Spinal manipulation and mobilisation in the treatment of infants, children, and adolescents: a systematic scoping review

Abstract Purpose To i) identify and map the available evidence regarding effectiveness and harms of spinal manipulation and mobilisation for infants, children and adolescents with a broad range of conditions; ii) identify and synthesise policies, regulations, position statements and practice guideli...

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Main Authors: Nikki Milne, Lauren Longeri, Anokhi Patel, Jan Pool, Kenneth Olson, Annalie Basson, Anita R. Gross
Format: Article
Language:English
Published: BMC 2022-12-01
Series:BMC Pediatrics
Subjects:
Online Access:https://doi.org/10.1186/s12887-022-03781-6
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author Nikki Milne
Lauren Longeri
Anokhi Patel
Jan Pool
Kenneth Olson
Annalie Basson
Anita R. Gross
author_facet Nikki Milne
Lauren Longeri
Anokhi Patel
Jan Pool
Kenneth Olson
Annalie Basson
Anita R. Gross
author_sort Nikki Milne
collection DOAJ
description Abstract Purpose To i) identify and map the available evidence regarding effectiveness and harms of spinal manipulation and mobilisation for infants, children and adolescents with a broad range of conditions; ii) identify and synthesise policies, regulations, position statements and practice guidelines informing their clinical use. Design Systematic scoping review, utilising four electronic databases (PubMed, Embase, CINHAL and Cochrane) and grey literature from root to 4th February 2021. Participants Infants, children and adolescents (birth to < 18 years) with any childhood disorder/condition. Intervention Spinal manipulation and mobilisation Outcome measures Outcomes relating to common childhood conditions were explored. Method Two reviewers (A.P., L.L.) independently screened and selected studies, extracted key findings and assessed methodological quality of included papers using Joanna Briggs Institute Checklist for Systematic Reviews and Research Synthesis, Joanna Briggs Institute Critical Appraisal Checklist for Text and Opinion Papers, Mixed Methods Appraisal Tool and International Centre for Allied Health Evidence Guideline Quality Checklist. A descriptive synthesis of reported findings was undertaken using a levels of evidence approach. Results Eighty-seven articles were included. Methodological quality of articles varied. Spinal manipulation and mobilisation are being utilised clinically by a variety of health professionals to manage paediatric populations with adolescent idiopathic scoliosis (AIS), asthma, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), back/neck pain, breastfeeding difficulties, cerebral palsy (CP), dysfunctional voiding, excessive crying, headaches, infantile colic, kinetic imbalances due to suboccipital strain (KISS), nocturnal enuresis, otitis media, torticollis and plagiocephaly. The descriptive synthesis revealed: no evidence to explicitly support the effectiveness of spinal manipulation or mobilisation for any condition in paediatric populations. Mild transient symptoms were commonly described in randomised controlled trials and on occasion, moderate-to-severe adverse events were reported in systematic reviews of randomised controlled trials and other lower quality studies. There was strong to very strong evidence for ‘no significant effect’ of spinal manipulation for managing asthma (pulmonary function), headache and nocturnal enuresis, and inconclusive or insufficient evidence for all other conditions explored. There is insufficient evidence to draw conclusions regarding spinal mobilisation to treat paediatric populations with any condition. Conclusion Whilst some individual high-quality studies demonstrate positive results for some conditions, our descriptive synthesis of the collective findings does not provide support for spinal manipulation or mobilisation in paediatric populations for any condition. Increased reporting of adverse events is required to determine true risks. Randomised controlled trials examining effectiveness of spinal manipulation and mobilisation in paediatric populations are warranted.
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spelling doaj.art-70851ca4d9d34722ac62d105dec1d7d02022-12-25T12:29:37ZengBMCBMC Pediatrics1471-24312022-12-0122112410.1186/s12887-022-03781-6Spinal manipulation and mobilisation in the treatment of infants, children, and adolescents: a systematic scoping reviewNikki Milne0Lauren Longeri1Anokhi Patel2Jan Pool3Kenneth Olson4Annalie Basson5Anita R. Gross6Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond UniversityDepartment of Physiotherapy, Faculty of Health Sciences and Medicine, Bond UniversityDepartment of Physiotherapy, Faculty of Health Sciences and Medicine, Bond UniversityResearch Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied SciencesInternational Federation of Orthopaedic Manipulative Physical Therapy and Northern Rehab Physical Therapy SpecialistsUniversity of WitwatersrandMcMaster UniversityAbstract Purpose To i) identify and map the available evidence regarding effectiveness and harms of spinal manipulation and mobilisation for infants, children and adolescents with a broad range of conditions; ii) identify and synthesise policies, regulations, position statements and practice guidelines informing their clinical use. Design Systematic scoping review, utilising four electronic databases (PubMed, Embase, CINHAL and Cochrane) and grey literature from root to 4th February 2021. Participants Infants, children and adolescents (birth to < 18 years) with any childhood disorder/condition. Intervention Spinal manipulation and mobilisation Outcome measures Outcomes relating to common childhood conditions were explored. Method Two reviewers (A.P., L.L.) independently screened and selected studies, extracted key findings and assessed methodological quality of included papers using Joanna Briggs Institute Checklist for Systematic Reviews and Research Synthesis, Joanna Briggs Institute Critical Appraisal Checklist for Text and Opinion Papers, Mixed Methods Appraisal Tool and International Centre for Allied Health Evidence Guideline Quality Checklist. A descriptive synthesis of reported findings was undertaken using a levels of evidence approach. Results Eighty-seven articles were included. Methodological quality of articles varied. Spinal manipulation and mobilisation are being utilised clinically by a variety of health professionals to manage paediatric populations with adolescent idiopathic scoliosis (AIS), asthma, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), back/neck pain, breastfeeding difficulties, cerebral palsy (CP), dysfunctional voiding, excessive crying, headaches, infantile colic, kinetic imbalances due to suboccipital strain (KISS), nocturnal enuresis, otitis media, torticollis and plagiocephaly. The descriptive synthesis revealed: no evidence to explicitly support the effectiveness of spinal manipulation or mobilisation for any condition in paediatric populations. Mild transient symptoms were commonly described in randomised controlled trials and on occasion, moderate-to-severe adverse events were reported in systematic reviews of randomised controlled trials and other lower quality studies. There was strong to very strong evidence for ‘no significant effect’ of spinal manipulation for managing asthma (pulmonary function), headache and nocturnal enuresis, and inconclusive or insufficient evidence for all other conditions explored. There is insufficient evidence to draw conclusions regarding spinal mobilisation to treat paediatric populations with any condition. Conclusion Whilst some individual high-quality studies demonstrate positive results for some conditions, our descriptive synthesis of the collective findings does not provide support for spinal manipulation or mobilisation in paediatric populations for any condition. Increased reporting of adverse events is required to determine true risks. Randomised controlled trials examining effectiveness of spinal manipulation and mobilisation in paediatric populations are warranted.https://doi.org/10.1186/s12887-022-03781-6SpineManipulationMobilisationInfantChildAdolescent
spellingShingle Nikki Milne
Lauren Longeri
Anokhi Patel
Jan Pool
Kenneth Olson
Annalie Basson
Anita R. Gross
Spinal manipulation and mobilisation in the treatment of infants, children, and adolescents: a systematic scoping review
BMC Pediatrics
Spine
Manipulation
Mobilisation
Infant
Child
Adolescent
title Spinal manipulation and mobilisation in the treatment of infants, children, and adolescents: a systematic scoping review
title_full Spinal manipulation and mobilisation in the treatment of infants, children, and adolescents: a systematic scoping review
title_fullStr Spinal manipulation and mobilisation in the treatment of infants, children, and adolescents: a systematic scoping review
title_full_unstemmed Spinal manipulation and mobilisation in the treatment of infants, children, and adolescents: a systematic scoping review
title_short Spinal manipulation and mobilisation in the treatment of infants, children, and adolescents: a systematic scoping review
title_sort spinal manipulation and mobilisation in the treatment of infants children and adolescents a systematic scoping review
topic Spine
Manipulation
Mobilisation
Infant
Child
Adolescent
url https://doi.org/10.1186/s12887-022-03781-6
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