Effect of the soft-tissue techniques in the quality of life in patients with Crohn's disease: A randomized controlled trial

Abstract

Background: Crohn's disease (CD) is a highly prevalent inflammatory bowel disease (IBD), characterized by recurring flares altered by periods of inactive disease and remission, affecting physical and psychological aspects and quality of life (QoL). The aim of this study was to determine the therapeutic benefits of soft non-manipulative osteopathic techniques in patients with CD.

Methods: A single-blind randomized controlled trial was performed. 30 individuals with CD were divided into 2 groups: 16 in the experimental group (EG) and 14 in the control group (CG). The intervention period lasted 30 days (1 session every 10 days). Pain, global quality of life (GQoL) and QoL specific for CD (QoLCD) were assessed before and after the intervention. Anxiety and depression levels were measured at the beginning of the study.

Results: We observed a significant effect of the treatment in both the physical and task subscales of the GQoL (P = .01 and P = .04, respectively) and also in the QoLCD (P ≤.0001) but not in pain score (P = .28). When the intensity of pain was taken into consideration in the analysis of the EG, there was a significantly greater increment in the QoLCD after treatment in people without pain than in those with pain (P = .02) The improvements in GQoL were independent from the disease status (P = .16).

Conclusions: Soft, non-manipulative osteopathic treatment is effective in improving overall and physical-related QoL in CD patients, regardless of the phase of the disease. Pain is an important factor that inversely correlates with the improvements in QoL.

Figure 1

Cluster of techniques included in the soft non-manipulative osteopathic treatment. FO = frontal-occipital cranial technique, MI = myofascial Induction Technique, NL = neurolymphatic reflexes technique, OV = visceral osteopathic technique, TR = cranial temporal rotation technique, VR = viscerosomatic reflexes technique.

Figure 2

Flowchart according to CONSORT statement for the report of randomized trials.

Figure 3

Quality of Life in the experimental group before and after treatment when divided in pain group (n = 8) and non-pain group (n = 8). NPG = no pain group, PG = pain group, QoLCD = quality of Life in CD measured with Inflammatory Bowel Disease Quality of Life-32 questionnaire score. ^∗Significant differences between the IBDQ32 score after (dark grey) and before (light grey) treatment within groups; ^#Significant differences between the IBDQ32 improvement between groups.