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Journal: International Journal of Osteopathic Medicine Date: 2026/03, 59Pages: 100813. doi: Subito , type of study: systematic review Meta analysis

Full text    (https://www.journalofosteopathicmedicine.com/article/S1746-0689(26)00005-2/abstract)

Keywords:

autonomic nervous system [142]
cardiovascular function [1]
endocrine system [10]
heart rate variability [63]
integrative physiology [1]
meta analysis [71]
OMT [3751]
osteopathic manipulative treatment [3771]
regulators [3]

Abstract:

Objective The objective was to estimate osteopathic manipulative treatment (OMT) effects on cardiovascular function directly and indirectly through nervous and endocrine system regulators. Methods A search found studies that compared controls and OMT groups with no restrictions. Two independent reviewers did title/abstract screening, full-text screening, quality appraisals, and data extraction per published protocol in Covidence. Outcome variables with sample size >2 were analyzed in an equal effects model (R software) with sub-group analysis for touch/passive controls and sensitivity analysis for adult/infant populations. Results 34 of 9140 studies met inclusion criteria. Selected studies had mean quality score 9.2/12; 18 were RCTs, and 18 incorporated touch controls. Studies measuring long-term (>24 hours) effects of OMT and those measuring endocrine variables, skin temperature and conductance, and cardiac output appeared in <3 studies. There were no short-term (<1 hour) OMT effects on heart rate (mean difference=-1.85 bpm; 95% confidence interval= -5.82,2.11) or systolic blood pressure (3.30; -6.86, 0.25 mmHg). High frequency heart rate variability (HRV) increased in adults (0.66; 0.30, 1.03) after OMT relative to control. Low frequency HRV decreased after OMT relative to passive (-1.78; -2.43, -1.41) but not touch (-0.04; -0.34, 0.25) controls. Time domain HRV did not respond to OMT in adults (-0.08; -0.53, 0.37). Conclusion Studies for long-term OMT effects on cardiovascular health are rare, while evidence for short-term effects are weak and convey and mixed messages regarding benefit vs harm. Better long-term studies with attention to statistical reporting and confounders such as body position and participant age are indicated.

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