Osteopathic Manipulation as a Method of Cortisol Modification: A Systematic Review

Area of Science:

• Integrative medicine
• Endocrinology
• Neuroscience

Background:

• Osteopathic manipulative treatment (OMT) is explored for hormonal effects.
• Quantitative data on OMT's influence on hormones, particularly cortisol, is limited.
• Existing research necessitates further investigation into OMT's impact on cortisol levels.

Purpose of the Study:

• To conduct a meta-analysis investigating the effects of OMT on cortisol levels.
• To quantitatively assess the influence of OMT on cortisol through a systematic literature review.
• To determine the magnitude of OMT's impact on cortisol by analyzing existing studies.

Main Methods:

• Systematic literature search of English articles (2000-2022) from Google Scholar, OSTMED.DR, and PubMed.
• Inclusion criteria required studies to measure control groups; 4 studies with 135 participants (68 OMT, 67 control) were selected.
• NIH bias assessment tool and standard mean differences were used; heterogeneity assessed using I².

Main Results:

• OMT demonstrated a 0.10μg/dl greater decrease in cortisol than sham treatments.
• A mean difference in cortisol of 0.10μg/dl was observed (95% CI -0.15, -0.04).
• Standard mean difference was -0.46 (95% CI -1.40, 0.48), indicating a medium effect size without statistical significance; heterogeneity was 0% for both salivary and serum cortisol analyses.

Conclusions:

• OMT may reduce cortisol levels more effectively than sham treatments, although the observed effect is small after a single treatment.
• The study highlights a need for more high-quality research, particularly on serum cortisol, to clarify the OMT-cortisol relationship.
• While not statistically significant, repeated OMT sessions might offer clinical utility for cortisol reduction.