Table 5 Summary results of descriptive synthesis with levels of evidence statement for spinal MANIPULATION to manage paediatric populations with a variety of conditions
Conditions (Population) | Levels of Evidence Statement | Adverse Events Documented in reviews and studies included in the descriptive synthesis | ||||
|---|---|---|---|---|---|---|
Reviews | High-Quality Studies | Summary Statement | ||||
Original Report (Author & Year) | Adverse Event / (Practitioner Type) | Further cited by | ||||
Spinal MANIPULATION | ||||||
 Adolescent Idiopathic Scoliosis ^ (AIS) (C&A) | Inconclusive | Insufficient | Inconclusive | Rowe (2006) | Two benign reactions (no further detail documented) (Chiropractic) | Theroux (2017) [107] Todd (2015) [108] |
 Asthma (C&A) | Inconclusive | STRONG Evidence of No Significant Effect | STRONG Evidence of No Significant Effect # |  |  |  |
 ASD ^ (C&A) | Inconclusive | - | Inconclusive |  |  |  |
 Spinal (Back / Neck) Pain ^ (C&A) (Combined Chronic and Acute Pain) | Inconclusive | Inconclusive | Inconclusive | *Evans (2018) | Unusual or increased soreness (51%-54%) and different type of pain (31%-34%) (Chiropractic) |  |
L’Ecuyer (1959) | Neck pain in 12-year-old girl with a history of congenital torticollis, progression to unsteady gait, poor coordination, drowsiness, and hospitalisation with delayed diagnosis of congenital occipitalisation. (Chiropractic) | Green (2020) [21] Vohra (2007) [110] | ||||
Ziv (1983) | Back pain in 12-year-old girl with history of osteogenesis imperfecta—progressive neuromuscular deficits in legs, clonus at rest, urinary urgency and frequency, paraplegia. (Chiropractic) | Vohra (2007) [110] | ||||
 Breastfeeding Difficulties ^ (I) | Inconclusive | - | Inconclusive |  |  |  |
 CP ^ (I, C, A) | Inconclusive | Insufficient | Inconclusive |  |  |  |
 Headache (C&A) | Insufficient | STRONG Evidence of No Significant Effect | STRONG Evidence of No Significant Effect | Borusiak (2010) | Hot skin and dizziness, transitory increase in headache intensity and frequency and loss of consciousness in both treatment sessions; quick recovery once treatment stopped. (Manual therapist) | Green (2020) [21] |
Zimmerman (1978) | Severe occipital and bifrontal headache, vomiting, left facial weakness, diplopia ataxia. (Chiropractic) | Vohra (2007) [110] | ||||
Held (1966) | Acute respiratory decompensation, tracheotomy, neurologic deficits at C6 and C7 vertebrae, neck pain. (Medical practitioner) | Vohra (2007) [110] | ||||
 Infantile Colic – crying (I) | Inconclusive | Inconclusive | Inconclusive | Miller (2012) | One child in comparison group reported an AE of increased crying. Incidence of increased crying in comparison group:2.94% (0.52, 14.92) (Chiropractic) | Corso (2020) [73] |
Shafrir (1992) | In three of these studies a small number of mild harms was reported; the other two studies (n = 145) reported no harms. One study (n = 956) reported side effects or reactions in children after chiropractic treatment (n = 557), but both side effects or reactions and treatment techniques were not specified. (Chiropractic) | Driehuis (2019) [26] Ellwood (2020) [114] | ||||
 Infantile Colic^ – Sleeping (I) | Inconclusive | Insufficient | Inconclusive | Koch (1998) | Vegetative reactions, bradycardia, tachycardia, and reflex apnoea recorded in more than half of patients. Although apnoea was of short duration (< 10 s) and reversible, it can be regarded as a potentially life-threatening adverse event. NB: Conditions were mixed (colic, opistotonus, hypertonus, wryneck, plagiocephaly, scoliosis, limb weakness and slobbering). (Chiropractic) | Brand (2005) [41] |
Wilson (2012) | Severe: Rib fractures (7th and 8th posterior) (Chiropractic) NB: referral reason not confirmed | Todd (2015) [108] | ||||
 Nocturnal Enuresis (C&A) | VERY STRONG Evidence of No Significant Effect | - | VERY STRONG Evidence of No Significant Effect | Leboeuf (1991) | 4 – 15-year-old children and adolescents: Severe headache, stiff neck and acute lumbar spine pain. (5th year Chiropractic students) | Green (2020) [21] Vohra (2007) [110] Hawk (2007) [98] Glazener (2005) [44] |
 Otitis Media ^ (I & C) | Inconclusive | Insufficient | Inconclusive | Sawyer (1999) | 6-months to 6 years—Mid-back soreness and increased irritability (Academic Chiropractors) | Green (2020) [21] Corso (2020) [73] Vohra (2007) [110] Hawk (2007) [98] Pohlman (2012) [105] Glazener (2005) [44] |
 Torticollis ^ (I & C) | Insufficient | Insufficient | Insufficient | Jacobi (2001) | Subarachnoid haemorrhage and death of 3-month-old girl (presenting condition unclear) (Physiotherapist) | Green (2020) [21] Vohra (2007) [110] Ellwood (2020) [27] Driehuis (2019) [26] Brand (2005) [41] |
Shafrir (1992) | Quadriplegia in 4-month-old boy, secondary to spinal cord astrocytoma; regressed to paraplegia (18Â months postoperatively). (Chiropractic) | Todd (2015) [108] Driehuis (2019) [26] Ellwood (2020) [27] | ||||