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Daily Archives: May 30, 2014

Chiropractic Care for Pediatric and Adolescent Attention-Deficit/Hyperactivity Disorder: A Systematic Review

By |May 30, 2014|Attention Deficit, Chiropractic Care|

Chiropractic Care for Pediatric and Adolescent Attention-Deficit/Hyperactivity Disorder: A Systematic Review

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SOURCE:   Chiropractic & Osteopathy 2010 (Jun 2);   18:   13 ~ FULL TEXT

Fay Karpouzis, Rod Bonello, and Henry Pollard

Department of Chiropractic,
Faculty of Science,
Macquarie University, Sydney, NSW 2109, Australia.

Background   Psychostimulants are first line of therapy for pediatric and adolescent AD/HD. The evidence suggests that up to 30% of those prescribed stimulant medications do not show clinically significant outcomes. In addition, many children and adolescents experience side-effects from these medications. As a result, parents are seeking alternate interventions for their children. Complementary and alternative medicine therapies for behavioural disorders such as AD/HD are increasing with as many as 68% of parents having sought help from alternative practitioners, including chiropractors.

Objective   The review seeks to answer the question of whether chiropractic care can reduce symptoms of inattention, impulsivity and hyperactivity for pediatric and adolescent AD/HD.

Methods   Electronic databases (Cochrane CENTRAL register of Controlled Trials, Cochrane Database of Systematic reviews, MEDLINE, PsycINFO, CINAHL, Scopus, ISI Web of Science, Index to Chiropractic Literature) were searched from inception until July 2009 for English language studies for chiropractic care and AD/HD. Inclusion and exclusion criteria were applied to select studies. All randomised controlled trials were evaluated using the Jadad score and a checklist developed from the CONSORT (Consolidated Standards of Reporting Trials) guidelines.

Results   The search yielded 58 citations of which 22 were intervention studies. Of these, only three studies were identified for pediatric and adolescent AD/HD cohorts. The methodological quality was poor and none of the studies qualified using inclusion criteria.

Conclusions   To date there is insufficient evidence to evaluate the efficacy of chiropractic care for pediatric and adolescent AD/HD. The claim that chiropractic care improves pediatric and adolescent AD/HD, is only supported by low levels of scientific evidence. In the interest of pediatric and adolescent health, if chiropractic care for AD/HD is to continue, more rigorous scientific research needs to be undertaken to examine the efficacy and effectiveness of chiropractic treatment. Adequately-sized RCTs using clinically relevant outcomes and standardised measures to examine the effectiveness of chiropractic care verses no-treatment/placebo control or standard care (pharmacological and psychosocial care) are needed to determine whether chiropractic care is an effective alternative intervention for pediatric and adolescent AD/HD.

From the FULL TEXT Article:


Attention-Deficit/Hyperactivity Disorder (AD/HD) is considered to be one of the most frequently diagnosed disruptive behaviour disorders in childhood [1-5], with world wide prevalence rates of 8-12%. [6] The American prevalence rates range between 3-7% [1], and 4-12%. [7] The Australian prevalence rates show 11% of 6-17 year olds are diagnosed with this disorder [8], where as the English and Welsh AD/HD prevalence rates find 5% of 6-16 year olds have the disorder. [9] The Diagnostic and Statistical Manual of Mental Disorders 4th Edition Text Revision (DSM-IV-TR) [1], is the most widely used classification system for mental disorders. [10, 11] The DSM-IV-TR characterises AD/HD as inappropriate, chronic levels of inattention, hyperactivity and impulsivity. [1] These children continually experience difficulties in academic achievement, and behavioural control, and as a consequence, they have difficulty in establishing positive relationships with family, authority figures and their peers. [12-14] As a result, much attention has been devoted to the development and evaluation of assessment and treatment for this disorder over the last fifty years. [2, 15-17] The majority of the AD/HD literature is dedicated to the treatment of this disorder. [2, 15-18] Most of this research can be found in the area of pharmacological therapies [12, 16, 17], with less emphasis in psychotherapy and other psychosocial interventions. [19] There is even less research in the area of AD/HD and complementary and alternative medicine (CAM) therapies. [20, 21]

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