Journal Article

Definition and classification for adverse events following spinal and peripheral joint manipulation and mobilization: A scoping review

Funabashi, Martha, Bergna, Andrea, Heneghan, Nicola R., Gorrell, Lindsay M., Pohlman, Katherine A.

2022

Overview

Spinal and peripheral joint manipulation and mobilization are interventions used by many healthcare providers to manage musculoskeletal conditions. Although there are many reports of adverse events (or undesirable outcomes) following such interventions, there is no common definition for an adverse event or clarity on any severity classification. This impedes advances of patient safety initiatives and practice. This scoping review mapped the evidence of adverse event definitions and classification systems following spinal and peripheral joint manipulation and mobilization for musculoskeletal conditions in adults. An electronic search of the following databases was performed from inception to February 2021: MEDLINE, EMBASE, CINAHL, Scopus, AMED, ICL, PEDro, Cochrane Library, Open Grey and Open Theses and Dissertations. Studies including adults (18 to 65 years old) with a musculoskeletal condition receiving spinal or peripheral joint manipulation or mobilization and providing an adverse event definition and/or classification were included. All study designs of peer-reviewed publications were considered. Data from included studies were charted using a standardized data extraction form and synthesised using narrative analysis. From 8248 identified studies, 98 were included in the final synthesis. A direct definition for an adverse event and/or classification system was provided in 69 studies, while 29 provided an indirect definition and/or classification system. The most common descriptors to define an adverse event were causality, symptom severity, onset and duration. Twenty-three studies that provided a classification system described only the end anchors (e.g., mild/minor and/or serious) of the classification while 26 described multiple categories (e.g., moderate, severe). A vast array of terms, definition and classification systems were identified. There is no one common definition or classification for adverse events following spinal and peripheral joint manipulation and mobilization. Findings support the urgent need for consensus on the terms, definition and classification system for adverse events related to these interventions.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adolescent / Adult / Adults / Adverse events / Aged / Ambulatory care / Biology and Life Sciences / Care and treatment / Classification / Classification systems / Clinical medicine / Health care / Humans / Intervention / Joints (anatomy) / Manipulation, Spinal - adverse effects / Manipulative therapy / Medicine and Health Sciences / Middle Aged / Musculoskeletal Diseases / Osteopathic medicine / Patient outcomes / Patient safety / People and Places / Professions / Research and Analysis Methods / Spinal cord injuries / Subject heading schemes / Young Adult