‘Proof of concept study’ of osteopathy – this one had me in stitches

Proof of Principle or Concept studies are investigations usually for an early stage of clinical drug development when a compound has shown potential in animal models and early safety testing. This step often links between Phase-I and dose ranging Phase-II studies. These small-scale studies are designed to detect a signal that the drug is active on a patho-physiologically relevant mechanism, as well as preliminary evidence of efficacy in a clinically relevant endpoint.

For therapies that have been in use for many years, proof of concept studies are unusual to say the least. A proof of concept study of osteopathy has never been heard of. This is why I was fascinated by this new paper. The objective of this ‘proof of concept’ study was to evaluate the effect of osteopathic manipulative therapy (OMTh) on chronic symptoms of multiple sclerosis (MS).

Patients (n=22) with MS received 5 forty-minute MS health education sessions (control group) or 5 OMTh sessions (OMTh group). All participants completed a questionnaire that assessed their level of clinical disability, fatigue, depression, anxiety, and quality of life before the first session, one week after the final session, and 6 months after the final session. The Extended Disability Status Scale, a modified Fatigue Impact Scale, the Beck Depression Inventory-II, the Beck Anxiety Inventory, and the 12-item Short Form Health Survey were used to assess clinical disability, fatigue, depression, anxiety, and quality of life, respectively. In the OMTh group, statistically significant improvements in fatigue and depression were found one week after the final session. A non-significant increase in quality of life was also found in the OMTh group one week after the final session.

The authors concluded that the results demonstrate that OMTh should be considered in the treatment of patients with chronic symptoms of MS.

Who said that reading alternative medicine research papers is not funny? I for one laughed heartily when I read this (no need at all to go into the many obvious flaws of the study). Calling a pilot study ‘proof of concept’ is certainly not without hilarity. Drawing definitive conclusions about the effectiveness of OMTh is outright laughable. But issuing a far-reaching recommendation for use of OMTh in MS is just better than the best comedy. This had me in stiches!

I congratulate the Journal of the American Osteopathic Association and the international team of authors for providing us with such fun.