Hello, my name is Mohamed Sabah. I'm a fourth-year medical student at VCOM Virginia. Today I'll be presenting our preliminary results from a study entitled Investigation of Suboccipital Release, Muscle Energy, and Combination Therapy, respectively evaluating their effect on common carotid artery blood flow. Our inspiration for this study emerged while reviewing existing literature on mild traumatic brain injuries and sports-related concussions. We found that cerebral blood flow tends to decrease following these injuries. This led us to consider what role we, as future osteopathic physicians, might play in improving outcomes for these patients. So with this in mind, we set out to evaluate how osteopathic manipulative treatments, or OMT, which is a key component of our training, how that could influence cerebral blood flow. We specifically focus on the common carotid arteries because they supply about 75% of the brain's blood flow. We chose two OMT techniques for our study, suboccipital release and muscle energy, given their potential to impact the autonomic nervous system. The primary question that we aimed to address was how do OMT techniques, specifically muscle energy, suboccipital release, and a combination of both muscle energy and suboccipital release, and then sham treatments. So we had four cohorts, and we sought out to see how those four cohorts could impact the common carotid artery blood flow. We used the peak systolic velocity and the end diastolic velocity as measures in our study, and we evaluated those using ultrasound. To conduct our study, we recruited 48 participants from the faculty, staff, and students at our medical school. The preliminary results here are based on data from those 48 individuals. In figure one, which is seen here in the middle panel, participants were randomly assigned to one of four treatment groups. After obtaining written consent, each participant completed an anonymous demographic survey using a randomized ID number. When the participants arrived for their scheduled session, they laid flat for five minutes on their backs before receiving any diagnosis or treatment. We followed a standardized protocol to minimize error. For example, participants in the suboccipital release group received suboccipital release treatment for 90 seconds, regardless of whether the practitioner sensed tissue release. Likewise, participants in the sham group were placed in a cranial vault hold for 90 seconds. Given the manual skill involved in both OMT and ultrasound techniques, we anticipated some variability in how effectively our research team performed these procedures. To reduce this variability, all members were trained and evaluated by faculty to ensure they can accurately diagnose and treat somatic dysfunctions, as well as efficiently use ultrasounds to measure carotid artery velocities. An error study was also conducted to assess variance among the ultrasonographers on our team. Now let's turn to the preliminary results. Displayed on the right side of our poster, while our findings are not yet statistically significant, we observed an intriguing trend. The peak systolic velocity and end diastolic velocity generally decreased post-treatment in all of the groups except for one. The muscle energy and suboccipital release group, so the combined therapy, was the only core cohort where this trend did not hold. And you can see a visual representation of this in figure 2a, where the peak systolic velocity remained stable rather than decreasing. Moving forward, we have approval from our IRB to expand our study to the general population with a goal of enrolling 180 participants. We're optimistic that as we increase our sample size, we'll be able to provide objective evidence on the effects of cervical spine OMT on cerebral blood flow. Ultimately, we hope that this study will help elucidate the biological impact of OMT and potentially suggest a role for OMT in the management of mild traumatic brain injuries and concussion recovery. The ability to enhance osteopathic practice with evidence-based data on cerebral blood flow modulation could provide a significant contribution to the field. Thank you for your time, and I'd like to thank the members of our team, which are seen here on the right-hand side under Meet the Author section. Thank you again for your time.

osteopathic manipulative treatments

cerebral blood flow

suboccipital release

ultrasound measurements

brain injuries