Adding Osteopathic Intervention to Albuterol Nebulization in Ambulatory Asthma Exacerbations

Abstract

Background: Asthma is a chronic obstructive airway disease affecting children and adults world wide. Patients often seek alternative therapies.Objective: We conducted this study to describe osteopathic manipulative treatment (OMT) as an adjunct to traditional therapies in acute asthma exacerbation.Methods: A sample of previously diagnosed asthma patients who were having an acute asthma exacerbation were offered to receive OMT treatment as an adjunct to traditional modalities of treatment for acute exacerbation. Each patient was given an albuterol nebulizer treatment followed by an accepted OMT technique known as “rib raising” maneuver for five minutes. Peak flows were obtained before and after each treatment. Each patient was asked to fill out a symptom score diary rating their asthma symptoms before nebulizer treatment, after nebulizer treatment and after OMT.Results: The data showed an average increase in peak flow rates after nebulizer treatment was 36 L/min with a further average increase in peak flow after OMT of 18 L/min with a net increase of 54 L/min (ANOVA, p<0.05). OMT was not associated with any adverse effects or complaints. Study patients reported that the combined nebulizer and OMT treatments made them feel better than in the past when they were offered only traditional albuterol nebulizer treatments. Conclusion: Patients treated for acute asthma exacerbation with nebulizer treatment followed by osteopathic treatment (rib raising maneuver) showed significant improvement in their overall breathing. Unfortunately, lack of a control group in which there would be nebulizer treatment plus no osteopathic treatment makes it uncertain whether this OMT treatment had more than a placebo effect. However, since more patients request alternative therapies more research in OMT techniques should be considered. Offering osteopathic treatments as adjunct to traditional asthma treatment in an acute setting appears to have no adverse effects and may have psychological benefits.