# Osteopathic Manipulative Treatment in 564 Children with Congenital Heart Disease: A Project Report

## TL;DR

Osteopathic manipulative treatment may safely reduce pain and improve musculoskeletal issues in children with congenital heart disease undergoing surgery.

## Contribution

A retrospective analysis of 564 pediatric patients showing the safety and potential benefits of osteopathic manipulative treatment in cardiac care.

## Key findings

- Pain scores and somatic dysfunction severity significantly decreased during hospitalization.
- No adverse events were reported from osteopathic manipulative treatments.
- Thoracic region and rib cage were most commonly affected by somatic dysfunctions.

## Abstract

What are the main findings?
Osteopathic manipulative treatment can be safely integrated into multidisciplinary pediatric cardiac care.It may help improve the severity of somatic dysfunctions and reduce postoperative pain in children undergoing congenital heart disease surgery.

Osteopathic manipulative treatment can be safely integrated into multidisciplinary pediatric cardiac care.

It may help improve the severity of somatic dysfunctions and reduce postoperative pain in children undergoing congenital heart disease surgery.

What are the implications of the main findings?
Osteopathic care presents a promising adjunct to traditional pediatric cardiac treatments, particularly for improving musculoskeletal function and pain management.Further research is needed to assess the long-term outcomes and functional recovery of children undergoing congenital heart disease surgery with osteopathic care.

Osteopathic care presents a promising adjunct to traditional pediatric cardiac treatments, particularly for improving musculoskeletal function and pain management.

Further research is needed to assess the long-term outcomes and functional recovery of children undergoing congenital heart disease surgery with osteopathic care.

Background: Congenital heart diseases are the most common congenital malformations, affecting 4 to 9 per 1000 children, with increasing global prevalence. As surgical mortality rates decline, the focus has shifted toward improving the quality of life and perioperative outcomes for pediatric patients. Multidisciplinary rehabilitation, including osteopathic care, is increasingly incorporated into recovery programs. Osteopathic manipulative treatment combines manual techniques with lifestyle guidance to alleviate postoperative pain and promote recovery. This project report describes the impact of osteopathic manipulative treatment (OMT) on pain and somatic dysfunctions in hospitalized pediatric cardiac patients, using validated pain assessment tools. It presents a retrospective analysis of data collected as part of a humanitarian volunteer project. Methods: The project report follows a retrospective descriptive study design, using patient note forms from children aged 0–18 years undergoing cardiac surgery at the Sri Sathya Sai Sanjeevani Center in India between October 2023 and March 2024. A total of 29 experienced osteopaths recorded pain assessments at three time points—pre-surgery, post-surgery, and pre-discharge—using age-appropriate pain scales (FLACC, Wong-Baker Faces, and Numerical Rating Scale). Somatic dysfunctions were evaluated and classified using ICD-10 M99 codes. Data analysis involved descriptive statistics and pre-post comparisons using statistical software (Excel and OPENEPI). Results: The study included 564 children (60.5% male, mean age 5.8 ± 4.3 years). The most common congenital defects were ventricular septal defects (38.5%) and tetralogy of Fallot (21.6%). The average hospital stay was 15.9 ± 11.1 days. Significant reductions in pain scores were observed from the Intensive Care Unit to the postoperative ward (p < 0.001). Similarly, somatic dysfunction severity decreased significantly across hospitalization phases (p < 0.001). The thoracic region and rib cage were the most frequently affected areas. No adverse events related to osteopathic manipulative treatments were reported. Conclusions: This project report indicates that osteopathic manipulative treatment is safe and feasible for pediatric patients undergoing surgery for congenital heart disease. Pain scores and somatic dysfunction severity decreased during hospitalization. However, the lack of a control group, the heterogeneity of the patient population, and the short observation period limit the ability to draw causal conclusions. These findings provide a descriptive framework for integrating OMT into multidisciplinary pediatric cardiac care. Future studies should involve prospective, multicenter designs with control groups and longer follow-up periods to assess clinical, functional, developmental, and quality-of-life outcomes.