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Osteopathic Manipulative Treatment for Trauma as Adjunct for Pain and Mobility Limitations after Chest Wall Injury

Journal: Journal of Osteopathic Medicine Date: 2025/12, 125(12):Pages: A671–672. doi: Subito , type of study: retrospective study

Full text    (https://www.degruyterbrill.com/document/doi/10.1515/jom-2025-2000/html)

Keywords:

chest wall [7]
injuries [87]
OMT [3896]
osteopathic manipulative treatment [3917]
retrospective study [337]
thoracic spine [94]
trauma [125]

Abstract:

Context: Osteopathic manipulative treatment (OMT) promotes optimal tissue function by applying manual forces to oppose and overcome physical restrictive barriers defined as somatic dysfunctions (SDs). SDs are often the result of forces imparted on the body during traumatic injury. OMT may restore or optimize structural mobility and function of the chest wall (ribs, sternum, thoracic vertebrae, myofascia and other soft tissues).1-5 In 2021, our Level 1 Trauma Center began a novel outpatient OMT for Trauma Program (OTP), targeting patients suffering subacute and chronic post-injury pain and mobility limitations. Objective: The objective of this study is to describe OTP chest wall injury patients and their outcomes and the potential benefits of OMT for the chest wall injury population. Methods: We retrospectively extracted and analyzed data for all patients who participated in the OTP and whose data were complete in the OTP database. We excluded patients who did not describe injury as etiology of their symptoms. We performed subgroup analyses of OTP patients who were treated for rib SD, suffered rib fractures and/or underwent surgical stabilization of rib fractures (SSRF). Data are represented as percentage or median [IQR] as appropriate. Results: During its first two years, the OTP provided 148 OMT sessions, 116 (77.7%) for which the etiology of symptoms was a mechanism of injury (40% falls, 33.3% motor vehicle collisions, 8.9% pedestrians struck, 8.9% lifting or sports-related injuries and 4.4% each blunt and penetrating assaults). One hundred and eight (93.1%) sessions for injured patients involved treatment of rib SD, reflecting a total of 45 patients (62% female, 51 [32-58] years-old) who received 2 [1-4] OMT sessions. Fifteen (33.3%) patients with rib SD reported chief complaints of chest wall pain and/or mechanical difficulty taking deep breaths. Twelve (26.7%) had image-confirmed rib fractures, and two had undergone SSRF. Forty-two (93.3%) injured patients treated for rib SD, including all patients who had suffered rib fractures and/or underwent SSRF, reported immediate post-OMT improvement in pain (3 [2-5] decrease in 10-point pain scale) and mobility; none suffered post-OMT complications. Time since injury of immediate OMT responders was 0.91 [0.79-3.0] years for all rib SD; 0.26 [0.68-0.27] years when chief complaint included chest wall pain or mechanical dysfunction; 0.26 [0.058-0.58] years with image-confirmed rib fractures; and 0.27 and 1.24 years after SSRF. All patients who had at least one follow-up OMT session reported consistent improvement in pain and mobility at subsequent sessions. Conclusions: A novel OMT for Trauma Program integrated into a Level 1 Trauma Center may identify and treat rib SD that may be contributing to post-traumatic pain and mobility limitations and may improve outcomes for patients who have suffered rib fractures or undergone SSRF, including after a variety of blunt or penetrating mechanisms and months or years after initial injury.


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