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Table 10 Data extraction for structural studies

From: Manual therapy for the pediatric population: a systematic review

Condition Author/year Study objective Study design sample size intervention Patient description/ condition Primary/main outcome(s) Main results/conclusions Adverse events
Cranial Asymmetry Cabrera-Martos I, et al. 2016 [58] Evaluate the effects of manual therapy as an adjuvant option on treatment duration and motor development in infants with severe nonsynostotic plagiocephaly. RCT
n = 46
Infants ages 4–8 months, with severe nonsynostotic plagiocephaly Treatment duration and motor development assessed with Alberta Infant Motor Scale Treatment duration was significantly reduced in manual therapy group (109.84 +/− 14.45) compared to the control group (148.65 +/− 11.53) days. Asymmetry after the treatment was minimal Type 0 or Type 1. Motor behaviour was normal in all the infants after treatment. Study reported no adverse effects were seen during the treatment period.
Lessard S, et al. 2011 [59] Does osteopathic manipulation alter cranial asymmetry in infants. Before-After
n = 12
Infants ages < 6.5 months, diagnosed with nonsynostotic plagiocephaly Anthropometric changes Osteopathic treatment led to improvements in cranial asymmetry. There is no mention of adverse events made in this study.
Postural Asymmetry Philippi H, et al. 2006 [60] To assess the therapeutic efficacy of osteopathic manipulation in infants with postural asymmetry. RCT
n = 32
Infant ages 6–12 weeks, with postural asymmetry Video-based measurements Significant improvement in postural asymmetry (mean 5.9 points) observed with osteopathic manipulation. “At least two of the seven vegetative symptoms aggravated for 2 days after the interventions in six patients of the control group and in four patients of the treatment group. Otherwise no adverse effects were seen.”
Scoliosis Byun S & Han D, 2016 [61] Examine whether chiropractic techniques would reduce the curvature of idiopathic scoliosis. Before-After
n = 5
Children ages 10–13, with Cobb angles > 10 degrees Reduction in Cobb angle No significant difference in Cobb angle was noted after the 4th week of chiropractic manipulation. There is no mention of adverse events made in this study.
Hasler C, et al. 2010 [65] Test to see if osteopathy alters trunk morphology, to unload the concave side of the scoliosis to halt curve progression. RCT
n = 20
Post-pubertal females ages 12–18, with Cobb angles 20–40 Trunk morphology, spine flexibility and scoliometer measurements Repeat measurements revealed no therapeutic effect on rib hump, lumbar prominence, plumb line, sagittal profile and global flexibility. “No intervention-related side effects or complications were noted”
Rowe D, et al. 2006 [62] To conduct a pilot (feasibility) study and explore issues of patient safety, patient recruitment and compliance, treatment standardization, sham treatment refinement, interprofessional cooperation, quality assurance, and outcome measure selection. RCT
n = 6
Children ages 10–16, with Cobb angles 20–40 degrees Reduction in Cobb angle Feasible to recruit AIS patients for a randomized clinical trial to compare chiropractic care and standard medical treatment. CMT delivered on 52 visits resulted in two benign reactions one with moderate pain lasting 24 h; the other produced mild pain lasting 6 h.
Morningstar M, et al. 2004 [63] Evaluate of scoliosis treatment using a combination of manipulative and rehabilitative therapy. Before-After
n = 19 (6 pediatrics)
Scoliotic patients aged 15–65 (6 patients 18 and under- identified in Table 3 of study) Reduction in Cobb angle Reduction in Cobb angles in all patients. There is no mention of adverse events made in this study.
Lantz C & Chen J, 2001 [64] Effect of chiropractic manipulation on small scoliotic curves in younger subjects. Before-After
n = 42
Children aged 6–17, with Cobb angles 6–25 Reduction in Cobb angle No overall reduction in Cobb angle after 6.5–28.5 months of care. There is no mention of adverse events made in this study.
Torticollis Haugen E, 2011 [66] Evaluate measurement methods and examine short-time effect of manual therapy in addition to physiotherapy in infants with torticollis. RCT
n = 32
Infant aged 3–6 months, diagnosed with torticollis Primary outcome: Videoclip recordings, Secondary outcomes: 12 parameters of body function, activity, participation No significant difference in primary outcome. Found non-significant tendency to greater improvement in lateral flexion and head righting in intervention group. There is no mention of adverse events made in this study.
Upper Cervical Dysfunction Saedt E, et al. 2018 [67] To gain insight into the patient characteristics and reasons for seeking care in infants with indications of upper cervical dysfunction referred for manual therapy. Before-After
n = 295
Infants aged < 27 weeks, with positional preference, restlessness, abnormal head position, excessive crying Improved flexion-rotation test and lateral flexion tests Parental perception of treatment effects Pre- and post treatment self-reported questionnaires Flexion- rotation test decreased from 78.8 to 6.8%. Lateral flexion test decreased from 91.5% tp 6.2%. All parents perceived positive treatment effects. No serious adverse events were reported during this study.