title: What "CAM" we learn about the level of evidence from 60 years of research into manipulative and body-based therapies in sports and exercise medicine?
abstract: BACKGROUND
  Complementary and alternative medicine (CAM) is becoming increasingly accepted in modern western society, including amongst amateur and professional athletes, however, it has not yet been determined how CAM is reflected in scientific publications in sports and exercise medicine (SEM).
  
  
  OBJECTIVE
  The aim of this study was to identify trends in the levels of evidence for manipulative and body-based therapies within the SEM literature.
  
  
  METHODS
  The literature was systematically searched with no language restrictions in seven databases and retrieved articles were screened and classified according to their study design using the Oxford Centre for Evidence-Based Medicine system.
  
  
  RESULTS
  From 6088 retrieved articles, 395 were retained for evaluation and these included 180 on massage, 96 on acupuncture and 95 on manipulation. The majority of the articles were published in English, with 88 in non-English languages. Level-1 evidence was available for acupuncture, manipulation, massage, and Pilates. From the nineteen-seventies onwards, a decreasing trend was observed for low evidence articles with a corresponding increasing trend for clinical trials. After the year 2000, over 50% of the published articles were clinical trials, RCTs or systematic reviews.
  
  
  CONCLUSIONS
  This review revealed an increase in the quantity and quality of published manipulative and body-based therapy articles in SEM over the last 60 years with the evidence level varying considerably between therapies. The timeframe associated with the development of evidence in CAM may reflect the move to provide scientific support for therapies previously justified primarily by anecdotal evidence, or traditional and cultural use.
authors.affiliation: Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, PO BOX 56, Dunedin 9054, New Zealand.
authors.forename: Aleksandra K
authors.initials: AK
authors.lastname: Mącznik
authors.affiliation: School of Human, Health and Social Sciences, Central Queensland University, University Drive, Branyan, Queensland 4670, Australia. Electronic address: a.schneiders@cqu.edu.au.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Schneiders
authors.affiliation: Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, PO BOX 56, Dunedin 9054, New Zealand.
authors.forename: S John
authors.initials: SJ
authors.lastname: Sullivan
authors.affiliation: Department of Preventive and Social Medicine, University of Otago, 18 Frederick Street, PO Box 913, Dunedin 9054, New Zealand.
authors.forename: Josie
authors.initials: J
authors.lastname: Athens
mesh_terms: D006801:Humans; D026201:Musculoskeletal Manipulations; D013178:Sports Medicine
keywords: Complementary and alternative medicine; Evaluation report; Evidence-based practice; Levels of evidence; Sports and exercise medicine