The use of osteopathic manipulative treatment (OMT) for asthma suggests the hands‑on therapy may offer modest improvements in certain breathing measures, though the overall evidence remains limited and inconsistent. Researchers conducted the new systematic review, “Osteopathic Manipulative Treatment for Asthma: A Systematic Review of Objective Pulmonary Function Outcomes,” to examine its potential. The paper was published in the journal, Cureus.
With a growing interest in non‑pharmacologic approaches to treat asthma, researchers initiated the comprehensive analysis of published clinical studies to determine whether OMT — manual techniques used to improve musculoskeletal and respiratory function — can meaningfully improve lung performance.
Upon screening 256 records, including five clinical studies involving both adults and children, researchers assessed objective pulmonary outcomes such as peak expiratory flow (PEF) and standard spirometry measures including FEV₁, FVC and FEV₁/FVC ratio. Sample sizes were small, and study methods varied considerably, the authors noted.
Researchers noted multiple conclusions from their analysis:
- Spirometry shows inconsistent improvement.
o Some studies found small statistical changes in spirometric measures, but these shifts were minimal and unlikely to be clinically meaningful.
o Multiple trials showed no significant differences after OMT in FEV₁, FVC or related airflow ratios.
o Pediatric results mirrored adult findings, showing no consistent improvements in spirometric outcomes.
- Peak flow gains are more frequent but modest.
o PEF improvements appeared more often, with two studies reporting statistically significant increases, including one showing a 4.8% rise after OMT.
o However, other trials found no meaningful difference, and the overall effects were small and not uniformly reproduced.
o Because PEF is an effort‑dependent measure, researchers caution that improvements might reflect variation in patient effort or chest wall mechanics rather than true lung function changes.
The review’s authors also noted substantial challenges across the studies included in the analysis:
- Small sample sizes, limiting statistical power
- Differences in treatment protocols, duration, and patient populations
- Limited blinding, particularly important in hands‑on interventions
- Inconsistent reporting, with some studies measuring only short‑term or immediate pre‑post results
- High risk of bias, especially for effort‑dependent outcomes
These issues prevented formal meta-analysis and reduce confidence in the reported benefits, they said.
Although researchers said the review found no strong evidence that OMT improves standard spirometric measures in asthma, the modest improvements in PEF point toward possible mechanical or respiratory-muscle benefits. Still, they emphasized that evidence remains low‑certainty and inconclusive.
The review’s authors said that OMT cannot yet be recommended as a routine adjunct therapy for asthma management based on current data. However, they believe OMT appears safe and warrants further investigation. They called for larger, well‑designed randomized controlled trials with standardized OMT protocols and clinically meaningful outcomes.
