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

Area of Science:

• Pediatric Medicine
• Complementary and Alternative Medicine
• Evidence-Based Practice

Background:

• Osteopathic manipulative treatment (OMT) is utilized for various pediatric conditions.
• Previous systematic reviews (SRs) have assessed OMT's efficacy in children.
• An updated review is necessary to evaluate recent evidence.

Purpose of the Study:

• To critically evaluate the evidence for or against Osteopathic manipulative treatment (OMT) in pediatric populations.
• To update a prior systematic review published in 2013.
• To assess OMT's effectiveness based on recent randomized clinical trials (RCTs).

Main Methods:

• Conducted a systematic search of eleven databases from January 2012 to November 2021.
• Included only randomized clinical trials (RCTs) of OMT in pediatric patients.
• Assessed risk of bias using the Cochrane tool and evidence quality with GRADE criteria.

Main Results:

• Thirteen trials met eligibility criteria; four underwent meta-analysis.
• OMT demonstrated little to no effect on reducing hospital stay in preterm infants (very low certainty of evidence).
• No significant effects were found on exclusive breastfeeding rates; methodological quality has improved, but adverse effects reporting remains poor.

Conclusions:

• The methodological quality of primary trials for OMT in pediatrics has improved.
• However, the overall quality of evidence remains low or very low.
• The effectiveness of OMT for specific pediatric populations is currently unproven.