Soft-tissue massage A pilot study comparing two manual therapy interventions for carpal tunnel syndrome.

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1 Soft-tissue massage Burke J, Buchberger DJ, Carey-Loghmani MT, Dougherty PE, Greco DS, Dishman JD A pilot study comparing two manual therapy interventions for carpal tunnel syndrome. J Manipulative Physiol Ther Jan;30(1): "The purpose of this study was to determine the clinical efficacy of manual therapy interventions for relieving the signs and symptoms of carpal tunnel syndrome (CTS) by comparing 2 forms of manual therapy techniques: Graston Instrumentassisted soft tissue mobilization (GISTM) and STM [soft tissue massage] administered with the clinician hands." "After both manual therapy interventions, there were improvements to nerve conduction latencies, wrist strength, and wrist motion. The improvements detected by our subjective evaluations of the signs and symptoms of CTS and patient satisfaction with the treatment outcomes provided additional evidence for the clinical efficacy of these 2 manual therapies for CTS. The improvements were maintained at 3 months for both treatment interventions. Data from the control hand did not change across measurement time points." Boline PD, Kassak K, Bronfort G, Nelson C, Anderson AV 1995 Spinal manipulation vs. amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial J Manipulative Physiol Ther 18: "Patients in the spinal manipulation group were treated twice weekly for 6 wk. Each therapy session typically lasted 20 min. The spinal manipulation group received spinal manipulation of a type described as short-lever, low-amplitude, high-velocity thrust techniques. At each visit, the treating doctor determined, by manual palpation, the cervical, thoracic or lumbar spinal segments to be manipulated. The investigative team thought that the greatest therapeutic effect would be achieved by paying particular attention to the upper three cervical segments. In preparation for the spinal manipulation, an average of 5-10 min of moist heat and 2 min of light massage were administered to the cervicothoracic musculature. " "The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. Amitriptyline therapy was slightly more effective in reducing pain at the end of the treatment period but was associated with more side effects. Four weeks after the cessation of treatment, however, the patients who received spinal manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitriptyline therapy, who reverted to baseline values. The sustained therapeutic benefit associated with spinal manipulation seemed to result in a decreased need for overthe-counter medication."

2 Dugaill P, Fassin S, Maroye L, Evers L, Klein P, Feipel V, 2014 Effect of a general osteopathic treatment on body satisfaction, global self perception and anxiety: A randomized trial in asymptomatic female students International Journal of Osteopathic Medicine Volume 17, Issue 2, June, Pages com/science/article/pii/s "Thirty-four asymptomatic female volunteers completed baseline autoquestionnaires about anxiety, body satisfaction and global self-perception. Then, they were randomly assigned to OG or to control group (restful state)." "At baseline, characteristics were comparable between groups. Following the intervention, we observed improvements in psychological state in both OG [general osteopathic treatment] and control groups. Nevertheless, OG had a significant larger effect over restful state for anxiety and global self-perception (p < 0.02)." "The present study suggests that an osteopathic approach using articular and soft tissue mobilisations has an effect, at least in the short term, on anxiety and global body perception. Further investigation is needed to confirm the relevance and broaden the scope of the present study." Lopez D, King HH, Knebl JA, Kosmopoulos V, Collins D, Patterson RM Effects of comprehensive osteopathic manipulative treatment on balance in elderly patients: a pilot study. J Am Osteopath Assoc Jun;111(6): gov/pubmed/ "The OMT [osteopathic manipulative technique] protocol consisted of the following elements: Soft-tissue and myofascial release at T1 to L5 and sacral rock (patient prone) (3-4 minutes); myofascial release in the shoulders and scapulae bilaterally26 (patient lateral recumbent) (4-5 minutes) Cervical spine myofascial, counterstrain,muscle energy, or soft-tissue techniques for release and correction (patient supine) (3-4 minutes); Occipitoatlantal and condylar decompression (1-2 minutes) Venous sinus technique (5-6 minutes) V-spread, frontal and parietal lifts, or both (2-3 minutes); CV4 technique26 (3-4 minutes); Recheck for other key tender points (2-3 minutes) and treat according to findings" "The OMT group had significantly reduced sway for the eyes-open test after 4 visits (P=.001)" "The OMT protocol used in the present study improved the postural stability of healthy elderly patients, as measured by changes in sway values." Ekici G, Bakar Y, Akbayrak T, Yuksel I Comparison of manual lymph drainage therapy and connective tissue massage in women with fibromyalgia: a randomized controlled trial. J Manipulative Physiol Ther Feb;32(2): gov/pubmed/ "For this particular group of patients, both MLDT [manual lymphatic drainage technique] and CTM [connective tissue massage] appear to yield improvements in terms of pain, health status, and HRQoL [health-related quality of life]." "However, MLDT was found to be more effective than CTM according to some subitems of FIQ (morning tiredness and anxiety) and FIQ total score. Manual lymph drainage therapy might be preferred"

3 Joos E, Bourgeois P, Famaey JP Lymphatic disorders in rheumatoid arthritis. Semin Arthritis Rheum Jun;22(6): "Pharmacological and surgical treatment of the edema have been disappointing, and treatment of the underlying RA does not improve the lymphedema. Physical treatment of the affected limb, such as massage, manual drainage techniques, light compression bandaging, and exercise, has been moderately effective." Wieting JM, Beal C, Roth GL, Gorbis S, Dillard L, Gilliland D, Rowan J The effect of osteopathic manipulative treatment on postoperative medical and functional recovery of coronary artery bypass graft patients. J Am Osteopath Assoc May;113(5): http: // "Patients scheduled to undergo a CABG [coronary artery bypass graft] operation were voluntarily enrolled and randomly assigned to receive 1 of 3 treatment protocols after their surgical procedure: standardized daily OMT and conventional postoperative care (the OMT group), daily time-matched placebo OMT and conventional postoperative care (the placebo group), or conventional postoperative care only (the control group)." "Specific OMT [osteopathic manipulative treatment] techniques used were thoracic inlet myofascial release, standard rib raising (with paraspinal muscle stretch to the L2 vertebral level), and soft tissue cervical paraspinal muscle stretch (with suboccipital muscle release). Primary outcome measures included time to discharge, time to postoperative bowel movement, and FIM functional assessment scores." "Patients in the OMT group were discharged 0.55 days earlier than those in the control group and 0.16 days earlier than those in the placebo group. The mean (SD) number of days to first postoperative bowel movement was 3.5 (0.9), 4.0 (0.8), and 4.0 (0.9) for the OMT group, the placebo group, and the control group, respectively. On day 3 after surgery, the mean (SD) total score on the FIM was 19.3 (6.7), 15.4 (7.3), and 18.6 (6.5) for the OMT, the placebo, and the control group, respectively; total score for the OMT group was 0.81 greater than that of the control group and 3.87 greater than that of the placebo group. None of the differences achieved statistical significance (P<.05)" "A daily postoperative OMT protocol improved functional recovery of patients who underwent a CABG operation." Radjieski JM, Lumley MA, Cantieri MS Effect of osteopathic manipulative treatment of length of stay for pancreatitis: a randomized pilot study. J Am Osteopath Assoc May;98 (5): "In this outcomes research study, the authors randomly assigned patients with pancreatitis to receive standard care plus daily OMT [osteopathic manipulative treatment] for the duration of their hospitalization (n = 6) or to receive only standard care (n = 8). Osteopathic manipulative treatment involved 10 to 20 minutes daily of a standardized protocol, using myofascial release, soft tissue, and straincounterstrain techniques. Attending physicians were blinded as to group assignment. Results indicated that patients who received OMT averaged significantly fewer days in the hospital before discharge (mean reduction, 3.5 days) than control subjects, although there were no significant differences in time to food intake or in use of pain medications. These findings suggest the possible benefit of OMT in reducing length of stay for patients with pancreatitis."

4 Berkowitz MR 2009 Application of Osteopathy in the Cranial Field to Successfully Treat Vertigo:A Case Series The AAO Journal 19(3) com/murray_berkowitz/30/ "These cases also demonstrate that the longer-standing and more chronic the presenting problem, the more treatments that may be necessary. This fits the generally accepted paradigm. They also show that even extremely chronic cases may be successfully treated with application of osteopathy in the cranial field in a relatively finite number of treatments; an osteopathic approach renders definitive care of vertigo and co- morbid tinnitus possible." Ammendolia C, Chow N 2015 Clinical outcomes for neurogenic claudication using a multimodal program for lumbar spinal stenosis: a retrospective study. J Manipulative Physiol Ther Mar-Apr;38(3): "The purpose of this preliminary study was to assess the effectiveness of a 6-week, nonsurgical, multimodal program that addresses the multifaceted aspects of neurogenic claudication." "In this retrospective study, 2 researchers independently extracted data from the medical records from January 2010 to April 2013 of consecutive eligible patients who had completed the 6-week Boot Camp Program. The program consisted of manual therapy twice per week (eg, soft tissue and neural mobilization, chiropractic spinal manipulation, lumbar flexion-distraction, and muscle stretching), structured home-based exercises, and instruction of self-management strategies. A paired t test was used to compare differences in outcomes from baseline to 6-week followup. Outcomes included self-reported pain, disability, walking ability, and treatment satisfaction." "A total of 49 patients were enrolled, with a mean age of 70 years. The mean difference in the Oswestry Disability Index was 15.2 (95% confidence interval [CI], ), and that for the functional and symptoms scales of the Swiss Spinal Stenosis Questionnaire was 0.41 (95% CI, ) and 0.74 (95% CI, ), respectively. Numeric pain scores for both leg and back showed statistically significant improvements. Improvements in all outcomes were clinically important." "This study showed preliminary evidence for improved outcomes in patients with neurogenic claudication participating in a 6-week nonsurgical multimodal Boot Camp Program."

5 4 Poland RE, Gertsik L, Favreau JT, Smith SI, Mirocha JM, Rao U, Daar ES Open-label, randomized, parallel-group controlled clinical trial of massage for treatment of depression in HIV-infected subjects. J Altern Complement Med Apr;19(4): http: // "The study objectives were to determine whether massage therapy reduces symptoms of depression in subjects with human immunodeficiency virus (HIV) disease." "Study inclusion required being at least 16 years of age, HIV-seropositive, with a diagnosis of major depressive disorder. " "Swedish massage and touch subjects visited the massage therapist for 1 hour twice per week. The touch group had a massage therapist place both hands on the subject with slight pressure, but no massage, in a uniform distribution in the same pattern used for the massage subjects." "For both the ITT and completers analyses, massage significantly reduced the severity of depression beginning at week 4 (p 0.04) and continuing at weeks 6 (p 0.03) and 8 (p 0.005) compared to no intervention and/or touch." "The results indicate that massage therapy can reduce symptoms of depression in subjects with HIV disease. The durability of the response, optimal \"dose\" of massage, and mechanisms by which massage exerts its antidepressant effects remain to be determined." 24 Kelmanson IA, Adulas EI 2006 Massage therapy and sleep behaviour in infants born with low birth weight. Complement Ther Clin Pract Aug;12(3): gov/pubmed/ "Babies in the experimental group were assigned massage intervention therapy that include gentle rubbing, stroking, passive movements of the limbs and other means of kinaesthetic stimulation performed by professionals until the infant is 8 months old. The findings suggest that 8-month-old LBW infants who received massage intervention were less likely to snore during sleep, required less feeding on waking-up at night, and appeared more alert during the day. These apparent correlations remained significant after adjustment was made for major potential confounders."