Avaliação do impacto da Osteopatia Cranial na cólica infantil

O tratamento osteopático pode aliviar as influências físicas e biomecânicas derivadas do parto ou das pressões intrauterinas, especialmente dos bebés que "deram a volta" muito cedo. Estas pressões podem manifestar-se sob a forma de plagiocefalia (alteração da forma da cabeça do bebé,referida num post deste blog), alterações do sono (bebés com choro excessivo sem causa aparente) e alterações intestinais (obstipação e cólica do lactante por ex.).

O tratamento  osteopático  em bebés e crianças é muito suave - realizado por osteopatas com formação na área - consistindo na avaliação dos padrões de tensão músculo-esquelética no corpo, libertando as zonas que se encontrem com tensão anormal. 

Especificamente, a abordagem da osteopatia infantil na cólica do lactente envolve a aplicação de técnicas manuais suaves craniais, bem como técnicas de tecidos moles aplicadas nas áreas que demonstrarem estar a influenciar esta condição do bebé, alcançando  uma libertação palpável das tensões e das áreas de disfunção físicas relevantes .

É frequente a participação dos pais no tratamento, de modo a facilitar o envolvimento dos cuidadores e explicar o que vai sendo realizado e ensinar estratégias e exercícios simples para serem aplicados em casa, de modo a potenciar o tratamento e acelerar a sua resolução.

Em diversos países da Europa e do continente Americano, é prática comum a avaliação osteopática em recém-nascidos, bebés e crianças, existindo serviços de Osteopatia em hospitais, na neonatologia e pediatria. Faz todo o sentido trabalhar nesta fase pois é um modo de prevenir ligeiras alterações que podem ser corrigidas nesta fase de formação e crescimento, evitando que se desenvolvam e se tornem mais relevantes.

• No seguinte estudo preliminar, randomizado e controlado, com 28 bebés com cólica do lactente, foi aplicado tratamento osteopático no grupo experimental.

• Todos foram vistos uma vez por semana durante 4 semanas. O tratamento foi feito de acordo com resultados individuais , e administrado pelo mesmo profissional .Os pais foram registando o tempo que os bebés choravam e dormiam durante os dias do estudo. Os resultados demonstraram ser muito significativos no que respeita ao choro (p<0,01) no grupo experimental (o que foi sujeito ao tratamento osteopático). Da mesma forma , houve uma melhora significativa no tempo de horas de sono (p<0,02) Em contrapartida, não foram detectadas diferenças significativas nestas variáveis ​​para o grupo controle . 

• Houve uma redução geral no tempo de choro, de 63% e 23% , respectivamente para o grupo experimental e de controlo. Registou-se uma melhoria no sono de 11 % e 2 %. Crianças tratadas também exigiram menos atenção parental do que o grupo não tratado Em conclusão, este estudo preliminar sugere que o tratamento osteopático cranial pode beneficiar bebés com cólicas.

Haydena, C., Mullingerb, B., (2006). A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic. Complementary  Therapies for Clinical practice an International journal, 12, pp. 83-90.

Osteopathic treatment consists of the diagnosis of the musculo-skeletal strain patterns in the body, followed by techniques to release these strains. Specifically, the cranial osteopathic approach to infantile colic involves the application of gentle manual techniques to the head as well as any other areas of the infant body that demonstrate palpably increased ligamentous/muscular tone, or decreased/abnormal articular mobility. Very light tactile pressure is applied to the affected area until a palpable release of the relevant physical tensions and areas of dysfunction (including parts of the cranium) is achieved. Osteopathic treatment may alleviate the physical and biomechanical influences of childbirth. It is also feasible that by attempting to reduce the distortions and twists in the musculoskeletal framework, improving joint mobility, and reducing apparent muscular hypertonia in the infant, manipulation may reduce the somatic afferent load into the central nervous system.

The objective of this preliminary study was to investigate the effect of cranial osteopathic manipulative treatment on the pattern of increased crying, irritability and disturbed sleep associated with infantile colic, as reported by the  parents. Methodology Study design and participants. The study was a prospective, randomized, open, controlled trial comparing cranial osteopathic manipulation with no treatment for infants suffering from infantile colic. Infants and their parent(s) were seen weekly over a 4-week period (total of 5 visits).

The study was pragmatic17; it was carried out at a single centre with all treatments given by the same osteopath (the principal author) following his usual clinical practice/management. Recruitment to the study was through health visitors (Gloucester and Cheltenham); by referral from local GP surgeries, osteopathic colleagues, the local National Childbirth Trust, and by self-referral. The study protocol conformed to the principles of the Declaration of Helsinki18 and was approved by the West Gloucestershire Local Research Ethics Committee. Infants were eligible for the study if they were between 1 and 12 weeks of age, had not been previously treated osteopathically, exhibited signs of nfantile colic (see below) and there were no signs or symptoms indicative of other disease. Infantile colic was defined as at least 90 min of inconsolable crying per 24 h on 5 out of the previous 7 days (as reported by the parents prior to inclusion in the study), with normal behaviour outside of these periods.19 Inconsolable crying during a colic attack was when the infants could not be comforted by being held, rocked or walked, or being soothed in any way. In addition, each infant was required to have displayed typical signs of colic: loud gurgling noises from the abdomen (borborygmi), knees drawn up to the chest, fists clenched and backward bending of the head or trunk.

In this open, controlled, prospective study, 28 infants with colic were randomized to either cranial osteopathic manipulation or no treatment; all were seen once weekly for 4 weeks. Treatment was according to individual findings, and administered by the same practitioner. Parents recorded time spent crying, sleeping and being held/rocked on a 24-hour diary. A progressive, highly significant reduction between weeks 1 and 4 in crying (hours/24 h) was detected (Po0:001) in treated infants; similarly, there was a significant improvement in time spent sleeping (Po0:002). By  contrast, no significant differences were detected in these variables for the control group. Overall decline in crying was 63% and 23%, respectively, for treated and controls; improvement in sleeping was 11% and 2%. Treated infants also required less parental attention than the untreated group. In conclusion, this preliminary study suggests that cranial osteopathic treatment can benefit infants with colic; a larger, double-blind study is warranted.