Forces of Commonly Used Chiropractic Techniques for Children: A Review of the Literature

Abstract

This review found that technique selection and application by chiropractors treating infants and young children are typically modified in force and speed to suit the age and development of the child.

Response to “Forces of Commonly Used Chiropractic Techniques for Children: A Review of the Literature”

“…An HVLA thoracic adjustment on an adult can produce a transmitted force of 400 to 500 N or more, so HVLA force of 70 N on an infant may be similar to 10% to 20% of force applied on an adult, an amount also suggested by Wiberg 7 and supported by randomized controlled trial evidence, 12 compared with less than 20 N (type not specified) and low velocity, as; suggested by Todd et al 1 Given the rarity of cases with adverse reactions noted by Todd et al, 13 and the presence of a guideline 14 on chiropractic care, including modified HVLA techniques, it would appear that the use of HVLA/SMT in infants and small children carries minimal risks when used by chiropractors. Additionally, Koch et al 15 noted no serious adverse events in over 20 000 cases.…”

Manual Interventions for Musculoskeletal Factors in Infants With Suboptimal Breastfeeding: A Scoping Review

“…Most of the exclusions made during screening (434 of 461) were made for nonrelevance to the research question. The types of studies represented in the final 27 were: 7 expert commentaries, 18,31–36 1 RCT, 37 1 pilot study, 38 1 cohort study, 39 2 cross-sectional studies (surveys), 40,41 5 narrative reviews, 42–46 and 10 case reports/series. 47–56…”

“…Two additional narrative reviews specifically addressed safety issues in manual treatment of infants. 45,46…”

“…A review by Todd et al 45 summarized studies of the amount of biomechanical force used in chiropractic manual therapy of infants in terms of appropriateness and safety. European guidelines for chiropractic spinal manipulation of infants recommend low-force, low-speed manipulation that is 10% of the force (equivalent to 11.2 N of force) for infants up to 3 months of age and 30% of the force used for adults for infants and toddlers aged 3 to 23 months (equivalent to 33.6 N).…”

“…This includes osteopathic craniosacral therapy, which has been measured at a force of 1 N and spinal manipulation/mobilization performed by physical therapists, measured at a force of 22 N in adults. Medical manual therapists have been found to apply manual therapy to children using forces of 50 to 70 N. 45…”