Osteopathic Manipulative Medicine in Pregnancy: Physiologic and Clinical Effects

描述（由申请人提供）：整骨疗法（OMM）是一种补充和替代的基于身体的治疗方法，其中对患者进行评估和治疗，包括肌肉骨骼系统，以改善生理功能并消除最佳健康和功能的障碍。在怀孕期间，女性的身体受到重大而广泛的生理和生物力学变化的挑战，这些变化会影响她的所有身体系统和生活的各个方面。许多这些变化都反映在她的肌肉骨骼系统中，并可能受到OMM的影响。这项建议将在五年内进行三项研究，调查OMM影响与怀孕、分娩和分娩有关的选定条件的功效和假设的生理机制。研究一将探讨妊娠晚期辅助OMM治疗在改善几种临床结果方面的疗效，而研究二和研究三将探讨可能有助于这些临床益处的潜在生理和生物力学机制。研究假设和目的包括：研究一假设OMM改善妊娠期的某些临床结果。目的：确定OMM是否可以减轻产前和产后腰痛目的：确定OMM是否可以改善产前和产后的功能状态目的：为了确定OMM是否可以降低产程和分娩中羊水粪染色的发生率，作为胎儿应激的一个指标，研究二假设在研究一中，与改善自主神经和外周血流动力学调节相关的生理变化在一定程度上导致了OMM的假设临床效果。目的：研究妊娠期OMM对自主神经平衡的影响。目的：确定OMM对妊娠晚期下肢水肿的影响。研究三假设研究一中，与改善步态相关的生物力学变化部分地解释了OMM的假设临床效果。目的：评估妊娠晚期步态的功能和生物力学变化，以及OMM对步态的影响。这3项研究将采用安慰剂对照、随机、盲法设计来测试OMM干预对选定结果的影响。如果发现OMM在治疗妊娠、分娩和分娩的特定结果方面有效，则应将其视为常规产前护理的补充部分，作为改善母胎健康的一种方式。

DESCRIPTION (provided by applicant): Osteopathic manipulative medicine (OMM) is a complementary and alternative body-based treatment method in which the patient is evaluated and treated including the musculoskeletal system to improve physiologic functioning and remove impediments to optimal health and functioning. During pregnancy, a woman's body is challenged by significant and extensive physiological and biomechanical changes that impact all her body systems and all aspects of her life. Many of these changes are reflected in her musculoskeletal system, and are able to be affected by OMM. This proposal will investigate the efficacy and hypothesized physiological mechanisms by which OMM affects selected conditions related to pregnancy, labor and delivery by conducting three studies over five years. Study One will address the efficacy of adjunctive OMM therapy during 3rd trimester of pregnancy in improving several clinical outcomes whereas Studies Two and Three will address potential physiological and biomechanical mechanisms that may contribute to these clinical benefits. Study hypotheses and aims include: Study One Hypothesis OMM improves selected clinical outcomes in pregnancy. Aim: To determine if OMM can decrease low back pain in the pre and post-partum period Aim: To determine if OMM can improve functional status in the pre and post-partum period Aim: To determine if OMM can decrease the incidence of meconium-stained amniotic fluid in labor and delivery as an index of fetal stress Study Two Hypothesis Physiological changes related to improved autonomic and peripheral hemodynamic regulation are, in part, responsible for the hypothesized clinical effects of OMM in Study One. Aim: To examine how OMM affects autonomic balance during pregnancy, Aim: To determine how OMM impacts lower extremity edema in the third trimester of pregnancy Study Three Hypothesis Biomechanical changes related to improved gait are, in part, responsible for the hypothesized clinical effects of OMM in Study One. Aim: To evaluate functional and biomechanical changes in gait in the third trimester of pregnancy, and how OMM may affect gait. These 3 studies will use a placebo-controlled, randomized, blinded design to test the impact of the OMM intervention on the selected outcomes. If OMM is found to be efficacious in the treatment of the selected outcomes of pregnancy, labor, and delivery, it should be considered a complementary part of routine prenatal care as a way to improve maternal-fetal health.