Chiropractic manipulation techniques and nuances

It is reasonable to think that patients responding to spinal manipulation (SM), a mechanically based therapy, would have mechanical derangement of the spine as a critical causal component in the mechanism of their condition. Consequently, SM practitioners routinely assess intervertebral motion, and treat patients on the basis of those assessments.

International Journal of Traditional and Complementary Medicine Research, 2022

The effects of chiropractic manipulation, muscle energy technique and home exercise program on pain, depression and functional level were compared in patients diagnosed with sacroiliac joint dysfunction (SIJD) in this study. Material-Method: Forty-five volunteer patients aged 20-65 years who were diagnosed with SIJD participated in this study. The patients were tested through chiropractic and orthopedic examination methods, and aspects of dysfunction were detected. Patients were randomized into 3 groups: Chiropractic Manipulation Group (CM), Muscle Energy Technique Group (MET), Control Group. All groups were assigned a home exercise program. All treatment groups were evaluated with numerical pain scale (NPS), Oswestry low back pain disability questionnaire (OLBPDQ), Beck depression inventory (BDI) and algometer before and after treatment. Descriptive statistics were used in data analysis, Kruskal-Wallis tests in intergroup comparisons, Mann-Whitney U tests in pairwise comparisons, and Friedman, post-hoc Wilcoxon Rank tests were used for intragroup comparisons. The statistical significance value was set at p<0.05 in the study. Results: Of the 45 volunteers who continued the study, 27 were female and 18 were male, and their mean age was 39.47±9.92 years. According to the results of intragroup analyses, a significant difference was found in all examination methods, and as a result of the intergroup analyses, there was a significant difference in all examination parameters except BDI. In the paired comparisons, positive results were obtained in all examinations in the CM and MET groups compared to the control group, in all parameters except for BDI in the analyses between CM and MET, and in examinations performed after the 4-week implementation in favor of CM (p<0.05). Conclusion: In patients with SIJD, CM performed in addition to exercises was found to be more effective than MET and exercise alone.

Journal of Manipulative and Physiological Therapeutics, 1999

Chiropractic & Manual Therapies, 2013

Background: With the development of increasing evidence for the use of manipulation in the management of musculoskeletal conditions, there is growing interest in identifying the appropriate indications for care. Recently, attempts have been made to develop clinical prediction rules, however the validity of these clinical prediction rules remains unclear and their impact on care delivery has yet to be established. The current study was designed to evaluate the literature on the validity and reliability of the more common methods used by doctors of chiropractic to inform the choice of the site at which to apply spinal manipulation. Methods: Structured searches were conducted in Medline, PubMed, CINAHL and ICL, supported by hand searches of archives, to identify studies of the diagnostic reliability and validity of common methods used to identify the site of treatment application. To be included, studies were to present original data from studies of human subjects and be designed to address the region or location of care delivery. Only English language manuscripts from peer-reviewed journals were included. The quality of evidence was ranked using QUADAS for validity and QAREL for reliability, as appropriate. Data were extracted and synthesized, and were evaluated in terms of strength of evidence and the degree to which the evidence was favourable for clinical use of the method under investigation.

Anuario Jurídico y Económico Escurialense, 2018

While this research was completed nearly a decade ago, for private health reasons, it was never been published, presented at any conference or submitted to any other award contest. The paper is concerned with the effects of general chiropractic therapy related to the states of normal and abnormal human postural physiology. In this research, the effects of general chiropractic therapy on patients' postures were recorded by taking notes of actual physical postural changes measured in postural balance of 896 patients against the force of gravity with an anatomical level. Patients, who were failing to produce postural changes after ordinary hands-only chiropractic therapy, were later treated with percussion hammers, the Trigger Point Hammer (TPH) and TriggerCiser (TC).

Focus on Alternative and Complementary Therapies, 2012

Background The evidence of effectiveness of chiropractic is controversial. Objectives To summarise all Cochrane reviews of chiropractic spinal manipulation. Methods The Cochrane database was searched for all Cochrane reviews of chiropractic manipulation. Cochrane reviews with the terms 'chiropractic', 'manipulation' or 'manual therapy' in the title, abstract or keywords were considered. Protocols of reviews were excluded, as were studies that did not focus specifically on chiropractic spinal manipulation. Data extraction was performed by the author according to predefined criteria. Results Five Cochrane reviews were eligible for inclusion. Due to clinical and statistical heterogeneity, a meta-analysis was not possible and the findings of the reviews were discussed narratively. The five reviews related to the following conditions: low back pain, asthma, dysmenorrhoea and neck pain. Each review included between three and 39 primary studies. Cautiously positive conclusions emerged for low back pain and neck pain. For the two non-spinal conditions, the conclusions were negative. Conclusions Cochrane reviews, generally considered to be the most reliable evidence, provide limited evidence that chiropractic may be effective for low back and neck pain, but failed to support the use of chiropractic for non-spinal conditions.

Science Based Medicine, 2014

Although obscured by controversy, there is evidence to indicate that spinal manipulation can be as effective as conventional treatment methods in relieving low-back pain. 1,2,3,4 This grain of truth mixed with chiropractic vertebral subluxation theory that encompasses a broad scope of ailments makes it difficult for the average person to distinguish between appropriate and inappropriate use of manipulation by chiropractors. A person who is satisfied with chiropractic manipulative treatment for back pain might be led to believe that the same treatment can be used to treat a variety of organic ailments by correcting "vertebral subluxations." Such treatment is usually described as a "chiropractic adjustment."

The beneficial effects of manipulation in relieving symptoms and enhancing spinal flexibility can be a valuable tool in the transition of persons with low back pain into lumbar rehabilitation programs . Manipulation may hasten their entry into active care, or permit them to complete programs that might otherwise be interrupted by symptomatic recurrence. Manipulation science and technical procedures are reviewed as a basis to help understand the utility of properly integrated chiropractic manipulation strategies.

Journal of Manipulative and Physiological Therapeutics, 2006

Objective: The purpose of this white paper is to help inform the chiropractic clinical research agenda with a focus on the United States. Methods and Discussion: The recommendations and action items from 2 previous articles published in 1997 are discussed within the context of 3 broad topics: research culture, research infrastructure, and clinical research studies. Progress made toward the action items in these areas is summarized. A summary of findings is presented of the most influential clinical research studies during the past decade performed by or with major contributions by chiropractic investigators. In light of the current evidence and previous recommendations, new clinical research recommendations are proposed. Conclusions: Based on the assessment of the scientific literature and research currently underway, it is evident that members of the chiropractic research community have made important progress in becoming active players in the clinical research arena. During the past decade, the work of chiropractic researchers has contributed substantially to the amount and quality of the evidence for or against spinal manipulation in the management of low back pain, neck pain, headache, and other conditions. (J Manipulative Physiol Ther 2006;29:695-706)

Journal of Manipulative and Physiological Therapeutics, 2006

Objective: To investigate the effect of chiropractic adjustments on movement time using Fitts Law. Methods: This was a prospective, randomized controlled trial. Ten patients from a private chiropractic practice participated. Participants in the treatment group received high-velocity, low-amplitude chiropractic adjustments to areas of joint dysfunction (chiropractic subluxation). A nonintervention group was used to control for improvement resulting from time and practice effects. Movement time was measured as participants moved a cursor onto a target appearing on a computer screen. A range of target widths and target distances were used to vary the index of difficulty. Results: All participants in the experimental group had significantly improved movement times following spinal adjustments compared with only 1 participant in the control group. The average improvement in movement time for the experimental group was 183 ms, a 9.2% improvement, whereas the average improvement in movement time for the control group was 29 ms, a 1.7% improvement. The difference (improvement) scores after the intervention were significantly greater for the chiropractic group compared with the control group as measured by a 2-tailed independent samples t test ( P b .05). Conclusion: The results of this study demonstrated a significant improvement in movement time with chiropractic care. These results suggest that spinal adjustments may influence motor behavior. (J Manipulative Physiol Ther 2006;29:257-266)