Send to

Choose Destination
J Manipulative Physiol Ther. 2016 Mar-Apr;39(3):158-68. doi: 10.1016/j.jmpt.2016.02.015. Epub 2016 Mar 31.

Best Practices for Chiropractic Care of Children: A Consensus Update.

Author information

Executive Director, Northwest Center for Lifestyle and Functional Medicine, University of Western States, Portland, OR. Electronic address:
Associate Professor, School of Health and Rehabilitation Sciences, Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh PA.
Private Practice, Kentuckiana Children's Center, Louisville, KY.
Adjunct Faculty, University of Western States, Private Practice, Portland OR.



Chiropractic care is the most common complementary and integrative medicine practice used by children in the United States, and it is used frequently by children internationally as well. The purpose of this project was to update the 2009 recommendations on best practices for chiropractic care of children.


A formal consensus process was completed based on the existing recommendations and informed by the results of a systematic review of relevant literature from January 2009 through March 2015. The primary search question for the systematic review was, "What is the effectiveness of chiropractic care, including spinal manipulation, for conditions experienced by children (<18 years of age)?" A secondary search question was, "What are the adverse events associated with chiropractic care including spinal manipulation among children (<18 years of age)?" The consensus process was conducted electronically, by e-mail, using a multidisciplinary Delphi panel of 29 experts from 5 countries and using the RAND Corporation/University of California, Los Angeles, consensus methodology.


Only 2 statements from the previous set of recommendations did not reach 80% consensus on the first round, and revised versions of both were agreed upon in a second round.


All of the seed statements in this best practices document achieved a high level of consensus and thus represent a general framework for what constitutes an evidence-based and reasonable approach to the chiropractic management of infants, children, and adolescents.


Adolescent; Chiropractic; Infant; Manipulation; Pediatrics; Spinal

[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center