Effects of osteopathic manipulative treatment on autonomic nervous system of a child in complete retinoblastoma remission: a case report.
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UNLABELLED: Recent studies suggest that heart rate variability (HRV), a measure of autonomic nervous system (ANS) balance, may predict survival outcomes in cancer patients, with increased parasympathetic (vagus nerve) activity being associated with improved survival and reduced metastatic risk. Osteopathic manipulative treatment (OMT) is known to regulate autonomic balance in both adults and children. This case report presents the clinical evaluation and findings of a 6-year-old girl in remission from bilateral retinoblastoma. By age 3, she had undergone chemotherapy and enucleation surgery and later received OMT care. PURPOSE: To assess the effects of osteopathic manipulative treatment (OMT) on autonomic nervous system (ANS) function, headache frequency, and quality of life (QoL) in a child in complete remission from retinoblastoma. METHODS: The patient was assessed at baseline using HRV parameters and clinical outcome measures, including the PedsQL, HIT-6, and Wong-Baker Faces Pain Rating Scale, alongside an evaluation of somatic dysfunction. HRV data were collected before and after each OMT session, while QoL and headache scales were administered at baseline and after the final treatment. RESULTS: The 6-year-old patient, in complete remission from retinoblastoma, experienced headaches and occasional insomnia. Following three OMT sessions, her ANS profile showed improvement, along with a reduction in headache frequency and insomnia, as reflected in clinically meaningful changes in outcome measures. CONCLUSION: OMT was well tolerated and accepted by both the patient and caregiver as a complementary therapy. Furthermore, an association was observed between the treatment of somatic dysfunctions and sympathovagal balance. Given that OMT is an emerging approach for conditions involving ANS imbalance, this report provides a detailed account of the clinical assessment and therapeutic process.