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Côté P, Hartvigsen J, Axén I, Leboeuf-Yde C, Corso M, Shearer H, Wong J, Marchand AA, Cassidy JD, French S, Kawchuk GN, Mior S, Poulsen E, Srbely J, Ammendolia C, Blanchette MA, Busse JW, Bussières A, Cancelliere C, Christensen HW, De Carvalho D, De Luca K, Du Rose A, Eklund A, Engel R, Goncalves G, Hebert J, Hincapié CA, Hondras M, Kimpton A, Lauridsen HH, Innes S, Meyer AL, Newell D, O'Neill S, Pagé I, Passmore S, Perle SM, Quon J, Rezai M, Stupar M, Swain M, Vitiello A, Weber K, Young KJ, Yu H. The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature. Chiropr Man Therap 2021; 29:8. [PMID: 33596925 PMCID: PMC7890602 DOI: 10.1186/s12998-021-00362-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 01/01/2021] [Indexed: 12/15/2022] Open
Abstract
Background A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial. Objectives We convened a Global Summit of international scientists to conduct a systematic review of the literature to determine the efficacy and effectiveness of SMT for the primary, secondary and tertiary prevention of non-musculoskeletal disorders. Global summit The Global Summit took place on September 14–15, 2019 in Toronto, Canada. It was attended by 50 researchers from 8 countries and 28 observers from 18 chiropractic organizations. At the summit, participants critically appraised the literature and synthesized the evidence. Systematic review of the literature We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health, and the Index to Chiropractic Literature from inception to May 15, 2019 using subject headings specific to each database and free text words relevant to manipulation/manual therapy, effectiveness, prevention, treatment, and non-musculoskeletal disorders. Eligible for review were randomized controlled trials published in English. The methodological quality of eligible studies was assessed independently by reviewers using the Scottish Intercollegiate Guidelines Network (SIGN) criteria for randomized controlled trials. We synthesized the evidence from articles with high or acceptable methodological quality according to the Synthesis without Meta-Analysis (SWiM) Guideline. The final risk of bias and evidence tables were reviewed by researchers who attended the Global Summit and 75% (38/50) had to approve the content to reach consensus. Results We retrieved 4997 citations, removed 1123 duplicates and screened 3874 citations. Of those, the eligibility of 32 articles was evaluated at the Global Summit and 16 articles were included in our systematic review. Our synthesis included six randomized controlled trials with acceptable or high methodological quality (reported in seven articles). These trials investigated the efficacy or effectiveness of SMT for the management of infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. None of the trials evaluated the effectiveness of SMT in preventing the occurrence of non-musculoskeletal disorders. Consensus was reached on the content of all risk of bias and evidence tables. All randomized controlled trials with high or acceptable quality found that SMT was not superior to sham interventions for the treatment of these non-musculoskeletal disorders. Six of 50 participants (12%) in the Global Summit did not approve the final report. Conclusion Our systematic review included six randomized clinical trials (534 participants) of acceptable or high quality investigating the efficacy or effectiveness of SMT for the treatment of non-musculoskeletal disorders. We found no evidence of an effect of SMT for the management of non-musculoskeletal disorders including infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. This finding challenges the validity of the theory that treating spinal dysfunctions with SMT has a physiological effect on organs and their function. Governments, payers, regulators, educators, and clinicians should consider this evidence when developing policies about the use and reimbursement of SMT for non-musculoskeletal disorders. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-021-00362-9.
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Affiliation(s)
- Pierre Côté
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada. .,Centre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCC, Oshawa, Canada. .,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. .,IHPME, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Iben Axén
- Intervention & Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,ELIB - et liv i bevegelse, Oslo, Norway
| | - Charlotte Leboeuf-Yde
- Department for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Melissa Corso
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.,Centre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCC, Oshawa, Canada
| | - Heather Shearer
- Centre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCC, Oshawa, Canada.,IHPME, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Jessica Wong
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.,Centre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCC, Oshawa, Canada.,Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Andrée-Anne Marchand
- Department de Chiropractique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - J David Cassidy
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Simon French
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, Australia
| | - Gregory N Kawchuk
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Silvano Mior
- Centre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCC, Oshawa, Canada.,Canadian Memorial Chiropractic College, Toronto, Canada
| | - Erik Poulsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - John Srbely
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, Canada
| | - Carlo Ammendolia
- IHPME, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Rebecca MacDonald Centre, Mount Sinai Hospital, Toronto, Canada
| | - Marc-André Blanchette
- Department de Chiropractique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Jason W Busse
- Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - André Bussières
- Department de Chiropractique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,School of Physical & Occupational Therapy, McGill University, Montreal, Canada
| | - Carolina Cancelliere
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.,Centre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCC, Oshawa, Canada
| | | | - Diana De Carvalho
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
| | - Katie De Luca
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, Australia
| | - Alister Du Rose
- Faculty of Life Sciences and Education University of South Wales, Cardiff, UK
| | - Andreas Eklund
- Intervention & Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Roger Engel
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, Australia
| | | | - Jeffrey Hebert
- Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
| | - Cesar A Hincapié
- Department of Chiropractic Medicine, Faculty of Medicine, University of Zurich & Balgrist University Hospital, Zurich, Switzerland
| | - Maria Hondras
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, USA
| | | | - Henrik Hein Lauridsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Stanley Innes
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia
| | | | | | - Søren O'Neill
- Department for Regional Health Research, University of Southern Denmark, Odense, Denmark.,Spine Center of Southern Denmark, University Hospital of Southern Denmark, Middelfart, Denmark
| | - Isabelle Pagé
- Department de Chiropractique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Steven Passmore
- Faculty of Kinesiology & Recreation Management University of Manitoba, Winnipeg, Canada
| | - Stephen M Perle
- School of Chiropractic, University of Bridgeport, Bridgeport, USA
| | - Jeffrey Quon
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Mana Rezai
- Centre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCC, Oshawa, Canada
| | - Maja Stupar
- Canadian Memorial Chiropractic College, Toronto, Canada
| | - Michael Swain
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, Australia
| | - Andrew Vitiello
- School of Health, Medical and Applied Sciences, CQ University, Sydney, Australia
| | - Kenneth Weber
- Stanford University School of Medicine, Stanford University, Stanford, USA
| | - Kenneth J Young
- School of Sport and Health Sciences, University of Central Lancashire, Preston, England
| | - Hainan Yu
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.,Centre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCC, Oshawa, Canada
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Xing L, Qu L, Chen H, Gao S. Clinical effect of traditional Chinese spinal orthopedic manipulation in treatment of Functional Abdominal Pain Syndrome. Complement Ther Med 2017; 32:19-24. [PMID: 28619300 DOI: 10.1016/j.ctim.2017.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 12/22/2016] [Accepted: 03/19/2017] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To evaluate the clinical effect of Traditional Chinese Spinal Orthopedic Manipulation (TCSOM) in treating Functional Abdominal Pain Syndrome (FAPS) in comparison with Pinaverium Bromide (Dicetel, PBD), and to assess a possible cause for FAPS. METHODS 60 cases of FAPS patients were randomly assigned to the TCSOM group and PBD group according to the random number table method. The TCSOM group was treated with thumb pressing manipulation, every other day in the first week, and once every three days in the second week, for 5 times treatments. Patients in the PBD group were instructed to take 50mg 3 times a day, consistently for 2 weeks. The symptoms of pre-treatment and post-treatment were assessed on a visual analog scale (VAS) pain score. A symptom improvement rating (SIR) was implemented in order to evaluate the effects of the treatments, and to statistically compare the two groups. RESULTS The symptoms of 21 patients of the TCSOM group were resolved soon after the first spinal manipulation treatment and 4 cases were significantly improved. The VAS pain scores in the TCSOM group were significantly lower than those in the PBD group after 2 weeks treatment. According to the SIR based on VAS, the TCSOM research group included 20 cases with excellent results, 8 cases with good, and 2 cases with poor. There were no side effects in the TCSOM group after treatment. Based on VAS, the PBD research group reported 6 cases with excellent results, 8 cases with good and 16 cases with poor. All cases were statistically analyzed, revealing a significant difference (P<0.001) between the two groups. CONCLUSION TCSOM group performed much better than PBD group for relief of the symptoms of FAPS. Thumb pressing manipulation on the thoracic and/or lumbar region can correct the displacement of inter-vertebral discs and/or vertebra, resolving the stimuli caused by pressure exerting on the nerves and vessels around the spine. TREATMENT with thumb pressing manipulation on the Back-Shu acupoints, the Jiaji (EX-B2) and the governor vessel acupoint had a very good clinical effect for abdominal pain indicating that it is an effective treatment for FAPS.
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Affiliation(s)
- Liyang Xing
- Department of Acupuncture and moxibustion, Zhongda Hospital, School of medicine, Southeast University, Nanjing 210009, China
| | - Liuxin Qu
- Department of Chinese Orthopedics and Traumatology, Zhongda Hospital, School of medicine, Southeast University, Nanjing 210009, China.
| | - Hong Chen
- Department of Gastroenterology, Zhongda Hospital, School of medicine, Southeast University, Nanjing 210009, China
| | - Song Gao
- Department of Chinese Orthopedics and Traumatology, Zhongda Hospital, School of medicine, Southeast University, Nanjing 210009, China
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