The aim of this study was to establish an international consensus regarding the use of spinal manipulation and mobilisation among infants, children, and adolescents among expert international physiotherapists. Twenty-six international expert physiotherapists in manual therapy and paediatrics voluntarily participated in a 3-Round Delphi survey to reach a consensus via direct electronic mail solicitation using Qualtrics®. Consensus was defined a-priori as ≥75% agreement on all items with the same ranking of agreement or disagreement. Round 1 identified impairments and conditions where spinal mobilisation and manipulation might be utilised. In Rounds 2 and 3, panelists agreed or disagreed using a 4-point Likert scale.

Eleven physiotherapists from seven countries representing five continents completed all three Delphi rounds. Consensus regarding spinal mobilisation or manipulation included:

● Manipulation is not recommended: (1) for infants across all conditions, impairments, and
spinal levels; and (2) for children and adolescents across most conditions and spinal levels.
● Manipulation may be recommended for adolescents to treat spinal region-specific joint
hypomobility (thoracic, lumbar), and pain (thoracic).
● Mobilisation may be recommended for children and adolescents with hypomobility, joint
pain, muscle/myofascial pain, or stiffness at all spinal levels.

The authors of this paper concluded that consensus revealed spinal manipulation should not be performed on infants regardless of condition, impairment, or spinal level. Additionally, the panel agreed that manipulation may be recommended only for adolescents to treat joint pain and joint hypomobility (limited to thoracic and/or lumbar levels). Spinal mobilisation may be recommended for joint hypomobility, joint pain, muscle/myofascial pain, and muscle/myofascial stiffness at all spinal levels among children and adolescents.

Various forms of spinal manipulations are the hallmark therapy of chiropractors. Almost 100% of their patients recieve these interventions. So, what will our friends, the chiros, say about the consensus? Might it be this:

  • Physiotherapists are not the experts on spinal manipulation.
  • Only chiropractors can do them properly.
  • And when WE do them, they are very good*!




(* for our income)

16 Responses to Spinal manipulation and mobilisation among infants, children, and adolescents: an international Delphi survey of expert physiotherapists

  • When chiropractors attend to children 12 and under, we do it safely. Trust I am clear.

    • when chiropractors state anything about chiropractic, they rarely tell the truth.

      • It’s your blog, so say what you like. When I made this claim, I supported it with evidence.

        • “It’s your blog, so say what you like.”
          “When I made this claim, I supported it with evidence.”

          • Prf. Ernst (Real doctor as he has a PhD). Please supply the evidence for this statement.

            “When chiropractors state anything about chiropractic, they rarely tell the truth”.

            It is hypocritical of you not to supply the evidence.

            I would suggest that you might like to read the book, “Manual Therapy in Children”, edited by the German Orthopaedic Surgeon Heiner Biedermann MD.
            It has sections on Birth Trauma, peripheral neurological disorders, Attention Deficit Disorders, Posture, Kinematic imbalances due to suboccipital Stress, (KISS) etc.
            Contributors include Neuropediatricians, Psychologists, Medical Practitioners, Orthopaedists, Physiotherapists and Radiologists, just to name a few.

            This book will give you and your readers a valuable insight into a multi-disciplinary approach to the treatment of children of all ages.

          • thanks for the tip; might I recommend you read this one?

          • Have you read it?
            “The report’s principal findings were that while spinal manipulation of children results in very rare instances of harm, since evidence of the effectiveness of SMT is lacking, SMT cannot be recommended for children under 12 for a list of conditions or for general wellness.”

      • The SCV brief was about safety. Over 99.6% of parents were satisfied with the care and no reported insurance claims were reported. The commentary reported that physical therapists are now delving into manual therapy for children 12 and under as noted in reference 55 of the CJA commentary. What is good for physios is good for chiropractors. What has been proven is that no reported injuries have occurred to children under chiropractic care under this review.

        • come on!
          even you cannot whitewash this conclusion
          [hint patient satisfaction is not the same as efficacy or harmlessness]

          • The SCV review concluded that chiropractic manipulation for children under 12 is safe. That is what its brief was and all the hundreds and thousands of dollars were spent on! Now we can move on and support level 1,2 research on its intervention. My level 5 opinion is that from the many children I have attended to over the last 40 years for headaches, torticollis, neck and lower back pain and severe postural distortions, it is effective. I will remind the high-level membership of the government of all these facts when I meet the Australian Shadow Minister of Health for dinner in the next few weeks.

    • Under what circumstances would any parent take an infant to a chiropractor and what sort of condition would a chiropractor try to treat?

      • under the circumstance that they believe the lies chiros tell them about birth trauma that needs correcting and other tall tales that chiros love.

      • burdle asked: “Under what circumstances would any parent take an infant to a chiropractor and what sort of condition would a chiropractor try to treat?”

        The most common conditions that chiropractors (cannot) help kids with
        Published Thursday 03 November 2022

        David Nette on Thursday 03 November 2022 at 15:40
        I am trying to wrap my head around (NO PUN INTENDED) why anyone would take an infant to a Chiropractor!

        This Chiropractor should definitely be reported. That’s quite the list of “cures”!

        Pete Attkins on Friday 04 November 2022 at 20:47
        The following lists are ‘impressive’, but even better, the website highlights the deployment of electronic gizmos on children:


        During infancy and toddlerhood, growth and development is occurring more rapidly than any other time in life. The stresses that our kids and teens are under these days are unprecedented. Taking all of this into consideration, we must have strategies to help support and nourish neurological development in our children. Supporting the delicate fibers of their nervous systems through chiropractic care can help to ensure proper growth and development, healing, relaxation, immune function, digestion, and much more!!

        By addressing the cause we have helped common childhood conditions:

        • Difficulty Breastfeeding
        • Colic & Excessive Crying
        • Reflux & Excessive Spitting Up
        • Stiffness & Tightness
        • Constipation & Gas Pains

        • Ear & Strep Infections
        • Congestion, Colds & Cough
        • Difficulty Sleeping
        • Speech Development
        • Balance & Coordination

        • ADHD, ADD, ODD, ASD & more
        • Hyperactivity & Behavior
        • Sensory Processing Issues
        • Allergies & Asthma
        • Bedwetting

        • Anxiety & Depression
        • Headaches & Migraines
        • Focus & Memory Issues
        • Sports Performance
        • Hormones

        ** We do not claim to treat or cure any of these conditions **

        • ADHD
        • Allergies/Asthma
        • Anxiety/Depression
        • Back/Neck
        • Bed Wetting/Accidents
        • Behavioral
        • Brain Injuries/Cerebral Palsy
        • Chronic Fatigue
        • Chronic Pain
        • Digestive
        • Ear Infections
        • Epilepsy
        • Headaches/Migraines
        • Hormones/Fertility
        • Immunity
        • Infants
        • Pain
        • Pregnancy/Postpartum
        • Scoliosis
        • Sensory
        • Sleep
        • Speech
        • Vertigo
        • Vision
        • Wellness


        END OF QUOTE

  • Prof. Ernst, What a book!!!!
    Stunning reviews by people and ranks as 2,094,431 in Medical Books.
    How many copies has it sold?
    How much did you have to discount it by?
    Just based upon the very eloquent reviews, I would not buy it. It looks like I am not the only person to express this opinion.

    A stunning read, especially the reviews, which I enjoyed immensely.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Subscribe via email

Enter your email address to receive notifications of new blog posts by email.

Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”

The most recent comments from all posts can be seen here.