The effect of osteopathic manual therapy on the vascular supply to the lower extremity in individuals with knee osteoarthritis: A randomized trial

Osteopathic principles guide treatments, one of which is the rule of the artery is absolute. Objectives of this study were to determine if selected osteopathic techniques (fascial releases along the arterial pathway and balancing of diaphragmatic tensions) were able to influence the vascular supply, dynamic balance, knee range of motion (ROM) and symptoms. Methods: Thirty subjects with radiographic confirmed knee osteoarthritis were randomly assigned to one of two groups: 1) osteopathic evaluation combined with treatment (treatment group); 2) osteopathic evaluation alone (no treatment group). Outcome measures were recorded before and after each osteopathic session: ultrasound/Doppler recordings of the resistive index (RI) of the superficial femoral artery (SFA), active knee flexion ROM, step test for balance and the visual analog scale (VAS) symptom rating. A two factor mixed model Analysis of Variance (ANOVA) for group (evaluation vs. treatment) with repeated measures (pre versus post test) was employed to test for main effects and all interactions for each dependent variable (alpha = 0.05). Results: The RI reduced significantly (p < 0.008) from pre to post test in the treatment group only. Significant pretest/posttest main effects were found for ROM, balance and symptom rating (p < 0.05). Conclusion: The significant difference in RI provides evidence for the benefits of specificity within osteopathic techniques, and reveal the vascular supply to the leg was affected by the fascial releases and will possibly influence some of the pathophysiological factors of an arthritic knee.