Hard Science post - do put fingers in ears and shout 'lalala' if you're a) a firm believer or b) utterly convinced it's all pants.
I?m reasonably convinced of the benefits of this for immediately-post-birth trauma, particularly after a difficult delivery, but the usefulness of it to older children perplexes me slightly.
I put my science hat on and had a look in the peer-reviewed literature in academic journals, and there seems to be very little hard data there. I?m an evidence-based medicine sort of girl and like my trials randomized and controlled and my confidence intervals small.
The only paper that came anywhere close to modelling that was a study about ear infections in Oklahoma - abstract is reproduced below because I?m not sure if you need a subscription to view the full text
The Use of Osteopathic Manipulative Treatment as Adjuvant Therapy in Children With Recurrent Acute Otitis Media
Mills et al, Arch Pediatr Adolesc Med. 2003;157:861-866
Objective To study effects of osteopathic manipulative treatment as an adjuvant therapy to routine pediatric care in children with recurrent acute otitis media (AOM).
Study Design Patients 6 months to 6 years old with 3 episodes of AOM in the previous 6 months, or 4 in the previous year, who were not already surgical candidates were placed randomly into 2 groups: one receiving routine pediatric care, the other receiving routine care plus osteopathic manipulative treatment. Both groups received an equal number of study encounters to monitor behavior and obtain tympanograms. Clinical status was monitored with review of pediatric records. The pediatrician was blinded to patient group and study outcomes, and the osteopathic physician was blinded to patient clinical course.
Main Outcome Measures We monitored frequency of episodes of AOM, antibiotic use, surgical interventions, various behaviors, and tympanometric and audiometric performance.
Results A total of 57 patients, 25 intervention patients and 32 control patients, met criteria and completed the study. Adjusting for the baseline frequency before study entry, intervention patients had fewer episodes of AOM (mean group difference per month, -0.14 [95% confidence interval, -0.27 to 0.00]; P= .04), fewer surgical procedures (intervention patients, 1; control patients, 8; P= .03), and more mean surgery-free months (intervention patients, 6.00; control patients, 5.25; P= .01). Baseline and final tympanograms obtained by the audiologist showed an increased frequency of more normal tympanogram types in the intervention group, with an adjusted mean group difference of 0.55 (95% confidence interval, 0.08 to 1.02; P= .02). No adverse reactions were reported.
Conclusions The results of this study suggest a potential benefit of osteopathic manipulative treatment as adjuvant therapy in children with recurrent AOM; it may prevent or decrease surgical intervention or antibiotic overuse.
The editorial in the same issue of the journal found the following seriousweaknesses_ in the methods of the study: Groups didn?t seem to be truly randomised ? kids chosen to be ?treated? were older and sicker than ?control? kids.
Parents weren?t blinded, so the ones in the control group knew their kids were missing out on something and many of them dropped out of the study to seek ?better? treatment.
There was no placebo control, so there was no proof that it wasn?t just the extra attention from a professional that helped rather than the actual manipulation.
The editor concluded that the manipulation was beneficial, but that the study did not determine whether this was because it merely reassured the parents, thus lessening their demands for antibiotics and/or surgery, or because it actually helped the child.
I appreciate this study was in the US where the healthcare system is very different to here (and parent pressure may be more of an issue), and I?m thrilled to hear that cranial osteoptahy gave so many of you good results. A lot more work still needs to be done to understand exactly why and how it affects the patients for whom it does work, which in turn may help us to determine the best way to help patients refactory to therapy.
End of hard science
Normal service has now resumed, thank you for your attention.