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Adverse events and manual therapy : a systematic review
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Carnes, Dawn, Mars, Tom S., Mullinger, Brenda, Froud, Robert J. and Underwood, Martin (2010) Adverse events and manual therapy : a systematic review. Manual Therapy, Vol.15 (No.4). pp. 355-363. doi:10.1016/j.math.2009.12.006
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Official URL: http://dx.doi.org/10.1016/j.math.2009.12.006
Abstract
Objective:
To explore the incidence and risk of adverse events with manual therapies.
Method:
The main health electronic databases, plus those specific to allied medicine and manual therapy, were searched. Our inclusion criteria were: manual therapies only; administered by regulated therapists; a clearly described intervention; adverse events reported. We performed a meta-analysis using incident estimates of proportions and random effects models.
Results:
Eight prospective cohort studies and 31 manual therapy RCTs were accepted. The incidence estimate of proportions for minor or moderate transient adverse events after manual therapy was ∼41% (CI 95% 17–68%) in the cohort studies and 22% (CI 95% 11.1–36.2%) in the RCTs; for major adverse events ∼0.13%. The pooled relative risk (RR) for experiencing adverse events with exercise, or with sham/passive/control interventions compared to manual therapy was similar, but for drug therapies greater (RR 0.05, CI 95% 0.01–0.20) and less with usual care (RR 1.91, CI 95% 1.39–2.64).
Conclusions:
The risk of major adverse events with manual therapy is low, but around half manual therapy patients may experience minor to moderate adverse events after treatment. The relative risk of adverse events appears greater with drug therapy but less with usual care.
| Item Type: | Journal Article | ||||
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| Subjects: | R Medicine > R Medicine (General) R Medicine > RM Therapeutics. Pharmacology R Medicine > RZ Other systems of medicine |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Manipulation (Therapeutics), Manipulation (Therapeutics) -- Complications, Systematic reviews (Medical research) | ||||
| Journal or Publication Title: | Manual Therapy | ||||
| Publisher: | Churchill Livingstone | ||||
| ISSN: | 1356-689X | ||||
| Official Date: | August 2010 | ||||
| Dates: |
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| Volume: | Vol.15 | ||||
| Number: | No.4 | ||||
| Page Range: | pp. 355-363 | ||||
| DOI: | 10.1016/j.math.2009.12.006 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access | ||||
| Funder: | General Osteopathic Council (UK) (GOsC), National Council for Osteopathic Research (NCOR) |
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