The study on the effectiveness of the Osteopathic Treatment Protocol (OTP) in people with Multiple Sclerosis (MS) is based on scientific evidence, which demonstrates that the inflammatory process, which occurs in MS, may be associated with vascular lesions in nervous tissue, derived from an alteration in the hemodynamics of the cerebral venous system. This mechanism would have as its basis the increase in intracranial pressure, in turn, supposedly caused by an abnormal muscular tension of postural-respiratory origin, which would be likely to be improved through osteopathic treatment. For this reason, we have designed a randomized, standardized, double-blinded, controlled clinical trial, in which, a group of patients with MS will undergo a cycle of protocol osteopathic treatments, evaluating the patients’ response to symptoms and the evolution of nervous tissue lesions, compared to a control group that will receive a cycle of sessions, where a progressive muscle relaxation protocol will be applied.

Materials and methods:

A group of 24 people with MS will be randomly divided into two sub-groups: study and control, with the study group receiving a cycle of standardized osteopathic treatments, while the control group, in the first phase of the research, will receive a cycle of progressive muscle relaxation sessions. Standardized osteopathic treatment was designed with a focus on normalizing respiratory postural tensions, improving cranial venous outflow, and reducing intracranial pressure. All patients will undergo an assessment protocol before the beginning and after the end of the treatment cycle, which will include the following assessments: functional tests to determine symptoms and quality of life in patients with MS, magnetic resonance imaging with contrast (gadolinium ), evaluation of intracranial pressure (ICP) using a non-invasive device for measuring ICP (B4C), evaluation of the flow of the jugular veins by venous Doppler. The results of the examinations of the two groups will be submitted to statistical evaluation to determine the effect of the treatment in the study group regarding the control. In case the evaluations show differences between the two groups, at the end of the first six months, the control group will also receive the standardized osteopathic treatment, according to the same modalities as the study group.

All patients must read and sign a consent form, which will explain all the modalities of the research in which they will participate, the procedures to which they will be submitted, and the possible risks associated with the treatment. Patients will be informed that they will be randomly assigned to one of the two groups.

Discussion:

According to scientific evidence, a chronic increase in abdominal and thoracic pressure, of mechanical origin, can lead to a collapse of the cerebrospinal venous system, with consequent insufficiency in cranial venous outflow and increased intracranial pressure (ICP); the tension on the vessels caused by the increase in blood volume would facilitate the permeability of the vessels to immune cells which, by crossing the blood-brain barrier (BBB), would activate the inflammatory process of the nervous tissue in people with a genetic predisposition to MS. Osteopathic treatment, normalizing the tensions of postural-respiratory origin, would have a positive effect in improving the hemodynamics of the cerebral venous system, normalizing the ICP, reducing inflammation of thegraduate.

#osteopathy     #multiple sclerosis    #autoimmune diseases     #intracranial pressure