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Introduction <p>An international taskforce of physiotherapists developed a&#xa0;practice position statement that recommends restricting the use of spinal mobilization and manipulation in infants and children. We analyzed the taskforce’s literature search and evaluations regarding adverse events (AEs), efficacy, and indications for a&#xa0;critical approach to these recommendations.</p> Material and methods <p>The literature used to inform the decision-making process was assessed for its reliability and relevance. In the case of inconsistencies or suspected misinterpretations the authors of the original publications were contacted. Based on the findings, the recommendations of the taskforce were questioned, followed by a&#xa0;discussion of our own assessments.</p> Results <p>The analysis of AEs reveals several inaccuracies and misinterpretations. Furthermore, the discussion is not balanced. The incidence of severe AEs in children remains unclear, severe AEs are rare. The evidence-based statement has not been updated and ignores manual therapy treatments as best practices for postural and movement disorders in infancy. Expert recommendations in Europe include musculoskeletal comorbidities in children with cerebral palsy and proprioceptive musculoskeletal coordination disorders within the therapeutic scope.</p> Conclusion <p>The recommendations of the taskforce are based on misinterpretations of the literature and outdated data. Additionally, there are multiple signs of biased reporting and argumentation. Manual therapy techniques, as well as age-appropriate spinal mobilization and manipulation, are integral to the diagnosis and treatment of children of all ages.</p>

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Restricted use of spinal mobilization and manipulation in infants

  • 期刊论文

  • 发表日期：

    2025年7月21日

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  • Robby Sacher,
  • Eric Saedt,
  • Marc Wuttke

摘要

Introduction

An international taskforce of physiotherapists developed a practice position statement that recommends restricting the use of spinal mobilization and manipulation in infants and children. We analyzed the taskforce’s literature search and evaluations regarding adverse events (AEs), efficacy, and indications for a critical approach to these recommendations.

Material and methods

The literature used to inform the decision-making process was assessed for its reliability and relevance. In the case of inconsistencies or suspected misinterpretations the authors of the original publications were contacted. Based on the findings, the recommendations of the taskforce were questioned, followed by a discussion of our own assessments.

Results

The analysis of AEs reveals several inaccuracies and misinterpretations. Furthermore, the discussion is not balanced. The incidence of severe AEs in children remains unclear, severe AEs are rare. The evidence-based statement has not been updated and ignores manual therapy treatments as best practices for postural and movement disorders in infancy. Expert recommendations in Europe include musculoskeletal comorbidities in children with cerebral palsy and proprioceptive musculoskeletal coordination disorders within the therapeutic scope.

Conclusion

The recommendations of the taskforce are based on misinterpretations of the literature and outdated data. Additionally, there are multiple signs of biased reporting and argumentation. Manual therapy techniques, as well as age-appropriate spinal mobilization and manipulation, are integral to the diagnosis and treatment of children of all ages.