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Anthroposophic therapy for children with chronic disease: a two-year prospective cohort study in routine outpatient settings.

Hamre HJ, Witt CM, Kienle GS, Meinecke C, Glockmann A, Willich SN, Kiene H - BMC Pediatr (2009)

Bottom Line: In conjunction with a health benefit program, consecutive outpatients starting anthroposophic treatment for any chronic disease participated in a prospective cohort study.Symptom Score improved similarly in patients not using adjunctive non-anthroposophic therapies within the first six study months.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.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute for Applied Epistemology and Medical Methodology, Zechenweg 6, Freiburg, Germany. harald.hamre@ifaemm.de

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.

Conclusion: 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.

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Disease and Symptom Scores. Range: 0 "not present", 10 "worst possible". Disease Score: physicians' assessment, n = 426. Symptom Score: caregivers' assessment, n = 433.
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Figure 1: Disease and Symptom Scores. Range: 0 "not present", 10 "worst possible". Disease Score: physicians' assessment, n = 426. Symptom Score: caregivers' assessment, n = 433.

Mentions: Disease and Symptom Scores (Figure 1) improved significantly and progressively between baseline and all subsequent follow-ups. After six months, an improvement of ≥ 50% of baseline scores was observed in 46.7% (n = 169/362) and 41.7% (n = 159/381) of evaluable patients for Disease and Symptom Scores, respectively. Standardised Response Mean effect sizes for the 0–6 month comparison were large for both scores (1.30 and 0.97, respectively). Symptom Score improved significantly in all four therapy modality groups (medical, eurythmy, art, rhythmical massage) (Table 3).


Anthroposophic therapy for children with chronic disease: a two-year prospective cohort study in routine outpatient settings.

Hamre HJ, Witt CM, Kienle GS, Meinecke C, Glockmann A, Willich SN, Kiene H - BMC Pediatr (2009)

Disease and Symptom Scores. Range: 0 "not present", 10 "worst possible". Disease Score: physicians' assessment, n = 426. Symptom Score: caregivers' assessment, n = 433.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2713221&req=5

Figure 1: Disease and Symptom Scores. Range: 0 "not present", 10 "worst possible". Disease Score: physicians' assessment, n = 426. Symptom Score: caregivers' assessment, n = 433.
Mentions: Disease and Symptom Scores (Figure 1) improved significantly and progressively between baseline and all subsequent follow-ups. After six months, an improvement of ≥ 50% of baseline scores was observed in 46.7% (n = 169/362) and 41.7% (n = 159/381) of evaluable patients for Disease and Symptom Scores, respectively. Standardised Response Mean effect sizes for the 0–6 month comparison were large for both scores (1.30 and 0.97, respectively). Symptom Score improved significantly in all four therapy modality groups (medical, eurythmy, art, rhythmical massage) (Table 3).

Bottom Line: In conjunction with a health benefit program, consecutive outpatients starting anthroposophic treatment for any chronic disease participated in a prospective cohort study.Symptom Score improved similarly in patients not using adjunctive non-anthroposophic therapies within the first six study months.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.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute for Applied Epistemology and Medical Methodology, Zechenweg 6, Freiburg, Germany. harald.hamre@ifaemm.de

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.

Conclusion: 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.

Show MeSH
Related in: MedlinePlus