TY - JOUR
T1 - Efficacy of osteopathic manipulation as an adjunctive treatment for hospitalized patients with pneumonia
T2 - A randomized controlled trial
AU - Noll, Donald R.
AU - Degenhardt, Brian F.
AU - Morley, Thomas F.
AU - Blais, Francis X.
AU - Hortos, Kari A.
AU - Hensel, Kendi
AU - Johnson, Jane C.
AU - Pasta, David J.
AU - Stoll, Scott T.
N1 - Funding Information:
The clinical trial was funded by a consortium of foundations, including the Foundation for Osteopathic Health Services, Osteopathic Heritage Foundation, Brentwood Foundation, Colorado Springs Osteopathic Foundation, Muskegon General Osteopathic Foundation, Northwest Oklahoma Osteopathic Foundation, Osteopathic Founders Foundation, Osteopathic Institute of the South, and Quad City Osteopathic Foundation. The Osteopathic Research Center at the University of North Texas Health Science Center provided administrative and fiscal oversight of the A.T. Still University in its primary role of coordinating the clinical trial. The authors thank MOPSE project manager, Kenneth Pamperin, MS; the voting members of the data and safety monitoring board, Michael Seffinger, DO, Eric Hurwitz, DC, PhD, and Michael Pierschbacher, PhD; and ATSU scientific writer, Deborah Goggin, MA. The authors also thank those personnel at participating sites who provided technical support: Lori Dillard, DO, Theodore Jordan, DO, David Mason, DO, Alvin Mathé, DO, Patty DiVito, RN, Kimberly Fulda, DrPH, Chandan Gupte, MA, Myra Ritz, Trina Williams, BS, Jill Dion, Jacqueline Drost-Miller, Asma Salam, MD, Janine Shinkle, Leslie Zang, Bryan Krusniak, MBA, Linda Sutton, BS, and des Anges Cruser, PhD. We thank all the OMT specialists and resident physicians who provided treatments to MOPSE subjects. Finally, the authors thank John Morley, MB, BCh, for his scientific expertise during the study as the Project Consultant.
PY - 2010/3/19
Y1 - 2010/3/19
N2 - Background: The Multicenter Osteopathic Pneumonia Study in the Elderly (MOPSE) is a registered, double-blinded, randomized, controlled trial designed to assess the efficacy of osteopathic manipulative treatment (OMT) as an adjunctive treatment in elderly patients with pneumonia.Methods: 406 subjects aged ≥ 50 years hospitalized with pneumonia at 7 community hospitals were randomized using concealed allocation to conventional care only (CCO), light-touch treatment (LT), or OMT groups. All subjects received conventional treatment for pneumonia. OMT and LT groups received group-specific protocols for 15 minutes, twice daily until discharge, cessation of antibiotics, respiratory failure, death, or withdrawal from the study. The primary outcomes were hospital length of stay (LOS), time to clinical stability, and a symptomatic and functional recovery score.Results: Intention-to-treat (ITT) analysis (n = 387) found no significant differences between groups. Per-protocol (PP) analysis (n = 318) found a significant difference between groups (P = 0.01) in LOS. Multiple comparisons indicated a reduction in median LOS (95% confidence interval) for the OMT group (3.5 [3.2-4.0] days) versus the CCO group (4.5 [3.9-4.9] days), but not versus the LT group (3.9 [3.5-4.8] days). Secondary outcomes of duration of intravenous antibiotics and treatment endpoint were also significantly different between groups (P = 0.05 and 0.006, respectively). Duration of intravenous antibiotics and death or respiratory failure were lower for the OMT group versus the CCO group, but not versus the LT group.Conclusions: ITT analysis found no differences between groups. PP analysis found significant reductions in LOS, duration of intravenous antibiotics, and respiratory failure or death when OMT was compared to CCO. Given the prevalence of pneumonia, adjunctive OMT merits further study.
AB - Background: The Multicenter Osteopathic Pneumonia Study in the Elderly (MOPSE) is a registered, double-blinded, randomized, controlled trial designed to assess the efficacy of osteopathic manipulative treatment (OMT) as an adjunctive treatment in elderly patients with pneumonia.Methods: 406 subjects aged ≥ 50 years hospitalized with pneumonia at 7 community hospitals were randomized using concealed allocation to conventional care only (CCO), light-touch treatment (LT), or OMT groups. All subjects received conventional treatment for pneumonia. OMT and LT groups received group-specific protocols for 15 minutes, twice daily until discharge, cessation of antibiotics, respiratory failure, death, or withdrawal from the study. The primary outcomes were hospital length of stay (LOS), time to clinical stability, and a symptomatic and functional recovery score.Results: Intention-to-treat (ITT) analysis (n = 387) found no significant differences between groups. Per-protocol (PP) analysis (n = 318) found a significant difference between groups (P = 0.01) in LOS. Multiple comparisons indicated a reduction in median LOS (95% confidence interval) for the OMT group (3.5 [3.2-4.0] days) versus the CCO group (4.5 [3.9-4.9] days), but not versus the LT group (3.9 [3.5-4.8] days). Secondary outcomes of duration of intravenous antibiotics and treatment endpoint were also significantly different between groups (P = 0.05 and 0.006, respectively). Duration of intravenous antibiotics and death or respiratory failure were lower for the OMT group versus the CCO group, but not versus the LT group.Conclusions: ITT analysis found no differences between groups. PP analysis found significant reductions in LOS, duration of intravenous antibiotics, and respiratory failure or death when OMT was compared to CCO. Given the prevalence of pneumonia, adjunctive OMT merits further study.
UR - http://www.scopus.com/inward/record.url?scp=77954741035&partnerID=8YFLogxK
U2 - 10.1186/1750-4732-4-2
DO - 10.1186/1750-4732-4-2
M3 - Article
C2 - 20302619
AN - SCOPUS:77954741035
VL - 4
JO - Osteopathic Medicine and Primary Care
JF - Osteopathic Medicine and Primary Care
SN - 1750-4732
M1 - 2
ER -