Sandhouse Mark E, Shechtman Diana, Sorkin Richard, Drowos Joanna Lauren, Caban-Martinez Alberto J, Patterson Michael M, Shallo-Hoffmann Josephine, Hardigan Patrick, Snyder Arthur
College of Osteopathic Medicine and Department of Osteopathic Principles and Practice, Health Professions Division of Nova Southeastern University in Fort Lauderdale, Florida 33328-2018, USA.
J Am Osteopath Assoc. 2010 Apr;110(4):239-43.
The effects of osteopathy in the cranial field on visual function-particularly on changes in the visual field and on the binocular alignment of the eyes-have been poorly characterized in the literature. The authors examined whether osteopathy in the cranial field resulted in an immediate, measurable change in visual function among a sample of adults with cranial asymmetry.
Randomized controlled double-blinded pilot clinical trial.
Adult volunteers between ages 18 and 35 years who were free of strabismus or active ocular or systemic disease were recruited. Inclusion criteria were refractive error ranging between six diopters of myopia and five diopters of hyperopia, regular astigmatism of any amount, and cranial somatic dysfunction.
All subjects were randomly assigned to the treatment or control group. The treatment group received a single intervention of osteopathy in the cranial field to correct cranial dysfunction. The control group received light pressure of a few ounces of force applied to the cranium without osteopathic manipulative treatment.
Preintervention and postintervention optometric examinations consisted of distant visual acuity testing, Donder push-up (ie, accommodative system) testing, local stereoacuity testing, pupillary size measurements, and vergence system (ie, cover test with prism neutralization, near point of convergence) testing. Global stereoacuity testing and retinoscopy were performed only in preintervention to determine whether subjects met inclusion criteria. Analysis of variance (ANOVA) was performed for all ocular measures.
Twenty-nine subjects completed the trial-15 in the treatment group and 14 in the control group. A hierarchical ANOVA revealed statistically significant effects within the treatment group and within the control group (P <.05) in distance visual acuity of the right eye (OD) and left eye (OS), local stereoacuity, pupillary size measured under dim illumination OD and OS, and near point of convergence break and recovery. For the treatment group vs the control group, a statistically significant effect was observed in pupillary size measured under bright illumination OS (P <.05).
The present study suggests that osteopathy in the cranial field may result in beneficial effects on visual function in adults with cranial asymmetry. However, this finding requires additional investigation with a larger sample size and longer intervention and follow-up periods. (ClinicalTrials.gov number NCT00510562).
颅骨整骨疗法对视觉功能的影响——尤其是对视野变化和双眼眼位对准的影响——在文献中描述甚少。作者研究了颅骨整骨疗法是否会在患有颅骨不对称的成年样本中导致视觉功能立即出现可测量的变化。
随机对照双盲试点临床试验。
招募年龄在18至35岁之间、无斜视或活动性眼部或全身性疾病的成年志愿者。纳入标准为近视6屈光度至远视5屈光度之间的屈光不正、任意度数的规则散光以及颅骨躯体功能障碍。
所有受试者被随机分配到治疗组或对照组。治疗组接受一次颅骨整骨疗法干预以纠正颅骨功能障碍。对照组接受对颅骨施加几盎司力的轻压，不进行整骨手法治疗。
干预前和干预后的验光检查包括远视力测试、东德推升（即调节系统）测试、局部立体视敏度测试、瞳孔大小测量以及聚散系统（即棱镜中和遮盖试验、近点集合）测试。仅在干预前进行整体立体视敏度测试和检影验光以确定受试者是否符合纳入标准。对所有眼部测量指标进行方差分析（ANOVA）。
29名受试者完成了试验——治疗组15名，对照组14名。分层方差分析显示，治疗组和对照组内右眼（OD）和左眼（OS）的远视力、局部立体视敏度、暗光下测量的OD和OS瞳孔大小以及近点集合破裂和恢复方面存在统计学显著效应（P <.05）。治疗组与对照组相比，在强光下测量的OS瞳孔大小方面观察到统计学显著效应（P <.05）。
本研究表明，颅骨整骨疗法可能对患有颅骨不对称的成年人的视觉功能产生有益影响。然而，这一发现需要通过更大样本量、更长干预和随访期的进一步研究来验证。（ClinicalTrials.gov编号NCT00510562）
