Osteopathic manipulative treatment (OMT) is a type of manual therapy that has been used by osteopathic clinicians to manage dizziness that is caused by neuro-otologic disorders. However, there is currently no comprehensive review that provides an overall assessment of the effectiveness of OMT in treating dizziness.

To our knowledge, there is no current systematic review that has evaluated the impact of OMT on dizziness. Such a systematic assessment of research findings and meta-analysis could provide valuable insights into the potential benefits of OMT as a primary or adjunctive treatment for this condition.

The objective of the meta-analysis conducted by Rahman and colleagues was to study the effectiveness of OMT and similar techniques in the management of dizziness.

The authors conducted a systematic literature search in several academic research databases for randomized controlled trials and observational studies that evaluated the effectiveness and safety of osteopathic manipulative treatment (OMT) or similar techniques in the management of dizziness caused by neuro-otological disorders. The studies included in the analysis compared OMT or OMT analogous techniques with other interventions, such as sham manipulation, different manual techniques, standard care, or non-pharmacological interventions like exercise or behavioral therapy.

The outcomes assessed included disability, severity and frequency of dizziness, risk of falls, improvement in quality of life, and return to work. Harm outcomes, such as all-cause dropout rates and adverse events, were also evaluated. The risk of bias was assessed using established tools, and the quality of evidence was evaluated using the GRADE approach. The meta-analysis was based on similarities between OMT or analogous techniques and the comparator interventions. The search spanned from inception of respective databases to March 2021.

Out of 3,375 studies identified and screened, only 12 studies (11 RCTs and 1 observational study, involving a total of 367 participants) met the inclusion criteria for data extraction. Moderate-quality evidence suggested that articular OMT techniques were associated with significant improvements in disability associated with dizziness, dizziness severity, and dizziness frequency. Low-quality evidence suggested that articular OMT was not associated with all-cause dropout rates.

When data were pooled for any type of OMT technique, findings were similar, but there was high heterogeneity in the disability associated with dizziness and all-cause dropout rates. None of the studies met all of the criteria for risk of bias.

The meta-analysis found moderate-quality evidence that OMT and similar techniques can effectively reduce disability associated with dizziness, dizziness severity, and dizziness frequency. This improvement is likely to lead to other benefits, including improved quality of life, decreased stress and medication use, and reduced perceptions of dizziness and disability. One study reviewed in the analysis found that articular OMT improved the MCS score but not the PCS score on the 36-Item Short-Form Health Survey, possibly because dizziness has a greater impact on physical function. The findings suggest that manual treatments may improve well-being by improving symptoms, but treatments to improve physical scores may require addressing dysfunctions outside of the head and neck. Future studies assessing the impact of whole-body treatments on quality of life are needed to better understand these findings.

Reference:

Rehman, Y., Kirsch, J., Wang, M. Y. F., Ferguson, H., Bingham, J., Senger, B., … & Snider, K. T. (2022). Impact of osteopathic manipulative techniques on the management of dizziness caused by neuro-otologic disorders: systematic review and meta-analysis. Journal of Osteopathic Medicine.