A Randomized Controlled Trial of Osteopathic Manipulative Therapy to Reduce Cranial Asymmetries in Young Infants with Nonsynostotic Plagiocephaly.

OBJECTIVE: This study aimed to compare the efficacy of osteopathic manipulative therapy (OMTh) versus light touch therapy (LTT) in reducing cranial asymmetries in infants with nonsynostotic plagiocephaly (NSP). STUDY DESIGN: A prospective, parallel-group, single-center, LTT-controlled randomized clinical trial was conducted in the Department of Neonatology of Sant'Anna Hospital in Turin, Italy, from September 6, 2016 to February 20, 2020. We enrolled infants of 1 to 6 months of age with NSP, who were then randomly assigned to the study group (repositioning therapy plus six sessions of OMTh) or the control group (repositioning therapy plus six sessions of LTT). The outcome was the reduction of the oblique diameter difference index (ODDI) score <104%, which was assessed at the end of the intervention protocol (at 3 months) and at 1 year of age. RESULTS: A total of 96 infants were randomized, 48 in the OMTh group and 48 in the LTT group, with mean ages of 3.1 versus 3.2 months, and baseline ODDI score of 110.2 versus 108.7%. In the OMTh group, a significant reduction of the ODDI score <104%, compared with the LTT group, was observed in the intension-to-treat (ITT) and per-protocol (PP) analyses. The ITT analysis revealed an ODDI score <104% in the OMTh group at 3 months (risk difference: 0.41; 95% confidence interval [CI]: 0.25-0.53; p < 0.001) and at the follow-up at 1 year of age (risk difference: 0.47; 95% CI: 0.31-0.64; p < 0.001). The PP analysis at 3 months reported a risk difference of 0.44 (95% CI: 0.27-0.60; p < 0.001), and at 1 year of age, a risk difference of 0.54 (95% CI: 0.36-0.72; p < 0.001). CONCLUSION: In infants with NSP, a course of six OMTh sessions significantly reduced cranial asymmetries at both the 3-month and 1-year follow-up assessments, compared with LTT. This study is registered with ClinicalTrial.gov (identifier: NCT03970395; www. CLINICALTRIALS: gov ). KEY POINTS: · OMTh plus repositioning therapy significantly decreased the risk and severity of NSP compared with LTT.. · OMTh reduced mild and moderate cranial asymmetries.. · The role of OMTh in severe cranial asymmetries should be investigated in a multicenter trial..

Efficacy and safety of osteopathic manipulative treatment: an overview of systematic reviews.

OBJECTIVE: To summarise the available clinical evidence on the efficacy and safety of osteopathic manipulative treatment (OMT) for different conditions. DESIGN: Overview of systematic reviews (SRs) and meta-analyses (MAs). PROSPERO CRD42020170983. DATA SOURCES: An electronic search was performed using seven databases: PubMed, EMBASE, CINAHL, Scopus, JBI, Prospero and Cochrane Library, from their inception until November 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: SRs and MAs of randomised controlled trials evaluating the efficacy and safety of OMT for any condition were included. DATA EXTRACTION AND SYNTHESIS: The data were independently extracted by two authors. The AMSTAR-2 tool was used to assess the methodological quality of the SRs and MAs. The overview was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RESULTS: The literature search revealed nine SRs or MAs conducted between 2013 and 2020 with 55 primary trials involving 3740 participants. The SRs reported a wide range of conditions including acute and chronic non-specific low back pain (NSLBP, four SRs), chronic non-specific neck pain (CNSNP, one SR), chronic non-cancer pain (CNCP, one SR), paediatric (one SR), neurological (primary headache, one SR) and irritable bowel syndrome (IBS, one SR). Although with a different effect size and quality of evidence, MAs reported that OMT is more effective than comparators in reducing pain and improving functional status in acute/chronic NSLBP, CNSNP and CNCP. Due to small sample size, presence of conflicting results and high heterogeneity, questionable evidence existed on OMT efficacy for paediatric conditions, primary headache and IBS.No adverse events were reported in most SRs. According to AMSTAR-2, the methodological quality of the included SRs was rated low or critically low. CONCLUSION: Based on the currently available SRs and MAs, promising evidence suggests the possible effectiveness of OMT for musculoskeletal disorders. Limited and inconclusive evidence occurs for paediatric conditions, primary headache and IBS. Further well-conducted SRs and MAs are needed to confirm and extend the efficacy and safety of OMT.

Osteopathy students profile in Italy: A cross sectional census.

INTRODUCTION: The Osteopathy Students Analysis (OSA) aims to profile osteopathy students in Italy as a target population in terms of sociodemographic characteristics, geographical distribution, health status, and previous and ongoing education specifications. MATERIALS AND METHODS: The OSA used a cross-sectional design. A Web-based survey was distributed to the Italian Osteopathic Education Institutions (OEIs). The OSA survey was composed of items organised into four sections: 1. Sociodemographic characteristics (11 items); 2. Geographical distribution (5 items); 3. Health status (3 items); 4. Previous and ongoing education specifications (16 items). A descriptive sample population analysis was performed. Dichotomous and categorical variables were presented as frequencies and percentages, and continuous variables were displayed as means and standard deviations. Some variables were analysed using a pentenary distribution. RESULTS: 49 out of the 61 OEIs identified matched the inclusion criteria, and among these, 22 accepted to propose the enrolment of their students into the study. The survey was administered to 4,720 students from all the participant OEIs. A total of 3,762 students responded to the survey, accounting for an estimated response rate of 53.7%. The majority of respondents were men (54%), with an average age of 26.9 ± 6.5 years. Almost the totality of the sample was composed of the European ethnic group (99.1%). Respondents were predominantly born in Italy (97.2%). The majority of the sample reported being in good (49.5%) to excellent (38.6%) health. To date, osteopathy students are almost evenly distributed between the two types of curricula (T1 = 46.6%; T2 = 53.4%). CONCLUSIONS: The OSA is the first study that aims to profile Italian osteopathy students as a target population in terms of sociodemographic characteristics, geographical distribution, health status, and previous and ongoing education specifications. Future studies should focus on investigating the correlation between the sociodemographic characteristics of students and their academic performance.

Osteopathic Manipulative Treatment in Pediatric and Neonatal Patients and Disorders: Clinical Considerations and Updated Review of the Existing Literature.

Osteopathic medicine is a form of complementary and alternative medicine. Osteopathic practitioners treat patients of all ages: according to the Osteopathic International Alliance's 2012 survey, about one-third of all treated patients are aged between 31 and 50 years and nearly a quarter (23.4%) are pediatric patients, with 8.7% of them being younger than 2 years. In 2013 a systematic review evaluated the effectiveness of osteopathic manipulative treatment (OMT) in pediatric patients with different underlying disorders, but due to the paucity and low methodological quality of the primary studies the results were inconclusive. The aim of this review is therefore to update the evidence concerning OMT in perinatal and pediatric disorders and to assess its clinical impact. Most published studies favor OMT, but the generally small sample sizes in these studies cannot support ultimate conclusions about the efficacy of osteopathic therapy in pediatric age. In turn, clinical trials of OMT in premature infants might represent an important step in the osteopathic research because they can address both cost-effectiveness issues, and an innovative, multidisciplinary approach to the management of specific pediatric diseases cared for by the same, common health care system. The available studies in neonatal settings provide evidence that OMT is effective in reducing the hospital length of stay of the treated infants, therefore, suggesting that robust cost-effectiveness analyses should be included in the future clinical trials' design to establish new possible OMT-shared strategies within the health care services provided to newborns.