Design: Best Evidence Topic.
Methods: Formulation of a clinical question based on a patient query. PubMed, Index to Chiropractic Literature and the Cochrane Library were searched on the 19th of June 2010. A total of nine specifically relevant articles were retrieved and critically reviewed.
Results: The reviewed published chiropractic literature suggests a rate of 0.53% to 1% mild adverse events (AE) associated with chiropractic paediatric manipulative therapy (PMT). Put in terms of individual patients, between one in 100 to 200 patients presenting for chiropractic care; or in terms of patient visits, between one mild AE per 1310 visits to one per 1812 visits. For a comparison, Osteopathic PMT have a reported rate of 9%, and medical practitioners utilising PMT under the auspices of ‘chiropractic therapy’ have reported a rate of 6%. No serious AE has been reported in the literature since 1992 and no death possibly associated with chiropractic PMT has been reported for over 40 years.
Conclusion: The application of modern chiropractic paediatric care within the outlined framework is safe. A reasonable caution to the parent/guardian is that one child per 100 to 200 attending may have a mild AE, with irritability or soreness lasting less than 24 h, resolving without the need for additional care beyond initial chiropractic recommendations.
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