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Results: We reviewed 3 418 unique hits from the literature search. We included three randomised controlled studies on the efficacy of manual therapy or osteopathy and three observational studies on possible adverse effects. Two studies on manual therapy suggested that manipulation techniques do not have any greater effect on symmetry and motor outcomes than parental guidance, physiotherapy and home exercises. One study suggested that osteopathy may contribute to increased symmetry compared to placebo, but the clinical significance of this change is uncertain. Neither the three randomised studies nor a large patient series involving 695 infants found manipulation techniques to be associated with a risk of serious adverse events, but three patient histories demonstrated that manipulation techniques may cause harm if the observed asymmetry has serious underlying causes.
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The mean total score for the DREEM was 135 and according to the interpretation suggested by Lai et al. [19] and McAleer and Roff [16], the VU osteopathy program would be classified as more positive than negative. This result suggests that there are areas within the program that the students perceive as positive, but also areas requiring attention. Comparing the mean total DREEM score to those reported by Luciani et al. [13] in their study of European osteopathy programs, reveals the mean score is comparable to the British School of Osteopathy (BSO, UK) (133) and Centre Européen d'Enseignement Supérieur de l'Ostéopathie (CEESO, France) (130) but lower than Accademia Italiana Osteopatia Tradizionale (AIOT, Italy) (147). However, as these values only represent final year students, a valid approach [14] is to make a direct comparison with the final year students in the present study (Figure 2). The mean total DREEM score for year 5 students in the present study (133) again is comparable to the BSO and CEESO, as are the subscale mean scores. Luciani et al. [13] suggested the higher mean total and subscale scores at the Italian teaching institution were due to the smaller class sizes (up to 12 students), leading to more tutorial-like learning. 153554b96e
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