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Yu H, Southerst D, Wong JJ, Verville L, Connell G, Ead L, Mior S, Hestbaek L, Swain M, Brunton G, Shearer HM, Papaconstantinou E, To D, Germann D, Pohlman K, Cedraschi C, Cancelliere C. Rehabilitation of back pain in the pediatric population: a mixed studies systematic review. Chiropr Man Therap 2024; 32:14. [PMID: 38720355 PMCID: PMC11080233 DOI: 10.1186/s12998-024-00538-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND A significant proportion of children and adolescents experience back pain. However, a comprehensive systematic review on the effectiveness of rehabilitation interventions is lacking. OBJECTIVES To evaluate benefits and harms of rehabilitation interventions for non-specific low back pain (LBP) or thoracic spine pain in the pediatric population. METHODS Seven bibliographic electronic databases were searched from inception to June 16, 2023. Moreover, reference lists of relevant studies and systematic reviews, three targeted websites, and the WHO International Clinical Trials Registry Platform were searched. Paired reviewers independently conducted screening, assessed risk of bias, and extracted data related to study characteristics, methodology, subjects, and results. Certainty of evidence was evaluated based on the GRADE approach. RESULTS We screened 8461 citations and 307 full-text articles. Ten quantitative studies (i.e., 8 RCTs, 2 non-randomized clinical trials) and one qualitative study were included. With very low to moderate certainty evidence, in adolescents with LBP, spinal manipulation (1-2 sessions/week over 12 weeks, 1 RCT) plus exercise may be associated with a greater likelihood of experiencing clinically important pain reduction versus exercise alone; and group-based exercise over 8 weeks (2 RCTs and 1 non-randomized trial) may reduce pain intensity. The qualitative study found information provided via education/advice and compliance of treatment were related to effective treatment. No economic studies or studies examining thoracic spine pain were identified. CONCLUSIONS Spinal manipulation and group-based exercise may be beneficial in reducing LBP intensity in adolescents. Education should be provided as part of a care program. The overall evidence is sparse. Methodologically rigorous studies are needed. TRIAL REGISTRATION CRD42019135009 (PROSPERO).
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Affiliation(s)
- Hainan Yu
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, L1G 0C5, Canada.
| | - Danielle Southerst
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, L1G 0C5, Canada
| | - Jessica J Wong
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, L1G 0C5, Canada
| | - Leslie Verville
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, L1G 0C5, Canada
| | - Gaelan Connell
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, L1G 0C5, Canada
| | - Lauren Ead
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, L1G 0C5, Canada
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Silvano Mior
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, L1G 0C5, Canada
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Lise Hestbaek
- The Chiropractic Knowledge Hub, Odense, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Michael Swain
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia
| | - Ginny Brunton
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, L1G 0C5, Canada
| | - Heather M Shearer
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, L1G 0C5, Canada
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Efrosini Papaconstantinou
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, L1G 0C5, Canada
| | - Daphne To
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Darrin Germann
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | | | - Christine Cedraschi
- Division of General Medical Rehabilitation, University of Geneva, Geneva, Switzerland
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Carol Cancelliere
- Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, L1G 0C5, Canada
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Keating G, Hawk C, Amorin-Woods L, Amorin-Woods D, Vallone S, Farabaugh R, Todd A, Ferrance R, Young J, O'Neill Bhogal S, Sexton H, Alevaki H, Miller J, Parkin-Smith G, Schielke A, Robinson A, Thompson R. Clinical Practice Guideline for Best Practice Management of Pediatric Patients by Chiropractors: Results of a Delphi Consensus Process. J Integr Complement Med 2024; 30:216-232. [PMID: 37902954 PMCID: PMC10954607 DOI: 10.1089/jicm.2023.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Objective: To build upon existing recommendations on best practices for chiropractic management of children by conducting a formal consensus process and best evidence synthesis. Design: Best practice guide based on recommendations from current best available evidence and formal consensus of a panel of experienced practitioners, consumers, and experts for chiropractic management of pediatric patients. Methods: Synthesis of results of a literature search to inform the development of recommendations from a multidisciplinary steering committee, including experts in pediatrics, followed by a formal Delphi panel consensus process. Results: The consensus process was conducted June to August 2022. All 60 panelists completed the process and reached at least 80% consensus on all recommendations after three Delphi rounds. Recommendations for best practices for chiropractic care for children addressed these aspects of the clinical encounter: patient communication, including informed consent; appropriate clinical history, including health habits; appropriate physical examination procedures; red flags/contraindications to chiropractic care and/or spinal manipulation; aspects of chiropractic management of pediatric patients, including infants; modifications of spinal manipulation and other manual procedures for pediatric patients; appropriate referral and comanagement; and appropriate health promotion and disease prevention practices. Conclusion: This set of recommendations represents a general framework for an evidence-informed and reasonable approach to the management of pediatric patients by chiropractors.
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Affiliation(s)
- Genevieve Keating
- Fielding Graduate University, Santa Barbara, CA, USA
- Private Practice, Melbourne, Australia
| | - Cheryl Hawk
- US-Clinical Compass, Lexington SC, USA
- Texas Chiropractic College, TX, USA
| | - Lyndon Amorin-Woods
- School of Allied Health, Murdoch University, Murdoch, Australia
- Private Practice, Perth, Australia
| | - Deisy Amorin-Woods
- Edith Cowan University, Joondalup, Australia
- Private Practice, Insight Counselling, Perth, Australia
| | | | - Ronald Farabaugh
- Advanced Medicine Integration Group, Columbus, OH, USA
- Clinical Compass, Columbus, OH, USA
| | - Angela Todd
- Private Practice, Sale, Australia
- Aus-ACA, Sale, Australia
| | | | | | | | | | | | - Joyce Miller
- Anglo European College of Chiropractic, Bournemouth, United Kingdom
| | - Gregory Parkin-Smith
- Private Practice, Perth, Australia
- School of Allied Health, Murdoch University, Murdoch, Australia
| | | | | | - Robyn Thompson
- Private Practice, The Thompson Method Breastfeeding, Melbourne, Australia
- Australian Catholic University, Fitzroy, Australia
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Zhou T, Cai W, Wang W, Wang L. Effects of Lifestyle Interventions on Health and Life Quality of Colorectal Cancer Survivors: A Systematic Review and Meta-analysis. Cancer Nurs 2024; 47:E93-E107. [PMID: 37088897 DOI: 10.1097/ncc.0000000000001166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND The results of previous studies on the effects of lifestyle interventions on the quality of life (QoL) in colorectal cancer (CRC) survivors remain controversial, and there have been several new publications in this area in recent years. OBJECTIVES To assess whether lifestyle interventions can lead to favorable health outcomes and improved QoL in CRC survivors, we performed a meta-analysis. METHODS PubMed, EMBASE, Web of Science, and Cochrane Library were systematically searched to obtain relevant literature published from January 1, 1990, to November 1, 2021. The required data were extracted and summarized to compare the physical activity levels, QoL, mental health assessment, and anthropometric data between lifestyle interventions and routine nursing. RESULTS Twelve studies were included. Compared with the control group, lifestyle interventions could significantly increase the physical activity time (weighted mean difference [WMD], 9.84; 95% confidence interval [CI], 1.20-18.48; P = .026), metabolic equivalent task levels (WMD, 10.40; 95% CI, 5.30-15.49; P < .001), and Functional Assessment of Cancer Therapy Scale-Colorectal scores (WMD, 3.12; 95% CI, 0.24-5.99; P = .034). However, lifestyle interventions were not noticeably able to improve the fatigue, depression levels, anxiety levels, waist circumference, or body mass index in CRC survivors. CONCLUSION Lifestyle interventions could generate an increase in physical activity time, metabolic equivalent task levels, and QoL in CRC survivors. IMPLICATIONS FOR PRACTICE Lifestyle interventions in the future that include physical activity, diet, or comprehensive programs are needed to increase physical activity levels and improve QoL in CRC survivors.
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Affiliation(s)
- Ting Zhou
- Author Affiliations: Department of General surgery, the First Affiliated Hospital of Hainan Medical University, Haikou, Hainan (Mss Zhou, Cai, and L Wang); and Nursing College, Guangdong Medical University, Dongguan, Guangdong (Ms W Wang), China
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Martínez-Lentisco MDM, Martín-González M, García-Torrecillas JM, Antequera-Soler E, Chillón-Martínez R. Osteopathic Manual Therapy for Infant Colic: A Randomised Clinical Trial. Healthcare (Basel) 2023; 11:2600. [PMID: 37761797 PMCID: PMC10531355 DOI: 10.3390/healthcare11182600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Infant colic is a multifactorial syndrome for which various therapeutic strategies have been proposed. In this study, we evaluate the effectiveness of osteopathic manual therapy in treating symptoms related to infant colic. METHOD A prospective, randomised, blinded clinical trial was conducted of patients diagnosed with infant colic. The treatment group were given osteopathic manual therapy, and their parents received two sessions of counselling. The control group received no such therapy, but their parents attended the same counselling sessions. The non-parametric Mann-Whitney U test was applied to determine whether there were significant differences between the groups for the numerical variables considered. For the qualitative variables, Fisher's exact test was used. The threshold assumed for statistical significance was 0.05. RESULTS A total of 42 babies were assigned to each group. Those in the experimental group presented less severe infant colic with a trend towards statistical significance after the first session (p = 0.09). In sucking, excretion, eructation and gas there were no significant differences between the groups. Crying was a statistically significant dimension both after the first intervention (p = 0.03) and two weeks after (p = 0.04). Regurgitation values were significantly lower in the experimental group during the three weeks of follow-up (p = 0.05). Values for sleep were lower in the experimental group, but the differences were not statistically significant. In both groups, colic severity decreased over time, with no side effects. CONCLUSIONS Treatment with osteopathic manual therapy alleviates the symptoms of infant colic and could be recommended for this purpose from the onset of the condition.
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Affiliation(s)
- María del Mar Martínez-Lentisco
- Andalusian Health Service, Almería Health District, 04002 Almería, Spain
- Department of Nursing Science, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (M.M.-G.); (E.A.-S.)
| | - Manuel Martín-González
- Department of Nursing Science, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (M.M.-G.); (E.A.-S.)
- Torrecárdenas University Hospital, 04009 Almería, Spain
| | - Juan Manuel García-Torrecillas
- Emergency and Research Unit, Torrecárdenas University Hospital, 04009 Almería, Spain;
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria Ibs, 18012 Granada, Spain
| | - Eduardo Antequera-Soler
- Department of Nursing Science, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (M.M.-G.); (E.A.-S.)
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Laubach L, Chiang B, Sharma V, Jacobs J, Krumme JW, Kuester V. Alternative and Adjunct Treatments for Scoliosis: A Google Trends Analysis of Public Popularity Compared With Scientific Literature. Cureus 2023; 15:e38682. [PMID: 37288184 PMCID: PMC10243736 DOI: 10.7759/cureus.38682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 06/09/2023] Open
Abstract
Purpose As Google searches have often been found to provide inaccurate information regarding various treatments for orthopedic conditions, it becomes important to analyze search trends to understand what treatments are most popularly considered and the quality of information available. We sought to compare the public interest in popular adjunct/alternative scoliosis treatments to the published literature on these topics and assess any temporal trends in the public interest in these treatments. Methods The study authors compiled the most common adjunct/alternative treatments for scoliosis on PubMed. Chiropractic manipulation, Schroth exercises, physical therapy, pilates, and yoga, along with "scoliosis," were each entered into Google Trends, collected from 2004 to 2021. A linear regression analysis of covariance (ANCOVA) was done to determine whether there was a linear relationship between Google Trends' popularity and PubMed publication data. The seasonal popularity of the terms was assessed using locally estimated scatterplot smoothing (LOESS) regression. Results Google Trends and publication frequency linear regression curves were different for chiropractic manipulation (p < 0.001), Schroth exercises (p < 0.001), physical therapy (p < 0.001), and pilates (p = 0.003). Chiropractic manipulation (p < 0.001), Schroth exercises (p = 0.003), and physical therapy (p < 0.001) had positive trends, and yoga (p < 0.001) had a negative trend. Chiropractic manipulation and yoga were more popular in the summer and winter months. Conclusion Google Trends can provide orthopedic surgeons and other healthcare professionals with valuable information on which treatments are gaining popularity with the public, so physicians may specifically inform themselves prior to patient encounters, leading to more productive shared decision-making.
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Affiliation(s)
- Logan Laubach
- Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, Richmond, USA
| | - Benjamin Chiang
- General Surgery, Riverside University Health System Medical Center, Riverside, USA
| | - Viraj Sharma
- Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, Richmond, USA
| | - Jonathon Jacobs
- Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, USA
| | - John W Krumme
- Orthopaedic Surgery, University of Missouri Kansas City School of Medicine, Leawood, USA
| | - Victoria Kuester
- Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, Richmond, USA
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Driehuis F, Bakker-Jacobs A, Staal JB, de Bie RA, Nijhuis-van der Sanden MWG, Hoogeboom TJ. Parents' and healthcare professionals' perspectives on manual therapy in infants: A mixed-methods study. PLoS One 2023; 18:e0283646. [PMID: 37023071 PMCID: PMC10079100 DOI: 10.1371/journal.pone.0283646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/14/2023] [Indexed: 04/07/2023] Open
Abstract
OBJECTIVES Manual therapy in infants is embedded in Dutch healthcare despite inconsistent evidence and ongoing debate about its safety and merits. This study examines decision-making in manual therapy in infants and explores parents' and healthcare professionals' perspectives on this treatment approach. METHODS This mixed-methods study consisted of an online survey among manual physiotherapists and paediatric physiotherapists exploring decision-making on manual therapy in infants and interprofessional collaboration. These data prompted further exploration and were combined with data collected with semi-structured interviews exploring parents' and healthcare professionals' perspectives. Interviews were analysed using an inductive content analysis approach. RESULTS 607 manual physiotherapists and 388 paediatric physiotherapists completed the online survey; 45% and 95% indicated they treat infants, respectively. Collaboration was reported by 46% of manual physiotherapists and 64% of paediatric physiotherapists for postural asymmetry, positional preference, upper cervical dysfunction, excessive crying, anxiety or restlessness. Reasons to not treat or collaborate were: limited professional competence, practice policy, not perceiving added value, lack of evidence and fear of complications. Analysis of interviews with 7 parents, 9 manual physiotherapists, 7 paediatric physiotherapists, 5 paediatricians and 2 maternity nurses revealed that knowledge and beliefs, professional norms, interpersonal relation, treatment experiences and emotions of parents influenced attitudes and decision-making towards choosing for manual therapy in infants. CONCLUSION Parents' and healthcare professionals' attitudes towards manual therapy in infants can be divided as 'in favour' or 'against'. Those who experienced a good interpersonal relation with a manual physiotherapist and positive treatment outcomes reported positive attitudes. Lack of evidence, treatment experience and related knowledge, safety issues due to publications on adverse events and professional norms led to negative attitudes. Despite lacking evidence, positive treatment experiences, good interpersonal relation and parents feeling frustrated and despaired can overrule negative attitudes and directly influence the decision-making process and choosing for manual therapy treatment.
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Affiliation(s)
- Femke Driehuis
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Annick Bakker-Jacobs
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J. Bart Staal
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Rob A. de Bie
- Caphri Research School, Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | | | - Thomas J. Hoogeboom
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Hauber SD, Robinson K, Kirby E, Kamper S, Lennox NN, O'Sullivan K. Describing the nonsurgical, nonpharmacological interventions offered to adolescents with persistent back pain in randomized trials: A scoping review. Eur J Pain 2023; 27:459-475. [PMID: 36587243 DOI: 10.1002/ejp.2073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Persistent nonspecific back pain is now established as a biopsychosocial phenomenon that can be meaningfully affected by individuals' cognitions, emotions, lifestyle factors and family and social relationships. Recent guidelines for the treatment of adolescents with persistent nonspecific back pain, as well as those for youth with mixed chronic pain, strongly recommend interdisciplinary care in which adolescents receive treatment for both mind and body. The objective of this scoping review was to examine the interventions evaluated in randomized trials for adolescents with persistent back pain to determine whether they correspond to these guidelines and to reveal future research priorities. DATABASES AND DATA TREATMENT The review protocol was registered in March 2022. We followed the PRISMA guidelines for scoping reviews. Twelve electronic databases were searched for relevant study reports. Data were charted on study characteristics, participant characteristics and intervention details using the Template for Intervention Description and Replication (TIDieR) checklist. RESULTS The search yielded 1952 records, of which eight reports representing seven randomized trials were eligible. The most common interventions were exercise therapy (n = 6) and back education (n = 4). Five studies employed multiple intervention components, but none was multidisciplinary. Studies primarily targeted posture or biomechanical factors. One study included an intervention addressing participants' fears and beliefs about pain. CONCLUSIONS Randomized trials for adolescents with persistent back pain have primarily relied upon an outdated, biomechanical explanation of persisting pain. Future randomized trials should align with current treatment recommendations and measure outcomes across multiple biopsychosocial domains. SIGNIFICANCE This scoping review describes in detail the interventions included in randomized trials for adolescents with persistent, nonspecific back pain. The review is important because it reveals discrepancies between those interventions and the interventions recommended for this population.
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Affiliation(s)
- Sara D Hauber
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Katie Robinson
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Edward Kirby
- Essex Partnership University NHS Foundation Trust, Runwell, UK
| | - Steven Kamper
- School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
- Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - Noirin Nealon Lennox
- Faculty of Life and Health Sciences, Ulster University, Belfast, UK
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Kieran O'Sullivan
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Sun Y, Zhang Y, Ma H, Tan M, Zhang Z. Spinal Manual Therapy for Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Biomed Res Int 2023; 2023:7928429. [PMID: 36644168 DOI: 10.1155/2023/7928429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 12/10/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023]
Abstract
Objective We conducted this meta-analysis to provide better evidence of the efficacy of manual therapy (MT) on adolescent idiopathic scoliosis (AIS). Methods All RCTs of MT for the management of patients with AIS were included in the present study. The treatment difference between the experimental and control group was mainly MT. The outcomes consisted of the total effective rate, the Cobb angle, and Scoliosis Research Society-22 (SRS-22) questionnaire score. Electronic database searches were conducted from database inception to July 2022, including the Cochrane Library, PubMed, Web of Science, Embase, Wanfang Data, CNKI, and VIP. The pooled data were analyzed using RevMan 5.4 software. Results Four RCTs with 213 patients in the experimental group were finally included. There are 2 studies of standalone MT in the experimental group and 3 studies of MT with identical conservative treatments in the control group. Three trials reported total effective rate, and a statistically significant difference was found (P = 0.004). Three trials reported Cobb angle, and a statistical difference was found (P = 0.01). Then, sensitivity analysis showed that there was a significant difference in the additional MT subgroup (P < 0.00001) while not in the standalone MT subgroup (P = 0.41). Three trials reported SRS-22 scores (P = 0.55) without significant differences. Conclusion There is insufficient data to determine the effectiveness of spinal manipulation limited by the very low quality of included studies. High-quality studies with appropriate design and follow-up periods are warranted to determine if MT may be beneficial as an adjunct therapy for AIS. Currently, there is no evidence to support spinal manipulation.
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Milne N, Longeri L, Patel A, Pool J, Olson K, Basson A, Gross AR. Spinal manipulation and mobilisation in the treatment of infants, children, and adolescents: a systematic scoping review. BMC Pediatr 2022; 22:721. [PMID: 36536328 PMCID: PMC9762100 DOI: 10.1186/s12887-022-03781-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
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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Affiliation(s)
- Nikki Milne
- grid.1033.10000 0004 0405 3820Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia ,International Organisation of Physiotherapists in Paediatrics, World Physiotherapy Subgroup, Queensland, Australia
| | - Lauren Longeri
- grid.1033.10000 0004 0405 3820Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia
| | - Anokhi Patel
- grid.1033.10000 0004 0405 3820Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia
| | - Jan Pool
- grid.5477.10000000120346234Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, The Netherlands
| | - Kenneth Olson
- International Federation of Orthopaedic Manipulative Physical Therapy and Northern Rehab Physical Therapy Specialists, Anchorage, USA
| | - Annalie Basson
- grid.11951.3d0000 0004 1937 1135University of Witwatersrand, Johannesburg, South Africa
| | - Anita R. Gross
- grid.25073.330000 0004 1936 8227McMaster University, Hamilton, Canada
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Franke H, Franke JD, Fryer G. Effectiveness of osteopathic manipulative treatment for pediatric conditions: A systematic review. J Bodyw Mov Ther 2022; 31:113-133. [DOI: 10.1016/j.jbmt.2022.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 02/23/2022] [Accepted: 03/18/2022] [Indexed: 11/25/2022]
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Dice JL, Dendy D, Sizer PS, Cook CE, Feuling S, Brismée JM. Manual Therapy in Preadolescent Children: A Delphi Investigation of Physical Therapists in the United States. Phys Ther 2021; 101:6123359. [PMID: 33513233 DOI: 10.1093/ptj/pzab027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 10/24/2020] [Accepted: 11/29/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Limited research has investigated the use of manual therapy to treat the preadolescent (0-12 years of age) population with musculoskeletal and neurological impairments. The purpose of this study was to identify the following among physical therapists holding advanced credentials in pediatrics, neurodevelopmental treatment, or manual therapy: (1) consensus regarding effective techniques in the preadolescent population, (2) differences in opinion, and (3) perceived decision-making barriers and factors regarding use of manual therapy techniques. METHODS Credentialed physical therapists in the United States were recruited for a 3-round Delphi investigation. An electronic survey in Round 1 identified musculoskeletal and neurological impairments and the manual techniques considered effective to treat such conditions, in addition to factors and barriers. Responses were used to create the second round, during which a 4-point Likert scale was used to score each survey item. A third round of scoring established consensus. Descriptive statistics and composite scores were calculated for each manual technique by impairment. Between-group differences were calculated using the Mann-Whitney U test with Bonferroni correction. RESULTS Consensus was determined for several concepts. First, neuromuscular techniques were considered effective across all impairments, and joint mobilizations (grades I-IV) were believed to be effective to treat joint and muscle and myofascial impairments. Second, visceral manipulation and craniosacral therapy were considered ineffective in treating most impairments. There was lack of consensus and clear differences of opinion regarding the use of grade V mobilizations and dry needling. Significant barriers to use of manual therapy were: lack of knowledge, lack of evidence, and fear of litigation and harming patients. CONCLUSION This study is an initial step for developing manual therapy guidelines, research, and educational opportunities regarding manual therapy in pediatric physical therapy.
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Affiliation(s)
- Jenifer L Dice
- Texas Children's Hospital, Department of Physical Medicine and Rehabilitation, Houston, Texas, USA.,Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Doug Dendy
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Phillip S Sizer
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Chad E Cook
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Sara Feuling
- Texas Children's Hospital, Department of Physical Medicine and Rehabilitation, Houston, Texas, USA
| | - Jean-Michel Brismée
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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12
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Abstract
Complementary medicine is being used more broadly by many patients and physicians; however, little formal education has been provided on the topic. Given the prevalence of its use, pediatricians should have awareness of the options available as well as a certain level of comfort in counseling patients and families. This article aims to broaden knowledge on this topic as well as the evidence to support its use. [Pediatr Ann. 2021;50(3):e91-e95.].
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13
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Cancelliere C, Wong JJ, Yu H, Mior S, Brunton G, Shearer HM, Rudoler D, Hestbæk L, Papaconstantinou E, Cedraschi C, Swain M, Connell G, Verville L, Taylor-Vaisey A, Côté P. Rehabilitative management of back pain in children: protocol for a mixed studies systematic review. BMJ Open 2020; 10:e038534. [PMID: 33055118 PMCID: PMC7559046 DOI: 10.1136/bmjopen-2020-038534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Little is known about effective, efficient and acceptable management of back pain in children. A comprehensive and updated evidence synthesis can help to inform clinical practice. OBJECTIVE To inform clinical practice, we aim to conduct a systematic review of the literature and synthesise the evidence regarding effective, cost-effective and safe rehabilitation interventions for children with back pain to improve their functioning and other health outcomes. METHODS AND ANALYSIS We will search MEDLINE, Embase, PsycINFO, CINAHL, the Index to Chiropractic Literature, the Cochrane Controlled Register of Trials and EconLit for primary studies published from inception in all languages. We will include quantitative studies (randomised controlled trials, cohort and case-control studies), qualitative studies, mixed-methods studies and full economic evaluations. To augment our search of the bibliographic electronic databases, we will search reference lists of included studies and relevant systematic reviews, the WHO International Clinical Trials Registry Platform and consult with content experts. We will assess the risk of bias using appropriate critical appraisal tools. We will extract data about study and participant characteristics, intervention type and comparators, context and setting, outcomes, themes and methodological quality assessment. We will use a sequential approach at the review level to integrate data from the quantitative, qualitative and economic evidence syntheses. ETHICS AND DISSEMINATION Ethics approval is not required. We will disseminate findings through activities, including (1) presentations in national and international conferences; (2) meetings with national and international decision makers; (3) publications in peer-reviewed journals and (4) posts on organisational websites and social media. PROSPERO REGISTRATION NUMBER CRD42019135009.
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Affiliation(s)
- Carol Cancelliere
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Jessica J Wong
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Hainan Yu
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Silvano Mior
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Ginny Brunton
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- EPPI-Centre, UCL Institute of Education, University College London, England, United Kingdom
- McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - Heather M Shearer
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - David Rudoler
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Lise Hestbæk
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | | | - Christine Cedraschi
- Division of General Medical Rehabilitation, Geneva University and University Hospitals, Geneva, Switzerland
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Michael Swain
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia
| | - Gaelan Connell
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie Verville
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Anne Taylor-Vaisey
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Division of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Pierre Côté
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Youn PS, Cho KH, Park SJ. Changes in Ankle Range of Motion, Gait Function and Standing Balance in Children with Bilateral Spastic Cerebral Palsy after Ankle Mobilization by Manual Therapy. Children (Basel) 2020; 7:children7090142. [PMID: 32961844 PMCID: PMC7552781 DOI: 10.3390/children7090142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate the effect of ankle joint mobilization in children with cerebral palsy (CP) to ankle range of motion (ROM), gait, and standing balance. We recruited 32 children (spastic diplegia) diagnosed with CP and categorized them in two groups: the ankle joint mobilization (n = 16) group and sham joint mobilization (n = 16) group. Thus, following a six-week ankle joint mobilization, we examined measures such as passive ROM in ankle dorsiflexion in the sitting and supine position, center of pressure (COP) displacements (sway length, area) with eyes open (EO) and closed (EC), and a gait function test (timed up and go test (TUG) and 10-m walk test). The dorsiflexion ROM, TUG, and 10-m walk test significantly increased in the mobilization group compared to the control group. Ankle joint mobilization can be regarded as a promising method to increase dorsiflexion and improve gait in CP-suffering children.
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Affiliation(s)
- Pong Sub Youn
- Department of Physical Therapy, Kyungbok University, Namyangju-si 425, Korea
| | | | - Shin Jun Park
- Department of Physical Therapy, Gangdong University, Daehak-gil 278, Korea
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15
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Pedro KM, Gaddi MJS, Sih IMY. Iatrogenic atlantoaxial rotatory subluxation after spinal manipulative therapy in a child. Interdisciplinary Neurosurgery 2020. [DOI: 10.1016/j.inat.2020.100721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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16
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Ellwood J, Draper-Rodi J, Carnes D. The effectiveness and safety of conservative interventions for positional plagiocephaly and congenital muscular torticollis: a synthesis of systematic reviews and guidance. Chiropr Man Therap 2020; 28:31. [PMID: 32522230 PMCID: PMC7288527 DOI: 10.1186/s12998-020-00321-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/12/2020] [Indexed: 12/24/2022] Open
Abstract
Aim To investigate for congenital muscular torticollis (CMT) and positional plagiocephaly (PP) the effectiveness and safety of manual therapy, repositioning and helmet therapy (PP only) using a systematic review of systematic reviews and national guidelines. Methods We searched four major relevant databases: PubMed, Embase, Cochrane and MANTIS for research studies published between the period 1999–2019. Inclusion criteria were systematic reviews that analysed results from multiple studies and guidelines that used evidence and expert opinion to recommend treatment and care approaches. Three reviewers independently selected articles by title, abstract and full paper review, and extracted data. Selected studies were described by two authors and assessed for quality. Where possible meta-analysed data for change in outcomes (range of movement and head shape) were extracted and qualitative conclusions were assessed. Results We found 10 systematic reviews for PP and 4 for CMT. One national guideline was found for each PP and CMT. For PP, manual therapy was found to be more effective than repositioning including tummy time (moderate to high evidence) but not better than helmet therapy (low evidence). Helmet therapy was better than usual care or repositioning (low evidence); and repositioning better than usual care (moderate to high evidence). The results for CMT showed that manual therapy in the form of practitioner-led stretching had moderate favourable evidence for increased range of movement. Advice, guidance and parental support was recommended in all the guidance to reassure parents of the favourable trajectory and nature of these conditions over time. Conclusions Distinguishing between superiority of treatments was difficult due to the lack of standardised measurement systems, the variety of outcomes and limited high quality studies. More well powered effectiveness and efficacy studies are needed. However overall, advice and guidance on repositioning (including tummy-time) and practitioner-led stretching were low risk, potentially helpful and inexpensive interventions for parents to consider. Systematic review registration number PROSPERO 2019 CRD42019139074.
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Affiliation(s)
- Julie Ellwood
- University College Osteopathy, 275 Borough High St, London, SE1 1JE, England
| | - Jerry Draper-Rodi
- University College Osteopathy, 275 Borough High St, London, SE1 1JE, England
| | - Dawn Carnes
- University College Osteopathy, 275 Borough High St, London, SE1 1JE, England. .,Faculty of Health, University Applied Sciences and the Arts Western Switzerland, Fribourg, Switzerland.
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17
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Ellwood J, Draper-Rodi J, Carnes D. Comparison of common interventions for the treatment of infantile colic: a systematic review of reviews and guidelines. BMJ Open 2020; 10:e035405. [PMID: 32102827 PMCID: PMC7202698 DOI: 10.1136/bmjopen-2019-035405] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To conduct a systematic review of systematic reviews and national guidelines to assess the effectiveness of four treatment approaches (manual therapy, probiotics, proton pump inhibitors and simethicone) on colic symptoms including infant crying time, sleep distress and adverse events. METHODS We searched PubMed, Embase, Cochrane and Mantis for studies published between 2009 and 2019. Inclusion criteria were systematic reviews and guidelines that used evidence and expert panel opinion. Three reviewers independently selected articles by title, abstract and full paper review. Data were extracted by one reviewer and checked by a second. Selected studies were assessed for quality using modified standardised checklists by two authors. Meta-analysed data for our outcomes of interest were extracted and narrative conclusions were assessed. RESULTS Thirty-two studies were selected. High-level evidence showed that probiotics were most effective for reducing crying time in breastfed infants (range -25 min to -65 min over 24 hours). Manual therapies had moderate to low-quality evidence showing reduced crying time (range -33 min to -76 min per 24 hours). Simethicone had moderate to low evidence showing no benefit or negative effect. One meta-analysis did not support the use of proton pump inhibitors for reducing crying time and fussing. Three national guidelines unanimously recommended the use of education, parental reassurance, advice and guidance and clinical evaluation of mother and baby. Consensus on other advice and treatments did not exist. CONCLUSIONS The strongest evidence for the treatment of colic was probiotics for breastfed infants, followed by weaker but favourable evidence for manual therapy indicated by crying time. Both forms of treatment carried a low risk of serious adverse events. The guidance reviewed did not reflect these findings. PROSPERO REGISTRATION NUMBER CRD42019139074.
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Affiliation(s)
- Julie Ellwood
- Research Department, University College of Osteopathy, London, UK
| | | | - Dawn Carnes
- Research Department, University College of Osteopathy, London, UK
- Faculty of Health, University of Applied Sciences Western Switzerland, Fribourg, Switzerland
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18
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Tao J, Rupar CA, Miller MR, Ratko S, Prasad C. Use of complementary and alternative medicine in patients with inborn errors of metabolism: A single-center study. JIMD Rep 2019; 51:105-112. [PMID: 32071845 PMCID: PMC7012736 DOI: 10.1002/jmd2.12089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/13/2019] [Accepted: 11/19/2019] [Indexed: 12/19/2022] Open
Abstract
Background and Objectives There is a paucity of information on the use of complementary and alternative medicine (CAM) in patients with inborn errors of metabolism (IEM). This study's objective was to evaluate the self-reported use and perceived effectiveness of CAM in adults and children with IEM. Methods Patients aged 0-70 years and caregivers seen at the London Health Sciences Centre Metabolic Clinic (London, Ontario, Canada) between July 2017 and August 2017 were recruited to complete a questionnaire regarding CAM use to help their IEM diagnosis and perceived effectiveness of these therapies. Survey responses were analyzed using descriptive statistics; age, sex, and education level associations among CAM users were tested using the Pearson χ 2 test. Results Of 50 potential participants, 44 (88%) completed the questionnaire, including 21 adults (6 by caregivers) and 23 children (22 by caregivers). The most common IEM category was Aminoacidopathies and Small Molecule Disorders (50%). Twenty-seven (61%) participants reported CAM use to help their IEM diagnosis. The most common CAM therapies used were chiropractic manipulation, omega-3 fatty acids, probiotics, and aromatherapy/essential oils. Most CAM users and caregivers (74%) perceived their CAM therapies as effective overall. Among CAM users, 40% had not discussed CAM use with a health care professional (HCP). CAM use was similar when comparing age, sex and education level. Conclusions CAM is commonly used among patients with IEM. The safety and efficacy of CAM therapies for IEM should be further investigated. HCPs and patients should openly discuss CAM use in order to evaluate safety.
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Affiliation(s)
- Jessica Tao
- Faculty of Science Western University London Ontario Canada
| | - C Anthony Rupar
- Department of Pathology & Laboratory Medicine and Biochemistry Western University London Ontario Canada.,Department of Paediatrics Western University London Ontario Canada.,Children's Health Research Institute, Western University London Ontario Canada
| | - Michael R Miller
- Department of Paediatrics Western University London Ontario Canada.,Children's Health Research Institute, Western University London Ontario Canada
| | - Suzanne Ratko
- Children's Hospital, London Health Sciences Centre London Ontario Canada
| | - Chitra Prasad
- Department of Paediatrics Western University London Ontario Canada.,Children's Health Research Institute, Western University London Ontario Canada
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