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Der osteopathische Ansatz bei der gastroösophagealen Refluxerkrankung im Säuglingsalter
(The osteopathic approach to gastroesophageal reflux in infants)

Journal: Unpublished MSc thesis Wiener Schule für Osteopathie, Date: 2009/12, Pages: 88, type of study: cctobs

Free full text   (https://www.osteopathicresearch.com/s/orw/item/2860)

Keywords:

gastroesophageal reflux [22]
infant [224]
pediatrics [375]
osteopathic manipulative treatment [2973]
OMT [2951]
controlled clinical trial [283]
WSO [433]

Abstract:

Study Design: This is a clinical, observational and controlled study. Outline/Problem Definition Gastroesophaegeal Reflux Disease is a common disease among infants and babies, approximately 10% of all 71000 in Austria born infants (Statistik Austria, 2009) suffer from Reflux Disease. Frequently osteopaths are confronted with this diagnose and in many cases they succeed and the symptoms become better (Kaiser, 2007). The aim of this study was to investigate at a scientific level whether Osteopathy is a useful complement to conservative-medical treatment. Research Question & Objective -Can the condition, that is measured with the help of a questionnaire, of infants with an MII proven GERD be more improved, when they get conservative-medical treatment and osteopatic treatment in comparison with infants, who get conservative-medical treatment alone? -Can the parameters, that are measured by MII, be more improved in infants with an MII proven GERD, when they get conservative-medical treatment and osteopathic treatment in comparison with infants, who get conservative-medical treatment alone? Hypothesis -The condition, measured with the help of a questionnaire, of infants, that suffer from Gastro Esophageal Reflux Disease, can be improved more in those infants who get conservative-medical treatment and osteopathic treatment than in those infants who get conservative-medical treatment alone. -The parameters that are measured by MII can be impoved more in infants who get conservative-medical treatment and osteopathic treatment than in infants who get conservative-medical treatment alone. Relevance for the Patients This study is an attempt to investigate if infants benefit from Osteopathy, when it is combined with the conservative-medical treatment. Relevance for Osteopathy Osteopaths are confronted with this diagnose and in many cases they succeed and the symptoms become better (Kaiser, 2007). But it has not been investigated enough, so that in the eyes of most doctors GERD has to be treated just conservative-medical or surgical. The aim of this study is to investigate, at a scientific level, whether Osteopathy is a useful complement to conservative-medical treatment. Methodology Included are infants that suffer from an MII- proven Gastroesophageal Reflux Disease and that haven’t reached their sixth month of living by the beginning of the study. The MII investigation is supposed to be the new gold-standard in dedecting Reflux Diseases (Höllwarth, 2008; Wise und Murray, 2007; Rosen et al., 2006; Tutuian und Castell, 2006). The results of these measurements are used for the study. The accompanying person of the infant fills in the questionnaire about the infant’s condition for the first time. He or she evaluates certain parameters on a scale of 0 to 4. Then the probands are put into the experimental or the reference group. The probands from the experimental group get conservative-medical (protonpumpinhibitors (PPI) once a day) and osteopathic treatment. The osteopathic treatment follows the “black box” principle. The probands from the reference group only get conservative-medical treatment (PPI once a day). After three months the questionnaire has to be filled in the second time for every proband and the MII investigation is carried out a second time for the probands of both groups. Results In order to make the questionnaires easier to analyse, the “Index of complaint” (IOC) was calculated for each proband. This is the average value of all parameters. In the experimental group the changing of the IOC from the first to the second measurement reached an average change of -0.62, in the reference group the average change was -0.38. The results from the questionnaire are statistical analysed with the help of the “t- Test”. The result is that there is a significant improvement of the mean values from the Index of complaint of the experimental group in comparison to the reference group. In order to make it possible to analyse the different parameters that the accompanying person of the infant had to evaluate, the changing of the average value of every parameter in each group is calculated. The results from the MII- measurements are statistical evaluated with the help of “4- Felder- X ²- Test”. The result is that none of the evaluated criteria shows a significant improvement of the experimental group in comparison to the reference group. Critical Reflection/Perspectives/Conclusions The most important conclusion drawn from this study is that osteopathy can improve the clinical condition of the infant, but not the Reflux Disease itself. So it seems to make sense to combine osteopathic treatment with conservative-medical treatment in case of a proven Gastroesophageal Reflux Disease. Infants suffering from GERD benefit clinically from osteopathic treatment, especially when the main problems are in connection with uncertain crying, asymmetry or if they get ophistotonic; when they are crying, osteopathy is indicated. The objective parameters are not influenced by the osteopathic treatment. The development of the objective parameter shows no significant difference between combined osteopathic and conservative-medical treatment and just conservative-medical treatment. The fact that the subjective criteria don’t relate to the objective criteria should be in the osteopath’s mind when treating GERD- babies. The presence of coughing and problems with swallowing seem to be the best indicators for the objective parameters of GERD.


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