{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:46:17Z","timestamp":1782312377743,"version":"3.54.5"},"reference-count":5,"publisher":"Walter de Gruyter GmbH","issue":"7","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,24]]},"abstract":"Abstract<\/jats:title>\n \n Context<\/jats:title>\n This study was undertaken to build upon the work of J. Gordon Zink, DO, FAAO, by developing a novel screening examination (Expanded Zink screen) that can correlate with proper identification of somatic dysfunction, the area of greatest restriction (AGR), and effective treatment in soccer players, which would elevate the osteopathic profession and advance the field of medicine.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n The objectives of this study are to determine whether the Expanded Zink screen can accurately correlate with the somatic dysfunctions found in soccer players, with what ended up being treated, and with effectiveness of treatment as measured by spirometry.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We performed a correlational study that involves female collegiate soccer players during the season who signed up to receive osteopathic manipulative treatment (OMT) after providing written informed consent. We screened 8 University of Pikeville (UPIKE) women\u2019s soccer players; exclusion criteria included any pre-existing health problems, such as bleeding disorders, congenital malformations, and spinal cord injuries. Each soccer player underwent pre-OMT spirometry measurements. Next, each soccer player received a screening examination (\u201cTraditional Zink\u201d screen or \u201cExpanded Zink screen\u201d) from Operator 1. The soccer player then received the same screening examination from Operator 2. Operator 2 then found somatic dysfunctions and performed OMT. Finally, Operator 1 completed a re-screen of the soccer player utilizing the initial screen and noted any changes in findings. The soccer player then completed post-OMT spirometry measurements.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n We find that all players in both groups after receiving OMT have a normal lung function pattern or one that improved from an obstructive pattern to a normal pattern as measured by spirometry. All eight soccer players had lumbar somatic dysfunction, innominate somatic dysfunction, and lower extremity somatic dysfunction. All players had all four junctions equalized post-OMT. Seven out of the eight players had cranial somatic dysfunction, and five of them had their cranial somatic dysfunction treated first, including Player 5, who showed clinically significant improvement in lung function post-OMT. Player 5\u2019s ribs were treated second in the treatment sequence. A novel Expanded Zink screen accurately correlated OMT of exhaled ribs to lateral asymmetry in rotation at the cervicothoracic junction in Player 5. Spirometry measurement post-OMT in Player 5 revealed clinically significant improvement in lung function showing 32\u202f% change from obstruction to a normal pattern, which we attribute to correction of restrictive ribcage motion\/dysfunction utilizing OMT. Both cranium and rib treatments accurately correlate with Expanded Zink screen findings of cranial and rib somatic dysfunctions in Player 5.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The Expanded Zink screen can be utilized as a screening model for the hypothesized correlating body regions to identify significant somatic dysfunction and to augment the physician\u2019s ability to detect key body regions that need OMT. Through the use of the Expanded Zink screen, we discovered an out-of-pattern rib somatic dysfunction, which may have led to what we call a \u201crestrictive ribcage motion\/dysfunction.\u201d This type of rib motion may have been the cause of the obstructive pattern on pre-OMT spirometry seen in Player 5. Once the rib was treated, the restrictive ribcage motion resolved, which allowed lung function to be restored to normal.<\/jats:p>\n <\/jats:sec>","DOI":"10.1515\/jom-2025-0011","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T15:55:46Z","timestamp":1764950146000},"page":"339-348","source":"Crossref","is-referenced-by-count":0,"title":["Clinically significant lung function improvement for collegiate soccer players after OMT with restrictive ribcage motion correlated with Expanded Zink screen"],"prefix":"10.1515","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5342-6114","authenticated-orcid":false,"given":"Daniel Y.","family":"Leung","sequence":"first","affiliation":[{"name":"Department of Osteopathic Principles and Practices , Kentucky College of Osteopathic Medicine, University of Pikeville , Pikeville , KY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward G.","family":"Stiles","sequence":"additional","affiliation":[{"name":"Kentucky College of Osteopathic Medicine, University of Pikeville , Pikeville , KY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"2026062413492850810_j_jom-2025-0011_ref_001","unstructured":"Zink, JG, Lawson, WB. An osteopathic structural examination and functional interpretation of the soma. Osteopath Ann 1979;12\u20139."},{"key":"2026062413492850810_j_jom-2025-0011_ref_002","doi-asserted-by":"crossref","unstructured":"Ching, LM, Benjamin, BA, Stiles, EG, Shaw, HH. Enabling health potential: exploring nonlinear and complex results of osteopathic manual medicine through complex systems theory. J Osteopath Med 2023;123:207\u201313. https:\/\/doi.org\/10.1515\/jom-2022-0118.","DOI":"10.1515\/jom-2022-0118"},{"key":"2026062413492850810_j_jom-2025-0011_ref_003","doi-asserted-by":"crossref","unstructured":"Graham, BL, Steenbruggen, I, Miller, MR, Barjaktarevic, IZ, Cooper, BG, Hall, GL, et al.. Standardization of spirometry 2019 update. An official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med 2019;200:e70\u201388. https:\/\/doi.org\/10.1164\/rccm.201908-1590ST.","DOI":"10.1164\/rccm.201908-1590ST"},{"key":"2026062413492850810_j_jom-2025-0011_ref_006","doi-asserted-by":"crossref","unstructured":"Stanojevic, S, Kaminsky, DA, Miller, MR, Thompson, B, Aliverti, A, Barjaktarevic, I, et al.. ERS\/ATS technical standard on interpretive strategies for routine lung function tests. Eur Respir J 2022;60:2101499. https:\/\/doi.org\/10.1183\/13993003.01499-2021.","DOI":"10.1183\/13993003.01499-2021"},{"key":"2026062413492850810_j_jom-2025-0011_ref_007","unstructured":"Ponce, MC, Sankari, A, Sharma, S. Pulmonary function tests; 2023. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482339\/ [Accessed 25 July 2025]."}],"container-title":["Journal of Osteopathic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jom-2025-0011\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jom-2025-0011\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T13:50:24Z","timestamp":1782309024000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jom-2025-0011\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,8]]},"references-count":5,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,6,25]]},"published-print":{"date-parts":[[2026,6,24]]}},"alternative-id":["10.1515\/jom-2025-0011"],"URL":"https:\/\/doi.org\/10.1515\/jom-2025-0011","relation":{},"ISSN":["2702-3648"],"issn-type":[{"value":"2702-3648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,8]]}}}