Albers 201837 | OMTh | Direct and indirect techniques (muscle energy, MFR, HVLA, functional techniques, and balanced ligamentous tension) and cranial/sacral techniques. | SC | Clinician directed | Pharmaceutical use NR but patients were excluded if they underwent manual therapy treatment or alternative treatment procedures during the study period. |
Altinbilek 201841 | OMTh + Exercise | Standardized mobilization and compression for bilateral patellofemoral and tibiofemoral joints followed by a lower extremity pumping technique. These techniques are taught to the patient to apply at home as well. | Exercise consisted of quadriceps muscle strengthening exercise, leg lifting, and muscle stretching such as iliotibial band, hamstring stretching, strengthening abductor and adductor muscles of the hip. | Per protocol | No - Prevented from taking non-steroidal anti-inflammatory drugs 1 week before and during the study. Paracetamol up to 3g/daily was allowed and drugs for systemic conditions continued. |
Burton 2000 49 | OMTh | Soft tissue stretching in combination with low amplitude passive articulatory maneuvers and high velocity thrust to the lumbar spine and buttock musculature. | Chemonucleolysis under general anesthesia, a single dose of chymopapain. | Clinician directed | No - Patients with previous manipulations on the same area were excluded. |
Chown 200852 | OMTh | Soft tissue massage, inhibition, muscle stretching, muscle energy, high velocity thrust (varying), articulation, mobilization, exercise advice, discussion of psychosocial issues, education, nutritional/ dietary advice. | Group exercise: Problem identification, anatomy education, home stretching exercise programme, basic postural setting use of transverses, multifidus. Manipulative physiotherapy: Education/advice, joint mobilization, soft tissue mobilization, global exercise for mobility, electrotherapy, postural correction. | Clinician directed | No - Patients with manipulations such as physiotherapy, acupuncture in the previous 3 months were excluded as well as users of steroids and anticoagulants. |
Cuccia 201043 | OMTh | MFR, joint articulation, membranous tension, muscle energy, high-velocity, low-amplitude thrust and cranial-sacral therapy. | Use of an oral appliance, physical therapy, therapies such as hot or cold packs (or both), transcutaneous electrical nerve stimulation. | Clinician directed | Yes - Non-steroidal medications, anti-inflammatory, analgesics and/or muscle relaxants were allowed when prescribed by their medical practitioner |
Knebl 200242 | OMTh | Treatment was defined as administration of the seven-step Spencer technique which is an articular treatment involving compression, traction, and muscle energy in various planes and axes. | The 7 positions of the Spencer technique without administration of the actual corrective forces (isometric muscle contraction). | Per protocol | NR |
Licciardone 200338 | OMTh | Combination of MFR, strain–counter strain, muscle energy, soft tissue, high-velocity–low-amplitude thrusts, and cranial–sacral. | ROM activities, light touch, and simulated OMTh techniques. | Clinician directed | Yes - Usual or other low back care allowed in both arms except OMTh or chiropractic manipulation. |
Licciardone 201350 | OMTh | The lumbosacral, iliac, and pubic regions were targeted using high-velocity, low-amplitude thrusts; moderate velocity, moderate-amplitude thrusts; soft tissue stretching, kneading, and pressure; MFR; positional treatment of myofascial tender points; and isometric muscle activation. | Sham OMTh involved hand contact, active and passive range of motion, and techniques that simulated OMTh but used such maneuvers as light touch, improper patient positioning, purposefully misdirected movements, and diminished physician force. | Clinician directed | Yes - Patients could self-initiate LB cotreatments including prescription and non-prescription drugs, exercise programs, lumbar supports, complementary, alternative medicine and physical therapies. |
Marske 201844 | OMTh & OMTh + Gabapentin | Treatment modalities included MFR, muscle energy, counter strain, facilitated positional release, articular ligamentous, high velocity/low amplitude, and cranial sacral OMTh. Indirect moving to direct as tolerated by the patient. | Gabapentin with variable dose (300mg to 900mg/day). | Clinician directed | Concurrent medications were continued. |
Marti-Salvador 201848 | Diaphragm OMTh | Lumbar MFR, normalization of the iliolumbar ligament, pumping, traction to the lumbar and sacral regions, techniques directed to the diaphragm included pumping, inhibition, muscle stretching, and a global abdominal hemodynamic maneuver. | Manual contact was applied but with no therapeutic intention. | Per protocol | Yes - Cointerventions were not analyzed - a noted limitation of the study. |
Papa 201245 | OMTh | Different techniques were used based on the results of the exam, objective techniques were performed on any body part that the osteopath found to be correlated with the disorder and the patient's functional limitation with considerations to myofascial, visceral, articulating and head structures. | Postural examination and palpation of non-specific different parts of the body in different positions supine. | Clinician directed | Yes - Patients were subjected to the usual therapy established as a result of medical specialist visits but were not reported. |
Schwerla 200840 | OMTh | Osteopathic techniques included direct techniques (high velocity, muscle energy, MFR), indirect techniques (functional techniques, balanced ligamentous tension), visceral and/or cranial techniques. | Inert therapeutic ultrasound. | Clinician directed | Yes - Excluded patients with concomitant physical therapy, corticosteroid use, anticoagulants. Patients kept a diary of analgesic and muscle relaxant use. |
Silva 201846 | OMTh | Osteopathic manipulation technique to the stomach followed by the liver. | Placebo manipulation technique | Per protocol | No - Patients using analgesics, muscle relaxants and anti-inflammatory drugs in the 5 days prior to the intervention were excluded. |
Stepnik 201839 | OMTh | Osteopathic techniques employed 5 specific techniques to the anterior neck region. These included superficial fascia stretch, pretracheal fascia stretch, carotid sheath stretches, deep cervical fascia stretches, and suspensory ligament of pleural cupula stretch | Laser therapy using Polaris 2 laser (turned off) | Per protocol | NR |
Tamer 201747 | vOMTh | Soft tissue mobilization, muscle-energy techniques, manipulation and mobilization for lumbar and thorax regions, lymphatic and liver pumping techniques, pelvic floor, diaphragm relaxation techniques, arterial, venous and neural techniques, fascial mobilization for visceral organs. | Soft-tissue mobilizations, muscle-energy techniques, manipulation and mobilization for lumbar and thorax regions. | Clinician directed | Yes - Physiotherapy used in conjunction with both treatment arms aimed at spinal stabilization strengthening and stretching. |
Vismara 201251 | OMTh + SE | High-velocity, low-amplitude thrust in thoracic spine, cranial techniques, and MFR at the practitioner's discretion. | Active exercises, and education: reinforcing and stretching of the back muscles; self-mobilizing the spine and pelvis; posture and breathing techniques; providing patients with correct ergonomic knowledge for the safe use of the spine and information on the changes in spinal physiology, pain, and posture as related to obesity and other risk factors. | Clinician directed | NR |