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A Survey of Parents on the Iatrogenesis Associated With Chiropractic Spinal Manipulative Therapy of Pediatric Patients: Results from a Practice-based Research Study

Joel Alcantara, DC and Jeanne Ohm, DC

Background: Hayes and Bezilla report a 9% incidence of treatment-associated aggravation following osteopathic manipulative therapy. A study of the iatrogenesis associated with pediatric spinal manipulative therapy (SMT) was performed based on a parental survey in a practice-based research network.

Materials and Methods: This study was approved by the Institutional Review Board of Life University, Atlanta, GA. Geographical information of parent (gender, age and level of education completed) and child (i.e., gender and age) was determined along with the child’s presenting complaint(s), the number of office visits and subjectively assessed treatment-associated iatrogenesis.

Results: Parents (222 females: 116 males; 1 unaccounted) contributed 239 pediatric cases consisting of 1735 office visits at an average of 7.26 visits. The parents were highly educated at an average age of 35.59 years. Their children (113 females: 119 males; 7 not indicated) had an averaged age of 6.16 years.

“Wellness care” (N=130) along with complaints involving the cervical spine and lumbopelvis were common. Treatment-related changes were not mutually exclusive with 163 parents reporting an improvement, 2 reported an aggravation (i.e., soreness and stiffness) with no complications. Approximately 47% (N=116) reported improvements with their child’s presenting complaint (i.e., decreased pain) while 67 were an unrelated improvement (i.e., improved immune function).

Discussion: The findings of this study suggest that the incidence of iatrogenesis associated with chiropractic SMT of children as reported by their parents is relatively low. Reported aggravations (0.008%) were self-limiting and did not deter the parent to continue care. No complications were reported.

Conclusion: This study provides supporting evidence on the safety and effectiveness of chiropractic SMT in children based on parental reports. We recommend continued research in this area to more accurately determine the true incidence and prevalence of the iatrogenesis (and its associated variables) associated with chiropractic SMT.

Joel Alcantara, DC 1 and Jeanne Ohm, DC 2

  1. Research Director, International Chiropractic Pediatric Association, Media, PA and Private Practice of Chiropractic, San Jose, CA, USA
  2. Private Practice of Chiropractic, Media, PA, USA

Presented at ACC/RAC Conference, March 2008.