The Use of Spinal Manipulative Therapy in the Management of Chronic Obstructive Pulmonary Disease: A Systematic Review

Wearing, Jaxson; Beaumont, Sheridan; Forbes, Danielle; Brown, Benjamin T.; Engel, Roger

doi:10.1089/acm.2015.0199

Cited by 27 publications

(31 citation statements)

References 17 publications

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“…16 There is growing evidence from research studies of the effectiveness of chiropractic and osteopathic manipulation for nonmusculoskeletal conditions, especially in patients with migraine and headache, 17,18 pulmonary disease, 21 and different pediatric conditions, 22 including CP. [23][24][25][26] Our study was aimed at evaluating changes in wrist muscle spasticity in children with CP after 1 SM and a 2-week intensive rehabilitation program with daily SM together with other treatment modalities: physical therapy, massage, reflexotherapy, extremity joint mobilization, mechanotherapy, and rehabilitation computer games.…”

Section: Discussionmentioning

confidence: 99%

Changes in Muscle Spasticity in Patients With Cerebral Palsy After Spinal Manipulation: Case Series

Kachmar

Voloshyn

Hordiyevych

2016

Journal of Chiropractic Medicine

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Objective: The purpose of this case series was to report quantitative changes in wrist muscle spasticity in children with cerebral palsy after 1 spinal manipulation (SM) and a 2-week course of treatment. Methods: Twenty-nine patients, aged 7 to 18 years, with spastic forms of cerebral palsy and without fixed contracture of the wrist, were evaluated before initiation of treatment, after 1 SM, and at the end of a 2-week course of treatment. Along with daily SM, the program included physical therapy, massage, reflexotherapy, extremity joint mobilization, mechanotherapy, and rehabilitation computer games for 3 to 4 hours' duration. Spasticity of the wrist flexor was measured quantitatively using a Neuroflexor device, which calculates the neural component (NC) of muscle tone, representing true spasticity, and excluding nonneural components, caused by altered muscle properties: elasticity and viscosity. Results: Substantial decrease in spasticity was noted in all patient groups after SM. The average NC values decreased by 1.65 newtons (from 7.6 ± 6.2 to 5.9 ± 6.5) after 1 SM. Another slight decrease of 0.5 newtons was noted after a 2-week course of treatment. In the group of patients with minimal spasticity, the decrease in NC after the first SM was almost twofold-from 3.93 ± 2.9 to 2.01 ± 1.0. In cases of moderate spasticity, NC reduction was noted only after the 2-week course of intensive treatment. Conclusions: In this sample of patients with cerebral palsy, a decrease in wrist muscle spasticity was noted after SM. Spasticity reduction was potentiated during the 2-week course of treatment. (J Chiropr Med 2016;15:299-304)

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Section: Discussionmentioning

confidence: 99%

Changes in Muscle Spasticity in Patients With Cerebral Palsy After Spinal Manipulation: Case Series

Kachmar

Voloshyn

Hordiyevych

2016

Journal of Chiropractic Medicine

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“…The included reviews consisted of 13 Cochrane reviews [14–17, 35–46], 41 other reviews including only RCTs [47–87], 53 reviews including study types other than RCTs [88–140], 3 guidelines [9, 141–143] and 8 health technology assessments [144–154]. …”

Section: Resultsmentioning

confidence: 99%

The risk associated with spinal manipulation: an overview of reviews

et al. 2017

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BackgroundSpinal manipulative therapy (SMT) is a widely used manual treatment, but many reviews exist with conflicting conclusions about the safety of SMT. We performed an overview of reviews to elucidate and quantify the risk of serious adverse events (SAEs) associated with SMT.MethodsWe searched five electronic databases from inception to December 8, 2015. We included reviews on any type of studies, patients, and SMT technique. Our primary outcome was SAEs. Quality of the included reviews was assessed using a measurement tool to assess systematic reviews (AMSTAR). Since there were insufficient data for calculating incidence rates of SAEs, we used an alternative approach; the conclusions regarding safety of SMT were extracted for each review, and the communicated opinion were judged by two reviewers independently as safe, harmful, or neutral/unclear. Risk ratios (RRs) of a review communicating that SMT is safe and meeting the requirements for each AMSTAR item, were calculated.ResultsWe identified 283 eligible reviews, but only 118 provided data for synthesis. The most frequently described adverse events (AEs) were stroke, headache, and vertebral artery dissection. Fifty-four reviews (46%) expressed that SMT is safe, 15 (13%) expressed that SMT is harmful, and 49 reviews (42%) were neutral or unclear. Thirteen reviews reported incidence estimates for SAEs, roughly ranging from 1 in 20,000 to 1 in 250,000,000 manipulations. Low methodological quality was present, with a median of 4 of 11 AMSTAR items met (interquartile range, 3 to 6). Reviews meeting the requirements for each of the AMSTAR items (i.e. good internal validity) had a higher chance of expressing that SMT is safe.ConclusionsIt is currently not possible to provide an overall conclusion about the safety of SMT; however, the types of SAEs reported can indeed be significant, sustaining that some risk is present. High quality research and consistent reporting of AEs and SAEs are needed.Systematic review registrationPROSPERO CRD42015030068.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-017-0458-y) contains supplementary material, which is available to authorized users.

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“…The trial’s design satisfies the recommendations of a recent systematic review into the use of SMT in the management of COPD [18] in that it is adequately powered, configured to have a low risk of bias and has the potential to deliver meaningful data for the use of MT in the management of COPD.…”

Section: Discussionmentioning

confidence: 99%

The effect of combining manual therapy with exercise for mild chronic obstructive pulmonary disease: study protocol for a randomised controlled trial

Engel

Wearing

Gonski

et al. 2017

Trials

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BackgroundChronic obstructive pulmonary disease (COPD) is a major cause of disability and hospital admission. Current management strategies have not been successful in altering the loss of lung function typically seen as the disease progresses. A recent systematic review into the use of spinal manipulative therapy (SMT) in the management of COPD concluded that there was low level evidence to support the view that a combination of SMT and exercise had the potential to improve lung function more than exercise alone in people with moderate to severe COPD.The aim of this study is to investigate whether the combination of exercise and manual therapy (MT) that includes SMT produces sustainable improvements in lung function and exercise capacity in people with mild COPD.Methods/designThe study is a randomised controlled trial of 202 people with stable mild COPD. The cohort will be divided into two equal groups matched at baseline. The first group will receive a standardised exercise program. The second group will receive MT that includes SMT plus the same standardised exercise program. Exercise will be administered a total of 36 times over an 18-week period, while MT will be administered in conjunction with exercise a total of 15 times over a 6-week period. The primary outcome measure is lung function (forced expiratory volume in the 1st second: FEV1 and forced vital capacity: FVC). The secondary outcome measures are the 6-minute walking test (6MWT), quality of life questionnaire (St George’s Respiratory Questionnaire: SGRQ), anxiety and depression levels (Hospital Anxiety and Depression Scale: HADS), frequency of exacerbations, chest wall expansion measurements (tape measurements) and systemic inflammatory biomarker levels. Outcome measurements will be taken by blinded assessors on seven occasions over a 48-week period. Adverse event data will also be gathered at the beginning of each intervention session.DiscussionThis randomised controlled trial is designed to investigate whether the combination of MT and exercise delivers any additional benefits to people with mild COPD compared to exercise alone. The study is designed in response to recommendations from a recent systematic review calling for more research into the effect of MT in the management of COPD.Trial registrationANZCTRN, 12614000766617. Registered on 18 July 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2027-z) contains supplementary material, which is available to authorized users.

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The Use of Spinal Manipulative Therapy in the Management of Chronic Obstructive Pulmonary Disease: A Systematic Review

Cited by 27 publications

References 17 publications

Changes in Muscle Spasticity in Patients With Cerebral Palsy After Spinal Manipulation: Case Series

Changes in Muscle Spasticity in Patients With Cerebral Palsy After Spinal Manipulation: Case Series

The risk associated with spinal manipulation: an overview of reviews

The effect of combining manual therapy with exercise for mild chronic obstructive pulmonary disease: study protocol for a randomised controlled trial

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