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OMT Improves Acute Hemodynamic Control in Pregnancy by Means of Improved Venous Return

  • Michael A. Seffinger and Justin Brohard
Published/Copyright: May 1, 2014
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Journal of Osteopathic Medicine
From the journal Journal of Osteopathic Medicine Volume 114 Issue 5

Hensel KL, Pacchia CF, Smith ML. Acute improvement in hemodynamic control after osteopathic manipulative treatment in the third trimester of pregnancy [published online August 30, 2013]. Complement Ther Med.2013;21(6):618-626. doi:10.1016/j.ctim.2013.08.008

For over a century, osteopathic physicians have been treating patients with pregnancy-related symptoms using osteopathic manipulative treatment (OMT).1 In an effort to better understand the effectiveness of OMT in these patients, much research has been conducted in this field. More recently, King et al2 reported that prenatal OMT has an impact on the occurrence of meconium-stained amniotic fluid and preterm delivery, and Licciardone et al3,4 found that OMT helps to prevent progressive back-specific dysfunction that typically arises during the third trimester of pregnancy. Related to this research, a recent study by Hensel et al revealed that OMT has an influence on hemodynamic stability and the cardiovascular changes that occur during pregnancy.

Participants of the PROMOTE study (an unpublished clinical trial involving OMT and low back pain in pregnancy) were enrolled in the substudy of Hensel et al if they were between the ages of 18 and 34 years, in the 30th week of pregnancy, and did not satisfy any of the exclusion criteria, including history of syncopal episodes, abruptio placenta, placenta previa, pre-eclampsia, eclampsia, pregnancy-induced hypertension, vaginal bleeding, gestational diabetes, and current injury to the lower extremity. The participants were randomly assigned to 1 of 3 treatment groups: OMT, including standardized soft tissue, articulatory, myofascial release, and muscle energy techniques to the head, neck, abdominal diaphragm, back, pelvis, and pelvic diaphragm (n=25); placebo ultrasound (n=31); or time control (n=34). Baseline measurements were taken, including heart rate, mean arterial pressure, and heart rate variability, followed by a second set of measurements taken after a 5-minute period of head-up tilt or a 4-minute period of heel raises. After a 20-minute treatment period, the same measurements were taken again.

The study revealed no significant changes between groups during the 5-minute head-up tilt period when comparing pretreatment and posttreatment measurements of all 3 variables (P>.36). However, when comparing the OMT group to the placebo ultrasound and time control groups during the 4-minute heel raise periods before and after treatment, the authors found a significant increase in mean arterial pressure (P=.02) and a significant decrease in heart rate (P<.01), indicating enhanced hemodynamic stability. The authors concluded that this impact is not a representation of a direct action on the autonomic nervous system, but rather a manifestation of improved venous return caused by OMT's removal of structural restrictions and somatic dysfunctions. Therefore, the OMT protocol used in this study may be beneficial in improving venous return in pregnant patients.

References

1 Whiting LM . Can the length of labor be shortened by osteopathic treatment?J Am Osteopath Assoc.1911;11:917-921.Search in Google Scholar

2 King HH Tettambel MA Lockwood MD Johnson KH Arsenault DA Quist R . Osteopathic manipulative treatment in prenatal care: a retrospective case control design study. J Am Osteopath Assoc.2003;103(12):577-582.Search in Google Scholar

3 Licciardone JC Buchanan S Hensel KL King HH Fulda KG Stoll ST . Osteopathic manipulative treatment of back pain and related symptoms during pregnancy: a randomized controlled trial[published online September 20, 2009]. Am J Obstet Gynecol.2010;202(1):43.e1-43.e8. doi:10.1016/j.ajog.2009.07.057.10.1097/01.aoa.0000389615.24499.e1Search in Google Scholar

4 Licciardone JC Aryal S . Prevention of progressive back-specific dysfunction during pregnancy: an assessment of osteopathic manual treatment based on Cochrane back review group criteria. J Am Osteopath Assoc.2013;113(10):728-736. doi:10.7556/jaoa.2013.043.10.7556/jaoa.2013.043Search in Google Scholar PubMed

Published Online: 2014-05-01
Published in Print: 2014-05-01

© 2014 The American Osteopathic Association

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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  1. Editorial
  2. The Journal of the American Osteopathic Association: The Next Generation
  3. Wikipedia: Proceed With Caution
  4. Letters
  5. Osteopathic Graduate Medical Education: New Research Standards Needed
  6. An Unexpectedly Progressed Lumbar Herniated Disk
  7. Response
  8. AOA Communication
  9. Official Call
  10. Original Contribution
  11. Somatic Dysfunction and Use of Osteopathic Manual Treatment Techniques During Ambulatory Medical Care Visits: A CONCORD-PBRN Study
  12. Association of Low Back Pain, Somatic Dysfunction, and Lumbar Bone Mineral Density: Reproducibility of Findings
  13. Wikipedia vs Peer-Reviewed Medical Literature for Information About the 10 Most Costly Medical Conditions
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  18. The ‘little m.d.’ or the ‘Big D.O.’: The Path to the California Merger
  19. The Somatic Connection
  20. Manual Therapy Shown to Be Effective for Tension-Type Headache
  21. OMT Improves Acute Hemodynamic Control in Pregnancy by Means of Improved Venous Return
  22. Several Manual Therapies Proven Beneficial for Patients With Chronic Neck Pain
  23. How Much of Your Low Back Pain Is Really in Your Head?
  24. Mechanical Changes of the Brain During Sleep Clear Metabolites and Provide Key Mechanism for Sutherland's Cranial Respiratory Impulse
  25. G.I. Joe: Could Visceral Osteopathy Help Fight the War against IBS?
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https://doi.org/10.7556/jaoa.2014.077
Creative Commons
BY-NC-ND 4.0

Articles in the same Issue

  1. Editorial
  2. The Journal of the American Osteopathic Association: The Next Generation
  3. Wikipedia: Proceed With Caution
  4. Letters
  5. Osteopathic Graduate Medical Education: New Research Standards Needed
  6. An Unexpectedly Progressed Lumbar Herniated Disk
  7. Response
  8. AOA Communication
  9. Official Call
  10. Original Contribution
  11. Somatic Dysfunction and Use of Osteopathic Manual Treatment Techniques During Ambulatory Medical Care Visits: A CONCORD-PBRN Study
  12. Association of Low Back Pain, Somatic Dysfunction, and Lumbar Bone Mineral Density: Reproducibility of Findings
  13. Wikipedia vs Peer-Reviewed Medical Literature for Information About the 10 Most Costly Medical Conditions
  14. Clinical Practice
  15. Effect of Osteopathic Manipulative Therapy in the Attentive Performance of Children With Attention-Deficit/Hyperactivity Disorder
  16. Management of Ionizing Radiation Injuries and Illnesses, Part 2: Nontherapeutic Radiologic/Nuclear Incidents
  17. Special Communication
  18. The ‘little m.d.’ or the ‘Big D.O.’: The Path to the California Merger
  19. The Somatic Connection
  20. Manual Therapy Shown to Be Effective for Tension-Type Headache
  21. OMT Improves Acute Hemodynamic Control in Pregnancy by Means of Improved Venous Return
  22. Several Manual Therapies Proven Beneficial for Patients With Chronic Neck Pain
  23. How Much of Your Low Back Pain Is Really in Your Head?
  24. Mechanical Changes of the Brain During Sleep Clear Metabolites and Provide Key Mechanism for Sutherland's Cranial Respiratory Impulse
  25. G.I. Joe: Could Visceral Osteopathy Help Fight the War against IBS?
  26. Clinical Images
  27. Sever Disease (Calcaneal Apophysitis)
  28. In Your Words
  29. To an Intern: What if You Were the Patient?
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