P04.21
Purpose: To evaluate the efficacy or effectiveness of manipulative therapies for infantile colic.
Methods: Major databases searched for studies in all languages including Centre Watch, NRR Archive and UKCRN in 2010. Study selection criteria: Randomized trials evaluating the effect of chiropractic, osteopathy or cranial osteopathy alone or in conjunction with other interventions for infantile colic.
Results: We identified 6 studies for inclusion in our review representing 325 infants. No information was found on 3 further studies and there were 3 on going studies. Of the 6 included studies, 5 were suggestive of a beneficial effect and one found no evidence of beneficial effects. Combined data shows manipulative therapies had a significant effect - reducing average crying time by 72 minutes per day (mean difference (MD) −1.20; 95% CI −1.89 to −0.51). This conclusion is sustained for studies with a low risk of selection bias and attrition bias. When analyzing only those studies with a low risk of performance bias (parental blinding) the improvement in daily crying hours was not statistically significant (MD −0.57; 95% CI −2.24 to 1.09). The quality of the studies was variable. There was a generally low risk of selection bias but a high risk of performance bias. One of the studies recorded adverse events and none were encountered.
Conclusion: Parents of infants receiving manipulative therapies reported fewer hours crying per day than parents whose infants did not and this difference was statistically significant. Most studies had a high risk of performance bias due to the fact that the assessors (parents) were not blind to who had received the intervention. When combining only those trials with a low risk of such performance bias the results did not reach statistical significance. Further research is required where those assessing the treatment outcomes do not know whether or not the infant has received manipulative therapy.
Contact: George Lewith, glewith@scmrt.org.uk
