Impact of Osteopathic Manipulative Treatment on Pursuit Eye Movements in Healthy Human Adults

Impact of Osteopathic Manipulative Treatment on External Lateral Ocular Pursuit, Measured in Healthy Human Adults: a Randomized, Double-blind, Controlled Study

The idea that osteopathic manipulative treatments (OMTs) should have an impact on the human visual system is not new. Nevertheless, there is a lack of scientific, objective, and experimental evidence. Our goal is to conduct a randomized, double-blind, controlled study to evaluate the effect of OMT on ocular pursuit. Eye movements will be measured by an infra-red video-based eye tracking system with a high spatial and temporal resolution. OMTs will be similar to regular treatments given by osteopaths in their daily practice. We hypothesize that OMT will improve the quality of ocular pursuit.

Study Overview

• Status: Completed
• Conditions: Healthy
• Intervention / Treatment: Other: Osteopathic manipulative treatment; Other: Sham Osteopathic manipulative treatment

Detailed Description

Our hypothesis is based on the implication of the fascial system (i.e., connective tissues) in the structural continuity that gives form and function to every tissue and organ. Fascial tissue, on which osteopathic manipulations are acting by restoring its elasticity, is also present in the eye cavity. The connection between fascia might explain how osteopathic manipulations, applied on structures which can be far from the original dysfunctional point, might improve oculomotricity.

Before and after OMT, practitioners will estimate the lateral and medial oculomotor muscles' and the fascia's tissue elasticity with a manual test. They will softly mobilize the eyeballs in medial and lateral directions (the amplitude of these passive mobilizations will always be lower than active eye rotations) and give an elasticity score. Before and after these tests, pursuit eye movements will be recorded by an independent technician. Participants will be asked to track a target that will be displaced horizontally on a computer screen. The target will move 30 times from left to right and 30 times from right to left with a constant speed of 20 degrees of visual angle per second.

The study will involve three independent groups (experimental, sham, test-retest) of healthy participants. We expect that pursuit improvement will be larger in the experimental group than in the two other groups. Moreover, as secondary goals, we will evaluate the correlation between pursuit eye movement data (obtained with a technical device, in a standardized situation) and subjective assessments of oculomotor muscles' elasticity made by the practitioners providing OMTs. We will also examine the possible practitioner effect (two exclusive osteopaths will provide OMTs).

• Study Type: Interventional
• Enrollment (Actual): 201
• Phase: Not Applicable

Contacts and Locations

Study Locations

• France
  • Paris, France, 75015
    • Ecole d'Osteopathie de Paris

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 35 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Adult between 18 and 35 years of age
• Affiliated to the French Social Security scheme
• Ability to understand and sign the written consent form

Exclusion Criteria:

• Eye movements that cannot be calibrated correctly and therefore measured by the eye-tracker
• Visual deficit that prevents from performing the ocular task
• Pregnancy or breastfeeding
• Neurologic, psychiatric or epileptic disorder, or any other neuromuscular disorder
• Medical treatment affecting the central, autonomous or peripheral nervous system, or affecting vigilance and/or attention
• Skull fracture less than 12 months ago, symptomatic whiplash less than 3 months ago, spinal pain, fever, abdominal or pelvic pain, myopathy, ocular pain, or nystagmus
• Legal protection
• Major risk to develop severe corona virus disease illness, or living with people presenting such a risk

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: OMT; Osteopathic manipulative treatment : participants will receive low-amplitude tissue mobilizations on peripheral, vertebral, cranial and/or visceral articular systems.	Other: Osteopathic manipulative treatment; Participants will be positioned on an exam table supine, seated, or decubitus. Osteopathic manipulations will consist in corrective micro-movements applied on synovial joints, on the skull, the teeth and/or visceral structures of the abdomen or the thorax. Local pressures won't exceed a few tens of grams/cm². Practitioners will realize between 15 and 25 technical gestures per participant. Treatment will last 30 minutes (plus or minus 5 minutes) on average. The technical gestures are referenced in the Glossary of Osteopathic Terminology published by the American Association of Colleges of Osteopathic Medicine (2017).
Sham Comparator: Sham; Participants will be applied gestures that look like actual osteopathic manipulations but are not therapeutic.	Other: Sham Osteopathic manipulative treatment; Participants will be positioned on an exam table supine, seated, or decubitus. They will receive 20 gestures that will be standardized and different from actual osteopathic manipulations (but not identifiable as sham manipulations by the participants). The duration of the sham treatment will be the same as the actual treatment.
No Intervention: Test-retest; Participants will undergo the two eye movement measurements, but will not receive any (actual or sham) treatment. 30 minutes will elapse between the two measurements.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Duration of external lateral ocular pursuit	Time spent to track a moving target, by generating smooth eye movements (as opposed to ocular saccades) with a velocity close to the target velocity. Metric: millisecond.	immediately before treatment
Mean change from baseline in duration of external lateral ocular pursuit	Change from baseline in time spent to track a moving target, by generating smooth eye movements (as opposed to ocular saccades) with a velocity close to the target velocity. Metric: millisecond.	immediately after treatment
Reaction time	Time elapsed between target displacement initiation and ocular pursuit initiation. Metric: millisecond.	immediately before treatment
Mean change from baseline in reaction time	Mean change from baseline in time elapsed between target displacement initiation and ocular pursuit initiation. Metric: millisecond.	immediately after treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Score on the test of eyeball passive manual mobilization	Tissue elasticity of an oculomotor muscle will be assessed using a 3-points scale (1 = no resistance to the mobilization, 3 = strong resistance). Four muscles (two per eyeball) will be assessed. Maximal score = 12 points.	immediately before treatment
Score on the test of eyeball passive manual mobilization	Tissue elasticity of an oculomotor muscle will be assessed using a 3-points scale (1 = no resistance to the mobilization, 3 = strong resistance). Four muscles (two per eyeball) will be assessed. Maximal score = 12 points.	immediately after treatment

Collaborators and Investigators

• Sponsor: Ecole d'ostéopathie de Paris
• Collaborators: University of Paris 5 - Rene Descartes
• Investigators: Principal Investigator: Mohamed Gharmaoui, MD, Ecole d'Osteopathie de Paris

Publications and helpful links

General Publications

• Bordoni B, Zanier E. Clinical and symptomatological reflections: the fascial system. J Multidiscip Healthc. 2014 Sep 18;7:401-11. doi: 10.2147/JMDH.S68308. eCollection 2014.

Study record dates

Study Major Dates

• Study Start (Actual): November 2, 2021
• Primary Completion (Actual): November 10, 2022
• Study Completion (Actual): December 10, 2022

Study Registration Dates

• First Submitted: August 18, 2021
• First Submitted That Met QC Criteria: August 18, 2021
• First Posted (Actual): August 24, 2021

Study Record Updates

• Last Update Posted (Actual): January 4, 2023
• Last Update Submitted That Met QC Criteria: January 2, 2023
• Last Verified: January 1, 2023

More Information

Terms related to this study

• Keywords: Osteopathic manipulative treatment; Ocular pursuit
• Other Study ID Numbers: OSTEOM-1

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No