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Objective: To evaluate the effectiveness of osteopathic manipulative treatment (OMT) associated with transcranial direct current stimulation (tDCS) in reducing pain, disability, and improving quality of life in participants with non-specific chronic low back pain. Design: A randomised double-blind clinical trial. Setting: Clinical outpatient unit. Subjects: 72 participants with non-specific chronic low back pain were randomised into three groups: active tDCS + OMT (n = 24), sham tDCS + sham OMT (n = 24), and sham tDCS + OMT (n = 24). Interventions: Evaluations were performed before, after the intervention, and one month post-intervention. tDCS consisted of ten 20-minute sessions over two weeks (five sessions per week). OMT was administered once per week, with two sessions conducted before the first and sixth tDCS sessions. Main measures: Pain, disability, and quality of life were assessed at baseline, after two weeks, and at one month of follow-up. Results: The visual analogue scale showed a significant decrease in all groups (p < 0.001). However, tDCS + OMT and sham tDCS + OMT demonstrated a clinically significant reduction compared to the sham combination (effect size n ² = 0.315). Roland-Morris scores decreased across all groups without specific group effects. EuroQoL 5-Dimension 3-Level improvement was observed only in the tDCS + OMT and sham tDCS + OMT groups (significant difference between T2 and T0, p = 0.002). Conclusion: The combination of OMT and tDCS did not provide clinically significant improvement over OMT alone in participants with non-specific chronic low back pain. [ABSTRACT FROM AUTHOR]

During pregnancy, the various changes women undergo can affect their health status. Manual therapies are important aids because they do not use medication. This study aimed to evaluate the influence of osteopathic manipulative treatment on the intensity of lumbar and pelvic pain and changes in quality of life. This prospective study included women over 18 years old and between 27 and 41 weeks pregnant, and excluded women with fetal malformations, multiple fetuses, premature rupture of membranes, and in labor. Forty-six pregnant women were selected and divided into two groups of ≤3 and ≥4 visits. Statistically significant improvements were observed in the intensity of maximum low back pain (7.54 ± 1.47 vs. 3.815 ± 1.73, p ≤ 0.01) and minimum low back pain (5.67 ± 2.03 vs. 3.111 ± 1.67, p ≤ 0.01), maximum pelvic pain (6.54 ± 2.22 vs. 2.77 ± 1.64, p = 0.01), and minimum pelvic pain (5.615 ± 2.21 vs. 2.615 ± 1.66, p = 0.01). Both groups achieved improvements in quality of life indices, with the improvements achieved by the ≥4-visits group being statistically significant. Osteopathic treatment was effective in reducing the intensity of lumbar and pelvic pain and in improving the quality of life of pregnant women in the third trimester. [ABSTRACT FROM AUTHOR]

Background: Osteopathic medicine is based on a diagnostic and therapeutic system to treat tissue mobility/motility dysfunctions in general, using different approaches (depending on the target tissue) known as osteopathic manipulative treatment. Among the available techniques those ones addressed to the cranial field are the most questioned because of the lack of scientific evidence; but the compression of the 4th ventricle technique has been largely studied in clinical trials. Studies have shown that the technique may affect both central and autonomous nervous system, modulating some reflexes (Traube-Hering baro signal), and modifying brain cortex electrical activity through central sensitization in subjects with chronic low back pain. Thus, investigators hypothesize that the compression of the 4th ventricle may modulate peak alpha frequency (eletroencephalographic assessment) and promote physical relaxation in subjects in vigil. Methods/Design: A randomized, controlled crossover trial with blinded assessor was designed to test the hypothesis. A total of 81 participants will be assigned to three treatment conditions, with seven days of washout: (I) compression of the 4th ventricle; (II) sham compression of the fourth ventricle; (III) control (no intervention). The (I) power amplitude and the (II) frequencies of the dominant peak in the alpha band will be the primary outcome measures of the study. All participants will be recruited at the Outpatient Rehabilitation Service of the University Hospital of Brasília - University of Brasília. All the electroencephalographic exams will be conducted by a blinded assessor. Discussion: The investigators hypothesize that patients with chronic low back pain submitted to the technique would have the peak alpha frequency modulated and, thus, would experience physical relaxation. [ABSTRACT FROM AUTHOR]