PDF(Pubmed)
Abstract：
UNASSIGNED: An international taskforce of clinician-scientists was formed by specialty groups of World Physiotherapy - International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) & International Organisation of Physiotherapists in Paediatrics (IOPTP) - to develop evidence-based practice position statements directing physiotherapists clinical reasoning for the safe and effective use of spinal manipulation and mobilisation for paediatric populations (<18 years) with varied musculoskeletal or non-musculoskeletal conditions.
UNASSIGNED: A three-stage guideline process using validated methodology was completed: 1. Literature review stage (one scoping review, two reviews exploring psychometric properties); 2. Delphi stage (one 3-Round expert Delphi survey); and 3. Refinement stage (evidence-to-decision summative analysis, position statement development, evidence gap map analyses, and multilayer review processes).
UNASSIGNED: Evidence-based practice position statements were developed to guide the appropriate use of spinal manipulation and mobilisation for paediatric populations. All were predicated on clinicians using biopsychosocial clinical reasoning to determine when the intervention is appropriate.1. It is not recommended to perform:• Spinal manipulation and mobilisation on infants.• Cervical and lumbar spine manipulation on children.•Spinal manipulation and mobilisation on infants, children, and adolescents for non-musculoskeletal paediatric conditions including asthma, attention deficit hyperactivity disorder, autism spectrum disorder, breastfeeding difficulties, cerebral palsy, infantile colic, nocturnal enuresis, and otitis media.2. It may be appropriate to treat musculoskeletal conditions including spinal mobility impairments associated with neck-back pain and neck pain with headache utilising:• Spinal mobilisation and manipulation on adolescents;• Spinal mobilisation on children; or• Thoracic manipulation on children for neck-back pain only.3. No high certainty evidence to recommend these interventions was available.Reports of mild to severe harms exist; however, risk rates could not be determined.
UNASSIGNED: Specific directives to guide physiotherapists\' clinical reasoning on the appropriate use of spinal manipulation or mobilisation were identified. Future research should focus on trials for priority conditions (neck-back pain) in children and adolescents, psychometric properties of key outcome measures, knowledge translation, and harms.
UNASSIGNED: A three-stage guideline process using validated methodology was completed: 1. Literature review stage (one scoping review, two reviews exploring psychometric properties); 2. Delphi stage (one 3-Round expert Delphi survey); and 3. Refinement stage (evidence-to-decision summative analysis, position statement development, evidence gap map analyses, and multilayer review processes).
UNASSIGNED: Evidence-based practice position statements were developed to guide the appropriate use of spinal manipulation and mobilisation for paediatric populations. All were predicated on clinicians using biopsychosocial clinical reasoning to determine when the intervention is appropriate.1. It is not recommended to perform:• Spinal manipulation and mobilisation on infants.• Cervical and lumbar spine manipulation on children.•Spinal manipulation and mobilisation on infants, children, and adolescents for non-musculoskeletal paediatric conditions including asthma, attention deficit hyperactivity disorder, autism spectrum disorder, breastfeeding difficulties, cerebral palsy, infantile colic, nocturnal enuresis, and otitis media.2. It may be appropriate to treat musculoskeletal conditions including spinal mobility impairments associated with neck-back pain and neck pain with headache utilising:• Spinal mobilisation and manipulation on adolescents;• Spinal mobilisation on children; or• Thoracic manipulation on children for neck-back pain only.3. No high certainty evidence to recommend these interventions was available.Reports of mild to severe harms exist; however, risk rates could not be determined.
UNASSIGNED: Specific directives to guide physiotherapists\' clinical reasoning on the appropriate use of spinal manipulation or mobilisation were identified. Future research should focus on trials for priority conditions (neck-back pain) in children and adolescents, psychometric properties of key outcome measures, knowledge translation, and harms.
摘要：
由世界物理治疗专业小组-国际骨科操作物理治疗师联合会（IFOMPT）和国际儿科物理治疗师组织（IOPTP）组成的国际临床医师科学家工作组-制定基于证据的实践立场陈述，指导物理治疗师临床推理，以安全有效地使用脊柱和动员非骨骼疾病人群（<18岁）的肌肉。
■完成了使用经过验证的方法的三阶段指南过程：1.文献综述阶段(一次范围界定综述，探索心理测量学属性的两篇评论)；2.Delphi阶段（一项3轮专家Delphi调查）；和3。细化阶段(证据到决策总结性分析，立场陈述发展，证据差距图分析，和多层审查过程)。
■制定了基于证据的实践立场陈述，以指导儿科人群适当使用脊柱操纵和动员。所有这些都是基于临床医生使用生物心理社会临床推理来确定何时干预是适当的。不建议进行:•对婴儿进行脊柱操纵和动员。•对儿童进行颈椎和腰椎操作。•对婴儿进行脊柱操纵和动员，孩子们,和青少年非肌肉骨骼儿科疾病，包括哮喘，注意缺陷多动障碍,自闭症谱系障碍，母乳喂养困难，脑瘫,婴儿绞痛,夜间遗尿症,中耳炎2.使用以下方法治疗肌肉骨骼疾病可能是适当的：•青少年的脊柱动员和操纵；•儿童的脊柱动员；或•仅对儿童的颈背痛进行胸部操纵。没有高确定性证据推荐这些干预措施。存在轻度至重度伤害的报告；然而，风险率无法确定。
■确定了指导物理治疗师关于适当使用脊柱操纵或动员的临床推理的具体指令。未来的研究应该集中在儿童和青少年的优先条件（颈背痛）的试验，关键结果测量的心理测量特性，知识翻译,和伤害。
■完成了使用经过验证的方法的三阶段指南过程：1.文献综述阶段(一次范围界定综述，探索心理测量学属性的两篇评论)；2.Delphi阶段（一项3轮专家Delphi调查）；和3。细化阶段(证据到决策总结性分析，立场陈述发展，证据差距图分析，和多层审查过程)。
■制定了基于证据的实践立场陈述，以指导儿科人群适当使用脊柱操纵和动员。所有这些都是基于临床医生使用生物心理社会临床推理来确定何时干预是适当的。不建议进行:•对婴儿进行脊柱操纵和动员。•对儿童进行颈椎和腰椎操作。•对婴儿进行脊柱操纵和动员，孩子们,和青少年非肌肉骨骼儿科疾病，包括哮喘，注意缺陷多动障碍,自闭症谱系障碍，母乳喂养困难，脑瘫,婴儿绞痛,夜间遗尿症,中耳炎2.使用以下方法治疗肌肉骨骼疾病可能是适当的：•青少年的脊柱动员和操纵；•儿童的脊柱动员；或•仅对儿童的颈背痛进行胸部操纵。没有高确定性证据推荐这些干预措施。存在轻度至重度伤害的报告；然而，风险率无法确定。
■确定了指导物理治疗师关于适当使用脊柱操纵或动员的临床推理的具体指令。未来的研究应该集中在儿童和青少年的优先条件（颈背痛）的试验，关键结果测量的心理测量特性，知识翻译,和伤害。
