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Table 8 Data extraction for respiratory 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
Asthma Guiney P, et al. 2005 [40] To demonstrate the therapeutic relevance of osteopathic manipulation in the pediatric asthma population. RCT
n = 140
Children ages 5–17, diagnosed with asthma by guidelines from NIH Peak Expiratory Flow Rates There was statistically significant improvement of 7 L per minute to 9 L per minute for peak expiratory flow rates in the treatment group. There was no mention of adverse events made in this study.
Bronfort G, et al. 2001 [41] To determine if chiropractic manipulative therapy in addition to optimal medical management resulted in clinically important changes in asthma-related outcomes. RCT
n = 34
Children ages 6–17, with persistent asthma Pulmonary function tests, diary recording peak expiratory flow and inhaler use, questionnaires assessing quality of life, asthma severity and improvement Little to no change in pulmonary function tests at 12 weeks and no change in patient, parent/guardian or pulmonologist rated improvement There was no mention of adverse events made in this study.
Obstructive Apnea Vandenplas Y, et al. 2008 [42] To evaluate if osteopathy can influence the incidence of obstructive apnea during sleep in infants. RCT
n = 34
Infants aged 1.5–4 months, with obstructive apnea as determined by a polysomnographic test Decrease in the number of obstructive apneas as measured by polysomnography. Infants aged 1.5–4 months, with obstructive apnea as determined by polysomnographic There was no mention of adverse events made in this study.
Otitis Media Steele D, et al.2014 [43] To evaluate the efficacy of an osteopathic manipulative treatment protocol on middle ear effusion resolution following acute otitis media. RCT
n = 52
Infant ages 6–24 months, with acute otitis media and abnormal tomogram Tympanometer and acoustic reflectometer Both tympanometer data and acoustic reflectometer analysis demonstrated significantly significant improvement in middle ear effusion at visit 3 in the standard care plus osteopathic treatment group. There were no serious adverse events reported during the study.
Wahl R, et al. 2008 [44] To assess the efficacy of Echinacea and osteopathic manipulative treatment for preventing acute otitis media. RCT
n = 90
Children aged 12–60 months, with recurrent otitis media Reduction in future episodes of OM No interaction was found between Echinacea and osteopathic manipulation. Echinacea was associated with a borderline increased risk of having at least one episode of acute otitis media during 6-month follow-up compared to placebo. Osteopathic manipulation did not significantly affect risk compared to sham. “One subject withdrew from the study following an adverse effect (vomiting after taking the Echinacea placebo). One additional subject reported adverse effects (vomiting and non-urticarial rash 2 days after starting Echinacea for a viral upper respiratory illness) but did not withdraw. Neither adverse effect was considered to have been caused by the study medication.
Degenhardt B & Kuchera M, 2006 [45] Does osteopathic manipulation decrease the recurrence of otitis media? Before-After
n = 8
Infants ages 7–35 months, with recurrent otitis media Decreased incidence of acute otitis media 5 participants had no recurrence after 1 year follow-up. 1 participant had 1 recurrence. 2 participants had a short-term of no recurrence only. There is no mention of adverse events made in this study.
Zhang J & Snyder B, 2004 [46] To study the effect of Toftness chiropractic adjustment for acute otitis media. Before-After
n = 22
Children ages 9 months −9 years, with acute otitis media Tympanic Membrane visualization via otoscopic exam and oral temperature After Toftness chiropractic adjustment, red and bulging tympanic membrane returned to normal in 95% of children. A decrease in average oral temperature was noted. “During the study protocol, no side effects or deterioration of clinical presentations were found among 21 children with otitis media.”
Mills M, et al. 2003 [47] To evaluate the effect of usual care and osteopathic manipulation for children with acute otitis media. RCT
n = 57
Children ages 6 months - 6 years, with recurrent otitis media Decreased frequency of acute otitis media, antibiotic us, surgical interventions, and improved tympanometric and audiometric performance Intervention group had fewer episodes of acute otitis media, fewer surgical procedures and an increased frequency of more normal tympanogram readings. There were no adverse events reported during the study.