No effect of osteopathic treatment on trunk morphology and spine flexibility in young women with adolescent idiopathic scoliosis

Abstract

Introduction Brace treatment is the gold standard for patients with mild adolescent idiopathic scoliosis (Cobb angle 20°-40°). However, negative psychosocial impacts, physical constraints and incompliance cause many patients and parents to seek for so-called holistic and apparently less harmful approaches within the field of complementary and alternative medicine (CAM). Osteopathy-manual interventions on the viscera and locomotor system-is widely used for scoliosis. There is, however, a complete lack of evidence regarding its efficacy. We, therefore, tested the hypothesis that osteopathy alters trunk morphology, a prerequisite to unload the concave side of the scoliosis, and that it halts curve progression.Methods This was a prospective, controlled trial of 20 post-pubertal young women (20°-40°idiopathic scoliosis) randomly allocated to an observation (group 0) or osteopathic treatment (group 1). The latter comprised three sessions (5 weeks). Trunk morphology (clinical examination, video rasterstereography) and spine flexibility (MediMouse Ò ) were assessed at a pre-and post-intervention with a 3-month interval (blinded examiner). We chose scoliometer measurement (rib hump, lumbar prominence) as the main outcome parameter. Results Two patients in the treatment group refused further treatment and the final examination, as they felt no benefit after two osteopathic treatments. Regression analysis for repeat measurements (independent statistician) revealed no therapeutic effect on rib hump, lumbar prominence, plumb line, sagittal profile and global spinal flexibility. Conclusions We found no evidence to support osteopathy in the treatment of mild adolescent idiopathic scoliosis. Therefore, we caution against abandoning the conventional standard of care for mild idiopathic scoliosis. As for other CAM therapies, the use of osteopathy as a treatment option for scoliosis still needs to be clearly defined.

Osteopathic Manipulative Treatment for Pediatric Conditions: A Systematic Review

“…A total of 887 pediatric patients were included in the RCTs. The included trials originated from Belgium, 14 Germany, 15,16 Italy, 17,18 Spain, 19 Switzerland, 20 the United Kingdom, 21,22 and the United States. [23][24][25][26][27][28][29][30] Cerebral Palsy Duncan et al 25 …”

Manual Therapy in the Treatment of Idiopathic Scoliosis. Analysis of Current Knowledge

“…One of these studies was devoted to idiopathic scoliosis [26]. Hasler et al (2010) analysed the effects of osteopathic manipulation on trunk morphology and spine flexibility in 20 subjects with IS.…”

“…Hasler et al (2010) analysed the effects of osteopathic manipulation on trunk morphology and spine flexibility in 20 subjects with IS. Ten individuals underwent treatments 3 times a week for 5 weeks (age 15-18 years, mean 16.5; Cobb angle 20-40°, mean 27.1°).…”

“…This study was limited by its small number of subjects and the lack of a control group treated with another method (placebo effect could not be ruled out) [26].…”

“…Ograniczeniami tego badania była mała liczebność badanych oraz brak grupy kontrolnej z inną metodą leczenia (brak możliwości wykluczenia efektu placebo) [26].…”