title: [Systematic review of the effects of therapy in infants with the KISS-syndrome (kinetic imbalance due to suboccipital strain)].
abstract: OBJECTIVE
  To establish the effects of manual therapy, chiropractic, or osteopathic treatment of the KISS-syndrome (kinetic imbalance due to suboccipital strain) in infants with positional preference, plagiocephaly, and colic.
  
  
  METHODS
  Systematic review of the literature.
  
  
  METHODS
  PubMed, Embase and the Cochrane Library were searched for articles on the effects of manual therapy, chiropractic and osteopathy on the KISS-syndrome. Experts in the field of manual medicine and osteopathy were asked to provide relevant articles. The bibliography in a textbook of manual therapy for children was hand-searched for additional references to the KISS-syndrome.
  
  
  RESULTS
  No clinical trials were found that evaluated the effects of manual therapy or osteopathy on either the KISS-syndrome or its symptoms. Pooled analysis of two randomised clinical trials on the effects of chiropractic in infantile colic showed no statistically significant difference between active and control treatments. In addition, we found that 22% of infants showed short episodes of apnoea during manual therapy of the spine, and that one case has been described in which such apnoea resulted in death.
  
  
  CONCLUSIONS
  Given the absence of evidence of beneficial effects of spinal manipulation in infants and in view of its potential risks, manual therapy, chiropractic and osteopathy should not be used in infants with the KISS-syndrome, except within the context of randomised double-blind controlled trials.
authors.affiliation: Isala Klinieken, Amalia kinderafdeling, Postbus 10.500, 8000 GM Zwolle. p.l.p.brand@isala.nl
authors.forename: P L P
authors.initials: PL
authors.lastname: Brand
authors.forename: R H H
authors.initials: RH
authors.lastname: Engelbert
authors.forename: P J M
authors.initials: PJ
authors.lastname: Helders
authors.forename: M
authors.initials: M
authors.lastname: Offringa
mesh_terms: D001049:Apnea / Q000209:etiology; D002574:Cervical Vertebrae / Q000002:abnormalities*; D003085:Colic / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D026882:Manipulation, Chiropractic / Q000009:adverse effects; D008349:Manipulation, Orthopedic / Q000009:adverse effects; D026301:Manipulation, Osteopathic / Q000009:adverse effects; D009333:Neck / Q000002:abnormalities; D049068:Plagiocephaly, Nonsynostotic / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D013577:Syndrome; D016896:Treatment Outcome