Giorn. It. Ost. Gin. Giornale Italiano di Ostetricia e Ginecologia CIC Edizioni Internazionali 2014 March-April; 36(2): 339–341. ISSN: 0391-9013
Published online 2014 May 30.

Randomized clinical trial on the effects of osteopathic treatment in menopausal women

G. NOCCIOLI,1 N. NOCCIOLI,2 S. GRAZIOSI,3 M. PETRACCA,4 O. GAMBARDELLA,5 and F. DAMMANDO6

1Gynecologist and Obstetrician, freelance Physician, “Sapienza” University of Rome, Rome, Italy
2Student, Degree Course in Surgery and Medicine, “Sapienza” University of Rome, Rome, Italy
3Endocrinologist, Homeopath, General Pathologist, freelance Physician, “San Pietro FBF” Hospital, Rome, Italy
4Physiotherapist, Osteopath, “San Pietro FBF” Hospital, Rome, Italy
5Physiotherapist, Osteopath, “CERDO” School of Osteopathy, Rome, Italy
6Osteopath, freelance Physician

Author for correspondence: Giuseppe Noccioli, e-mail: giuseppenoccioli@tiscali.it

Summary

This randomized clinical trial concerns the value of osteopathic treatment in menopausal women. Two randomized groups of 10 patients each filled in two questionnaires before and after 3 months: group A without treatment and group B after an osteopathic treatment. The group B had good results in term of quality of life after treatment, till long period of follow-up.

Keywords: Menopause, Osteopathy

Keywords: Menopausa, Osteopatia

Introduction

In recent decades, the prolongation of life expectancy has meant that the postmenopausal period represents about a third of a woman’s life. This period, especially at the beginning, is accompanied by a set of symptoms psychoneuroendocrine amending women’s homeostasis. The woman is in a constant search for adaptation, so as to represent a critical period in the experience of many women (1).

The depletion of ovarian function with hypoestrogenism that goes with it, is the cause of many symptoms of menopause (which strictly speaking is the last menstrual flow, but collective experience indicates that in the period following the last menstrual period) like hot flashes, trouble sleep, memory problems, attention problems, irritability, sudden mood changes, arthralgia, myalgia, depression mood, dyspareunia, decreased libido. Those are just some of the symptoms that can accompany postmenopausal women (2, 3). More late symptoms may be related to atrophy genitourinary estrogen deficiency. Other troubles are coronary artery disease, hypertension, diabetes, osteoporosis, which are easily linked to estrogen deficiency.

Osteopathy is a manual medicine that takes care of stressing the resources of each individual, in order to stimulate his ability of self-regulation and of self-healing (4, 5). This discipline is based on the precise knowledge of the physiology and anatomy of the human body. From the osteopathic point of view the lack of mobility of the tissues is at the basis of changes in the overall balance of each individual, and of the onset of pathological condition. Osteopathy deals with treating mobility restrictions of the structures, and restoring a good function of the whole. The osteopathic manipulative treatment (OMT) uses the hands to diagnose and to treat somatic lesions in order to stimulate the homeostasis of the persons, caring to identify the origin of the biomechanical imbalance in relation to the disorder reported by the patient.

Purpose of the study

To evaluate the long-term effect of osteopathic treatment on symptoms of menopause and its importance in improving the quality of life of menopausal women.

Materials and methods

During a period of three months two groups of subjects were studied: group A of 10 subjects that received no treatment and group B of 10 patients undergoing osteopathic treatment.

All persons admitted to take part in the study were postmenopausal for at least 12 months, showed autonomic disturbances caused in the pre or post-menopausal. The subjects were randomized in the two groups according to the criteria of simple randomization (www.random.org/integers/). The initial number of patients was 57 women. From this number they excluded the women treated with hormone therapy, the women operated to thyroid, and those who undergone gynecological oncological surgery or in the previous 12 months had been subjected to any form of breast surgery for cancer.

The final number was of only 20 patients in the study, divided into the above mentioned two groups. Both groups completed at the beginning and at the end of the study two questionnaires validated for menopause: the MENopause specific Quality of Life questionnaire -MENQol (6) and the Menopause Rating Scale (MRS) (7). The B group filled in the questionnaires also 9 months after the end of the study. The statistical evaluation of the results was carried out using the chiquadro test.

Results

The group A with a starting score average in MENQoL of 101.8 ± 45.7 and 12.8 ± 8.02 in MRS has a final score average of 110.2 ± 34.09 in MENQoL (−8.6 difference with P = 0.64731) and 13.1 ±7.15 in MRS (difference − 0, 5; P = 0.9307). These differences are not statistically significant. The group B with a starting score average MENQoL 124.5 ± 17.9 and MRS 18.8 ± 6.5, has, after 3 months of OMT, the average score of 95.2 ± 26.02 in MENQoL (difference 29.3 with P = 0.009) and of 9.2 ± 6.28 in MRS. (difference 9.6 with P = 0.0036). These differences are statistically significant (P <0.01). The administration of the questionnaires after a median follow-up of 9 months got the following scores: MENQol 94 and MRS 8,7; these are not statistically different from those obtained in the administration the post-treatment questionnaire, while maintaining a slight advantage over the score before treatment.

Table 1 summarizes the characteristics of the groups A and B and the obtained results.

TABLE 1TABLE 1
GROUPS CHARACTERISTICS AND RESULTS.

There is a clear difference between the results in the questionnaires administered to the groups before and after the period of observation. While in the group A the difference was not significant, in the group B treated with osteopathic treatment, the difference is significant. After the period of follow-up of more than nine months, the benefits obtained by the treatment were maintained. The results obtained in the questionnaire administered before the follow-up, not significantly differ from those obtained after the follow-up.

Conclusions

In patients undergoing osteopathic treatment there was an improvement of the psychophysical balance and of the quality of life. The questionnaires administered before and after treatment and following the follow-up period without any treatment, demonstrate the improvement of the general conditions of the patients and their state of well-being, with a significant reduction of hot flashes, night sweats and of the headache episodes.

In the study group subjected to osteopathic treatment there was a not homogeneous improvement of symptoms such as palpitations, anxiety, irritability, insomnia and back pain.

The osteopathy is then a useful tool for improving the quality of life of menopausal patients.

Devoid of side effects, with no environmental impact, freed from the use of potentially toxic chemicals, osteopathy acts soliciting the best personal resources of the individual stimulating the capacity of self-regulation. Therefore, this discipline can be considered, alone or with the help of other disciplines integrated or conventional, in the treatment of menopausal syndrome.

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