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Assessment of the Efficacy of An Osteopathic Treatment in Infants with Biomechanical Impairments to Suckling
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Effectiveness of osteopathic craniosacral techniques: a meta-analysis.

Alfred Amendolara1,2, Alexander Sheppert1, Ryan Powers1

  • 1Department of Biomedical Science, Noorda College of Osteopathic Medicine, Provo, UT, United States.

Frontiers in Medicine
|October 21, 2024
PubMed
Summary

Craniosacral therapy (CST) showed no significant clinical effectiveness in this meta-analysis of randomized controlled trials. The review found no evidence to support CST

Keywords:
alternative and complementary medicinecraniosacralmanual therapyosteopathic manipulation (osteopathic manipulative treatment/osteopathic manual medicine)osteopathic medicine

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Area of Science:

  • Osteopathic Manipulative Medicine
  • Craniosacral Therapy (CST)
  • Evidence-Based Medicine

Background:

  • Craniosacral osteopathic manipulative medicine, also known as craniosacral therapy (CST), is a widely taught and utilized component of osteopathic medicine.
  • This systematic review and meta-analysis focuses on assessing the clinical effectiveness of CST.

Purpose of the Study:

  • To systematically review and conduct a meta-analysis of randomized controlled trials (RCTs).
  • To assess the clinical effectiveness of CST compared to standard care, sham treatment, or no treatment.
  • To evaluate CST's efficacy in both adult and pediatric populations.

Main Methods:

  • Comprehensive literature search of Embase, PubMed, Scopus, and Google Scholar (grey literature) conducted on 10/29/2023 and updated on 5/8/2024.
  • Inclusion of all RCTs assessing CST for any clinical outcome, with exclusion of studies not in English or lacking adequate data.
  • Meta-analysis using Hedge's G for effect sizes, random effects models, Cochrane's Risk of Bias 2 tool for bias assessment, and GRADE system for evidence quality.

Main Results:

  • Twenty-four RCTs with 1,613 participants were included in the final meta-analysis.
  • No significant effects were found when analyzing primary outcomes alone.
  • Subgroup analyses including secondary outcomes indicated potential, but unreliable, statistically significant effects for Neonate health, structure and Pain, chronic somatic, tempered by wide prediction intervals and high bias.

Conclusions:

  • Craniosacral therapy (CST) demonstrated no significant overall effects in this meta-analysis.
  • The findings suggest a lack of demonstrated usefulness for CST in patient care across the studied indications.
  • Limitations including bias and statistical constraints temper the interpretation of any observed effects.