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Development of national consensus-based recommendations for history taking, examination and clinical management of
Freja Gomez Overgaard1,2,3, Lise Hestbæk4,5, Elisabeth Davidson6
1Medical Spinal Research Unit, Spine Centre of Southern Denmark, University Hospital of Southern Denmark, Sygehusvej 24, 6000, Kolding, Denmark. Freja.gomez.overgaard@rsyd.dk.
Background:
Chiropractors in many countries provide care for infants, yet few structured, evidence-informed recommendations exist to guide history taking, examination, and clinical management in this population. In Denmark, variation in practice and limited public understanding of chiropractic care for infants highlighted the need for national recommendations to support safe, consistent, and transparent care.
Objective:
To describe the development of national recommendations outlining the minimum requirements for history taking, examination, and clinical management considerations for infants aged 0-12 months in chiropractic practice.
Methods:
These recommendations were commissioned by the Danish Society of Chiropractic and initially developed in 2020, with an update in 2025. The manuscript was reported with consideration of the RIGHT Statement. Recommendation development was informed by a targeted literature review, a national knowledge-sharing workshop involving 71 chiropractors, expert review by a seven-member panel with extensive paediatric experience, and external stakeholder consultation. Feedback from each stage was incorporated through an iterative drafting process.
Results:
The recommendations describe minimum requirements for medical history taking, red flag screening, general and musculoskeletal examination, referral, and clinical management considerations for infants. Minimum and supplementary assessment components are presented in structured tables to support consistent clinical assessment and decision-making.
Conclusions:
These national recommendations establish minimum requirements for history taking, examination, and clinical management considerations for infants in chiropractic practice. Developed through a structured process integrating a targeted literature review, practice-based input, expert review, and stakeholder consultation, they provide a transparent and practical framework to support safe, consistent, and collaborative paediatric care. Transparent reporting of the development process may facilitate the adaptation of these recommendations and the development of similar recommendations in other healthcare settings.
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