Research

Efficacy of osteopathic manipulation as an adjunctive treatment for hospitalized patients with pneumonia: a randomized controlled trial

Donald R Noll¹ , Brian F Degenhardt² , Thomas F Morley³ , Francis X Blais⁴ , Kari A Hortos⁵ , Kendi Hensel⁶ , Jane C Johnson² , David J Pasta⁷ and Scott T Stoll⁸

¹  New Jersey Institute of Successful Aging, University of Medicine and Dentistry - School of Osteopathic Medicine, Stratford, New Jersey, USA

²  AT Still Research Institute, AT Still University, Kirksville, Missouri, USA

³  Department of Medicine, University of Medicine and Dentistry of New Jersey - School of Osteopathic Medicine, Stratford, New Jersey, USA

⁴  Department of Internal Medicine, Galion Community Hospital, Galion, Ohio, USA

⁵  Michigan State University - College of Osteopathic Medicine Macomb University Center, Clinton Township, Michigan, USA

⁶  Department of Osteopathic Manipulative Medicine, University of North Texas Health Science Center at Fort Worth - Texas College of Osteopathic Medicine, Fort Worth, Texas, USA

⁷  ICON Clinical Research, San Francisco, California, USA

⁸  Stoll Neurodiagnostics, PA, Fort Worth, Texas, USA

author email corresponding author email

Osteopathic Medicine and Primary Care 2010, 4:2doi:10.1186/1750-4732-4-2

Published:	19 March 2010

Abstract

Background

The Multicenter Osteopathic Pneumonia Study in the Elderly (MOPSE) is a registered, double-blinded, randomized, controlled trial designed to assess the efficacy of osteopathic manipulative treatment (OMT) as an adjunctive treatment in elderly patients with pneumonia.

Methods

406 subjects aged ≥ 50 years hospitalized with pneumonia at 7 community hospitals were randomized using concealed allocation to conventional care only (CCO), light-touch treatment (LT), or OMT groups. All subjects received conventional treatment for pneumonia. OMT and LT groups received group-specific protocols for 15 minutes, twice daily until discharge, cessation of antibiotics, respiratory failure, death, or withdrawal from the study. The primary outcomes were hospital length of stay (LOS), time to clinical stability, and a symptomatic and functional recovery score.

Results

Intention-to-treat (ITT) analysis (n = 387) found no significant differences between groups. Per-protocol (PP) analysis (n = 318) found a significant difference between groups (P = 0.01) in LOS. Multiple comparisons indicated a reduction in median LOS (95% confidence interval) for the OMT group (3.5 [3.2-4.0] days) versus the CCO group (4.5 [3.9-4.9] days), but not versus the LT group (3.9 [3.5-4.8] days). Secondary outcomes of duration of intravenous antibiotics and treatment endpoint were also significantly different between groups (P = 0.05 and 0.006, respectively). Duration of intravenous antibiotics and death or respiratory failure were lower for the OMT group versus the CCO group, but not versus the LT group.

Conclusions

ITT analysis found no differences between groups. PP analysis found significant reductions in LOS, duration of intravenous antibiotics, and respiratory failure or death when OMT was compared to CCO. Given the prevalence of pneumonia, adjunctive OMT merits further study.