World Summit on the Efficacy and Efficacy of Spinal Manual Therapy for the Prevention and Treatment of Nonmusculoskeletal Disorders: A Systematic Review of the Literature
Our systematic review included six randomized clinical trials (534 participants) of acceptable or high quality investigating the efficacy or effectiveness of SMT for the treatment of nonmusculoskeletal disorders. They found no evidence of an effect of SMT on the management of non-musculoskeletal disorders such as infantile colic, childhood asthma, hypertension, primary dysmenorrhea, or migraine. This finding challenges the validity of the theory that treating spinal dysfunction with SMT has a physiological impact on the organ and its function. Governments, payers, regulators, educators, and clinicians need to consider this evidence when developing policies regarding the use and reimbursement of SMT for non-musculoskeletal disorders.
Côté, P., Hartvigsen, J., Axén, I. etal. World summit on the efficacy and effectiveness of spinal manual therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature. Chiropr Man Therap 29, 8 (2021). https://doi.org/10.1186/s12998-021-00362-9
Commentary
This research paper will test whether spinal manipulative therapy (SMT), used by a small percentage of chiropractors, osteopathic physicians, and other manual therapy providers, is useful for non-musculoskeletal disorders. To conduct a systematic review of these literatures, a global summit of international scientists was organized and this was held in Toronto, Canada on September 14-15, 2019.
Launched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health, and Index to ChiropracticLiterature to May 15, 2019, using the subject and operation-related free text words specific to each database, and the review included randomized controlled trials published in English.
As a result, 3874 citations were screened, of which 32 articles were assessed for eligibility at the Global Summit and 16 articles were included in the systematic review.
None of these studies investigated the efficacy or effectiveness of SMT for the management of infantile colic, pediatric asthma, hypertension, primary dysmenorrhea, or migraine, and none evaluated the efficacy of SMT in preventing the development of non-musculoskeletal disorders.
A consensus was reached on all risks of bias and the content of the evidence tables, and all randomized controlled trials of high or acceptable quality found that SMT was no better than sham interventions for the treatment of these non-musculoskeletal disorders.
However, six of the 50 participants (12%) at the Global Summit did not approve the final report.It means that we have to choose and practice the treatment we adapt.
