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Preliminary Results from a Randomized Controlled Trial on the Efficacy of Osteopathic Manipulative Medicine in Recovery from Concussions

Journal: Journal of Osteopathic Medicine Date: 2022/12, 122(12):Pages: A71-A72. doi: Subito , type of study: randomized controlled trial

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

Keywords:

athletes [16]
concussion [29]
OMT [2951]
osteopathic manipulative treatment [2973]
randomized controlled trial [710]
sports [103]

Abstract:

Statement of Significance: Sports-related concussions (SRC) are a significant public health concern in organized sports.[1] Current treatment of athletes that sustain an SRC includes monitoring symptoms using standardized symptom scores, physical and cognitive rest, physical and vestibular rehabilitation, and a gradual return to play plan.[2] Osteopathic manipulative medicine has been proposed as a safe, adjunctive treatment for patients with post-concussion symptoms.[3,4] Research Methods: A total of 15 athletes with an SRC (10 women, ages 14-25 years old) were randomized to either an experimental (usual care+OMT, n=9) or control (usual care alone, n=6) group. The Sport Concussion Assessment Tool Symptom Evaluation Score (SCAT) (taken at the initial visit and at two weeks post-concussion) and time to return to play (RTP) were measured. The administered SCAT consists of self-reported 22 concussion symptoms on a scale ranging from 0 (none) to 6 (severe), providing 22 possible symptoms with a severity score out of 132.[5] Inclusion criteria include a minimum and maximum age of 14 and 25, respectively, primary diagnosis of sports-related concussion within the last 10 days, and active participation in an organized sport. Exclusion criteria include contraindications for OMT such as skull/cervical fracture, intracranial bleeding, and stroke, surgery within the last 6 month, will not be under the care of healthcare professional, or having any conditions that contraindicates or impedes protocol implementation. For this preliminary analysis, Cohen’s d was used to assess effect size of the differences between the groups, where the magnitude of the effect size can be interpreted as small (d=0.2), medium (d=0.5), and large (d=0.8).[6] Intention-to-treat (ITT) analysis was applied, whereby any SCAT score missing at week 2 follow-up were replaced with the corresponding baseline score (the last observation carried forward). Data Analysis/Results: The athletes participated in a variety of organized sports including rowing, wrestling, wake surfing, swimming, diving, basketball, and soccer. On average, athletes in the experimental group received 2 OMT sessions during the 2-week period. Groups were similar in terms of age and gender (p>0.05). Based on the ITT analysis, athletes receiving usual care+OMT reduced the number of their symptoms from 12(SD=5) to 5(6) and their symptom severity score from 32(23) to 9(11), whereas the number of symptoms and severity score in the control group reduced from 12(6) to 6(6) and from 23(17) to 11(12), respectively. RTP for athletes in the usual care+OMT group was 2.6 days sooner than athletes in the control group (10.7(5.6) vs. 13.3(8.3) days, respectively), which produced a medium effect size of d=0.40. For 5 athletes (2 from usual care and 3 from usual care+OMT), RTP was not reported. Conclusion: The results from this preliminary analysis suggest that OMT used as complementary to current concussion management helps enhance the recovery process in athletes who sustained an SRC.[7] Further research is needed to determine the specific mechanisms of OMT enhancing the recovery from SRCs.


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