By David Kiefer, MD, Editor
Source: Posadzki P, et al. Osteopathic manipulative treatment for pediatric conditions: A systematic review. Pediatrics 2013;132:140-152.
This analysis lumped together results from 17 randomized, controlled trials evaluating osteopathic manipulative treatment (OMT) for pediatric conditions. The authors point out that only five of the trials were of high methodological quality, and, of those five, only one showed efficacy of OMT over placebo. The symptoms that may have been improved were associated with congenital nasolacrimal duct obstruction, daily weight gain, length of hospital stay, dysfunctional voiding, infantile colic, or postural asymmetry, whereas those that did not seem to benefit from OMT were cerebral palsy, idiopathic scoliosis, obstructive apnea, or temporomandibular disorders. Mixed results were seen for otitis media and asthma. Only eight of the 17 studies had adequate statistics available to calculate effect sizes; the mean effect size for these eight studies was 0.20, or small. The wide variety of OMT techniques used, as well as the spectrum of medical conditions included, varying sizes of study populations, and statistical deficiencies all limit the clinical applicability of the results from this systemic review. As stated by the authors, the evidence for OMT’s efficacy in pediatric conditions is "weak, limited, and contradictory." However, it does serve as a starting point of a discussion for researchers (hopefully, future well-designed projects will address the literature gaps) and it provides a few hints for when to consider OMT in children.