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Effects of Visceral Manipulation Treatment on Women with Infertility and Adults with Low Back Pain

Journal: Unpublished Dissertation Azusa Pacific University, Date: 2021/12, , type of study: systematic review

Full text    (https://dialog.proquest.com/professional/pqdtprof)

Keywords:

acupuncture [48]
female [379]
infertility [17]
low back pain [413]
pregnancy [142]
systematic review [297]
visceral osteopathy [55]
women [333]

Abstract:

Background. Visceral manipulation (VM) is a manual therapy treatment approach applied to the abdominal region that focuses on releasing restrictions around the visceral tissue. There are many benefits of this treatment, ranging from improved digestion to improvement of women’s health conditions, such as endometriosis. Over 6.7 million women currently struggle with the devastating effects of infertility worldwide. Current treatment options include hormone therapy, in-vitro fertilization (IVF), and acupuncture. These options tend to be expensive, carry a variety of short- and long-term health risks, and have not proven to always be effective. Current research suggests that many of the issues contributing to infertility are connected to restrictions within the fascia, scar tissue build-up, and lymphatic congestion. Therefore, we conducted a systematic review (SR) to synthesize the current research on VM. Our purpose was to determine if VM is a more effective treatment option than acupuncture in helping to increase rates of pregnancy in women struggling with infertility. Adult low-back pain (LBP) is a worldwide challenge that has led to a decrease in quality of life and physical activity as well as detrimental increases in health-related costs. Currently, the most common treatments for LBP are prescription medications and therapeutic exercise. However, even with the use of these treatments, there are still people who are unable to find relief from their pain, leading us to question what other treatments could be effective. Therefore, the purpose of the critically appraised topic (CAT) was to examine the current research in order to assess if VM is more effective than the current treatment options in assisting adults struggling with LBP. Methods. We conducted the search for the SR over five databases from May 2020 to January 2021. Two independent reviewers screened abstracts and full-text articles about this topic that included human female subjects and full-text articles in English. Exclusion criteria included articles that were not relevant, treatment options other than acupuncture and IVF, pilot studies, premature ovarian failure, and polycystic ovary syndrome. Two investigators independently rated the risk of bias using the PEDro and NIH-NHLBI tools. We conducted the search for the CAT from January 2010 to January 2021. Two independent reviewers screened the resulting articles about the topic that included human subjects, adults, and in English. Articles that included patients with pre-existing conditions or additional treatment options besides osteopathic manipulative treatment (OMT), VM, or therapeutic exercise were excluded from the results. Two investigators independently rated the risk of bias using the PEDro and NIH-NHLBI tools. P-values and confidence intervals are reported in this paper.Results. For the SR, there were a total 1,346 articles screened, and, of those, 152 full-text articles were assessed for eligibility, resulting in 11 articles included in the SR. The results of the SR revealed that VM could be a potential non-invasive treatment option for women struggling with infertility. Kramp (2012), Wurn et al. (2008), and Rice et al. (2015) assessed pregnancy rates after a manual therapy treatment program and showed significantly improved pregnancy rates. For the CAT, there were a total of 187 articles screened, and only three of those full-text articles were appraised. Tamer et al. (2017) and Licciardone and Gatchel (2020) revealed significant improvements in patients who received VM or OMT for their LBP (p 8 < 0.05). Santos et al. (2019) also recorded improvements in LBP within the VM group. However, there was not significant differences in improvement when compared to the control. Conclusions. The results appeared to be promising for the use of VM. Current studies demonstrated decreased restrictions leading to improvements in hormone production as well as increased patency rates. Due to the small sample sizes, quality of evidence, and other limitations displayed within the current research, there appears to be insufficient evidence to conclude that VM will increase pregnancy rates for women struggling with infertility at this time. Further research should be done before any conclusion or generalization can be made.


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