Table 2.
- Summary table of levels of evidence [181] and grades of recommendations of manual therapies for primary headaches
| Type of manual therapies | Levels of evidence | Grades of recommendations |
|---|---|---|
| Chiropractic therapy | 1- | C |
| Osteopathic Manipulative Treatment | 1+ | B |
| Myofascial technique | 2- | D |
| Multimodal Approach | 2- | D |
Legend for Levels of evidence
1++ High quality meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias
1+ Well-conducted meta-analyses, systematic reviews, or RCTs with a low risk of bias
1- Meta-analyses, systematic reviews, or RCTs with a high risk of bias
2++ High quality systematic reviews of case control or cohort or studies; high quality case control or cohort studies with a very low risk of confounding or bias and a high probability that the relationship is causal
2+ Well-conducted case control or cohort studies with a low risk of confounding or bias and a moderate probability that the relationship is causal
2- Case control or cohort studies with a high risk of confounding or bias and a significant risk that the relationship is not causal
3 Non-analytic studies, e.g., case reports, case series
4 Expert opinion
Legend for Grades of recommendations
A: At least one meta-analysis, systematic review, or RCT rated as 1++, and directly applicable to the target population; or a body of evidence consisting principally of studies rated as 1+, directly applicable to the target population, and demonstrating overall consistency of results
B: A body of evidence including studies rated as 2++, directly applicable to the target population, and demonstrating overall consistency of results; or extrapolated evidence from studies rated as1++ or 1 +
C: A body of evidence including studies rated as 2+, directly applicable to the target population and demonstrating overall consistency of results; or extrapolated evidence from studies rated as 2++
D: evidence level 3or4; or extrapolated evidence from studies rated as 2 +
GPP: recommended best practice based on the clinical experience of the guideline development group