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Table 6 Data extraction for the gastrointestinal/urinary 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
Constipation Tarsuslu T, et al. 2009 [18] Investigate potential effects of osteopathic treatment on constipation in children with cerebral palsy. Interrupted Time Series (with comparison group)
n = 13
OMT
Children with CP, ages 2–16, with constipation Defecation frequency, gross motor function classification system, Modified Ashworth scale, functional independence measure for children, constipation assessment scale, visual analog scale Both groups showed significant changes from all baseline measures at 3 mos. There was no mention of adverse events made in this study.
Infantile Colic Miller JE, et al. 2012 [19] Two-fold: 1. Determine efficacy of chiropractic manipulation therapy for infants with colic; and
2. Parental reporting bias.
RCT
n = 104
CMT
Infants < 8 weeks, diagnosed with colic Decreased crying (as assessed by parent questionnaire and 24 h crying diary) 1. Greater decrease in crying in colicky infants treated with CMT compared to infants who were not treated.
2. Unlikely that observed treatment effect is due to bias on part of reporting parent.
One patient in the control group noted increased crying.
Wiberg K & Wiberg J, 2010 [20] Investigate if the outcome of excessively crying infants treated with chiropractic manipulation is associated with age. Interrupted Time Series (without comparison group)
n = 749
CMT
Healthy, thriving infants, ages 0–3 months, who fit diagnostic criteria of infantile colic Parent report of crying: classified as “improved”, “uncertain recovery”, “non recovered” No apparent link between clinical effect of chiropractic treatment and a natural crying pattern was found, Slightly older age was found to be linked to crying infants with clinical improvement There was no mention of adverse events made in this study.
Browning M & Miller J, 2008 [21] To compare chiropractic manual therapy and occipital-sacral decompression in the treatment of infant colic. RCT
n = 43
CMT
Infants < 8 weeks, who cried more than 3 h a day for at least 4 of the previous 7 days Change in group mean daily hours of crying (recorded in crying diary) Mean hours of crying were significantly reduced in both groups. Both treatments appear to offer benefits to infants with colic. There was no difference between two treatment approaches. There was no mention of adverse events made in this study.
Olafsdottir E, et al. 2001 [22] To evaluate chiropractic spinal manipulation management on infantile colic. RCT
n = 86
CMT
Infants ages 3–9 weeks, diagnosed with infantile colic 24 h diary of infant’s crying (crying diary) completed by parent;
Parent report of effect after last visit (8–14 days later)
No difference between groups with either outcome. There was no mention of adverse events made in this study.
Hayden C & Mullinger B, 2006 [23] To determine the impact of cranial osteopathy on infantile colic. RCT
n = 28
OMT/CST
Infants 1–12 weeks, with signs of infantile colic that included; 90 min/24 h. of inconsolable crying on 5 out of 7 days and additional clinical signs such as borborygmi, knees drawn up to chest, fists clenched, backward bending of head or trunk Parents record of time spent crying and sleeping in a 24-h diary No between group comparisons done. While both groups, demonstrated decreases, only the OMT/CST group had significant reduction for time spent crying and sleeping. There was no mention of adverse events made in this study.
Pediatric dysfunctional voiding Nemett D, et al. 2008 [24] To determine whether manual physical therapy-osteopathic approach added to standard treatment improves dysfunctional voiding more effectively than standard treatment alone. RCT
n = 21
OMT
Children ages 4–11, diagnosed with dysfunctional voiding and symptoms of daytime incontinence and or vesicoureteral reflux Improved dysfunctional voiding symptoms;
1. improved or resolved vesicoureteral reflux
2. elimination of post-void urine residuals
Results suggest that manual physical therapy-osteopathic approach treatment can improve short-term outcomes in children with dysfunctional voiding, beyond improvements observed with standard treatments. There was no mention of adverse events made in this study.
Nocturnal Enuresis van Poecke A & Cunliffe C, 2009 [25] To evaluate the effect of chiropractic treatment on the wet night frequency of patients with nocturnal enuresis. Before-After
n = 33
CMT
Children ages 3–18, diagnosis of nocturnal enuresis Diary of wet night frequency, diurnal urinary output 66.6% resolution rate within 1 year, indication for possible effectiveness of chiropractic treatment (Neuroimpulse instrument) in patients with primary nocturnal enuresis. There was no mention of adverse events made in this study.
Suboptimal infant breastfeeding Miller J, et al. 2009 [26] To determine the effect of chiropractic manipulative therapy on infants who had difficulty breastfeeding. Before-After
n = 114
CMT
Infants ages 2 days - 12 weeks diagnosed by medical provider with feeding difficulties Mother’s report of exclusivity of breastfeeding, rating of improving and infant weight gain Exclusively of breastfeeding was accomplished in 78%. No negative side effects were reported.
Vallone S, 2004 [27] To investigate problems interfering with successful breastfeeding and to see if proper lactation management can increase the bonding experience. Before-After
n = 25
CMT/CST
Infants ages 5 days - 12 weeks, referred by other healthcare providers as having difficulty breastfeeding Improvement in ability to latch and ability to breastfeed > 80% of infants experienced improvement in latch and ability to breastfeed. There was no mention of adverse events made in this study.