ASTHMA AND CHIROPRACTIC
 
   

Chiropractic and Asthma

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:   Frankp@chiro.org

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Chiropractic Research Results for Asthma
 
   


[Green Ball]   
Chiropractic Co-management of Medically Treated Asthma
           Clinical Chiropractic 2005 (Sep);   8 (3):   140–144

           This article presents three cases where patients, being treated by conventional pharmacological means, had chiropractic manipulation administered to the upper thoracic spine twice a week for a period of 6 weeks. Objective measurements were collected using a peak flow meter and subjective data using an asthma specific questionnaire. All three cases resulted in increased subjective and objective parameters and suggest the need for larger studies with appropriate methodology.


[Green Ball]   
Spinal Manipulation May Benefit Asthma Patients
           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).


[Green Ball]    Join Us in Documenting the Effects of Spinal Manipulative Therapy on Asthma
Anthony L. Rosner, Ph.D., Director of Research and Education for FCER

This project, conducted by researchers at Macquarie University in Sydney with 420 subjects, follows on the heels of preliminary observations which suggest that chiropractic management of spinal dysfunction in asthmatic subjects reduces symptoms, anxiety and cortisol levels.


[Green Ball]    Asthma Trial Update: Preliminary Data Encouraging ~ Your Help Needed to Put Funding “Over the Top”
Vincent P. Lucido, D.C., President of FCER

This trial is of paramount importance in addressing the major flaws in a previous and unfortunately highly visible clinical trial published in The New England Journal of Medicine.1 It also represents one of the few investigations that taps into the field of endocrinology—an area that must be addressed if one is to gain further insight into the systemic effects of spinal dysfunctions and their management by chiropractic care. This research represents only a handful of investigations that have addressed the consequences of manipulation involving chemical (as opposed to electrical) messengers within the body.


[Green Ball]   Response to the “Manual Therapy for Asthma” Cochrane Review
Anthony Rosner, PhD, FCER Director of Research

Hondras' recently published systematic review of randomized clinical trials 1 addressed to manual therapy represents a sincere effort to summarize those investigations in what is commonly regarded as the gold standard of clinical research. That said, however, one has to remain particularly vigilant against accepting randomized clinical trials at face value, particularly in those instances involving physical interventions, in which the complete blinding of practitioners [and most likely patients as well] in the traditional RCT design is all but impossible.


[Green Ball]   
Effect of Chiropractic Treatment on the Endocrine and Immune System in Asthmatic Patients
Proceedings of the 2002 International Conference on Spinal Manipulation. 2002 (Oct)

The broad aims of this FCER funded study is to determine whether stress is a factor in the pathophysiology of asthma and to determine if chiropractic management of asthmatics can alleviate stress induced asthma. More specifically for this meeting, our study aims to determine whether chiropractic treatment has beneficial effects on the endocrine system through measurement of salivary cortisol and on the immune system via salivary IgA determination.


[Green Ball]    Chiropractic Management of 47 Asthma Cases
           Todays Chiropractic 2000 (Nov) ~ FULL TEXT

           Over a seven-year period, 47 cases of asthma were managed in an outpatient setting. Every case was followed for a minimum of two years to observe effectiveness of care. The study group comprised 28 males and 19 females, ranging from 7 to 42 years of age. Of the 47 cases, 32 patients ranged in age from 7 to 19 years.


[Green Ball]   
Chronic Pediatric Asthma and Chiropractic Spinal Manipulation: A Prospective Clinical Series and Randomized Clinical Pilot Study
J Manipulative Physiol Ther 2001;   24 (6) July:   369–377

After 3 months of combining chiropractic SMT with optimal medical management for pediatric asthma, the children rated their quality of life substantially higher and their asthma severity substantially lower. These improvements were maintained at the 1-year follow-up assessment. You may also be interested in this follow-up letter to the authors which notes the continuing problems with the design of placebos in manual spinal trials.



An Example of Flawed Asthma Research


[Green Ball]   
Comparison of Active and Simulated Chiropractic Manipulation as Adjunctive Treatment for Childhood Asthma
NEJM 1998 (Oct 8);   339 (15):   1013–1020

This article raises an interesting question. Was the “Simulated Chiropractic Manipulation” sham treatment a confounder? How else to explain their findings that “Symptoms of asthma and use of {beta}-agonists decreased and the quality of life increased in both groups, with no significant differences between the groups.” You may want to review the Problems with Placebos/Shams Page for a more in-depth discussion of this topic.


[Green Ball]   
Anthony Rosner, Ph.D.'s response to the NEJM Asthma Study
At a time when public interest in the application of alternative medicine is rising, it is regrettable that a study with such deep flaws should have found its way to the lead position in such a prominent journal. Major deficiencies of the study are summarized as follows. Thanks to FCER for permission to reproduce this article. Dr. Rosner is the FCER Director of Research.


[Green Ball]   
Other Responses to This Article by the Chiropractic Academic and Research Community
Here are comments from researcher Bill Meeker, D.C., Daniel Redwood, D.C., the Meridian Institute, Daniel Becker, D.C., DABCN, James Provoost, D.C., and the Pennsylvania Chiropractic Association.


   End of Flawed Asthma Research Articles   


[Green Ball]   
Manual Medicine Diversity:
Research Pitfalls and the Emerging Medical Paradigm

J Am Osteopath Assoc 2001;   101 (8) Aug:   441-444 ~ FULL TEXT

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.


[Green Ball]   
An Impairment Rating Analysis Of Asthmatic Children Under Chiropractic Care
Journal of Vertebral Subluxation Research 1997;   1 (4) Jul:   1–8

A self-reported asthma-related impairment study was conducted on 81 children under chiropractic care. The intent of this study was to quantify self-reported changes in impairment experienced by the pediatric asthmatic subjects, before and after a two month period under chiropractic care. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care when compared to the pre-chiropractic scores (p < 0.05) with an effect size of 0.96.


[Green Ball]   
Osteopathic Manipulative Treatment Applications for the Emergency Department Patient
J Am Osteopath Assoc 1996;   96 (7) Jul:   403–409

The emergency department (ED) setting offers osteopathic physicians multiple opportunities to provide osteopathic manipulative treatment (OMT) as either the primary therapy or as an adjunct to the intervention. In doing so, osteopathic physicians can decrease or eliminate the morbidity and symptoms associated with protracted dysfunction. Low back pain, chest pain, torticollis, asthma, and sinusitis are some of the illnesses in which OMT should be implemented as part of the management plan


[Green Ball]  
Management of Pediatric Asthma & Enuresis with Probable Traumatic Etiology
ICA Internat Rev Chiro 1995 (Jan):   37–40

On May 20, 1988 the child was seen for chiropractic examination and evaluation, and from that date to August 3, 1991 the child received 28 chiropractic adjustive/manipulative treatments. Dramatic improvement of asthma and enuresis followed chiropractic management.


[Green Ball]  
Manipulative Therapy an Alternative Treatment for Asthma: A Literature Review
Chiro: The J Chiro Res and Clin Invest 1992;   8(2):   40–42

This is a literature review of the effects of manipulative therapy as alternative treatment for asthma. Subjective studies show that manipulation of the spine relieves the patients' symptoms. However, objective findings have yet to be compiled using respiratory indices. We recommend an extensive study be performed to determine the effects of manipulation on bronchial asthma.


[Green Ball]  
A Wholistic Approach to the Treatment of Bronchial Asthma in a Chiropractic Practice
Chiro J Aust 1993;   23 (1):   4–8

Three case studies involving two children and a mature adult with established diagnoses of bronchial asthma are presented. Management in each case involve chiropractic adjustments combined with a "clinical ecology" approach which has been found useful in identifying food and environmental allergens that may act as triggering factors for asthma attacks. This paper suggests that such a broad-based management approach may lead to higher rates of response to chiropractic treatment of asthma, as well as providing greater long-term relief for its victims.


[Green Ball]    Review More Abstracts on Chiropractic and Asthma
           Review abstracts about chiropractic and a variety of organic and visceral disorders at the wonderful International Chiropractic Pediatric Association (ICPA) website

 
   

Other Management Approaches for Asthma
 
   


[Green Ball]   
Research Perspectives in Asthma:   A Rationale for the Therapeutic Application of Magnesium, Pyridoxine, Coleus forskholii and Ginkgo biloba in the Treatment of Adult and Pediatric Asthma
The Internist 1998;   5 (3) Sept:   14–16 ~ FULL TEXT

Thanks to the American Chiropratic Association's Council On Family Practice for their permission to reprint this article exclusively at Chiro.Org!


[Green Ball]   
The Etiologies, Pathophysiology, and Alternative/Complementary Treatment of Asthma
Alternative Medicine Review 2001;   6 (1):   20–47 ~ FULL TEXT

Antioxidant nutrients, especially vitamins C and E, selenium, and zinc appear to be necessary in asthma treatment. Vitamins B6 and B12 also may be helpful. Omega-3 fatty acids from fish, the flavonoid quercetin, and botanicals Tylophora asthmatica, Boswellia serrata and Petasites hybridus address the inflammatory component. Physical modalities, including yoga, massage, biofeedback, acupuncture, and chiropractic can also be of help.


[Green Ball]   
Natural Asthma Relief
           Asthma is best described as a chronic inflammatory condition rather than a respiratory disease. In fact, asthma's origins have more in common with arthritis than they do with emphysema or tuberculosis. Asthma is simply a chronic inflammation of the airway rather than the joints. People with asthma have inflamed, hyperreactive airways that produce excessive bronchial mucus. After repeated asthma attacks, the airway lining becomes scarred, and immune cells, which cause or exacerbate inflammation, proliferate there.2 Asthma eventually damages the airway permanently, making it more prone to inflammation and less functional overall.


[SWIRL 2]


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