How do the Number and the Duration Between Osteopathic Treatments Influence the Effect on Patients Suffering from Foot-Related Pain? A Dose-Response Study
Joachim Kaufmann* and Stig Larsen
Aim: To determine the combination of the “number of treatments” and the “interval between treatments” in order to optimize the osteopathic treatment effect on foot-related pain.
Material & Methods: The material consists of 32 female and 22 male patients with a mean age of 42 years (SD =13.1) and BMI of 27.0 (SD =4.4). Ten patients reported injury on the left side, 17 patients on the right side, and 27 patients suffered on both sides. The study was performed as an observer blinded, randomized single center trial with 32 -factorial design. The factors used were “number of treatments” and “treatment intervals”. Patients were allocated to treatment groups by nested block randomization with a fixed block size of 18 and 6, respectively. “Pain at rest” and “pain at load” were recorded on a 10 cm Visual Analog Scale before, one day after final treatment, and 4-week follow-up.
Results: Four treatments with 7-day intervals were found to be the superior combination for reducing pain at rest. Significant reduction in pain at rest was obtained in all groups given four treatments. Both the 7-day and 10-day interval groups reported a significant reduction in pain at load after receiving four treatments and the 10-day treatment interval found to be the optimal combination. Number of treatments seemed to be the dominant factor, but the treatment intervals played an important role. An increase in the number of treatments recommended an increased duration between treatments in order to obtain effective and significant pain reduction.
Conclusion: The most significant reduction in pain at rest and at load occurs after four treatments administered at 7- and 10-day intervals, respectively.