The article is a systematic review and meta-analysis evaluating the effectiveness of osteopathic manipulative treatment (OMT) for gastrointestinal disorders in term and preterm infants.
Nine studies met the inclusion criteria, of which five treated term infants and the others treated preterm infants.
The main outcomes were related to gastrointestinal function and secondary outcomes such as length of hospital stay, parental satisfaction and potential adverse events (AEs).
The gastrointestinal tract plays a critical role in infant development, but disorders such as sucking and swallowing problems, infantile colic, functional diarrhea and cyclic vomiting syndrome can affect infant health.
OMT is a non-invasive, complementary therapy that uses various manual approaches to improve physiological response and support physical homeostasis.
This therapy focuses specifically on the manipulation and movement of the visceral fascia.
The literature search included various databases such as PubMed, Scopus, Embase, Cochrane, Cinahl and PEDro.
The included studies used various osteopathic techniques, including craniosacral therapy (CST), myofascial release, balanced ligamentous/membranous tension, indirect fluid therapy and V-spread, visceral treatment, cranial sutures, articulation, and muscle and bone treatment, depending on the structures associated with the dysfunctional areas.
The number of OMT sessions varied between 1-2 per week, and one study performed three sessions in the first week of life.
The duration of each session varied from 20 to 60 minutes.
The results showed that OMT was effective in some cases, particularly in reducing colic crying over time, and in one study a significant reduction in spitting up/vomiting was also observed at five months.
For feeding preterm infants, one study showed a statistically significant improvement in achieving full oral feeding in the OMT group.
There were no statistically significant results for weight gain and breast milk feeding.
In terms of length of hospital stay, there were mixed results, with some studies showing a reduction in the OMT group, while others found no significant difference.
In terms of breastfeeding, one study showed a significant improvement in infants’ ability to suckle at the breast and in mothers’ perceptions of breastfeeding.
Overall, OMT was found to be mostly safe, with only one study reporting transient adverse events.
The study concludes that OMT is effective in some cases, but generalization is not possible due to conflicting evidence and lack of high-quality replication studies.
It is recommended that high-quality randomized controlled trials be conducted to provide better evidence.
The interventions and main results described in Table 2 of the article are summarized as follows:
Hayden et al.
(2009), Cerritelli et al.
(2013, 2015) – Randomized control trials (RCTs): These studies implemented osteopathic manipulative therapy (OMT) with various techniques such as craniosacral therapy (CST), myofascial release, balanced ligamentous/membranous tension, indirect fluid therapy and V-spread.
The control groups received either no intervention or standard medical care with osteopathic evaluation.
The sessions took place once or twice a week and lasted between 20 and 30 minutes.
Results on colic cries and weight gain: Some studies showed a significant reduction in the average hours of colic crying per day in favor of the OMT group.
However, there were no significant differences between OMT and control groups in terms of average daily weight gain.
Herzaft-Le Roy et al.
(2017): This RCT focused on OMT in combination with breastfeeding counseling.
OMT included balanced membranous tension, cranial sutures and myofascial release.
The results showed statistically significant differences in the infants’ ability to latch onto the breast and in the mothers’ perception of breastfeeding in favor of the OMT group.
Castejón-Castejón et al.
(2019), Vismara et al.
(2019) – RCT and retrospective cohort study: These studies included OMT techniques for the treatment of myofascial and connective tissues and CST for the treatment of colic symptoms.
The results showed significant differences in favor of the OMT group in terms of colic severity and time to full oral nutrition.
Mills et al.
(2021) – Case-control study: In this study, OMT was used to treat infants, with techniques including direct and indirect joint treatments, balanced membranous and ligamentous tension.
There were statistically significant differences between OMT and control groups in terms of spitting up/vomiting and colic symptoms, but no significant Differences in terms of weight gain or breastfeeding.
Techniques used
In summary, the following OMT techniques were used in the studies:
- Craniosacral therapy (CST)
- Myofascial relaxation
- Balanced ligament/membranous tension
- Indirect fluid therapy and V-spread
- Treatment of the myofascial and connective tissue
- Treatment of specific areas of the body (e.g. thorax, clavicle, diaphragm)
- Global and local auscultation of the abdomen
- Treatment of the ileocecal valve and colon
- Breastfeeding advice in combination with OMT
This technique has been used in various combinations and frequencies to treat a variety of symptoms and conditions in infants, particularly colic crying and breastfeeding difficulties. Link to the original article
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