Table 2.
Description of interventions and main results of the included studies.
| Author/Year | Description of Interventions | Main Results |
|---|---|---|
| Müller et al. (2002) [29] |
OMT group: specific OMT During each session an osteopath performed an evaluation of the suture occipito mastoidea, epigastric zone, and colon in relation to small intestine and to parietal planes. According to the severity (0–2), the osteopath treated the dysfunctional areas. Each technique was performed for about 8 min. CG: sham OMT The patients underwent an osteopathic examination of the spine from T11 to L5, ribs 11 and 12, symphysis, sacroiliac joint and coccygeum. Both groups were allowed to take medications, except during the 48 h before the treatment |
Abdominal pain (VAS) OMT: baseline—30 days (p = 0.0002) baseline—45 days (p = 0.0103) baseline—60 days (p < 0.0001) baseline—75 days (p < 0.0001) CG: baseline—75 days (p = 0.017) OMT vs. CG: at 75 days in favor of OMT (p < 0.0001) Diarrhea OMT vs. CG: at 60 days in favor of OMT (p = 0.0225) at 75 days in favor of OMT(p = 0.0165) Constipation OMT vs. CG: at 60 days in favor of OMT (p = 0.0183) at 75 days in favor of OMT (p = 0.0080) |
| Hundscheid et al. (2007) [30] |
OMT group: black box method OMT was performed adapting the treatment to the clinical history of each patient. Patients could not to take any medication used in the standard care of IBS, and they did not nor receive the advice to consume more fiber. CG: standard care Patients were advised to have a diet rich in fiber. They could take extra fiber or laxatives in case of constipation, loperamide for predominant diarrhea, and mebeverine for cramps. |
IBSQOL OMT: baseline—month 3: from 111 ± 22 to 125 ± 20 (p < 0.009) baseline—month 6: from 111 ± 22 to 129 ± 19 (p < 0.009) CG: no statistically significant differences (p > 0.05) Symptom score OMT: no statistically significant differences (p > 0.05) CG: no statistically significant differences (p > 0.05) OMT vs. CG: OMT was superior to CG (p = 0.02) FBDSI OMT: baseline—month 6: from 174 ± 36 to 74 ± 64 (p < 0.0001) CG: baseline—month 6: from 171 ± 31 to 119 ± 48 (p < 0.0001) OMT vs. CG: OMT was superior to CG (p = 0.02) AEs None. OMT: slight increase in the severity of the symptoms after the first session which resolved quickly. |
| Florance et al. (2012) [31] |
OMT group: standardized OMT During each session an osteopath performed a physical examination and treatment of the spine and the abdomen. The operator used both direct techniques (hand pressure on each segment of the spine for 90 s) and an indirect technique (pressure on the segment using hands, knees, or the chest). Each session was completed by visceral osteopathy. CG: sham OMT The osteopath touched the same areas treated in the OMT group (spine and abdomen) with a gentle massage. |
IBS severity score OMT: baseline—day 7: 196 ± 88 (p < 0.01) baseline—day 28: 224 ± 102 (p < 0.01) CG: baseline—day 7: 244 ± 75 (p = 0.04) baseline—day 28: no statistically significant differences (p = 0.07). OMT vs. CG: at day 7 in favor of OMT (p = 0.01) at day 28 no differences (p = 0.8). Stool frequency and consistency No statistically significant differences (p > 0.05) AEs None. |
| Attali et al. (2013) [32] |
OMT group: standardized OMT The osteopath performed abdominal and sacral gentle manipulations. At the beginning of the session, the operator applied a global visceral technique, performing gentle vibrations with both hands. Then, the areas addressed as highly sensitive by the patients were treated by pressing and vibrating the fingers. Eventually, the osteopath performed a sacral technique. CG: sham OMT Superficial massage in the same points of the OMT. Movements were similar in variety and duration. After 3 sessions of either OMT or sham OMT, the two groups switched to the other intervention: group A received sham OMT in Phase 1 and OMT in Phase 2, while group B received OMT in Phase 1 and sham OMT in Phase 2. |
IBS symptoms Phase 1 OMT (group B): baseline—week 5: constipation (p = 0.022) diarrhea (p = 0.016) abdominal distension (p = 0.001) abdominal pain (p = 0.005) CG (group A): baseline—week 5: abdominal distension (p = 0.026) abdominal pain (p = 0.001) OMT vs. CG: at week 5 no statistically significant differences (p > 0.05). Phase 2 OMT (group A): week 5—week 11: abdominal distension (p = 0.002) abdominal pain (p = 0.003) CG (group B): week 5—week 11: no differences (p > 0.05) All patients: baseline—week 11: constipation (p < 0.001) diarrhea (p = 0.003) abdominal distension (p < 0.001) abdominal pain (p < 0.001) baseline—1 year: diarrhea (p = 0.029) abdominal distension (p = 0.001) abdominal pain (p < 0.001) |
| Piche et al. (2014) [33] |
OMT group: standardized OMT During each session an osteopath performed a physical examination and treatment of the spine and the abdomen. The operator used both direct techniques (hand pressure on each segment of the spine for 90 s) and an indirect technique (pressure on the segment using hands, knees, or the chest). Each session was completed by visceral osteopathy. CG: no intervention The osteopath offered caring attention and listening without manipulation. |
IBS severity score OMT: baseline—15 days: no statistically significant differences (p = 0.3) baseline—30 days: 67 (16–116), p = 0.05 baseline—45 days: 50 (12–99), p = 0.01 baseline—60 days: 32 (15–106), p = 0.01 CG: no statistically significant differences (p > 0.05) OMT vs. CG: at 15 days no statistically significant differences (p > 0.05) at 30 days in favor of OMT (p = 0.01) at 45 days in favor of OMT (p = 0.04) at 60 days in favor of OMT (p = 0.05) IBDq OMT: baseline—15 days: no statistically significant differences (p = 0.6) baseline—30 days: 200 (177–213), p = 0.01 baseline—45 days: 204 (174–216), p = 0.01 baseline—60 days: 196 (174–209), p = 0.05 CG: no statistically significant differences (p > 0.05) OMT vs. CG: at 15, 30 and 60 days no statistically significant differences (p > 0.05) at 45 days in favor of OMT (p = 0.05) AEs None. OMT: brief sensation of fatigue immediately after intervention. |
| Bouchoucha et al. (2018) [34] NCT02932111 |
OMT group: standardized OMT Friction in the hourly sense, vibration, inhibitions or rebounds in the abdominal projection of the junction, where there is the trigger zone. CG: sham OMT The osteopath will mimic the techniques provided in the OMT group without any intention of treatment. |
Ongoing study, hence no reported results. |
Abbreviations: OMT “Osteopathic Manipulative Treatment”, CG “Control Group”, VAS “Visual Analogue Scale”, IBSQOL questionnaire “Irritable Bowel Syndrome Quality Of Life questionnaire”, FBDSI “Functional Bowel Disorder Severity Index”, AEs “Adverse Events”, IBS “Irritable Bowel Syndrome”, IBDq “Inflammatory Bowel Disease questionnaire”, FIS “Fatigue Impact Scale”.