title: Anthroposophic therapy for children with chronic disease: a two-year prospective cohort study in routine outpatient settings.
abstract: BACKGROUND
  Many children with chronic disease use complementary therapies. Anthroposophic treatment for paediatric chronic disease is provided by physicians and differs from conventional treatment in the use of special therapies (art therapy, eurythmy movement exercises, rhythmical massage therapy) and special medications. We studied clinical outcomes in children with chronic diseases under anthroposophic treatment in routine outpatient settings.
  
  
  METHODS
  In conjunction with a health benefit program, consecutive outpatients starting anthroposophic treatment for any chronic disease participated in a prospective cohort study. Main outcome was disease severity (Disease and Symptom Scores, physicians' and caregivers' assessment on numerical rating scales 0-10). Disease Score was documented after 0, 6, and 12 months, Symptom Score after 0, 3, 6, 12, 18, and 24 months.
  
  
  RESULTS
  A total of 435 patients were included. Mean age was 8.2 years (standard deviation 3.3, range 1.0-16.9 years). Most common indications were mental disorders (46.2% of patients; primarily hyperkinetic, emotional, and developmental disorders), respiratory disorders (14.0%), and neurological disorders (5.7%). Median disease duration at baseline was 3.0 years (interquartile range 1.0-5.0 years). The anthroposophic treatment modalities used were medications (69.2% of patients), eurythmy therapy (54.7%), art therapy (11.3%), and rhythmical massage therapy (6.7%). Median number of eurythmy/art/massage therapy sessions was 12 (interquartile range 10-20), median therapy duration was 118 days (interquartile range 78-189 days).From baseline to six-month follow-up, Disease Score improved by average 3.00 points (95% confidence interval 2.76-3.24 points, p < 0.001) and Symptom Score improved by 2.41 points (95% confidence interval 2.16-2.66 points, p < 0.001). These improvements were maintained until the last follow-up. Symptom Score improved similarly in patients not using adjunctive non-anthroposophic therapies within the first six study months.
  
  
  CONCLUSIONS
  Children under anthroposophic treatment had long-term improvement of chronic disease symptoms. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study findings suggest that anthroposophic therapies may play a beneficial role in the long-term care of children with chronic illness.
authors: Institute for Applied Epistemology and Medical Methodology, Zechenweg 6, Freiburg, Germany. harald.hamre@ifaemm.de
authors: Harald J
authors: HJ
authors: Hamre
authors: Claudia M
authors: CM
authors: Witt
authors: Gunver S
authors: GS
authors: Kienle
authors: Christoph
authors: C
authors: Meinecke
authors: Anja
authors: A
authors: Glockmann
authors: Stefan N
authors: SN
authors: Willich
authors: Helmut
authors: H
authors: Kiene
mesh_terms: D000293:Adolescent; D001155:Art Therapy; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000628:therapy*; D000529:Complementary Therapies; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008405:Massage; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome