The majority of research carried out in osteopathy has been to determine its effectiveness for the treatment of various musculoskeletal conditions. This text aims to demonstrate that the benefits of osteopathy go beyond joint discomfort but also a range of systemic conditions.

Fitzgerald and Stiles

Fitzgerald and Stiles (19) reported a reduction in length of hospital stay when osteopathic care was used for patients with the following:

  • Asthma: 14%
  • Pneumonia: 10%
  • Cholecystectomy: 7%
  • Hysterectomiy: 12%

Fitzgerald and Stiles also report a reduction in shock, heart rhythm disturbances, and mortality when osteopathic care was integrated into the care of patients with myocardial infarction.

Cantieri

More recently, Cantieri (27) carried out a survey on the use of osteopathy in 18 osteopathic hospitals. A decrease in length of stay of one day or more has been noted in a number of systemic conditions, including:

  • Non-cancerous pancreatic disorders
  • Psychosis
  • Upper gastrointestinal procedures
  • Intestinal obstructions
  • Transient ischemic attacks
  • Cardiovascular disorders in patients with acute myocardial infarction
  • Complex cardiovascular disorders undergoing cardiac catheterization

Response from 50 patients with myocardial infarction. (Adapted from the work of Ed Stiles, DO.

Kelso

Kelso (28) reports a double-blind clinical study of osteopathic outcomes in hospitalized patients. In 5174 separate examinations, somatic findings were significantly more common in acute visceral disease than in controls.

Nicholas

Nicholas (29) reports a pilot study that examined 286 hospitalized patients with 73 different illnesses. Again, a variety of identifiable somatic patterns were found with different disease entities. The study focused on somatically identified cervical and dorsal spine configuration differences associated with respiratory, gastrointestinal, and genitourinary diseases.

Location and incidence of thoracic somatic dysfunction in 94 cardiac patients. (After Kuchera ML, Kuchera WA. Osteopathic Considerations in Systemic Function, rev. 2nd ed. Columbus, OH: Greyden Press; 1994.)

Other observational studies based on osteopathy have evaluated somatic correlations with gastrointestinal diseases. Their results closely mirror the findings of pain profiles recorded by surgeons at the Mayo Clinic (30). Several well-controlled studies have identified patterns of somatic dysfunction common in patients with coronary heart disease and myocardial infarction (31, 32). The somatic findings are mainly located in the left upper thoracic region. Signs of upper cervical (C2) dysfunction have also been found in patients with certain acute visceral diseases. These findings are hypothesized to correlate with the anatomy of the vagus nerve proximal to the second cervical vertebra.

Beal and Kleiber

Beal and Kleiber evaluated 70 patients before angiography. Specificity for positive and negative cervicothoracic palpatory findings in patients with and without coronary heart disease was 79% (33).

Nonetheless, these authors identified similar clinical outcomes and outcomes associated with adding manipulative treatment to an overall management plan.

Similar studies have been performed for the vertebral levels of somatic signs associated with lung diseases (39,40). The authors report a strong dominance of problems located in the upper thoracic region and C2 of the spine.

Howell and Associates

Many of these authors report beneficial results associated with osteopathic manipulative treatment (OMT). Howell and associates (41) reported the effectiveness of OMT in 17 patients who showed improvement in severity score over a 1-year period.

Miller

Miller (42) demonstrated using a study of 23 patients with chronic obstructive pulmonary disease randomly assigned to a treatment or control group.

With the exception of OMT, the treatment received by all patients was the same.

Although there was a small change in the average viral capacity of the treated group compared to the untreated group, this parameter was not considered statistically significant.

What proved to be clinically significant was a marked improvement in the functional capacity of the treated group with a reduction in cough, an increase in walking ability, less dyspnea and fewer respiratory tract infections.

Many other observational studies and pilot projects suggest the value of continued use of manipulative treatment to improve self-healing mechanisms in patients with systemic diseases.

Many other observational studies and pilot projects suggest the value of continued use of manipulative treatment to improve self-healing mechanisms in patients with systemic diseases.

Sleszynski and Kelso

In double-blind randomized trials, Sleszynski and Kelso (45) demonstrated similar results using the OMT thoracic lymphatic pump compared to the use of incentive spirometry in the prevention of postcholecystectomy atelectasis.

Patients developing atelectasis had earlier recoveries and were a more rapid return to preoperative forced viral capacity and forced expiratory volume in 1 second values than the incentive spirometry groups.

Radjieski and Lumley

Radjieski and Lumley (46) demonstrated a significant reduction in length of stay when OMT was added to a randomized, controlled study for the management of hospitalized patients with pancreatitis (mean reduction, 3.5 days).

Noll

In another randomized controlled study, Noll (47) demonstrated that the addition of OMT resulted in shorter length of stay and shorter duration of intravenous antibiotic use in geriatric hospitalized patients with pneumonia.

Some studies suggest that osteopathic treatment may be effective in reducing blood pressure and aldosterone levels in hypertensive patients (48-50).

Other OMT research reports suggest that fibromyalgia hotspots can be reduced, with an improvement in quality of life (51-53). The value of osteopathic treatment in the context of health promotion in preventive practices is noted by osteopathic pediatricians and can extend to improving the effectiveness of certain immunizations.

Jackson and his colleagues

Jackson and colleagues (54) documented data to support an enhanced immunological response in subjects who received an OMT lymphatic and splenic pump.

Measel had also documented this in previous studies (55). The value of promoting health through prevention of degenerative changes and maximizing function through reduction of biomechanical risk factors is discussed in more detail in Chapter XX.

Simons and Travell

The paper by Simons and Travell (56) improved visceral function ions when related somatic components are corrected with manipulative treatment and other manual neuromuscular release techniques. Issues that have improved include:

  • Supraventricular tachyarrhythmia
  • Gastrointestinal functioning
  • Reduction in peptic ulcer recurrence

Reference

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