Osteopathic intervention in chronic non-specific low back pain: a systematic review

Abstract

BackgroundChronic Non Specific Low Back Pain (CNSLBP) is a common, complex and disabling condition that has been present for longer than three months and is not caused by a serious pathology. Osteopaths are health practitioners who commonly diagnose and treat CNSLBP patients using a complex set of interventions that includes manual therapy. The study aimed to complete a Systematic Review of clinical research into osteopathic intervention in CNSLBP using a rigorous assessment of study quality.MethodsThe literature was searched to August 2011 using the following databases: AMED, CINAHL Plus, Cochrane Central Register of Clinical Trials, MEDLINE Plus, EMBASE, MANTIS, OSTMED, PEDro, ScienceDirect. Multiple search terms were used in various combinations: osteopathy/osteopathic, osteopathic manipulative technique, OMT, Spinal Manipulative Therapy, SMT, clinical trial, back pain, chronic back pain. The inclusion criteria were papers that: reported clinical trials; had adult participants; tested the effectiveness and/or efficacy of osteopathic manual therapy intervention applied by osteopaths, and had a study condition of CNSLBP. The quality of the papers was assessed using the Cochrane Back Review Risk of Bias criteria. A meta-analysis would proceed if the studies had adequate clinical and methodological homogeneity.ResultsInitial searches revealed 809 papers, 772 of which were excluded on the basis of abstract alone. The remaining 37 trial papers were subjected to a more detailed analysis of the full text, which resulted in 35 being excluded. The two remaining trials had a lack of methodological and clinical homogeneity, precluding a meta-analysis. The trials used different comparators with regards to the primary outcomes, the number of treatments, the duration of treatment and the duration of follow-up.ConclusionThere are only two studies assessing the effect of the manual therapy intervention applied by osteopathic clinicians in adults with CNSLBP. One trial concluded that the osteopathic intervention was similar in effect to a sham intervention, and the other suggests similarity of effect between osteopathic intervention, exercise and physiotherapy. Further clinical trials into this subject are required that have consistent and rigorous methods. These trials need to include an appropriate control and utilise an intervention that reflects actual practice.

Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis

“…The Orrock and Myers review[30] was restricted to chronic nonspecific LBP and consequently fewer studies met their inclusion criteria. The current review was not restricted to the English language or the published literature, and we located 6 unpublished studies in German[42, 46, 48, 53–55] and 1 study in Italian[52].…”

Bel Ağrısında Tamamlayıcı ve Alternatif Tedavi

“…Osteopati bir sinirin veya sinirlerin fiziksel veya duygusal etkilenmeden dolayı organlarda, özellikle eklemlerde görülen fizyolojik bozuklukları, hareket kısıtlılığını düzeltmek, ağrı ve fonksiyonel bozuklukları ortadan kaldırmak amacıyla uygulanan bir tedavi yöntemidir 61 . Osteopatik manipülatif tedavi(OMT), manuel terapi ve yardımcı tedavilerin yaygın bir şekilde kullanılarak, somatik dokuların disfonksiyonunu değerlendirme ve azaltma amacıyla kullanılır 62,63 .…”

Aplicação do questionário QVWOQOL‑Bref antes e após tratamento manipulativo osteopático

“…A dor crônica compromete as atividades profissionais 3 , a relação interpessoal, e a estabilidade psicoemocional 8 resultando em quadros de depressão e ansiedade levando a levando a uma redução importante da qualidade de vida 9 . A qualidade de vida é um conceito amplo e abrangente afetado de forma complexa pela saú-de física, estado psicológico, crenças pessoais, relações sociais e ambientais do indivíduo 10 .…”

“…O diagnóstico e o tratamento da dor crônica é complexo, por este motivo com a osteopatia, que visa identificar uma gama complexa de mecanismos geradores de dor crônica, é possivel identificar desequilíbrios biomecânicos, neurofisiológicos, psicoemocionais e neuroendócrinos e trata-los de forma integrada 9,13 . Além disso, o Osteopata é capaz de realizar uma avaliação física minuciosa com teste de sensibilidade, avaliação da mobilidade articular, assimetrias, compensações posturais, reflexos viscero-somáticos, percepção da qualidade dos tecidos, para desta forma buscar a normalização das disfunções somáticas e dos seus mecanismos de sustentação, avaliando também a necessidade de um cuidado multidisciplinar desse individuo 9,13 . O tratamento manipulativo osteopático (TMO) é uma abordagem dirigida ao tratamento e diagnóstico que considera o individuo como um ser único e integrado, sendo os seus objetivos relacionados ao restabelecimento dos mecanismos funcionais homeostásicos do organismo e favorecer a inter-relação da estrutura com função.…”