ANALYZING AND EVALUATING VISCERAL OSTEOPATHIC MANIPULATION TECHNIQUES IN CLINICAL IMPROVEMENT AND PAIN: SYSTEMATIC REVIEW WITH META-ANALYSIS

• DOI: https://doi.org/10.22533/at.ed.1595332528108

• Palavras-chave: Visceral manipulation; Osteopathic manipulative treatment; Visceral manual therapy.

• Keywords: Visceral manipulation; Osteopathic manipulative treatment; Visceral manual therapy.

• Abstract:

  Visceral manipulation, a technique based on the principles of osteopathy, has been widely used as a manual therapeutic approach with the purpose of restoring the mobility and motility of internal organs. Its clinical application has been linked to the improvement of musculoskeletal and visceral symptoms; however, controversies remain regarding the scientific soundness that supports its effectiveness. OBJECTIVE: To analyze the clinical efficacy of visceral manipulation in different pathological conditions, with an emphasis on outcomes such as pain, functional capacity, and quality of life, through a systematic review of the literature with an attempt at meta-analysis. METHODOLOGY: This is a systematic review developed based on the PRISMA guidelines. Two randomized controlled clinical trials were included, extracted from the PubMed database, which met the previously defined eligibility criteria. The selected studies were assessed for risk of bias using the Cochrane Collaboration's RoB 2.0 tool and for quality of evidence based on the GRADE approach, including a summary of findings table. Data extraction included general characteristics of the studies, population characteristics, interventions, comparisons, measurement instruments, and clinical outcomes summarized descriptively in a table. Finally, quantitative synthesis was performed through a meta-analysis. RESULTS: The studies pointed to positive effects favoring visceral manipulation in pain reduction. However, heterogeneity and high risk of bias were observed in crucial domains, in addition to limitations related to sample size and low recommendation for clinical practice. CONCLUSION: Visceral manipulation demonstrated great therapeutic potential represented in the meta-analyses; however, the methodological quality in one of the studies was at high risk of bias. It is worth considering that in the GRADE approach, one of these studies presented great fragility in its design, thus demonstrating a low level of recommendation in the outcome of pain improvement.