The Effects of Spinal Manipulation on Oculomotor Control in Children with Attention Deficit Hyperactivity Disorder: A Pilot and Feasibility Study

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent, chronic neurodevelopmental disorder that affects oculomotor (eye movement) control. Dysfunctional oculomotor control may result in reading or educational difficulties. This randomized controlled crossover study sought to investigate the feasibility of a larger scale trial and effects of a single session of spinal manipulation on oculomotor control in children with ADHD. Thirty children participated in the study and were randomized into either control-first or spinal manipulation first groups. The results indicate that the trial was feasible. Secondary outcomes showed that there was a significant decrease in reading time after the spinal manipulation intervention compared to the control intervention. Future studies of the effects of spinal manipulation on oculomotor control in children with ADHD are suggested.

The effects of chiropractic adjustment on inattention, hyperactivity, and impulsivity in children with attention deficit hyperactivity disorder: a pilot RCT

“…Studies have identified a role of frontal eye fields in the regulation of attention ( Funahashi and Andreau, 2013 ). One recent study found that chiropractic adjustment led to improved oculomotor control and reading time in children with ADHD ( Cade et al, 2021 ). The study’s authors proposed that as oculomotor control is thought to rely on accurate sensory processing, the changes in the afferent input after spinal adjustment could have accounted for the observed positive treatment response.…”

“…Since these reviews were published, one case series ( n = 4), and multiple case reports described improvements in ADHD potentially related to chiropractic adjustments ( Wittman et al, 2009 ; Alcantara and Davis, 2010 ; Muir, 2012 ; Fairest et al, 2019 ). A pilot and feasibility randomized controlled crossover trial ( n = 30) found that a single session of chiropractic adjustment led to a significant improvement in reading time measured by an eye tracker in children with ADHD ( Cade et al, 2021 ). While reading time can provide insights into certain aspects of attention and eye movements related to reading, it may not capture the full range of ADHD symptoms or assess other domains of impairment.…”

“…While reading time can provide insights into certain aspects of attention and eye movements related to reading, it may not capture the full range of ADHD symptoms or assess other domains of impairment. Due to these limited, but insufficient findings, previous authors have proposed that the effect of chiropractic adjustment on clinical outcomes be investigated for individuals with ADHD using randomized controlled trials ( Lystad and Pollard, 2009 ; Karpouzis et al, 2010 ; Cade et al, 2021 ). Finally, a survey of chiropractic research priorities in Australia highlighted ADHD as an often-requested topic among practitioners ( Amorin-Woods et al, 2023 ).…”

Effects of Cervical Spinal Manipulation on Saccadic Eye Movements

“…Spinal manipulation also improves proprioception, as observed through a post-manipulative reduction in Joint Position Error (JPE) values [ 77 , 78 , 79 ]. It has been suggested that the post-manipulative effect on saccadic movements is most likely due to improved proprioceptive input from the cervical spine [ 30 ].…”

“…It is often accompanied by an audible “cracking” noise resulting from cavitation of the joint. Spinal manipulation is also most commonly known for its ability to reduce musculoskeletal pain [ 29 ], and it has also been shown to improve proprioceptive input and the function of those brain networks involved in producing various eye movements [ 30 , 31 , 32 ]. However, despite the known effects of altering proprioceptive input into the brain, the effects of cervical spinal manipulation on saccadic eye movements and in patients diagnosed with (PCS), to the best of our knowledge, have not been directly investigated.…”