Chiropractic Treatment has been found to help reduce the severity and incidence of asthma attacks.
Chronic Paediatric Asthma and Chiropractic Spinal Manipulation: A Prospective Clinical Series and Randomized Clinical Pilot Study
Gert Bronfort, DC, PhD, Roni L. Evans, DC, Paul Kubic, MD, PhD, Patty Filkin
Objectives: The first objective was to determine if chiropractic spinal manipulative therapy (SMT) in addition to optimal medical management resulted in clinically important changes in asthma-related outcomes in children. The second objective was to assess the feasibility of conducting a full-scale, randomized clinical trial in terms of recruitment, evaluation, treatment, and ability to deliver a sham SMT procedure.
Study Design: Prospective clinical case series combined with an observer-blinded, pilot randomized clinical trial with a 1-year follow-up period.
Setting: Primary contact, college outpatient clinic, and a paediatric hospital.
Patients: A total of 36 patients aged 6 to 17 years with mild and moderate persistent asthma were admitted to the study.
Outcome Measures: Pulmonary function tests; patient- and parent- or guardian-rated asthma-specific quality of life, asthma severity, and improvement; am and pm peak expiratory flow rates; and diary-based day and night-time symptoms.
Interventions: Twenty chiropractic treatment sessions were scheduled during the 3-month intervention phase. Patients were randomly assigned to receive either active SMT or sham SMT in addition to their standardized ongoing medical management.
Results: It is possible to blind the participants to the nature of the SMT intervention, and a full-scale trial with the described design is feasible to conduct. At the end of the 12-week intervention phase, objective lung function tests and patient-rated day and night time symptoms based on diary recordings showed little or no change. Of the patient-rated measures, a reduction of approximately 20% in 2 bronchodilator use was seen (P = .10). The quality of life scores improved by 10% to 28% (P < .01), with the activity scale showing the most change. Asthma severity ratings showed a reduction of 39% (P < .001), and there was an overall improvement rating corresponding to 50% to 75%. The pulmonologist-rated improvement was small. Similarly, the improvements in parent- or guardian-rated outcomes were mostly small and not statistically significant. The changes in patient-rated severity and the improvement rating remained unchanged at 12-month post treatment follow-up as assessed by a brief postal questionnaire.
Conclusion: After 3 months of combining chiropractic SMT with optimal medical management for paediatric 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.
Chiropractic Co-management of Medically Treated Asthma
Chiropractic treatment has been shown through research to reduce the severity and incidence of asthma attacks.
Amy Louise Gibbs Swindon Chiropractic Clinic, 10 Swindon Road, Stratton St. Margaret, Swindon SN3 4PZ, UK
Asthma is the most common chronic disease in Australia. An inflammatory disorder, it is characterized by increased mucus production and airway hypersensitivity, both of which contribute to a decreased airflow. Common symptoms include shortness of breath, wheezing, coughing and a feeling of chest tightness. 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.