Osteopathic Research Articles

Osteopathic Research in Family Medicine.

Osteopathic physicians (DOs) comprise a growing portion of family physicians. In 2023, more DO seniors matched into family medicine than MD seniors, and nearly a quarter of US DO seniors matched into family medicine. Family medicine benefits from the osteopathic philosophy of whole-person care, though this provides challenges regarding research in family medicine. Notably, among students entering family medicine, MD students report an average of 2.4 research activities compared with 1.7 for DO students, marking the lowest values across specialties. There are multifarious reasons for the limited research exposure of osteopathic medical students, and 2 may be amenable to change. First, osteopathic trainees have relatively limited research exposure. Second, osteopathic manipulation training emphasizes techniques that are not compatible with current theories of anatomy and pathology. The reduced research emphasis among osteopathic trainees can be addressed by strategies that focus on enhanced research exposure and a cultural shift toward fearless reevaluation of these inconsistent beliefs. Improvements in research training and culture among osteopathic trainees (including medical students and residents) will directly benefit osteopathic medicine, family medicine, and patients.

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

Impact of osteopathic manipulative medicine training during graduate medical education and its integration into clinical practice.

Osteopathic manipulative medicine (OMM) is a unique skill set consisting of physical manipulations that treatthe neuromusculoskeletal system. Although OMM can improve patient outcomes such as functionality and pain, as well as increase physician reimbursement, its use is declining. Barriers to its use include a lack of proficiency, support, reimbursement, and time. Knowledge gaps remain as to how OMM training during graduate medical education (GME) affects OMM use. This study describes relationships between OMM exposure during GME and the use of OMM in practice. An online survey of physicians in a variety of medical fields during late 2022 assessed the impact of OMM education during postgraduate training on its use in clinical practice. Survey data were analyzed to compare training characteristics and OMM use via chi-square tests and binary logistic regression. A total of 299 surveys were completed. Respondents who received formal OMM education during residency were more likely (59.8 %) to utilize OMM in medical practice than those who practiced OMM informally (37.8 %, p<0.001) and those who had no OMM exposure during residency (10.3 %, p<0.001). Respondents who trained with more osteopathic attendings (p<0.001) and co-residents (p=0.012) were also more likely to utilize OMM. Those who completed residencies that were accredited by the Accreditation Council for Graduate Medical Education (ACGME) with an Osteopathic recognition track, by the American Osteopathic Association (AOA), and were dually-accredited (ACGME/AOA), were all more likely to utilize OMM (60 %, 56 %, and 53 %, respectively) than those who completed residencies with ACGME accreditation alone (22 %, p<0.01). Although OMM can improve patient outcomes, it is underutilized by Doctors of Osteopathic Medicine (DOs) in practice. Lack of training after medical school has been identified as a contributing factor to its disuse. The results of our study illustrate that there is a positive association between OMM education during postgraduate training and OMM use in clinical practice.

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.

Available Treatments and Adjunctive Therapies for Polycystic Ovarian Syndrome (PCOS) Patients of Reproductive Age: A Scoping Review.

Polycystic ovarian syndrome (PCOS) impacts the health of women worldwide. It is a condition consisting of dysfunctional cystic ovaries resulting in hormonal imbalance. Many women have symptoms such as infertility, increased production of androgens, and insulin resistance. Barriers to effective treatment of PCOS include issues such as delays in diagnosis and inconsistencies in treatment plans among physicians. Despite the current use of available medications to decrease symptomatology, women with PCOS continue to report a decreased quality of life. Using the electronic databases PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and ScienceDirect, a scoping review was conducted on the globally available treatments for PCOS. After applying pre-determined inclusion criteria, 41 studies were included in this scoping review. The literature on the available treatments for PCOS revealed a wide range of therapeutics with evidence of reduction of symptoms and/or improvement in fertility status and pathological processes such as insulin resistance, hormone imbalance, obesity, inflammation, and infertility. Dozens of treatment options for PCOS have been identified, including new medications and modifications to existing treatment regimens. The hormonal drug Fezolinetant demonstrated effective suppression of hyperandrogenism. Drugs used to treat diabetes, such as Liraglutide, were found effective for weight loss. Green cardamom, cinnamon, and other supplements proved effective in treating metabolic dysfunction. Alternative approaches, such as osteopathic manipulative therapy and acupuncture, decreased sympathetic tone and androgen levels. This review provides a succinct overview of PCOS therapies that can be used by those with PCOS and their physicians everywhere. With a better understanding of their options, women with PCOS can become more involved in the decision-making process to improve their health. More research is needed on novel therapies that aim to reduce the primary pathogenesis of PCOS.

Evaluation of the clinical effectiveness of osteopathic gallbladder drainage techniques

Introduction. In recent decades, a lot of new materials about etiology and pathogenesis of biliary system diseases have been obtained and new effective drugs have been introduced. But, despite this, there remains much unrecognized and controversial in etiopathogenesis and principles of treatment of the disease. Moreover, the frequency of complicated forms of the disease and the overall incidence of biliary pathology continues to grow, which clearly shows the need to search for new approaches to diagnosis and treatment of these conditions. The leading causes of biliary tract pathology formation, actual problems of pharmacotherapy (allergic reactions, side effects, polypragmasy), certain aspects of comorbid pathology make clinicians pay closer attention to non-medicament treatment methods, including osteopathic correction. Previous studies have already demonstrated a good clinical effect of osteopathic correction in the treatment of patients with biliary disorders. At the same time, most studies in osteopathy present an assessment of the possibility of using osteopathic correction in the treatment of certain nosological forms. But no less important, in our opinion, is to conduct studies aimed at evaluating the clinical effectiveness (efficiency) of individual osteopathic approaches and techniques.The aim of the study: to investigate the clinical effectiveness of osteopathic techniques of gallbladder drainage.Materials and methods. The study was conducted in 2022–2023 on the basis of Polyclinic of the Federation of Independent Trade Unions of Russia (Moscow) and City Mariinsky Hospital (St. Petersburg). There were 30 people (9 men and 21 women) aged 18 to 59 years (mean age was 40,4±2,3 years) without pathology of the gastrointestinal tract and gallbladder (biliary tract) who agreed to participate in the study. All participants underwent a fasting gallbladder volume study, followed by a gallbladder volume study one hour after eating a trial breakfast (TB). One week after the first study, the same patients underwent another fasting gallbladder volume study, then a gallbladder volume study after osteopathic correction (OC) techniques. Thus two observation groups were formed: observation 1 (TB) — study of gallbladder function before and after taking a trial breakfast; observation 2 (OC) — study of gallbladder function before and after gallbladder drainage techniques. Participants did not receive other treatments during the study. All respondents underwent clinical osteopathic examination and biliary ultrasound with motor function score (MFS) was performed. Outcomes in this study were defined as changes in gallbladder size and motility.Results. No global level somatic dysfunction was identified in the study participants. Regional biomechanical disorders and separate local somatic dysfunctions were more typical for them. However, it was not possible to identify any predominant dysfunctions, as all of them were detected in single cases. After the exposure was completed, the osteopathic status was re-evaluated. The analysis showed that there were no statistically significant changes in the frequency of detection of the main somatic dysfunctions in both observations (p&gt;0,05). In the observed respondents, no abnormalities in the basic size and volume of the gallbladder at the beginning of the study were revealed. After the conducted stimulation no statistically significant differences in gallbladder size (length and width) both within and between the observation groups were registered (p&gt;0,05), but statistically significant dynamics was obtained in the form of gallbladder volume decrease in response to the effect (p&lt;0,05) both when using TB and after OC. All participants were assessed with a measure of gallbladder motor function (MFS). In case of observation 1 (TB), the MFS value was 0,66±0,09 and observation 2 (OC) was 0,58±0,07, which corresponds to normal gallbladder functional activity. Compared to the use of a trial breakfast, osteopathic correction demonstrated a slightly less pronounced effect on gallbladder motor function, but these differences between the groups were not statistically significant (p&gt;0,05).Conclusion. Osteopathic manipulations on the gallbladder and biliary tract have an effect on the gallbladder volume and motor activity comparable to the effect of the trial breakfast.

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.

Comparing cranial suture interdigitation in humans and non-human primates: unearthing links to osteopathic cranial concept.

Since William Garner Sutherland's inception of osteopathic cranial manipulative medicine (OCMM), osteopathic physicians have practiced with the knowledge that cranial sutures exhibit motion. We hypothesize that the complexity of suture interdigitation in humans may provide clues to elucidate the concept of OCMM. We compared the interdigitation of sagittal, coronal (left and right), and lambdoid (left and right) sutures in computed tomography (CT) scans of humans and five nonhuman primate species (Gorilla gorilla, Pongo pygmaeus, Pan troglodytes, Hylobates lar, and Nasalis larvatus). Human ages are evenly distributed between 10 and 65 years of age, with an equal number of males (n=16) and females (n=16) in the sample. Nonhuman primates are all females, and the sample includes juveniles (n=6) and adults (n=34). Sutures were evaluated on a scale ranging from 0 to 3 (0: fused sutures; 1: no interdigitation; 2: low complexity; and 3: representing the highest degree of interdigitation and complexity). Based on ordinary least squares linear regression, we found no significant relationship between suture interdigitation and age in humans. Chi-square tests were utilized to assess sex differences within humans, species-level differences, and differences between humans and nonhuman primates across all five sutures. Humans exhibited a statistically significant greater degree of suture complexity than all five nonhuman species across all five sutures. These findings indicate that human suture interdigitation is more complex than their closest living relatives (African apes) and other primates (Asian monkeys and apes). We theorize that this would enable subtle movement and serve to transmit forces at the cranial sutures from dietary or ethological behaviors, similar to the pattern observed in other mammals. While humans have a softer diet compared to other living primates, the uniqueness of human craniofacial growth and extended developmental period could contribute to the necessity for complex cranial sutures. More studies are needed to understand variation in human and nonhuman sutural complexity and its relationship to cranial motion.

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.

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.

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.

Trends in Utilization and Cost of Nonpharmacological Pain Therapies in the United States Under Medicare Part B, 2000-2022.

Background: Many clinical practice guidelines for management of pain disorders now favor first-line use of nonpharmacological therapies (NPT). However, Medicare coverage of NPT is limited. Methods: Using a serial cross-sectional design, we examined temporal trends in the utilization and cost of NPT procedures commonly used to treat pain under Medicare. Results: Utilization and costs for physical therapy increased while those for spinal and osteopathic manipulation declined. Discussion: Future research on NPT under Medicare should focus on equity of patient access and comparative outcomes.

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.

Challenges With Osteopathic Manipulative Medicine Research

Challenges With Osteopathic Manipulative Medicine Research