Evaluation of effectiveness of osteopathic visceral manipulation in patients with chronic mechanical low back pain: A multi-center, single-blind, randomized-controlled study.

Objectives: In this study, we aimed to evaluate the effectiveness of osteopathic visceral manipulation (OVM) combined with physical therapy in pain, depression, and functional impairment in patients with chronic mechanical low back pain (LBP). Patients and methods: A total of 118 patients with chronic mechanical LBP were assessed, and 86 who met the inclusion criteria were included in the randomized-controlled study between January 2021 and August 2022. The patients were randomized to either Group 1 (n=43), which underwent physical therapy (5 days/week, for a total of 15 sessions) combined with OVM (2 days/week with three-day intervals), or Group 2 (n=43), which underwent physical therapy (5 days/week, for a total of 15 sessions) combined with sham OVM (2 days/week with three-day intervals). Both groups were assessed before and after treatment and at the fourth week post-treatment. Results: Seven patients were lost to follow-up, and the study was completed with 79 patients (25 males, 54 females; mean age: 46.87±14.12 years; range, 19 to 75 years). Pain, depression, and functional impairment scores were all improved in both groups (p=0.001 for all). This improvement was sustained at week four after the end of treatment. However, improvement in the pain, depression, and functional impairment scores was significantly higher in Group 1 than in Group 2 (p=0.001 for all). Conclusion: The results suggest that OVM combined with physical therapy is useful to improve pain, depression, and functional impairment in patients with chronic mechanical low back pain. We believe that OVM techniques should be combined with other physical therapy modalities in this patient population.

The effect of maternity support belts on postural balance in pregnancy.

OBJECTIVE: The purpose of this study was to evaluate the effect of maternity support belts (MSB) on postural balance during pregnancy. DESIGN: Prospective, observational cohort study. SETTING: Outpatient visits at a university hospital, obstetrics and gynecology clinic. PARTICIPANTS: A total of 90 pregnant women in first, second, and third trimesters of pregnancy; 30 pregnant women for each trimester. METHODS: Dynamic and postural stability by using a Biodex Stability System and comparing pregnant women with and without an MSB in each cohort group. MAIN OUTCOME MEASURES: Overall, anterior-posterior stability index, medial-lateral stability index, and fall risk test (FRT) scores were obtained with 1 stance at platform stability of level 8. Four measurements from the Biodex Stability System were compared between pregnant women with and without an MSB in each group. RESULTS: The scores of anterior-posterior stability index and FRT were significantly lower in the first-trimester group with an MSB than without an MSB (P < .05). Medial-lateral stability index and FRT scores were significantly lower in the second-trimester group with an MSB than without an MSB (P < .05). In the third-trimester group, overall, medial-lateral stability index, and FRT scores were lower for participants with an MSB compared with participants without an MSB (P < .05). In all trimester groups, FRT scores were detected to be lower in pregnant women with an MSB than in those without an MSB (P < .05). CONCLUSIONS: MSB use improves impaired balance and FRT scores during all periods of pregnancy, especially in the third trimester. MSB is useful for fall prevention during pregnancy, especially during the third trimester.