Journal of Osteopathic Medicine, 2023/12, 123(12):A117. doi: 10.1515/jom-2023-2000, type of study: ,scr,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2023-2000/html)

Keywords:

autism [16]
children [321]
myofascial release [62]
pediatrics [573]
scoping review [57]
soft tissue [22]

Abstract:

Statement of Significance: Children with Autism Spectrum Disorders (ASD) often have difficulty in self-regulating their behaviors and actions which leads to decreased function and ability to focus. Occupational therapists (OT) utilize techniques that apply deep pressure to the child’s body to improve self-regulation and, therefore, function; a beneficial effect has been anecdotally asserted but not heavily researched. However, whether Osteopathic techniques have been used and/or beneficial remains to be determined. The goal of this scoping review is to determine if any research exists on the use and/or effectiveness of osteopathic manipulative techniques (OMT), specifically myofascial release (MFR) and soft tissue techniques, in improving the self-regulation and function of children with ASD. Thus, this review aims to fill the gap on indication for the use of OMT in the ASD population to improve outcomes. The conclusions would be significant for the ASD population and the Osteopathic community. Research Methods: An organized review of current literature was conducted to evaluate the potential benefits of OMT for children with ASD. The search was performed on the database PubMed as well as two journals: The American Association of Osteopathy Journal, and The Journal of Osteopathic Medicine. The following search strings were used: “osteopathic manipulative medicine and autism spectrum disorder”, “autism”, autism osteopathic, “osteopathic manipulative medicine and special needs”, “autism spectrum disorder and occupational therapy or physical therapy”, “osteopathic in autism population”, “osteopathic manipulation in autism”, “soft tissue technique in autism patients”. We included systematic reviews, case reports, clinical trials, and review trials in our analysis. Studies that did not focus on either ASD or the use of OMT/OT were excluded. Data Analysis: There were three articles that specifically focused on the use of OMT in the ASD population, however two of the three articles focused on the use of visceral or cranial OMT. The first study was a longitudinal study utilizing the Autism Research Institute Secretin Outcomes Survey Form to measure the results of visceral osteopathic technique (VOT) on behavior and gastrointestinal symptoms in children with autism (1). There was a significant symptomatic improvement in social behavior and communication, digestive signs, vomiting, poor appetite, and eye contact post VOT application (1). The second article was a randomized controlled trial utilizing the Autism Treatment Evaluation Checklist to compare the efficacies between Upper Cervical Cranial Manipulative Therapy (CMT) and Full Spine CMT in children with autism (2). It was concluded that Upper Cervical CMT had better improvement in autism related behaviors than Full Spine CMT (2). Significant to note was that there did exist a single case report that stated the use of MFR on a pediatric participant with ASD showed global improvement in all symptoms (3). Conclusion: While there has been promise shown in the use of CMT and VOT in people with ASD, there is only one case report that reports on the benefits of physical OMT techniques, specifically the use of MFR. Additionally, this case report was on a singular pediatric participant indicating that these results may not be generalizable. Further research needs to be done on the use and effectiveness of MFR and soft tissue OMT in the ASD population. Furthermore, it will be clinically useful to determine if the use of such treatments does improve self-regulation and function.