VCOM View Magazine Vol. 13 | No. 1

Al Kozar, DO, professor of osteopathic manipulative medicine and sports medicine at VCOM-Virginia

guidance to apply a dextrose solution to the TLF to separate its tissue layers and restore any glide restriction that might be contributing to causing a patient’s pain. Additional funding from the American Osteopathic Association will enable an 18-month study on how osteopathic manipulative treatments can do essentially the same thing—relieve the restriction in the TLF. Dr. Kozar anticipates that he will spend more than 1,500 hours over the next two years using ultrasound to acquire images of patients’ TLF. Wang’s research team will then perform detailed computer-based image analyses to help them quantify lower back flexibility and examine potential relationships between pain, function and imaging metrics. In addition to using conventional image analyses, the researchers will develop artificial intelligence approaches to objectively determine whether an image is from an individual with LBP. Dr. Kozar’s team will study the clinical efficacy of osteopathic manipulative treatments and track patients over time. “We will be testing some physical exam maneuvers to see if they will be able to predict that a patient’s pain is being caused by TLF as opposed to something else,” he says. Dr. Kozar has been using these maneuvers for several years and the research will help him understand their effectiveness at predicting an issue with a patient’s TLF.

“For years, we taught that an acute episode of back pain would go away in a couple of days, and it was nothing to worry about, but that’s not true at all,” Dr. Kozar says. “For 65-85% of people, those episodes get closer together, and they eventually end up with daily chronic pain that can be debilitating. I think it is important to view back pain as a progressive disease that can be altered and stopped.” In addition to developing effective treatments for LBP, the research may be able to prove to entities like insurance companies that there are evolving technologies that are useful for patients and that physicians should be able to use them. Dr. Kozar and Wang, who have already worked together for several years on tendon studies, are eager to expand their collaboration to similar tissues like the TLF. “[Physicians] do a lot of things clinically, but we don’t always know how they work,” Dr. Kozar notes. “I don’t have the capacity to conduct mechanistic studies, so we need somebody to partner with us to look at those things.” “Collaborations are vital,” Wang said in 2022. “I pursue what I regard to be highly important and timely clinical topics, but I’m not a physician. Combining expertise is how we address these challenges and hopefully improve others’ lives.”

fall 2024 | VCOM V iew M agazine 31