Osteopathischer Behandlungseffekt auf Dysmenorrhö

Effectiveness of osteopathic treatment in women with primary dysmenorrhea: A randomised controlled trial

OBJECTIVES

Effectiveness of five osteopathic treatments in patients with primary dysmenorrhea. Two-centre randomised controlled trial with women in northern Germany of ages between 12 and 53 years with medically-diagnosed primary dysmenorrhea. Treatments were allocated by an external institution using computer generated tables. Neither the therapists nor the participants were blinded. Five individual, findings-based osteopathic treatments (black box method) and follow-up time versus waiting-list. Main outcome measures Intensity and duration of menstrual pain with Numeric Rating Scale. 72 individuals were randomised to treatment group (n = 35) or control group (n = 35) (drop-outs n = 2). The inter-group comparison demonstrated a statistically significant decrease in pain intensity (NRS score: difference in mean value 1.7; 95% CI: 0.9 to 2.6; p < 0.005). In the inter-group comparison, the number of days in pain decreased in a statistically significant way by the mean value of 0.8 days (95% CI: -2 to 0.4; p = 0.04). Five osteopathic treatments over a period of three menstrual cycles may be effective in relieving the duration and intensity of menstrual pain in women with primary dysmenorrhea. Additional and larger studies using sham control group interventions are needed to confirm the current results.

Osteopathic manipulative treatment in gynecology and obstetrics: A systematic review

OBJECTIVE

The aim of the review was to evaluate the effects of the osteopathic manipulative treatment (OMT) on women with gynaecological and obstetric disorders.

MATERIALS AND METHODS

An extensive search from inception to April 2014 was conducted on MEDLINE, Embase, the Cochrane library using MeSH and free terms. Clinical studies investigating the effect of OMT in gynaecologic and obstetric conditions were included as well as unpublished works. Reviews and personal contributions were excluded. Studies were screened for population, outcome, results and adverse effects by two independent reviewers using an ad-hoc data extraction form. The high heterogeneity of the studies led to a narrative review.

RESULTS

24 studies were included (total sample=1840), addressing back pain and low back functioning in pregnancy, pain and drug use during labor and delivery, infertility and subfertility, dysmenorrhea, symptoms of (peri)menopause and pelvic pain. Overall, OMT can be considered effective on pregnancy related back pain but uncertain in all other gynaecological and obstetrical conditions. Only three studies (12.5%) mentioned adverse events after OMT.

CONCLUSIONS

Although positive effects were found, the heterogeneity of study designs, the low number of studies and the high risk of bias of included trials prevented any indication on the effect of osteopathic care. Further investigation with more pragmatic methodology, better and detailed description of interventions and systematic reporting of adverse events are recommended in order to obtain solid and generalizable results.