title: The effect of osteopathic manipulative treatment on postoperative medical and functional recovery of coronary artery bypass graft patients.
abstract: BACKGROUND
  Several studies have investigated the use of osteopathic manipulative treatment (OMT) after coronary artery bypass graft (CABG) operations; however, there is little information regarding the effect of OMT in the postoperative recovery of patients undergoing CABG operations.
  
  
  METHODS
  Patients scheduled to undergo a CABG operation were voluntarily enrolled and randomly assigned to receive 1 of 3 treatment protocols after their surgical procedure: standardized daily OMT and conventional postoperative care (the OMT group), daily time-matched placebo OMT and conventional postoperative care (the placebo group), or conventional postoperative care only (the control group). Specific OMT techniques used were thoracic inlet myofascial release, standard rib raising (with paraspinal muscle stretch to the L2 vertebral level), and soft tissue cervical paraspinal muscle stretch (with suboccipital muscle release). Primary outcome measures included time to discharge, time to postoperative bowel movement, and FIM functional assessment scores.
  
  
  RESULTS
  Fifty-three patients completed the study protocol: 17 in the OMT group, 18 in the placebo group, and 18 in the control group. After surgical procedures, patients were discharged to home at a mean (standard deviation [SD]) rate of 6.1 (1.4), 6.3 (1.5), and 6.7 (3.0) days for the OMT group, placebo group, and control group, respectively. Patients in the OMT group were discharged 0.55 days earlier than those in the control group and 0.16 days earlier than those in the placebo group. The mean (SD) number of days to first postoperative bowel movement was 3.5 (0.9), 4.0 (0.8), and 4.0 (0.9) for the OMT group, the placebo group, and the control group, respectively. On day 3 after surgery, the mean (SD) total score on the FIM was 19.3 (6.7), 15.4 (7.3), and 18.6 (6.5) for the OMT, the placebo, and the control group, respectively; total score for the OMT group was 0.81 greater than that of the control group and 3.87 greater than that of the placebo group. None of the differences achieved statistical significance (P<.05)
  
  
  CONCLUSIONS
  A daily postoperative OMT protocol improved functional recovery of patients who underwent a CABG operation.
authors.affiliation: Department of Physical Medicine and Rehabilitation and Osteopathic Principles and Practice, Lincoln Memorial University-DeBusk College of Osteopathic Medicine, Harrogate, Tennessee, USA.
authors.forename: J Michael
authors.initials: JM
authors.lastname: Wieting
authors.forename: Christopher
authors.initials: C
authors.lastname: Beal
authors.forename: Gary L
authors.initials: GL
authors.lastname: Roth
authors.forename: Sherman
authors.initials: S
authors.lastname: Gorbis
authors.forename: Lori
authors.initials: L
authors.lastname: Dillard
authors.forename: Dennis
authors.initials: D
authors.lastname: Gilliland
authors.forename: Jacob
authors.initials: J
authors.lastname: Rowan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D026301:Manipulation, Osteopathic / Q000379:methods*; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult