The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature
Abstract Background A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders rem...
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-02-01
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| Series: | Chiropractic & Manual Therapies |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12998-021-00362-9 |
| _version_ | 1819283670743121920 |
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| author | Pierre Côté Jan Hartvigsen Iben Axén Charlotte Leboeuf-Yde Melissa Corso Heather Shearer Jessica Wong Andrée-Anne Marchand J. David Cassidy Simon French Gregory N. Kawchuk Silvano Mior Erik Poulsen John Srbely Carlo Ammendolia Marc-André Blanchette Jason W. Busse André Bussières Carolina Cancelliere Henrik Wulff Christensen Diana De Carvalho Katie De Luca Alister Du Rose Andreas Eklund Roger Engel Guillaume Goncalves Jeffrey Hebert Cesar A. Hincapié Maria Hondras Amanda Kimpton Henrik Hein Lauridsen Stanley Innes Anne-Laure Meyer David Newell Søren O’Neill Isabelle Pagé Steven Passmore Stephen M. Perle Jeffrey Quon Mana Rezai Maja Stupar Michael Swain Andrew Vitello Kenneth Weber Kenneth J. Young Hainan Yu |
| author_facet | Pierre Côté Jan Hartvigsen Iben Axén Charlotte Leboeuf-Yde Melissa Corso Heather Shearer Jessica Wong Andrée-Anne Marchand J. David Cassidy Simon French Gregory N. Kawchuk Silvano Mior Erik Poulsen John Srbely Carlo Ammendolia Marc-André Blanchette Jason W. Busse André Bussières Carolina Cancelliere Henrik Wulff Christensen Diana De Carvalho Katie De Luca Alister Du Rose Andreas Eklund Roger Engel Guillaume Goncalves Jeffrey Hebert Cesar A. Hincapié Maria Hondras Amanda Kimpton Henrik Hein Lauridsen Stanley Innes Anne-Laure Meyer David Newell Søren O’Neill Isabelle Pagé Steven Passmore Stephen M. Perle Jeffrey Quon Mana Rezai Maja Stupar Michael Swain Andrew Vitello Kenneth Weber Kenneth J. Young Hainan Yu |
| author_sort | Pierre Côté |
| collection | DOAJ |
| description | Abstract Background A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial. Objectives We convened a Global Summit of international scientists to conduct a systematic review of the literature to determine the efficacy and effectiveness of SMT for the primary, secondary and tertiary prevention of non-musculoskeletal disorders. Global summit The Global Summit took place on September 14–15, 2019 in Toronto, Canada. It was attended by 50 researchers from 8 countries and 28 observers from 18 chiropractic organizations. At the summit, participants critically appraised the literature and synthesized the evidence. Systematic review of the literature We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health, and the Index to Chiropractic Literature from inception to May 15, 2019 using subject headings specific to each database and free text words relevant to manipulation/manual therapy, effectiveness, prevention, treatment, and non-musculoskeletal disorders. Eligible for review were randomized controlled trials published in English. The methodological quality of eligible studies was assessed independently by reviewers using the Scottish Intercollegiate Guidelines Network (SIGN) criteria for randomized controlled trials. We synthesized the evidence from articles with high or acceptable methodological quality according to the Synthesis without Meta-Analysis (SWiM) Guideline. The final risk of bias and evidence tables were reviewed by researchers who attended the Global Summit and 75% (38/50) had to approve the content to reach consensus. Results We retrieved 4997 citations, removed 1123 duplicates and screened 3874 citations. Of those, the eligibility of 32 articles was evaluated at the Global Summit and 16 articles were included in our systematic review. Our synthesis included six randomized controlled trials with acceptable or high methodological quality (reported in seven articles). These trials investigated the efficacy or effectiveness of SMT for the management of infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. None of the trials evaluated the effectiveness of SMT in preventing the occurrence of non-musculoskeletal disorders. Consensus was reached on the content of all risk of bias and evidence tables. All randomized controlled trials with high or acceptable quality found that SMT was not superior to sham interventions for the treatment of these non-musculoskeletal disorders. Six of 50 participants (12%) in the Global Summit did not approve the final report. Conclusion Our systematic review included six randomized clinical trials (534 participants) of acceptable or high quality investigating the efficacy or effectiveness of SMT for the treatment of non-musculoskeletal disorders. We found no evidence of an effect of SMT for the management of non-musculoskeletal disorders including infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. This finding challenges the validity of the theory that treating spinal dysfunctions with SMT has a physiological effect on organs and their function. Governments, payers, regulators, educators, and clinicians should consider this evidence when developing policies about the use and reimbursement of SMT for non-musculoskeletal disorders. |
| first_indexed | 2024-12-24T01:35:11Z |
| format | Article |
| id | doaj.art-55875ae223e84ce1aca0d3b6a629668b |
| institution | Directory Open Access Journal |
| issn | 2045-709X |
| language | English |
| last_indexed | 2024-12-24T01:35:11Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Chiropractic & Manual Therapies |
| spelling | doaj.art-55875ae223e84ce1aca0d3b6a629668b2022-12-21T17:22:13ZengBMCChiropractic & Manual Therapies2045-709X2021-02-0129112310.1186/s12998-021-00362-9The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literaturePierre Côté0Jan Hartvigsen1Iben Axén2Charlotte Leboeuf-Yde3Melissa Corso4Heather Shearer5Jessica Wong6Andrée-Anne Marchand7J. David Cassidy8Simon French9Gregory N. Kawchuk10Silvano Mior11Erik Poulsen12John Srbely13Carlo Ammendolia14Marc-André Blanchette15Jason W. Busse16André Bussières17Carolina Cancelliere18Henrik Wulff Christensen19Diana De Carvalho20Katie De Luca21Alister Du Rose22Andreas Eklund23Roger Engel24Guillaume Goncalves25Jeffrey Hebert26Cesar A. Hincapié27Maria Hondras28Amanda Kimpton29Henrik Hein Lauridsen30Stanley Innes31Anne-Laure Meyer32David Newell33Søren O’Neill34Isabelle Pagé35Steven Passmore36Stephen M. Perle37Jeffrey Quon38Mana Rezai39Maja Stupar40Michael Swain41Andrew Vitello42Kenneth Weber43Kenneth J. Young44Hainan Yu45Faculty of Health Sciences, Ontario Tech UniversityDepartment of Sports Science and Clinical Biomechanics, University of Southern DenmarkIntervention & Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska InstitutetDepartment for Regional Health Research, University of Southern DenmarkFaculty of Health Sciences, Ontario Tech UniversityCentre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCCFaculty of Health Sciences, Ontario Tech UniversityDepartment de Chiropractique, Université du Québec à Trois-RivièresDivision of Epidemiology, Dalla Lana School of Public Health, University of TorontoDepartment of Chiropractic, Faculty of Science and Engineering, Macquarie UniversityDepartment of Physical Therapy, Faculty of Rehabilitation Medicine, University of AlbertaCentre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCCDepartment of Sports Science and Clinical Biomechanics, University of Southern DenmarkDepartment of Human Health & Nutritional Sciences, University of GuelphIHPME, Dalla Lana School of Public Health, University of TorontoDepartment de Chiropractique, Université du Québec à Trois-RivièresDepartment of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster UniversityDepartment de Chiropractique, Université du Québec à Trois-RivièresFaculty of Health Sciences, Ontario Tech UniversityNordic Institute of Chiropractic and Clinical BiomechanicsFaculty of Medicine, Memorial University of NewfoundlandDepartment of Chiropractic, Faculty of Science and Engineering, Macquarie UniversityFaculty of Life Sciences and Education University of South WalesIntervention & Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska InstitutetDepartment of Chiropractic, Faculty of Science and Engineering, Macquarie UniversityInstitut Franco-Européen de ChiropraxieFaculty of Kinesiology, University of New BrunswickDepartment of Chiropractic Medicine, Faculty of Medicine, University of Zurich & Balgrist University HospitalDepartment of Anesthesiology, University of Kansas Medical CenterRMIT UniversityDepartment of Sports Science and Clinical Biomechanics, University of Southern DenmarkCollege of Science, Health, Engineering and Education, Murdoch UniversityInstitut Franco-Européen de ChiropraxieAECC University CollegeDepartment for Regional Health Research, University of Southern DenmarkDepartment de Chiropractique, Université du Québec à Trois-RivièresFaculty of Kinesiology & Recreation Management University of ManitobaSchool of Chiropractic, University of BridgeportSchool of Population and Public Health, Faculty of Medicine, University of British ColumbiaCentre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCCCanadian Memorial Chiropractic CollegeDepartment of Chiropractic, Faculty of Science and Engineering, Macquarie UniversitySchool of Health, Medical and Applied Sciences, CQ UniversityStanford University School of Medicine, Stanford UniversitySchool of Sport and Health Sciences, University of Central LancashireFaculty of Health Sciences, Ontario Tech UniversityAbstract Background A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial. Objectives We convened a Global Summit of international scientists to conduct a systematic review of the literature to determine the efficacy and effectiveness of SMT for the primary, secondary and tertiary prevention of non-musculoskeletal disorders. Global summit The Global Summit took place on September 14–15, 2019 in Toronto, Canada. It was attended by 50 researchers from 8 countries and 28 observers from 18 chiropractic organizations. At the summit, participants critically appraised the literature and synthesized the evidence. Systematic review of the literature We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health, and the Index to Chiropractic Literature from inception to May 15, 2019 using subject headings specific to each database and free text words relevant to manipulation/manual therapy, effectiveness, prevention, treatment, and non-musculoskeletal disorders. Eligible for review were randomized controlled trials published in English. The methodological quality of eligible studies was assessed independently by reviewers using the Scottish Intercollegiate Guidelines Network (SIGN) criteria for randomized controlled trials. We synthesized the evidence from articles with high or acceptable methodological quality according to the Synthesis without Meta-Analysis (SWiM) Guideline. The final risk of bias and evidence tables were reviewed by researchers who attended the Global Summit and 75% (38/50) had to approve the content to reach consensus. Results We retrieved 4997 citations, removed 1123 duplicates and screened 3874 citations. Of those, the eligibility of 32 articles was evaluated at the Global Summit and 16 articles were included in our systematic review. Our synthesis included six randomized controlled trials with acceptable or high methodological quality (reported in seven articles). These trials investigated the efficacy or effectiveness of SMT for the management of infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. None of the trials evaluated the effectiveness of SMT in preventing the occurrence of non-musculoskeletal disorders. Consensus was reached on the content of all risk of bias and evidence tables. All randomized controlled trials with high or acceptable quality found that SMT was not superior to sham interventions for the treatment of these non-musculoskeletal disorders. Six of 50 participants (12%) in the Global Summit did not approve the final report. Conclusion Our systematic review included six randomized clinical trials (534 participants) of acceptable or high quality investigating the efficacy or effectiveness of SMT for the treatment of non-musculoskeletal disorders. We found no evidence of an effect of SMT for the management of non-musculoskeletal disorders including infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. This finding challenges the validity of the theory that treating spinal dysfunctions with SMT has a physiological effect on organs and their function. Governments, payers, regulators, educators, and clinicians should consider this evidence when developing policies about the use and reimbursement of SMT for non-musculoskeletal disorders.https://doi.org/10.1186/s12998-021-00362-9Spinal manipulationMobilizationEffectivenessEfficacySystematic reviewNon-musculoskeletal |
| spellingShingle | Pierre Côté Jan Hartvigsen Iben Axén Charlotte Leboeuf-Yde Melissa Corso Heather Shearer Jessica Wong Andrée-Anne Marchand J. David Cassidy Simon French Gregory N. Kawchuk Silvano Mior Erik Poulsen John Srbely Carlo Ammendolia Marc-André Blanchette Jason W. Busse André Bussières Carolina Cancelliere Henrik Wulff Christensen Diana De Carvalho Katie De Luca Alister Du Rose Andreas Eklund Roger Engel Guillaume Goncalves Jeffrey Hebert Cesar A. Hincapié Maria Hondras Amanda Kimpton Henrik Hein Lauridsen Stanley Innes Anne-Laure Meyer David Newell Søren O’Neill Isabelle Pagé Steven Passmore Stephen M. Perle Jeffrey Quon Mana Rezai Maja Stupar Michael Swain Andrew Vitello Kenneth Weber Kenneth J. Young Hainan Yu The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature Chiropractic & Manual Therapies Spinal manipulation Mobilization Effectiveness Efficacy Systematic review Non-musculoskeletal |
| title | The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature |
| title_full | The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature |
| title_fullStr | The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature |
| title_full_unstemmed | The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature |
| title_short | The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature |
| title_sort | global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non musculoskeletal disorders a systematic review of the literature |
| topic | Spinal manipulation Mobilization Effectiveness Efficacy Systematic review Non-musculoskeletal |
| url | https://doi.org/10.1186/s12998-021-00362-9 |
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