Evaluation of osteopathic treatment effectiveness in patients with upper thoracic aperture syndrome

Abstract

Background. Upper thoracic aperture syndrome occurs in 2–8% of people in the population and affects patients of the most working age, mainly women. Aim. Evaluation of the combined (drug + osteopathic) treatment effectiveness of patients with upper thoracic aperture syndrome compared to drug therapy. Material and methods. In a randomized study, patients with signs of upper thoracic aperture syndrome were divided into two groups: the main group received combined (osteopathic + drug) treatment for 2 months; the control group received only drug treatment (non-steroidal anti-inflammatory drugs, muscle relaxants, thioctic acid preparations) for 2 months. Each group consisted of 15 women aged from 25 to 47 years (main group — 36.31±7.33 years, control group — 35.18±6.76 years), the duration of the disease ranged from 6 to 18 months (main group — 12.02±3.57 months, control group — 11.07±3.97 months). The groups were comparable in age composition and duration of the disease. To assess the effectiveness of the treatment, the dynamics of symptoms of neuropathic pain, stimulation electroneuromyography, and the dynamics of osteopathic status indicators were used. Data were presented as arithmetic mean and standard deviation. When analyzing intergroup differences, the nonparametric Mann–Whitney test (U-test), and when analyzing intragroup differences, the nonparametric Wilcoxon test (W-test) were used. The statistical significance of the difference in the frequency of osteopathic dysfunctions and other frequency parameters before and after treatment was assessed using the Pearson χ2 test. The critical level of statistical significance was taken as 5% (p=0.05). Results. The combination of osteopathic and drug treatment led to a difference in conduction along the right ulnar nerve between groups (p=0.0003) in the main group — an increase in speed from 48.1±1.54 m/s to 61.0±3.34 m/s (p=0.0007), in the control group — from 46.8±1.89 m/s to 50.2±4.85 m/s (p=0.0009). Analysis of the NTTSS-9 scale (assessment of symptoms of neuropathic pain) after treatment showed no difference between the groups (p=0.0941): the main group — before treatment 14±2.14 points, after treatment 2±1.4 points (p =0.0003), control group — before treatment 15±1.95 points, after treatment 6±2.80 points (p=0.0007). Conclusion. In the group that received combined (osteopathic + drug treatment), a greater increase in conductivity along the ulnar nerve was found.