Author Names

Franke, H., Franke, J., Belz, S., Fryer, G.

Reviewer Name

Joy Senkungu, SPT

Reviewer Affiliation(s)

Duke University School of Medicine Department of Physical Therapy

 

Paper Abstract

Background Low back pain (LBP) is a common complaint during pregnancy. This study examined the effectiveness of osteopathic manipulative treatment (OMT) for LBP in pregnant or postpartum women.  Methods Randomized controlled trials unrestricted by language were reviewed. Outcomes were pain and functional status. Mean difference (MD) or standard mean difference (SMD) and overall effect size were calculated.  Results Of 102 studies, 5 examined OMT for LBP in pregnancy and 3 for postpartum LBP. Moderate-quality evidence suggested OMT had a significant medium-sized effect on decreasing pain (MD, −16.65) and increasing functional status (SMD, −0.50) in pregnant women with LBP. Low-quality evidence suggested OMT had a significant moderate-sized effect on decreasing pain (MD, −38.00) and increasing functional status (SMD, −2.12) in postpartum women with LBP.  Conclusions This review suggests OMT produces clinically relevant benefits for pregnant or postpartum women with LBP. Further research may change estimates of effect, and larger, high-quality randomized controlled trials with robust comparison groups are recommended.

 

NIH Risk of Bias Tool

Quality Assessment of Systematic Reviews and Meta-Analyses

  1. Is the review based on a focused question that is adequately formulated and described?
  • Yes
  1. Were eligibility criteria for included and excluded studies predefined and specified?
  • Yes
  1. Did the literature search strategy use a comprehensive, systematic approach?
  • Yes
  1. Were titles, abstracts, and full-text articles dually and independently reviewed for inclusion and exclusion to minimize bias?
  • Yes
  1. Was the quality of each included study rated independently by two or more reviewers using a standard method to appraise its internal validity?
  • Cannot Determine, Not Reported, Not Applicable
  1. Were the included studies listed along with important characteristics and results of each study?
  • Yes
  1. Was publication bias assessed?
  • Yes
  1. Was heterogeneity assessed? (This question applies only to meta-analyses.)
  • Yes

 

Key Finding #1

Osteopathic manual therapy improves low back pain and functional status in postpartum women.

Key Finding #2

Osteopathic manual therapy can be beneficial and there have been minor adverse effects seen through one study, although more research should be done on longevity of results.

 

Please provide your summary of the paper

This study was a systematic review of osteopathic manipulative therapy during and after pregnancy on the low back and pelvic girdle pain. It found that there was a significant improvement in both pain and function in the low back for pregnant women as well as postpartum. Overall greater research is needed for longer periods of time in order to increase the quality of evidence needed to solidify longterm effects.

Please provide your clinical interpretation of this paper.  Include how this study may impact clinical practice and how the results can be implemented.

This paper may impact clinical practice minimally due to a lack of follow-up results. More research would need to be done to see the longevity of decreased pain and increased function in both pregnant women and those who are postpartum. Because there are not many adverse effects and some significant findings, these results can be applied to cases where OMT may be beneficial.