EBM studies in osteopathy

[reading time: 2 minutes]

As stated in the last OIA Global Report¹, osteopathy is growing all over the world, but nevertheless the debate remains lively about the effectiveness of the results that can be achieved by its application. The lack of solid scientific evidence on a large scale greatly penalizes the recognition of osteopathy and its inclusion in the health care systems.

Many considerations have been made within the osteopathic community with regard to the methodological issues and to the possibilities to use the EBM criteria during the implementation of the scientific studies in the osteopathic field.

In fact, in the research of osteopathic medicine it is not possible to apply one of the requirements of the RCT, ie, the blinding of the practitioner.

However, some studies have been carried out on both the single intervention (like the high-velocity low amplitude thrust, which alleviates the acute condition of a rachialgia) and the effect of OMT on specific parameters in the study participants. In this last case often a protocol called “black box” is used. The black box leaves the practitioner free to apply the main principles of osteopathy treating “what he or she finds” in the patient, while to measure the outcomes indirect parameters are evaluated, like the length of stay or the reduction of the medicines administered².

Notwithstanding the foregoing, it is undeniable that numerous studies have been carried out in the osteopathic field.

An article on the osteopathic empirical research³, published in 2021, carried out a bibliometric analysis from 1966 to 2018, including 389 eligible articles. It results that the number of studies has doubled every 5 years, especially thanks to the contribution of the United States, Italy, Spain and the United Kingdom.

The articles of osteopathic research, 23 of which are mentioned more than 100 times, have been published in 103 different indexed journals, although more than half of the articles (53,7%) have been published in one of the three niche magazines for osteopaths.

The most frequent study design is the RCT, although they are often pilot studies, nevertheless there are also many systematic reviews. According to the recommendations emerging from these review studies, there is the need to conduct bigger and more robust studies to evaluate the efficacy of osteopathy, but also the mechanisms of action underlying the osteopathic interventions. In fact the understanding of the physiological mechanisms would contribute to establish objective and measured outcomes and in turn it would support the design of rigorous clinical experimentations.

For further details please refer to the page of Osteopedia reporting the reviews of the osteopathic scientific studies.g

Bibliography

1. OIA Osteopathic Healthcare. Global review of osteopathic medicine and osteopathy 2020, International Alliance.
2. Cerritelli, F., Pizzolorusso, G., Renzetti, C., Cozzolino, V., D’Orazio, M., Lupacchini, M., Marinelli, B., Accorsi, A., Lucci, C., Lancellotti, J., Ballabio, S.,
3. Castelli, C., Molteni, D., Besana, R., Tubaldi, L., Perri, F. P., Fusilli, P., D’Incecco, C. A multicenter, randomized, controlled trial of osteopathic manipulative treatment on preterms. PloS one, 10(5), e0127370.
4. Cerritelli F, Lanaro D. Elementi di ricerca in osteopatia e terapie manuali. Napoli: Edises, 2018.
5. Morin C, Gaboury I. Osteopathic empirical research: a bibliometric analysis from 1966 to 2018. BMC Complement Med Ther. 2021 Jul 7;21(1):196. doi: 10.1186/s12906-021-03366-3.