Osteopathic Manipulative Treatment for Asthma: A Systematic Review of Objective Pulmonary Function Outcomes

Asthma is a common obstructive airway disease associated with significant functional impairment and morbidity. Osteopathic manipulative treatment (OMT) has been proposed as an adjunctive therapy to address musculoskeletal and respiratory mechanical dysfunctions associated with asthma; however, supporting evidence remains limited. This systematic review evaluates whether OMT, compared with sham treatment or usual care, improves pulmonary function outcomes in patients with asthma, as measured by peak expiratory flow (PEF) and spirometric indices including forced expiratory volume in 1 second (FEV₁) and forced vital capacity (FVC). A systematic literature search of MEDLINE/PubMed, Google Scholar, Cochrane Library, and Semantic Scholar databases was conducted to identify clinical studies evaluating OMT in patients with asthma. Five clinical studies met the inclusion criteria and were included in the qualitative synthesis. Sample sizes were small across studies, and there was substantial heterogeneity in study design, intervention protocols, and outcome measures. While some studies reported improvements in pulmonary function following OMT, the overall risk of bias was moderate, and the certainty of evidence was low to moderate. In conclusion, available evidence suggests that OMT may be associated with improvements in pulmonary function in patients with asthma; however, these findings should be interpreted cautiously due to limited sample sizes, heterogeneity, and methodological limitations. Larger, well-designed randomized controlled trials are needed to more definitively determine the role of OMT in the management of asthma.