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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

Craniosacral therapy: a systematic review of the clinical evidence

E Ernst.

Review published: 2012.

CRD summary

This review of randomised trials found insufficient evidence to support any specific therapeutic effect of craniosacral therapy. The review had some methodological and reporting weaknesses but the authors' conclusions reflect the limitations of the evidence and are likely to be reliable.

Authors' objectives

To evaluate the evidence of effectiveness of craniosacral therapy for any condition.

Searching

MEDLINE, EMBASE and The Cochrane Library were searched with no language or date restrictions. The author's files and bibliographies (unspecified) were also searched. Search terms were reported. The date of the search was not reported.

Study selection

Randomised controlled trials (RCTs) of craniosacral therapy for the treatment of any condition were eligible for inclusion. Studies with healthy volunteers were excluded.

Included trials involved adults or children with various conditions (adults with tension-type headache, fibromyalgia or migraine; children with colic or cerebral palsy). The number of therapy sessions ranged from one to 50 for up to 25 weeks. Control groups received different interventions. A range of outcomes were assessed.

One reviewer selected studies for inclusion.

Assessment of study quality

Study quality was assessed by one reviewer using the Jadad score.

Data extraction

Data were extracted by one reviewer.

Methods of synthesis

A narrative synthesis was presented. Methodological limitations of the included trials were highlighted.

Results of the review

Six RCTs with 471 participants (range 28 to 142) were included in the review. On the Jadad scale of trial quality (maximum score 5), two trials scored 2 points, three scored 3 and one scored 4.

Five trials reported positive effects of craniosacral therapy. The largest and best quality trial (involving children with cerebral palsy) found no benefit for motor function or a range of secondary outcomes. However, carers were more likely to report improvements in global health in children given craniosacral therapy compared with those in the control group.

Authors' conclusions

There was insufficient evidence to support any specific therapeutic effect of craniosacral therapy.

CRD commentary

The review question and inclusion criteria were clear. The search covered three relevant sources, although there was no specific attempt to locate unpublished studies. Only one author was credited, which suggested that review processes were not carried out in duplicate, so the risk of errors or bias in the review process should be taken into account in interpreting the review.

Trial quality was assessed using standard criteria, although only summary scores were presented. Other limitations of included trials were discussed in the text. A narrative synthesis was appropriate in view of the differences between the included trials. The synthesis presented was limited and mainly devoted to highlighting the limited evidence base.

The review had some methodological and reporting weaknesses but the author's conclusions reflect the limitations of the evidence and are likely to be reliable. The conclusions were also supported by another systematic review with different inclusion criteria (see linked record).

Implications of the review for practice and research

The author did not state any implications for practice or further research.

Funding

Not reported.

Bibliographic details

Ernst E. Craniosacral therapy: a systematic review of the clinical evidence. Focus on Alternative and Complementary Therapies 2012; 17(4): 197-201.

Indexing Status

Subject indexing assigned by CRD

MeSH

Humans; Musculoskeletal Manipulations; Intracranial Pressure; Cranial Sutures

AccessionNumber

12012056542

Date bibliographic record published

28/01/2013

Date abstract record published

19/08/2014

Record Status

This is a critical abstract of a systematic review that meets the criteria for inclusion on DARE. Each critical abstract contains a brief summary of the review methods, results and conclusions followed by a detailed critical assessment on the reliability of the review and the conclusions drawn.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

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