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Safety and Efficacy of Osteopathic Manipulative Treatment (OMT) in the Pediatric Oncology Inpatient Setting

Journal: Journal of Osteopathic Medicine Date: 2023/12, 123(12):Pages: A62-A63. doi: Subito , type of study: case series

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

Keywords:

adolescents [18]
cancer [48]
case series [40]
children [228]
OMT [2951]
osteopathic manipulative treatment [2973]
pediatrics [375]

Abstract:

Statement of Significance: Pediatric patients undergoing treatment for cancer are frequently hospitalized1,2 and experience therapy-induced side effects that diminish quality of life.3,4 Osteopathic manipulative treatment (OMT) is a medical intervention that utilizes manual techniques to diagnose and treat body structures. Few studies have investigated the implementation of OMT in the pediatric oncology outpatient setting. To date, no studies have investigated the safety of OMT in the pediatric oncology inpatient setting. To investigate the safety and efficacy of OMT in the pediatric oncology inpatient setting. Research Methods: Single institution, observational case series evaluating children and adolescents and young adults (AYAs) aged 2-39 years undergoing treatment for an oncologic diagnosis at Riley Hospital for Children (Riley) who were hospitalized on the Riley pediatric inpatient oncology unit for cancer-related treatment or management of treatment-related complications. Approval was obtained from the Riley Institutional Review Board. Patients were evaluated daily with history and physical exam as part of routine inpatient management. Patients who reported chemotherapy side effects were offered OMT. Verbal informed consent/assent was obtained from caregivers/patients prior to patients receiving OMT. OMT was provided by trained osteopathic medical students under the supervision of a board-certified osteopathic physician and included techniques commonly taught in first- and second-year osteopathic medical school curricula. Safety was assessed by a validated pain (FACES) scale pre/post-OMT and by adverse event grading per Common Terminology Criteria for Adverse Event (CTCAE) 24 hours post-OMT. Between September 2022 and January 2023, a total of 9 patients received OMT, for a total of 34 separate OMT encounters. All data were summarized using descriptive statistics. Osteopathic significance is demonstrated by the novelty of investigating the safety and efficacy of OMT in hospitalized pediatric patients with cancer. Data Analysis: A total of 9 patients received OMT, with 34 separate OMT encounters and 37 chief complaints included in the analysis. All patients had a diagnosis of leukemia or lymphoma. The majority of the patients were male (n=6, 66.7%) with a median age of 17 years at the time of OMT (range 12.9-29.3 years). Primary chief complaints included musculoskeletal pain (n=20, 54.1%), headache (n=5, 13.5%), and lower extremity edema (n=7, 18.9%). Additional chief complaints included neuropathic pain or neurologic symptoms (n=2, 5.4%), constipation (n=2, 5.4%), and epigastric pain (n=1, 2.7%). There were no reported adverse events attributed to OMT. Furthermore, there were no FACES scores that correlated with worsening pain or symptomatology. Pre/post-OMT FACES scores were collected for 43 separate body regions during 24 OMT encounters. Median FACES scores pre- and post-OMT were 6 and 3, respectively. All FACES scores post-OMT were unchanged or decreased in all encounters and for all body regions assessed. Conclusion: Hospitalized children and AYAs with cancer received OMT safely. Limitations include single institutional data, small sample size, and limited representation of oncologic diagnoses. However, these findings support further investigation into the safety, feasibility, and efficacy of implementing OMT in the pediatric oncology inpatient setting and to a broader inpatient pediatric oncology population.


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