Osteopathic Manual Treatment for Amyotrophic Lateral Sclerosis: A Feasibility Pilot Study

Alberto Maggiani1, *, Lucio Tremolizzo1, 2, 3, 4, Andrea Della Valentina1, Laurent Mapelli1, Silvia Sosio1, Valeria Milano1, Manuel Bianchi1, Francesco Badi1, Carolina Lavazza1, Marco Grandini1, Giovanni Corna4, Paola Prometti4, Christian Lunetta5, Nilo Riva6, Alessandra Ferri7, Francesca Lanfranconi4, for the ME&SLA Study #
1 Italian Academy of Osteopathic Medicine (AIMO), Saronno, Italy
2 Neurology Unit, “San Gerardo” Hospital, Monza, Italy
3 Milan-Center for Neuroscience (NeuroMI), Milan, Italy
4 School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
5 NEuroMuscular Omnicentre (NEMO), Fondazione Serena Onlus, Milano, Italy
6 “San Raffaele” Scientific Institute, Milano, Italy
7 Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia

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© Maggiani et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the AIMO, Pizza Santuario 7, 21047 Saronno (VA), Italy; Tel: +39-0296705292; Email:,

ME&SLA Study; besides the Authors of the byline including also: Riccardo Bonazzi (Monza), Annalisa Bosio (Monza), Dario Bovio (Milano), Carlo Ferrarese (Monza), Andrea Magnoni (Monza), Vittorio Mantero (Lecco), Samuele Marchese (Saronno), Ornella Mauri (Monza), Luca Pollastri (Monza), Andrea Rigamonti (Lecco), Caterina Salito (Milano), Vincenzo Silani (Milano), Dino Tenderini (Monza), Barbara Uva (Milano).



Current interventions in amyotrophic lateral sclerosis (ALS) are focused on supporting quality of life (QoL) and easing pain with a multidisciplinary approach.


Primary aim of this pilot work assessed feasibility, safety, tolerability and satisfaction of osteopathic manual treatment (OMT) in 14 ALS outpatients.


Patients were randomized according to an initial single-blind design (12 weeks, T0-T1), in order to receive OMT (weekly for 4 weeks, and fortnightly for the following 8 weeks) versus usual-care (n=7 each group), followed by an OMT open period (T1-T2, once a week for 8 weeks, n=10). Secondary aims included blind osteopathic assessment of somatic dysfunctions (SD) for goal attainment scale (GAS) calculation, Brief Pain Inventory-short form and McGill QoL-16 items.


OMT was demonstrated feasible and safe and patients displayed high satisfaction (T1-VAS=8.34 ± 0.46; T2-VAS=8.52 ± 0.60). Considering secondary aims no significant differences emerged. Finally, at study entry (T0), a cervico-dorsal SD was found in 78% of ALS patients versus 28% of healthy matched controls (p<0.01).


OMT was found feasible, safe and satisfactory in ALS. The lack of secondary aim differences can be due to the limited sample size. OMT could be an interesting option to explore in ALS.

Keywords: Amyotrophic lateral sclerosis, Feasibility, Osteopathic manual treatment, Pilot trial.