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CMT in Pediatrics

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Pediatrics

A 2012 systematic reviewed stated, “studies that monitored both subjective and objective outcome measures of relevance to both patients and parents tended to report the most favorable response to SMT, especially among children with asthma.” [1]

  • ADHD
  • Evidence is insufficient to support chiropractic care for ADHD in children. [2] [3]
  • Autism spectrum disorders
  • Limited literature regarding chiropractic care and autism.4 Preliminary studies suggest some benefit from chiropractic care. [4]
  • “Given the ineffectiveness of pharmaceutical agents, a trial of chiropractic care for sufferers of autism is prudent and warranted.”[4]
  • Asthma
  • A 2010 systematic review states that SMT is not effective for asthma, compared to sham manipulation. [5] However, a 2007 review indicates that the entire clinical encounter of chiropractic care, including SMT, is beneficial to patients with asthma. [6]
  • Another 2010 systematic review states that “chiropractic care showed improvements in subjective measures and, to a lesser degree objective measures, none of which were statistically significant. Some asthmatic patients may benefit from this treatment approach; however, at this time, the evidence suggests chiropractic care should be used as an adjunct, not a replacement, to traditional medical therapy.” [7]
  • Best practices recommendations
  • Figure included in article listing “Red Flags” that require emergent treatment or referral and co-management (Figure 2) [8]
  • Standards for pediatric education should be developed in chiropractic college curriculum including post graduate education [8]
  • Chiropractic treatment for infants, children and adolescents include, but are not limited to spinal manipulation, vitamins, dietary interventions, therapeutic exercise, posture correction, and physical agents. Patient preference is important. [8]
  • Adult research may not be generalizable to pediatric population [8]
  • Colic
  • “Chiropractic care is a viable alternative to the care of infantile colic and congruent with evidence-based practice, particularly when one considers that medical care options are no better than placebo or have associated adverse events.” [9]
  • Cochrane database systematic review and a 2010 review found that evidence was insufficient to make conclusions about the effectiveness of SMT.[3] [10]
  • Musculoskeletal conditions
  • Evidence is insufficient for manual therapy for spinal disorders in the pediatric population specifically. There was one RCT for TMJ disorders. [11]
  • Nocturnal enuresis
  • Evidence is insufficient for SMT. [3]
  • Otitis media
  • Evidence is insufficient to support or refute SMT for OM3,12 but there is no evidence of serious adverse events from SMT for children with OM. [12]
  • Respiratory disease
  • Study looked at osteopathic manipulation, massage and chiropractic and found that the literature is insufficient. [13]


References

  1. ↑ Gleberzon, BJ et al (Jun 2012). "The use of spinal manipulative therapy for pediatric health conditions: a systematic review of the literature". The Journal of the Canadian Chiropractic Association 56 (2): 128-141. http://www.ncbi.nlm.nih.gov/pubmed/?term=The+use+of+spinal+manipulative+therapy+for+pediatric+health+conditions%3A+a+systematic+review+of+the+literature. Retrieved 1-9-2014. 
  2. ↑ Karpouzis, F et al (Jun 2010). "Chiropractic care for paediatric and adolescent Attention-Deficit/Hyperactivity Disorder: A systematic review". Chiropr Osteopat 18 (13). http://www.ncbi.nlm.nih.gov/pubmed/20525195. Retrieved 1-9-2014. 
  3. ↑ 3.0 3.1 3.2 Ferrance, RJ et al (Jun 2010). "Chiropractic diagnosis and management of non-musculoskeletal conditions in children and adolescents". Chiropr Osteopat 18 (14). http://www.ncbi.nlm.nih.gov/pubmed/?term=Chiropractic+diagnosis+and+management+of+non-musculoskeletal+conditions+in+children+and+adolescents. Retrieved 1-9-2014. 
  4. ↑ 4.0 4.1 Alcantara, J et al (Nov-Dec 2011). "A systematic review of the literature on the chiropractic care of patients with autism spectrum disorder". Explore (NY) 7 (6): 384-390. http://www.ncbi.nlm.nih.gov/pubmed/?term=A+systematic+review+of+the+literature+on+the+chiropractic+care+of+patients+with+autism+spectrum+disorder. Retrieved 1-9-2014. 
  5. ↑ Bronfort, G et al (Feb 2010). "Effectiveness of manual therapies: the UK evidence report". Chiropr Osteopat 18 (3). http://www.ncbi.nlm.nih.gov/pubmed/20184717. Retrieved 1-9-2014. 
  6. ↑ Hawk, C et al (Jun 2007). "Chiropractic care for nonmusculoskeletal conditions: a systematic review with implications for whole systems research". J Altern Complement Med 13 (5): 491-512. http://www.ncbi.nlm.nih.gov/pubmed/?term=Chiropractic+care+for+nonmusculoskeletal+conditions%3A+a+systematic+review+with+implications+for+whole+systems+research. Retrieved 1-9-2014. 
  7. ↑ Kaminskyj, A et al (March 2010). "Chiropractic care for patients with asthma: A systematic review of the literature". The Journal of the Canadian Chiropractic Association 54 (1): 24-32. http://www.ncbi.nlm.nih.gov/pubmed/20195423. Retrieved 1-9-2014. 
  8. ↑ 8.0 8.1 8.2 8.3 Hawk, C et al (Oct 2009). "Best practices recommendations for chiropractic care for infants, children, and adolescents: results of a consensus process". J Manipulative Physiol Ther 32 (8): 639-647. http://www.ncbi.nlm.nih.gov/pubmed/?term=Best+practices+recommendations+for+chiropractic+care+for+infants%2C+children%2C+and+adolescents%3A+results+of+a+consensus+process. Retrieved 1-9-2014. 
  9. ↑ Alcantara, J et al (May-Jun 2011). "The chiropractic care of infants with colic: a systematic review of the literature". Explore (NY) 7 (3): 168-174. http://www.ncbi.nlm.nih.gov/pubmed/21571236. Retrieved 1-9-2014. 
  10. ↑ Dobson, D et al (Dec 2012). "Manipulative therapies for infantile colic". Cochrane Database Syst Rev 12 (CD004796). http://www.ncbi.nlm.nih.gov/pubmed/23235617. Retrieved 1-9-2014. 
  11. ↑ Hestbaek, L et al (June 2010). "The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: The emperor's new suit?". Chiropr Osteopat 18 (15). http://www.ncbi.nlm.nih.gov/pubmed/?term=The+evidence+base+for+chiropractic+treatment+of+musculoskeletal+conditions+in+children+and+adolescents%3A+The+emperor's+new+suit%3F. Retrieved 1-9-2014. 
  12. ↑ Pohlman, KA et al (Sep 2012). "Otitis media and spinal manipulative therapy: a literature review". J Chiropr Med 11 (3): 160-169. http://www.ncbi.nlm.nih.gov/pubmed/23449823. Retrieved 1-9-2014. 
  13. ↑ Pepino, VC et al (Jan 2013). "Manual therapy for childhood respiratory disease: a systematic review". J Manipulative Physiol Ther 36 (1): 57-65. http://www.ncbi.nlm.nih.gov/pubmed/23380215. Retrieved 1-9-2014. 
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