Effect of osteopathic manipulative treatment on length of stay in a population of preterm infants: a randomized controlled trial

Francesco Cerritelli, Gianfranco Pizzolorusso, Francesco Ciardelli, Emiliano La Mola, Vincenzo Cozzolino, Cinzia Renzetti, Carmine D'Incecco, Paola Fusilli, Giuseppe Sabatino, Gina Barlafante, Francesco Cerritelli, Gianfranco Pizzolorusso, Francesco Ciardelli, Emiliano La Mola, Vincenzo Cozzolino, Cinzia Renzetti, Carmine D'Incecco, Paola Fusilli, Giuseppe Sabatino, Gina Barlafante

Abstract

Background: The use of osteopathic manipulative treatment (OMT) in preterm infants has been documented and results from previous studies suggest the association between OMT and length of stay (LOS) reduction, as well as significant improvements in several clinical outcomes. The aim of the present study is to investigate the effect of OMT on LOS in premature infants.

Methods: A randomized controlled trial was conducted on preterm newborns admitted to a single NICU between 2008-2009. N=110 subjects free of medical complications and with gestational age >28 and < 38 weeks were enrolled and randomized in two groups: study group (N=55) and control group (N=55). All subjects received routine pediatric care and OMT was performed to the study group for the entire period of hospitalization. Endpoints of the study included differences in LOS and daily weight gain.

Results: Results showed a significant association between OMT and LOS reduction (mean difference between treated and control group: -5.906; 95% C.I. -7.944, -3.869; p<0.001). OMT was not associated to any change in daily weight gain.

Conclusions: The present study suggests that OMT may have an important role in the management of preterm infants hospitalization.

Trial registration: ClinicalTrials.gov, NCT01544257.

Figures

Figure 1
Figure 1
Flowchart for the selection of the study population.
Figure 2
Figure 2
Multivariate linear regression for LOS.
Figure 3
Figure 3
Multivariate linear regression for weight gain.

References

    1. Slattery MM, Morrison JJ. Preterm delivery. Lancet. 2002;360(9344):1489–1497. doi: 10.1016/S0140-6736(02)11476-0.
    1. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;371(9606):75–84. doi: 10.1016/S0140-6736(08)60074-4.
    1. Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, Rubens C, Menon R, Van Look PF. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010;88(1):31–38. doi: 10.2471/BLT.08.062554.
    1. McCormick MC. The contribution of low birth weight to infant mortality and childhood morbidity. N Engl J Med. 1985;312(2):82–90. doi: 10.1056/NEJM198501103120204.
    1. Petrou S, Mehta Z, Hockley C, Cook-Mozaffari P, Henderson J, Goldacre M. The impact of preterm birth on hospital inpatient admissions and costs during the first 5 years of life. Pediatrics. 2003;112(6 Pt 1):1290–1297.
    1. Petrou S. The economic consequences of preterm birth during the first 10 years of life. BJOG. 2005;112(Suppl 1):10–15.
    1. Russell RB, Green NS, Steiner CA, Meikle S, Howse JL, Poschman K, Dias T, Potetz L, Davidoff MJ, Damus K. Cost of hospitalization for preterm and low birth weight infants in the United States. Pediatrics. 2007;120(1):e1–9. doi: 10.1542/peds.2006-2386.
    1. Mistry H, Dowie R, Franklin RC, Jani BR. Costs of neonatal care for low-birthweight babies in English hospitals. Acta Paediatr. 2009;98(7):1123–1129. doi: 10.1111/j.1651-2227.2009.01316.x.
    1. McLaurin KK, Hall CB, Jackson EA, Owens OV, Mahadevia PJ. Persistence of morbidity and cost differences between late-preterm and term infants during the first year of life. Pediatrics. 2009;123(2):653–659. doi: 10.1542/peds.2008-1439.
    1. Bakewell-Sachs S, Medoff-Cooper B, Escobar GJ, Silber JH, Lorch SA. Infant functional status: the timing of physiologic maturation of premature infants. Pediatrics. 2009;123(5):e878–886. doi: 10.1542/peds.2008-2568.
    1. Field T, Diego M, Hernandez-Reif M. Preterm infant massage therapy research: a review. Infant Behav Dev. 2010;33(2):115–124. doi: 10.1016/j.infbeh.2009.12.004.
    1. Vickers A, Ohlsson A, Lacy JB, Horsley A. Massage for promoting growth and development of preterm and/or low birth-weight infants. Cochrane Database Syst Rev. 2004;2 CD000390.
    1. Pizzolorusso G, Turi P, Barlafante G, Cerritelli F, Renzetti C, Cozzolino V, D'Orazio M, Fusilli P, Carinci F, D'Incecco C. Effect of osteopathic manipulative treatment on gastrointestinal function and length of stay of preterm infants: an exploratory study. Chiropr Man Therap. 2011;19:15. doi: 10.1186/2045-709X-19-15.
    1. Ward RC, Hruby RJ, Jerome JA, Jones JM, Kappler RE, Kuchera ML, Kuchera WA, Patterson MM, Rubin BR, Association AO. Foundations for Osteopathic Medicine, 2nd Revised edition edn. : Lippincott Williams; 2002.
    1. Magoun H. 3rd ed. Osteopathy in the Cranial Field. Journal Printing Co: Kirksville, Mo; 1976.
    1. R Development Core Team. R: A language and environment for statistical computing. Vienna, Austria: In: R Foundation for Statistical Computing; 2010.
    1. American Academy of Pediatrics. Committee on Fetus and Newborn. Hospital discharge of the high-risk neonate--proposed guidelines. Pediatrics. 1998;102(2 Pt 1):411–417.
    1. Italian Ministry of Health. Rapporto annuale sull'attività di ricovero ospedaliero - dati SDO 2009. Ministero della salute: In. Roma; 2010.
    1. FASDAC. : Nomenclatore tariffario; 2012.
    1. ISTAT. Consumer price indices, September 2012. Italian National Institute of Statistics: In. Rome; 2012.
    1. Hayden C, Mullinger B. A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic. Complement Ther Clin Pract. 2006;12(2):83–90. doi: 10.1016/j.ctcp.2005.12.005.
    1. Vandenplas Y, Denayer E, Vandenbossche T, Vermet L, Hauser B, Deschepper J, Engelen A. Osteopathy may decrease obstructive apnea in infants: a pilot study. Osteopath Med Prim Care. 2008;2:8. doi: 10.1186/1750-4732-2-8.
    1. Philippi H, Faldum A, Schleupen A, Pabst B, Jung T, Bergmann H, Bieber I, Kaemmerer C, Dijs P, Reitter B. Infantile postural asymmetry and osteopathic treatment: a randomized therapeutic trial. Dev Med Child Neurol. 2006;48(1):5–9. discussion 4.
    1. Narendran V, Visscher MO, Abril I, Hendrix SW, Hoath SB. Biomarkers of epidermal innate immunity in premature and full-term infants. Pediatr Res. 2010;67(4):382–386. doi: 10.1203/PDR.0b013e3181d00b73.
    1. Meltzer KR, Standley PR. Modeled repetitive motion strain and indirect osteopathic manipulative techniques in regulation of human fibroblast proliferation and interleukin secretion. J Am Osteopath Assoc. 2007;107(12):527–536.
    1. Degenhardt BF, Darmani NA, Johnson JC, Towns LC, Rhodes DC, Trinh C, McClanahan B, DiMarzo V. Role of osteopathic manipulative treatment in altering pain biomarkers: a pilot study. J Am Osteopath Assoc. 2007;107(9):387–400.
    1. Longin E, Gerstner T, Schaible T, Lenz T, Konig S. Maturation of the autonomic nervous system: differences in heart rate variability in premature vs. term infants. J Perinat Med. 2006;34(4):303–308.
    1. Henley CE, Ivins D, Mills M, Wen FK, Benjamin BA. Osteopathic manipulative treatment and its relationship to autonomic nervous system activity as demonstrated by heart rate variability: a repeated measures study. Osteopath Med Prim Care. 2008;2:7. doi: 10.1186/1750-4732-2-7.

Source: PubMed

3
Se inscrever