NMM/OMTREVIEW ARTICLE

Osteopathic manipulative treatment for concussions and postconcussive syndrome in athletes: a literature review

Kevin D. Thomas, DO; Zoe K. Lombard, BS; and Anthony L. Shadiack, DO
Notes and Affiliations
Notes and Affiliations

Received: November 2, 2022

Accepted: April 27, 2023

Published: June 7, 2023

  • Kevin D. Thomas, DO, 

    HCA Healthcare/Mercer University School of Medicine/Grand Strand Medical Center Family Medicine Residency Program, Myrtle Beach, SC, USA

  • Zoe K. Lombard, BS, 

    Edward Via College of Osteopathic Medicine-Carolinas, Spartanburg, SC, USA

  • Anthony L. Shadiack, DO, 

    HCA Healthcare/Mercer University School of Medicine/Grand Strand Medical Center Family Medicine Residency Program, Myrtle Beach, SC, USA

J Osteopath Med; 123(8): 395-403
Abstract

Context: Concussions are the most common type of traumatic brain injury (TBI) and can often occur in athletes. These injuries have many deleterious acute symptoms and can lead to the development of postconcussive syndrome (PCS). Osteopathic manipulative treatment (OMT) is a treatment option that may benefit patients with concussions and PCS.

Objectives: The objective of this review is to determine whether OMT can improve symptoms associated with concussions and PCS in athletes.

Methods: A comprehensive literature review was conducted between August 2021 and March 2022 by two authors (Z.K.L. and K.D.T.) who searched the literature utilizing PubMed, Google Scholar, and Cochrane Library. Articles reviewed included case reports, case studies, randomized control trials, meta-analyses, and peer-reviewed journal articles. Search terms included concussion, postconcussive symptoms, osteopathic manipulative medicine, and manipulation. To be included into this study, articles must have included OMT from an osteopathic physician or manipulative techniques by nonosteopathic providers for patients with a concussion or PCS, and the insulting injury must have occurred in an athletic setting. No disagreements occurred between authors about what studies to include. However, we were prepared to come to a unanimous decision through discussion among the authors. A narrative synthesis was performed. No other data analyses were conducted in this study.

Results: Included in this review were nine articles including randomized control trials, retrospective review, case series, longitudinal, retrospective studies, and case reports. The literature shows the positive effects of OMT and manipulative techniques on symptom resolution after a concussion. However, most of the literature is qualitative rather than quantitative in nature, lacking in randomized control trials.

Conclusions: There is a scarcity of high-quality studies evaluating the effectiveness of OMT on concussions and PCS. More research is needed to understand the degree of benefit for this treatment option.

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