A Multicenter, Randomized, Controlled Trial of Osteopathic Manipulative Treatment on Preterms

Abstract

BackgroundDespite some preliminary evidence, it is still largely unknown whether osteopathic manipulative treatment improves preterm clinical outcomes.Materials and MethodsThe present multi-center randomized single blind parallel group clinical trial enrolled newborns who met the criteria for gestational age between 29 and 37 weeks, without any congenital complication from 3 different public neonatal intensive care units. Preterm infants were randomly assigned to usual prenatal care (control group) or osteopathic manipulative treatment (study group). The primary outcome was the mean difference in length of hospital stay between groups.ResultsA total of 695 newborns were randomly assigned to either the study group (n= 352) or the control group (n=343). A statistical significant difference was observed between the two groups for the primary outcome (13.8 and 17.5 days for the study and control group respectively, p<0.001, effect size: 0.31). Multivariate analysis showed a reduction of the length of stay of 3.9 days (95% CI -5.5 to -2.3, p<0.001). Furthermore, there were significant reductions with treatment as compared to usual care in cost (difference between study and control group: 1,586.01€; 95% CI 1,087.18 to 6,277.28; p<0.001) but not in daily weight gain. There were no complications associated to the intervention.ConclusionsOsteopathic treatment reduced significantly the number of days of hospitalization and is cost-effective on a large cohort of preterm infants.

Osteopathic manipulative treatment showed reduction of length of stay and costs in preterm infants

“…Four studies were conducted in Italy [27–30] and 1 in Austria. [31] The publication period ranged from 2007 to 2015.…”

“…All studies considered LOS as clinical outcome, 4 trials as primary outcome, [27–30] whereas 1 considered it as a secondary outcome. [31] Further studies’ aims were: average daily gut symptoms, [27] costs, [28–30] daily weight gain, [28–30] meconium evacuation, full enteral feeding, and weight gain at discharge home.…”

Osteopathic Manipulative Therapy for Preterm Infants, Acupuncture for Menopausal Symptoms, Mindfulness-Based Stress Reduction for Chronic Low Back Pain, Chocolate for Ischemic Heart Disease, Berberine for Irritable Bowel Syndrome

“…Length of hospitalization, which varies inversely with GA and birth weight, 4 is a common measure of treatment success in the neonatal intensive care unit (NICU). 5 Osteopathy is a system of healing that employs manual techniques to diagnosis and treat "somatic dysfunction", which may manifest as restricted range of motion, tenderness, asymmetry and aberrant tissue texture. 5 Two previous trials have indicated a favorable effect of osteopathic manipulative therapy (OMT) on length of stay (LOS) for preterm infants.…”

“…5 Osteopathy is a system of healing that employs manual techniques to diagnosis and treat "somatic dysfunction", which may manifest as restricted range of motion, tenderness, asymmetry and aberrant tissue texture. 5 Two previous trials have indicated a favorable effect of osteopathic manipulative therapy (OMT) on length of stay (LOS) for preterm infants. 6,7 In this Italian trial, researchers randomized 720 preterm infants (GA 29-37 weeks) into two groups: OMT plus usual care and usual care alone.…”

“…6,7 In this Italian trial, researchers randomized 720 preterm infants (GA 29-37 weeks) into two groups: OMT plus usual care and usual care alone. 5 Patients were free of congenital disorders or serious morbidities associated with prematurity. Osteopaths conducted manual assessments of skull, spine, pelvis, abdomen and upper and lower limbs in all patients.…”