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Mindfulness-based waiting room intervention for osteopathic manipulation patients: a pilot randomized controlled trial.

Adam W. Hanley, Eric L Garland, Rebecca Wilson Zingg

Journal of osteopathic medicine February 24, 2021 DOI: 10.1515/jom-2020-0186 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Pilot randomized controlled trial Peer reviewed
Sample size 39
Population Patients seeking osteopathic manipulative treatment from a single osteopathic physician at an integrative health clinic; mean age 57 years, 64.1% women, most common pain locations neck, back, and joint, and 51.3% had a cancer diagnosis
Interventions Guided mindfulness meditation osteopathic manipulative treatment
Measures Numeric rating scales for mindfulness and embodied safety, global pain rating, sensation manikin, single-item session satisfaction survey
Topics Meditation
Keywords Omt Chronic pain Osteopathic manipulative treatment Patient satisfaction
Key findings Listening to a guided mindfulness meditation before an OMT session increased patients' mindful connection to and safety within their bodies and their session satisfaction compared with a history-of-osteopathic-medicine recording. OMT itself, paired with either recording, decreased pain and increased the ratio of pleasant to unpleasant sensations. Greater embodied safety and mindful connection predicted greater pain relief.

Abstract

Osteopathic manipulative treatment (OMT) and mindfulness-based interventions are both efficacious pain management strategies. Combining these two therapeutic approaches may offer added benefits to pain patients. To determine whether engaging in a mindfulness-based intervention before an OMT session improved OMT session outcomes. Patients seeking OMT care from a single osteopathic physician at an integrative health clinic were recruited for this pilot randomized, controlled trial at an academic hospital. All patients scheduled for osteopathic structural evaluation and treatment with the provider from March 2019 to September 2019 were eligible and invited to participate during the reminder call before their visit. Participants were randomly assigned to listen to one of two audio recordings matched for length: (1) the history of osteopathic medicine, or (2) a guided mindfulness meditation practice. Patients completed surveys including numeric rating scales to measure mindfulness and embodied safety (a self-reported feeling that the patient's body was in a safe place) immediately before and after listening to the audio recording. A global pain rating report along with a sensation manikin (a digital human figure silhouette overlaid with a grid of 786 "sensation" pixels) capturing both pleasant and unpleasant sensation were collected before and after the OMT session. Session satisfaction was also assessed with a single survey item. A total of 57 participants were enrolled in the study; however, 18 were unable to listen to the full audio recording and were excluded from further analysis. The final study sample consisted of 39 patients, with 19 (48.7%) randomized to the history audio recording and 20 (51.3%) randomized to the mindfulness recording. The mean age of patients was 57 years (standard deviation, 11.75 years); 25 (64.1%) were women and 14 (35.9%) were men. The most common primary pain location was the neck (16; 41.0%), followed by back (12; 30.8%) and joint (5; 12.8%). Twenty (51.3%) participants were cancer patients; 19 (48.8%) did not have a cancer diagnosis. Practicing mindfulness before OMT increased patients' sense of mindful connection to (p=0.036) and safety within (p=0.026) their bodies as well as their overall session satisfaction (p=0.037). Additionally, OMT paired with either study condition (mindfulness vs. history) decreased pain (p<0.001) and increased the ratio of pleasant to unpleasant sensations reported by patients (p<0.001). Finally, regardless of experimental condition (mindfulness vs. history), increased safety within the body predicted greater pain relief (β=-0.33, p=0.035) and larger sensation ratio changes (β=0.37, p=0.030) at the OMT session's end. Additionally, increased mindful connection to the body predicted less pain (β=-0.41, p=0.005) at the session's end. This study demonstrated the feasibility of integrating a mindfulness-based intervention with OMT and results suggest that having patients listen to an audio-guided mindfulness practice while waiting for their OMT session may increase their mindful connection to and safety within their bodies as well as their session satisfaction. This study also provides empirical evidence that OMT may increase the distribution of pleasant sensations reported by pain patients while decreasing the distribution of unpleasant sensations reported.

Comparable studies

Other randomized controlled trials on meditation, most cited first.

Study Year Design Participants
Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment 2003 Randomized controlled trial n = 41
Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients 2000 Randomized controlled trial n = 145
Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults 2008 Randomized controlled trial n = 139
Short-term meditation training improves attention and self-regulation Undergraduate Chinese students 2007 Randomized controlled trial n = 40
Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients 2004 Randomized controlled trial n = 73

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