CHIROPRACTIC RESEARCH
Currently in the works:
(1) Measuring the Effects of Specific Cervical
Chiropractic Adjustments on Blood Pressure and
Pulse Rate: A Randomized Controlled Trial
and
(2) A Randomized Controlled Trial to Measure the
Effects of Specific Thoracic Chiropractic Adjustments
on Blood Pressure and Pulse Rate
Prinicpal Investigator: Steven D. Roffers DC
Co-Investigators and Co-Authors:
Anquonette L. Stiles DC
Laura L. Huber DC
David H. Morris MD
Derek A. Barton DC
Therese A. House DC
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ABSTRACT
Measuring the Effects of Specific Cervical Chiropractic Adjustments on Blood Pressure and Pulse Rate:
A Randomized Controlled Trial
OBJECTIVE: Several studies have reported the effects
of various specific cervical chiropractic adjustments on
blood pressure(1-5) and pulse rate.(1-3) However, those
studies have been criticized due to small sample size
and various methodological concerns. The purpose of
this randomized controlled trial (RCT) was to measure
the effects of specific cervical (C3 to Occiput [“C0”])
chiropractic adjustments on blood pressure (BP) and
pulse rate (PR) in a larger sample size of both
normotensive and hypertensive humans.
METHODS: After IRB approval, Informed Consent was
obtained and 331 human subjects who met the inclusion
criteria were randomly assigned to one of three groups:
Control (N=108; no treatment, no placebo); Placebo
Treatment (N=117; sham adjustment with inactive device);
or Active Treatment (N=106; adjustment with active device). Subjects were seated in a relaxing climate-controlled room
for a minimum of 15 minutes prior to obtaining a baseline
blood pressure (BP) (systolic and diastolic) and pulse rate
(PR) measurement with an electronic oscillometric BP
monitor. The subjects were then moved to chairs stationed according to the study group in which they were assigned. Subjects had another BP and PR measured (“anxiety” BP
and PR measurements) after being called upon for active treatment, placebo treatment, or no treatment at all. Active treatment involved the use of the Activator IV(6) adjusting instrument to correct subluxations detected according to
the Activator Methods Chiropractic Technique(7) for cervical vertebrae C3 to C0. Placebo treatment was performed with
an Activator II8 adjusting instrument in the “off” position
which mimics all aspects of the treatment that is administered when in the “on” position but no manipulative force is
delivered. Following active treatment (or placebo treatment
or no treatment), subjects had their BP and PR measured
once again.
RESULTS: Subjects ranged in age from 18 to 85 years old
(mean age = 52) and 64% of them were female. Systolic and diastolic BP decreased significantly (p<0.0001) in the active treatment group, whereas no significant changes occurred
in the placebo treatment and control groups. Similarly, PR decreased significantly (p<0.0001) in the active treatment
group, whereas no significant changes occurred in the
placebo treatment and control groups.
DISCUSSION: Similar smaller studies, utilizing various chiropractic adjusting techniques, served as the foundation
for this larger and important RCT. The results of this RCT indicate, with strong statistical significance, that specific
cervical (C3 to C0) chiropractic adjustments decrease systolic
and diastolic BP, as well as PR.
CONCLUSION: This significant and important RCT
demonstrates that specific cervical chiropractic adjustments decrease BP and PR. In follow-up to this RCT, a longitudinal
pilot study of both normotensive and hypertensive subjects is currently in progress by the authors to determine how long a decrease in BP and PR is sustained following specific cervical chiropractic adjustments. Given the worldwide burden of hypertension and its adverse effects on health, further studies
on the effects of chiropractic adjustments on BP and PR are warranted.
REFERENCES
1. Bakris G, Dickholtz M Sr, Meyer PM, Kravitz G, Avery E,
Miller M, Brown J, Woodfield C, and Bell B. Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study. J Hum Hypertens. 2007 May;21(5):347-52.
2. Welch A and Boone R. Sympathetic and parasympathetic responses to specific diversified adjustments to chiropractic vertebral subluxations of the cervical and thoracic spine. J Chiropr Med. Sep 2008(7:3): 86-93.
3. Knutson GA. Significant changes in systolic blood pressure post vectored upper cervical adjustment vs resting control groups: a possible effect of the cervicosympathetic and/or
pressor reflex. J Manipulative Physiol Ther. 2001 Feb;24(2):
101-109
4. Hannah JS. Changes in systolic and diastolic blood pressure for a hypotensive patient receiving upper cervical specific:
A case report. Chiropr J Aust. 2009 Sep;39(3):118-121.
5. Beck RW, Holt K, Sexton SG. Reflex effects of a spinal adjustment on blood pressure [platform presentation; the Association of Chiropractic Colleges' Thirteenth Annual Conference, 2006]. J Chiropr Educ. 2006 Spr;20(1):23
6. Activator IV chiropractic adjusting instrument. Website accessed on May 27, 2010. www.activator.com/catalog_item.asp?ID=95. Activator Methods International Ltd, Phoenix, AZ.
7. Fuhr AW. The Activator Method. Second Edition. Textbook. ISBN-10: 0323048528; ISBN-13: 978-0323048521. 2008.
8. Activator II chiropractic adjusting instrument. Website accessed on May 27, 2010. www.activator.com/catalog_item.asp?ID=8. Activator Methods International Ltd, Phoenix, AZ.
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ABSTRACT
A Randomized Controlled Trial to Measure the Effects of Specific Thoracic Chiropractic Adjustments on Blood Pressure and Pulse Rate
OBJECTIVE: Previous studies on the effects of chiropractic treatment on blood pressure (BP) and pulse rate (PR) have reported decreases in both systolic and diastolic BP,(1,2,3) as well as PR.(2,3) However, those studies have been criticized as being flawed, and accused of drawing erroneous conclusions, due to small sample size and various methodological concerns.(4,5,6,7) The purpose of this randomized controlled trial (RCT) was to measure the effects of specific thoracic (T5 to T1) chiropractic adjustments on BP and PR in a larger sample size of both normotensive and hypertensive humans.
METHODS: Informed consent was obtained and 290 human subjects who met the inclusion criteria were randomly assigned to one of three groups: Control (N=95; no treatment, no placebo); Placebo Treatment (N=96; sham adjustment with inactive
device); or Active Treatment (N=99; adjustment with active device). Subjects were seated in a relaxing climate-controlled room for a minimum of 15 minutes prior to obtaining a baseline blood pressure (BP) (systolic and diastolic) and pulse rate (PR) measurement with an electronic oscillometric BP monitor. The subjects were then moved to chairs stationed according to the study group in which they were assigned. Subjects had another BP and PR measured (“anxiety” BP and PR measurements) after being called upon for active treatment, placebo treatment, or no treatment at all. Active treatment involved the use of the Activator IV(8) adjusting instrument to correct subluxations detected according to the Activator Methods Chiropractic Technique(9) for thoracic vertebrae T5 to T1. Placebo treatment was performed with an Activator II(10) adjusting instrument in the “off” position which mimics all aspects of the treatment that is administered when in the “on” position but no manipulative force is delivered. Following active treatment (or placebo treatment or no treatment), subjects had their BP and PR measured once again.
RESULTS: Subjects ranged in age from 18 to 100 years old (mean age = 52) and 66% of them were female. Systolic and diastolic BP decreased significantly (p<0.0001) in the active treatment group, whereas no significant changes occurred in the placebo treatment and control groups. Similarly, PR decreased significantly (p<0.0001) in the active treatment group, whereas no significant changes occurred in the placebo treatment and control groups.
DISCUSSION: Previous smaller studies, with various weaknesses, served as the foundation for this larger and important RCT. The results of this RCT indicate, with strong statistical significance, that specific thoracic (T5 to T1) chiropractic adjustments decrease systolic and diastolic BP, as well as PR.
CONCLUSION: This important and significant RCT demonstrates that specific thoracic chiropractic adjustments decrease BP and PR. A follow-up longitudinal pilot study of both normotensive and hypertensive subjects is currently in progress by the authors to determine how long a decrease in BP and PR is sustained following specific chiropractic adjustments. Hypertension and its adverse effects are worldwide health problems warranting further studies on the effects of chiropractic adjustments on BP and PR.
REFERENCES
1. Yates RG, Lamping Dl, Abram NL, and Wright C. Effects of chiropractic treatment on blood pressure and Anxiety: A randomized, controlled trial. J Manipulative Physiol Ther. 1988 Dec;11(6):484-8.
2. Welch A and Boone R. Sympathetic and parasympathetic responses to specific diversified adjustments to chiropractic vertebral subluxations of the cervical and thoracic spine. J Chiropr Med. Sep 2008(7:3): 86-93.
3. Bakris G, Dickholtz M Sr, Meyer PM, Kravitz G, Avery E, Miller M, Brown J, Woodfield C, and Bell B. Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study. J Hum Hypertens. 2007 May;21(5):347-52.
4. Gemmell HA. Comment on: J Manipulative Physiol Ther. 1988 Dec;11(6):484-8. J Manipulative Physiol Ther. 1989 June;12(3):240.
5. Nykoliation J. Comment on: J Manipulative Physiol Ther. 1988 Dec;11(6):484-8. J Manipulative Physiol Ther. 1990 Feb;13(2):113.
6. Osterbauer PJ and Fuhr AW. Comment on J Manipulative Physiol Ther. 1988 Dec;11(6):484-8. J Manipulative Physiol Ther. 1991 Jan;14(1):74-77.
7. Richards D. Comment in: J Manipulative Physiol Ther. 1988 Dec;11(6):484-8. J Manipulative Physiol Ther. 1992 Mar-Apr;15(3):210-212.
8. Activator IV chiropractic adjusting instrument. Website accessed on May 27, 2010. www.activator.com/catalog_item.asp?ID=95. Activator Methods International Ltd, Phoenix, AZ.
9. Fuhr AW. The Activator Method. Second Edition. Textbook. ISBN-10: 0323048528; ISBN-13: 978-0323048521. 2008.
10. Activator II chiropractic adjusting instrument. Website accessed on May 27, 2010. www.activator.com/catalog_item.asp?ID=8. Activator Methods International Ltd, Phoenix, AZ.
