MSU awarded $4.2M to develop clinical research tools for osteopathic manipulative medicine study

Tools sought to measure muscular manipulation

A multidisciplinary team of Michigan State University researchers has been awarded $4.2 million to develop accurate clinical research tools for studying osteopathic manipulative medicine, a hands-on approach to the diagnosis and treatment of musculoskeletal disorders.

Using a five-year grant from the National Institutes of Health, principal investigator Jacek Cholewicki of the College of Osteopathic Medicine is leading a team to research OMM, which focuses on improving patient function and mobility. What is unique is the team's use of systems science, a branch of engineering that studies complex systems in a way that not only includes their parts but also how the parts interact to affect the entire system.

"We need to apply well-established engineering concepts to develop objective tools that will allow for the rigorous study of OMM," said Cholewicki, who serves as a co-director of MSU's Center for Orthopedic Research at Ingham Regional Orthopedic Hospital in Lansing.

"While this form of osteopathic treatment is popular, its underlying physiological mechanisms are unknown," he added. "What does the evidence support? How can we optimize treatments and make better patient selection? Those are key questions."

Applying engineering concepts and systems science to osteopathic treatments provides an excellent framework for investigating the musculoskeletal system's performance, said Jongeun Choi of the College of Engineering.

"The challenge is to develop methods that can measure changes in the body, are accurate and are safe when applied on patients," added engineering professor Clark Radcliffe.

MSU represents a unique environment for such research, said Peter Reeves of the College of Osteopathic Medicine.

"We have a major research university housing the nation's leading osteopathic college with extensive resources in engineering and in complementary/alternative medicine," he said. "Additionally, the aggressive research agenda of Osteopathic Dean William Strampel and the partnership with Ingham Regional Orthopedic Hospital have provided an ideal environment for this type of research."

The NIH grant will allow MSU to tackle three projects:

• Osteopathic manipulative medicine and postural control: Preliminary studies suggest OMM improves postural control in patients; however, the mechanisms responsible are unknown. MSU researchers hypothesize OMM targets impaired functions of the neuro-musculoskeletal system that arise from a dysfunction in the muscle spindles; they will study that process.

• OMM's effect on sudden events causing low back pain: Sudden, unexpected loading to the spine results in severe and costly back injuries. While appropriate postural control can spare the spine from harm, people with low back pain have impaired postural control, which suggests they are more likely to re-injure themselves. If osteopathic manipulative medicine can effectively reduce dysfunction and pain, then improvements in postural control, including faster responses of trunk muscles, should be realized, MSU researchers hypothesize. This improvement in postural control should then mitigate any adverse effects from an unexpected event. To test the hypothesis, researchers will develop objective performance measures of the postural control system.

• Effects of osteopathic manipulative medicine on neuromuscular control of the head-neck system: Neck pain is one of the three most frequently reported musculoskeletal complaints, affecting 70 percent of individuals. OMM appears to be effective in relieving musculoskeletal pain in the head-neck area. However, the measures used to support those findings have been limited to subjective tests such as survey statements provided by patients. The overall goal of the project is to develop objective clinical research tools for the assessment of motor control of the head-neck system.