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Evaluation of Osteopathic Manipulative Treatment in Patients with Chikungunya Fever in the Chronic Phase: A Randomized Controlled Trial

Journal: Journal of Clinical Rheumatology Date: 2023/05, 29(4):Pages: S59. doi: Subito , type of study: randomized controlled trial

Full text    (https://journals.lww.com/jclinrheum/Fulltext/2023/05001/PANLAR_2023___ABSTRACT_SUBMISSION.1.aspx)

Keywords:

chikungunya fever [1]
chronic pain [204]
conference abstract [108]
fever [4]
joint pain [6]
OMT [2951]
osteopathic manipulative treatment [2973]
randomized controlled trial [710]

Abstract:

Objectives: To evaluate the effects of osteopathic manipulative treatment (OMT) in reducing chronic musculoskeletal manifestations such as pain and joint functional limitation in patients with Chikungunya Fever (CF). Methods: A randomized, controlled clinical trial, blinded to volunteers and evaluators, was conducted at the Rheumatology outpatient clinic of the Hospital das Clínicas (Federal University of Pernambuco, Brazil). The instruments used for evaluation were Brief Pain Inventory Questionnaire (BPI), Visual Analog Scale (VAS) for pain, algometry and joint functional limitation, evaluated by Disabilities of the Arm, Shoulder, Hand Questionnaire (DASH) and the nine-pin connector test (9HPT). The primary outcome was a reduction in the BPI pain intensity score (reduction of at least two points). Secondary outcomes were BPI pain interference score, pain VAS scale, algometry pressure, DASH, runtime of 9HPT. Four OMT sessions were performed (S1 to S4), once a week, and two post-treatment evaluations, within 15 (S5) and 30 days (S6) after the last session. For the analysis of the results, the significance level of p ≤ 0.05 was adopted. Results: Forty-four patients were evaluated, divided into two groups: OMT group (OMTG), with 24 patients and control group (CG), with 20 patients. The mean age of the sample was 53.5 (16.5) years, the majority were female (95.0%) and the groups had similar clinical characteristics. Of the total of 24 GOMT patients, 16 reached the primary endpoint, and only 3 in the CG, with a calculated efficacy of 77.3% and maintenance of efficacy in S5 and S6 of 91.5% and 81.2%, respectively. In the analysis between the groups, a statistically significant reduction in pain intensity in the GOMT can be observed when compared to the control group (CG) (Figure 1). In the intragroup analysis, only the GOMT showed a statistically significant reduction in relation to the primary outcome. Regarding secondary outcomes, efficacy was observed in all evaluated instruments and in the 15-day and 30-day follow-up after receiving the OMT, except for algometry and the 9HPT test, where there was no statistically significant improvement in the intragroup and intergroup analyses. Conclusion: OMT proved to be effective in reducing pain and improving functionality in patients with musculoskeletal manifestations in the chronic phase of CF.


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