Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects: the PROMOTE study - 19/12/14
, Steve Buchanan, DO, FACOOG (Dist) b, Sarah K. Brown, DrPH c, Mayra Rodriguez, MPH d, des Anges Cruser, PhD eAbstract |
Objective |
The purpose of this study was to evaluate the efficacy of osteopathic manipulative treatment (OMT) to reduce low back pain and improve functioning during the third trimester in pregnancy and to improve selected outcomes of labor and delivery.
Study Design |
Pregnancy research on osteopathic manipulation optimizing treatment effects was a randomized, placebo-controlled trial of 400 women in their third trimester. Women were assigned randomly to usual care only (UCO), usual care plus OMT (OMT), or usual care plus placebo ultrasound treatment (PUT). The study included 7 treatments over 9 weeks. The OMT protocol included specific techniques that were administered by board-certified OMT specialists. Outcomes were assessed with the use of self-report measures for pain and back-related functioning and medical records for delivery outcomes.
Results |
There were 136 women in the OMT group: 131 women in the PUT group and 133 women in the UCO group. Characteristics at baseline were similar across groups. Findings indicate significant treatment effects for pain and back-related functioning (P < .001 for both groups), with outcomes for the OMT group similar to that of the PUT group; however, both groups were significantly improved compared with the UCO group. For secondary outcome of meconium-stained amniotic fluid, there were no differences among the groups.
Conclusion |
OMT was effective for mitigating pain and functional deterioration compared with UCO; however, OMT did not differ significantly from PUT. This may be attributed to PUT being a more active treatment than intended. There was no higher likelihood of conversion to high-risk status based on treatment group. Therefore, OMT is a safe, effective adjunctive modality to improve pain and functioning during the third trimester.
Le texte complet de cet article est disponible en PDF.Key words : low back pain, osteopathic manipulation, pregnancy
Plan
| Supported by grants number K23AT003304 and K23AT3304-4S1 from the National Center for Complementary and Alternative Medicine of the National Institutes of Health and grant number 06-11-549 from the American Osteopathic Association. Additional financial support was provided by the Medical Education Foundation of the American College of Osteopathic Obstetricians and Gynecologists, the American Academy of Osteopathy, Osteopathic Heritage Foundations, and the Osteopathic Research Center at the University of North Texas Health Science Center. |
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| The authors report no conflict of interest. |
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| Cite this article as: Hensel KL, Buchanan S, Brown SK, et al. Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects: the PROMOTE study. Am J Obstet Gynecol 2015;212:108.e1-9. |
Vol 212 - N° 1
P. 108.e1-108.e9 - janvier 2015 Retour au numéro
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