Racca V, Bordoni B, Castiglioni P, Modica M, Ferratini M. Osteopathic manipulative treatment improves heart surgery outcomes: a randomized controlled trial. Ann Thorac Surg. 2017;pii:S0003-4975(16)31438-2. doi:10.1016/j.athoracsur.2016.09.110 [Epub ahead of print]
Researchers from the Cardiology Rehabilitation Center at the Santa Maria Nascente Institute in Milan, Italy, evaluated the effects of osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) combined with standard cardiorespiratory rehabilitation care compared with standard cardiorespiratory rehabilitation care alone for patients who underwent heart surgery. Eighty patients who underwent elective heart surgery using sternotomy for coronary artery bypass grafting, valve replacement or repair, or ascending aorta surgery were randomly assigned to the OMTh or standard care group on admission to the rehabilitation center. Patients were aged 18 years or older and capable of providing informed consent. Exclusion criteria included a history of heart surgery with minithoracotomy, heart transplant, or implantation of ventricular assistance; diabetes mellitus; autoimmune disease; or altered cognitive capabilities. The groups were evenly matched for age, sex, demographics, type of cardiac surgery, and comorbid conditions.
All patients received a supervised rehabilitation program, which began 24 hours after admission and continued throughout hospitalization. The patients in the OMTh group received OMTh on admission to the cardiac rehabilitation unit, which was the day after they were discharged from the hospital. The OMTh was administered for 5 days, for approximately 15 minutes per session. The OMTh procedures used were myofascial release to the diaphragm and sternal and thoracic inlet areas.
Outcome measures included pain intensity measured by a visual analog scale (VAS), functional respiratory capacity, and the hospital length of stay. On entry to the rehabilitation center, the mean inspiratory volume was 744 mL for the OMTh group and 825 mL for the standard care group. Both groups had a statistically nonsignificant pain VAS score of 4 at the time of admittance to the rehabilitation unit. At the end of rehabilitation, the median VAS score was 1 for the OMTh group and 3 for the standard care group (P<.01). The mean (SD) inspiratory volume at the time of discharge was 1781 (633) mL for the OMTh group and 1400 (588) mL for the standard care group (P<.01). The mean (SD) hospital length of stay was shorter in the OMTh group than in the standard care group (19.1 [4.8] days vs 21.7 [6.3] days, respectively; P<.05).
The researchers concluded that the addition of OMTh probably increased the rate of recovery by reducing pain and improving physiologic function of chest cavity structures. These results support previous findings on the application of OMT by osteopathic physicians to manage symptoms in similar patients.1,2 These results add to the growing evidence that OMTh has significant benefits in the management of systemic disorders and physiologic dysfunctions, in addition to musculoskeletal conditions.
References
1. O-Yurvati AH , CarnesMS, ClearfieldMB, StollST, McConathyWJ. Hemodynamic effects of osteopathic manipulative treatment immediately after coronary artery bypass graft surgery. J Am Osteopath Assoc. 2005;105(10):475-481.Search in Google Scholar
2. Wieting JM , BealC, RothGL, et al. The effect of osteopathic manipulative treatment on postoperative medical and functional recovery of coronary artery bypass graft patients. J Am Osteopath Assoc. 2013;113(5):384-393.Search in Google Scholar
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