1. Osteopathic Manipulative Therapy in Women With Postpartum Low Back Pain and Disability: A Pragmatic Randomized Controlled Trial
- Author
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Florian Schwerla, Denis Rother, Michaela Ruetz, Karl-Ludwig Resch, and Katrin Rother
- Subjects
Adult ,Complementary and Manual Therapy ,medicine.medical_specialty ,Visual analogue scale ,Population ,Context (language use) ,law.invention ,Young Adult ,Randomized controlled trial ,Quality of life ,Pregnancy ,law ,medicine ,Humans ,Disabled Persons ,education ,Pain Measurement ,Retrospective Studies ,education.field_of_study ,business.industry ,Postpartum Period ,Manipulation, Osteopathic ,Low back pain ,Oswestry Disability Index ,Treatment Outcome ,Complementary and alternative medicine ,Quality of Life ,Physical therapy ,Female ,medicine.symptom ,business ,Low Back Pain ,Postpartum period ,Follow-Up Studies - Abstract
Context: Persistent low back pain (LBP) is a common complaint among women during and after pregnancy, and its effects on quality of life can be disabling. Objective: To evaluate the effectiveness of osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) in women with persistent LBP and functional disability after childbirth. Methods: A pragmatic randomized controlled trial was conducted among a sample of women with a history of pregnancy-related LBP for at least 3 months after delivery. Participants were identified from the general population in Germany. By means of external randomization, women were allocated to an OMTh group and a waitlist control group. Osteopathic manipulative therapy was provided 4 times at intervals of 2 weeks, with a follow-up after 12 weeks. The OMTh was tailored to each participant and based on osteopathic principles. The participants allocated to the control group did not receive OMTh during the 8-week study; rather, they were put on a waiting list to receive OMTh on completion of the study. Further, they were not allowed to receive any additional treatment (ie, medication, physical therapy, or other sources of pain relief) during the study period. The main outcome measures were pain intensity as measured by a visual analog scale and the effect of LBP on daily activities as assessed by the Oswestry Disability Index (ODI). Results: A total of 80 women aged between 23 and 42 years (mean [SD], 33.6 [4.5] years) were included in the study, with 40 in the OMTh group and 40 in the control group. Pain intensity decreased in the OMTh group from 7.3 to 2.0 (95% CI, 4.8-5.9; PP=.005). The between-group comparison of changes revealed a statistically significant improvement in pain intensity in the OMTh group (between-group difference of means, 4.8; 95% CI, 4.1-5.4; PP Conclusion: During 8 weeks, OMTh applied 4 times led to clinically relevant positive changes in pain intensity and functional disability in women with postpartum LBP. Further studies that include prolonged follow-up periods are warranted. (German Clinical Trials Register: DRKS00006280.)
- Published
- 2015
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