30903 

Roos S., Steinbauer U., Amann P. 

osteopathie.steinbauer@web.de 

Akademie für Osteopathie (AFO), Deutschland

Do osteopathic treatments improve the symptoms of headache and/or sinus pressure in patients with Chronic Rhino sinusitis (CRS)? A randomized controlled trial 

Sinusitis, Chronic Disease, Osteopathic Treatment 

Akademie für Osteopathie (AFO), Deutschland 

October 2006 

Germany 

 Abstract:
Background:
Chronic rhino-sinusitis (CRS) is one of the most common illnesses with which patients present in the field of otorhinolaryngology. It has significant negative effects on the patient's quality of life and impairs the patient both physically and emotionally. The first choice of therapy is the administration of antibiotics.
Objective:
To investigate whether osteopathic treatments improve the symptoms of headache and/or sinus pressure in patients with CRS.
Study design:
This study is a randomized controlled interventional study which compares two cohorts: a group which received treatment (osteopathic group) and a group without treatment (control group). A follow-up was conducted 4 months after completion of treatment.
Setting:
3 licensed osteopaths of the European College of Osteopathy C.O.E. Munich conducted the study in their private practices. Participants were recruited among the inhabitants of Munich.
Patients:
61 patients (15 male, 45 female, mean age 43.5) with diagnoses of chronic rhino-sinusitis were randomised into 2 groups: 31 in the osteopathic group and 30 in the control group. One patient in the control group did not complete the study.
Intervention:
The osteopathic group was treated 5 times at intervals of two weeks. The control group was not treated for 10 weeks and then also received 5 treatments at two week intervals. The diagnosis of osteopathic dysfunction was ascertained in both the cranium and viscera according to a standardised clinical findings protocol. Treatment was given based on individual patient findings.
Main outcome measures:
The primary parameter was subjectively felt headache and/or sinus pressure measured via numeric rating scale (NRS). Overall symptomatology was assessed using the Sinonasal Assessment Questionnaire (SNAQ-11).
Results:
A direct comparison between the osteopathic and control groups using the primary parameter of “intensity of headache and/or sinus pressure” produced a statistical significance in favour of the osteopathic group (p=0.039, CI=-3.2 to -0.1 and p=0.002, 95% CI= -3.3 to -0.3 respectively). During the course of the study (beginning/end), the osteopathic group reported an improvement in subjectively felt headaches from 3.2 to 1.7 on the NRS (47%, p=0.011, 95% CI=0.37 to 2.60) and an improvement in sinus pressure from 3.7 to 2.1 (43%, p=0.002, 95% CI=0.61 to 2.55), in contrast to the control group, who reported slightly worsened symptoms. The parameter “frequency of headache and/or sinus pressure” also displayed a statistical significance (p=0.001) between the two groups, with an improvement of 47% reported by the osteopathic group. The SNAQ-11 also exhibited a similar trend. Possible distortion of the results by external influences was compensated for by sensitivity analyses. A follow-up of all patients treated (n=51) 4 months after completion of the last patient’s treatment confirmed the sustainability of the treatment method with an additional slight improvement in the results.
Conclusion:
The positive evidence for the effectiveness of osteopathic treatments for patients with CRS found by this study is promising. Five osteopathic treatments within an eight-week period had a clinically relevant bearing on overall symptomatology and pain in CRS. Osteopathy appears to be an effective form of producing sustainable results in the treatment of patients with CRS. Further studies should follow to substantiate these findings. 

Finished 

Thesis/Dissertation, Randomized Controlled Trial 

German 

November 2006