Psychometric measurement properties of patient-reported and observer-reported outcome measures for spinal mobilisations and manipulation on paediatric subjects with diverse medical conditions: A systematic review

ABSTRACT

Introduction

Reliable, valid, and responsive outcomes is foundational to address concerns about the risks and benefits of performing spinal manipulation and mobilization in pediatric populations. The aim of this systematic review was to synthesize evidence on measurement properties from cohort/case-control/cross-sectional/randomized studies on patient-reported (SQLI – Scoliosis Quality of Life Index; VAS-Visual Analog Scale; PAQLQ – Pediatric Asthma Quality of Life Questionnaire), observer-reported (Crying Diaries; ATEC – Autism Treatment Evaluation Checklist) and mixed (PedsQL – Pediatric Quality of Life Inventory) outcome measurements identified through a scoping review on manipulation and mobilization for pediatric populations with diverse medical conditions.

Method and Analysis

Electronic databases, clinicaltrial.gov and Ebsco Open Dissertations were searched up to 21 October 202221 October 2022. Two independent reviewers selected studies, extracted data, and assessed risk of bias. Qualitative synthesis was performed using COSMIN and Cochrane GRADE methodology to establish the certainty of evidence and overall rating: sufficient (+), insufficient (-), inconsistent (±), indeterminate (?).

Results

Eighteen studies (2 SQLI for scoliosis; 1 VAS – perceived influence of exertion or movement/position on low back problems; 1 PAQLQ for asthma; 1 Crying Diaries for infantile colic; 8 ATEC for autism; 5 PedsQL for cerebral palsy/scoliosis/healthy) with 9653 participants were selected. ATEC and PedsQL had overall sufficient (+) measurement properties with moderate certainty evidence. PAQLQ had indeterminate measurement properties with moderate certainty evidence. Very low certainty of evidence identified measurement properties to be indeterminate (?) for SQLI, Crying Diaries, and VAS- perceived influence of exertion or movement/position on low back problems.

Conclusion

ATEC for autism and PedsQL for asthma may be a suitable clinical outcome assessment (COA); additional validation studies on responsiveness and the minimal important difference are needed. Other COA require further validation.

KEYWORDS:

• Psychometrics; outcome measures
• mobilization
• manipulation
• pediatric

Acknowledgements

Jurgen Mollema, University of Applied Sciences, The Netherlands was our medical information specialist and research librarian. Derek Clewney, Duke University, USA is a member of the collaborative International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) and International Organisation of Physical Therapists in Paediatrics (IOPTP) Task Force on Spinal Manipulation in Children and assisted with data screening.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics and dissemination

Ethical approval was not required for this systematic review. Results were disseminated via a peer reviewed journal, profession specific position guidelines, and conferences.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10669817.2023.2281650

Additional information

Funding

Funding was provided by the Canadian Academy of Manipulative Physiotherapy (CAMPT), Research Fund for CAMPT Accredited Programs. This is a private fund held within this organization. https://manippt.org/member-resources/.

Notes on contributors

Tricia Hayton

Tricia Hayton is a private practitioner in Oakville, Ontario, Canada. She was a graduate student of the OMPT program at McMaster University and completed this work as part of her research requirements.

Anita Gross

Anita Gross is an Associate Clinical Professor at McMaster University on the School of Rehabilitation Sciences leading their advanced orthopedic musculoskeletal-manipulative physical therapy (OMPT) program. She is a lecturer in the Master’s of Clinical Science program in Manipulative Therapy at Western University and the Canadian Physiotherapy Association AIM program. She is the chair of the IFOMPT/ IOPTP Taskforce on Pediatric Manipulation informing PT policy with systematic reviews and evidence gap maps. She is a clinician scientist and educator. She has over 150 peer reviewed publications, has been principal/co-investigator on 30 grants and has been an invited speaker at 20 international conferences. She coordinates the Cervical Overview Group, an International Network that conducts and maintains Cochrane systematic reviews on neck pain and participates in randomized clinical trials on back pain (Welback). She works in private practice OMPT and is a Fellow of the Canadian Academy of Manipulative Physiotherapy (FCAMPT).

Annalie Basson

Annalie Basson is a clinician and part-time lecturer at the University of Witwatersrand, Johannesburg, South Africa working in private practice in Pretoria.

Ken Olson

Ken Olson is the president and co-owner of the physical therapy private practice Northern Rehab Physical Therapy Specialists in DeKalb, Illinois and is adjunct faculty for Northern Illinois University. He is a Past-President of both the International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) and the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT).

Oliver Ang

Oliver Ang primary research interests are innovative interventions using digital technologies to address cervical disorders and contextual factors, particularly therapeutic alliance, in physical therapy treatments. He is currently involved in the Spinal Manipulation and Patient SelfManagement for Preventing Chronic Back Pain (PACBACK), the Integrated Supported Biopsychosocial Self-Management for Back Related Leg Pain (SUPPORT) and Partners4Pain studies, funded by the US National Institute of Health (NIH). He is a member of the validity assessment team of the Cervical Overview Group.

Nikki Milne

Nikki Milne works as an Associate Professor of Physiotherapy (Paediatrics) at Bond University where she has worked for the past 16 years. Prior to starting work in the academic setting Nikki worked as a Paediatric physiotherapist for NSW Health which led to her research interests in child health and wellbeing and paediatric curriculum. Nikki has a special interest in child health, learning and paediatric physiotherapy and is passionate about the inclusion of paediatric curriculum in entry-level physiotherapy programs, to ensure that all graduates of accredited entry-level programs have knowledge and skills to safely and effectively work with children.

Jan Pool

Jan Pool has worked as Associate Professor Institute of Human Movement Studies, Faculty of Health Care and as a Coordinator/Head of Master Program Physical Therapy division; Orthopedic Manual Therapy. He was senior researcher of Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands. He worked as a manual therapist for over 30 years in a private clinic. His scientific interest culminated in a master degree in epidemiology in 2003 and a doctorate in medicine in 2007 both at the Free University Amsterdam. He wrote numerous articles on the topics neck pain, chronic pain and manipulative therapy and has a special interest in clinimetry. He was a member of the board of the Dutch Association of Manual therapy in The Netherlands (NVMT), from 1990 till 1998. From 2000-2016 he was a member of the Standard Committee of the International Federation of Manipulative Physical Therapy (IFOMPT). Jan became a member of the Spinal Manipulation Taskforce in 2020