The use of osteopathic manipulative treatment in the newborn nursery and its effect on health in the first six months of life: A retrospective observational case-control study
“…Seven (78%) of the included studies (n = 9) were RCTs with a parallel design [ 4 , 25 , 26 , 27 , 28 , 29 , 30 ], one was a retrospective cohort study [ 13 ], and one a retrospective case–control study [ 31 ].…”
Section: Resultsmentioning
confidence: 99%
“…All the studies had no active treatment as a comparison: three trials (33%) provided the same osteopathic evaluation, which was also delivered to the OMT group [ 25 , 26 , 27 ], and five studies (56%) provided standard medical care and/or parents recommendations [ 13 , 28 , 29 , 30 , 31 ], while one trial (11%) performed sham OMT [ 4 ].…”
Section: Resultsmentioning
confidence: 99%
“…The total number of participants was 1368, with a mean of 152 ± 215.79. Five studies (56%) involved term infants [ 4 , 26 , 30 , 31 , 32 ]; data about age were reported with different measures; therefore, it was not possible to calculate a total mean for age in term infants. Then, three studies (33%) involved preterm infants with a mean gestational age (weeks) of 33.33 ± 1.47 [ 13 , 26 , 27 ]; only one trial (11%) was conducted on very preterm infants (median gestational age in days: 187.5) [ 29 ].…”
Section: Resultsmentioning
confidence: 99%
“…Two studies (22%) had LOS reduction as the primary outcome [ 26 , 27 ], two (22%) colic crying [ 25 , 29 ], one complete meconium excretion (11%) [ 25 ], one breast feeding at 1 month (11%) [ 30 ], one time of oral feeding (11%) [ 13 ], one infant’s biomechanical sucking difficulties [ 4 ], and one general health status (11%)—including vomiting, food intolerance, colic suggested, diarrhea—during the first 6 months of life [ 31 ].…”
Section: Resultsmentioning
confidence: 99%
“…Secondary outcomes included feeding amount and full enteral feeding [ 28 ], weight gain [ 13 , 26 , 27 , 28 , 31 ] maternal feeding perception [ 4 ], colic severity [ 29 ], costs for hospitalization [ 26 , 27 ], and AEs related to OMT [ 13 , 26 , 27 , 28 , 29 , 30 , 31 ].…”
The aim of this systematic review and meta-analysis is to evaluate the effectiveness of osteopathic manipulative treatment (OMT) for gastrointestinal disorders in term and preterm infants. Eligible studies were searched on PubMed, Scopus, Embase, Cochrane, Cinahl, and PEDro. Two reviewers independently assessed if the studies were randomized controlled trials (RCTs) and retrospective studies with OMT compared with any kind of control in term or preterm infants to improve gastrointestinal disorders. Nine articles met the eligibility criteria, investigating OMT compared with no intervention, five involving term infants, and the remaining treating preterm infants. Five studies showed low risk of bias. In the meta-analysis, two studies were included to analyze the hours of crying due to infantile colic, showing statistically significant results (ES = −2.46 [−3.05, −1.87]; p < 0.00001). The quality of evidence was “moderate”. The other outcomes, such as time to oral feeding, meconium excretion, weight gain, and sucking, were presented in a qualitative synthesis. OMT was substantially safe, and showed efficacy in some cases, but the conflicting evidence and lack of high-quality replication studies prevent generalization. High-quality RCTs are recommended to produce better-quality evidence.
“…Seven (78%) of the included studies (n = 9) were RCTs with a parallel design [ 4 , 25 , 26 , 27 , 28 , 29 , 30 ], one was a retrospective cohort study [ 13 ], and one a retrospective case–control study [ 31 ].…”
Section: Resultsmentioning
confidence: 99%
“…All the studies had no active treatment as a comparison: three trials (33%) provided the same osteopathic evaluation, which was also delivered to the OMT group [ 25 , 26 , 27 ], and five studies (56%) provided standard medical care and/or parents recommendations [ 13 , 28 , 29 , 30 , 31 ], while one trial (11%) performed sham OMT [ 4 ].…”
Section: Resultsmentioning
confidence: 99%
“…The total number of participants was 1368, with a mean of 152 ± 215.79. Five studies (56%) involved term infants [ 4 , 26 , 30 , 31 , 32 ]; data about age were reported with different measures; therefore, it was not possible to calculate a total mean for age in term infants. Then, three studies (33%) involved preterm infants with a mean gestational age (weeks) of 33.33 ± 1.47 [ 13 , 26 , 27 ]; only one trial (11%) was conducted on very preterm infants (median gestational age in days: 187.5) [ 29 ].…”
Section: Resultsmentioning
confidence: 99%
“…Two studies (22%) had LOS reduction as the primary outcome [ 26 , 27 ], two (22%) colic crying [ 25 , 29 ], one complete meconium excretion (11%) [ 25 ], one breast feeding at 1 month (11%) [ 30 ], one time of oral feeding (11%) [ 13 ], one infant’s biomechanical sucking difficulties [ 4 ], and one general health status (11%)—including vomiting, food intolerance, colic suggested, diarrhea—during the first 6 months of life [ 31 ].…”
Section: Resultsmentioning
confidence: 99%
“…Secondary outcomes included feeding amount and full enteral feeding [ 28 ], weight gain [ 13 , 26 , 27 , 28 , 31 ] maternal feeding perception [ 4 ], colic severity [ 29 ], costs for hospitalization [ 26 , 27 ], and AEs related to OMT [ 13 , 26 , 27 , 28 , 29 , 30 , 31 ].…”
The aim of this systematic review and meta-analysis is to evaluate the effectiveness of osteopathic manipulative treatment (OMT) for gastrointestinal disorders in term and preterm infants. Eligible studies were searched on PubMed, Scopus, Embase, Cochrane, Cinahl, and PEDro. Two reviewers independently assessed if the studies were randomized controlled trials (RCTs) and retrospective studies with OMT compared with any kind of control in term or preterm infants to improve gastrointestinal disorders. Nine articles met the eligibility criteria, investigating OMT compared with no intervention, five involving term infants, and the remaining treating preterm infants. Five studies showed low risk of bias. In the meta-analysis, two studies were included to analyze the hours of crying due to infantile colic, showing statistically significant results (ES = −2.46 [−3.05, −1.87]; p < 0.00001). The quality of evidence was “moderate”. The other outcomes, such as time to oral feeding, meconium excretion, weight gain, and sucking, were presented in a qualitative synthesis. OMT was substantially safe, and showed efficacy in some cases, but the conflicting evidence and lack of high-quality replication studies prevent generalization. High-quality RCTs are recommended to produce better-quality evidence.
Osteopathic manipulative treatment (OMT) is used in both inpatient and outpatient settings. Evidence suggests that OMT can reduce both patients’ recovery time and the financial cost of their acute medical treatment and rehabilitation. Multiple studies from neonatal intensive care units (NICUs) are presented in this article that demonstrate infants treated with OMT recover faster, are discharged earlier, and have lower healthcare costs than their non-OMT-treated counterparts. Data clearly show that adjunctive OMT facilitates feeding coordination in newborns, such as latching, suckling, swallowing, and breathing, and increases long-term weight gain and maintenance, which reduces hospital length of stay (LOS). Osteopathic techniques, such as soft tissue manipulation, balanced ligamentous tension, myofascial release, and osteopathic cranial manipulation (OCM), can reduce regurgitation, vomiting, milky bilious, or bloody discharge and decrease the need for constipation treatment. OMT can also be effective in reducing the complications of pneumonia in premature babies. Studies show the use of OCM and lymphatic pump technique (LPT) reduces the occurrence of both aspiration and environmentally acquired pneumonia, resulting in significantly lower morbidity and mortality in infants. Based on published findings, it is determined that OMT is clinically effective, cost efficient, a less invasive alternative to surgery, and a less toxic choice to pharmacologic drugs. Therefore, routine incorporation of OMT in the NICU can be of great benefit in infants with multiple disorders. Future OMT research should aim to initiate clinical trial designs that include randomized controlled trials with larger cohorts of infants admitted to the NICU. Furthermore, a streamlined and concerted effort to elucidate the underlying molecular mechanisms associated with the beneficial effects of OMT will aid in understanding the significant value of incorporating OMT into optimal patient care.
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