Abstract
Asthma is a leading cause of pediatric chronic illness, and poor disease control can lead to decreased quality of life and impaired academic performance. Although osteopathic manipulative treatment (OMT) has been shown to have positive effects on pulmonary function in adult patient populations, less is known about its impact in children. To evaluate changes in pulmonary function testing (PFT) in pediatric patients on the same day they received OMT compared with PFT in those who received usual care. We recruited patients between the ages of 7-18 years with a diagnosis of asthma who were receiving routine care at a primary care asthma clinic and had undergone baseline spirometry. Patients were excluded if they met any of the following criteria: clinical indication for pre- and postbronchodilator spirometry on the day of their visit, albuterol use in the last 8hours, oral steroid use in the previous 2weeks, or diagnosis of asthma exacerbation in the previous 4weeks. Eligible patients were then randomized to either an OMT or a control group. Patients in the OMT group were treated with rib raising and suboccipital release in addition to standard asthma care, while control group patients received standard care only. A second PFT was performed for patients in both groups at the end of the visit. OMT was performed by multiple osteopathic pediatric residents specifically trained for this study. Change in spirometry results (forced vital capacity [FVC], forced expiration volume in 1second [FEV1], FVC/FEV1, and forced expiratory flow 25-75%) were then compared. The study population included 58 patients: 31 (53.4%) were assigned to the OMT group and 27 (46.6%) were assigned to the standard of care group. Patients who received OMT had greater improvement in all spirometry values compared to the usual group; however, these changes were not statistically significant. The benefits of OMT on short term spirometry results in pediatric asthma patients remain unclear.
Highlights
Context: Asthma is a leading cause of pediatric chronic illness, and poor disease control can lead to decreased quality of life and impaired academic performance
To evaluate changes in pulmonary function testing (PFT) in pediatric patients on the same day they received osteopathic manipulative treatment (OMT) compared with PFT in those who received usual care
Pediatric patients with asthma who were seen in the Nationwide Children’s Hospital (NCH) primary care asthma specialty clinic and completed a PFT during the visit were recruited and randomized into two groups: OMT intervention and usual care only
Summary
Context: Asthma is a leading cause of pediatric chronic illness, and poor disease control can lead to decreased quality of life and impaired academic performance. Objectives: To evaluate changes in pulmonary function testing (PFT) in pediatric patients on the same day they received OMT compared with PFT in those who received usual care. In that patient cohort (n=8), the OMT group experienced improvements in forced expiratory flow 25–75% (FEF 25–75%) and forced expiration volume in 1 second (FEV1), and did not report adverse events, though statistical significance was not reached [3]. Given these results, the current study was developed to evaluate the effects of OMT in a larger patient cohort. We compared FEV1, forced vital capacity (FVC), FEV1/FVC, and FEF 25–75% changes from baseline PFT to a second PFT conducted later in the same day in both groups
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