Cerner Corporation, Workforce Health Services, Overland Park, Kansas, USA.
Texas Tech University Health Sciences Center, DPT Program, Lubbock, Texas, USA.
J Man Manip Ther. 2023 Jun;31(3):162-173. doi: 10.1080/10669817.2022.2118653. Epub 2022 Sep 1.
To describe variability in spinal manipulation technique details and adverse event (AE) documentation of spinal manipulation during pregnancy.
Five databases were searched for peer-reviewed investigations of spinal manipulation during pregnancy. Criteria for inclusion was as follows: high velocity, low amplitude thrust manipulation performed, subjects pregnant during manipulation, and English language. Studies were excluded when participants were not currently pregnant, and when the manipulation performed was not high-velocity, low-amplitude thrust. Data extraction included study design, number of participants, gestational age, spinal region, number of manipulations, manipulation technique details, profession of manipulator, AE reporting (Yes vs. No), type, and number of AE.
Out of 18 studies included in the review, only three provide details of the spinal manipulation technique. The reported variables include patient position, practitioner position, and direction of thrust. Fourteen studies documented AE; however, only seven provide AE details.
Reporting of spinal manipulation techniques and AE during pregnancy were inconsistent. Replication of methods in future investigations is limited without more detailed documentation of manipulation techniques performed. Furthermore, determining the relative risk and safety of spinal manipulation during pregnancy is not possible without more detailed reporting of AE. Due to these inconsistencies, a checklist is proposed for standardized reporting of spinal manipulation techniques and AE. With more consistent reporting of these parameters, results of future investigations may allow for more definitive and generalizable safety recommendations on spinal manipulation during pregnancy.
描述孕期脊柱手法治疗技术细节和不良事件（AE）记录的变异性。
检索了 5 个数据库中有关孕期脊柱手法治疗的同行评议研究。纳入标准如下：高速度、低幅度推力手法操作、研究对象在手法治疗期间怀孕、以及使用英文。当参与者未处于妊娠状态，或实施的手法治疗不是高速度、低幅度推力时，研究将被排除在外。数据提取包括研究设计、参与者数量、孕龄、脊柱区域、操作次数、手法技术细节、操作者的专业、AE 报告（是/否）、AE 的类型和数量。
在综述中纳入的 18 项研究中，只有 3 项提供了脊柱手法技术的详细信息。报告的变量包括患者体位、治疗师体位和推力方向。14 项研究记录了 AE，但只有 7 项提供了 AE 细节。
关于孕期脊柱手法治疗技术和 AE 的报告不一致。如果没有更详细地记录所实施的手法治疗技术，未来研究对方法的复制将受到限制。此外，如果没有更详细地报告 AE，就不可能确定孕期脊柱手法治疗的相对风险和安全性。由于这些不一致性，我们提出了一个标准化报告脊柱手法治疗技术和 AE 的检查表。通过更一致地报告这些参数，未来研究的结果可能允许对孕期脊柱手法治疗提供更明确和更具普遍性的安全性建议。
