A Literature Review of Pediatric Spinal Manipulation and Chiropractic Manipulative Therapy: Evaluation of Consistent Use of Safety Terminology

J Manipulative Physiol Ther. 2015 Nov-Dec;38(9):692-698. doi: 10.1016/j.jmpt.2012.07.009. Epub 2012 Aug 27.


Objective: The purpose of this study was to perform a literature search to identify relevant studies on pediatric spinal manipulation and chiropractic manipulative therapy and to assess if safety terminology was consistent with the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH).

Methods: A literature search was performed in PubMed using the following terms: spinal manipulation pediatric, chiropractic safety pediatric, and manual therapy safety pediatric. PubMed was searched from inception to April 2012 with no language limitations. The international standards included the terminology of the World Health Organization on side effects, adverse reactions, adverse events and the ICH guideline templates that were adapted for manual therapy for this study.

Results: Of the 9 relevant articles identified in this study, 3 reported methodology for classifying safety incidents, and all 9 used safety terminology (adverse effects or adverse events). However, terminology was not used consistently.

Conclusion: Most of the articles identified in this literature review did not use terminology consistent with the standards established by the ICH when reporting on safety incidents following pediatric spinal manipulation or chiropractic manipulative therapy. More efforts should be taken to include consistent terminology for studies of spinal manipulation and chiropractic manipulative therapy for children.

Keywords: Children; Chiropractic; Manual Therapy; Pediatrics; Safety.

Publication types

  • Review

MeSH terms

  • Child
  • Humans
  • Manipulation, Chiropractic* / adverse effects
  • Manipulation, Spinal* / adverse effects
  • Terminology as Topic