Karen M Steele1, Jane E Carreiro2, Judith Haug Viola2, Josephine A Conte2, Lance C Ridpath2. 1. From the Department of Osteopathic Medical Education (Dr Steele) and the Department of Assessment and Educational Development (Mr Ridpath) at the West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg; the Department of Osteopathic Manipulative Medicine (OMM) at the University of New England College of Osteopathic Medicine in Biddeford, Maine (Dr Carreiro); the Department of Emergency Medicine at Duke University in Durham, North Carolina (Dr Viola); and the Maine Dartmouth Family Medicine Residency in Augusta, Maine (Dr Conte). Dr Steele is now retired from WVSOM as professor emerita and has established a private OMM practice ksteele@osteo.wvsom.edu. 2. From the Department of Osteopathic Medical Education (Dr Steele) and the Department of Assessment and Educational Development (Mr Ridpath) at the West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg; the Department of Osteopathic Manipulative Medicine (OMM) at the University of New England College of Osteopathic Medicine in Biddeford, Maine (Dr Carreiro); the Department of Emergency Medicine at Duke University in Durham, North Carolina (Dr Viola); and the Maine Dartmouth Family Medicine Residency in Augusta, Maine (Dr Conte). Dr Steele is now retired from WVSOM as professor emerita and has established a private OMM practice.
Abstract
CONTEXT: Childhood acute otitis media (AOM) is highly prevalent. Its usual sequela of middle ear effusion (MEE) can lead to conductive hearing loss, for which surgery is commonly used. OBJECTIVE: To evaluate the efficacy of an osteopathic manipulative treatment (OMT) protocol on MEE resolution following an episode of AOM. The authors hypothesized that OMT provided adjunctively to standard care for young children with AOM would reduce the duration of MEE following the onset of AOM. METHODS: We compared standard care only (SCO) and standard care plus OMT (SC+OMT) for the duration of MEE following AOM. Patients were aged 6 months to 2 years. The SC+OMT group received OMT during 3 weekly visits. Weekly tympanometric and acoustic reflectometer (AR) readings were obtained from all patients. RESULTS: There were 52 patients enrolled, with 43 completing the study and 9 dropping out. No demographic differences were noted. Only ears from each patient with abnormal tympanograms at entry were included. There were 76 ears in the tympanogram analysis (38 from SCO; 38 from SC+OMT) and 61 ears in the AR data analysis (31 from SCO; 30 from SC+OMT). Dependence of bilateral ear disease noted in AR readings was accounted for in statistical analysis. Tympanogram data demonstrated a statistically significant improvement in MEE at visit 3 in patients in the SC+OMT group (odds ratio, 2.98; 95% confidence interval, 1.16, 7.62; χ(2) test for independence, P=.02). The AR data analysis showed statistically significant improvement at visit 3 for the SC+OMT group (z=2.05; P=.02). There was no statistically significant change in MEE before or immediately after the OMT protocol. CONCLUSION: A standardized OMT protocol administered adjunctively with standard care for patients with AOM may result in faster resolution of MEE following AOM than standard treatment alone. (ClinicalTrials.gov number NCT00520039.).
RCT Entities:
CONTEXT: Childhood acute otitis media (AOM) is highly prevalent. Its usual sequela of middle ear effusion (MEE) can lead to conductive hearing loss, for which surgery is commonly used. OBJECTIVE: To evaluate the efficacy of an osteopathic manipulative treatment (OMT) protocol on MEE resolution following an episode of AOM. The authors hypothesized that OMT provided adjunctively to standard care for young children with AOM would reduce the duration of MEE following the onset of AOM. METHODS: We compared standard care only (SCO) and standard care plus OMT (SC+OMT) for the duration of MEE following AOM. Patients were aged 6 months to 2 years. The SC+OMT group received OMT during 3 weekly visits. Weekly tympanometric and acoustic reflectometer (AR) readings were obtained from all patients. RESULTS: There were 52 patients enrolled, with 43 completing the study and 9 dropping out. No demographic differences were noted. Only ears from each patient with abnormal tympanograms at entry were included. There were 76 ears in the tympanogram analysis (38 from SCO; 38 from SC+OMT) and 61 ears in the AR data analysis (31 from SCO; 30 from SC+OMT). Dependence of bilateral ear disease noted in AR readings was accounted for in statistical analysis. Tympanogram data demonstrated a statistically significant improvement in MEE at visit 3 in patients in the SC+OMT group (odds ratio, 2.98; 95% confidence interval, 1.16, 7.62; χ(2) test for independence, P=.02). The AR data analysis showed statistically significant improvement at visit 3 for the SC+OMT group (z=2.05; P=.02). There was no statistically significant change in MEE before or immediately after the OMT protocol. CONCLUSION: A standardized OMT protocol administered adjunctively with standard care for patients with AOM may result in faster resolution of MEE following AOM than standard treatment alone. (ClinicalTrials.gov number NCT00520039.).
Authors: Pierre Côté; Jan Hartvigsen; Iben Axén; Charlotte Leboeuf-Yde; Melissa Corso; Heather Shearer; Jessica Wong; Andrée-Anne Marchand; J David Cassidy; Simon French; Gregory N Kawchuk; Silvano Mior; Erik Poulsen; John Srbely; Carlo Ammendolia; Marc-André Blanchette; Jason W Busse; André Bussières; Carolina Cancelliere; Henrik Wulff Christensen; Diana De Carvalho; Katie De Luca; Alister Du Rose; Andreas Eklund; Roger Engel; Guillaume Goncalves; Jeffrey Hebert; Cesar A Hincapié; Maria Hondras; Amanda Kimpton; Henrik Hein Lauridsen; Stanley Innes; Anne-Laure Meyer; David Newell; Søren O'Neill; Isabelle Pagé; Steven Passmore; Stephen M Perle; Jeffrey Quon; Mana Rezai; Maja Stupar; Michael Swain; Andrew Vitiello; Kenneth Weber; Kenneth J Young; Hainan Yu Journal: Chiropr Man Therap Date: 2021-02-17