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Table 1 Primary reason for exclusion of RCTs in phase 3 screening

From: The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature

First author, Year Population Primary reason for ineligibility
Attali 2013 [63]a Patients with irritable bowel syndrome The sample size was < 20 per group.
Bevilaqua-Grossi 2016 [64]a Patients with migraine and neck pain SMT was part of a multimodal intervention. The effect of SMT could not be isolated.
The multimodal intervention included medication plus a physiotherapy protocol diaphragm training, cervical mobilization and training, massage, myofascial release, trigger point therapy, passive stretching. The control group received medication alone.
Budgell 2006 [18] Healthy adults Experimental trial with physiological outcome (heart rate variability) not related to primary prevention of a non-musculoskeletal disorder
de Araujo 2018 [65] Healthy asymptomatic individuals Experimental trial with physiological outcome (heart rate variability) not related to primary prevention of a non-musculoskeletal disorder
Davidson 2018 [66]a Patients with migraine SMT was part of a multimodal intervention. The effect of SMT could not be isolated. The multimodal intervention included Maitland C0-C3 mobilization and Watson Headache Approach (exercise and advice). The control intervention was ‘wait list’.
Goertz 2002 [67] Patients with high blood pressure or stage 1 hypertension SMT was part of a multimodal intervention. The effect of SMT could not be isolated. The multimodal intervention included dietary modification, SMT and ultrasound, moist heat, soft-tissue massage. The control group received dietary modification alone.
Hensel 2013 [68] Pregnant women at the 30th week of pregnancy Experimental trial with physiological outcomes (arterial pressure and heart rate variability) not related to primary prevention of a non-musculoskeletal disorder
Holt 2016 [69] Community-dwelling adults 65 years or older Experimental trial with physiological/ biomechanical outcomes (joint position sense, choice stepping reaction time, postural stability, multisensory processing, health-related quality of life) not related to primary prevention of a non-musculoskeletal disorder
Jones 2015 [70] Patients with dysfunctional breathing SMT was part of a multimodal intervention. The effect of SMT could not be isolated. The multimodal intervention included respiratory physiotherapy plus Maitland mobilization, muscle energy technique, trigger point therapy, myofascial release, diaphragm and rib cage mobilization. The control group received respiratory physiotherapy alone.
Kachmar 2018 [71] Patients with spastic forms of cerebral palsy Experimental trial with outcomes (muscle spasticity, manual dexterity) not related to tertiary prevention of a non-musculoskeletal disorder
Nelson 1998 [72]a Patients with migraine SMT was part of a multimodal intervention. The effect of SMT could not be isolated. The multimodal intervention included SMT, massage and/or trigger point therapy with or without amitriptyline. The control intervention was amitriptyline alone.
Nielsen 1995 [73] Patients with chronic asthma The sample size was < 20 per group.
Noll 2000 [74] Patients (≥ 60 years of age) hospitalized with acute pneumonia. The osteopathic manipulative therapy did not include SMT.
Pizzolorusso 2014 [75] Pre-term birth in infants The osteopathic manipulative therapy did not include SMT.
Schwerla 2014 [76]a Patients with primary dysmenorrhea SMT was part of a multimodal intervention. The effect of SMT could not be isolated. The multimodal intervention included high velocity thrust, muscle energy technique, myofascial release, balanced ligamentous tension, visceral and cranial techniques. The control group was not treated.
Steele 2014 [77] Patients enrolled in the study were between the ages of 6 months and 24 months with acute otitis media and an abnormal tympanogram. SMT was part of a multimodal intervention. The effect of SMT could not be isolated. The multimodal intervention included combinations of Sacroiliac mobilization, myofascial release, balance ligamentous tension, suboccipital inhibition, venous sinus draining, occipital decompression, sphenobasilar decompression
  1. SMT spinal manipulative therapy
  2. aThese studies were considered for both secondary and tertiary prevention