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Excerpt: Hawk et al. reported a Delphi study on the effectiveness or efficacy of spinal manipulation thearpy (SMT) in persons over age 65 years and the adverse events associated with chiropractic care, including SMT. [Hawk C, Schneider MJ, Haas M, Katz P, Dougherty P, Gleberzon B, Killinger LZ, Weeks J. Best practices for chiropractic care for older adults: A systematic review and consensus update. J Manipulative Physiol Ther. 2017 May;40(4):217-229.] Complementing this study is a review by Nielsen et al., who identified 118 studies on the adverse and serious adverse events associated with SMT; 54 (46%) reported that it is safe, 15 (13%) reported that it is harmful, and 49 (42%) were neutral or unclear. Nielsen et al. stated that it is currently not possible to provide an overall conclusion about the safety of SMT; however, the types of serious adverse events reported can, indeed, be significant, indicating that some risk is present.
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