Osteopathic Manipulative Treatment Improves Heart Surgery Outcomes: A Randomized Controlled Trial Annals of Thoracic Surgery

(The Society of Thoracic Surgeons)


January 18, 2017; Vol. 16 [epub]

Vittorio Racca, MD, Bruno Bordoni, MS, Paolo Castiglioni, PhD, Maddalena Modica, MS, Maurizio Ferratini, MD


Cardiology Rehabilitation Center and Biomedical Technology Department, Santa


Maria Nascente Institute-IRCCS, Don C. Gnocchi Foundation, Milan, Italy

The aim of this study was to assess whether osteopathic manipulative treatment


(OMT) contributes to post heart surgical sternal pain relief and “improves

postoperative outcomes.”


Eighty post-sternotomy patients were randomly allocated to receive a standard ,cardiorespiratory rehabilitation program alone (control group) or standard cardiorespiratory rehabilitation with spinal manipulation. Pain intensity and respiratory functional capacity were quantified by the Visual Analogue Scale score and by a standardized breathing test, at the start and end of rehabilitation.




1) “Controlling sternal pain after heart surgery is important to reduce the risk of postoperative complications, but pain is often undertreated because of contraindications and side effects of analgesic drugs.” Postoperative pain

“diminishes patients’ ability to cooperate, delays recovery and may lead to worse outcomes.”

2) “Inadequately controlled postoperative pain negatively affects the immune system, wound healing, and pulmonary function.”

3) Pain can “activate the sympathetic system, increasing demands on cardiac function and favoring cardiac complications such as tachycardia, arrhythmia, or myocardial ischemia.”

4) “Uncontrolled postoperative pain is often responsible for neurologic

complications, episodes of delirium, and other acute confusional states with a multifactorial pathogenesis.”

5) “In addition to discomfort and suffering, pain may cause sleep deprivation, may delay return to normal functioning, and may have nociception-induced adverse effects on cardiovascular functioning and pulmonary morbidity.”

6) Pain intensity was measured using a 10-cm visual analogue scale (VAS)

ranging from “no pain at all” to “unbearable pain.”

7) The improvement in respiratory function was more marked in the

[manipulation] group. “The inspiratory volume was significantly greater in the [manipulation] group.”

8) “Hospitalization was significantly shorter in the [manipulation] group than in the control group (19.1 ± 4.8 versus 21.7 ± 6.3 days).”

9) “Anti-inflammatory drugs may impair renal function, interact with platelet

aggregation, and increase the risk of gastrointestinal damage and bleeding;

analgesic drugs have detrimental neurologic effects and negatively affect visceral motility; and opioids may decrease survival during in-hospital resuscitation and increase duration of hospitalization.”

10) The manipulation in this study began the day after being discharged from the surgery department, and was administered for 5 days.

11) At the end of rehabilitation:

• The manipulation group had a lower Visual Analogue Scale score.

• The manipulation group had higher mean inspiratory volume.

• The manipulation group had shorter stays.


“At the end of the rehabilitation program, the reduction in perceived pain was more marked in the [manipulation] group and the VAS score was significantly lower in [manipulation] patients than in controls.”


13) “The combination of standard care with [manipulation] is effective in

inducing pain relief and functional recovery, and significantly improves the

management of patients after heart surgery with sternotomy.”

14) These authors reference articles that show spinal manipulation does the


• “Intervenes in the process that transforms nociceptive information into the

subjective experience of pain.”

• “Controls pain after abdominal surgery.”

• “Facilitates recovery of functional ability after coronary artery bypass graft


• “Improves cardiac function.”

• “Reduces analgesia that patients with musculoskeletal problems need after

elective knee or hip arthroplasty.”

15) Of the patients who took pain medications, side effects occurred in

22.5%; these side effects included nausea, vomiting, dizziness, difficulty

concentrating, drowsiness, light-headedness, abdominal discomfort, constipation, dry mouth, itching, rash, and blurred vision.

16) Nonsteroidal anti-inflammatory drugs “may increase the risk of thrombotic cardiovascular events, including myocardial infarction, and of gastrointestinal bleeding.”

17) “Overuse of opioid analgesics induces side effects that can delay recovery and worsen the outcome.”

18) “This is the first randomized controlled trial evaluating the effect of OMT on both pain perception and functional outcomes after heart surgery.”

19) “The main results of our study are that OMT treatment decreases dramatically the level of perceived pain, and substantially improves the functional capacity in terms of inspiratory volumes.”

20) “We also observed a reduced hospitalization, on average by more than 2

days, in the OMT-treated group, that could be consequence of the improved

functional capacity.”

21) The gating mechanism of spinal manipulation would have an “analgesic effect, reducing somatic reactivity and muscle spasms.”

22) “The lower pain intensity in the OMT group at discharge suggests that OMT had a direct analgesic effect.” “The shorter duration of hospitalization

in the OMT group might suggest a more rapid functional improvement.”

23) “It can be hypothesized that the pain-relieving action of [manipulation]

enables lower doses of analgesic drugs.” “Our study suggests that [manipulation] may reduce the use of analgesic drugs, lowering the risk of adverse effects during rehabilitation programs.”

24) “The efficacy of [manipulation] on rehabilitation outcomes can therefore be summarized in terms of a more pronounced reduction in pain intensity and a greater improvement in rib cage mobility, both factors that might have played a role in shortening hospitalization.”

25) “Manipulative treatment is safe, free of side effects, and well

accepted by patients. Moreover, it is relatively inexpensive and only moderately time consuming. For these reasons, cardiac rehabilitation programs should include MT.”

26) Manipulation “should begin before the development of the respiratory

sequelae associated with reduced chest and diaphragm mobility.”

27) “We believe that adding [manipulation] to traditional care programs 1 week after surgery is neither too soon nor too late.”

28) These authors suggest that postoperative manipulation “can be expected to improve the quality of patient care and its cost efficiency, by leading to better and more rapid outcomes and by reducing morbidity.”




This amazing study supports that all post surgical patients should start spinal manipulation within 5 days of surgery, during the rehabilitation process. The benefits include:


• Significantly reduced pain

• Significantly improved function

• Reduced hospital stay and it associated reduced costs

• Avoidance of drugs and all the risks (complications and side effects)

associated with pharmacology

Dear Total Health Family,

I have many reasons to be excited as I write this. For the past 30 years, I have had a passion of serving the Mid-South community through the power of a chiropractic adjustment.  Returning function, vitality, and life to my patients has given me joy. My patients who have been a part of our family practice for many years have seen a decline in my health and function of my feet. My hope was not lost. I was not defeated.  With the help of God, my family, colleagues, employees, and patients, I was going to find something to bring me my life back. I’m excited to say I have found 2 techniques that are giving me what I have been giving to my patients, hope! These services have changed my life so much I want to share the opportunity with my patients, so we will be bringing these technologies into our clinic! 

P.E.M.F. (Pulsed Electromagnetic Field Therapy). What is PEMF you ask? Have you have ever held two magnets in your hands, tried to force them together, and felt a resistance? This is a magnetic field. All energy is electromagnetic and nothing happens in the body without an electromagnetic exchange between the cells. In other words, it’s treatment at the cellular level. Our cells are designed to generate energy to eliminate waste, to repair and regenerate itself, and perform its predetermined functions based on the cell’s type and location in the body.  When our cells are injured it can cause diseases such as neuropathy, pain, althimeziers, neuromuscular problems, multiple sclerosis, Parkinson’s, etc.  By using the electromagnetic field, PEMF protects your cells, restores cellular function

PEMF uses a safe, natural electromagnetic fields which are of lower frequency and are complimentary to the chemistry and function of the body. These electromagnetic fields are for therapeutic purposes are safe unlike other man-made electromagnetic fields like power lines, microwave ovens, cell phones, etc.

  • Improves circulation & cell metabolism
  • Enhances muscle function
  • Decreases inflammation
  • Chronic & Acute Pain
  • Depression & anxiety
  • Stress Reduction
  • Bone Healing
  • Blood oxygenation
  • Average treatment time 30 minutes

Cellular Energy Transfer Science or C.E.T.S. (pronounced seets) boosts energy levels, increases vitality and achieve optimal wellness with a non-invasive & pain-free protocol.  It combines life-giving properties of water with a specialized bio-electric charge, which enhances and amplifies the body’s ability to healHeal yourself naturally without painful treatments or drugs. 

Benefits of C.E.T.S.:

  • Enhances your body’s ability to detoxify & heal
  • Increase of energy levels
  • Balances energy pathways within the body
  • Supportive therapy in cancer recovery
  • Increases stamina & endurance
  • Easing of arthritic pain & disability
  • Improves cardiovascular support
  • Strengthens neuromuscular function in M.S.
  • Symptomatic improvement in neurological conditions including Parkinson’s and stroke
  • Improves memory in Alzheimer’s disease
  • Normalizing effect in autism
  • Normalizing renal function

In closing, I found a strong overlap in the 2 different systems of cell restoration. I had my blood tests taken 2 days before beginning C.E.T.S. After 2 weeks, my blood was rechecked, and there were already positive changes. My energy level increased, and I started sleeping better. Then I added the P.E.M.F therapy with soft tissue body work in addition to the C.E.T.S. After 3 to 4 of the combo treatments, I put the cane away that I had been using since last year and haven’t picked it up since. I continually improve as I hope some of my patients will too.

In Yours in Health,

Dr. Ken

Creator of the C.E.T.S. Therapy:

Marcy Purnell is a licensed Family Nurse Practitioner and Associate Clinical Professor at the University of Memphis, Loewenberg School of Nursing • Sub-Investigator, University of Tennessee Preventive Medicine, Clinical Trials Department • NP in both acute care and clinic settings (part time )f Stern Cardiovascular Clinic • BSN from the University of Tennessee Health Science Center • MSN, FNP from the University of Memphis • Licensed in both Tennessee and Mississippi as an Advance Practice Nurse • Credentialed as a Nurse Practitioner with Baptist Hospital Systems • Ph.D candidate, University of Tennessee Health Science Center with a focus on Bioenergy


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Dear Chiropractic Friends,

How fast summer passes  . . . our kids are back to their classes! Time to shed a tear, or perhaps, time to shout and cheer!  Back to school is here!!  While the sun is setting on summer, start the fall season with renewed purpose and energy in your pursuit of a healthier lifestyle and true well-being.

Take advantage of the benefits and savings of one or more of our following Back-to-School Specials:

  • Design your own sale with our Back-to-School Healthy Nutrition Packages:
    •  Receive $5 OFF on your supplement purchase of $50, or
    • Receive $10 OFF on your supplement purchase of $100!


  • Lower your body’s toxicity with our Back-to-School Detoxification Packages:
    • Receive 10% OFF one $40 detox therapy for only $36!   $4 Savings!!
    • Receive 30% OFF one $240 detox 6-therapy package for only $168! $72 Savings!!
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    • Whether you have 10 pounds or 100 pounds to lose, stop procrastinating and take action!  Invest in your health by committing to losing weight and getting rid of at-risk body fat before the holidays arrive! 
      • Receive 50% OFF one $189 consultation fee to start the Ideal Protein diet for only $95!  Savings of $95!!
    • Perhaps your goal is to simply maintain your weight prior to the holidays.  If so, purchase healthy, nutritious snack foods and shakes. 
      • Receive $5 OFF on your snack purchase of $50, or
      • Receive $10 OFF on your snack purchase of $100!


  • Minimize your stubborn bulges of unwanted fat with a Body Shaping and Slimming Package:
    • First-Time 12 Zerona Package Price only $1,249! Savings of $926!!
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As the heat of summer sizzles into the fall, enhance your spine, diet, health, and lifestyle before the busy holiday season arrives.  Do you need a maintenance adjustment before the hustle and bustle of the holidays?  If so, call 683-5971 to schedule an appointment today!

Dr. Bomar-Hyong and I believe one or more of the above packages will benefit your lifestyle greatly.  All Back-to-School savings will be available through September 30.  Shortly, you will be receiving information about two life-changing therapies that I am super excited to introduce to my practice! 

Yours in Health, 

Dr. Ken

By Total Health Chiropractic and Wellness Center
February 03, 2015

Have you ever wondered how your body—a virtually endless system of muscles, organs and nerves—can keep itself held together, let alone maneuver so seamlessly through your day-to-day activities? The secret is in fascial tissue, or essentially, the intricate weave of connective tissue that runs from the top of your head to the tips of your toes.

More and more, doctors are realizing that when it comes to physical therapy, body parts can not simply treated individually, but rather, as one piece to a complex puzzle. “Muscle memory” can refer to the effect fascial tissue has on the body’s muscular system, meaning that it can “remember” past injuries and limit the mobility of joints and other body parts even years after wounds have healed.

Why Would I Ever Need Myofascial Therapy?

As mentioned earlier, fascial tissue can often cause problems with the future flexibility or functionality of your arms, legs, hands, neck, or other body parts after an injury has occurred. And, because it runs through your entire body, compromised fascial tissue can even cause issues in parts of your body that were never injured in the first place. What may have been a hip injury three years ago could easily turn into back or neck pain today without proper physical therapy treatments. Myofascial therapy is an effective way of releasing tension in the fascial tissue and works on the entire body, preventing you from discomfort on down the road.

The chiropractic team at Total Health Chiropractic and Wellness Center is fully-trained in myofascial therapy techniques and can help you regain mobility after an injury or surgery.

To learn more about myofascial percussion therapy or chiropractic medicine in the Memphis, TN area, call (901) 683-5971 and schedule a consultation with the professionals at Total Health Chiropractic and Wellness Center

By Total Health Chiropractic and Wellness Center
January 06, 2015

Back pain is a common and unfortunate condition that many of our Memphis patients experience. When you experience back pain that’s unrelieved by traditional methods, it may be time to come to our office for innovative techniques, including spinal decompression.

Spinal decompression is a non-surgical back pain relief technique that involves stretching the spinal bones to reduce discomfort. Back PainThis treatment is ideal for patients who experience bulging, degenerating or herniating discs. Additional conditions that may benefit from treatment with spinal decompression include sciatica, neck pain and spinal nerve injuries known as radiculopathies.

The idea behind spinal decompression is to create negative pressure on the spine, which reduces the force placed on diseased or damaged disks. With repeated treatments, the negative pressure can help these inflamed disks to shrink. This reduces the pressure placed on the spinal nerves that can cause pain. The negative force also encourages the movement of healthy nutrients and oxygen to the discs, which promotes healing.

The treatment itself involves lying down on a special table where you are harnessed in to ensure you will not slip or slide out of place. The table is computerized, and we will program it according to your unique spine condition. Treatment times may vary, but typically take between 30 and 45 minutes to perform.

We often recommend spinal decompression therapy in coordination with other back-healing activities, such as physical therapy, massage, cold therapy and even electrical stimulation. When these chiropractic techniques are combined, our patients have a greater chance of not only finding immediate relief from back pain, but also healing their conditions for long-term results.

To learn more about how spinal decompression can help you find relief from chronic back and neck pain or other treatments we provide, please call our Memphis chiropractor office at (901) 683-5971.

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