Effectiveness of osteopathic craniosacral techniques: a meta-analysis.

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.