Manipulative Treatment Research Articles

Is Osteopathic Manipulative Treatment Clinically Superior to Sham or Placebo for Patients with Neck or Low-Back Pain? A Systematic Review with Meta-Analysis

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.

Osteopathic Manipulative Treatment: A Safe and Feasible Adjunct in Sickle Cell Disease Pain Management.

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.

The Effectiveness Of Physical Therapy And Rehabilitation Approaches In Low Back Pain On Pain Severity And Disability; A Systematic Review

Low Back Pain encompasses nociceptive pain, neuropathic pain radiating to the legs, and nociplastic pain, often classified as non-specific due to central nervous system exaggeration. Globally, Low Back Pain is a leading cause of activity restriction and loss of productivity, significantly impacting finances. Objective; This study aimed to review the efficacy of physical therapy and rehabilitation approaches for LBP, focusing on pain intensity and disability. Materials and Methods; A literature review was conducted in PubMed and Web of Science databases up to January 30, 2024. English studies were required, using keywords: “low back pain,” “pain intensity,” “pain severity,” “disability,” and “physical therapy.” Pain intensity was measured using the Visual Analog Scale (VAS) and Numeric Rating Scale (NRS), including the 11-point Pain Intensity Numerical Rating Scale (PI-NRS). Disability was assessed using ADL, IADL scales, Roland Morris Disability Questionnaire (RMDQ), and Oswestry Disability Index (ODI). Results; Seven study met the inclusion criteria from 665 initial records. Interventions included osteopathic manipulative treatment (OMT), core muscle exercise with interferential current (IFC), cognitive functional therapy (CFT), dry cupping therapy, high-intensity machine-based core muscle resistance training (C-IPU), heat therapy, TENS, pelvic traction, Reiki, dynamic muscular stabilization technique (DMST), and McGill Big 3 (MB3). Sample sizes ranged from 30 to 1090 participants. IFC combined with core muscle exercises significantly reduced pain intensity compared to each method alone, though not statistically significant (p > 0.05). The C-IPU group had greater pain relief (P 0.05). Dry cupping did not outperform sham cupping. CFT reduced absenteeism in the first two years but not later. Reiki showed significant improvement in pain and ADL compared to drug therapy, but not to physiotherapy. Conclusions; Physical therapy interventions effectively alleviate symptoms and improve outcomes in LBP. However, variability in interventions and outcome measures necessitates cautious interpretation. Further research with standardized protocols is essential to understand the effectiveness and optimal duration of physical therapy for LBP. Keywords; low back pain; pain intensity; pain severity; disability; physical therapy

Autonomic rehabilitation: Vagal and sympathetic impacts of modified occipitomastoid suture V-spread.

Autonomic rehabilitation using osteopathic manipulative treatment (OMT) to stimulate the vagus nerve may be a good adjunct therapy by physiatrists who treat dysautonomia. Heart rate variability (HRV) may provide quantitative evidence for the benefits of OMT on autonomic nervous system function. Elevated HRV indicates optimal health and reduced mortality risk, whereas low HRV is associated with stress, pain, and chronic disease pathology. To analyze the impact of modified occipitomastoid suture v-spread OMT technique on vagal tone by measuring HRV. Within-participant design with 5-minute HRV measurement pre- and post-OMT treatment. Clinical examination suites. Thirty healthy osteopathic medical students. A modified occipitomastoid suture v-spread treating somatic dysfunction by osteopathic physicians trained in osteopathic neuromusculoskeletal medicine. HRV variables related to vagal tone including root mean square of successive differences (RMSSD), percentage of successive normal sinus RR intervals >50 ms (pNN50), high frequency (HF), Parasympathetic Nervous System Index (PNSI), and Sympathetic Nervous System Index (SNSI). Repeated measures t-test analyzed the difference in mean HRV values after OMT. There were statistically significant increases in each of the HRV measures after OMT. Participants had a mean (95% confidence interval) RMSSD of 50.5 ms (38.3-62.8) at baseline and 55.0 ms (41.2-68.7, p = .013) post-OMT. pNN50 was 24.5% (17.6-31.3, n = 30) at baseline and 28.2% (20.8-35.6, p = .003) post-OMT. HF was 1549.6 ms2 (389.8-2709.4) at baseline and 1901.8 ms2 (618.2-3185.4, p = .103) post-OMT. PNSI was -0.1 (-0.5 to 0.2) at baseline and 0.1 (-0.3 to 1.5, p < .01) post-OMT, and SNSI was 0.2 (-0.1 to 0.6) at baseline and 0.05 (-0.3 to 0.4, p < .01) post-OMT. Normalization, due to high baseline variance, results include RMSSD 1.1 ms (1.0 to 1.1, p = .012), pNN50 1.3 (1.1 to 1.4, p = .011), and HF 1.2 ms2 (1.1 to 1.4, p = .018). Modified occipitomastoid suture v-spread may provide clinical benefit through increased vagal tone and decreased sympathetic activity.

Effects of Osteopathic Manipulative Treatment on Rare Diseases: A Case Report on Gordon Syndrome

Effects of Osteopathic Manipulative Treatment on Rare Diseases: A Case Report on Gordon Syndrome

Effects of osteopathic manipulative treatment associated with transcranial direct current stimulation in individuals with chronic low back pain: A double-blind, randomised placebo-controlled trial

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 n² = 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.

Why do physicians practice osteopathic manipulative treatment (OMT)? A survey study.

Few osteopathic physicians (Doctors of Osteopathic Medicine [DOs]) utilize osteopathic manipulative treatment (OMT) in their clinical practice, although all DOs are trained to do so. The reasons why many do not utilize OMT are not entirely clear. Anecdotally, these authors have observed that if a physician utilizes OMT, it is because they witnessed the efficacy for themselves in real-life clinical diagnoses found on patients or volunteers. This study seeks to explore this phenomenon. This study seeks to explore the relationship between witnessing the efficacy of OMT and the future use of OMT in clinical practice. Surveys were sent to DOs who work with Des Moines University's College of Osteopathic Medicine (COM) clinical students as well as osteopathic medical students enrolled at the Des Moines University's COM. Survey data were analyzed by separating physicians into cohorts based on their use of OMT and students into cohorts based on their interest in utilizing OMT in future practice. DOs who practice OMT reported at least one, and often multiple, instances of witnessing the efficacy of OMT on real-life patients or volunteers while in their first 2 years of medical school. Those who do not utilize OMT reported few opportunities to witness the efficacy of OMT on a real-life patient. For physicians, 96.1 % of those who utilize OMT in their practice had the opportunity to see it work positively during the first 2 years of medical school, whereas only 7.4 % who do not utilize OMT had the opportunity. These findings are mirrored in the experience of current osteopathic medical students who are interested and uninterested in utilizing OMT in their future practice. These findings emphasize the importance of exposing our medical students to some type of 'real-life' experience early in their careers; the data show that these experiences can be very beneficial in expanding the interest in utilizing osteopathic manipulative medicine (OMM) in future practice. COMs can consider the implementation of programs that provide this experience to students, including extracurricular activities dedicated to the use of OMT.

Osteopathische herzfokussierte Palpation und Herzfrequenzvariabilität: Teil 1 – Ziele, Material und Methoden der randomisierten, kontrollierten Pilotstudie

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.

Osteopathic Considerations in the Medical Treatment of a Patient with COVID-Related Respiratory Distress

Abstract We present a case of a woman hospitalized for acute hypoxic respiratory failure secondary to suspected post coronavirus disease 19 (COVID-19) pneumonitis who clinically improved after addition of sequenced Osteopathic Manipulative Treatment (OMT) to her medical management. Objective signs (such as oxygen saturation, SPO2) improved, resulting in decreased oxygen volume requirements by 75% after 1 treatment of OMT, and by 97.5% over her remaining hospitalization. Subjective symptoms of dyspnea, chest tightness, fatigue and mental health also improved. Her most significant somatic dysfunctions (SD), which were primarily in her thoracic, ribcage and cervical regions, were correlated with her clinical presentation and disease process. This suggests that SD was likely a modifiable risk factor impairing her normal adaptive physiologic processes and therefore treating SD with sequenced OMT may have contributed to her realizing a higher health potential when combined with standard medical care.

Chronic Rhinosinusitis Management: A Narrative Review Comparing Interventional Treatment With Osteopathic Manipulation.

Chronic rhinosinusitis (CRS) is an inflammatory disease affecting the nasal cavity and paranasal sinuses. Diagnosis of CRS typically requires two of the following four symptoms to persist for a minimum of 12 weeks: anterior or posterior nasal drainage, hyposmia or anosmia, facial pain or pressure, or nasal obstruction. Additionally, diagnosis necessitates the visualization of inflammation on physical examination or diagnostic imaging. This review aims to compare the outcomes of CRS patients who undergo interventional treatment via functional endoscopic sinus surgery (FESS) to those who opt for noninterventional treatment with osteopathic manipulation. FESS is not the sole interventional method utilized for CRS, but it is the focus of this review since it is the gold standard surgical treatment, encompassing a variety of techniques. Although there is limited literature discussing the use of osteopathic manipulative treatment (OMT) to remedy CRS, some evidence indicates OMT can alleviate symptoms for individuals seeking non-surgical alternatives. Moreover, osteopathic manipulation for CRS may be beneficial for patients unresponsive to previous medical or surgical management. Pharmacologic treatment is typically the initial approach to CRS and is discussed briefly herein, though it largely falls beyond the scope of this review.

A Critical Appraisal of Reporting in Randomized Controlled Trials Investigating Osteopathic Manipulative Treatment: A Meta-Research Study.

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.

Effectiveness of Osteopathic Manipulative Treatment on Hemodynamic and Pulmonary Response in Coronary Artery Bypass Graft Patients: A Meta-Analysis.

In the realm of cardiovascular care, the quest for innovative and holistic approaches to enhance patient outcomes persists. This study analyzes osteopathic manipulative treatment (OMT) and its potential impact on pain intensity, length of hospitalization, respiratory function, and hemodynamic response in patients undergoing coronary artery bypass grafting (CABG). OMT, with its emphasis on physical manipulation of the body's muscles and tissues, presents a potential treatment beyond the realms of conventional post-operative care. Google Scholar was used to identify four relevant articles for further review. RevMan 5.4 was utilized for meta-analytic evaluation in order to produce forest plots with associated standardized mean difference (SMD), confidence interval (CI), and heterogeneity (I²). Output from collection and analysis revealed statistically significant decreases in negatively viewed outcomes, including length of stay (SMD 0.39; 95% CI -0.02,-0.76; I² ≤ 0%) and pain control (SMD 1.67; 95% CI -1.34,-0.67; I² ≤ 94%). Parameters for respiratory function and hemodynamic response, including vital capacity (SMD 0.91; 95% CI 0.57,1.24; I² ≤ 96%) and maximal aerobic capacity (SMD 0.50; 95% CI 0.19, 0.82; I² ≤ 0%), showed a statistically significant increase. These findings suggest the incorporation of OMT as a viable adjunct for postoperative management in CABG patients, yielding favorable reductions in adverse outcomes such as length of hospitalization and pain. Moreover, it has demonstrated enhancement in maximal aerobic and vital capacity. This study suggests that the addition of osteopathic management to post-bypass standards can ultimately prevent certain morbidities associated with this specific patient population.

A Review on Osteopathic Manipulation in Patients With Headache.

Headaches are a common neurological disorder, significantly impacting patients' quality of life. Traditional treatments include pharmacological and nonpharmacological approaches. Osteopathic manipulative treatment (OMT) is a holistic, hands-on technique used by osteopathic physicians to alleviate pain and improve function by addressing musculoskeletal dysfunctions. This review aims to evaluate the effectiveness of osteopathic manipulation in managing headaches, focusing on the different types of headaches, the specific techniques used, and the overall outcomes reported in clinical studies. A comprehensive literature search was conducted across multiple databases, including PubMed, Google Scholar, and MEDLINE, to identify relevant studies published in the past two decades. Inclusion criteria were studies involving adult patients diagnosed with headaches and treated with OMT. Both randomized controlled trials (RCTs) and observational studies were included. The review identified 15 studies meeting the inclusion criteria. Evidence suggests that OMT can be beneficial in reducing the frequency, intensity, and duration of headaches, particularly tension-type headaches (TTHs) and migraines. Techniques such as myofascial release, cranial osteopathy, and muscle energy techniques were commonly employed. Many studies reported significant improvements in patients' quality of life and functional status post-treatment. However, the heterogeneity in study designs, sample sizes, and outcome measures warrants cautious interpretation of the results. Osteopathic manipulation shows promise as a complementary approach for managing headaches, with positive effects on pain relief and functional improvement. Further large-scale, high-quality RCTs are needed to confirm these findings and to establish standardized treatment protocols. Integrating OMT into multidisciplinary headache management strategies could potentially enhance patient outcomes and reduce reliance on pharmacological interventions.

The Role of Osteopathic Manipulative Treatment in Neonatal Abstinence Syndrome

The Role of Osteopathic Manipulative Treatment in Neonatal Abstinence Syndrome

Osteopathic treatment of a person with Arnold-Chiari malformation and Syringomyelia: A case report

We present the case of a symptomatic patient diagnosed with Arnold Chiari I malformation (ACI) and Syringomyelia (S) who evolves favorably through an initial osteopathic treatment plan lasting 6 months and osteopathic maintenance treatment up to 36 months. The objectives of the treatment were to reduce pain and increase mobility of the shoulders and Scapular waist/Shoulder/Elbow/Wrist with a secondary objective to improve balance and coordination.After the administration of 32 sessions of Osteopathic Manipulative Treatment (OMT) started in August 2020, applying an initial treatment plan of 6 sessions monthly the patient was asymptomatic with remission of pain and increased mobility in the shoulders and cervical spine and a normal neurological examination (including normal gait).The main symptoms and relevant clinical findings were: functional impairment of the upper extremities that limited activities of daily living (ADLs) requiring assistance, headaches, cervical and dorsal spine pain in bilateral belt at T6 level, vertiginous sensation and gait instability. The patient was diagnosed with ACI and Syringomyelia in 2012. She received surgical and pharmacological treatment without clinical improvement and performed relaxation and breathing exercises on her own.We present evidence of the beneficial effect of osteopathic treatment on the associated symptomatology in a case of ACI and Syringomyelia.

The Effects of Osteopathic Manipulative Treatment on Brain Activity: A Scoping Review of MRI and EEG Studies.

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.

Effectiveness of Cervical Chuna Manipulative Treatment (CCMT) in Treating Peripheral Facial Paralysis: A Systematic Review and Meta-Analysis

Effectiveness of Cervical Chuna Manipulative Treatment (CCMT) in Treating Peripheral Facial Paralysis: A Systematic Review and Meta-Analysis

A systematic review of manual therapy modalities and anxiety.

Anxiety disorders have a far-reaching impact on society, with profound implications on both mental and physical health. In response, there is growing interest in manual therapy modalities, with emerging research suggesting their potential to alleviate related symptoms. To establish a consensus regarding manual therapy modalities for addressing anxiety symptoms, a systematic review of current literature was conducted. A literature search was conducted between May and August 2023, utilizing a systematic search on both PubMed and Google Scholar, adhering to the defined inclusion criteria. In addition, information was gathered utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Both authors (KLW and TH) conducted the literature review. The inclusion criteria include articles written in English, peer-reviewed, anxiety conditions documented, and manual therapy delivered by a respectfully qualified professional. Manual therapy modalities include massage therapy, osteopathic manipulative treatment (OMT), foot reflexology, acupressure, manual therapy, healing touch, therapeutic touch, and gentle touch. After initial data collection, both researchers independently screened articles utilizing two metrics: a level of evidence (LOE) table and a screening criterion incorporating unique elements from the search process. The quality of the included articles was assessed utilizing Strength of Recommendation Taxonomy (SORT). When reviewer discrepancies arose, authors reread full-text studies and discussed the inclusion and exclusion criteria to achieve consensus. The data searches identified 8,979 articles, with 239 articles remaining after duplicates and nonapplicable articles were removed. A total of 42 articles met the inclusion criteria, with only 40 articles able to be obtained for full-article review. After full review and the exclusion of articles with invalid author conclusions, meta-analysis, or systematic reviews, 34 articles were included in the review. All articles received an LOE rating of 2 or better and aligned with our specific screening criteria. Based on SORT, each modality was assigned a "B" rating. Among the included articles, n=27 demonstrated statistical significance in favor of manual therapy modalities as an anxiety treatment. The positive results for the aforementioned manual therapies on anxiety symptom improvement are shown: 15/18 (83 %) massage therapy, 2/6 (33 %) OMT, 5/5 (100 %) foot reflexology, 1/1 (100 %) acupressure, 1/1 (100 %) manual therapy, 0/2 (0 %) healing touch, 1/1 (100 %) therapeutic touch, and 1/1 (100 %) gentle touch. A pattern emerged, wherein individuals receiving manual therapy interventions displayed a statistically significant reduction in anxiety intensity. Considering the positive results, manual therapy should be considered an effective strategy for anxiety management.

Immediate Effect Of Lumbar Manipulation On Lumbar Range Of Motion And Lower Limb Functional Test In Recreational Football Players: An Experimental Study

Context: Football is a commonly played sport. Functional impediments in footballers may arise due to decreased spinal mobility, which affects quality of life and performance. Manipulative treatment is a manual therapy techniques which uses a high velocity “thrust” applied to a synovial joint over very short amplitude. Aims:To evaluate the immediate effect of lumbar manipulation on lumbar range of motion (ROM) and lower limb function in footballers. Methods and Material:22 male footballers of 18 to 30 years underwent a single session of lumbar manipulation. Modified-modified Schober‟s test was used to evaluate changes in lumbar ROM, while Anterior, Postero-lateral and Postero- medial components of Star excursion balance test (SEBT) were used to measure dynamic balance and single leg triple hop distance test for lower limb strength. Results: Statistical analysis revealed significant differences in outcome measures obtained. Post intervention t-value and p-value for SEBT Anterior (t= 5.583, p= 0.001), SEBT Postero-medial (t=10.376, P=0.001), SEBT Postero-lateral (t=8.495, P=0.001), Lumbar ROM (t=2.569, p=0.018), Triple hop (t=6.492, p=0.001). Conclusions: Lumbar manipulation has shown to increase lumbar ROM and enhance performance of lower limb functional tests in footballers. Thus this study recommends lumbar manipulation can be applied to enhance the performance of the players.

Osteopathic Manipulative Medicine and Disorders: An Overview of Peer-Reviewed Publications 2018-2022.

Context Osteopathic manipulative medicine (OMM) has been claimed to be effective in various human disorders and conditions. There have been many anecdotal claims to lend credence to the efficacy of this treatment modality. Recently, much work has been done in evidence-based, government-funded projects, and clinical trials in OMM research, and these studies have further demonstrated the efficacy of OMM as direct, integrated, or complementary mechanisms in treating various conditions. Objectives As the field of OMM research has grown significantly in the past few years, we set out to analyze the peer-reviewed publications on OMM in human disorders between January 2018 and December 2022. Methods We used keywords and termswhich included "osteopath," "osteopathic," osteopathic manipulative medicine," "osteopathic manipulative treatment," and "disorder," to systematically sample two public databases, PubMed and Science Direct. After the first query was recorded, we then applied more specific and stringent criteria to identify publications that (a) were written in English, (b) contained at least one human disorder/condition treated by OMM, (c) were co-authored by at least one osteopathic physician-scientist, and (d) contained at least one OMM technique. Results Our initial sampling of databases resulted in 404 publications. After applying our screening criteria, we identified and analyzed 249 (62%; 249/404) qualified publications in "OMM and Human Disorders" We then categorized them into (a) types of publications, (b) country origins of corresponding author(s), (c) groups of disorder and condition, (d) classification of the OMM used, and (e) relating the treated conditions with the five models of OMM. We found that in the 249 publications, 158 (63%) are research articles, 66 (27%) review papers, and 25 (10%) case reports. In addition, nine countries, the United States, Italy, Brazil, Spain, France, Germany, Canada, the United Kingdom (UK), and Australia contributed most of the publications of OMM. VOSviewer analysis identified a wide range of human disorders that were effectively treated with OMM. These included musculoskeletal, low back pain, neurological, headache, inflammation (including autoimmune conditions, COVID-19, lymphatic drainage), neonate/preterm infant disorders, anxiety, and dizziness. Conclusions Our comprehensive analysis showed that there has been a significant increase in peer-reviewed OMM publications in recent years, led by the United States osteopathic physician-scientists and European osteopathic scientists. OMM was found effective in treating not only common conditions such as pneumonia, low back pain, and musculoskeletal disorders, but also disorders such as inflammation, dizziness, headache, anxiety, and neonate/preterm infant disorders.