Brief Report  |   January 2019
Tolerance of Rib Raising Among Hospitalized Patients: A Pilot Study
Author Notes
  • From the Departments of Graduate Medical Education (Drs Chin, Fischione, and Shilian), Internal Medicine (Drs Walter, Bejanishvili, and Wynbrandt) and Family Medicine (Dr Ratay) at University Hospitals–Richmond Medical Center in Richmond Heights, Ohio; the Department of Internal Medicine at Case Western Reserve University School of Medicine in Cleveland, Ohio (Dr Wynbrandt); and the Department of Family Medicine at Lake Erie College of Osteopathic Medicine in Erie, Pennsylvania (Dr Rowane). 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Andrew J. Chin, DO, MS, MPH, University Hospitals–Richmond Medical Center, University Hospitals–Richmond Medical Center, 27155 Chardon Rd, Richmond Heights, OH 44143-1183. Email: andrew.chin@uhhospitals.org
     
Article Information
Osteopathic Manipulative Treatment / Pulmonary Disorders
Brief Report   |   January 2019
Tolerance of Rib Raising Among Hospitalized Patients: A Pilot Study
The Journal of the American Osteopathic Association, January 2019, Vol. 119, 19-23. doi:10.7556/jaoa.2019.003
The Journal of the American Osteopathic Association, January 2019, Vol. 119, 19-23. doi:10.7556/jaoa.2019.003
Web of Science® Times Cited: 1
Abstract

Context: Rib raising is an osteopathic manipulative treatment modality that can help patients with various respiratory conditions to improve their work of breathing. However, the tolerance of this technique in hospitalized patients has not been assessed in a systematic manner. We hypothesized that rib raising would be a well-tolerated treatment modality for hospitalized patients admitted for asthma, pneumonia, chronic obstructive pulmonary disease, and/or congestive heart failure.

Objective: To determine hospitalized patients’ tolerance of rib raising through a prospective pilot study.

Methods: The study included patients at University Hospitals–Richmond Medical Center and University Hospitals–Bedford Medical Center who were admitted for asthma, pneumonia, chronic obstructive pulmonary disease, and/or congestive heart failure between November 1, 2016, and October 31, 2017. Each patient was treated with rib raising, which was performed in a standardized fashion. Immediately after treatment, patients were asked to rate their tolerance of the procedure on a scale of 0 to 10, where 0 represented no discomfort and 10 represented maximum discomfort.

Results: The study population consisted of 87 hospitalized, non–intensive care unit patients. The mean tolerance score for rib raising was 1.18, and the median score was 0. The score was between 0 and 3 in 80 patients (92.0%), between 4 and 6 in 6 patients (6.9%), and between 7 and 10 in 1 patient (1.1%).

Conclusion: Rib raising was shown to be well tolerated by the majority of the patients in the study population.

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