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Modeled Repetitive Motion Strain and Indirect Osteopathic Manipulative Techniques

Research study looks into the cellular mechanisms supporting the efficacy of osteopathic manipulative techniques (OMT):

“Modeled Repetitive Motion Strain and Indirect Osteopathic Manipulative Techniques in Regulation of Human Fibroblast Proliferation and Interleukin Secretion”; Kate R. Meltzer, MS and Paul R. Standley, PhD, JAOA, Volume 107, No 12, December 2007, pp. 527-536.

“Although clinical studies have supported the efficacy of various osteopathic manipulative techniques, an evidence base for the cellular mechanisms underlying these observed outcomes is lacking.” In a previous study Dr. Standley had demonstrated that in vitro human fibroblasts responded to strain unequally in two axes with increased secretion of proinflammatory interleukin 6 (IL-6) and nitric oxide, increased proliferation, and distinct changes in cellular structure and intracellular actin activity.

“In the present study, we expand on these findings by modeling repetitive motion strain (RMS) and an indirect osteopathic manipulative technique (IOMT), using human fibroblasts cultured on collagen matrices. We hypothesized that the modeled RMS would induce increased proliferation of fibroblasts and increased secretion of proinflammatory interleukins, both of which may be responsible for the decreased range of motion, pain and edema characteristic of repetitive strain injuries. We also hypothesized that the modeled IOMT would reverse this proliferative response and lead to attenuation of proinflammatory interleukin secretion, induction of anti-inflammatory interleukin secretion, or both.”


Human fibroblasts were cultured on flexible-bottomed, collagen I-coated Bioflex plates and then exposed in vitro to one of the following strains:

  1. Baseline cell secretion: All cells in each category were grown on membranes prestrained to 10% beyond resting length.
  2. Repetitive Motion Strain (RMS): subjected to RMS for 8 hours and then immediately sampled.
  3. 24 hours post RMS: subjected to RMS for 8 hours and sampled 24 hours later.
  4. 24 hours post IOMT: cells prestrained as all groups to 10% beyond resting length, then subjected to IOMT for 60 seconds and then sampled 24 hours later.
  5. 24 hours post RMS and IOMT: subjected to RMS for 8 hours, followed by 3 hour resting period, then subjected to IOMT for 60 seconds and finally sampled 24 hours post IOMT.


  1. RMS with immediate sampling after 8 hours of RMS showed significant induction in IL-1a, but all other interleukins displayed little change from baseline.
  2. 24 hours post RMS: displayed additional induction of IL-1a as well as notable induction of four other proinflammatory interleukins (IL-1B, IL-2, IL-3, and IL-6). They also displayed the anti-inflammatory IL-1ra and the dual action IL-16.
  3. 24 hours post IOMT: showed no induction of interleukins
  4. 24 hours post RMS and IOMT: showed no induction of interleukins.


“Repetitive Motion Strain appears to cause a delayed inflammatory response and a reduction in fibroblast proliferation. The IOMT profile not only failed to induce an inflammatory response or decrease in proliferation, it actually reversed these effects in cells subject to repetitive strain.”

“These results suggest that fibroblast proliferation and expression/secretion of both proinflammatory and anti-inflammatory interleukins may contribute to the clinical efficacy of indirect osteopathic manipulative techniques.”

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