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Background/Objectives: Manual therapies like Osteopathic Manipulative Treatment (OMT) and Gentle Touch Intervention (GTI) are widely employed for improving posture and spinal alignment, but their effects as measured using advanced technologies remain underexplored. This study aims to evaluate the short-term postural effects of these interventions using a non-invasive three-dimensional rasterstereography-based approach, focusing on the cervical arrow, lumbar arrow, kyphotic angle, and lordotic angle parameters. Methods: A three-armed randomized controlled trial was conducted with 165 healthy participants. The subjects were divided into control (CTRL), OMT, and GTI groups. Their postural parameters were assessed pre- and post-intervention using the Spine3D system by Sensor Medica (Guidonia Montecelio, Italy). The statistical analyses included paired t-tests and an ANOVA, with the significance set at p < 0.05. Results: Significant reductions in the cervical arrow were observed in both the OMT (p < 0.005) and GTI (p < 0.05) groups, while the kyphotic angle significantly improved only in the GTI group (p < 0.05). No significant changes were found in the lumbar arrow or the lordotic angle across the groups. The control group showed no postural variations, reinforcing the specificity of the interventions. Conclusions: Both OMT and GTI influence spinal posture, particularly in the cervical and thoracic regions. GTI, with its gentle approach, demonstrated unique effects on the thoracic curvature, suggesting neurophysiological mechanisms. These findings highlight the potential of manual therapies for posture modulation and suggest future research should explore their long-term benefits and applications in clinical populations. [ABSTRACT FROM AUTHOR]

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]

Objectives: The aim of this systematic review and meta-analysis was to compare whether osteopathic manipulative treatment (OMT) for somatic dysfunctions was more effective than sham or placebo interventions in improving pain intensity, disability, and quality of life for patients with neck pain (NP) or low-back pain (LBP). Methods: A systematic review and meta-analysis was carried out. Searches were conducted in PubMed, Physiotherapy Evidence Database, Cochrane Library, and Web of Science from inception to September 2024. Studies applying a pragmatic intervention based on the diagnosis of somatic dysfunctions in patients with NP or LBP were included. The methodological quality was assessed with the PEDro scale. The quantitative synthesis was performed using random-effect meta-analysis calculating the standardized mean difference (SMD) with RevMan 5.4. The certainty of evidence was evaluated using GRADEPro. Results: Nine studies were included in the qualitative synthesis, and most of them showed no superior effect of OMTs compared to sham or placebo in any clinical outcome. The quantitative synthesis reported no statistically significant differences for pain intensity (SMD = −0.15; −0.38, 0.08; seven studies; 1173 patients) or disability (SMD = −0.09; −0.25, 0.08; six studies; 1153 patients). The certainty of evidence was downgraded to moderate, low, or very low. Conclusions: The findings of this study reveal that OMT is not superior to sham or placebo for improving pain, disability, and quality of life in patients with NP or LBP. [ABSTRACT FROM AUTHOR]

Medial Tibial Stress Syndrome (MTSS) is one of the most common and disabling leg injuries in military personnel and in athletes participating in sports that involve running and jumping. The objective of this case report was to verify the efficacy of osteopathic manipulation as sole treatment in a basketball player suffering from Medial Tibial Stress Syndrome (MTSS). Case report. The patient in the study was a 26-year-old basketball player who reported a 6-week history of MTSS pain. MTSS diagnosis was made clinically, based on the patient's medical history and pain on palpation. A postural and biomechanical evaluation was also performed in order to study the patient's gait cycle and identify possible risk factors for MTSS. MTSS treatment is mainly conservative. From the initial diagnosis to the end of the follow-up period, no other therapy was performed other than osteopathic manipulative treatment. Overall positive results were obtained after a 2-month follow-up: VAS scores gradually decreased pain during exercise and daily activities diminished and an increase of game statistics was recorded. Considering the results obtained, osteopathic manipulative treatment has proven highly efficient in the treatment of MTSS, without the use of drugs and a decisive role in avoiding suspension from sports. [ABSTRACT FROM AUTHOR]

Background/Objectives: In osteopathy, it becomes necessary to produce high-quality evidence to demonstrate its effectiveness. The aim of this meta-research study is to assess the reporting quality of RCTs published in the osteopathic field. Methods: The protocol was preliminarily registered on the "Open Science Framework (OSF)" website. For reporting, we considered the PRISMA 2020 checklist. We included all the RCTs, published between 2011 and 2023, investigating the effectiveness of Osteopathic Manipulative Treatment (OMT) in any possible condition. The search process was conducted on four major biomedical databases including PubMed, Central, Scopus and Embase. A data extraction form was implemented to collect all relevant information. The completeness of reporting was calculated as the percentage of adherence to the CONSORT checklist; the Cochrane ROB 2 tool was considered to assess the risk of bias (RoB) in the following five major domains: randomization (D1), interventions (D2), missing data (D3), outcome measurement (D4), selective reporting (D5). Results: A total of 131 studies were included and the overall adherence was 57%, with the worst section being "other information" (42%). Studies with a lower RoB showed higher adherence to the CONSORT. The "results" section presented the highest differences as follows: D1 (−36.7%), D2 (−27.2%), D3 (−21.5%) and D5 (−25.5%). Significant correlations were also found between the preliminary protocol registration, higher journal quartile, publication in hybrid journals and the completeness of reporting (β: 19.22, CI: 14.45–24.00, p < 0.001; β: 5.41; CI: 2.80–8.02, p ≤ 0.001; β: 5.64, CI: 1.06–10.23, p = 0.016, respectively). Conclusions: The adherence to the CONSORT checklist in osteopathic RCTs is lacking. An association was found between a lower completeness of reporting and a higher RoB, a good journal ranking, publication in hybrid journals and a prospective protocol registration. Journals and authors should adopt all the strategies to adhere to reporting guidelines to guarantee generalization of the results arising from RCTs. [ABSTRACT FROM AUTHOR]

Verändert die osteopathische herzfokussierte Palpation die Herzfrequenzvariabilität bei Personen mit muskuloskelettalen Schmerzen, die unter Stress stehen? Teil 1 des zweiteiligen Artikels beschreibt Ziele, Material und Methoden der randomisierten, kontrollierten Pilotstudie, in Teil 2 in der folgenden Ausgabe werden die Ergebnisse präsentiert. Die Herzfrequenzvariabilität (HRV) beschreibt Schwankungen in den Zeitintervallen zwischen den Herzschlägen und spiegelt die autonome Aktivität wider. Die HRV ist bei gestressten Patient*innen mit Muskel-Skelett-Schmerzen reduziert und verbessert sich nach einer osteopathischen manipulativen Behandlung und Mind-Body-Interventionen. Die herzfokussierte Palpation (HFP) kombiniert manuelle und Mind-Body-Ansätze um die Entspannung zu fördern. Diese randomisierte, kontrollierte Pilotstudie untersuchte die Durchführbarkeit und den Stichprobenumfang für eine künftige randomisierte, kontrollierte Studie sowie die Wirkung einer einmaligen Behandlung mit HFP oder Schein-HFP (SHAM) auf die kurzfristige HRV. Insgesamt 33 Teilnehmende schlossen die Studie ab. Does osteopathic heart-focused palpation change heart rate variability in people with musculoskeletal pain who are under stress? Part 1 of this two-part article describes the aims, material, methods and participants of the randomized, controlled pilot study; part 2 in the following issue will present the results. Heart rate variability (HRV) describes fluctuations in time intervals between heartbeats and reflects autonomic activity. HRV is reduced in stressed patients with musculoskeletal pain and improved after osteopathic manipulative treatment and mind–body interventions. Heart-focused palpation (HFP) combines manual and mind–body approaches to facilitate relaxation. This randomised controlled pilot study investigated the feasibility and sample size for a future randomised controlled trial and the effect of a single treatment with HFP or sham HFP (SHAM) on short-term HRV. A total of 33 adults with stress and musculoskeletal pain completed the trial. [ABSTRACT FROM AUTHOR]

The Morel-Lavallee lesion (MLL) is a closed, degloving soft-tissue injury, wherein the skin and subcutaneous tissue are separated from the underlying fascia. This syndrome causes disruption of wound healing. Infrared thermography is a noninvasive and pain-free tool that can be used to evaluate scar and the influence of osteopathic manipulative treatment. To evaluate the influence of post-operative osteopathic manipulative treatment (OMT) of Morel-Lavallee lesions (MLL). During four osteopathic sessions on one volunteer patient, 28-year-old male, resulting in MLL of the left knee after motorcycle accident. The effects of OMT were assessed using an infrared thermal imaging camera and qualitative palpation examination of osteopathic dysfunction, scored on a scale of 1–4. and discussion: Both scar and peri-scar area temperatures increased after OMT. The difference in temperature between the scar and the peri-scar area decreased after OMT. Increase in temperature was greater when the OMT was applied around the scar than when applied at a distance from the scar site. The palpation score for dysfunction of the MLL scar site decreased from 4/4 to 2/4 after the final session. Several OMT sessions focusing on the MLL scar site appear necessary to obtain noteworthy results. OMT improved mobility and increased the temperature of the scar and the peri-scar area. [ABSTRACT FROM AUTHOR]

Osteopathic manipulative treatment (OMT) is a hands-on therapy aiming to achieve the global homeostasis of the patient. OMT focuses on treating the somatic dysfunctions characterized by tissue modifications, body asymmetry, and range-of-motion restrictions. The benefits related to OMT are thought to be associated with the interconnectedness of the body's systems and the inherent capacity for self-healing. However, whether OMT can influence brain activity, and, consequently, neurophysiological responses is an open research question. Our research investigates the literature to identify the effects of OMT on brain activity. The main purpose of the research question is: can OMT influence brain activity and consequently neurophysiological responses? A scoping review was conducted, searching the following databases: PubMed, Google Scholar, and OSTEOMED.DR (Osteopathic Medical Digital Repository), Scopus, Web of Science (WoS), and Science Direct. The initial search returned 114 articles, and after removing duplicates, 69 were considered eligible to be included in the final sample. In the end, eight studies (six randomized controlled trials, one pilot study, and one cross-over study) were finally included and analyzed in this review. In conclusion, OMT seems to have a role in influencing functional changes in brain activity in healthy individuals and even more in patients with chronic musculoskeletal pain. However, further RCT studies are needed to confirm these findings. Registration protocol: CRD42024525390. [ABSTRACT FROM AUTHOR]

Background and Aim: The aim of this study is to compare the effects of osteopathic manipulative therapy home program (OMT‐H) versus abdominal massage home program (AMHP) in treating constipation in children with cerebral palsy (CP). Methods: Twenty‐nine children with CP with a mean age of 12.2 ± 3.76 years, who were constipated and were not on medication, were divided into three randomized groups: (i) control group (n = 10), (ii) AMHP (n = 10), and (iii) OMT‐H (n = 9). In AMHP and OMT‐H groups, treatment was applied as 20‐min sessions every other day for 10 sessions for 3 weeks. Modified Constipation Assessment Scale (MCAS), Rome III criteria, and the Bristol Stool Form Scale (BSFS) were used for evaluation before treatment and once a week during treatment. Results: While there was no change in constipation symptoms in the control group, there was an improvement in constipation symptoms after treatment in the AMHP and OMT‐H groups (AMHP, P = 0.003; OMT‐H, P = 0.000014). While the treatment showed to be effective from the first week in the OMT‐H group, the change in BSFS (P = 0.026) and MCAS sub‐parameters was found to be superior. Conclusion: AMHP and OMT‐H are effective and beneficial in treating constipation. In children with CP, OMT‐H was found to be quicker and more successful compared with AMHP. The OMT‐H can be effectively used in clinical practice in relieving constipation in CP. [ABSTRACT FROM AUTHOR]

Chronic inflammatory diseases (CIDs) are debilitating and potentially lethal illnesses that affect a large proportion of the global population. Osteopathic manipulative treatment (OMT) is a manual therapy technique developed and performed by osteopathic physicians that facilitates the body's innate healing processes. Therefore, OMT may prove a beneficial anti‐inflammatory modality useful in the management and treatment of CIDs. This work aims to objectively evaluate the therapeutic benefits of OMT in patients with various CIDs. In this review, a structured literature search was performed. The included studies involving asthma, chronic obstructive pulmonary disease, irritable bowel syndrome, ankylosing spondylitis, and peripheral arterial disease were selected for this work. Various OMT modalities, including lymphatic, still, counterstain, and muscle energy techniques, were utilized. Control treatments included sham techniques, routine care, or no treatment. OMT utilization led to variable patient outcomes in individuals with pathologies linked to CID. [ABSTRACT FROM AUTHOR]

Zielsetzung: Postoperative Schmerzen zu lindern und die Genesung zu fördern, ist das Ziel der osteopathischen Manipulationstherapie (OMT) bei chirurgischen Patient*innen. Die Auswirkungen der OMT wurden bei herzchirurgischen Patient*innen nicht umfassend untersucht, was vor allem darauf zurückzuführen ist, dass nur wenige osteopathisch tätige Ärztinnen und Ärzte eine thoraxchirurgische Ausbildung haben. Methoden: Systematische Literaturrecherche zur Ermittlung aller derzeit verfügbaren Daten zur postoperativen OMT bei herzchirurgischen Patient*innen; Ausschluss von Fallberichten und Fallserien. Das Risiko einer Verzerrung wurde anhand spezifischer Protokolle für jede Studie einzeln bewertet. Zu den interessierenden Ergebnissen gehörten postoperative Schmerzen, Dauer des Krankenhausaufenthalts, Veränderungen der Atmungskapazität sowie Veränderungen von Herzindex und gemischtvenösen Sauerstoffsättigung (SvO2). Ergebnisse: In die quantitative Analyse dieser Übersichtsarbeit wurden 4 in Frage kommende Studien einbezogen: 3 randomisierte kontrollierte Studien (RCTs) und 1 nicht-randomisierte kontrollierte Kohortenstudie. Die am häufigsten durchgeführten herzchirurgischen Eingriffe waren koronare Bypass-OPs, Klappen- und kombinierte Eingriffe und Aortenoperationen. Postoperativ wurden die Patient*innen mittels zahlreicher OMT-Modalitäten behandelt. In der OMT-Gruppe zeigten sich Verbesserungen hinsichtlich Schmerzen und Atmungskapazität sowie eine kürzere Krankenhausverweildauer. Schlussfolgerungen: Die osteopathische Behandlung könnte als Ergänzung zu den derzeitigen medizinischen Therapien hilfreich sein, um postoperative Schmerzen zu lindern und den Funktionsstatus von Patient*innen insgesamt zu verbessern. Objective: Osteopathic manipulative treatment (OMT) in surgical patients aims at reducing postoperative pain and enhancing recovery. The effects of OMT have not been extensively studied in cardiac surgery patients, mostly owing to the fact that a limited number of osteopathic physicians are trained in thoracic surgery. Methods: A systematic review of the literature was performed to identify all currently available data on post- operative OMT in cardiac surgery patients. Case reports and case series were excluded. Risk of bias of the eligible studies was assessed individually using specific protocols. Among the outcomes of interest were postoperative pain, hospital length of stay, changes in respiratory capacity, and changes in cardiac index and mixed oxygen venous saturation (SvO2) measurements. Results: We identified four eligible studies which were included in the quantitative analysis of the present review. There were three randomized controlled trials (RCTs) and one non-randomized controlled cohort study which investigated on outcomes of OMT in cardiac surgery patients. The most common cardiac operations performed were coronary artery bypass grafting, valve procedures, combined procedures, and aortic operations. Numerous OMT modalities were used on postoperative patients. The OMT group of patients showed improvement in pain management and respiratory capacity, and shorter hospital length of stay. Conclusions: Osteopathic treatment might be helpful as an adjunct to current medical therapies in mitigating postoperative pain and improving the overall patient's functional status. [ABSTRACT FROM AUTHOR]

BackgroundManipulative treatment can effectively improve knee pain and function, but no previous studies have shown that lumbar osteopathic manipulative treatment can improve knee symptoms. To explore the influence of lumbar manipulation on KOA and analyze its principlerelationship between coronal position of lumbar spine and KOA.MethodsPatients were divided into OMT group and DT group according to treatment. WOMAC scores were compared between the two groups, and X-ray examinations before and after treatment were performed in OMT group to analyze the imaging changes.ResultsBoth OMT group and DT group showed significant improvement in WOMAC score after treatment, and the improvement in OMT group was better than that in DT group. After OMT treatment, cTMI(P = 0.034), mL-SOD (P < 0.001), mΔL-KOD (P = 0.001), LL (P = 0.036), and FTA(P = 0.026) were significantly changed.ConclusionCompared with drug therapy, lumbar manipulation can better improve WOMAC scores in KOA patients. It relives symptoms by loosening muscles and correcting small joint disorders to improve local knee alignment.

Background and purpose: Osteopathic Manipulative Treatment (OMT) is a therapeutic whole-body approach mainly focused on correcting somatic dysfunctions. The aim of this scoping review is to systematically map the literature regarding the documented biological effects observed following OMT. Methods: The 2020 JBIRM version and the PRISMA-ScR were followed for the conceptualization and reporting of this review. The protocol was registered on the “Open Science Framework Registry” (https://doi.org/10.17605/OSF.IO/MFAUP). We searched for original articles published on Medline, Embase, and Scopus, from inception to the present. Results: Overall, 10,419 records were identified. After duplicate removal, screening for title and abstract, and specific exclusions with reasons, a total of 146 studies were included. Wide differences were detected among studies in their geographical localization, study design, temporal distribution, participants’ condition, OMT protocols, and documented biological effects. Such variety in frequency distribution was properly described through descriptive statistics. Conclusions: Biological modifications that appear to be induced by OMT have been detected in several body systems, but mostly in neurophysiological correlates and musculoskeletal changes. Results suggest a growing interest over the years on this topic, especially in the last two decades. More efforts in research are recommended to highlight whether such changes specifically depend on OMT, and to demonstrate its specific contribution to clinical practice.

Abstract Background and Aim The aim of this study is to compare the effects of osteopathic manipulative therapy home program (OMT‐H) versus abdominal massage home program (AMHP) in treating constipation in children with cerebral palsy (CP). Methods Twenty‐nine children with CP with a mean age of 12.2 ± 3.76 years, who were constipated and were not on medication, were divided into three randomized groups: (i) control group (n = 10), (ii) AMHP (n = 10), and (iii) OMT‐H (n = 9). In AMHP and OMT‐H groups, treatment was applied as 20‐min sessions every other day for 10 sessions for 3 weeks. Modified Constipation Assessment Scale (MCAS), Rome III criteria, and the Bristol Stool Form Scale (BSFS) were used for evaluation before treatment and once a week during treatment. Results While there was no change in constipation symptoms in the control group, there was an improvement in constipation symptoms after treatment in the AMHP and OMT‐H groups (AMHP, P = 0.003; OMT‐H, P = 0.000014). While the treatment showed to be effective from the first week in the OMT‐H group, the change in BSFS (P = 0.026) and MCAS sub‐parameters was found to be superior. Conclusion AMHP and OMT‐H are effective and beneficial in treating constipation. In children with CP, OMT‐H was found to be quicker and more successful compared with AMHP. The OMT‐H can be effectively used in clinical practice in relieving constipation in CP.

Objectives: The aim of this systematic review and meta-analysis was to compare whether osteopathic manipulative treatment (OMT) for somatic dysfunctions was more effective than sham or placebo interventions in improving pain intensity, disability, and quality of life for patients with neck pain (NP) or low-back pain (LBP). Methods: A systematic review and meta-analysis was carried out. Searches were conducted in PubMed, Physiotherapy Evidence Database, Cochrane Library, and Web of Science from inception to September 2024. Studies applying a pragmatic intervention based on the diagnosis of somatic dysfunctions in patients with NP or LBP were included. The methodological quality was assessed with the PEDro scale. The quantitative synthesis was performed using random-effect meta-analysis calculating the standardized mean difference (SMD) with RevMan 5.4. The certainty of evidence was evaluated using GRADEPro. Results: Nine studies were included in the qualitative synthesis, and most of them showed no superior effect of OMTs compared to sham or placebo in any clinical outcome. The quantitative synthesis reported no statistically significant differences for pain intensity (SMD = −0.15; −0.38, 0.08; seven studies; 1173 patients) or disability (SMD = −0.09; −0.25, 0.08; six studies; 1153 patients). The certainty of evidence was downgraded to moderate, low, or very low. Conclusions: The findings of this study reveal that OMT is not superior to sham or placebo for improving pain, disability, and quality of life in patients with NP or LBP.

Abstract Background In the United States, osteopathic manipulative treatment (OMT), is a popular complementary physical health approach for the treatment of neuromusculoskeletal disorders. However, post-OMT adverse events (AEs) are poorly defined in terms of frequency, severity, and temporal evolution. To date, no benchmark for patient safety exists. To improve understanding in this field, we set out to model the landscape of patient harm after OMT. Methods We conducted a comprehensive search of all available primary clinical research studies reporting on the occurrence of post-OMT AEs in nonpregnant, adult outpatients treated by an osteopathic physician in the United States. The methodology of eligible studies was then reviewed to select those containing the minimum required dataset to model the post-OMT AEs. The minimum required dataset consisted of four model parameters: ‘post-OMT interval’, ‘OMT encounters with post-OMT interval assessment’, ‘AEs preceded by an OMT encounter’, and ‘AE severity.’ We used the dataset extracted from selected studies to calculate a patient safety benchmark defined as the incidence rate of AEs per 100 post-OMT interval-days. Results From 212 manuscripts that we identified, 118 primary clinical research studies were assessed for eligibility. A total of 23 studies met inclusion criteria for methodological review, of which 13 studies passed and were selected for modeling. Mild AEs were the most frequent, accounting for n = 161/165 (98%) of total AEs observed in the literature. The cumulative incidence of mild AEs was also significantly greater (P = 0.01) than both moderate and severe grades. The benchmark incidence rate was 1.0 AEs per 100 post-OMT interval-days. Conclusions The majority of post-OMT AEs observed in the primary clinical literature were of mild severity. Modeling of the combined dataset on post-OMT AEs allowed for the derivation of a patient safety benchmark that, to date, has not been established in the field of osteopathic manipulative medicine. Additional research is needed to improve model resolution during the post-OMT period. This work conceptualized a model for identifying and grading post-OMT AEs, which should facilitate future comparisons between institutions in order to continually improve patient safety standards in the field of osteopathic manipulative medicine.

Introduction: Migraines are the leading cause of disability in the United States, and the use of non-pharmaceutical treatments like osteopathic manipulative treatment (OMT) has shown promise. Despite its potential, the lack of mechanistic understanding has hindered widespread adoption. This study aims to investigate the efficacy of OMT in treating acute migraines and unravel its underlying mechanisms of action. Methods: Female rats were subjected to a "two-hit" approach to induce migrainelike pain. This involved bilateral injections of Complete Freund's Adjuvant (CFA) into the trapezius muscle (1st hit) followed by exposure to Umbellulone, a human migraine trigger, on Day 6 post-CFA (2nd hit). Soft tissue and articulatory techniques were applied to the cervical region for acute abortive or repeated prophylactic treatment. Cutaneous allodynia and trigeminal system activation were assessed through behavioral tests and immunohistochemical staining. Results: Following Umbellulone inhalation, CFA-primed rats exhibited periorbital and hind paw allodynia. Immediate application of OMT after Umbellulone inhalation as an abortive treatment partially alleviated cutaneous allodynia. With OMT applied thrice as a prophylactic measure, complete suppression of tactile hypersensitivity was observed. Prophylactic OMT also prevented the increase of c-fos signals in the trigeminal nucleus caudalis and the elevation of calcitonin gene-related peptide expression in trigeminal ganglia induced by CFA and Umbellulone exposure at 2 h post-inhalation. Discussion: These findings providemechanistic insights intoOMT'smigraine-relief potential and underscore its viability as a non-pharmacological avenue for managing migraines. [ABSTRACT FROM AUTHOR]

Heart rate variability (HRV) describes fluctuations in time intervals between heartbeats and reflects autonomic activity. HRV is reduced in stressed patients with musculoskeletal pain and improved after osteopathic manipulative treatment and mind–body interventions. Heart-focused palpation (HFP) combines manual and mind–body approaches to facilitate relaxation. This randomised controlled pilot study investigated the feasibility and sample size for a future randomised controlled trial and the effect of a single treatment with HFP or sham HFP (SHAM) on short-term HRV. A total of Thirty-three adults (47.7 ± 13.5 years old) with stress and musculoskeletal pain completed the trial with acceptable rates of recruitment (8.25 subjects per site/month), retention (100%), adherence (100%), and adverse events (0%). HFP (n = 18), but not SHAM (n = 15), significantly increased the root mean square of successive RR interval differences (p = 0.036), standard deviation of the NN intervals (p = 0.009), and ratio of the low-frequency to high-frequency power band (p = 0.026). HFP and SHAM significantly decreased the heart rate (p < 0.001, p = 0.009) but not the stress index and ratio of the Poincaré plot standard deviation along and perpendicular to the line of identity (p > 0.05). A power analysis calculated 72 participants. Taken together, the study was feasible and HFP improved HRV in stressed subjects with musculoskeletal pain, suggesting a parasympathetic effect. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome (PCOS) is a complex hormonal condition associated with psychological, reproductive, and metabolic features. Low-grade inflammation is a recognised factor causing metabolic and reproductive disorders in PCOS, which is why anti-inflammation approaches in PCOS treatment, especially during the COVID pandemic, are considered. A promising therapeutic option is osteopathic manipulative treatment (OMT), which activates the cholinergic anti-inflammatory pathway and can inhibit proinflammatory cytokines, such as TNF, IL-1ß, and TNF-a. In our paper we analysed the influence of OMT in women with PCOS. Material and methods: Seventy-three patients, aged 29-46 years, with a history of reproductive failure, who underwent a physiotherapeutic treatment were evaluated. Six months after the end of a physiotherapy session, a follow-up questionnaire was performed. Results: The results show that most women (83.6%) were satisfied with the therapeutic process, and that the sessions met the patient's expectations. Reducing the level of anxiety related to infertility treatment and pregnancy was declared by 60 (82.2%) women, an improvement in well-being was declared by 72 (97.3%) (p = 0.04), and increasing awareness of the body after physiotherapy sessions was declared by 70 (95.9%) women. Conclusions: The physiotherapeutic sessions improved infertility treatment, enhanced quality of life, and had a positive effect on overall health in PCOS women. [ABSTRACT FROM AUTHOR]

Background: Each year in France, there are an average of 55000 preterms, the number of wich has been increasing since the 90's. Their management is complex and requires a multidisciplinary approach, with cognitives, motor en sensory after-effects observed. The object of this study was to evaluate if osteopathy have a place in the management of preterms without associate comorbidities. Methods: In this review of the literature 14 articles from 2011 to 2020 were selected and studied among clinical trials, literature review and meta-analysis. Results: There was a reduction in length of stay of 3 days on average, a theoretical reduction in hospital costs, a reduction of heart rate and an improvement in orality disorders. No significant results for weigth gain, and meconium evacuation. Conclusion: Osteopathic manipulative treatment seem to have a positive impact in the care of preterms. It favors homeostatis, thus a better neurological development and the reduction of length of stay. [ABSTRACT FROM AUTHOR]

Purpose: Manual therapy is used as a conservative treatment for people with low back pain (LBP). The scale of the problem encourages the search for the most effective methods to assess of manual treatment. Therefore, the aim of the study was to investigate magnitude of changes in muscle endurance using the Biering-Sorensen test (BST) and to analyse balance in patients with LBP treated with ERS and FRS muscle energy techniques (MET). Methods: The study included fifteen men with LBP (mean age: 42 years) working as automotive assemblers. Endurance of the biceps femoris (BF), gluteus maximus (GM) and erector spinae (ES) muscles were analysed using sEMG during the BST. The level of experienced pain, degree of disability and postural stability were also examined. Results before and after a three-week treatment cycle using MET were compared. Results: The MET therapy resulted in a reduction in pain (p = 0.001), an improvement in the degree of disability (p < 0.001) and an increase in the duration of the BST (p < 0.001). After therapy, the values of the NMFs parameter indicating the degree of fatigue increased, i.e., ES muscle endurance increased, both right (p = 0.004) and left (p < 0.001). There was also a statistically significant decrease in the centre of pressure (COP) movement velocity in balance tests. Conclusions: The use of MET in patients with LBP increases muscle endurance, improves postural balance, and reduces pain levels on the VAS and disability levels according to the ODI. MET appears to be a good tool for preventing LBP. [ABSTRACT FROM AUTHOR]

Fibromyalgia (FM) is a chronic pain syndrome characterized by a large variety of symptoms. Evidence suggests that an alteration of central nervous system processing of pain could be involved. The purpose of this study is to analyze clinical records of patients affected by FM who underwent osteopathic manipulative treatment (OMT), predominantly based on a myofascial release approach (MFR). This retrospective study considered records of 21 FM patients with moderate or severe functional impact, who consented to OMT in addition to their usual care. The assessment considered the following measures: FIQ (functional status), SF36 (quality of life), VAS (pain), TSK (kinesiophobia) and PSQI (quality of sleeping). Patients were preliminarily assessed over a 1 month run-in phase, then after 1, 2 and 4 months; a 1 month follow-up was also considered. After one month, 71% of patients reported a decrease in functional impact and scores remained stable until follow-up (from 69.8 to 52.37, p≤0.001). Overall, after four months, patients improved their quality of life, with a score ranging from 33.47 to 42.6 (p≤0.05). We also observed a reduction of pain (p≤0.05). A series of OMT sessions based on MFR could play a therapeutic role in improving functional status, pain and quality of life over a period of 4 months. [ABSTRACT FROM AUTHOR]

IntroductionMigraines are the leading cause of disability in the United States, and the use of non-pharmaceutical treatments like osteopathic manipulative treatment (OMT) has shown promise. Despite its potential, the lack of mechanistic understanding has hindered widespread adoption. This study aims to investigate the efficacy of OMT in treating acute migraines and unravel its underlying mechanisms of action.MethodsFemale rats were subjected to a “two-hit” approach to induce migraine-like pain. This involved bilateral injections of Complete Freund's Adjuvant (CFA) into the trapezius muscle (1st hit) followed by exposure to Umbellulone, a human migraine trigger, on Day 6 post-CFA (2nd hit). Soft tissue and articulatory techniques were applied to the cervical region for acute abortive or repeated prophylactic treatment. Cutaneous allodynia and trigeminal system activation were assessed through behavioral tests and immunohistochemical staining.ResultsFollowing Umbellulone inhalation, CFA-primed rats exhibited periorbital and hind paw allodynia. Immediate application of OMT after Umbellulone inhalation as an abortive treatment partially alleviated cutaneous allodynia. With OMT applied thrice as a prophylactic measure, complete suppression of tactile hypersensitivity was observed. Prophylactic OMT also prevented the increase of c-fos signals in the trigeminal nucleus caudalis and the elevation of calcitonin gene-related peptide expression in trigeminal ganglia induced by CFA and Umbellulone exposure at 2 h post-inhalation.DiscussionThese findings provide mechanistic insights into OMT's migraine-relief potential and underscore its viability as a non-pharmacological avenue for managing migraines.

Background: Chronic Low Back Pain (cLBP) poses a significant health challenge, leading to functional disability and reduced quality of life. Osteopathic Manipulative Treatment (OMT) is emerging as a therapeutic option for cLBP, but the brain mechanisms underlying its analgesic effect remain unclear. Materials and Methods: Thirty cLBP patients were randomly exposed to either four weekly sessions of OMT (N=16) or Sham treatment (N=14). Resting-state Magnetic Resonance Imaging (rs-MRI) scans and pain perception questionnaires were collected before and after treatment. A voxel-wise, rs-fMRI data-driven analysis was conducted to identify changes in the intrinsic functional connectivity across the whole brain that were associated with the OMT. Spearman’s correlations were used to test for the association between changes in intrinsic connectivity and individual reports of pain perception. Results: Compared to the Sham group, participants who received OMT showed significant alterations in the functional connectivity of several regions belonging to the pain matrix. Specifically, OMT was associated with decreased connectivity of a parietal cluster that includes the somatosensory cortex and an increase of connectivity of the right anterior insula and ventral and dorsal anterolateral prefrontal areas. Crucially, the change in connectivity strength observed in the ventral anterolateral prefrontal cortex, a putative region of the affective-reappraisive layer of the pain matrix, correlates with the reduction in pain perception caused by the OMT. Conclusions: This study offers insights into the brain mechanisms underlying the analgesic effect of OMT. Our findings support a link between OMT-driven functional cortical architecture alterations and improved clinical outcomes.

Background: In the United States, osteopathic manipulative treatment (OMT), is a popular complementary physical health approach for the treatment of neuromusculoskeletal disorders. However, post-OMT adverse events (AEs) are poorly defined in terms of frequency, severity, and temporal evolution. To date, no benchmark for patient safety exists. To improve understanding in this field, we set out to model the landscape of patient harm after OMT. Methods: We conducted a comprehensive search of all available primary clinical research studies reporting on the occurrence of post-OMT AEs in nonpregnant, adult outpatients treated by an osteopathic physician in the United States. The methodology of eligible studies was then reviewed to select those containing the minimum required dataset to model the post-OMT AEs. The minimum required dataset consisted of four model parameters: 'post-OMT interval', 'OMT encounters with post-OMT interval assessment', 'AEs preceded by an OMT encounter', and 'AE severity.' We used the dataset extracted from selected studies to calculate a patient safety benchmark defined as the incidence rate of AEs per 100 post-OMT interval-days. Results: From 212 manuscripts that we identified, 118 primary clinical research studies were assessed for eligibility. A total of 23 studies met inclusion criteria for methodological review, of which 13 studies passed and were selected for modeling. Mild AEs were the most frequent, accounting for n = 161/165 (98%) of total AEs observed in the literature. The cumulative incidence of mild AEs was also significantly greater (P = 0.01) than both moderate and severe grades. The benchmark incidence rate was 1.0 AEs per 100 post-OMT interval-days. Conclusions: The majority of post-OMT AEs observed in the primary clinical literature were of mild severity. Modeling of the combined dataset on post-OMT AEs allowed for the derivation of a patient safety benchmark that, to date, has not been established in the field of osteopathic manipulative medicine. Additional research is needed to improve model resolution during the post-OMT period. This work conceptualized a model for identifying and grading post-OMT AEs, which should facilitate future comparisons between institutions in order to continually improve patient safety standards in the field of osteopathic manipulative medicine. [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]

The aim of this systematic review and meta-analysis was to evaluate the effectiveness of the osteopathic manipulative treatment (OMT) in adults with irritable bowel syndrome (IBS). A literature resview was carried out on the following databases: PubMed, Embase, Cochrane, Cinahl, Scopus, PEDro and ClinicalTrials.gov. 350 articles were recovered. Eligibility criteria were evaluated by two independent reviewers, including randomized controlled trials (RCTs), quasi-RCTs, or ongoing RCTs with OMT compared to any kind of control in patients diagnosed with IBS. Six studies (five RCTs and one ongoing RCT) were considered eligible. Four RCTs were classified as some concerns and one as high risk of bias. In the meta-analysis, OMT compared to sham/no intervention showed statistically significant results for abdominal pain (effect size ES = −1.14 [−1.66, −0.62]; p < 0.0001) and constipation (ES = −0.66 [−1.12, −0.20]; p = 0.005). Instead, OMT was not superior to the control for the IBS symptoms measured with the IBS Severity Score and the Likert scale (ES = −0.34 [−0.83, 0.16]; p = 0.19), and diarrhea (ES = −1.20 [−2.84, 0.43]; p = 0.15). The quality of evidence was "low" for IBS symptoms in general for abdominal pain and constipation, while it was judged as "very low" for diarrhea. OMT turns out to be safe in the treatment of IBS without major adverse effects. OMT may be effective in IBS patients, however the results must be interpreted carefully due to the low methodological quality of the studies. [ABSTRACT FROM AUTHOR]

The primary aim of the study is to explore the knowledge and use of palpatory tests in detecting somatic dysfunction, the second is to assess the knowledge about the inhibitory tests among osteopathic practitioners in Italy, England, and France. A quantitative survey was conducted, between March and May 2021, through the administration of a semi-structured questionnaire. The participants had to answer 8 questions. A total of 2,223 e-mails were sent: 423 manual therapy professionals participated in the survey. Subsequently, only the responses of the 385 osteopaths (280 Italian, 23 French and 82 British) were included in the data processing; the 38 excluded were physiotherapists and chiropractors. The most significative outcomes for the total sample were found to: years of working experience and knowledge of a palpatory test that allows to discriminate two dysfunctional anatomical structures was significant with a χ2=12.509 (p-value <0.006); 68.5% answered in the affirmative to this last question. It was found that less work experience is associated with knowledge of a palpatory test to discriminate two dysfunctional structures. The correlation between years of work experience and knowledge of the inhibitory test was explored with the result being statistically significant (p-value <0.001). 64.4% know and use the inhibitory test. 39.1% base the inhibitory test on tissue change. The clinical practice of Italian and French professionals, makes possible to establish the hierarchy between two somatic dysfunctions with respect to English sample. The osteopaths reported a wider use of the tissue change parameters rather than pain reported by the patient. Furthermore, more than half of the sample-based their discriminatory test on the musculoskeletal and fascial systems. There is a vast knowledge of the inhibition test among osteopaths. [ABSTRACT FROM AUTHOR]

Esophageal atresia (EA) is a congenital malformation that affects the normal esophageal development. Surgical treatment, although restoring the integrity of the alimentary tract, may lead to long-term sequelae-like developmental abnormalities and musculoskeletal deformities. We evaluated the effects of osteopathic manipulative treatment (OMT) on the recovery of the range of the right upper limb movement and on the rise of the auxological parameters. A case series of five children affected by type C EA were described. Six OMT sessions were performed over a 4-month period. At each treatment, height, weight, body mass index (BMI) and range of motion (ROM) in elevation of the right upper limb were assessed. OMT was applied to improve scar, larynx, rib cage, and sternum mobility. An average change of 2.3 cm in height and an average increase of 8° in the ROM of the upper limb in the period of study were detected. Additionally, OMT could improve the anthropometric data and the mobility of the right upper limb of children surgically treated for EA. Further studies that evaluate the effectiveness of OMT in post surgical treatment of congenital malformations of the thorax can be considered in the future.

The clinical case describes the presence of hyoid bone syndrome (HBS) in a patient with a left ventricular assist device (LVAD) implantation, and the resolution of painful symptoms through an osteopathic manual technique (unwinding) applied to the tongue. To the knowledge of the authors, it is the first case report involving an LVAD patient with HBS treated with an osteopathic approach. The article briefly reviews the data relating to surgical therapy for patients with a clinical history of end-stage heart failure and symptoms related to HBS and posits some hypotheses on the presence of pain radiating from the hyoid bone to other areas of the body. The text reminds us to place greater clinical emphasis on the palpatory evaluation of the hyoid in the presence of non-specific painful symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Despite reports about improved nerve conduction after manual therapy, the literature offers no studies in which the impact would be assessed regarding rhythmic manual stimulation of the nerve structures on the functions of the innervated effectors.Research objective: The aim of the study was to evaluate the effects of brachial plexus manual stimulation on handgrip strength (HGS) as an indicator of brachial plexus function.Material and methods: A total of 63 volunteers were randomly divided into 2 groups that received manual stimulation (Intervention Group IG) or sham stimulation (Control Group CG) of the brachial plexus. Pre- and post-stimulation HGS of the dominant hand was measured using the JAMAR hydraulic hand dynamometer.Results: With regard to IG, a statistically significant increase (p

Die Studienlage bezüglich osteopathisch manipulativer Therapie (OMT) bei nicht-synostotischer, lagebedingter Plagiozephalie und infantiler Haltungsasymmetrie ist aktuell als spärlich zu bezeichnen. Ziel der vorliegenden Arbeit war es, den Therapieeffekt von osteopathisch manipulativer Therapie (OMT) gegenüber einer Verumgruppe nach dem Vojta-Konzept auf den Grad der Plagiozephalie zu vergleichen. In einer multizentrischen klinischen, kontrollierten, nicht-randomisierten Studie wurden insgesamt n = 45 Säuglinge mit bestehender infantiler Haltungsasymmetrie und Plagiozephalie untersucht. Nach einer standardisierten klinischen Untersuchung wurden als Zielparameter der Asymmetriescore nach Phillipi sowie das Severity Assessment for Plagiocephaly erhoben. Die OMT-Gruppe (n = 33) erhielt innerhalb der ersten 4 Wochen 3 befundorientierte osteopathische Behandlungen, die Vojta-Gruppe (n = 12) erhielt 1–2 Behandlungen wöchentlich über den gesamten 3-monatigen Zeitraum der Studie. Zum Vergleich wurde eine Nullgruppe symmetrischer Säuglinge (n = 8) mittels oben aufgeführter Assessments untersucht. Beide Behandlungsmethoden zeigten zum Follow-up T4 eine signifikante Verbesserung des Severity Assessment Scores (OMT-Gruppe: p = 0,000; Vojta-Gruppe: p = 0,015). Die OMT-Gruppe erreichte im Zwischengruppenvergleich zudem zum Zeitpunkt T2 (p = 0,031) sowie zu T3 (p = 0,000) Signifikanz. Die Therapieeffekte näherten sich wiederum zum Follow-up T4 an. 3× OMT verbessert ebenso wie eine durchgängig 1–2× wöchentlich durchgeführte Physiotherapie nach dem Vojta-Konzept bei Säuglingen unter 6 Monaten den Schweregrad einer lagebedingten, nicht-synostotischen Plagiozephalie. Currently, studies on osteopathic manipulative therapy (OMT) for non-synostotic positional plagiocephaly and infantile postural asymmetry are scarce. The aim of the present study focusses on the therapeutic effect regarding the degree of plagiocephaly, comparing osteopathic manipulative therapy (OMT) and treatment according to the Vojta concept. In a multicenter clinical, controlled, non-randomized study, a total of n = 45 infants with existing infantile postural asymmetry and plagiocephaly were examined. After a standardized clinical examination, the Phillipi asymmetry score and the Severity Assesment for Plagiocephaly were used as outcome parameters. The OMT group (n = 33) received 3 diagnosis-oriented osteopathic treatments within the first 4 weeks, while the Vojta group (n = 12) received 1–2 treatments weekly over the entire 3-month period of the study. For comparison, a zero-group of symmetric infants (n = 8) were examined using the assessments mentioned above. Both treatment methods showed a significant improvement in the severity assessment score at follow-up T4 (OMT group, p = 0.000; Vojta group, p = 0.015). The OMT group also reached significance in the between-group comparison at T2 (p = 0.031) and T3 (p = 0.000). The treatment effects of both groups converged at follow-up T4. Three diagnosis-based OMT, as well as continuous physiotherapy 1–2 times a week according to the Vojta concept improved the severity of positional non-synostotic plagiocephaly in infants under 6 months of age. [ABSTRACT FROM AUTHOR]

Die Osteopathie wird von Osteopath*innen und osteopathisch tätigen Ärzt*innen zur Behandlung einer Vielzahl pädiatrischer Beschwerden eingesetzt. In der aktuellen Studie wurden die vorhandenen Studien ausgewertet, um die Wirksamkeit der Osteopathie bei pädiatrischen Beschwerden zu bestimmen. Im Juli 2020 wurde eine systematische Literatursuche nach randomisierten kontrollierten Studien (RCTs) ohne Einschränkung in Sprache oder Publikationsstatus in elektronischen medizinischen Datenbanken durchgeführt. Eingeschlossene Studien wurden ausgewertet und nach dem Cochrane Risk of Bias-Schema (RoB) bewertet. Die Gesamteffektgröße wurde, wenn möglich, berechnet. Die Daten wurden anhand des GRADE-Ansatzes zusammengeführt. 47 RCTs, die 37 pädiatrische Erkrankungen untersuchten, wurden in das systematische Review eingeschlossen und ausgewertet. 23 Studien berichteten über signifikant günstige Ergebnisse für die Osteopathie im Vergleich zur Kontrollintervention. 14 weitere Studien berichteten über nicht signifikante Ergebnisse, die auf potenziell günstige Auswirkungen der Osteopathie hindeuten. 15 der Studien wurden mit einem niedrigen RoB bewertet, 12 hatten ein hohes Risiko zur Verzerrung, bei den restlichen war das Verzerrungsrisiko unklar. Bei der Qualitätsbewertung der Evidenz (GRADE) gab es eine moderate Evidenz für die Wirksamkeit der Osteopathie für 13 der 43 Vergleiche, insbesondere für die Dauer des Krankenhausaufenthalts bei Frühgeborenen, aber keine hochwertige Evidenz für die osteopathische Behandlung bei irgendeiner pädiatrischen Erkrankung. Obwohl eine Reihe von Studien auf positive Ergebnisse der osteopathischen Behandlung hinweisen, wurden nur wenige pädiatrische Erkrankungen von mehr als einer Studie untersucht, so dass die Osteopathie bei keiner Erkrankung eine hochwertige Evidenz erreichte. Es ist wahrscheinlich, dass weitere Forschungsergebnisse die Einschätzungen dieser Studie in die eine oder andere Richtung verändern werden. Zum Aufbau einer hochwertigen Evidenz werden größere, qualitativ hochwertige RCTs, die sich auf eine kleinere Anzahl von Erkrankungen konzentrieren, empfohlen. Registrierung des systematischen Reviews: PROSPERO ID : CRD42020162479. Osteopathic manipulative treatment (OMT) is commonly used by osteopaths and osteopathic physicians to manage a large variety of pediatric complaints. The current study reviewed the literature to determine the effectiveness of OMT for all pediatric complaints. A systematic literature search for randomized controlled trials (RCTs) unrestricted by language or publication status was performed in July 2020 in electronic and ongoing trials databases. Included studies were assessed using the Cochrane Risk of Bias (RoB) instrument. Mean difference or standard mean difference and overall effect size were calculated. Data were synthesized using the GRADE approach. 47 RCTs examining 37 pediatric conditions were reviewed. 23 studies reported significant favorable outcomes for OMT relative to the control intervention, and 14 additional studies reported non-significant outcomes, which suggested potential favorable effects of OMT. 15 of the studies were judged to have a low RoB, 12 had high risk, and the remainder had unclear RoB. Using GRADE, there was moderate evidence for the effectiveness of OMT for 13 of the 43 comparisons, particularly for length of hospital stay for preterm infants, but no high-quality evidence for any condition. Although a number of studies indicated positive results with use of OMT, few pediatric conditions have been investigated in more than one study, which results in no high-quality evidence for any condition. Additional research may change estimates of effect, and larger, high-quality RCTs focusing on a smaller range of conditions are recommended. Systematic review registration: PROSPERO ID: CRD42020162479. [ABSTRACT FROM AUTHOR]

Osteopathic manipulative treatment (OMT) in surgical patients aims at reducing postoperative pain and enhancing recovery. The effects of OMT have not been extensively studied in cardiac surgery patients, mostly owing to the fact that a limited number of osteopathic physicians are trained in thoracic surgery. A systematic review of the literature was performed to identify all currently available data on postoperative OMT in cardiac surgery patients. Case reports and case series were excluded. Risk of bias of the eligible studies was assessed individually using specific protocols. Among the outcomes of interest were postoperative pain, hospital length of stay, changes in respiratory capacity, and changes in cardiac index and mixed oxygen venous saturation (SvO 2) measurements. We identified four eligible studies which were included in the quantitative analysis of the present review. There were three randomized controlled trials (RCTs) and one non-randomized controlled cohort study which investigated on outcomes of OMT in cardiac surgery patients. The most common cardiac operations performed were coronary artery bypass grafting, valve procedures, combined procedures, and aortic operations. Numerous OMT modalities were used on postoperative patients. The OMT group of patients showed improvement in pain management and respiratory capacity, and shorter hospital length of stay. Osteopathic treatment might be helpful as an adjunct to current medical therapies in mitigating postoperative pain and improving the overall patient's functional status. • The present review identified studies on the postoperative effects of osteopathic manipulative treatment (OMT) in cardiac surgery patients. • Cardiac surgery patients who received OMT displayed decreased perception of postoperative pain as well as improved hemodynamics. • Although a small number of cardiac surgery patients are available for quantitative analysis through published studies, OMT therapies seem to hasten postoperative recovery. [ABSTRACT FROM AUTHOR]

Esophageal atresia (EA) is a congenital malformation that affects the normal esophageal development. Surgical treatment, although restoring the integrity of the alimentary tract, may lead to long-term sequelae-like developmental abnormalities and musculoskeletal deformities. We evaluated the effects of osteopathic manipulative treatment (OMT) on the recovery of the range of the right upper limb movement and on the rise of the auxological parameters. A case series of five children affected by type C EA were described. Six OMT sessions were performed over a 4-month period. At each treatment, height, weight, body mass index (BMI) and range of motion (ROM) in elevation of the right upper limb were assessed. OMT was applied to improve scar, larynx, rib cage, and sternum mobility. An average change of 2.3 cm in height and an average increase of 8° in the ROM of the upper limb in the period of study were detected. Additionally, OMT could improve the anthropometric data and the mobility of the right upper limb of children surgically treated for EA. Further studies that evaluate the effectiveness of OMT in post surgical treatment of congenital malformations of the thorax can be considered in the future. [ABSTRACT FROM AUTHOR]

Ventilation weaning is a key intensive care event influencing preterm infants' discharge from a neonatal intensive care unit (NICU). Osteopathic manipulative treatment (OMT) has been recently introduced in some Italian NICUs. This retrospective cohort study tested if OMT is associated with faster non-invasive ventilation (NIV) weaning. The time to NIV weaning was assessed in very preterm and very low birth weight infants who either received or did not receive OMT. The propensity score model included gender, antenatal steroids, gestational age (GA), birth weight (BW), and Apgar score 5′. Out of 93 infants, 40 were included in the multilevel survival analysis, showing a reduction of time to NIV weaning for GA (HR: 2.58, 95%CI: 3.91 to 1.71, p < 0.001) and OMT (HR: 3.62, 95%CI: 8.13 to 1.61, p = 0.002). Time to independent ventilation (TIV) was modeled with GA and BW as dependent variables and OMT as the factor. A negative linear effect of GA and BW on TIV was shown. OMT exposure studied as the factor of GA had effects on TIV in infants born up to the 32nd gestational week. Preterm infants exposed to OMT were associated with earlier achievement of NIV weaning. This result, together with the demonstrated OMT safety, suggests the conduct of clinical trials in preterm infants younger than 32 weeks of GA. [ABSTRACT FROM AUTHOR]

Children and adolescents and young adults (CAYAs) with sickle cell disease (SCD) suffer from recurrent acute pain episodes that result in hospitalization and confer substantial morbidity. Pharmacologic pain control is often inadequate, thus non-pharmacologic modalities are needed. Osteopathic manipulative treatment (OMT) is a potentially valuable non-pharmacologic addition to pain management. We describe eight patients hospitalized with SCD pain who received OMT. OMT was safe, feasible, and a promising adjunctive option for management of SCD pain., (© 2024 Wiley Periodicals LLC.)

This double-blind randomized controlled trial investigated the effects of osteopathic manipulative treatment (OMT) on cardiac arrhythmias in patients with cardiac implantable electronic devices (CIEDs). Participants (n = 41) with CIEDs were randomly assigned to either the OMT group or the control group (light touch/sham) and received a one-time intervention. No significant change in arrhythmia burden was found in the 1 month following intervention ( P = .14). Discrete heart rate (HR), HR variability (HRV), and activity data were obtained from CIEDs in 17 of 41 subjects 1, 3, 7, 14, and 30 days prior to and after intervention. No significant difference was observed. An additional short-term substudy was performed on 20 subjects at the time of the intervention (5 min prior to and after intervention), and HR, respiratory rate, blood pressure, blood oxygen saturation (SpO 2 ), and 1-min short-term HRV were compared. This study did not demonstrate an effect of OMT on arrhythmias, HR, respiratory rate, blood pressure, and blood SpO 2 . However, differences in OMT versus sham were observed for short-term HRV ( P = .022) and a trend for long-term HRV. Importantly, there were no reported adverse effects with either intervention. OMT appears to be safe in cardiac patients., Competing Interests: The authors report no conflicts of interest for the published content. No funding information was provided., (Copyright: © 2024 Innovations in Cardiac Rhythm Management.)

Osteopathic manipulative treatment (OMT) is used in both inpatient and outpatient settings. Evidence suggests that OMT can reduce both patients' recovery time and the financial cost of their acute medical treatment and rehabilitation. Multiple studies from neonatal intensive care units (NICUs) are presented in this article that demonstrate infants treated with OMT recover faster, are discharged earlier, and have lower healthcare costs than their non-OMT-treated counterparts. Data clearly show that adjunctive OMT facilitates feeding coordination in newborns, such as latching, suckling, swallowing, and breathing, and increases long-term weight gain and maintenance, which reduces hospital length of stay (LOS). Osteopathic techniques, such as soft tissue manipulation, balanced ligamentous tension, myofascial release, and osteopathic cranial manipulation (OCM), can reduce regurgitation, vomiting, milky bilious, or bloody discharge and decrease the need for constipation treatment. OMT can also be effective in reducing the complications of pneumonia in premature babies. Studies show the use of OCM and lymphatic pump technique (LPT) reduces the occurrence of both aspiration and environmentally acquired pneumonia, resulting in significantly lower morbidity and mortality in infants. Based on published findings, it is determined that OMT is clinically effective, cost efficient, a less invasive alternative to surgery, and a less toxic choice to pharmacologic drugs. Therefore, routine incorporation of OMT in the NICU can be of great benefit in infants with multiple disorders. Future OMT research should aim to initiate clinical trial designs that include randomized controlled trials with larger cohorts of infants admitted to the NICU. Furthermore, a streamlined and concerted effort to elucidate the underlying molecular mechanisms associated with the beneficial effects of OMT will aid in understanding the significant value of incorporating OMT into optimal patient care. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MSy) is a risk factor for cardiovascular disease. The decrease in vagal activity has been related to the mechanism of MSy development. Recently, it has been proposed that the WBV exercise, as well as osteopathic manipulative treatment (OMT) stimulate cardiac autonomic modulation. The aim of this study is to evaluate the acute effects of whole body-vibration (WBV) exercise and OMT on heart rate variability (HRV) in individuals with MSy. Cross-sectional, randomized, cross-over study (one-week wash-out between interventions) and blinding analysis. Individuals with MSy will be randomized into 5 groups: 1) whole body-vibration exercise group (WBVG), 2) osteopathic manipulative treatment group (OMTG), 3) WBVG + OMTG, 4) OMTG + WBVG, 5) control group (CG). OMT will consist of suboccipital decompression technique, myofascial relaxation on cervical and diaphragm muscles. The HRV measurement will be done with the individual at rest, during the 2-min step test (2MST) and during interventions. After the treatment, the measurements will be repeated. The modulation of ANS is important in the management of MSy individuals. The investigation of intervention modalities to improve this modulation is necessary and it is expected that this protocol can promote this modulation and improve the HRV. [ABSTRACT FROM AUTHOR]

Abstract Background Osteopathy is a type of complementary medicine based on specific manual techniques. In many countries, including Germany, the profession is not officially regulated, and evidence for the effectiveness of osteopathy is insufficient for most diseases. Nevertheless, many health insurances in Germany offer reimbursement for therapy costs, if osteopathy is recommended by a physician. This cross-sectional survey of German general practitioners (GPs) explored beliefs and attitudes towards osteopathic medicine and described their daily interactions with it. Methods A random sample of 1000 GPs from all federal states was surveyed by mail using a self-designed questionnaire. We collected data on sociodemographics, personal experiences with osteopathy, and attitudes and expectations towards osteopathy. In particular, participants were asked about indications for osteopathic treatment and their beliefs about its effectiveness for different patient groups and diagnoses. A self-designed score was used to estimate general attitudes towards osteopathy and identify factors correlated with greater openness. Additionally, we performed logistic regression to reveal factors associated with the frequency of recommending osteopathy to patients. Results Response rate was 34.4%. 46.5% of participants were women, and the median age was 56.0 years. 91.3% of GPs had referred patients to an osteopath, and 88.0% had recommended osteopathy to their patients. However, 57.5% acknowledged having little or no knowledge about osteopathy. Most frequent reasons for a recommendation were spinal column disorders (46.2%), other complaints of the musculoskeletal system (18.2%) and headaches (9.8%). GPs estimated the highest benefit for chronically ill and middle-aged adults. Female gender (OR 2.09; 95%CI 1.29–3.38) and personal treatment experiences (OR 5.14; 95%CI 2.72–9.72) were independently positively associated with more frequent treatment recommendation. Conclusion GPs in Germany have frequent contact with osteopathy, and the vast majority have recommended osteopathic treatment to some extent in their practice, with foci and opinions comparable to other Western countries. The discrepancy between GPs making frequent referrals for osteopathic treatment while self-assessing to have little knowledge about it demonstrates need for intensified research on the collaboration with osteopaths and how to best integrate osteopathic treatments. Our results may help to focus future effectiveness studies on most relevant clinical conditions in general practice.

Osteopathic manipulative treatment (OMT) is a hands-on therapy that aims to promote homeostasis by individuating and treating somatic dysfunctions (SDs), including alterations in muscular tissue. Presently, patients affected by neurological disorders (e.g., Parkinson's disease [PD], multiple sclerosis [MS], and mild traumatic brain injury) often present to the osteopaths for treatment of motor symptoms, fatigue, stiffness, and chronic pain. OMT could be a safe adjunct treatment to promote physical wellness in such patients. However, there are many unanswered questions about its efficacy, especially regarding patients with neurological diseases. In this commentary, the authors encourage and promote the implementation of OMT as a complementary therapy in the neurorehabilitation field. [ABSTRACT FROM AUTHOR]