The Use Of Sequenced Osteopathic Manipulative Therapy (OMT) and Area of Greatest Restriction-Hindrance (AGR-H) Model to Identify and Resolve Control in BioTensegrity System: Measured Utilizing a Pressure Sensitive Treadmill was a recent published article by a team including our very own Sean Roach and Cooper Boydston.
The hypothesis of this research was that these 10, early proof of concept, n-of-1 studies propose a different perspective on the musculoskeletal models.
- Proport sequenced OMT treatment results in previously undocumented changes in a patient’s motor function/performance
- Honor their unique complexity
- Address somatic dysfunction at the AGR-H
The methods used were:
- 10 volunteers ran and/or walked for 1 minute on the Pressure Sensitive Treadmill (PST)
- Ground Reaction Forces (GRF) were determined prior to and after receiving one sequenced OMT treatment, addressing their unique somatic dysfunction at the AGR-H
Results:
- A two-sided T-Test compared each 1% increment of the gait cycle, pre- and post-treatment, with p<.001 considered statistically significant change.
- Subsequently, each 1% increment of the GRF curve exhibiting p<.001 change was tabulated for each person, whether running or walking, and considering the gait cycle portion when the foot contacted the ground.
Table 1
Group Mean % of ground contact time in walking trials showing significant changes in Ground Reaction Force (GRF) after requenced OMT and AGR-H model [p value <.001 (99.9% confidence)]
| Mean % of Steps | Standard Dev. | |
| Left Steps | 64.5% | 30% |
| Right Steps | 58.5% | 29% |
| Both | 61.5% | 29% |
Table 2
% of ground contact time in walking trials showing significant changes in Ground Reaction Force (GRF) after sequenced OPMT and AGR-H model [p value <.001 (99.9% confidence)]
| % of Left Steps | % of Right Steps | |
| Runner 1 | 95% | 97% |
| Runner 2 | 79% | 78% |
| Runner 3 | 97% | 91% |
| Runner 4 | 78% | 79% |
| Patient 1 | 5% | 29% |
| Patient 2 | 20% | 11% |
| Patient 3 | 57% | 28% |
| Patient 4 | 74% | 61% |
| Patient 5 | 76% | 51% |
| Patient 6 | 64% | 60% |
Table 3
% of ground contact time in running trials showing significant changes in Ground Reaction Force (GRF) after sequenced OMT and AGR-H model [p value <.001 (99.9% confidence)]
| % of Left Steps | % of Right Steps | |
| Runner 1 | 87% | 74% |
| Runner 2 | 83% | 44% |
| Runner 3 | 12% | 25% |
| Runner 4 | 49% | 5% |
Conclusion
- These findings suggest use of the AGR-H model provides the sequencing necessary to identify and affect statistically significant changes in motor control with one treatment.
- Measurement tools, such as the PST, appear effective in validating these results.
- Research utilizing additional tools and functional measurements, other than the GRF, also appear to substantiate findings of this study.
References
- Stiles EG (2017) Primary Lesion, key lesion, sequencing. In: Johannes Mayer, MD, DOM and Clive Standen MA,DO eds. Textbook of Osteopathic Medicine. Edinburgh: Elsevier, 265-270.
- Stiles EG (2017) Osteopathic Problem Solving: Finding the “Key S/D”. Available at: http://files.academyofosteopathy.org/convo/2017/Presentations/Stiles ApplicationsOfTensegrity.pdf (Accessed June 2017)
- Guyatt GH, Keller JL, Jaeschke R, Rosenbloom D, Adachi JD, and Newhouse MT (February 1990). The n-of-1 randomized controlled trial: clinical usefulness. Our threeyear experience. Ann. Intern. Med. 112(4):293-9