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Carrasco-Uribarren A, Mamud-Meroni L, Tarcaya GE, Jiménez-Del-Barrio S, Cabanillas-Barea S, Ceballos-Laita L. Clinical Effectiveness of Craniosacral Therapy in Patients with Headache Disorders: A Systematic Review and Meta-analysis. Pain Manag Nurs 2024; 25:e21-e28. [PMID: 37709558 DOI: 10.1016/j.pmn.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/03/2023] [Accepted: 07/29/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVES To analyze the effectiveness of craniosacral therapy in improving pain and disability among patients with headache disorders. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Physiotherapy Evidence Database, Scopus, Cochrane Library, Web of Science, and Osteopathic Medicine Digital Library databases were searched in March 2023. REVIEW METHODS Two independent reviewers searched the databases and extracted data from randomized controlled trials comparing craniosacral therapy with control or sham interventions. The same reviewers assessed the methodological quality and the risk of bias using the PEDro scale and the Cochrane Collaboration tool, respectively. Grading of recommendations, assessment, development, and evaluations was used to rate the certainty of the evidence. Meta-analyses were conducted using random effects models using RevMan 5.4 software. RESULTS The searches retrieved 735 studies, and four studies were finally included. The craniosacral therapy provided statistically significant but clinically unimportant change on pain intensity (Mean difference = -1.10; 95% CI: -1.85, -0.35; I2: 44%), and no change on disability or headache effect (Standardized Mean Difference = -0.34; 95% CI -0.70, 0.01; I2: 26%). The certainty of the evidence was downgraded to very low. CONCLUSION Very low certainty of evidence suggests that craniosacral therapy produces clinically unimportant effects on pain intensity, whereas no significant effects were observed in disability or headache effect.
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Affiliation(s)
| | - Lucas Mamud-Meroni
- Flores University, Department of Kinesiology and Physiotherapy, Comahue, Argentina
| | - Germán E Tarcaya
- Flores University, Department of Kinesiology and Physiotherapy, Comahue, Argentina
| | - Sandra Jiménez-Del-Barrio
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, University of Valladolid, Soria, Spain
| | - Sara Cabanillas-Barea
- Faculty of Medicine and Health Sciences, Universitat International de Catalunya, Barcelona, Spain
| | - Luis Ceballos-Laita
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, University of Valladolid, Soria, Spain.
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Dickerson M, Murphy S, Hyppolite N, Brolinson PG, VandeVord P. Osteopathy in the Cranial Field as a Method to Enhance Brain Injury Recovery: A Preliminary Study. Neurotrauma Rep 2022; 3:456-472. [PMCID: PMC9622209 DOI: 10.1089/neur.2022.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Michelle Dickerson
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA
| | - Susan Murphy
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA
| | - Natalie Hyppolite
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, USA
| | | | - Pamela VandeVord
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA
- Salem VA Medical Center, Salem, Virginia, USA
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3
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Espi-Lopez GV, Ingles M, Carrasco-Fernandez JJ, Serra-Añó P, Copete-Fajardo L, Gonzalez-Gerez JJ, Saavedra-Hernandez M, Marques-Sule E. Effects of Foam Rolling vs. Manual Therapy in Patients with Tension-Type Headache: A Randomized Pilot Study. J Clin Med 2022; 11:jcm11071778. [PMID: 35407385 PMCID: PMC8999161 DOI: 10.3390/jcm11071778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 12/10/2022] Open
Abstract
Background: This study compares the effect of foam rolling (FR) vs. manual therapy (MT) on pain, pressure pain threshold (PPT), headache disability (HDI) and impact of headache (HIT-6) in patients with tension-type headache (TTH). Methods: A total of 38 participants with TTH were randomly assigned to an FR group (FRG, n = 13), an MT group (MTG, n = 13) or a control group (CG, n = 12). FRG received FR treatment; MTG received MT techniques; CG received a placebo treatment. The treatment lasted one month. Outcome measures were assessed at baseline, post-intervention and follow-up. Results: Both FRG and MTG showed significant improvements in all variables after the treatment, but the intervention effect was maintained only for functional disability (p = 0.002 and p = 0.005, respectively), overall disability (p = 0.007; p = 0.030) and HIT-6 (p = 0.002; p = 0.001) at follow-up. After treatment, FRG and MTG presented a significantly higher PPT in right (p = 0.044; p = 0.009) and left suboccipital (p = 0.004; p = 0.021). MTG showed a significantly lower HIT-6 than CG (p = 0.008). No differences between FRG and MTG were found in any variable. Conclusions: Both FR and MT are effective treatments for the improvement of clinical symptoms in TTH. Further studies are needed to confirm our findings in a larger population.
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Affiliation(s)
- Gemma V. Espi-Lopez
- Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, 46010 Valencia, Spain; (G.V.E.-L.); (M.I.); (J.J.C.-F.); (P.S.-A.); (L.C.-F.); (E.M.-S.)
| | - Marta Ingles
- Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, 46010 Valencia, Spain; (G.V.E.-L.); (M.I.); (J.J.C.-F.); (P.S.-A.); (L.C.-F.); (E.M.-S.)
| | - Juan J. Carrasco-Fernandez
- Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, 46010 Valencia, Spain; (G.V.E.-L.); (M.I.); (J.J.C.-F.); (P.S.-A.); (L.C.-F.); (E.M.-S.)
| | - Pilar Serra-Añó
- Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, 46010 Valencia, Spain; (G.V.E.-L.); (M.I.); (J.J.C.-F.); (P.S.-A.); (L.C.-F.); (E.M.-S.)
| | - Luis Copete-Fajardo
- Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, 46010 Valencia, Spain; (G.V.E.-L.); (M.I.); (J.J.C.-F.); (P.S.-A.); (L.C.-F.); (E.M.-S.)
| | - Juan Jose Gonzalez-Gerez
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, c/Carretera de Sacramento s/n, La Cañada, 04120 Almería, Spain;
- Fisiosur I + D Research Institute, Garrucha, 04630 Almería, Spain
| | - Manuel Saavedra-Hernandez
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, c/Carretera de Sacramento s/n, La Cañada, 04120 Almería, Spain;
- Fisiosur I + D Research Institute, Garrucha, 04630 Almería, Spain
- Correspondence: or ; Tel.: +34-95021-4593
| | - Elena Marques-Sule
- Department of Physical Therapy, Faculty of Physical Therapy, University of Valencia, 46010 Valencia, Spain; (G.V.E.-L.); (M.I.); (J.J.C.-F.); (P.S.-A.); (L.C.-F.); (E.M.-S.)
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Effect of a Craniosacral Therapy Protocol in People with Migraine: A Randomized Controlled Trial. J Clin Med 2022; 11:jcm11030759. [PMID: 35160211 PMCID: PMC8836770 DOI: 10.3390/jcm11030759] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Migraine is a common neurological disorder, and it is the second leading cause of disability worldwide. Manual techniques based on physical therapy have been proposed to improve migraine aspects; however, further research is needed on their effectiveness. The aim of this study was to evaluate the effectiveness of a craniosacral therapy protocol on different features in migraine patients. Methods: Fifty individuals with migraine were randomly divided into two groups (n = 25 per group): (i) craniosacral therapy group (CTG), following a craniosacral therapy protocol, and (ii) sham control group (SCG), with a sham treatment. The analyzed variables were pain, migraine severity and frequency of episodes, functional, emotional, and overall disability, medication intake, and self-reported perceived changes, at baseline, after a 4 week intervention, and at 8 week follow-up. Results: After the intervention, the CTG significantly reduced pain (p = 0.01), frequency of episodes (p = 0.001), functional (p = 0.001) and overall disability (p = 0.02), and medication intake (p = 0.01), as well as led to a significantly higher self-reported perception of change (p = 0.01), when compared to SCG. In addition, the results were maintained at follow-up evaluation in all variables. Conclusions: A protocol based on craniosacral therapy is effective in improving pain, frequency of episodes, functional and overall disability, and medication intake in migraineurs. This protocol may be considered as a therapeutic approach in migraine patients.
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Mills MV. 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. Complement Ther Clin Pract 2021; 43:101357. [PMID: 33714862 DOI: 10.1016/j.ctcp.2021.101357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Limitations of traditional medicine and rising interest in complementary medicine call for a closer look at the potential relevance of manual medicine, specifically osteopathic manipulative treatment (OMT) in children. OBJECTIVE To conduct a retrospective observational pilot study of babies who received OMT in the newborn nursery compared to those who did not, by quantifying their outpatient health issues in the first 6 months of life, and to determine the feasibility of further definitive randomized controlled trials of a similar nature. DESIGN Retrospective chart review of the first 6 months of life from pediatric clinic records of 58 case-matched pairs of children, half of whom received OMT as part of their routine newborn care by virtue of their physician "call" assignment to the author. The sample from which the case-matched control group was chosen were babies who had received routine allopathic newborn care without OMT. Both groups received their pediatric care in the same academic ambulatory clinic and received no further OMT. METHODS Outpatient paper chart review consisted of tabulation by points of the following variables: mention of spitting/vomiting, gassiness, food intolerance, irritability/sleeplessness, colic suggested or diagnosed, episodes of otitis media, frequency of antibiotics given, frequency of upper respiratory infections, frequency of lower respiratory problems, diarrhea, and rashes, separated by month of visit in which the variable was reported. RESULTS Exploratory analysis by Pearson Chi-square yielded a few statistically significant differences between the 2 groups, in favor of the OMT-treated group, including Month 2 food intolerance (Χ21 = 4.14, P = .04), Month 3 colic suggested (Χ21 = 4.14, P = .04), Month 5 spitting/vomiting (Χ21 = 8.59, P = .003), and Month 5 antibiotic usage (Χ21 = 6.33, P = .012). CONCLUSIONS Findings point to the need for further research in this area based on the suggestion that OMT given to a newborn can positively affect that baby's short-term and quite possibly long-term health, specifically related to GI complaints and irritability. Other studies would benefit from a variety of methodologic changes, including correlation of timing of administration of OMT with possible symptoms and changes in those symptoms over longer periods of observation, as well as correlation of anatomic osteopathic findings with specific symptoms.
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Affiliation(s)
- Miriam V Mills
- Department of Osteopathic Manual Medicine, Oklahoma State University Center for Health Sciences, 1111 West 17th Street, Tulsa, OK, 74107, USA.
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Demers K, Morin C, Collette L, DeMont R. Moderate to Substantial Inter-Rater Reliability in the Assessment of Cranial Bone Mobility Restrictions. J Altern Complement Med 2021; 27:263-272. [PMID: 33395535 DOI: 10.1089/acm.2020.0325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The World Health Organization benchmarks for osteopathic training consider cranial osteopathy as an important manual skill. Studies of cranial manual therapy have exhibited poor reliability. The aim of this study was to investigate the inter-rater reliability of the manual mobility tests of the spheno-occipital synchondrosis (SOS), and the temporal, parietal, and frontal bones, as assessed in osteopathic manual therapy. Methods: Twenty-one adults were assessed on a single day by three experienced osteopaths using a standard assessment protocol. Before data collection, the osteopaths participated in a consensus training, which included establishing the criteria for identifying a cranial bone mobility restriction; the application of the seven-step palpation method; a pretesting practice; a fine-tuning palpation training; and a calibration period before the assessment of the subjects. Three subjects were assessed simultaneously with the evaluators rotating to assess each subject. The evaluators were blinded to the subject by a curtain, and each other's assessments. Each bone was rated as restricted or not restricted. The authors applied the Landis and Koch classification to describe the magnitude of inter-rater reliability. Results: Moderate reliability was established for a lateral strain of the SOS (Fleiss' generalized kappa 0.48), substantial reliability was established for the other SOS strain patterns (Fleiss' generalized kappa 0.62-0.75), and almost perfect reliability for temporal, parietal, and frontal bone (Fleiss' generalized kappa 0.81-0.96). Conclusion: The results demonstrate consistency when three experienced osteopaths evaluate cranial bone mobility restrictions. The results highlight the importance of consensus training and rigorous methodology in manual therapy reliability studies.
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Affiliation(s)
- Kyla Demers
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada.,Centre Ostéopathique du Québec, Montréal, Canada
| | - Chantal Morin
- Centre Ostéopathique du Québec, Montréal, Canada.,Faculty of Medicine and Health Sciences, School of Rehabilitation, Sherbrooke University, Sherbrooke, Canada
| | | | - Richard DeMont
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada
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Abenavoli A, Badi F, Barbieri M, Bianchi M, Biglione G, Dealessi C, Grandini M, Lavazza C, Mapelli L, Milano V, Monti L, Seppia S, Tresoldi M, Maggiani A. Cranial osteopathic treatment and stress-related effects on autonomic nervous system measured by salivary markers: A pilot study. J Bodyw Mov Ther 2020; 24:215-221. [PMID: 33218514 DOI: 10.1016/j.jbmt.2020.07.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 07/03/2020] [Accepted: 07/19/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Variations in the concentration of salivary alpha amylase (sAA) may indicate a change in the autonomic nervous system functionality. In osteopathic medicine it has long been stated that the osteopathic manipulative treatment (OMT) can modulate the autonomic nervous system. Studies carried out on the compression of the fourth ventricle (CV4) have shown a positive effect in reducing the sympathetic tone. The goal of this pilot study is measuring the physiological response of the sAA levels after CV4 technique. METHODS 90 subjects were randomly assigned to a sham, a control or a CV4 group. Randomization accounted for sex and score in the STAI-2 (form Y) questionnaire. Each subject completed the STAI-1 (form Y) questionnaire to evaluate the anxiety of the moment. sAA activity and saliva flow rate were measured. Saliva was collected before, immediately after and 30 min after treatment. RESULTS Within group analysis revealed that sAA activity increased significantly immediately after the technique application only in the CV4 group (p = 0,05). Between groups analysis show a significant difference of the sAA activity in the CV4 group respect the control group (p < 0,05), but no significant difference between CV4 and sham group (p > 0,05). The effect in the CV4 group after the intervention is highly variable and appeared to be related to the level of stress measured with the STAI-Y1 questionnaire (p = 0,002). CONCLUSIONS This study shows a positive effect of the CV4 procedure on sAA activity even if not significantly different from the sham procedure, probably due to the confounding effect of stress variability between groups.
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Affiliation(s)
- A Abenavoli
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy.
| | - F Badi
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy
| | - M Barbieri
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy
| | - M Bianchi
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy
| | - G Biglione
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy
| | - C Dealessi
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy
| | - M Grandini
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy
| | - C Lavazza
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy
| | - L Mapelli
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy
| | - V Milano
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy
| | - L Monti
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy
| | - S Seppia
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy
| | - M Tresoldi
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy
| | - A Maggiani
- AIMO Accademia Italiana di Medicina Osteopatica, Piazzale del Santuario 7, 21047, Saronno, (VA), Italy
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Kamonseki DH, Lopes EP, van der Meer HA, Calixtre LB. Effectiveness of manual therapy in patients with tension-type headache. A systematic review and meta-analysis. Disabil Rehabil 2020; 44:1780-1789. [DOI: 10.1080/09638288.2020.1813817] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Danilo Harudy Kamonseki
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Erika Plonczynski Lopes
- Physiotherapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Hedwig Aleida van der Meer
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Letícia Bojikian Calixtre
- Physiotherapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
- Department of Dental Materials and Prosthodontics, Araraquara Dental School, Universidade Estadual Paulista (UNESP), Araraquara, SP, Brazil
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Haller H, Lauche R, Sundberg T, Dobos G, Cramer H. Craniosacral therapy for chronic pain: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord 2019; 21:1. [PMID: 31892357 PMCID: PMC6937867 DOI: 10.1186/s12891-019-3017-y] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 12/22/2019] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES To systematically assess the evidence of Craniosacral Therapy (CST) for the treatment of chronic pain. METHODS PubMed, Central, Scopus, PsycInfo and Cinahl were searched up to August 2018. Randomized controlled trials (RCTs) assessing the effects of CST in chronic pain patients were eligible. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for pain intensity and functional disability (primary outcomes) using Hedges' correction for small samples. Secondary outcomes included physical/mental quality of life, global improvement, and safety. Risk of bias was assessed using the Cochrane tool. RESULTS Ten RCTs of 681 patients with neck and back pain, migraine, headache, fibromyalgia, epicondylitis, and pelvic girdle pain were included. CST showed greater post intervention effects on: pain intensity (SMD = -0.32, 95%CI = [- 0.61,-0.02]) and disability (SMD = -0.58, 95%CI = [- 0.92,-0.24]) compared to treatment as usual; on pain intensity (SMD = -0.63, 95%CI = [- 0.90,-0.37]) and disability (SMD = -0.54, 95%CI = [- 0.81,-0.28]) compared to manual/non-manual sham; and on pain intensity (SMD = -0.53, 95%CI = [- 0.89,-0.16]) and disability (SMD = -0.58, 95%CI = [- 0.95,-0.21]) compared to active manual treatments. At six months, CST showed greater effects on pain intensity (SMD = -0.59, 95%CI = [- 0.99,-0.19]) and disability (SMD = -0.53, 95%CI = [- 0.87,-0.19]) versus sham. Secondary outcomes were all significantly more improved in CST patients than in other groups, except for six-month mental quality of life versus sham. Sensitivity analyses revealed robust effects of CST against most risk of bias domains. Five of the 10 RCTs reported safety data. No serious adverse events occurred. Minor adverse events were equally distributed between the groups. DISCUSSION In patients with chronic pain, this meta-analysis suggests significant and robust effects of CST on pain and function lasting up to six months. More RCTs strictly following CONSORT are needed to further corroborate the effects and safety of CST on chronic pain. PROTOCOL REGISTRATION AT PROSPERO CRD42018111975.
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Affiliation(s)
- Heidemarie Haller
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Romy Lauche
- Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia
- Nursing and Midwifery, Monash University, Melbourne, Australia
| | - Tobias Sundberg
- Nursing and Midwifery, Monash University, Melbourne, Australia
- Musculoskeletal & Sports Injury Epidemiology Center, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia
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10
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Espí-López GV, Inglés M, Soliva-Cazabán I, Serra-Añó P. Effect of the soft-tissue techniques in the quality of life in patients with Crohn's disease: A randomized controlled trial. Medicine (Baltimore) 2018; 97:e13811. [PMID: 30572544 PMCID: PMC6320155 DOI: 10.1097/md.0000000000013811] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/30/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Crohn's disease (CD) is a highly prevalent inflammatory bowel disease (IBD), characterized by recurring flares altered by periods of inactive disease and remission, affecting physical and psychological aspects and quality of life (QoL). The aim of this study was to determine the therapeutic benefits of soft non-manipulative osteopathic techniques in patients with CD. METHODS A single-blind randomized controlled trial was performed. 30 individuals with CD were divided into 2 groups: 16 in the experimental group (EG) and 14 in the control group (CG). The intervention period lasted 30 days (1 session every 10 days). Pain, global quality of life (GQoL) and QoL specific for CD (QoLCD) were assessed before and after the intervention. Anxiety and depression levels were measured at the beginning of the study. RESULTS We observed a significant effect of the treatment in both the physical and task subscales of the GQoL (P = .01 and P = .04, respectively) and also in the QoLCD (P ≤.0001) but not in pain score (P = .28). When the intensity of pain was taken into consideration in the analysis of the EG, there was a significantly greater increment in the QoLCD after treatment in people without pain than in those with pain (P = .02) The improvements in GQoL were independent from the disease status (P = .16). CONCLUSIONS Soft, non-manipulative osteopathic treatment is effective in improving overall and physical-related QoL in CD patients, regardless of the phase of the disease. Pain is an important factor that inversely correlates with the improvements in QoL.
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Espí-López GV, Ruescas-Nicolau MA, Nova-Redondo C, Benítez-Martínez JC, Dugailly PM, Falla D. Effect of Soft Tissue Techniques on Headache Impact, Disability, and Quality of Life in Migraine Sufferers: A Pilot Study. J Altern Complement Med 2018; 24:1099-1107. [DOI: 10.1089/acm.2018.0048] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Gemma-Victoria Espí-López
- Department of Physical Therapy, University of Valencia, Valencia, Spain
- Research Unit in Manual Locomotor Therapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | | | | | | | - Pierre-Michel Dugailly
- Laboratory of Functional Anatomy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Deborah Falla
- Center of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, United Kingdom
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12
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Pellet M, Chenel A, Behr M, Thollon L. Is digital image correlation able to detect any mechanical effect of cranial osteopathic manipulation? – A preliminary study. INT J OSTEOPATH MED 2018. [DOI: 10.1016/j.ijosm.2018.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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Compression of the Fourth Ventricle Using a Craniosacral Osteopathic Technique: A Systematic Review of the Clinical Evidence. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:2974962. [PMID: 29234380 PMCID: PMC5664229 DOI: 10.1155/2017/2974962] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/29/2017] [Accepted: 09/18/2017] [Indexed: 02/07/2023]
Abstract
Compression of the fourth ventricle (CV4) is a well-known osteopathic procedure, utilized by osteopaths, osteopathic physicians, craniosacral therapists, physical therapists, and manual therapists as part of their healthcare practice based on some evidence suggesting impact on nervous system functions. The main objective of the study was to identify randomized controlled trials (RCTs) assessing the clinical benefits of CV4 and to show the evidence supporting clinical prescriptions, guides, and advice in treating. A computerized search of the PubMed, CINAHL Complete, Scopus, Web of Science, and ScienceDirect databases was performed. Two filters were used (article type: RCTs; species: humans). The methodological quality of the trials was assessed using the Downs and Black quality checklist for healthcare intervention studies. Only six studies met the inclusion criteria, of which four were RCTs and two were observational studies. The Downs and Black score ranged from 17 to 24 points out of a maximum of 27 points. The present review revealed the paucity of CV4 research in patients with different clinical problems, as five out of six included studies investigated healthy adults. According to the results of the included studies, CV4 may be beneficial for patients with different functional problems.
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Abstract
Objectives: With growing evidence for the effectiveness of craniosacral therapy (CST) for pain management, the efficacy of CST remains unclear. This study therefore aimed at investigating CST in comparison with sham treatment in chronic nonspecific neck pain patients. Materials and Methods: A total of 54 blinded patients were randomized into either 8 weekly units of CST or light-touch sham treatment. Outcomes were assessed before and after treatment (week 8) and again 3 months later (week 20). The primary outcome was the pain intensity on a visual analog scale at week 8; secondary outcomes included pain on movement, pressure pain sensitivity, functional disability, health-related quality of life, well-being, anxiety, depression, stress perception, pain acceptance, body awareness, patients’ global impression of improvement, and safety. Results: In comparison with sham, CST patients reported significant and clinically relevant effects on pain intensity at week 8 (−21 mm group difference; 95% confidence interval, −32.6 to −9.4; P=0.001; d=1.02) and at week 20 (−16.8 mm group difference; 95% confidence interval, −27.5 to −6.1; P=0.003; d=0.88). Minimal clinically important differences in pain intensity at week 20 were reported by 78% within the CST group, whereas 48% even had substantial clinical benefit. Significant between-group differences at week 20 were also found for pain on movement, functional disability, physical quality of life, anxiety and patients’ global improvement. Pressure pain sensitivity and body awareness were significantly improved only at week 8. No serious adverse events were reported. Discussion: CST was both specifically effective and safe in reducing neck pain intensity and may improve functional disability and the quality of life up to 3 months after intervention.
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Guillaud A, Darbois N, Monvoisin R, Pinsault N. Reliability of Diagnosis and Clinical Efficacy of Cranial Osteopathy: A Systematic Review. PLoS One 2016; 11:e0167823. [PMID: 27936211 PMCID: PMC5147986 DOI: 10.1371/journal.pone.0167823] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 11/21/2016] [Indexed: 12/19/2022] Open
Abstract
CONTEXT In 2010, the World Health Organization released benchmarks for training in osteopathy in which they considered cranial osteopathy as an important osteopathic skill. However, the evidence supporting the reliability of diagnosis and the efficacy of treatment in this field appears scientifically weak and inconsistent. OBJECTIVES To identify and critically evaluate the scientific literature dealing with the reliability of diagnosis and the clinical efficacy of techniques and therapeutic strategies used in cranial osteopathy. METHODS Relevant keywords were used to search the electronic databases MEDLINE, PEDro, OSTMED.DR, Cochrane Library, and in Google Scholar, Journal of American Osteopathy Association and International Journal of Osteopathic Medicine websites. Searches were conducted up to end June 2016 with no date restriction as to when the studies were completed. As a complementary approach we explored the bibliography of included articles and consulted available previous reviews dealing with this topic. STUDY SELECTION Regarding diagnostic processes in cranial osteopathy, we analyzed studies that compared the results obtained by at least two examiners or by the same examiner on at least two occasions. For efficacy studies, only randomized-controlled-trials or crossover-studies were eligible. We excluded articles that were not in English or French, and for which the full-text version was not openly available. We also excluded studies with unsuitable study design, in which there was no clear indication of the use of techniques or therapeutic strategies concerning the cranial field, looked at combined treatments, used a non-human examiner and subjects or used healthy subjects for efficacy studies. There was no restriction regarding the type of disease. SEARCH RESULTS In our electronic search we found 1280 references concerning reliability of diagnosis studies plus four references via our complementary strategy. Based on the title 18 articles were selected for analysis. Nine were retained after applying our exclusion criteria. Regarding efficacy, we extracted 556 references from the databases plus 14 references through our complementary strategy. Based on the title 46 articles were selected. Thirty two articles were not retained on the grounds of our exclusion criteria. DATA EXTRACTION AND ANALYSIS Risk of bias in reliability studies was assessed using a modified version of the quality appraisal tool for studies of diagnostic reliability. The methodological quality of the efficacy studies was assessed using the Cochrane risk of bias tool. Two screeners conducted these analyses. RESULTS For reliability studies, our analysis leads us to conclude that the diagnostic procedures used in cranial osteopathy are unreliable in many ways. For efficacy studies, the Cochrane risk of bias tool we used shows that 2 studies had a high risk of bias, 9 were rated as having major doubt regarding risk of bias and 3 had a low risk of bias. In the 3 studies with a low risk of bias alternative interpretations of the results, such as a non-specific effect of treatment, were not considered. CONCLUSION Our results demonstrate, consistently with those of previous reviews, that methodologically strong evidence on the reliability of diagnostic procedures and the efficacy of techniques and therapeutic strategies in cranial osteopathy is almost non-existent.
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Affiliation(s)
- Albin Guillaud
- CORTECS team, Univ. Grenoble-Alpes, Grenoble, France
- Critical Thinking Research Federation, Univ. Grenoble-Alpes, FED 4270, Grenoble, France
| | - Nelly Darbois
- CORTECS team, Univ. Grenoble-Alpes, Grenoble, France
- Critical Thinking Research Federation, Univ. Grenoble-Alpes, FED 4270, Grenoble, France
| | - Richard Monvoisin
- CORTECS team, Univ. Grenoble-Alpes, Grenoble, France
- Critical Thinking Research Federation, Univ. Grenoble-Alpes, FED 4270, Grenoble, France
| | - Nicolas Pinsault
- ThEMAS team, TIMC-IMAG laboratory, UMR CNRS-UGA 5525, Grenoble, France
- School of Physiotherapy, Grenoble-Alpes University Hospital, Grenoble, France
- Critical Thinking Research Federation, Univ. Grenoble-Alpes, FED 4270, Grenoble, France
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Efficacy of manual therapy on anxiety and depression in patients with tension-type headache. A randomized controlled clinical trial. INT J OSTEOPATH MED 2016. [DOI: 10.1016/j.ijosm.2016.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Cerritelli F, Ruffini N, Lacorte E, Vanacore N. Osteopathic manipulative treatment in neurological diseases: Systematic review of the literature. J Neurol Sci 2016; 369:333-341. [PMID: 27653920 DOI: 10.1016/j.jns.2016.08.062] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/29/2016] [Accepted: 08/29/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of the present systematic review is to critically evaluate the effectiveness of OMT as an adjuvant therapy in the management of patients with neurological diseases. METHODS A systematic review was conducted and the findings were reported following the PRISMA statement. Twelve databases were searched for articles reporting the use of osteopathic manipulative treatment in neurological disorders. Each article was assessed using the Cochrane risk of bias tool and the Jadad score. RESULTS 10 articles were included. OMT was used to test its efficacy and/or effectiveness in treating tension-type headache, migraine, cerebral palsy and gait analysis in patients affected by Parkinson's Disease. The general quality of the included trials ranged from very low, to low and moderate according to Cochrane standards. High heterogeneity between studies was found for the type of intervention, control and outcome measures used. CONCLUSION Results showed that studies on the efficacy and/or effectiveness of OMT treatments are scarce, heterogeneous, and of low methodological quality. Further studies should be conducted including a more pragmatic methodology, an exhaustive description of all investigated and concurrent interventions, and a systematic report of adverse events, so as to obtain robust and generalizable results.
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Affiliation(s)
- Francesco Cerritelli
- Clinical-based Human Research Department, C.O.ME. Collaboration, Pescara, Italy; Department of Neuroscience, Imaging and Clinical Sciences "G. D'Annunzio", ITAB-Institute for Advanced Biomedical Technologies, "G. D'Annunzio" University of Chieti-Pescara, Italy.
| | - Nuria Ruffini
- Clinical-based Human Research Department, C.O.ME. Collaboration, Pescara, Italy
| | - Eleonora Lacorte
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy
| | - Nicola Vanacore
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy
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Effects of the Fourth Ventricle Compression in the Regulation of the Autonomic Nervous System: A Randomized Control Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015. [PMID: 26199632 PMCID: PMC4496659 DOI: 10.1155/2015/148285] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Introduction. Dysfunction of the autonomic nervous system is an important factor in the development of chronic pain. Fourth ventricle compression (CV-4) has been shown to influence autonomic activity. Nevertheless, the physiological mechanisms behind these effects remain unclear. Objectives. This study is aimed at evaluating the effects of fourth ventricle compression on the autonomic nervous system. Methods. Forty healthy adults were randomly assigned to an intervention group, on whom CV-4 was performed, or to a control group, who received a placebo intervention (nontherapeutic touch on the occipital bone). In both groups, plasmatic catecholamine levels, blood pressure, and heart rate were measured before and immediately after the intervention. Results. No effects related to the intervention were found. Although a reduction of norepinephrine, systolic blood pressure, and heart rate was found after the intervention, it was not exclusive to the intervention group. In fact, only the control group showed an increment of dopamine levels after intervention. Conclusion. Fourth ventricle compression seems not to have any effect in plasmatic catecholamine levels, blood pressure, or heart rate. Further studies are needed to clarify the CV-4 physiologic mechanisms and clinical efficacy in autonomic regulation and pain treatment.
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Wilkinson J, Thomas K, Freeman J, McKenna B. Day-to-day practice of osteopaths using osteopathy in the cranial field, who are affiliated with the Sutherland Cranial College of Osteopathy (SCCO): A national survey by means of a standardised data collection tool. INT J OSTEOPATH MED 2015. [DOI: 10.1016/j.ijosm.2014.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hanten WP, Olson SL, Lindsay WA, Lounsberry KA, Stewart JK. The Effect of Manual Therapy and a Home Exercise Program on Cervicogenic Headaches: A Case Report. J Man Manip Ther 2013. [DOI: 10.1179/106698105790835859] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Changes in alpha band activity associated with application of the compression of fourth ventricular (CV-4) osteopathic procedure: A qEEG pilot study. J Bodyw Mov Ther 2013; 17:291-6. [DOI: 10.1016/j.jbmt.2012.10.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Revised: 09/30/2012] [Accepted: 10/04/2012] [Indexed: 11/23/2022]
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Affiliation(s)
- Edzard Ernst
- Peninsula Medical School; University of Exeter; Veysey Building, Salmon Pool Lane; Exeter; EX2 4SG; UK
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Bryans R, Descarreaux M, Duranleau M, Marcoux H, Potter B, Ruegg R, Shaw L, Watkin R, White E. Evidence-based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther 2011; 34:274-89. [PMID: 21640251 DOI: 10.1016/j.jmpt.2011.04.008] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Revised: 03/10/2011] [Accepted: 04/03/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this manuscript is to provide evidence-informed practice recommendations for the chiropractic treatment of headache in adults. METHODS Systematic literature searches of controlled clinical trials published through August 2009 relevant to chiropractic practice were conducted using the databases MEDLINE; EMBASE; Allied and Complementary Medicine; the Cumulative Index to Nursing and Allied Health Literature; Manual, Alternative, and Natural Therapy Index System; Alt HealthWatch; Index to Chiropractic Literature; and the Cochrane Library. The number, quality, and consistency of findings were considered to assign an overall strength of evidence (strong, moderate, limited, or conflicting) and to formulate practice recommendations. RESULTS Twenty-one articles met inclusion criteria and were used to develop recommendations. Evidence did not exceed a moderate level. For migraine, spinal manipulation and multimodal multidisciplinary interventions including massage are recommended for management of patients with episodic or chronic migraine. For tension-type headache, spinal manipulation cannot be recommended for the management of episodic tension-type headache. A recommendation cannot be made for or against the use of spinal manipulation for patients with chronic tension-type headache. Low-load craniocervical mobilization may be beneficial for longer term management of patients with episodic or chronic tension-type headaches. For cervicogenic headache, spinal manipulation is recommended. Joint mobilization or deep neck flexor exercises may improve symptoms. There is no consistently additive benefit of combining joint mobilization and deep neck flexor exercises for patients with cervicogenic headache. Adverse events were not addressed in most clinical trials; and if they were, there were none or they were minor. CONCLUSIONS Evidence suggests that chiropractic care, including spinal manipulation, improves migraine and cervicogenic headaches. The type, frequency, dosage, and duration of treatment(s) should be based on guideline recommendations, clinical experience, and findings. Evidence for the use of spinal manipulation as an isolated intervention for patients with tension-type headache remains equivocal.
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Affiliation(s)
- Roland Bryans
- Guidelines Development Committee Chair and Chiropractor, Private Practice, Clarenville, Newfoundland and Labrador, Canada.
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de Groot FM, Voogt-Bode A, Passchier J, Berger MY, Koes BW, Verhagen AP. Headache: the Placebo Effects in the Control Groups in Randomized Clinical Trials; an Analysis of Systematic Reviews. J Manipulative Physiol Ther 2011; 34:297-305. [DOI: 10.1016/j.jmpt.2011.04.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 04/02/2011] [Accepted: 04/03/2011] [Indexed: 11/28/2022]
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Bosy D, Etlin D, Corey D, Lee JW. An interdisciplinary pain rehabilitation programme: description and evaluation of outcomes. Physiother Can 2010; 62:316-26. [PMID: 21886371 PMCID: PMC2958070 DOI: 10.3138/physio.62.4.316] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE The purpose of this archival report is to describe the essential elements of an intensive 8-week interdisciplinary pain rehabilitation programme (IPRP) with a cognitive-behavioural emphasis and the results that can be expected in treating patients with chronic pain conditions. METHOD This report describes a private outpatient program providing treatment services to patients with long-term disabling pain arising from work- or accident-related musculoskeletal injuries. The cohort consists of 338 consecutive patients who completed the program over a 3-year period (patients discharged between January 1, 2005, and December 31, 2007). RESULTS Improvements in vocational status were noted in 75% of patients with chronic pain. Patients were also able to reduce their pain levels by approximately 16% and to reduce their levels of anxiety and depression by 13% and 17% respectively. At the same time, 61% of patients were able to reduce or eliminate their pain medications. CONCLUSIONS Outcomes are consistent with evidence-based clinical practice guidelines for the management of chronic pain conditions. The published literature supports the efficacy of this interdisciplinary approach in highly disabled patients for whom effective treatment has been delayed. Early intervention in the subacute phase is recommended for prevention of long-term disability in patients with chronic pain.
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Affiliation(s)
- Dan Bosy
- Dan Bosy, BScH, BSc (PT), FCAMPT: Physiotherapist, Health Recovery Clinic, Mississauga, Ontario
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Bronfort G, Haas M, Evans R, Leininger B, Triano J. Effectiveness of manual therapies: the UK evidence report. CHIROPRACTIC & OSTEOPATHY 2010; 18:3. [PMID: 20184717 PMCID: PMC2841070 DOI: 10.1186/1746-1340-18-3] [Citation(s) in RCA: 274] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Accepted: 02/25/2010] [Indexed: 12/14/2022]
Abstract
BACKGROUND The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions. METHODS The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs. RESULTS By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines.Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments. CONCLUSIONS Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation, or for Stage 1 hypertension when added to an antihypertensive diet. In children, the evidence is inconclusive regarding the effectiveness for otitis media and enuresis, and it is not effective for infantile colic and asthma when compared to sham manipulation.Massage is effective in adults for chronic low back pain and chronic neck pain. The evidence is inconclusive for knee osteoarthritis, fibromyalgia, myofascial pain syndrome, migraine headache, and premenstrual syndrome. In children, the evidence is inconclusive for asthma and infantile colic.
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Affiliation(s)
- Gert Bronfort
- Northwestern Health Sciences University, Bloomington, MN, USA.
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Mann JD, Faurot KR, Wilkinson L, Curtis P, Coeytaux RR, Suchindran C, Gaylord SA. Craniosacral therapy for migraine: protocol development for an exploratory controlled clinical trial. Altern Ther Health Med 2008; 8:28. [PMID: 18541041 PMCID: PMC2442042 DOI: 10.1186/1472-6882-8-28] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Accepted: 06/09/2008] [Indexed: 11/14/2022]
Abstract
Background Migraine affects approximately 20% of the population. Conventional care for migraine is suboptimal; overuse of medications for the treatment of episodic migraines is a risk factor for developing chronic daily headache. The study of non-pharmaceutical approaches for prevention of migraine headaches is therefore warranted. Craniosacral therapy (CST) is a popular non-pharmacological approach to the treatment or prevention of migraine headaches for which there is limited evidence of safety and efficacy. In this paper, we describe an ongoing feasibility study to assess the safety and efficacy of CST in the treatment of migraine, using a rigorous and innovative randomized controlled study design involving low-strength static magnets (LSSM) as an attention control intervention. Methods The trial is designed to test the hypothesis that, compared to those receiving usual care plus a treatment with low-strength static magnets (attention-control complementary therapy), subjects receiving usual medical care plus CST will demonstrate significant improvement in: quality-of-life as measured by the Headache Impact Test (HIT-6); reduced frequency of migraine; and a perception of clinical benefit. Criteria for inclusion are either gender, age > 11, English or Spanish speaking, meeting the International Classification of Headache Disorders (ICHD) criteria for migraine with or without aura, a headache frequency of 5 to 15 per month over at least two years. After an 8 week baseline phase, eligible subjects are randomized to either CST or an attention control intervention, low strength static magnets (LSSM). To evaluate possible therapist bias, videotaped encounters are analyzed to assess for any systematic group differences in interactions with subjects. Results 169 individuals have been screened for eligibility, of which 109 were eligible for the study. Five did not qualify during the baseline phase because of inadequate headache frequency. Nineteen have withdrawn from the study after giving consent. Conclusion This report endorses the feasibility of undertaking a rigorous randomized clinical trial of CST for migraine using a standardized CST protocol and an innovative control protocol developed for the study. Subjects are able and willing to complete detailed headache diaries during an 8-week baseline period, with few dropouts during the study period, indicating the acceptability of both interventions. Trial Registration ClinicalTrials.gov NCT00665236
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Milnes K, Moran RW. Physiological effects of a CV4 cranial osteopathic technique on autonomic nervous system function: A preliminary investigation. INT J OSTEOPATH MED 2007. [DOI: 10.1016/j.ijosm.2007.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Anderson RE, Seniscal C. A comparison of selected osteopathic treatment and relaxation for tension-type headaches. Headache 2007; 46:1273-80. [PMID: 16942472 DOI: 10.1111/j.1526-4610.2006.00535.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of this study was to compare the effects of osteopathic treatment and progressive muscular relaxation (PMR) exercises on patients with tension-type headache (TTH). BACKGROUND Relaxation is generally accepted as a treatment for TTH. Osteopathy is considered by some practitioners to be useful for headache management but there is limited scientific evidence regarding the effectiveness. This study compares relaxation and relaxation plus selected osteopathic techniques in the treatment of people with TTH. DESIGN This was a single-blind, randomized, clinical study using an experimental design. Twenty-nine patients with TTH according to the International Headache Classification Subcommittee, 2004, were recruited for this study and randomly placed in either a control or experimental group. Both groups practiced PMR exercises at home while the experimental group also received 3 osteopathic treatments. METHOD All participants recorded headache frequency and intensity in a headache diary (HD) for 2 weeks pretreatment, and continued recording during the treatment period until reassessment for a total of 6 to 7 weeks. All tests of significance were set at P</= .05. RESULTS Twenty-six people completed the study. Results indicated that the number of Headache Free Days Per Week was significantly improved (P= .016) in the experimental group. Two other measures, the Headache Degree of Improvement (P= .075) and the HD rating (P= .059), which combine headache frequency and intensity, did not meet our criteria for statistical significance but both scores are <.10 indicating a trend toward improvement in the experimental group that is clinically significant. The HD Rating also showed that the experimental group improved 57.5%, while the control group improved 15.6%. The intensity of headache did not show a significant improvement (P= .264). CONCLUSION The people in this study who did relaxation exercises and received 3 osteopathy treatments had significantly more days per week without headache than those who did only relaxation exercises.
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Fernández-de-Las-Peñas C, Alonso-Blanco C, Cuadrado ML, Miangolarra JC, Barriga FJ, Pareja JA. Are Manual Therapies Effective in Reducing Pain From Tension-Type Headache? Clin J Pain 2006; 22:278-85. [PMID: 16514329 DOI: 10.1097/01.ajp.0000173017.64741.86] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES A systematic review was performed to establish whether manual therapies have specific efficacy in reducing pain from tension-type headache (TTH). METHODS Computerized literature searches were performed in MEDLINE, EMBASE, AMED, MANTIS, CINAHL, PEDro, and Cochrane databases. Papers were included if they described clinical (open noncontrolled studies) or randomized controlled trials in which any form of manual therapy was used for TTH, and if they were published after 1994 in the English language. The methodologic quality of the trials was assessed using the PEDro scale. Levels of scientific evidence, based on the quality and the outcomes of the studies, were established for each manual therapy: strong, moderate, limited, and inconclusive evidence. RESULTS Only six studies met the inclusion criteria. These trials evaluated different manual therapy modalities: spinal manipulation (three trials), classic massage (one trial), connective tissue manipulation (two trials), soft tissue massage (one trial), Dr. Cyriax's vertebral mobilization (one trial), manual traction (one trial), and CV-4 craniosacral technique (one trial). Methodologic PEDro quality scores ranged from 2 to 8 points out of a theoretical maximum of 10 points (mean=5.8+/-2.1). Analysis of the quality and the outcomes of all trials did not provide rigorous evidence that manual therapies have a positive effect in reducing pain from TTH: spinal manipulative therapy showed inconclusive evidence of effectiveness (level 4), whereas soft tissue techniques showed limited evidence (level 3). CONCLUSIONS The authors found no rigorous evidence that manual therapies have a positive effect in the evolution of TTH. The most urgent need for further research is to establish the efficacy beyond placebo of the different manual therapies currently applied in patients with TTH.
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Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain.
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Fernández-de-Las-Penãs C, Alonso-Blanco JC, Cuadrado ML, Miangolarra JC, Barriga FJ, Pareja JA. Manual Therapies in the Management of Tension-Type Headache. Headache 2005; 45:169-71. [PMID: 15705127 DOI: 10.1111/j.1526-4610.2005.05034_3.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We describe a patient with successive attacks (40 to 90 minutes) of cluster-like headache associated with aphasia, and contralateral hemihypesthesia and hemiplegia. The condition can best be described as cluster-like headache aura status.
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Lenssinck MLB, Damen L, Verhagen AP, Berger MY, Passchier J, Koes BW. The effectiveness of physiotherapy and manipulation in patients with tension-type headache: a systematic review. Pain 2004; 112:381-388. [PMID: 15561394 DOI: 10.1016/j.pain.2004.09.026] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2004] [Revised: 07/29/2004] [Accepted: 09/17/2004] [Indexed: 10/26/2022]
Abstract
The study design is a systematic review of randomised clinical trials (RCTs). The objectives of the present study are to assess the effectiveness of physiotherapy and (spinal) manipulation in patients with tension-type headache (TTH). No systematic review exists concerning the effectiveness of physiotherapy and (spinal) manipulation primarily focussing on TTH. Literature was searched using a computerised search of MEDLINE, EMBASE and the Cochrane library. Only RCTs including physiotherapy and/or (spinal) manipulation used in the treatment of TTH in adults were selected. Two reviewers independently assessed the methodological quality of the RCTs using the Delphi-list. A study was considered of high quality if it satisfied at least six points on the methodological quality list. Twelve publications met the inclusion criteria, including three dual or overlapping publications resulting in eight studies included. These studies showed a large variety of interventions, such as chiropractic spinal manipulation, connective tissue manipulation or physiotherapy. Only two studies were considered to be of high quality, but showed inconsistent results. Because of clinical heterogeneity and poor methodological quality in many studies, it appeared to be not possible to draw valid conclusions. Therefore, we conclude that there is insufficient evidence to either support or refute the effectiveness of physiotherapy and (spinal) manipulation in patients with TTH.
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Affiliation(s)
- Marie-Louise B Lenssinck
- Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands Department of Medical Psychology and Psychotherapy, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
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Fryer G. Letters to the editor. J Osteopath Med 2002. [DOI: 10.1016/s1443-8461(02)80036-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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