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Osteopathic Manipulation for Pediatric Patients – Does It Help? Is It Safe? :

January 27, 2021

A growing proportion of physicians who care for children are those who were educated at schools of osteopathic medicine – where, in addition to courses such as anatomy and pharmacology, students are trained in osteopathic manipulation. However, there are very few studies on the use of osteopathic manipulation in the pediatric population.

A growing proportion of physicians who care for children are those who were educated at schools of osteopathic medicine – where, in addition to courses such as anatomy and pharmacology, students are trained in osteopathic manipulation. However, there are very few studies on the use of osteopathic manipulation in the pediatric population.

This week in Pediatrics, we publish the results of a scoping review of pediatric osteopathic manipulative medicine, conducted by Dr. Samantha DeMarsh and colleagues (10.1542/peds.2020-016162). A scoping review is conducted when the research to date is unlikely to be sufficient for a systematic review or meta-analysis to formulate clinical treatment guidelines.

There were 30 studies – including 9 randomized controlled trials, 8 case reports, 7 cross-sectional surveys, 4 prospective cohort studies, and 2 retrospective cohort studies that met inclusion criteria for the review. Osteopathic manipulation was used for multiple conditions, including musculoskeletal, neurological, and otorhinolaryngologic conditions, and there was variability among the studies as to whether treatments were delivered via a protocol or not.

When the methodological quality of the studies was assessed, only 9 of the 30 studies provided a strong level of evidence. However, given that the outcomes in these 9 studies were all different, the results are not sufficient for formulating clinical treatment guidelines. Additionally, although no serious adverse events were reported and many of the papers commented on the safety of osteopathic manipulation, most did not have statistical power to assess the safety of this therapy.

Please take a look at this well-done scoping review and the video abstract; you can see the variability in study methodology and outcomes. This will give you important talking points when you discuss osteopathic manipulation as a potential treatment with parents who inquire about this for their child’s condition.

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