Gathering place for osteopaths
Osteopathy in Pregnancy
The study included 144 otherwise healthy pregnant women, about 24 years old on average, with moderate levels of back pain and related movement difficulties during late pregnancy. The women were randomly assigned to one of three groups: usual obstetric care only, usual obstetric care plus weekly 30-minute osteopathic manipulation treatments from the 30th week of pregnancy through delivery, or usual obstetric care plus sham ultrasound skin stimulation sessions.
Over the course of the study, women in the osteopathic group reported improved back pain and related symptoms, Licciardone noted. The sham ultrasound group reported no pain improvement and those in the standard care group reported increased pain. However, none of these differences were statistically significant.
Late pregnancy back-related movement problems generally worsened until delivery, but did so to a lesser degree in the osteopathic manipulation group.
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What impact do you think this will have (if any) on how osteos can promote therapy during pregnancy?
Replies to This Discussion
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Permalink Reply by Hume O'Rous on -
Though LBP is more likely at the latter stages of pregnancy, osteopathic intervention is probably more effectively introduced prior to the onset of symptoms. In other words as prophylaxis, and as a means of allowing the body to cope with foetal development better.
Comparing two groups, one group who are given osteopathic assessment and advice either pre-conceptually, or at the earlier stages when body mass and hormonal surges aren't at such an intensive level, would be valuable.
Most if not all of John Liccardione's work suggests that osteopathy works better (in terms of producing evidence of positive effects and benefit), when introduced to a 'healthy' study group.
The clues are all there. If you want stats which can grab the headlines and aren't simply cooked up and deliberately skewed to reflect a pre-determned result, try to treat patients who are relatively 'healthy' to begin with, as it will take longer to assist those who begin from a relatively 'unhealthy' beginning...
Must have been boring being the practitioners administering the sham ultrasound. I wonder what they talked about to their patients whilst they were doing nothing in particular...!
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Permalink Reply by Rich Moore on -
I think the more significant thing for me here is that this was news reported in mainstream news resources (Yahoo/Reuters) casting osteopathy in a positive light.
As a third year student at Oxford Brookes, there's a definite move to focus more on research and evidence-based treatment so this is all good in my book. Even if the findings are less than definitive, they are positive and out there for people to see.
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Permalink Reply by Hume O'Rous on
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It's true that a lot of studies on many complaints seem to suggest that ultrasound is no more likely to influence treatment outcomes than 'sham' alternatives. The same implications surfaced last week when a meta-analysis of TENS treatment was published. Again if you believe the stats both forms of treatment are a poor choice if you have a patient with a chronic soft tissue inflammatory disorder.
I have very limited with TENS, but I've been using ultrasound for over 20 years, and I can cite many patients who would claim great benefit from treatment, so clearly there is a discrepancy in these views.
I suspect the effect of the practitioner's input is greatly undervalued in these studies, and until some way of measuring the effect of 'patient-practitioner chemistry' for want of a better term, is included in the results, we'll continue to have this failure to understand the effect of treatments.
Also there's the issue that nobody, whether they're a physiotherapist, osteopath or other physical therapist, ever delivers a single therapy in isolation. Measuring complex interventions with a variety of inputs just isn't on the radar at present within the research world. It's still fixated with the analysis of single events and their effects on the presenting symptoms.
Hence not realistic nor wholistic....
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Permalink Reply by Hume O'Rous on
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Here's an example of anti-TENS reporting:
http://www.quackometer.net/blog/2010/02/boots-maternity-tens-machin...
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Permalink Reply by Carly Yates on
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Hey, where can I find the full research paper for this? Thanks
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Permalink Reply by melonfarmer on -
with google it took me about 2 seconds....http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811218/?tool=pubmed
Carly Yates said:Hey, where can I find the full research paper for this? Thanks
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