Chiropractic research studies for chronic conditions

Background:
Characterized with hyperactivity, inattention and impulsivity, attention-deficit/hyperactivity disorder (ADHD) has a prevalence in children, ranging from 2.6% to 11.4%. The medical approach is multimodal, with combination therapies of behavioral modification and pharmacotherapy. With growing concerns regarding the safety of both short-term and long-term use of psychotropic medications, the need for investigating alternative approaches to the care of children is warranted. OBJECTIVE:
The aim of this review was to describe the chiropractic care of children with medically diagnosed ADHD.
DESIGN:
Retrospective case series were reviewed.
SETTING:
The review was conducted in a private practice of chiropractic with a solo practitioner. PATIENTS/PARTICIPANTS: Pediatric patients (agedINTERVENTION: The intervention was chiropractic spinal manipulative therapy augmented by diet therapyal supplements.
Results:
Our review found four patient files satisfying the inclusion criteria. All patients were males, ranging in age from nine to 13 years (mean age, 10 years), with three patients having a history of medication use and two patients having prescribed medication at the start of chiropractic care. Using a 15-item parent/teacher ADHD questionnaire, the patients’ responses to chiropractic care were monitored. Using the Friedman test to compare observations repeated on the same subjects, our findings found improvement in ADHD symptoms (ie, hyperactivity, impulsivity, and inattentiveness, as well as behavioral, social, or emotional difficulties) and provide supporting evidence on the effectiveness of chiropractic in the treatment of children with ADHD.
Conclusion:
A retrospective case series of ADHD patients under chiropractic care is described. This provides supporting evidence on the benefits of chiropractic spinal manipulative therapy. We encourage further research in this area.

OBJECTIVE:
This study presents a case series of 157 children with developmental delay syndromes, including the conditions such as dyspraxia, dyslexia, attention-deficit hyperactivity disorder, and learning disabilities who received chiropractic care. CLINICAL FEATURES: A consecutive sample of 157 children aged 6 to 13 years (86 boys and 71 girls) with difficulties in reading, learning, social interaction, and school performance who met these inclusion criteria were included. INTERVENTION AND OUTCOMES: Each patient received a multimodal chiropractic treatment protocol, applied kinesiology chiropractic technique. The outcome measures were a series of 8 standardized psychometric tests given to the children by a certified speech therapist pre- and posttreatment, which evaluate 20 separate areas of cognitive function, including patient- or parent-reported improvements in school performance, social interaction, and sporting activities. Individual and group data showed that at the end of treatment, the 157 children showed improvements in the 8 psychometric tests and 20 areas of cognitive function compared with their values before treatment. Their ability to concentrate, maintain focus and attention, and control impulsivity and their performance at home and school improved. CONCLUSIONS: This report suggests that a multimodal chiropractic method that assesses and treats motor dysfunction reduced symptoms and enhanced the cognitive performance in this group of children.

OBJECTIVE:
To provide a review of the literature and rate the quality of published studies regarding chiropractic care, including spinal manipulation, for asthmatic patients.
METHODS:
A multimodal search strategy was conducted, including multiple database searches, along with reference and journal hand-searching. Studies were limited to those published in English and in peer-reviewed journals or conference proceedings between January 1980 and March 2009. All study designs were considered except personal narratives or reviews. Retrieved articles that met the inclusion criteria were rated for quality by using the Downs and Black checklist. A brief summary was also written for each retrieved study.
Results:
Eight articles met the inclusion criteria of this review in the form of one case series, one case study, one survey, two randomized controlled trials (RCTs), one randomized patient and observer blinded cross-over trial, one single blind cross study design, and one self-reported impairment questionnaire. Their quality scores ranged from 5 to 22 out of 27.
Conclusion:
Results of the eight retrieved studies indicated that chiropractic care showed improvements in subjective measures and, to a lesser degree objective measures, none of which were statistically significant. It is evident that some asthmatic patients may benefit from this treatment approach; however, at this time, the evidence suggests chiropractic care should be used as an adjunct, not a replacement, to traditional medical therapy.

OBJECTIVE:
To determine whether there is a short-term effect of spinal manipulation in the treatment of infantile colic. DESIGN: A randomized controlled trial. SETTING: A private chiropractic practice and the National Health Service’s health visitor nurses in the suburb Ballerup (Copenhagen, Denmark). SUBJECTS: Infants seen by the health visitor nurses, who fulfilled the diagnostic criteria for infantile colic. INTERVENTION: One group received spinal manipulation for 2 weeks, the other was treated with the drug dimethicone for 2 weeks. OUTCOME MEASURE: Changes in daily hours of crying as registered in a colic diary.
Results:
By trial days 4 to 7, hours of crying were reduced by 1 hour in the dimethicone group compared with 2.4 hours in the manipulation group (P = .04). On days 8 through 11, crying was reduced by 1 hour for the dimethicone group, whereas crying in the manipulation group was reduced by 2.7 hours (P = .004). From trial day 5 onward the manipulation group did significantly better that the dimethicone group.
Conclusion:
Spinal manipulation is effective in relieving infantile colic.

OBJECTIVE:
Investigation into the alleviation of long-term effects of infant colic on the toddler is a neglected area of research. The aim of this study was to document any behavioral or sleep disturbances experienced by post-colicky toddlers who were previously treated with chiropractic care vs those who had not experienced this treatment as an infant.
METHODS:
Two groups of children were sampled from clinic records from a chiropractic clinic and from a child care center in similar regions of England. Patients were classified in the treatment group if they had been treated for infant colic with routine low-force chiropractic manual therapy. The nontreatment group consisted of post-colicky children in the same age group who had received no chiropractic care for their diagnosed colic as infants. A survey of parents of 117 post-colicky toddlers in a treatment group and 111 toddlers in the nontreatment group was performed.
Results:
Toddlers who were treated with chiropractic care for colic were twice as likely to not experience long-term sequelae of infant colic, such as temper tantrums (relative risk, 2.0; 95% confidence interval, 1.3-3.0) and frequent nocturnal waking (relative risk, 2.0; 95% confidence interval, 1.5-2.8) than those who were not treated with chiropractic care as colicky infants.
Conclusion:
Untreated post-colicky infants demonstrated negative behavioral patterns at 2 to 3 years of age. In this study, parents of infants treated with chiropractic care for excessive crying did not report as many difficult behavioral and sleep patterns of their toddlers. These findings suggest that chiropractic care for infants with colic may have an effect on long-term sequelae.

OBJECTIVE:
The purpose of this study was to determine the efficacy of chiropractic manual therapy for infants with unexplained crying behavior and if there was any effect of parental reporting bias.
METHODS:
Infants with unexplained persistent crying (infant colic) were recruited between October 2007 and November 2009 at a chiropractic teaching clinic in the United Kingdom. Infants younger than 8 weeks were randomized to 1 of 3 groups: (i) infant treated, parent aware; (ii) infant treated, parent unaware; and (iii) infant not treated, parent unaware. The primary outcome was a daily crying diary completed by parents over a period of 10 days. Treatments were pragmatic, individualized to examination findings, and consisted of chiropractic manual therapy of the spine. Analysis of covariance was used to investigate differences between groups.
Results:
One hundred four patients were randomized. In parents blinded to treatment allocation, using 2 or less hours of crying per day to determine a clinically significant improvement in crying time, the increased odds of improvement in treated infants compared with those not receiving treatment were statistically significant at day 8 (adjusted odds ratio [OR], 8.1; 95% confidence interval [CI], 1.4-45.0) and at day 10 (adjusted OR, 11.8; 95% CI, 2.1-68.3). The number needed to treat was 3. In contrast, the odds of improvement in treated infants were not significantly different in blinded compared with nonblinded parents (adjusted ORs, 0.7 [95% CI, 0.2-2.0] and 0.5 [95% CI, 0.1-1.6] at days 8 and 10, respectively). CONCLUSIONS: In this study, chiropractic manual therapy improved crying behavior in infants with colic. The findings showed that knowledge of treatment by the parent did not appear to contribute to the observed treatment effects in this study. Thus, it is unlikely that observed treatment effect is due to bias on the part of the reporting parent.