Posted on 11/23/2002 2:53:59 PM PST by krodriguesdc
Spinal Manipulation May Benefit Asthma Patients
FROM: Foundation for Chiropractic Education and Research (FCER)
Patients afflicted with asthma may benefit from spinal manipulation in terms of symptoms, immunological capacity, and endocrine effects, an audience was told on October 5 at the 9th International Conference on Spinal Manipulation in Toronto. The investigative team, headed by Ray Hayek, Ph.D., has been conducting a trial at 16 treatment centers in Australia involving 420 patients with an average age of 46 in an effort to find out what effects spinal manipulation has on symptoms, depression and anxiety, general health status, and the levels of immunity as reflected by the concentrations of both an immunoglobulin (IgA) and an immunosuppressant (cortisol). This investigation draws from several references in the scientific literature which suggest that different forms of manual therapy (including massage) improve the symptomatology and lower cortisol levels in asthma patients.
Dr. Hayek reported that only the patient group which underwent spinal manipulation (by any of four commonly used manipulative treatment protocols) displayed significant improvement in asthma symptoms and depression and anxiety scores. Simply experiencing structured interviews at the treatment centers or being monitored at home did not yield these improvements. In addition, patients actually undergoing spinal manipulation displayed dramatic increases of IgA and decreases of cortisol through the posttreatment period, suggesting that there were physiological consequences to their manipulative treatments reflecting increased immunological capacities which would be expected to ward off subsequent asthmatic attacks.
These biochemical changes not only suggest that the effects of spinal manipulation are more far-reaching than commonly believed, but that they may be more long-term as well. The gain in immunological capacity achieved with the simultaneous loss of the immunosuppressant cortisol and the increase of the immunoglobulin IgA following spinal manipulation would be expected to reduce the incidence and severity of pathogenic invasion of the airways. There would be less of a risk under these circumstances of compounding the symptoms of asthma.
The immunosuppressing mechanism of glucocorticoids is believed to occur by their reducing the permeability of capillaries, decreasing the migration of white blood cells in inflamed areas, suppressing the release of interleukins, and inhibiting the production of proteolytic enzymes by stabilizing the lysosomal membranes which release them.
This followed contacts that the Director of Research at FCER was able to make with the Australian research community in 1995, taking into consideration the expertise of the investigative team as well as the fact that Australia's 2 million asthma sufferers have given the Island Continent the dubious distinction of being the asthma capital of the world...
and that is becoming more and more common place...
Update in:
Cochrane Database Syst Rev. 2001;(1):CD001002.
Manual therapy for asthma.
Hondras MA, Linde K, Jones AP.
Western States Chiropractic College, 2900 NE 132nd Avenue, Portland, Oregon 97230-3099, USA. mhondras@wschiro.edu
BACKGROUND: A variety of manual therapies with similar postulated biologic mechanisms of action are commonly used to treat patients with asthma. Manual therapy practitioners are also varied, including physiotherapists, respiratory therapists, chiropractic and osteopathic physicians. A systematic review across disciplines is warranted.
OBJECTIVES: To evaluate the evidence for the effects of manual therapies for treatment of patients with bronchial asthma.
SEARCH STRATEGY: Trials were searched in computerized general (EMBASE, CINAHL and MEDLINE) and specialized databases (Cochrane Complementary Medicine Field, Cochrane Rehabilitation Field, ICL, and MANTIS). In addition, bibliographies from included studies were assessed, and authors of known studies were contacted for additional information about published and unpublished trials. Date of most recent search: December 1998.
SELECTION CRITERIA: Trials were included if they: (1) were randomised; (2) included asthmatic children or adults; (3) examined one or more types of manual therapy; and (4) included clinical outcomes.
DATA COLLECTION AND ANALYSIS: All three reviewers independently extracted data and assessed trial quality using a standard form.
MAIN RESULTS: From an initial 316 unique citations, 48 full text articles were retrieved and evaluated, which resulted in nine citations to five RCTs (290 patients) suitable for inclusion. Trials could not be pooled statistically because studies that addressed similar interventions used disparate patient groups or outcomes. The methodological quality of one of two trials examining chiropractic manipulation was good and neither trial found significant differences between chiropractic spinal manipulation and a sham manoeuvre on any of the outcomes measured. Quality of the remaining three trials was poor. One small trial compared massage therapy with a relaxation control group and found significant differences in many of the lung function measures obtained. However, this trial had poor reporting characteristics and the data have yet to be confirmed. One small trial compared chest physiotherapy to placebo and one small trial compared footzone therapy to a no treatment control. Neither trial found differences in lung function between groups.
REVIEWER'S CONCLUSIONS: There is insufficient evidence to support the use of manual therapies for patients with asthma. There is a need to conduct adequately-sized RCTs that examine the effects of manual therapies on clinically relevant outcomes. Future trials should maintain observer blinding for outcome assessments, and report on the costs of care and adverse events. Currently, there is insufficient evidence to support or refute the use of manual therapy for patients with asthma.
how can you say conclusively that chiropractic cannot help asthma!
you always do so by labeling the studies that show there is a beneficial effect garbage!
as I stated before, chiro research is in its infancy and there will be studies that will show chiropractic to be beneficial for more than back pain...
I'm not labeling studies that showed beneifit garbage. I'm labeling studies that showed NOTHING garbage, because they showed NOTHING.
Notice selection criteria #4: included clinical outcomes. That's EXCATLY the data I'm asking for. Clinical outcomes, that would be quantitative data on the improvment of their breathing.
Ooh here's another good part from the main results: The methodological quality of one of two trials examining chiropractic manipulation was good... looks like even these guys aren't impressed with how chiropractors keep and study data. In continues: ...and neither trial found significant differences between chiropractic spinal manipulation and a sham manoeuvre on any of the outcomes measured. (my emphasis)
And the sentence before your highlight: Future trials should maintain observer blinding for outcome assessments, and report on the costs of care and adverse events. (my emphasis again)
so even your own source says your studies are garbage. Hoisted by your own pitard I'd say.
J Am Osteopath Assoc 2001 Aug;101(8):441-4
Manual medicine diversity: research pitfalls and the emerging medical paradigm.
Mein EA, Greenman PE, McMillin DL, Richards DG, Nelson CD.
Meridian Institute, 1853 Old Donation Parkway, Suite 1, Virginia Beach, VA 23454, USA. meridian@meridianinstitute.com
Recent studies published in leading medical journals have concluded that chiropractic treatment is not particularly helpful for relieving asthma and migraine symptoms because even though study participants showed notable improvement in symptoms, those subjects who received sham manual medicine treatments also showed improvement.
Yet the sham treatment received by control groups in these studies is reminiscent in many ways of traditional osteopathic manipulation. This seems to represent not only a failure to recognize the value of many manual medicine techniques but also an ignorance of the broad spectrum of manual medicine techniques used by various practitioners, from osteopathic physicians to chiropractors to physical therapists.
Such blind spots compromise research methodology with regard to manual medicine studies, which could, in turn, diminish the role of manual medicine in clinical practice. Osteopathic manipulative treatment provides an excellent model for recognizing and integrating the full range of manual medicine techniques into research and clinical applications because of the wide range of techniques employed. The potential exists for these techniques to contribute much to medical research and clinical practice--provided that osteopathic physicians and other manual medicine practitioners work to alleviate ignorance about the efficacy of various forms of manipulation.
PMID: 11526876 [PubMed - indexed for MEDLINE]
yup - those studies showing chiropractic to be not beneficial are just bunk...
I AGREE :)
This is what I am trying to point out - these studies that you say are real science are bunk and have flaws...
Western States looked at these anti-chiro studies and this is what they found - so glad you agree...
even the osteopaths found trouble with some of the studies you say are real science...
HMMMMM!
FWIW, Canada has been a hot bed of Chiropractic research for a number of years, while some of the early research was done at the University of Colorado by Dr. Shue.
When you were asking your questions to krodriguesdc it reminded me of a study that was done in Canada.
The way I remembered it was that the Peak Flow rate and the Vital Capacity which would be directly proportional to the amount of Oxygen absorbed was greatly increased after the third Chiropractic adjustment. Perhaps krodriguesdc can look north of the boarder to find some of the studies he should be looking for.
krodriguesdc, here's a starting point for you.
STUDIES
A study was conducted on 58 patients to determine whether the upper cervical knee chest adjustment, influenced pulmonary function. FEV-1 and FVC were measured before care and two weeks after care on a computerized auto-spiro spirometer. Analysis of the spirometry measurements revealed predictable statistically significant changes in FVC and FEV-1. Of the 58 patients, 57% of the subject population were considered to have "abnormal" lung function before care. The abnormal group showed the greatest increases in FVC and FEV-1 over the two-week study. Forty-two percent of the abnormal patient population actually tested within normal limits after the two-week study. The "normal" subject population also showed predictable increases in tendency to return to normal was clearly observed in just two weeks under specific chiropractic care.
Kessinger, R. Specific upper cervical chiropractic care and lung function. CRJ 1997; 4(1): 27 / Mantis ID: 38010
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Lung volumes were measured in 50 patients presenting with complaints. Post treatment forced vital capacity (FVC) was found to be greater than pre-treatment. Post-treatment forced expiratory volume in one second (FEV-1) was found to be greater than pre-treatment FEV-1.
Masarsky C; Weber M; Chiropractic and lung volumes--A retrospective study. ACA J of Chiropr 1986; 23(9): 65-8 / Mantis ID: 13721
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FVC and FEV-1 both improved significantly in asthmatic patients under chiropractic care.
Kessinger R; Changes in pulmonary function associated with upper cervical specific chiropractic care. J Vertebral Subluxation Res 1997; 1(3): 43-9 / Mantis ID: 38608
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76.5% of patients with bronchial asthma said they benefited from chiropractic treatment. Peak flow rate and vital capacity increased after the third treatment.
Hviid C; A comparison of the effect of chiropractic treatment on respiratory function in patients with respiratory distress symptoms and patients without. Bull Eur Chiro Union 1978; 26: 17-34 / Mantis ID: 3222
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Over the course of the study, non-specific bronchial hyperreactivity (n-BR) improved by 36% (P = 0.01) and patient-rated asthma severity decreased by 34% (P = 0.0002) compared with the baseline values.
Nielsen NH, Bronfort G, Bendix T, Madsen F, Weeke B. Chronic asthma and chiropractic spinal manipulation: a randomized clinical trial.Clin Exp Allergy 1995; 25 (1): 80-88 / Medline ID: 95245893
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Mobility and kyphosis of the thoracic spine were correlated with lung function in 185 men and 87 women not suffering from respiratory disease. Mobility of the thoracic spine was shown to directly effect respiratory function.
Mellin G; Harjula R; Lung function in relation to thoracic spinal mobility and kyphosis. Scand J Rehabil Med 1987; 19(2):89-92 / Medline ID: 87291944
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hey have a Great Thanksgiving everyone...
Only YOU, would recognize oneself. Are you this rude to everyone you meet??YOU are the one with the agenda, not me. You are completely incapable of any conversation of intelligence. Now stop wasting bandwidth, spewing your venom, and throwing your tripe and excrement around. I'm outta here.
BUMP and thanks for posting the #'s!
Have a great Thanksgiving
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