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Chiropractic care of children with nocturnal enuresis: a prospective outcome study
1School of Chiropractic, Phillip Institute of Technology, Bundoora, Victoria, Australia.
Insights
Chiropractic care for functional nocturnal enuresis (bedwetting) showed a decrease in wet nights but did not yield favorable results compared to other therapies. The study found no evidence to support chiropractic as a primary treatment for childhood bedwetting.
Area of Science:
- Pediatrics
- Complementary and Alternative Medicine
Background:
- Functional nocturnal enuresis is a prevalent childhood condition causing significant family stress.
- Chiropractic practitioners propose chiropractic adjustments as a therapeutic intervention for enuresis.
Purpose of the Study:
- To evaluate the efficacy of chiropractic care in treating functional nocturnal enuresis in children.
- To determine if chiropractic adjustments offer a valid treatment option for childhood bedwetting.
Main Methods:
- A study involving 171 children aged 4-15 with functional nocturnal enuresis.
- Children received chiropractic adjustments, with parents monitoring the weekly number of wet nights.
- A 2-week period without therapy preceded the chiropractic treatment phase.
Main Results:
- The median number of wet nights decreased from 7.0 to 5.6 after a 2-week non-therapy period (p = .01).
- Following chiropractic treatment, the median number of wet nights reduced to 4.0 (p < .0001).
- Only 15.5% of subjects achieved a favorable outcome (≤2 wet nights/fortnight or ≤1 wet night/week).
Conclusions:
- The observed improvement rates with chiropractic care are less favorable than established therapies for nocturnal enuresis.
- Initial enuresis severity was the sole predictor of treatment outcome, with more severe cases showing less improvement.
- The study's findings, in the absence of a control group, do not support chiropractic care as a treatment of choice for functional nocturnal enuresis.
Abstract:
Functional nocturnal enuresis is a common problem which causes a great deal of stress to the suffering children and their families. Some chiropractors advocate chiropractic care as a mode of therapy for this complaint. One hundred and seventy-one enuretic children, aged 4 to 15, were treated with chiropractic adjustments, and their number of wet nights was monitored by their parents. The median number of wet nights per week was 7.0 at the onset of the study. After 2 wk without any therapy, the number of wet nights had decreased to 5.6 (p = .01) and by the end of the treatment this figure was 4.0 (p less than .0001). Following the course of treatment, 15.5% of subjects wet a maximum of 2 nights per fortnight, or, where data for the last 2 wk of therapy were unavailable, a maximum of 1 night/wk. This result is less favorable than the therapeutic success of other common types of therapy, which have reported "cure" rates well above 50%. The only variable which predicted treatment outcome was the initial estimate of bed-wetting; the more severe the condition at the onset, the less likely was the child to improve by the end of the study. In the absence of a control group there appears to be no validity in the claim that chiropractic is a treatment of choice for functional nocturnal enuresis.