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Manipulative therapy
64 ComplementaryTherapies in Medicine to either a treatment (n = 6) or a control group (n = 6). One subject, randomized to the treatment group, withdrew prior to the intervention. Intervention: All 11 subjects received standard orthopedic care including serial radiographs and clinical assessments through 12 weeks following injury. The treatment group received a hypnotic intervention (individual sessions, audiotapes) designed to augment fracture healing. Main outcome measures: Radiological and orthopaedic assessments of fracture healing 12 weeks following injury and hypnotic subjects' final questionnaires and test scores on the Hypnotic Induction Scale. Results: Results showed trends toward faster healing for the hypnosis group through week 9 following injury. Objective radiographic outcome data revealed a notable difference in fracture edge healing at 6 weeks. Orthopaedic assessments showing trends toward better healing for hypnosis subjects through week 9 included improved ankle mobility; greater functional ability to descend stairs; lower use of analgesics in weeks 1, 3, and 9; and trends toward lower self-reported pain through 6 weeks. Conclusion: Despite a small sample size and limited statistical power, these data suggest that hypnosis may be capable of enhancing both anatomical and functional fracture healing, and that further investigation of hypnosis to accelerate healing is warranted.
MANIPULATIVE THERAPY Wells MR, Giantinoto S, D'Agate D, Areman RD, Fazzini EA, Dowling D, Bosak A. Institution: Department of Biomechanics and Bioengineering, New York College of: Osteopathic Medicine, New York Institute of Technology, Old Westbury 11568-8000, USA. Standard osteopathic manipulative treatment
acutely improves gait performance in patients with Parkinson's disease. Journal of the American Osteopathic Association 1999; 99(2): 92-98 Patients with Parkinson's disease exhibit a variety of motor deficits which can ultimately result in complete disability. The primary objective of this study was to quantitatively evaluate the effect of osteopathic manipulative treatment (OMT) on the gait of patients with Parkinson's disease. Ten patients with idiopathic Parkinson's disease and a group of eight age-matched normal control subjects were subjected to an analysis of gait before and after a single session of an OMT protocol. A separate group of 10 patients with Parkinson's disease was given a sham-control procedure and tested in the same manner. In the treated group of patients with Parkinson's • disease, statistically significant increases were observed in stride length, cadence, and the maximum velocities of upper and lower extremities after treatment. There were no significant differences observed in the control groups. The
data demonstrate that a single session of an OMT protocol has an immediate impact on Parkinsonian gait. Osteopathic manipulation may be an effective physical treatment method in the management of movement deficits in patients with Parkinson's disease.
T'AI CHI
Young DR, Appel LJ, Jee S, Miller ER 3rd. Institution: Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA. The effects of aerobic exercise and T'ai Chi on blood pressure in older people: results of a randomized trial. Journal of the American Geriatrics Society 1999; 47(3): 277-284 Objective: To compare the effects on blood pressure of a 12-week moderate-intensity aerobic exercise programme and a T'ai Chi programme of light activity. Design: A randomized clinical trial. Setting: A suburban clinic in the Baltimore, MD, area. Participants: Sixty-two sedentary older adults (45% black, 79% women, aged _> 60 years) with systolic blood pressure 130-159 mm Hg and diastolic blood pressure <95 mm Hg (not on antihypertensive medication), h~teJa,ention: Participants were randomized to a 12-week aerobic exercise programme or a light intensity T'ai Chi programme. The goal of each condition was to exercise 4 days per week, 30 minutes per day. Measurements: Blood pressure was measured during three screening visits and every 2 weeks during the intervention. Estimated maximal oxygen uptake and measures of physical activity level were determined at baseline and at the end of the intervention period. Results: Mean (SD) baseline systolic and diastolic blood pressures were 139.9 (9.3) lama Hg and 76 (7.3) nun Hg, respectively. For systolic blood pressure, adjusted mean (SE) changes during the 12-week intervention period were -8.4 (1.6) mm Hg and -7.0 (1.6) mm Hg in the aerobic exercise and T'ai Chi groups, respectively (each within-group P <0.001" between- group P = 0.56). For diastolic blood pressure, corresponding changes were -3.2 (1) mm Hg in the aerobic exercise group and -2.4 (1) mm Hg in the T'ai Chi group (each within-group P <0.001; between-group P = 0.54). Body weight did not change in either group. Estimated maximal aerobic capacity tended to increase in aerobic exercise (P = 0.06) but not in T'ai Chi (P = 0.24). Conclusions: Programmes of moderate intensity aerobic exercise and light exercise may have similar effects on blood pressure in previously sedentary older individuals. If additional trials confirm these results, promoting light intensity activity could have substantial public health benefits as a means to reduce blood pressure in older aged persons.
MANIPULATIVE THERAPY Wells MR, Giantinoto S, D'Agate D, Areman RD, Fazzini EA, Dowling D, Bosak A. Institution: Department of Biomechanics and Bioengineering, New York College of: Osteopathic Medicine, New York Institute of Technology, Old Westbury 11568-8000, USA. Standard osteopathic manipulative treatment
acutely improves gait performance in patients with Parkinson's disease. Journal of the American Osteopathic Association 1999; 99(2): 92-98 Patients with Parkinson's disease exhibit a variety of motor deficits which can ultimately result in complete disability. The primary objective of this study was to quantitatively evaluate the effect of osteopathic manipulative treatment (OMT) on the gait of patients with Parkinson's disease. Ten patients with idiopathic Parkinson's disease and a group of eight age-matched normal control subjects were subjected to an analysis of gait before and after a single session of an OMT protocol. A separate group of 10 patients with Parkinson's disease was given a sham-control procedure and tested in the same manner. In the treated group of patients with Parkinson's • disease, statistically significant increases were observed in stride length, cadence, and the maximum velocities of upper and lower extremities after treatment. There were no significant differences observed in the control groups. The
data demonstrate that a single session of an OMT protocol has an immediate impact on Parkinsonian gait. Osteopathic manipulation may be an effective physical treatment method in the management of movement deficits in patients with Parkinson's disease.
T'AI CHI
Young DR, Appel LJ, Jee S, Miller ER 3rd. Institution: Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA. The effects of aerobic exercise and T'ai Chi on blood pressure in older people: results of a randomized trial. Journal of the American Geriatrics Society 1999; 47(3): 277-284 Objective: To compare the effects on blood pressure of a 12-week moderate-intensity aerobic exercise programme and a T'ai Chi programme of light activity. Design: A randomized clinical trial. Setting: A suburban clinic in the Baltimore, MD, area. Participants: Sixty-two sedentary older adults (45% black, 79% women, aged _> 60 years) with systolic blood pressure 130-159 mm Hg and diastolic blood pressure <95 mm Hg (not on antihypertensive medication), h~teJa,ention: Participants were randomized to a 12-week aerobic exercise programme or a light intensity T'ai Chi programme. The goal of each condition was to exercise 4 days per week, 30 minutes per day. Measurements: Blood pressure was measured during three screening visits and every 2 weeks during the intervention. Estimated maximal oxygen uptake and measures of physical activity level were determined at baseline and at the end of the intervention period. Results: Mean (SD) baseline systolic and diastolic blood pressures were 139.9 (9.3) lama Hg and 76 (7.3) nun Hg, respectively. For systolic blood pressure, adjusted mean (SE) changes during the 12-week intervention period were -8.4 (1.6) mm Hg and -7.0 (1.6) mm Hg in the aerobic exercise and T'ai Chi groups, respectively (each within-group P <0.001" between- group P = 0.56). For diastolic blood pressure, corresponding changes were -3.2 (1) mm Hg in the aerobic exercise group and -2.4 (1) mm Hg in the T'ai Chi group (each within-group P <0.001; between-group P = 0.54). Body weight did not change in either group. Estimated maximal aerobic capacity tended to increase in aerobic exercise (P = 0.06) but not in T'ai Chi (P = 0.24). Conclusions: Programmes of moderate intensity aerobic exercise and light exercise may have similar effects on blood pressure in previously sedentary older individuals. If additional trials confirm these results, promoting light intensity activity could have substantial public health benefits as a means to reduce blood pressure in older aged persons.