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Assessment of the Efficacy of An Osteopathic Treatment in Infants with Biomechanical Impairments to Suckling
Published on: February 5, 2019
A randomized controlled trial of the effectiveness of osteopathy-based manual physical therapy in treating pediatric
Diane R Nemett1, Barbara A Fivush, Ranjiv Mathews
1Kennedy Krieger Institute, Physical Therapy Department, 707 North Broadway, Baltimore, MD, USA. nemett@kennedykrieger.org
Insights
Manual physical therapy based on an osteopathic approach (MPT-OA) added to standard treatment significantly improved pediatric dysfunctional voiding (DV) symptoms. This approach offers a promising, well-liked treatment option for children with DV.
Area of Science:
- Pediatric Urology
- Physical Therapy
- Osteopathic Medicine
Background:
- Pediatric dysfunctional voiding (DV) poses significant physical, emotional, and renal health risks.
- Manual physical therapy based on an osteopathic approach (MPT-OA) is effective in adults but unstudied in children.
- Standard treatment (ST) efficacy for pediatric DV requires further enhancement.
Purpose of the Study:
- To evaluate the efficacy of MPT-OA combined with ST versus ST alone for pediatric DV.
- To determine if MPT-OA improves DV symptoms more effectively than ST alone.
Main Methods:
- A randomized trial involving 21 children (4-11 years) with DV.
- Participants were assigned to MPT-OA plus ST or ST alone.
- Pre- and post-treatment evaluations assessed DV symptoms and treatment outcomes.
Main Results:
- The MPT-OA plus ST group showed significantly greater improvement in DV symptoms compared to the ST-only group (p=0.008).
- Resolution of vesicoureteral reflux and elimination of post-void urine residuals were more pronounced in the treatment group.
- MPT-OA was well-received by children and their parents.
Conclusions:
- MPT-OA added to ST improves short-term outcomes in pediatric DV.
- This approach offers benefits beyond standard treatments.
- Further multi-center trials are recommended for MPT-OA in children with related conditions.
Objective:
Pediatric dysfunctional voiding (DV) presents physical and emotional challenges as well as risk of progression to renal disease. Manual physical therapy and osteopathic treatment have been successfully used to treat DV in adult women; a pediatric trial of manual physical therapy based on an osteopathic approach (MPT-OA) has not been reported. The aim of this study was to determine whether MPT-OA added to standard treatment (ST) improves DV more effectively than ST alone.
Methods:
Twenty-one children (aged 4-11 years) with DV were randomly assigned to receive MPT-OA plus standard treatment (treatment group) or standard treatment alone (control group). Pre-treatment and post-treatment evaluations of DV symptoms, MPT-OA evaluations and inter-rater reliability of DV symptom resolution were completed.
Results:
The treatment group exhibited greater improvement in DV symptoms than did the control group (Z=-2.63, p=0.008, Mann-Whitney U-test). Improved or resolution of vesicoureteral reflux and elimination of post-void urine residuals were more prominent in the treatment group.
Conclusions:
Results suggest that MPT-OA treatment can improve short-term outcomes in children with DV, beyond improvements observed with standard treatments, and is well liked by children and parents. Based on these results, a multi-center randomized clinical trial of MPT-OA in children with vesicoureteral reflux and/or post-void urinary retention is warranted.
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