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Volume 339:1013-1020 October 8, 1998 Number 15 Next

	Full Text PDF Editorial by Shekelle, P. G. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Chiropractic spinal manipulation has been reported to be of benefit in nonmusculoskeletal conditions, including asthma.

Methods We conducted a randomized, controlled trial of chiropractic spinal manipulation for children with mild or moderate asthma. After a three-week base-line evaluation period, 91 children who had continuing symptoms of asthma despite usual medical therapy were randomly assigned to receive either active or simulated chiropractic manipulation for four months. None had previously received chiropractic care. Each subject was treated by 1 of 11 participating chiropractors, selected by the family according to location. The primary outcome measure was the change from base line in the peak expiratory flow, measured in the morning, before the use of a bronchodilator, at two and four months. Except for the treating chiropractor and one investigator (who was not involved in assessing outcomes), all participants remained fully blinded to treatment assignment throughout the study.

Results Eighty children (38 in the active-treatment group and 42 in the simulated-treatment group) had outcome data that could be evaluated. There were small increases (7 to 12 liters per minute) in peak expiratory flow in the morning and the evening in both treatment groups, with no significant differences between the groups in the degree of change from base line (morning peak expiratory flow, P=0.49 at two months and P=0.82 at four months). Symptoms of asthma and use of -agonists decreased and the quality of life increased in both groups, with no significant differences between the groups. There were no significant changes in spirometric measurements or airway responsiveness.

Conclusions In children with mild or moderate asthma, the addition of chiropractic spinal manipulation to usual medical care provided no benefit.

Source Information

From the Division of Graduate Studies and Research, Canadian Memorial Chiropractic College, Toronto (J.B., P.D.A., E.R.C.); the Department of Research, Los Angeles College of Chiropractic, Los Angeles (C.D.); the Firestone Regional Chest and Allergy Unit, St. Joseph's Hospital, and the Department of Medicine, McMaster University, Hamilton, Ont., Canada (P.G.C., D.O., C.W., M.R.S.); and the Department of Clinical Epidemiology and Biostatistics and the Centre for Evaluation of Medicines, Father Sean O'Sullivan Research Centre, St. Joseph's Hospital and McMaster University, Hamilton, Ont., Canada (C.H.G., E.D.).

Address reprint requests to Dr. Sears at the Firestone Regional Chest and Allergy Unit, St. Joseph's Hospital, 50 Charlton Ave. East, Hamilton, ON L8N 4A6, Canada.

Full Text of this Article

Related Letters:

Chiropractic Manipulation for Childhood Asthma
Jongeward B. V., Richards D. G., Mein E. A., Nelson C. D., Balon J., Crowther E. R., Sears M. R.
Extract | Full Text  
N Engl J Med 1999; 340:391-392, Feb 4, 1999. Correspondence

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