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The Efficacy of Osteopathic Manipulation Treatment (OMT) on Post-Operative Outcomes: An Abstract

Journal: Journal of Osteopathic Medicine Date: 2023/12, 123(12):Pages: A15-A16. doi: Subito , type of study: review

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2023-2000/html)

Keywords:

narrative review [39]
OMT [2951]
osteopathic manipulative treatment [2973]
post-operative care [28]

Abstract:

Statement of Significance: Post-operative complications are a significant concern in surgical care, leading to prolonged hospital stays, delayed recovery, and reduced well-being[1]. Osteopathic Manipulation Treatment (OMT) is a non-invasive therapy that shows promise in improving postoperative outcomes and reducing complications[2]. While the use of OMT in managing musculoskeletal conditions has been extensively studied, its potential role in mitigating postoperative complications has not yet been fully documented[3]. To determine whether OMT significantly improves post-surgical outcomes, including postoperative complications in adult patients. This study aims to provide evidence-based recommendations on using OMT as an adjunctive therapy in post-operative care. Research Methods: This study was a literature review on the efficacy of Osteopathic Manipulation Treatment (OMT) on Post-Operative Complications and explores the potential benefits of OMT in reducing complications following surgical procedures in adult patients. The application of OMT in the treatment of postoperative complications was thoroughly analyzed in recent studies. A comprehensive search of PubMed databases yielded relevant papers that were published between 2000 and 2020. “[OMM OR OMT OR osteopathic manipulative treatment OR osteopathic manipulative medicine OR osteopathic manipulation] AND [post-operative complications OR post-operative therapy OR post-operative care]“ were among the search terms utilized. The chosen publications were then examined for possible advantages and disadvantages of this adjunctive therapy, the ideal patient demographics, and future paths of study. Data Analysis: In a 2013 study, OMT was used postoperatively to treat patients after gastrointestinal surgery to address factors contributing to the development of postoperative ileus. The length of postoperative hospital stays (LOS) in patients who received OMT was an average of 6.1 days compared to an average of 11.5 days in the control group (p-value of 0.006). The average time to flatus was 3.1 days in patients who received OMT compared to 4.7 days in the control group (p-value of 0.035)[4]. Another study was done that assessed the effect of OMT on reducing postoperative complications, specifically on sternal pain levels in post-sternotomy patients. 40 patients received OMT concurrently with cardiorespiratory rehabilitation, and 40 patients solely received cardiac rehabilitation. The OMT significantly reduced pain scores assessed via visual analogue scale, increased mean inspiratory volume, and reduced length of hospitalization with p-values of 0.007, 0.01, and 0.04, respectively. The LOS in the control group had a 21.7 day stay compared to 19.1 days for the OMT group[5]. Shorter LOS were also seen in a 2000 study assessing the effect of OMT after knee or hip arthroplasty. 38 patients each were enrolled in the control and the OMT group which resulted in a significant 43% increase in ambulation distance on postoperative day 3 with a p-value of 0.008 [6]. The impact of OMT has also been assessed in patients immediately post-surgery, specifically in a 2005 study on patients after coronary artery bypass graft surgery. OMT was performed within 2 hours postoperatively and the difference in thoracic impedance, mixed venous oxygen saturation (SvO2), and cardiac index was assessed between the control and OMT groups. OMT was shown to significantly increase thoracic impedance and reduce central blood volume with a p-value of 0.02, increase SvO2 with a p-value of 0.005, and improve cardiac index with a p-value of 0.01 [7]. Conclusion: OMT was shown to have a significant impact on reducing post-operative complications and mitigating factors contributing to these complications in a postoperative setting. The studies analyzed in this literature review indicate that a variety of OMT techniques, including soft tissue techniques and myofascial release, can be used in a postoperative setting to improve patient recovery. Factors such as hospital length of stay, patient pain scores, ambulation, gastrointestinal complications, and hemodynamics postoperatively were all shown to significantly improve after OMT. These findings were associated in a variety of surgeries including gastrointestinal, orthopedic, and cardiovascular as well as with OMT being provided immediately postoperatively to several days after. The positive impact of OMT remains consistent throughout these variations due to its purpose of improving blood flow and lymphatic drainage as well as range of motion. As a result, OMT can be used as an alternative or as adjunctive therapy to current postsurgical protocol to help reduce adverse effects of any analgesic drugs given post-operatively. For future direction, the specific OMT techniques that should be used to optimize efficient patient recovery can be more thoroughly investigated. This may include assessing the effectiveness of passive versus active techniques as well as direct versus indirect techniques in mitigating postoperative complications. Limitations to be addressed in future literature reviews include analyzing articles with a wider variation of OMT techniques and a wider age range as many of the current studies involved patients older than 60 years old.


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