Virginia Research Day 2022

Medical Student Research Cl inical

08 Restoration Of Vibratory Sense After Osteopathic Techniques

Madeline Smart, OMS II; Hope Baisley, OMS II, Delmas Bolin, MD, PhD Corresponding author: Msmart@vt.vcom.edu

VCOM Virginia

Introduction: Vibratory neuropathy is an important contributor to morbidity in diabetes and other systemic disease. There is little research that suggests it could arise from somatic dysfunction. Somatic dysfunction of the feet can result from chronic repetitive forces across the feet in a long-distance runner. Compensatory changes can produce somatic dysfunction, but these are thought to be sources of pain or perhaps contributors to degenerative change. Osteopathic manipulative method (OMM) is well established for treating these dysfunctions. There is very little published evidence that somatic dysfunction may contribute to nerve impairment. Further, there is no published literature suggesting correction of osteopathic dysfunction improves sensation. The purpose of this investigation was to determine if impaired vibratory sense could

be improved following OMM treatments. Method: (N=1) A long distance runner (50 miles per week) was tested for vibratory sense using a 128 Hz tuning fork. The testing site was the dorsal IP joint of the great toe (2 times each site). The duration of vibration sense was determined for each toe. Osteopathic dysfunction at the IP joint was screened and treated using facilitated positional release (FPR) and muscle energy (ME) techniques. After 2 minutes, the vibratory sense was retested. Results: Right toe vibratory sense was greater than 7 seconds. Left great toe vibratory sense was less than 2 seconds. An evaluation of the left great toe demonstrated posterior glide and internal rotation dysfunction of the left great toe IP joint and distal phalanx. ME and

FPR were used to restore motion. After OMM, both left and right toe vibratory sense were identical at greater than 7 seconds. Conclusion: The correction of osteopathic dysfunction had immediate improvement of vibratory sense in our patient. We hypothesize that the loss of vibratory sensation is related to somatic dysfunction the left great toe. A search of the literature returned no results relating OMM and restoration of nerve function. Our results are intriguing and suggest further study may be warranted.

72