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Osteopathic Manipulative Treatment for Pediatric Conditions: An Update of Systematic Review and Meta-Analysis

Osteopathic manipulative treatment (OMT) continues to be used for a range of diseases in children. Objectives: The aim of this paper is to update our previous systematic review (SR) initially published in 2013 by critically evaluating the evidence for or against this treatment. Methods: Eleven datab...

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Autores principales: Posadzki, Pawel, Kyaw, Bhone Myint, Dziedzic, Arkadiusz, Ernst, Edzard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369972/
https://www.ncbi.nlm.nih.gov/pubmed/35956072
http://dx.doi.org/10.3390/jcm11154455
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author Posadzki, Pawel
Kyaw, Bhone Myint
Dziedzic, Arkadiusz
Ernst, Edzard
author_facet Posadzki, Pawel
Kyaw, Bhone Myint
Dziedzic, Arkadiusz
Ernst, Edzard
author_sort Posadzki, Pawel
collection PubMed
description Osteopathic manipulative treatment (OMT) continues to be used for a range of diseases in children. Objectives: The aim of this paper is to update our previous systematic review (SR) initially published in 2013 by critically evaluating the evidence for or against this treatment. Methods: Eleven databases were searched (January 2012 to November 2021). Study selection and data extraction: Only randomized clinical trials (RCTs) of OMT in pediatric patients compared with any type of controls were considered. The Cochrane risk-of-bias tool was used. In addition, the quality of the evidence was rated using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria, as recommended by the Cochrane Collaboration. Results: Thirteen trials met the eligibility criteria, of which four could be subjected to a meta-analysis. The findings show that, in preterm infants, OMT has little or no effect on reducing the length of hospital stay (standardized mean difference (SMD) −0.03; 95% confidence interval (CI) −0.44 to 0.39; very low certainty of evidence) when compared with usual care alone. Only one study (8.3%) was judged to have a low risk of bias and showed no effects of OMT on improving exclusive breastfeeding at 1 month. The methodological quality of RCTs published since 2013 has improved. However, adverse effects remain poorly reported. Conclusions: The quality of the primary trials of OMT has improved during recent years. However, the quality of the totality of the evidence remains low or very low. Therefore, the effectiveness of OMT for selected pediatric populations remains unproven.
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spelling pubmed-93699722022-08-12 Osteopathic Manipulative Treatment for Pediatric Conditions: An Update of Systematic Review and Meta-Analysis Posadzki, Pawel Kyaw, Bhone Myint Dziedzic, Arkadiusz Ernst, Edzard J Clin Med Article Osteopathic manipulative treatment (OMT) continues to be used for a range of diseases in children. Objectives: The aim of this paper is to update our previous systematic review (SR) initially published in 2013 by critically evaluating the evidence for or against this treatment. Methods: Eleven databases were searched (January 2012 to November 2021). Study selection and data extraction: Only randomized clinical trials (RCTs) of OMT in pediatric patients compared with any type of controls were considered. The Cochrane risk-of-bias tool was used. In addition, the quality of the evidence was rated using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria, as recommended by the Cochrane Collaboration. Results: Thirteen trials met the eligibility criteria, of which four could be subjected to a meta-analysis. The findings show that, in preterm infants, OMT has little or no effect on reducing the length of hospital stay (standardized mean difference (SMD) −0.03; 95% confidence interval (CI) −0.44 to 0.39; very low certainty of evidence) when compared with usual care alone. Only one study (8.3%) was judged to have a low risk of bias and showed no effects of OMT on improving exclusive breastfeeding at 1 month. The methodological quality of RCTs published since 2013 has improved. However, adverse effects remain poorly reported. Conclusions: The quality of the primary trials of OMT has improved during recent years. However, the quality of the totality of the evidence remains low or very low. Therefore, the effectiveness of OMT for selected pediatric populations remains unproven. MDPI 2022-07-30 /pmc/articles/PMC9369972/ /pubmed/35956072 http://dx.doi.org/10.3390/jcm11154455 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Posadzki, Pawel
Kyaw, Bhone Myint
Dziedzic, Arkadiusz
Ernst, Edzard
Osteopathic Manipulative Treatment for Pediatric Conditions: An Update of Systematic Review and Meta-Analysis
title Osteopathic Manipulative Treatment for Pediatric Conditions: An Update of Systematic Review and Meta-Analysis
title_full Osteopathic Manipulative Treatment for Pediatric Conditions: An Update of Systematic Review and Meta-Analysis
title_fullStr Osteopathic Manipulative Treatment for Pediatric Conditions: An Update of Systematic Review and Meta-Analysis
title_full_unstemmed Osteopathic Manipulative Treatment for Pediatric Conditions: An Update of Systematic Review and Meta-Analysis
title_short Osteopathic Manipulative Treatment for Pediatric Conditions: An Update of Systematic Review and Meta-Analysis
title_sort osteopathic manipulative treatment for pediatric conditions: an update of systematic review and meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369972/
https://www.ncbi.nlm.nih.gov/pubmed/35956072
http://dx.doi.org/10.3390/jcm11154455
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