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OMT can be defined as “the therapeutic application of manually guided forces by an osteopathic physician to improve physiologic function and/or support homeostasis that has been altered by somatic dysfunction.” According to the Glossary of Osteopathic Terminology, OMT refers to a broad array of manipulative techniques ranging from articulatory to visceral manipulation and includes cranial osteopathy.5 It seems relevant to clarify the difference between chiropractors and (nonphysician) osteopaths. The former “focuses on the relationship between the body’s structure—mainly the spine—and its functioning.”6 Chiropractors primarily perform manipulations of the spine or the limbs with the goal of correcting subluxations,7–9 whereas osteopaths employ mainly (but not exclusively) mobilizations of soft tissues such as fascia, ligaments, and muscles.5 The similarities between the 2 professions are, however, undeniable. The prevalence of OMT use in pediatric populations varies throughout the world. Data from the National Health Interview Survey 2007, Child Alternative Medicine survey as well as the Child Core Sample indicated that 2.3 million children (2.3%) in the United States had used OMT or chiropractic manipulation in 2007. Numerous clinical trials investigating the effects of OMT in pediatric patients have been conducted; however, no systematic reviews (SRs) evaluating the effectiveness of OMT in pediatrics have been published. The paucity of high quality research in OMT is a critical factor undermining the credibility of the osteopathic profession. The objective of this SR is to critically evaluate the effectiveness of OMT as a treatment option for pediatric conditions, by using data from randomized clinical trials (RCTs). The present SR included all RCTs investigating the effect of OMT on pediatric conditions. Only children and adolescents #18 with a clinical condition were included. Any types of controls were considered admissible. Both published and unpublished RCTs were considered eligible. No gender, time, or language restrictions were imposed. Studies involving the use of OMT in conjunction with other treatments were included. Nonrandomized or un-controlled trials were excluded. Studies of chiropractic manipulations were also excluded. The first reviewer (Dr Posadzki) searched the following electronic databases (from their respective inceptions to November 2012): AMED (EBSCO), Cumulative Index to Nursing and Allied Health Literature (EBSCO), Embase (OVID), Medline (OVID), OSTMED.DR, PsycINFO, The Cochrane Library, ISI Web of Knowledge, Osteopathic Research Web, PEDro, and Rehabdata.

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