DOCSLIB.ORG

Chiropractic Safety Letter to the Editor

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Chiropractic Safety Letter to the Editor LETTERS TO THE EDITOR To the Editor, waiting rooms. It's pretty obvious though that chiropractors Dr. Cohn's contribution (A Review of the Literature have relatively more than do physicians. Regarding Stroke And Chiropractic, J.V.S.R., 4(3), 2001) is 3. “Only 15% of all medical procedures have been found to most timely. He points out that the recent literature would be supported by any literature at all and only 1% of that appear to support the prevalence of CVAs in chiropractic as literature has actually been deemed scientifically rigorous” being somewhere between 1 in 1 million and 1 in 2 million and and “....appendectomies which have a death rate of 1 in 74....”. this may eventually indeed be shown to be the case. In fact a The literature fails to support either observation. In fact there recent review of the literature in the Canadian Medical is excellent data indicating that approximately 85% of what Association Journal1 put the figure at 1 in 5.85 million cervical physicians do as physicians is evidence-based.3 I would manipulations, describing the association as “....both small and recommend this paper to Dr. Cohn and your readers as being a inaccurately estimated”. This contrasts with the estimates thorough assessment of “the evidence for evidence-based derived from surveys of neurologists2 which vary between 1 in medicine”. 500,000 and 1 million. Of the 39 references Dr. Cohn managed to find but one. The In any event, it is most encouraging to see the chiropractic overwhelming majority of medical procedures have been community participating in research with a view to quantitatively rated on the quality of supporting evidence. The determining the safety of cervical manipulation and I am sure few exceptions tend not to be suitable for such trials: applying that we in the medical community would encourage any tourniquets to bleeding vessels being an example. In truth, movement of the chiropractic establishment towards evidence- appendectomies are not particularly dangerous, (and Dr. Cohn based scientific practices. The next step in this direction will fails to provide any reference here: did he make up the 1 in 74 be to acquire more accurate data and to develop sufficiently mortality rate?). A far more plausible and accurate figure could powerful studies to address the safety and efficacy issues have been obtained from a number of recent studies, some of associated with this practice. which he and his peers who apparently reviewed his article However, Dr. Cohn's review contains a substantial number should have been aware of. One4 looked at the mortality rate of misleading and unsubstantiated assertions which should be among 4950 patients who underwent surgery for appendicitis. corrected. Among them are the following: The death rate was 1 in 1250, even though high-risk patients 1. Medicine, “.... bases its treatment on the philosophy of with co-morbidity were included. allopathy”. Not true. We simply look for the best objective Prior to surgery for this condition the mortality rate was evidence that treatment is effective and safe. We are highly closer to 25%. Does Dr. Cohen advise his own patients against suspicious of anecdotal evidence that cannot be backed up by appendectomy because it is too dangerous? If he believes his randomized controlled trials of adequate power and quality, own statistics he surely must do so. and surveys of patient satisfaction. Both can be highly It may eventually be demonstrated that neck manipulation misleading. We always maintain a healthy scepticism, is a relatively safe procedure. Dr. Cohn's review however, fails particularly of established treatment modes and those with a to provide the material on which such a judgement can be financial interest in a particular outcome. made. 2. Dr Cohn attempts to demonstrate the safety of chiropracty (sic) by contrasting the incidence of iatrogenic Dr. Antony C.H. Hammer M.D. mortality associated with chiropracty and medicine. Family practitioner Unfortunately, he fails to point out that his conclusions are Windsor, Ontario Canada. invalid because the chiropractic and medical cohorts he chooses are not comparable. How many of those submitting References: themselves to chiropracty in the studies he cites were suffering 1. Kapral M. & Bondy S., “Cervical Manipulation and Risk of Stroke”. from life-threatening conditions? Few, I suspect. How many Canadian Medical Assn. J. October 2, 2001. in the medical cohort would have died had they not received 2. Lee K.P., Carlini W.G., McCormick G.F., Albers G.W.,Neurologic complications following chiropractic manipulation: a survey of California treatment? Without knowing the answers to these questions neurologists. Neurology, 1995;45(6): 1213-5. and many more, it is simply not possible to draw any 3. Imrie R., Ramey D.W., “The evidence for Evidence-Based Medicine”. conclusions about whether chiropracty is safer than medicine. Compliment. Ther. Med. June; 8(2): 123-126. We all have our share of the “worried well” and those suffering 4. Hale et Al. Ann. Surg. 225:252-261. 1997. from relatively benign self-limiting diseases sitting in our Letters to the Editor J. Vertebral Subluxation Res., 4(4), 2002 83 Dr. Cohn Responds: blinded studies that utilize doppler ultrasound which show that Dr. Hammer’s response to the article that was published in there is no change in the blood flow of the vertebral arteries JVSR “A Review of the Literature Regarding Stroke and during different head positions or even during or after an Chiropractic” was commendable. Many Medical Doctors adjustment or manipulation.7 Evidence also shows that there is would probably not have had the interest to read a chiropractic not an effect on the vertebral arteries sufficient to cause an journal, no less respond to one. Unfortunately, I believe that injury or embolus to break loose which would be the causal Dr. Hammer has misunderstood some of the points I made in mechanism for a stroke.7 the review. The theory that a cervical adjustment or manipulation may 1. In my review I made the point that medical doctors cause a stroke from the carotid arteries has been thoroughly typically fall into the allopathic model. Dr. Hammer ruled out in the literature.9 The literature demonstrates that vehemently opposed this idea. Bringing up this point was not there is no change in blood flow in the carotid arteries with meant as an insult. In fact, there are some chiropractors that any neck position or during or after an adjustment or fall into the allopathic model as well. According to Mosby’s manipulation, and therefore these actions have no effect on the Medical Encyclopedia, allopathy is the treatment of blood vessel.8 A great deal of the literature suggests that these symptoms and disease; the example cited by Mosby’s is same actions have no effect on the vertebral arteries administering an antibiotic for a bacterial infection. This is not either.3,4,5,6,7,10 The literature clearly demonstrates that there is a bad thing; it is just different from the vitalistic approach of no basis for any correlation between stroke and spinal traditional chiropractic. The objectives of traditional manipulation or a chiropractic adjustment. chiropractic are to remove interference from the nervous I also compared the rates of strokes that were related to system so that the body is able to react to the environment chiropractic adjustments and spinal manipulations to the rate more efficiently and more effectively.1 Sometimes this results of strokes in the general population. I cited 15 review of in an increase in the intensity of a person’s symptoms (the literature studies that showed an average of 1 stroke to body’s way of repairing and cleaning itself). Allopathy is the 7,825,477 adjustments or manipulations.4,9,11-18 This ratio treatment of symptoms ranging from giving an antihistamine should be compared to the incidence of stroke in the general to someone with sinus congestion to stretching a tight muscle. population, which is approximately 1 in 447.3.18,19 Dr. Regardless if the treatment is effective, safe or thoroughly Hammer addressed a statistic that was taken from a single tested the intent is to treat and counteract the symptom and by survey of neurologists in California. This study calculates the definition is allopathy. risk of stroke caused by manipulations or adjustments to be 1 2. Dr. Hammer seemed to be under the impression that I in 500,000. Even if we were to use this statistic, the general brought up iatrogenic mortality to defend the safety of population would still be at a much higher risk than those chiropractic. The true reason I brought up iatrogenic mortality people that receive any type of spinal manipulation including was to offer a different perspective, not to compare the safety chiropractic adjustments. of two completely different professions. I also wanted to pose 3. In response to the statistic cited in my review stating 1% the question, “Why is there so much scrutiny of chiropractic of all medical procedures are scientifically sound, Dr. and so little scrutiny of medicine?” I am well aware that Hammer responded “that according to Imrie R. in medicine typically deals with people in more acute situations, “Therapeutic Medicine” up to 85% of what physicians do is and should reasonably have a higher death rate. However, the evidence-based”. However, according to the British Journal of rate of iatrogenic deaths (those deaths caused by medical Medicine, only 1% of that evidence is scientifically sound.20 treatment) is extremely high while the death and injury rate This means that although many procedures have been tested or proposed to be caused by chiropractic is extremely low.2 are effective that only about 1% are examined through In demonstrating the safety of chiropractic I raised a rigorous scientific evaluation.20 I originally brought this point number of points.
Load more

Recommended publications
  • Chiropractic & Osteopathy
    Chiropractic & Osteopathy BioMed Central Debate Open Access Subluxation: dogma or science? Joseph C Keating Jr*1, Keith H Charlton2, Jaroslaw P Grod3, Stephen M Perle4, David Sikorski5 and James F Winterstein6 Address: 16135 North Central Avenue, Phoenix, AZ, 85012, USA, 2School of Medicine, Mayne Medical School, University of Queensland, Herston, Queensland 4006, Australia, 3Department of Graduate Education and Research, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto ON, M2H 3J1, Canada, 4Department of Clinical Sciences, College of Chiropractic, University of Bridgeport, 225 Myrtle Ave., Bridgeport, CT 06604, USA, 5Department of Chiropractic Procedures, Southern California University of Health Sciences, 16200 E. Amber Valley Drive, Whittier, CA 90604, USA and 6President, National University of Health Sciences, 200 East Roosevelt Road, Lombard, IL 60148, USA Email: Joseph C Keating* - [email protected]; Keith H Charlton - [email protected]; Jaroslaw P Grod - [email protected]; Stephen M Perle - [email protected]; David Sikorski - [email protected]; James F Winterstein - [email protected] * Corresponding author Published: 10 August 2005 Received: 25 May 2005 Accepted: 10 August 2005 Chiropractic & Osteopathy 2005, 13:17 doi:10.1186/1746-1340-13-17 This article is available from: http://www.chiroandosteo.com/content/13/1/17 © 2005 Keating et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Subluxation syndrome is a legitimate, potentially testable, theoretical construct for which there is little experimental evidence.
    [Show full text]
  • The Effects of Chiropractic Spinal Manipulation on Central
    www.nature.com/scientificreports OPEN The efects of chiropractic spinal manipulation on central processing of tonic pain - a pilot study using Received: 10 September 2018 Accepted: 8 April 2019 standardized low-resolution brain Published: xx xx xxxx electromagnetic tomography (sLORETA) Muhammad Samran Navid 1,2,3, Dina Lelic1, Imran Khan Niazi 3,4,5, Kelly Holt3, Esben Bolvig Mark1, Asbjørn Mohr Drewes1,2 & Heidi Haavik3 The objectives of the study were to investigate changes in pain perception and neural activity during tonic pain due to altered sensory input from the spine following chiropractic spinal adjustments. Fifteen participants with subclinical pain (recurrent spinal dysfunction such as mild pain, ache or stifness but with no pain on the day of the experiment) participated in this randomized cross-over study involving a chiropractic spinal adjustment and a sham session, separated by 4.0 ± 4.2 days. Before and after each intervention, 61-channel electroencephalography (EEG) was recorded at rest and during 80 seconds of tonic pain evoked by the cold-pressor test (left hand immersed in 2 °C water). Participants rated the pain and unpleasantness to the cold-pressor test on two separate numerical rating scales. To study brain sources, sLORETA was performed on four EEG frequency bands: delta (1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz) and beta (12–32 Hz). The pain scores decreased by 9% after the sham intervention (p < 0.05), whereas the unpleasantness scores decreased by 7% after both interventions (p < 0.05). sLORETA showed decreased brain activity following tonic pain in all frequency bands after the sham intervention, whereas no change in activity was seen after the chiropractic spinal adjustment session.
    [Show full text]
  • The Evolution of Chiropractic
    THE EVOLUTION OF CHIROPRACTIC ITS DISCOVERY AND DEVELOPMENT BY A. AUG. DYE, D.C. (P.S.C., 1912) COPYRIGHTED 1939 Published by A. AUG. DYE, D.C. 1421 ARCH STREET PHILADELPHIA, PENNA. Printed in U. S. A. C O N T E N T S Chapter Title Page 1 Introduction—Discoverer of Chiropractic............................ 9 2 The Discovery of Chiropractic............................................. 31 3 “With Malice Aforethought” ............................................... 47 4 Early Development; Early School........................................ 61 5 Early Controversies; The Universal Chiropractors’ Asso- ciation; Morris and Hartwell; The Chiropractic Health Bureau; Lay Organization ................................................ 81 6 Medicine vs. Chiropractic.................................................... 103 7 The Straight vs. the Mixer ................................................... 113 8 The Straight vs. the Mixer ................................................... 127 9 The Straight vs. the Mixer; the Final Outcome .................... 145 10 The Chiropractic Adjustment; Its Development ................... 157 11 Chiropractic Office Equipment; Its Development ................ 175 12 The Spinograph; Its Development........................................ 189 13 Chiropractic Spinal Analyses; Nerve, Tracing; Retracing; the Neurocalometer .......................................................... 203 14 The Educational Development of Chiropractic; Basic Science Acts....................................................................
    [Show full text]
  • Bagnaro N. Improvement in Subjective, Academic and TOVA Measures in a Child with ADHD Following Upper
    CASE STUDY Improvement in Subjective, Academic and TOVA Measures in a Child with ADHD Following Upper Cervical Chiropractic Management Nick Bagnaro D.C.1 ABSTRACT Purpose of study: The case study is to report the improvement of an 11 year old boy with Attention Deficit Hyperactivity Disorder (ADHD) and neck pain utilizing the NUCCA Upper Cervical Chiropractic Technique, neurological exercises and nutritional support. Clinical Features: An 11 year old male presented with primary health concerns of ADHD with noted difficulties in concentration, completion of schoolwork, preparation for tests and reading comprehension. The patient also presented with daily neck pain for 3 years since having his head physically twisted by a teacher attempting to get him to pay attention in class. Intervention and Outcomes: The patient was treated for 3 months with the NUCCA upper cervical technique being monitored with 2 office visits per week for 3 months. Daily nutritional supplementation, dietary changes and chiropractic neurological exercises 6 days per week were also utilized. ADHD symptoms reduced, Test of Variables of Attention (TOVA) and academic performance improved. Conclusion: In this case study NUCCA chiropractic care, dietary changes, and neurological exercises improved the parameters of attention and quality of life for this child suffering with ADHD. Key Words: ADHD, NUCCA , upper cervical chiropractic, vertebral subluxation, TOVA, nutritional supplementation, chiropractic neurology Introduction Attention deficit hyperactive disorder (ADHD) is a condition alarm that the medical community maybe over diagnosing and known to cause bouts of inattention, hyperactivity, thereby over medicating children.2 impulsivity, poor academic performance and disruptive social behavior. It is has been shown to effect 5% of children and Although medication has been shown to help in the 1 4% of adults.
    [Show full text]
  • The Chiropractic Adjuster (1921)
    THE CHIROPRACTIC ADJUSTER A Compilation of the Writings of D. D. PALMER by his son B. J. PALMER. D. C., Ph. C. President THE PALMER SCHOOL OF CHIROPRACTIC Davenport, Iowa, U. S. A. The Palmer School of Chiropractic Publishers Davenport, Iowa Copyright, 1921 B. J. PALMER, D. C., Ph. C. Davenport, Iowa, U. S. A. PREFACE My father was a prolific writer. He wrote much on many subjects. Some were directly apropos to chiropractic, many of them were foreign to it. He was very versatile in thinking, writing and speaking. He was a broad reader and a radical thinker. Away back in the years past, when I was but a boy, I recall going to his waste-basket each night, picking out the many sheets of long-hand, hand-written copies of his writings. I saved them. I saved them through the years, as much as I could. The compilation of these constituted my first step towards a scrapbook. Although chiropractic was not so named until 1895, yet the naming of “chiropractic” was much like the naming of a baby; it was nine months old before it was named. Chiropractic, in the beginning of the thoughts upon which it was named, dates back at least five years previous to 1895. During those five years, as I review many of these writings, I find they talk about various phases of that which now constitutes some of the phases of our present day philosophy, showing that my father was thinking along and towards those lines which eventually, suddenly crystallized in the accidental case of Harvey Lillard, after which it sprung suddenly into fire and produced the white hot blaze.
    [Show full text]
  • Chiropractic Scope of Practice Sunrise Review
    Information Summary and Recommendations Chiropractic Scope of Practice Sunrise Review December 2013 Publication Number 631-046 For more information or additional copies of this report contact: Health Systems Quality Assurance Office of the Assistant Secretary PO Box 47850 Olympia, WA 98504-7850 360-236-4612 John Wiesman, DrPH, MPH Secretary of Health This page left intentionally blank. Page Contents 1 The Sunrise Review Process 3 Executive Summary 7 Summary of Information 19 Review of Proposal Using Sunrise Criteria 21 Detailed Recommendations 23 Summary of Rebuttals to Draft Recommendations Appendix A: Applicant Report Appendix B: Proposed Bill Appendix C: Applicant Follow-Up Appendix D: Public Hearing Transcript and Participant List Appendix E: Written Comments Appendix F: Pre-participation Physical Evaluation Form Recommended by the Washington Interscholastic Activities Association (WIAA) Appendix G: Medical Examination Report for Commercial Driver Fitness Determination Appendix H: Rebuttals to Draft Recommendations This page left intentionally blank. THE SUNRISE REVIEW PROCESS A sunrise review is an evaluation of a proposal to change the laws regulating health professions in Washington. The Washington State Legislature’s intent, as stated in chapter 18.120 RCW, is to permit all qualified people to provide health services unless there is an overwhelming need for the state to protect the interests of the public by restricting entry into the profession. Changes to the scope of practice should benefit the public. The Sunrise Act (RCW 18.120.010) says a health care profession should be regulated or scope of practice expanded only when: Unregulated practice can clearly harm or endanger the health, safety or welfare of the public, and the potential for the harm is easily recognizable and not remote or dependent upon tenuous argument; The public needs and can reasonably be expected to benefit from an assurance of initial and continuing professional ability; and The public cannot be effectively protected by other means in a more cost-beneficial manner.
    [Show full text]
  • Chiropractic History: a Primer
    PracticeMakers_504474 3/21/05 3:35 AM Page 1 Chiropractic History: a Primer Joseph C. Keating, Jr., Ph.D. Secretary & Historian, National Institute of Chiropractic Research Director, Association for the History of Chiropractic Carl S. Cleveland III, D.C. President, Cleveland Chiropractic Colleges Director, Association for the History of Chiropractic Michael Menke, M.A., D.C. Faculty Member, National University of Health Sciences Faculty Member, University of Arizona 1 PracticeMakers_504474 3/21/05 3:35 AM Page 2 The NCMIC Insurance Company is proud to make this primer of chiropractic history possible through a grant to the Association for the History of Chiropractic. NCMIC recognizes the importance of preserving the rich history of our profession. This primer will hopefully stimulate your interest in this saga, help you to understand the trials and tribula- tions our pioneers endured, and give you a sense of pride and identity. Lee Iacocca, in his book about LIBERTY said: I know that liberty brings with it some obligations. I know we have it today because others fought for it, nourished it, protected it, and then passed it on to us. That is a debt we owe. We owe it to our parents, if they are alive, and to their memory if they are not. But mostly we have an obligation to our own kids. An obligation to pass on this incredible gift to them. This is how civilization works... whatever debt you owe to those who came before you, you pay to those who follow. That is essentially the same responsibility each of us has to preserve and protect the extraordinary history of this great profession.
    [Show full text]
  • The Mechanism of the Chiropractic Spinal Adjustment/Manipulation: Chiropractic Vs
    3/7/2018 The Mechanism of the Chiropractic Spinal Adjustment/Manipulation: Chiropractic vs. Physical Therapy for Spine Part 5 of a 5 Part Series - US C… Monday, 11 December 2017 22:38 The Mechanism of the Chiropractic Spinal Adjustment/Manipulation: Chiropractic vs. Physical Therapy for Spine Part 5 of a 5 Part Series Written by admin The Mechanism of the Chiropractic Spinal Adjustment/Manipulation: Chiropractic vs. Physical Therapy for Spine Part 5 of a 5 Part Series By: Mark Studin William J. Owens Reference: Studin M., Owens W., (2017) The Mechanism of the Chiropractic Spinal Adjustment/Manipulation: Chiropractic vs. Physical Therapy for Spine, Part 5 of 5, American Chiropractor 39 (12) pgs. 20, 22, 24, 26, 28, 30, 31 A report on the scientific literature According to the Cleveland Clinic (2017): The Cleveland Clinic Spine Care Path is a process-based tool designed for integration in the electronic medical record (EMR) to guide clinical work flow and help providers make evidence-based guidelines operational. The care path was developed by Cleveland Clinic’s Center for Spine Health with input from Department of Pain Management staff like Dr. Berenger. One goal was to match appropriate treatments and providers to patients at various points along the care continuum for low back pain. “We know acute back pain is common and often resolves with simple therapy or even no therapy,” Dr. Berenger says. “For patients without red flags, imaging is rarely required.” These patients may be best served through prompt access to care from physical therapists or nurse practitioners as entry-level providers.
    [Show full text]
  • Appendix J Glossary of Terms Or References
    Appendix J Glossary of Terms or References ACA APA American Chiropractic Association American Psychological Association activator technique applied kinesiology A system of adjustment using a hand held, manu­ The dynamics of smooth and striated muscle and ally assisted, spring activated device which deliv­ the impact of these tissues on body structure, ers a controlled thrust. healing processes, and disease processes. In particular, applied kinesiology focuses on the acupressure/Meridian therapy identification and correction of proprioceptive The practice of applying digital pressure to stimu­ dysfunction of ligaments and of the muscle spindle late certain sites on the skin to affect distant cells and golgi tendons. In addition, applied functional mechanisms of the body. This therapy kinesiology is concerned with the vascular, lym­ is based on the belief that these sites are organized phatic, and othersystems supportingpropermuscle along meridians which carry the life force that dynamics. innervates the body. arterial aneurysm acupuncture An enlargement of one aspect of an artery caused The practice of insertion of needles into specific by weakness in the arterial wall. exterior body locations to relieve pain, to induce surgical anesthesia, and for therapeutic purposes. aseptic necrosis A condition which is not a specific disease entity adjustment but caused by disruption in normal circulation to A forceful thrust which is meticulously con­ the involved bone. It can result in pain, loss of trolled as to its direction, amount of force em­ bone density, bone collapse or fracture. Some ployed, and the quickness with which it is ap­ possible areas of involvement include the hip, plied. shoulder, elbow, wrist, knee, or heel.
    [Show full text]
  • Manipulative Therapy – Commercial Medical Policy
    UnitedHealthcare® Commercial Medical Policy Manipulative Therapy Policy Number: 2021T0541N Effective Date: July 1, 2021 Instructions for Use Table of Contents Page Related Commercial Policies Coverage Rationale ........................................................................... 1 • Electrical Stimulation for the Treatment of Pain and Definitions ........................................................................................... 2 Muscle Rehabilitation Applicable Codes .............................................................................. 2 • Home Traction Therapy Description of Services ..................................................................... 2 • Manipulation Under Anesthesia Clinical Evidence ............................................................................... 3 • Motorized Spinal Traction U.S. Food and Drug Administration ..............................................17 • References .......................................................................................17 Neuropsychological Testing Under the Medical Policy History/Revision Information..............................................23 Benefit Instructions for Use .........................................................................23 • Spinal Ultrasonography • Temporomandibular Joint Disorders Community Plan Policy • Manipulative Therapy Medicare Advantage Coverage Summary • Chiropractic Services Coverage Rationale Manipulative therapy is proven and medically necessary for treating Musculoskeletal Disorders, except as
    [Show full text]
  • Mechanism of Action of Spinal Manipulative Therapy
    Joint Bone Spine 70 (2003) 336–341 www.elsevier.com/locate/bonsoi Review Mechanism of action of spinal manipulative therapy Jean-Yves Maigne a,*, Philippe Vautravers b a Physical Medicine Department, Hôtel-Dieu Teaching Hospital, Place du Parvis de Notre-Dame, 75004 Paris, France b Physical Medicine Department, Hautepierre Teaching Hospital, Strasbourg, France Received 9 April 2002; accepted 15 November 2002 Abstract Spinal manipulative therapy (SMT) acts on the various components of the vertebral motion segment. SMT distracts the facet joints, with faster separation when a cracking sound is heard. Intradiscal pressure may decrease briefly. Forceful stretching of the paraspinal muscles occurs, which induces relaxation via mechanisms that remain to be fully elucidated. Finally, SMT probably has an inherent analgesic effect independent from effects on the spinal lesion. These changes induced by SMT are beneficial in the treatment of spinal pain but short-lived. To explain a long-term therapeutic effect, one must postulate a reflex mechanism, for instance the disruption of a pain–spasm–pain cycle or improvement of a specific manipulation-sensitive lesion, whose existence has not been established to date. © 2003 Éditions scientifiques et médicales Elsevier SAS. All rights reserved. Keywords: Spinal manipulative therapy; Low back pain; Manual medicine; Chiropractics; Osteopathy 1. Introduction vertebral motion segment. The conclusions call into question a number of widely held beliefs about SMT. Spinal manipulative therapy (SMT) has been proved ef- fective in alleviating acute low back pain and may help to improve neck pain, sciatica, and chronic low back pain [1,2]. 2. Effects on the vertebral motion segment The definition of SMT is not agreed on and varies across specialties (osteopathy, chiropractic, and medicine).
    [Show full text]
  • The Effects of 4 Weeks of Chiropractic Spinal Adjustments on Motor Function in People with Stroke: a Randomized Controlled Trial
    brain sciences Article The Effects of 4 Weeks of Chiropractic Spinal Adjustments on Motor Function in People with Stroke: A Randomized Controlled Trial Kelly Holt 1 , Imran Khan Niazi 1,2,3,* , Imran Amjad 1,4 , Nitika Kumari 1,2 , Usman Rashid 2 , Jens Duehr 1, Muhammad Samran Navid 1,3 , Muhammad Shafique 4 and Heidi Haavik 1 1 Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand; [email protected] (K.H.); [email protected] (I.A.); [email protected] (N.K.); [email protected] (J.D.); [email protected] (M.S.N.); [email protected] (H.H.) 2 Faculty of Health & Environmental Sciences, Health & Rehabilitation Research Institute, AUT University, Auckland 0627, New Zealand; [email protected] 3 Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark 4 Faculty of Rehabilitation and Allied Health Sciences and Department of Biomedical Engineering, Riphah International University, Islamabad 46000, Pakistan; muhammad.shafi[email protected] * Correspondence: [email protected] Abstract: Chiropractic spinal adjustments have been shown to result in short-term increases in muscle strength in chronic stroke patients, however, the effect of longer-term chiropractic spinal adjustments on people with chronic stroke is unknown. This exploratory study assessed whether 4 weeks of chiropractic spinal adjustments, combined with physical therapy (chiro + PT), had a greater impact than sham chiropractic with physical therapy (sham + PT) did on motor function (Fugl Citation: Holt, K.; Niazi, I.K.; Amjad, Meyer Assessment, FMA) in 63 subacute or chronic stroke patients.
    [Show full text]