MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Chiropractic is a therapy that has been in search for an indication ever since it was invented some 120 years ago. So far, this search seems to have been unsuccessful.

Perhaps it could be promoted as a means of enhancing athletic performance?

That would be excellent news for chiropractic cash-flow!

The authors of this study wanted to analyse the acute effects of spinal manipulative therapy (SMT) on performance and autonomic modulation. A total of 37 male recreational athletes who had never received SMT were assigned to a sham (n = 19) or actual SMT group (n = 18). Study endpoints included autonomic modulation (heart rate variability), handgrip strength, jumping ability and cycling performance (8-minute time trial [TT]). Differences in custom effects between interventions were determined using magnitude-based inferences.

A significant and very likely lower value of a marker of sympathetic modulation, the stress score, was observed in response to actual compared to sham SMT (p = 0.007; effect size [ES] = -0.97). A trend towards a significant and likely lower sympathetic:parasympathetic ratio (p = 0.055; ES = -0.96) and a likely higher natural logarithm of the root-mean-square differences of successive heartbeat intervals ([LnRMSSD], p = 0.12; ES = 0.36) was also found with actual SMT. Moreover, a significantly lower mean power output was observed during the TT with actual compared with sham SMT (p = 0.035; ES = -0.28). Non-significant (p > 0.05) and unclear or likely trivial differences (ES < 0.2) were found for the rest of endpoints, including handgrip strength, heart rate during the TT, and jump loss thereafter.

A single pre-exercise SMT session induced an acute shift towards parasympathetic dominance and slightly impaired performance in recreational healthy athletes.

Ooops!

The search was unsuccessful yet again!

SMT impaired performance; this might not convince athletes to become fans of chiropractic.

What indication should the desperate chiros try next?

Any suggestions?

6 Responses to Chiropractic = a therapy in search for an indication

  • My suggestion is for the Chiropractics is to carry out some research into how manipulations could possibly work.After all, their founder claimed it could treat a wide variety of conditions so some basic research would be good to at least see if the treatments hasver any chance of working. Homeopathy is an interesting comparison. It is obvious it couldn’t work since everything is do dilute that there is nothing left but water and sugar. Maybe chiropractic is like this – not possible way to work.

  • The most obvious indication for Chiropractic is, and has always been to make a mockery out of the word “Doctor”.

  • So the subjects relaxed but athletic performance decreased? Is there a theoretical explanation for that?

  • The Chiropractic Subluxation is a pseudo-pathology invented by chiropractors so that they can sell themselves and their panoply of so-called Adjustments as the solution to this fictional problem. Inasmuch as only the chiropractor can tell you if you’re Suffering Needlessly from this invented disorder, you have a closed diagnostic-therapuetic loop in which the treating chiropractor is, in effect, touching their own Chiropractic Nose.

    If you’re in the office of a chiropractor, you’re going to get “chiropractic.” No indication needed. The entering complaint is just an excuse for the chiropractor to act-out and bill for their “chiropractic.”

    ~TEO.

  • Did Ernst even read the paper? Or did he just not understand it?

    “Participants in the actual SMT group were assessed through the activator method protocol [for specific details see Fuhr & Menke (2005)12]. SMT was performed with the Activator IV Adjusting Instrument.”

  • Also…

    “The subject was lying supine and relaxed for 10 minutes, analysing all R-R intervals during the last 5 minutes…”

    However,

    “Circadian rhythms, core body temperature, metabolism, the sleep cycle, and the renin–angiotensin system contribute to 24 h HRV recordings, which represent the “gold standard” for clinical HRV assessment (12). These recordings achieve greater predictive power than short-term measurements (10, 27–29). Although we calculate 24 h and short-term HRV measurements using the same mathematical formulas, they cannot substitute for each other and their physiological meaning can profoundly differ (9). Front Public Health. 2017; 5: 258

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