Monday, May 23, 2011

Osteopathic Manipulative Treatment and Vertigo

OBJECTIVE: To assess the safety and feasibility of studying osteopathic manipulative treatment and its potential effectiveness for patients with vertigo.
DESIGN: A nonrandomized pilot study.
SETTING: Outpatient clinic affiliated with a teaching hospital and osteopathic medical school.
PATIENTS: The subjects were older than 18 years of age, with the diagnosis of vertigo for longer than 3 months.
INTERVENTION: The patients were treated with osteopathic manipulative treatment (OMT).
MAIN OUTCOME MEASUREMENTS: Treatment effectiveness was measured with the use of the Dizziness Handicap Inventory (DHI), a validated symptom inventory. Intensity and duration of adverse effects after OMT were used to measure study safety.
RESULTS: Of the 18 patients who were recruited all 18 (100%) met the inclusion criteria and were enrolled in the study. Sixteen patients (88.9%) completed the treatment course with OMT, and data with respect to the DHI were obtained from all 16 (100%). Significant improvement (P<.001) in total and subcomponent DHI scores was observed after completion of treatment. Of the 8 patients with moderate pretest scores, 7 (87.5%) had mild post-test scores after undergoing OMT, and of the 8 patients with severe pretest scores, 4 (50%) had mild post-test scores. Of the 18 enrolled patients, 3 (16.7%) experienced an exacerbation of their vertigo, and 5 (27.8%) experienced muscle soreness after OMT. These adverse effects were mild and transient, not lasting longer than 24 hours.
CONCLUSIONS: This study showed that OMT is generally well tolerated in patients with vertigo. It also demonstrated that it is feasible to recruit a population of patients with vertigo who can complete a course of OMT and collect data by using the DHI. A randomized control trial that examines the efficacy of OMT in patients with vertigo is warranted, given that OMT may be a reasonable treatment for vertigo and the functional impairment associated with it.

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