However, all these studies were performed with adult patients. On a pediatric level, most of the literature focuses on infant colic. The most notable reference is the Cochrane review in 2012 in which several manipulative therapies are evaluated in the. One of the weaknesses identified in this review is that parents entrusted to objectify the improvements were not blinded. This defect is corrected in a subsequent study in the chiropractor field. The effectiveness of osteopathic treatment for infantile colic has also been studied but always with small samples or methodological flaws. An example is the study by Hayden et al. Silva et al which shows that the use of physical therapy (muscle exercises, breathing and abdominal massage) is effective in pediatric chronic constipation with defecation increasing frequency.