PUBLICATIONS
The following publications in MEDLINE-listed journals have been developed from German Thesis under the supervision of the German Academy of Osteopathy (listed according to the year of publication)
(Die folgenden Publikationen in MEDLINE-gelisteten Journalen sind aus deutschen osteopathischen wissenschaftlichen Studien unter der Supervision der AFO - Akademie für Osteopathie entstanden (geordnet nach Erscheinungsjahr))
Urologe A. 2009 Aug; 48:1339-45. [Article in German]
Chronic prostatitis/chronic pelvic pain syndrome : Influence of osteopathic treatment - a randomized controlled study.
Marx S, Cimniak U, Beckert R, Schwerla F, Resch KL.
Contact: Silvia Marx D.O., Praxis für Osteopathie und Naturheilkunde, Germany
Email: info@osteopathie-marx.de.
BACKGROUND: Prostatitis is the most common urological disease in males over the age of 50 years old. As bacteria are detected in only <5% of cases the disease can mostly be classified as chronic nonbacterial prostatitis. The symptoms of this problem complex, often described as chronic prostatitis and chronic pelvic pain syndrome (CP-CPPS), seem to be multifactorial so that an improvement can only rarely be achieved with conventional forms of therapy. MATERIALS AND METHODS: The aim of this study was to investigate whether osteopathic treatment can influence the symptoms of CP-CPPS (randomized controlled study, 5 sessions, follow-up after 6 weeks and 1.5 years without treatment). The study was carried out in a practice for osteopathy. Patients were recruited by referral from urologists, newspaper articles and lectures on the topic. A total of 35 males with medically diagnosed CP-CPPS aged 29-70 years old took part in the study. Of the patients 20 were allocated to the treatment group and 15 to the placebo group whereby 2 patients had to retire from the study prematurely. Patients in the treatment group received 5 osteopathic treatment sessions separated by 1 week at the beginning and by up to 3 weeks at the end (total period 8 weeks). The osteopathic dysfunctions of the patients were treated according to the principles of osteopathy. The placebo treatment in the control group consisted of a training program with simple gymnastic and physiotherapeutic exercises. Improvements of the complaints by urination (LUTS), chronic pelvic pain (CPPS) and quality of life (QOL) were measured using the questionnaires for international prostate symptom score (IPSS), the National Institutes of Health chronic prostatitis symptom index (NIH-CPSI) and the quality of life index (QOL). RESULTS: Comparison of the results from the osteopathy and placebo groups revealed statistically significant differences in favor of the osteopathy group (p<0.0005). During the study period the average IPSS in the osteopathy group improved from 19.7 to 10.3 points (48%, p<0.0005), the NIH from 26.0 to 12.0 (54%; p<0.0005) and the QOL from 4.4 to 1.9 points (58%, p<0.0005). In contrast the corresponding values in the placebo group remained relatively constant. At the follow-up 6 weeks after the last session the improvements in the osteopathy group were found to be stabile and remained so at least up to the second follow-up after 1.5 years. CONCLUSIONS: The positive results of this study indicate that osteopathic treatment can be considered a genuine alternative to the conventional treatment of CP-CPPS and a closer cooperation between urologists/internists and osteopaths would be desirable. Further studies with larger numbers of patients should be carried out to substantiate these results.
Forsch Komplement Med. 2008 Jun;15(3):138-45.
Osteopathic treatment of patients with chronic non-specific neck pain: a randomised controlled trial of efficacy.
Schwerla F, Bischoff A, Nurnberger A, Genter P, Guillaume JP, Resch KL.
Contact: German Academy of Osteopathy (AFO), Research Commission
Email: f.schwerla@german-afo.de
OBJECTIVE: Chronic non-specific neck pain (CNP) is a common, often disabling condition which still lacks a reliable therapeutic standard. Empiric evidence suggests that osteopathic interventions might be effective in alleviating CNP symptoms. A randomized controlled clinical trial of efficacy was performed to test this hypothesis. MATERIALS AND METHODS: 135 CNP sufferers were identified through advertisements, and 41 patients who met all relevant predefined criteria were recruited. All participants received a 12-min session of sham ultrasound once a week for an average of 10 weeks. In addition, a test-dependent osteopathic intervention of 45 min was given to 24 participants every other week. 40 participants could be followed up for 12 weeks after the end of therapy. The main outcome parameter was pain intensity measured on a numeric rating scale (NRS, range: 0-10). RESULTS: There were 2 dropouts in the intervention group and 2 in the control group. Average pain intensity decreased from 4.7 to 2.2 in the osteopathic group (p < 0.0005), and from 4.8 to 4.0 in the control group (p = 0.09). The intergroup difference of longitudinal changes was clearly significant, too (p = 0.02). Further slight but comparable reductions were observed at follow-up (0.3 and 0.4 NRS points, respectively). These changes seem to have a positive impact on quality of life, as assessed by generic and specific instruments such as the MOS SF-36 and the Northwick Park Pain Questionnaire. CONCLUSIONS: A series of test-dependent osteopathic interventions may be a promising therapeutic regimen for CNP sufferers. Further studies will have to demonstrate a) whether these findings are reproducible, and b) whether positive long-term outcomes can be achieved.
Dev Med Child Neurol. 2006 Jan;48(1):5-9.
Infantile postural asymmetry and osteopathic treatment: a randomized therapeutic trial.
Philippi H, Faldum A, Schleupen A, Pabst B, Jung T, Bergmann H, Bieber I, Kaemmerer I, Dijs P, Reitter B.
Contact: Department of Paediatric Neurology, University Children's Hospital, Heidelberg, Germany.
Email: hphilippi@vae-ev.de
The aim of this study was to assess the therapeutic efficacy of osteopathic treatment in infants with postural asymmetry. A randomized clinical trial of efficacy with blinded videoscoring was performed. Sixty-one infants with postural asymmetry aged 6 to 12 weeks (mean 9wks) were recruited. Thirty-two infants (18 males, 14 females) with a gestational age of at least 36 weeks were found to be eligible and randomly assigned to the intervention groups, 16 receiving osteopathic treatment and 16 sham therapy. After a treatment period of 4 weeks the outcome was measured using a standardized scale (4-24 points). With sham therapy, five infants improved (at least 3 points), eight infants were unchanged (within 3 points), and three infants deteriorated (not more than -3 points); the mean improvement was 1.2 points (SD 3.5). In the osteopathic group, 13 infants improved and three remained unchanged; the mean improvement was 5.9 points (SD 3.8). The difference was significant (p=0.001). We conclude that osteopathic treatment in the first months of life improves the degree of asymmetry in infants with postural asymmetry.
Forsch Komplement Med. 2004 Apr;11(2):93-97. [Article in German]
Osteopathic versus orthopedic treatments for chronic epicondylopathia humeri radialis: a randomized controlled trial
Geldschläger S.
Contact: Stephanie Geldschläger D.O., Praxis für Osteopathie/Naturheilkunde, Munich, Germany.
Email: St.Geldschlaeger@t-online.de
BACKGROUND: The Epicondylopathia humeri radialis is mainly caused by an overload of the extensor muscles of the hand, the afflicted side is generally the dominant hand. There is a multitude of treatment methods, none of them, however, can guarantee success. OBJECTIVE: Can an osteopathic treatment of the chronic Epicondylopathia humeri radialis reduce the pain more effectively than an orthopedic treatment? STUDY DESIGN: Randomized controlled clinical study. MATERIAL AND METHODS: 53 patients were randomly distributed among examination and control group. They were treated for 8 weeks. The osteopathic treatment was done exclusively manually, with parietal, visceral, and craniosacral techniques, individually chosen for each patient. The orthopedic treatment was performed with chiropractic techniques, antiphlogistics, and mostly with injections of cortison. Four common tests were used, all 4 valuing pain and development of power: pressure pain test, Thomsen test, middle finger extension test, and test for strength. Additionally a questionnaire about the attendant circumstances of the chronic Epicondylopathia humeri radialis was raised. RESULTS: Subjective pain sensation reduced from 50% to 33% (p < 0.01) in the intervention group and from 48% to 32% (p = 0.03) in the orthopedic group. A reduction of pain as well as an increase of power could be measured. The difference between the two treatment methods, however, was not statistically significant. CONCLUSIONS: In this study it was possible to successfully treat the chronic Epicondylopathia humeri radialis with an osteopathic approach. A significant difference to an orthopedic treatment could not be proved.
Forsch Komplement Med. 1999 Dec;6(6):302-10. [Article in German]
Evaluation and critical review published in the European literature on osteopathic studies in the clinical field and in the area of fundamental research
Schwerla F, Hass-Degg K, Schwerla B.
Contact: German Academy of Osteopathy (AFO), Research Commission
OBJECTIVE: Identification of studies of osteopathic treatment in defined countries. Evaluation of methods and results of the studies and assessment of the available evidence concerning the effectiveness of osteopathy. STUDY DESIGN: Systematic review. Assessment of the quality of the studies, with respect to the osteopathic concept and current methodological criteria according to predefined keys. DATA SOURCES: Clinical trials and fundamental studies originating from Germany, England, Austria, The Netherlands, Scandinavia +/- published or unpublished. RESULTS: Out of a total of 30 studies retrieved, 9 reached the predetermined minimum number of points to be rated into quality categories. In 2 of these studies the osteopathic treatment was more effective than the control intervention (p < 0.05). CONCLUSIONS: No definitive conclusions about the effectiveness of osteopathy can be drawn so far because of the low number of evaluated studies. It seems necessary to scrutinize the relevance of osteopathy through further methodologically adequate studies. Additionally, criteria for evaluation are proposed which correspond to the highest international standards in order to ensure a valid (and commonly accepted) evaluation of the osteopathic literature.
