and well-structured control groups. Also, it would be helpful to include more blood pressure assessments to better evaluate the effect of OMT.