Research Studies

As we comment on research studies within the blog, we’ll reproduce the sources on this page for easy access at any time. You may choose to use these in any way you wish in your own newsletters, websites and social networking comments. The abstracts are all linked to the full source and we give full credit to www.chiro.org for this.

Chiropractic Paediatrics

Chiropractic Care of Children from Birth to Adolescence and Classification of Reported Conditions: An Internet Cross-Sectional Survey of 956 European Chiropractors
J Manipulative Physiol Ther. 2012 (Jun);   35 (5):   372–380

Pediatric patients represent between 5% and 17% of general chiropractic practice and 39% of specialist pediatric chiropractic practice. In the absence of high levels of evidence, doctors of chiropractic have relied on clinical experience and education to provide care. Pediatric health conditions seen by chiropractors have been reviewed systematically.

Several authors have traditionally reported conditions in 2 distinct categories of musculoskeletal and nonmusculoskeletal conditions. The rationale behind such a separation has not been investigated (to the author’s knowledge). The safety of spinal manipulative therapy in pediatric care has been addressed in the literature with few safety incidents reported. Of the 956 (23.3%) participating chiropractors, 921 reported 19,821 pediatric patients per month. Children represented 8.1% of chiropractors’ total patient load over the last year. A total of 557 (534 mild, 23 moderate, and 0 severe) negative (adverse) side effects were reported for an estimated incidence of 0.23%. On the given treatment statements, chiropractors reported varying agreement and disagreement rates based on patient age. The 8,309 answers on conditions were grouped into skeletal (57.0%), neurologic (23.7%), gastrointestinal (12.4%), infection (3.5%), genitourinary (1.5%), immune (1.4%), and miscellaneous conditions (0.5%). The number of treatment sessions delivered varied according to the condition and the patient age.

 

Neck and Back Pain in Children:
Prevalence and Progression Over Time

Musculoskelet Disord. 2011 (May 16);   12:   98 ~ FULL TEXT

The following article appears to be the first study to track and review the progression of back pain in the same group of children, over a prolonged period, to see how (or if) it is a contributor to those same complains in adulthood. Of particular interest is Table 2, because it breaks down and tracks complaints of either neck, mid back, or low back pain in the same group of children at 3 different time periods: ages 9, 13 and 15 years old.

 

Effect of Backpack Load Carriage on Cervical Posture
in Primary Schoolchildren

Work. 2012 (Jan 1);   41 (1):   99—108

Subjects demonstrated immediate and statistically significant changes in craniovertebral angle (CVA), indicating increased forward head positions upon donning the backpacks containing 15% and 20% body weight. Following the walking of 6 minutes, the CVA demonstrated further statistically significant changes for all backpack loads indicating increased forward head postures. For the 15 & 20% of body weight conditions, more than 50% of the subjects reported discomfort after walking, with the neck as the primary location of reported pain.

 

Is Chiropractic Pediatric Care Safe?
A Best Evidence Topic

Clinical Chiropractic 2011 (Sep);   14 (3):   97–105

The reviewed published chiropractic literature suggests a rate of 0.53% to 1% mild adverse events (AE) associated with chiropractic paediatric manipulative therapy (PMT). Put in terms of individual patients, between one in 100 to 200 patients presenting for chiropractic care; or in terms of patient visits, between one mild AE per 1310 visits to one per 1812 visits. For a comparison, Osteopathic PMT have a reported rate of 9%, and medical practitioners utilising PMT under the auspices of ‘chiropractic therapy’ have reported a rate of 6%. A reasonable caution to the parent/guardian is that one child per 100 to 200 attending may have a mild adverse events, with irritability or soreness lasting less than 24 hours, resolving without the need for additional care.

 

Attitudes and Views on Chiropractic:
A Survey of United States Midwives

Complement Ther Clin Pract. 2011 (Aug);   17 (3):   135–140

A total of 187 midwife respondents completed the (online) questionnaire resulting in a superficial response rate of 2.1%. Responders were certified nurse-midwives and had some form of training regarding chiropractic. The responders were aware that chiropractors worked with “birthing professionals” and attended to patients with both musculoskeletal and non-musculoskeletal disorders. The vast majority indicated a positive personal and professional clinical experience with chiropractic and that chiropractic was safe for pregnant patients and children. There is great awareness of and positive personal and professional experience with chiropractic on the part of midwives who participated in this survey.

 

Demographic Survey of Pediatric Patients
Presenting to a Chiropractic Teaching Clinic

Chiropractic & Manual Therapies 2010 (Dec 15); 18: 33 ~ FULL TEXT

This data review included 2,645 pediatric patients (0-15 years of age). Of these, 2,303 (87%) were under the age of five and 342 (13%) were between the ages of 5 and 15. The complaints of all children over five years were categorized as musculoskeletal. In all age groups, just over a third (34.7%) presented with musculoskeletal problems, 29.6% presented with excess crying (previously known as infant colic) and 15.7% with feeding disorders. All children had previously presented to at least one medical practitioner for the same condition and some had presented to multiple healthcare practitioners (Figure 3). The younger the child, the more common the referral with 83% of infants under 12 weeks of age being sent by a medical practitioner, 39% between 3 and 12 months of age and a 4-5% rate of referral in age groups over one year

 

The Chiropractic Care of Children
J Altern Complement Med. 2010 (Jun);   16 (6):   621–626 ~ FULL TEXT

A majority of the responders were female with an average practice experience of 8 years. They attended an average of 133 patient visits per week, with 21% devoted to the care of children (<18 years of age). Practice income was derived primarily from out-of-pocket reimbursement with charges of an average of $127 and $42 for the first and subsequent visits, respectively. These visits were reimbursed to address common conditions of childhood (i.e., asthma, ear infections, etc.). Approach to patient care was spinal manipulative therapy (SMT) augmented with herbal remedies, exercises, rehabilitation, and so on. Wellness care also figured prominently as a motivator for chiropractic care. Fifty-eight percent (58%) indicated an established relationship with an osteopathic or medical physician. Eighty percent (80%) of the responders indicated referring patients to medical practitioners while only 29% indicated receiving a referral from a medical/osteopathic physician.

 

Contribution of Chiropractic Therapy to Resolving Suboptimal
Breastfeeding: A Case Series of 114 Infants

J Manipulative Physiol Ther 2009 (Oct);   32 (8):   670–674

Cooperative multidisciplinary care to support breastfeeding was demonstrated in this population. Chiropractic treatment may be a useful adjunct to routine care given by other professionals in cases of diagnosed breastfeeding problems with a biomechanical component.

 

The Safety and Effectiveness of Pediatric Chiropractic: A Survey
of Chiropractors and Parents in a Practice-based Research Network

Explore (NY) 2009 (Sep);   5 (5): 290–295

The indicated primary reason for chiropractic care of children was “wellness care.” With respect to condition-based presentations, musculoskeletal conditions were the most common, in addition to nonmusculoskeletal conditions of childhood. The most common techniques used were diversified technique, Gonstead technique, Thompson technique, and activator methods. Treatment-associated complications were not indicated by the chiropractic and parent responders. Chiropractor responders indicated three adverse events per 5,438 office visits from the treatment of 577 children. The parent responders indicated two adverse events from 1,735 office visits involving the care of 239 children.

 

Adverse Effects of Spinal Manipulative Therapy in Children
Younger Than 3 Years:   A Retrospective Study
in a Chiropractic Teaching Clinic

J Manipulative Physiol Ther 2008 (Jul);   31 (6):   419–423

This study shows that for the population studied, chiropractic manipulation produced very few adverse effects and was a safe form of therapy in the treatment of patients in this age group.

 

Evaluation of Chiropractic Management of Pediatric Patients
with Low Back Pain: A Prospective Cohort Study

J Manipulative Physiol Ther 2003 (Jan);   26 (1):   1—8 ~ FULL TEXT

Fifteen chiropractors provided data on 54 consecutive pediatric patients with LBP. The average age of the patients was 13.1 years, 57% were male, 61% were acute, with 47% attributing onset to a traumatic event (most commonly sports-related); 24% reported an episode duration of greater than 3 months. Almost 90% of cases presented with uncomplicated mechanical LBP, most frequently diagnosed as lumbar facet dysfunction or subluxation.

 

Chiropractic Spinal Manipulation for Cervicogenic Headache
in an 8-Year-Old

J Neuromusculoskeletal System 2002 (Fall); 10 (3): 98—103

A case of cervicogenic headache (CEH) in an 8-year-old boy that improved after chiropractic spinal manipulation is reported. An 8-year-old boy presented with a complaint of daily headache. The duration of symptoms was over 3 years. The patient met the diagnostic criteria for CEH. Awkward head position reproduced head pain, as did palpation of the upper cervical region. Decreased range of motion of the neck was evident, as well as abnormal tenderness and primarily of the right upper cervical region, and ancillary myofascial release. A significant decrease in headache frequency as reported by the patient and parent was seen after the first treatment. After four treatments the headache frequency decreased to approximately one per month.

 

Back Pain in Children Who Present to the Emergency Department
Clin Pediatr 1999 (Jul);   38 (7):   401—406

When present, pediatric back pain is most often musculoskeletal, associated with an acute infectious illness or a traumatic event. Although the etiology is rarely serious, back pain often affects the daily activities of symptomatic children.

 

 

 

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