The role of osteopathic manipulative medicine in cerebral palsy: bridging treatment gaps and enhancing care

Osteopathic manipulative medicine (OMM) is a hands-on approach utilized by physicians to diagnose, treat, and prevent various conditions through the application of muscle manipulation techniques. It has been applied in managing chronic musculoskeletal (MSK) pain, headaches, migraines, Parkinsonian gait, and psychological conditions such as stress, anxiety, and depression. In our narrative review, we aim to integrate both direct clinical studies of OMM in cerebral palsy (CP) and supportive literature on mechanisms and related conditions. A comprehensive literature search was conducted utilizing PubMed and Google Scholar to identify relevant studies on OMM in CP management. Search strategies were intentionally broad to capture mechanistic, supportive, and clinical evidence. Representative terms included "osteopathic manipulative medicine and cerebral palsy," "osteopathic treatment and neurological disorders," and "manual therapy and cerebral palsy." Additionally, reference lists of relevant articles were manually reviewed to identify additional studies. Overall, we found that integrating OMM into CP management may offer a noninvasive approach to improving MSK function and neuromuscular control while alleviating the emotional and physical challenges, as well as increasing movement to reduce joint contractures associated with the condition. OMM techniques may also help reduce stress, anxiety, and constipation, which are prevalent among CP patients due to the psychological and physiological burdens of the disorder. OMM's holistic approach has the potential to enhance outcomes for individuals with CP by addressing their multifaceted needs. While further research and advocacy are necessary to fully integrate OMM into mainstream CP management, existing evidence suggests that OMM may improve patient outcomes and quality of life. However, the current evidence has remained somewhat limited.