Overview
Chronic Rhinosinusitis (CRS) is a chronic condition with limited therapeutic options. Moreover, the pathophysiology is poorly understood. The aim of this study is to evaluate the efficacy of osteopathic manipulative treatment (OMT) in the course of this condition by applying several techniques supposed to be related to the autonomic nervous system. Our hypothesis is that these techniques could have beneficial effects on inflammation and head symptoms in CRS.
MethodsA sample of 90 patients diagnosed by ENT specialist will be randomly assigned to the OMT group or the placebo group. The placebo procedure will consist in using light touch around the nose, on the throat and on the thorax. Treatment and placebo protocols are composed of two visits at day 0 and day 30.
A general practitioner will determine the eligibility for the study.
The outcomes include Peak Nasal Inspiratory Flow (PNIF) measured five times: at day 0, 30 (twice each, before and after treatment) and 180 (once). The two groups will be compared regarding short and long term evolution.
The evolution of symptoms will be assessed by the Sino-nasal Outcome Test (SNOT-22) seven times: at day 0, 30, 60, 90, 120, 150 and 180. This outcome will be analyzed using mixed effect modelling
A Qualitative study will be conducted in the two groups to understand the patients' experiences during care.
This protocol has been approved by a french ethic committee (Comit de Protection des Personnes Sud Ouest et Outre-Mer II, 2020.04.09).
Description
Statistical analysis details:
PNIF middle term evolution:
If the two groups can be compared regarding their socio-demographics characteristics, a student's t-test will compare evolution (day 0 before treatment to day 30 before treatment) of the PNIF between groups.
If characteristics are different, a multivariate linear model will be applied.
PNIF long term evolution:
The same tests will be made. The evolution will be assessed between day 0 (before treatment) and day 180.
PNIF short term evolution:
The same tests will be made. The evolution will be assessed before and after treatment at day 0 and day 30.
SNOT-22 evolution:
Mixed effect model will assess the evolution of symptoms from day 0 to day 180
Response Shift detection:
For the SNOT-22, an Oort procedure will be performed in order to detect Response shift among individuals.
Eligibility
Inclusion Criteria:
- age between 18 and 50
- Chronic rhinosinusitis diagnosed by ear, nose, and throat (ENT) specialist or general practitioner
- informed consent given
- registered under french social security system
Exclusion Criteria:
- contraindication to spine manipulation
- receiving other treatment for CRS during this study
- being pregnant
- being under legal protection
- withdrawal of consent