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Comparison of Occupational Therapy and Osteopathic Manipulative Treatment in Neonatal Intensive Care Units
Saleem, S. [1]
Burger, K. [1]
Takata, B. [1]
Zufall, B. [1]
Oosterbaan, C. [2]

Journal: Journal of Investigative Medicine Date: 2023/05, 71(1):Pages: 541. doi: Subito , type of study: systematic review

Full text    (https://journals.sagepub.com/doi/epub/10.1177/10815589221142328)

Keywords:

sucking [9]
bottle feeding [2]
clinical assessment [4]
osteopathic manipulative treatment [2973]
OMT [2951]
newborns [11]
systematic review [297]
controlled study [6]
hypothermia [1]
neonatal intensive care unit [8]
hyperbilirubinemia [2]
pediatrics [375]
conference abstract [108]
length of stay [22]
low birth weight [3]
practice guideline [18]
occupational therapy [1]

Abstract:

Purpose of Study: Premature babies, due to their smaller size and low birthweight (less than 5 lbs), experience difficulties with latching and oral feeding, hypothermia, respiratory distress, and infection. For these reasons, a low birth weight contributes to 60 to 80% of all neonatal deaths. The purpose of this study is to demonstrate how Occupational Therapy (OT) and Osteopathic Manipulative Treatment (OMT) improve breast or bottle feeding, promote weight gain, reduce reflux and jaundice, regulate body temperature, achieve developmental milestones, correct plagiocephaly, and reduce the length of stay in the NICU. According to guidelines set by the American Academy of Pediatrics, the three major physiologic criteria for hospital discharge of preterm infants are autonomous oral feeding that results in proper weight gain, maintenance of appropriate body temperature in a home environment, and mature respiratory control for sufficient oxygenation. Thus, these clinical indicators help assess the effectiveness OT and OMT in achieving these criteria and supporting the development of preterm infants. Methods Used: Systematic Review of six research studies that compare seven treatment outcomes of OT to OMT in the NICU. The OT treatment modalities (standard of care) are neonatal massage, myofascial release (MFR), neurodevelopmental treatment (NDT), skin-to-skin (kangaroo care), and caregiver education. The OMT treatment modalities (adjuvant care) are soft tissue, MFR, balanced ligamentous tension, paraspinal inhibition, v-spread, condylar decompression. Summary of Results: Both OT and OMT techniques decreased hospital length of stay by improving oral feeding and promoting weight gain (95% CI -3.99, -1.43; P < 0.001). However, OMT also achieved better results in the seven treatment outcomes. The treatments were for hyperbilirubinemia, ileus of prematurity, congenital or acquired torticollis, nonsynostotic occipital plagiocephaly, delayed motor development, gastroesophageal reflux, and nipple latching. Conclusions: While many techniques of OT and OMT are similar, the main differences are that OT places a larger emphasis on social components of parental education and bonding as part of the therapeutic approach. OMT relies more on the physical technique to address somatic dysfunction and restore health. There is a growing emphasis to incorporate OMT as adjuvant therapy into the standard of care for the NICU. Osteopathic physicians who perform OMT should work in coordination with different specialists, such as lactation consultants and physical therapists, to improve biomechanical sucking difficulties and positional plagiocephaly. These techniques demonstrate numerous benefits that cultivate in shorter NICU stays for newborns, however, they are still underutilized in most settings. Moving forward, steps need to be taken to encourage these treatment modalities in the NICU and in all newborn physical exams when indicated. They are quick, noninvasive methods that are proven to prevent, treat, and improve outcomes for patients.

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