Osteopathic manipulation improves spine mobility in obese

By Lucy Piper, Senior medwireNews Reporter

Osteopathic manipulative therapy (OMT), when combined with specific exercises (SE), has an added benefit of improving kinematics of the thoracic spine in obese patients with chronic low back pain (LBP), Italian study findings show.

Italian clinical guidelines say a reduction of disability should be the main goal for patients with LBP, note the researchers.

"Our study shows that, in obese patients, a combined passive (OMT) and an active approach (SE) can be successfully combined to improve the LBP-related disability," they say.

"Special exercises alone appear to reduce pain significantly but do not affect trunk kinematics."

For the study, published in Manual Therapy, 19 obese women with chronic LBP were randomly assigned to receive specific exercises plus OMT or specific exercises alone.

The forward flexion of the spine was studied using an optoelectronic system and a biomechanical model was developed in order to analyze kinematics.

SE involved 10 45-minute sessions aimed at reinforcing and stretching the abdominal and back muscles, mobilizing the spine, and providing the patients with correct ergonomic knowledge for the safe use of the spine.

Patients receiving OMT underwent an additional 45-minute individual session with an osteopath who used high-velocity, low-amplitude thrust in the thoracic spine, cranial techniques, and myofascial release.

Participants undergoing SE alone showed no changes in biomechanical parameters following treatment, whereas patients receiving OMT as well showed a significant improvement of nearly 20% in the thoracic range of movement (ROM).

"ROM improvements seem to be specifically due to OMT, since the group treated with SE alone did not report the same results," Luca Vismara (Ospedale San Giuseppe, Piancavallo) and colleagues comment.

Both groups showed clinical improvements, but these were significantly greater for the patients receiving OMT plus SE.

Specifically, pain scores on a visual analog scale fell by an average 74% for patients receiving OMT plus SE versus 46% for those receiving SE alone, while scores on the Roland Morris Disability Questionnaire fell by 67% versus 24%, and Oswestry Low Back Pain Disability Questionnaire scores by 64% versus 29%.

However, the researchers acknowledge that, due to the kinematic approach being costly and time-consuming, their study sample size is small and larger studies are needed to confirm their findings.

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