A
pilot study to examine the effect of osteopathy on health outcome measures
and immunological markers in Human Immunodeficiency Virus (HIV) positive
patients
Glenn Sontag
Supervisor: Emma Chippendale
ABSTRACT
Background and
Objectives: Patients living with
the Human Immunodefiency Virus (HIV) often experience symptoms within the
neuromusculoskeletal system, either as a direct result of the virus,
opportunistic infections and / or side-effects of the medication known as
‘Highly Active Anti-retroviral Therapy’ (HAART). Many HIV positive
patients use osteopathy to help manage these symptoms. The aim of this
randomised waiting-list controlled study was to examine the effects of
osteopathy on the quality of life and the immunological markers of HIV
positive patients.
Methods:
Subjects (n=42) were randomised to either a treatment group (n=21),
receiving up to 5 fortnightly osteopathic treatments with immediate effect,
or a delayed treatment / waiting-list control group (n=21). Subjects were
asked to have their routine immunological markers (viral load, CD4, CD4%,
CD8, CD8% and CD4/CD8 ratio) taken up to 4 weeks before starting the study
and up to 4 weeks after completing the study. Additionally, all subjects
were asked to complete an HIV specific health-related quality of life
measurement questionnaire (‘MOS-HIV’) before, mid-point and at the end
of the study.
Analysis:
Only data from
those who received a minimum of 4 osteopathic treatments were included
in the analysis, excluding 5 subjects (new n=16). Results from the MOS-HIV
questionnaire showed that HIV positive subjects who received a minimum of 4
osteopathic treatments over an 8 week period showed a significant
(p=<0.05) improvement in overall health (p=0.0494),
cognitive function (p=0.015), pain (p=0.018) and health transition (p=0.003) when data collected at
visit 1 and 5 were compared. Osteopathy made no significant (p=>0.05)
difference to the other MOS-HIV parameters measured (physical function, role
function, social function, mental health, energy / fatigue, health distress
and quality of life) for any of the visit comparisons (visit 1 and 3, visit
3 and 5 and visit 1 and 5). Osteopathy
made no significant difference (p=>0.05) to any of the immunological
markers.
Conclusion:
This study showed that osteopathy
significantly improved 4 out of 11 measurements of health contained within
the MOS-HIV questionnaire (overall health, cognitive
function, pain and health
transition) in those who are HIV positive and who completed
at least 4 osteopathic treatments within 8 weeks. Osteopathy did not
significantly affect the other parameters contained within the questionnaire
or any of the immunological markers.