Search Results (37)

Background: Cancer is one of the leading causes of disability in both the United States and worldwide. Its high global prevalence is accompanied not only by the burden of the disease itself but also by the adverse effects of treatment, which can significantly diminish patients’ quality of life (QoL). Osteopathic manipulative treatment (OMT), an emerging complementary therapy, seems to show promise in the improvement in quality of life (QoL) in these patients. The purpose of this systematic review is to evaluate the effectiveness of OMT as a complementary and integrative therapy for the relief of symptoms and improved functional capabilities in cancer patients. Methods: The literature search was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using PubMed, Scopus, Science Direct and Web of Science databases. A risk of bias analysis was conducted by evaluating the included randomized controlled trials to assess domains, such as randomization, intended intervention, incomplete outcome data, outcome measurement, and selective reporting. Between the 20 randomized controlled trials and observational studies, information regarding OMT in the treatment of general cancers, oral, pediatric, head and neck, gynecological, breast, and gastric cancers was collected. Results: Our analysis displayed a patient-reported increase in QoL, especially through the reduction in pain and lymphedema, as well as an increase in overall functional capabilities. Conclusions: Overall, the findings underscore the potential role of OMT as an adjunctive therapy for patients with a wide range of cancers, contributing to symptomatic management and enhanced QoL. Full article

Background: Congenital heart diseases are the most common congenital malformations, affecting 4 to 9 per 1000 children, with increasing global prevalence. As surgical mortality rates decline, the focus has shifted toward improving the quality of life and perioperative outcomes for pediatric patients. Multidisciplinary rehabilitation, including osteopathic care, is increasingly incorporated into recovery programs. Osteopathic manipulative treatment combines manual techniques with lifestyle guidance to alleviate postoperative pain and promote recovery. This project report describes the impact of osteopathic manipulative treatment (OMT) on pain and somatic dysfunctions in hospitalized pediatric cardiac patients, using validated pain assessment tools. It presents a retrospective analysis of data collected as part of a humanitarian volunteer project. Methods: The project report follows a retrospective descriptive study design, using patient note forms from children aged 0–18 years undergoing cardiac surgery at the Sri Sathya Sai Sanjeevani Center in India between October 2023 and March 2024. A total of 29 experienced osteopaths recorded pain assessments at three time points—pre-surgery, post-surgery, and pre-discharge—using age-appropriate pain scales (FLACC, Wong-Baker Faces, and Numerical Rating Scale). Somatic dysfunctions were evaluated and classified using ICD-10 M99 codes. Data analysis involved descriptive statistics and pre-post comparisons using statistical software (Excel and OPENEPI). Results: The study included 564 children (60.5% male, mean age 5.8 ± 4.3 years). The most common congenital defects were ventricular septal defects (38.5%) and tetralogy of Fallot (21.6%). The average hospital stay was 15.9 ± 11.1 days. Significant reductions in pain scores were observed from the Intensive Care Unit to the postoperative ward (p < 0.001). Similarly, somatic dysfunction severity decreased significantly across hospitalization phases (p < 0.001). The thoracic region and rib cage were the most frequently affected areas. No adverse events related to osteopathic manipulative treatments were reported. Conclusions: This project report indicates that osteopathic manipulative treatment is safe and feasible for pediatric patients undergoing surgery for congenital heart disease. Pain scores and somatic dysfunction severity decreased during hospitalization. However, the lack of a control group, the heterogeneity of the patient population, and the short observation period limit the ability to draw causal conclusions. These findings provide a descriptive framework for integrating OMT into multidisciplinary pediatric cardiac care. Future studies should involve prospective, multicenter designs with control groups and longer follow-up periods to assess clinical, functional, developmental, and quality-of-life outcomes. Full article

Background: Persistent fatigue is among the most commonly reported symptoms in patients suffering from post-acute sequelae of SARS-CoV-2 infection (long COVID). Autonomic dysfunction, measurable via heart rate variability, has been implicated as a contributing factor. Osteopathic manipulative treatment is a manual therapeutic approach that targets autonomic balance and may offer a novel intervention for long COVID-related fatigue. Methods: In this single-blind, randomized controlled trial, 42 participants (mean age 51 ± 11 years; fatigue severity score: 31 ± 5 points) with long COVID and persistent fatigue ≥12 weeks post-infection were allocated to either a 45 min standardized osteopathic treatment (n = 21) or a sham-treatment group (n = 21). Heart rate variability was assessed using a 10 min resting electrocardiogram before intervention, immediately after, and again 48 h later. The analysis of heart rate variability encompassed time-domain indices, including the root mean square of successive differences, the standard deviation of normal-to-normal intervals, mean heart rate, and mean RR interval. Additionally, frequency-domain measures such as low-frequency, high-frequency, total power, and the LF/HF ratio were considered. Results: The osteopathy group showed a statistically significant increase in root mean square of successive differences post-treatment (p < 0.01), accompanied by a decrease in the stress index (p < 0.05) and an increase in the mean of the standard deviations of RR intervals (p < 0.05). Significant between-group differences were observed for mean heart rate and mean of RR intervals (p < 0.05). Frequency-domain measures also improved significantly from baseline in the intervention group. Outlier patterns suggest potential subgroup effects, possibly due to underlying dysautonomia. Conclusions: A single session of osteopathic treatment significantly enhanced short-term heart rate variability in long COVID patients with fatigue. These findings highlight the potential role of manual autonomic modulation as a supportive therapy in long COVID management. Further research is needed to assess the long-term effects and optimal treatment frequency of osteopathic manipulative treatment in this population. Full article

Background and Rationale: Visceral disorders, both functional and organic, significantly impact health-related quality of life and pose a challenge for healthcare systems. Osteopathy offers manual, systemic, and patient-centered approaches for their management, yet these remain controversial due to limited scientific support and methodological inconsistencies. In the evolving landscape of healthcare regulation in Europe, and particularly in Italy, exploring clinical reasoning and operational models in visceral osteopathy is essential. This study aimed to explore the beliefs, clinical reasoning, and management strategies of experienced Italian osteopaths in the treatment of visceral disorders using a Constructivist Grounded Theory approach. Methods: This qualitative study applied a Constructivist Grounded Theory approach to explore the beliefs and clinical practices of 10 experienced Italian osteopaths. Semi-structured interviews were transcribed, coded, and thematically analyzed, integrating literature comparisons to support theory generation. Results: Four core themes emerged: (1) education and professional development, (2) definition and identification of visceral disorders, (3) clinical management strategies, and (4) multidisciplinary collaboration. The findings reveal marked heterogeneity in diagnostic frameworks and treatment rationales, often driven by tradition and subjective interpretation rather than empirical evidence. Palpatory assessments were frequently prioritized over patient-reported outcomes. Conclusion: The study highlights substantial fragmentation in Italian visceral osteopathic practice, echoing challenges across Europe. Promoting a shift towards critical thinking, evidence-based models, shared terminology, and interprofessional integration is essential for contextualising osteopathic contributions to the care of individuals presenting with visceral-related problems. These findings provide insights into the fragmented clinical practices of Italian osteopaths and may contribute to shaping a more critical and evidence-informed approach within Italian osteopathic practice and professional development, which is now more relevant than ever, given the recent integration of osteopathy into the Italian higher education system. Full article

The objective structured clinical examination (OSCE) is a well-established tool for assessing clinical skills, providing reliability, validity, and generalizability for high-stakes examinations. Des Moines University College of Osteopathic Medicine (DMU-COM) adapted the OSCE for formative assessments in undergraduate medical education, focusing on interpersonal aspects in the primary care setting. Students are graded by standardized patients and faculty observers on interpersonal skills, history/physical examination, oral case presentation, and documentation. The purpose of the study is to establish the reliability and to identify sources of variation in the DMU-COM OSCE to aid medical educators in their understanding of the accuracy of clinical skills. We examined student performance data across five OSCE domains. We assessed intra- and inter-OSCE reliability by calculating KR20 values, determined sources of variation by multivariate regression analysis, and described relationships among observed variables through factor analysis. The results indicate that the OSCE captures student performance in three dimensions with low intra-OSCE reliability but acceptable longitudinal inter-OSCE reliability. Variance analysis shows significant measurement error in rubric-graded scores but negligible error in checklist-graded portions. Physical exam scores from patients and faculty showed no correlation, indicating value in having two different observers. We conclude that a series of formative OSCEs is a valid tool for assessing clinical skills in preclinical medical students. However, the low intra-assessment reliability cautions against using a single OSCE for summative clinical skills competency assessments. Full article

Objective: This study aimed to quantitatively assess the efficacy of osteopathic manipulative treatment (OMT) as an adjunct to stabilization splint treatment for temporomandibular joint anterior disc displacement with reduction (ADDwR) disorder. Method: Thirty-eight joints were evaluated in this study. OMT, in addition to splint treatment, was administered to the study group, and the control group only received splint treatment. Before and after the treatments, the quality of life, the pain levels of distinct body regions, and the sleep quality were evaluated, while mandibular movements were assessed and condyle–disc position differences measured on magnetic resonance images. Results: In all the life qualities, except social functionality, increases after treatment were present for both control and study groups, but the increase was significant in bodily pain for the control group (p = 0.034) while increases were significant in physical functionality (p = 0.018), general health perception (p = 0.027), and reported health transition (p = 0.019) for the study group. Significant pain reduction in all body regions was seen in the study groups (p = 0.007–0.033), but the decrease was only significant for the temporomandibular joint for the control group (p = 0.011). The sleep quality significantly improved for the study group (p = 0.018). Limited after-treatment improvements in the condyle–disc positions were determined for both the normal joints and joints with ADDwR in the study group. Conclusions: The application of OMT adjunct to splint treatment increases quality of life and sleep, reduces bodily pain, and improves condyle–disc positions over the MRIs of TMJ. Full article

Background. A major goal for a significant portion of the osteopathic community is to update osteopathic principles, satisfying three needs: sourcing from the origin, proposing original and unique practical approaches, and describing the entire process in a scientifically updated way. On this line, several interprofessional proposals for healthcare providers have already been made by implementing patient-centered care and touch-based strategies informed by the enactive model. Enactivism principles can provide a foundation for rethinking osteopathic care by integrating environmental, psychological, social, and existential factors to facilitate the patient’s biobehavioral synchronization with the environment and social context, address health needs, and enhance the quality of multiprofessional healthcare services. However, there is a need to develop a conceptual model that offers a framework for organizing and interpreting disciplinary knowledge, guiding clinical observation and practical strategies, and defining both interprofessional collaboration and the unique focus of the profession. This scoping review and integrative hypothesis aim to fulfill the need for a more detailed and comprehensive understanding of the distinctive osteopathic care to biobehavioral synchrony, emphasizing both interprofessional collaboration and the profession’s unique competencies. Methods. The present article was developed in accordance with established guidelines for writing biomedical scoping reviews. Results. A total of 36 papers were considered for thematic and qualitative analyses, which supported the integrative hypothesis. Considering the current tenets for osteopathic rational practice, we propose an integrative hypothesis to focus on a practical framework for osteopathic patient biobehavioral synchronization. Patient–practitioner–environment synchronization could be promoted through a four-step process: (1) a narrative-based sense-making and decision-making process; (2) a touch-based shared sense-making and decision-making process; (3) hands-on, mindfulness-based osteopathic manipulative treatment; (4) patient active participatory osteopathic approaches to enhance person-centered care and rational practice. Conclusions and future directions: The proposed model fosters patient–practitioner synchronization by integrating updated traditional osteopathic narratives and body representations into practice, offering a culturally sensitive approach to promoting health, addressing contemporary health needs, and improving inclusive health services. Future studies are required to assess the transferability and applicability of this framework in modern settings worldwide. Full article

Background: Visceral manipulation is a soft tissue manual work technique that originates from and is classified within the Osteopathic Manipulative Technique (OMT), focusing on the fascial tissue mobilisation of the visceral system. Manual therapy on internal organs is based on anatomy, physiology and physics. Methods: Sixty women with endometriosis and pelvic organ prolapse, aged 41.5 ± 12.02, participated in the study. The women had manipulation therapy once a week for 5 weeks. The World Health Organisation Quality of Life BREF questionnaire and a postural stability assessment were administered before and after performing visceral manipulation. Results: The p-value = 0.0093 obtained in the group with prolapses and the p-value = 0.0001 in the group with endometriosis indicated that the applied visceral manipulation improved the women’s quality of life. No effect of therapy was observed on postural stability. Conclusions: Visceral manipulation improved the quality of life of both study groups of women. A significant difference was also observed when comparing the two groups for area. Full article

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. Full article

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. Full article

Background/Objective: Short hamstring syndrome is common in the general population and can lead to impaired balance, function, and posture, and increased risk of injuries. Local treatments have obtained controversial results, so it is necessary to evaluate the effectiveness of other types of therapy such as osteopathic treatment. To evaluate the efficacy of osteopathic techniques in increasing the elasticity of the hamstring musculature in short hamstring syndrome. Methods: A systematic review of randomised controlled trials was conducted in PubMed, Medline, Cinhal, Scopus, WOS, SPORTDiscuss, and PEDro. The PEDro scale was used to evaluate the methodological quality and the RoB2 for the evaluation of biases. Results: A total of eight articles were selected. Most of the participants were assessed with the Active Knee Extension or Straight Leg Raise tests. The osteopathic techniques used were the muscle energy technique, suboccipital inhibition, and vertebral mobilisations. As for the control interventions, they mainly included passive stretching and placebo. Conclusions: The results suggest that osteopathic techniques are more effective than placebo or other interventions in increasing flexibility in adult patients with short hamstring syndrome. This effect can be explained by neurophysiological (Golgi apparatus, neuromuscular spindle activity, and Hoffmann reflex) and structural factors (dura mater, posture, and myofascial chains). Nevertheless, the evidence suggests that it would be beneficial to incorporate this type of treatment into flexibility improvement programmes. Full article

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. Full article

Amyotrophic lateral sclerosis (ALS) is an incurable rare neurodegenerative condition, with 45% of cases showing the symptom of dysphagia; its clinical signs are atrophy, weakness, and fasciculations of the facial muscles, tongue, and pharynx. Furthermore, dysphagia is the main cause of aspiration pneumonia. The traditional treatment for dysphagia varies based on the patient’s difficulty of swallowing. The initial phase consists of dietary consistency adjustments, progressing to alternatives like nasogastric tubes or percutaneous endoscopic gastrostomy (PEG) in advanced stages. Osteopathic manipulative treatment (OMT) is a complementary ‘hands-on’ approach that has already shown positive results as an add-on therapy in various health conditions. This study is a case report of a man diagnosed with ALS with initial dysphagia, managed with a protocol that extraordinarily included OMT. The patient showed somatic dysfunctions in the mediastinal region, upper cervical region, and occipital area which are all anatomically related to the nervous system, especially the glossopharyngeal reflex. At the end of the rehabilitation protocol, there was a reduction in the swallowing problems measured with Strand Scale and swallowing tests, and the patient reported an improved psycho-physical well-being assessed with the Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ-40). Instead, the neurological function measured with ALSFRS-S remained stable. Although the nature of this study design prevents any causal assumption, the positive results should lead to future randomized controlled trials to assess the effectiveness of OMT as an adjunctive therapeutic proposal to improve the health of ALS patients. Full article

Despite the care provided, some newborns, who are perfectly healthy, show functional alterations that impair a good breast attack in the first few days. This situation often leads to the early failure of lactation. We conducted a randomized single-blind controlled trial to evaluate whether four weeks of osteopathic treatment can normalize the sucking score in a group of neonates with impaired lactation ability. Forty-two healthy full-term neonates were enrolled in this study. On the basis of the sucking score and the assessment of the infant’s breastfeeding skills, infants who had intrinsic breastfeeding difficulties were selected. The inclusion criteria were healthy infants born > 37 weeks, a suction score ≤ 6, and any breast milk at enrolment. At the end of the study, the sucking score was significantly greater in the osteopathic group than in the untreated group; the median sucking score in the treated group was in the normal range, while it remained lower in the untreated group. At the end of the follow-up, the percentage of exclusively breastfeeding infants in the treatment group increased by +25%. This pilot study demonstrates the efficacy of early osteopathic intervention to relieve breastfeeding difficulties in newborns in the first few weeks of life. Full article

(1) Background: This study investigated the effects of sequenced electromagnetic fields, modulated at extremely low frequencies and intensities, in the treatment of drug-resistant Escherichia coli (E. coli)-induced chronic bacterial cystitis. (2) Methods: A total of 148 female participants, aged 18 to 80 years diagnosed with chronic bacterial cystitis caused by drug-resistant E. coli, were recruited for this study. Participants were randomly assigned to two groups: an experimental group (n = 74) with osteopathic palpation and assessment treated with a sequence of electromagnetic fields, and a control group (n = 74) receiving a placebo treatment. Both groups were assessed at this study’s outset, 4 weeks after eight applications, and at 12 weeks for symptomatic presentation and laboratory parameters. (3) Results: After 4 weeks of treatment, a significant difference was observed between the two groups regarding D-DIMER levels, IL-6 levels, erythrocyte levels, leukocyte levels, and E. coli levels (p < 0.001). By the 12th week, the experimental group continued to exhibit a significant reduction in the examined parameters compared to the control group (p < 0.001). Additionally, the treatment did not induce any side effects in the patients in the experimental group. (4) Conclusions: Treatment with coherently sequenced electromagnetic fields, modulated at an extremely low frequency and intensity, not only appears to provide an effective alternative for the symptoms of chronic bacterial cystitis caused by drug-resistant E. coli but also demonstrates a potent antibacterial effect. Full article