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The Use of Osteopathic Manipulative Treatment (OMT) in the Management of Patients With Post-COVID Symptoms
Foss, V. [2]
Kaur, J. [2]
Stoukides, G. [1]
Yao, S. C. [54]

Journal: Journal of Osteopathic Medicine Date: 2022/12, 122(12):Pages: A64-A65. doi: Subito , type of study: cross sectional study

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2022-2000/html)

Keywords:

covid-19 [76]
cross sectional study [597]
OMT [2951]
osteopathic manipulative treatment [2973]
post covid [3]

Abstract:

Statement of Significance: Patients continue to face the reality of chronic multisystem post-COVID symptoms even weeks after the resolution of acute illness (1,2). Since COVID-19 impacts body tissues similarly to other viral illnesses, OMT may be a powerful tool to optimize symptom management (3,4). Identifying the most effective OMT approaches and target areas for treatment through the perspective of osteopathic physicians can help determine the best ways OMT can be utilized in post-COVID care to improve outcomes. Research Methods: This project was approved by the NYIT IRB on January 25, 2022, BHS-1719. NYITCOM OMM department faculty and adjunct faculty were sent an email invitation with a REDcap survey link. The survey collected information on osteopathic physician demographics and experiences treating patients with post-COVID symptoms in specific organ systems, including the musculoskeletal, pulmonary, cardiovascular, genitourinary, neurological, and gastrointestinal systems. Additionally, there were questions regarding OMT modality used, body regions treated, number of manipulation sessions, and perceived efficacy. Participants were given one week to complete the survey; to follow up, three weekly reminders were sent via email. A participant was considered a non-responder if they did not complete the survey after three email reminders. Those physicians who responded to the survey (N=18) answered the questions based on any and all patients for whom they provided OMT for the management of post-COVID symptoms. Statistical analysis of the data was performed to assess the use of OMT in the management of post-COVID symptoms. Data Analysis/Results: A total of 18 osteopathic physicians responded to the survey and 77.8% (14/18) reported seeing patients presenting with post-COVID symptoms and providing OMT accordingly. Of the responders who utilized OMT, 92.9% (13/14) addressed pulmonary complaints, predominantly dyspnea and cough; 92.9% (13/14) addressed musculoskeletal complaints, predominantly muscle fatigue and pain; 85.7% (12/14) addressed neurological complaints, predominantly headache, anosmia, and sleep disturbance. 42.9% (6/14) treated cardiovascular complaints, predominantly palpitations and chest wall pain; 14.3% (2/14) addressed gastrointestinal complaints, including diarrhea, acid reflux, nausea, and abdominal pain; 7.14% (1/14) addressed genitourinary complaints, including dysuria and pelvic pain; 21.4% (3/14) treated patients presenting with miscellaneous complaints, including otorhinolaryngological, rheumatological, and psychobehavioral symptoms. Across all systems listed in the survey, the 14 physicians who incorporated OMT into the management of post-COVID patients reported a total of 51 clinical presentations encountered. The most frequently utilized technique was reported to be Balanced ligamentous tension (utilized by providers in 90.2% (46/51) of the various clinical presentations), followed by Osteopathic Cranial Manipulative technique (utilized in 88.2% (45/51) of the presentations). The least frequently reported techniques were Chapman Point Release (utilized in 7.84% (4/51) of the presentations), Still technique (utilized in 11.8% (6/51) of the presentations), Counterstrain (utilized in 19.6% (10/51) of the presentations), and Muscle Energy Technique (utilized in 19.6% (10/51) of the presentations). Furthermore, the application of OMT in post-COVID cases was deemed ‘extremely effective’ in 35.3% (18/51), ‘very effective’ in 43.1% (22/51), and ‘somewhat effective’ in 15.7% (8/51) of the presentations. None of the providers rated OMT as ‘slightly effective’ or ‘not effective at all.’ Conclusion: While post-COVID patients presented with various symptoms, the pulmonary, musculoskeletal, and neurological systems were most commonly involved. Overall, Balanced ligamentous tension and Cranial OMT was reported by respondents to be more beneficial than Chapman Point Release, Still technique, Counterstrain, and Muscle Energy Technique. At least one-third of the osteopathic physicians who utilized OMT were able to effectively address multisystem post-COVID symptoms experienced by their patients. These promising findings can help guide future research and potentially build larger-scale prospective studies concerning the role of OMT in post-COVID management. Some of the limitations of this study include the retrospective data collection, which may lead to recall bias. Other limitations are the small sample size and possible selection bias, as only NYITCOM faculty members and affiliates were surveyed. In order to make more reliable conclusions about the effectiveness of OMT in post-COVID patients, the goal is to distribute the survey to include OMM department faculty of all Osteopathic Medical Schools in the United States. Learning more about COVID-19 and its pathophysiology, osteopathic physicians can utilize diverse training and knowledge to address persistent symptoms. By sharing their experiences of using OMT to treat the sequelae of this novel illness and improve function, providers can help alleviate the burden of disease for their patients.

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