Action for Victims of Chiropractic

Various related Published Papers and useful Links

OVERVIEW

Research into complementary and alternative medicine: problems and potential

Richard l. Nahin, Stephen E. Straus 

British Medical Journal BMJ 2001;322:161-164 (20th January 2001)

[CONCLUSION: We envision that compelling data will facilitate meaningful interactions between conventional and complementary practitioners and ultimately lead to the development of interdisciplinary partnerships that incorporate validated complementary practices into patient care]

http://bmj.com/cgi/content/full/322/7279/161

 

The role of complementary and alternative medicine

E. Ernst   

British Medical Journal BMJ 2000; 321:1133-1135 (4th November 2000)

[CONCLUSION:  Patients and healthcare providers need to know which forms are safe and effective.  Its future should (and hopefully will) be determined by unbiased scientific evaluation]

http://bmj.com/cgi/content/full/321/7269/1133

 

OSTEOPATHY AND CHIROPRACTIC

The manipulative therapies: osteopathy and chiropractic

Andrew Vickers, Catherine Zollman   

British Medical Journal BMJ 1999;319:1176-1179 (30th October 1999)

[CLINICAL REVIEW - no conclusion]

http://bmj.com/cgi/content/full/319/7218/1176

 

Does spinal manipulation have specific treatment effects?

E. Ernst

Family Practice  Vol.17, No.6, 554-556  (2000)

[CONCLUSION:  The results available to date suggest that the therapeutic success of spinal manipulation is largely due to a placebo effect]

http://fampract.oupjournals.org/cgi/content/full/17/6/554

 

Chiropractic - Origins, Controversies and Contributions

Ted J. Kaptchuk, OMD; David M. Eisenberg, MD

Archives of Internal Medicine Vol.158 No.20  158:2215-2224 (9th November 1998)

[CONCLUSION:  While the core belief that the correction of spinal abnormality is a critical health care intervention is open to debate, chiropractic's most important contribution may have to do with the

patient-physician relationship]

http://archinte.ama-assn.org/cgi/content/abstract/158/20/2215

 

 

HEADACHES AND MIGRAINE

 

The effectiveness of spinal manipulation for the treatment of headache disorders: a systematic review of randomized clinical trials

J. A. Astin, E. Ernst   

Cephalalgia, Volume 22 Issue 8 Page 617 (October 2002)

[CONCLUSION:  Despite claims that spinal manipulation is an effective treatment for headache, the data available to date do not support such definitive conclusions]

http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0333-1024&date=2002&volume=22&issue=8&spage=617

 

Efficacy of spinal manipulation for chronic headache: A systematic review

Gert Brontfort, DC, PhD, Willem J. J. Assendelft, MD, PhD, Roni Evans, DC, Mitchell Haas, DC, Lex Bouter, PhD.    

Journal of Manipulative and Physiological Therapeutics, JMPT Vol. 24 No.7 (September 2001)

[CONCLUSION:  Spinal manipulative therapy appears to have a better effect than massage for cervicogenic headache.  Before any firm conclusions can be drawn, further testing should be done in rigorously designed, executed  and analyzed trials with follow-up periods of sufficient length]

http://www2.us.elsevierhealth.com/scripts/om.dll/serve?retrieve=/pii/S0161475401994230&

 

A randomized controlled trial of chiropractic spinal manipulative therapy for migraine

Peter J. Tuchin, GradDipChiro, DipOHS, Henry Pollard, GradDipChiro, GradDipAppSc, Rod Bonello, DC, DO

Journal of Manipulative and Physiological Therapeutics, JMPT Vol.23 No.2 (February 2000)

[CONCLUSION:  It appears that chiropractic care has an effect on the physical conditions related to stress and that in these people the effects of the migraine are reduced]

http://www2.us.elsevierhealth.com/scripts/om.dll/serve?retrieve=/pii/S0161475400343822&

 

***JAMA Publishes Chiropractic Study on Episodic Tension-Type Headache

(See study below)

Response from The Foundation for Chiropractic Education and Research  FCER (11th November 1998)

[CONCLUSION:  This study achieves the distinction of stimulating further inquiry into the entire realm of the etiology and classification of headache, as it demonstrates a major difference in response mechanisms]

http://www.fcer.org/html/news/tension.htm

 

Spinal manipulation in the treatment of episodic tension-type headache: a randomized controlled trial

Bove, G., Nilsson N   

Journal of the American Medical Association, JAMA 1998;280(18):1576-9 (11th November 1998)

[CONCLUSION:  As an isolated intervention, spinal manipulation does not seem to have a positive effect on episodic tension-type headache]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=9820258&dopt=Citation

 

The effect of spinal manipulation in the treatment of cervicogenic headache

Nilsson N., Christensen H. W., Hartvigsen J.   

Journal of Manipulative and Physiological Therapeutics, JMPT:20(5):326-30 (June 1997)

[CONCLUSION:  Spinal manipulation has a significant positive effect in cases of cervicogenic headache]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=9200048&dopt=Citation

 

 

NECK PAIN

 

Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: economic evaluation alongside a randomised controlled trial

Ingeborg B. C. Korthals-de Bos, Jan L. Hoving, Maurits W. van Tulder, Maureen P. M. H. Rutten-van Molken, Herman J. Ader, Henrica C. W. de Vet, Bart W. Koes, Hindrik Vondeling, Lex M. Bouter   

British Medical Journal BMJ 2003;326:911 (26th April 2003)

[CONCLUSION:  Manual therapy (spinal mobilisation) is more effective and less costly for treating neck pain than physiotherapy or care by a general practitioner]

http://bmj.com/cgi/content/full/326/7395/911

 

A Randomized Trial of Chiropractic Manipulation and Mobilization for Patients With Neck Pain: Clinical Outcomes From the UCLA Neck-Pain Study

Eric L. Hurwitz, DC, PhD, Hal Morgenstern, PhD, Philip Harber, MD, MPH, Gerald F. Kominski, PhD, Fei Yu, PhD and Alan H. Adams, DC, MS   

American Journal of Public Health, AJPH Vol.92 No.10:1634-1641 (October 2002)

[CONCLUSION:  Cervical spine manipulation and mobilization yield comparable clinical outcomes]

http://www.ajph.org/cgi/content/abstract/92/10/1634

 

***Bournemouth Questionnaire for Neck Pain Patients Developed as Short-Form Comprehensive Outcome Measure

The Foundation for Chiropractic Education and Research  FCER (17th May 2002)

[The Neck BQ is the first neck-specific outcome measure that works under the assumption that neck pain is a biopsychosocial illness, rather than a "disease"]

http://www.fcer.org/html/News/JMPT0502.htm

 

Active range of motion in the cervical spine increases after spinal manipulation (toggle recoil)

Wayne Whittingham, DC PhD, Niels Nilsson, DC, MD, PhD   

Journal of Manipulative and Physiological Therapeutics, JMPT Vol.24 No.9 (November/December 2001)

[CONCLUSION:  Spinal manipulation of the cervical spine increases active range of motion]

http://www2.us.elsevierhealth.com/scripts/om.dll/serve?retrieve=/pii/S0161475401251343&

 

Chiropractic Management of mechanical neck and low-back pain: A retrospective, outcome-based analysis

Gordon McMorland, DC, Esther Suter, PhD   

Journal of Manipulative and Physiological Therapeutics, JMPT Vol.23 No.5 (June 2000)

[CONCLUSION:  Patients with mechanical neck pain or low back pain had statistically significant reductions in their pain-related disability after treatment.  The study does not account for the natural history of low back or neck pain-related disability and therefore does not allow for claims of treatment efficacy]

http://www2.us.elsevierhealth.com/scripts/om.dll/serve?retrieve=/pii/S0161475400246381&

 

Intensive Training, Physiotherapy, or Manipulation for Patients With Chronic Neck Pain

A Prospective, Single-Blinded, Randomized Clinical Trial

Alan Jordan, DC, PhD; Tom Bendix, MD, PhD; Henrik Nielsen, MD, PhD; Finn Rolsted Hansen, MD; Dorte Host, PT; Anette Winkel, PT, BSc    

Spine;23(3):311-318 (February 1998)

[CONCLUSION:  There was no clinical difference between the three treatments.  Further studies will be necessary to delineate ideal treatment strategies]

http://ipsapp003.lwwonline.com/content/getfile/1140/25/5/abstract.htm

 

Conservative management of mechanical neck pain: systematic overview and meta-analysis

Peter D. Aker, Anita R. Gross, Charles H. Goldsmith, Paul Peloso    

British Medical Journal, BMJ 1996;313:1291-1296 (23rd November 1996)

[CONCLUSION:  There is little information available from clinical trials to support many of the treatments for mechanical neck pain.  In general, conservative interventions have not been studied in enough detail to assess efficacy or effectiveness adequately]

http://bmj.com/cgi/content/full/313/7068/1291

 

Manipulation and Mobilization of the Cervical Spine

A systematic Review of the Literature.

Eric L. Hurwitz, DC PhD; Peter D. Aker, DC; Alan H. Adams, DC; William C. Meeker, DC, MPH; Paul G. Shekelle, MD, PhD  

Spine;21(15):1746-1759 (August 1996)

[CONCLUSION:  Cervical spine manipulation and mobilization probably provide at least short-term benefits for some patients with neck pain and headaches.  Although the complication rate of manipulation is small, the potential for adverse outcomes must be considered because of the possibility of permanent impairment or death]

http://ipsapp006.lwwonline.com/content/getfile/1140/86/7/abstract.htm

 

The effectiveness of manual therapy, physiotherapy, and treatment by the general practitioner for nonspecific back and neck complaints.  A randomized clinical trial

B. W. Koes, L. M. Bouter, H. van Mameren, A. H. Essers, G. M. Verstegen, D. M. Hofhuizen, J. P. Houben, P G. Knipschild   

Spine;18(1):169-70 (January 1993)

[CONCLUSION:  Both physiotherapy and manual therapy decreased the severity of complaints more, although differences in their effectiveness could not be shown.  A substantial part of the effect of manual therapy and physiotherapy appeared to be due to nonspecific (placebo) effects]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=1531552&dopt=Citation

 

 

LOW BACK PAIN

 

Spinal Manipulative Therapy for Low back Pain

A Meta-Analysis of Effectiveness Relative to Other Therapies

Willem J.J. Assendelft, MD, PhD; Sally C. Morton, PhD; Emily I. Yu, MPH; Marika J. Suttorp, MS; and Paul G. Shekelle, MD, PhD   

Annals of Internal Medicine 2003;138:871-881 (3rd June 2003)

[CONCLUSION: No evidence that spinal manipulative therapy is superior to other standard treatments for patients with acute or chronic low back pain]

http://www.annals.org/issues/v138n11/abs/200306030-00008.html

 

A Randomized Trial of Medical Care With and Without Physical Therapy and Chiropractic care With and Without Physical Modalities for Patients With Low Back Pain: 6-month Follow-Up Outcomes From the UCLA Low Back Pain Study

Eric L. Hurwitz, DC, PhD, Hal Morgenstern, PhD, Philip Harber, MD, MPH, Gerald F. Kominski, PhD, Thomas R. Belin, PhD, Fei Yu, PhD, Alan H. Adams, DC, MS

Spine;27(20):2193-2204 (2002)

[CONCLUSION:  After 6 months of follow-up, chiropractic care and medical care for low back pain were comparable in their effectiveness]

http://www.spinejournal.org/article.asp?ISSN=0362-2436&VOL=27&ISS=20&PAGE=2193

 

Reliability of chiropractic methods commonly used to detect manipulable lesions in patients with chronic low-back pain

Simon D. French, BAppSc(Chiro), MPH, Sally Gren, BApp(Sc(Pysio), GradDip(ManipPhysio), Andrew Forbes, PhD   

Journal of Manipulative and Physiological Therapeutics Vol.23 No.4 (May 2000)

[CONCLUSION: Chiropractic diagnostic methods should not be seen by practitioners to provide reliable information in patients with chronic mechanical low-back pain]

http://www2.us.elsevierhealth.com/scripts/om.dll/serve?retrieve=/pii/S0161475400649357&

 

A Comparison of Osteopathic Spinal Manipulation with Standard Care for Patients with Low Back Pain

Gunnar B.J. Andersson, M.D., Ph.D., Tracy Lucente, M.P.H., Andre M. Davis, M.D., M.P.H., Robert E. Kappler, D.O., James A. Lipton, D.O., and Sue Leurgans, Ph.D.

The New England Journal of Medicine,  Vol.314:1426-1431 (4th November 1999)

[CONCLUSION:  Osteopathic manual care and standard medical care have similar clinical results in patients with subacute low back pain.  However, the use of medication is greater with standard care]

http://content.nejm.org/cgi/content/abstract/341/19/1426

 

***FCER Director of Research Anthony Rosner, PhD, Addresses the New England Journal of Medicine Study on Low Back Pain  (See study below)

The Foundation of Chiropractic Education and Research  FCER (14th October 1998)

[CONCLUSION:  The study is a poor representation of therapies as applied to the live patient in the physician's office]

http://www.fcer.org/html/news/cherkin1.htm

 

A Comparison of Physical Therapy, Chiropractic Manipulation, and Provision of an Educational Booklet for the Treatment of Patients with Low Back Pain

Daniel C. Cherkin, PhD, Richard A. Deyo, MD, MPH, Michele Battie, PhD, RPT, Janet Street, MN, CPNP, and William Barlow, PhD   

The New England Journal of Medicine Vol. 339:1021-1029 No.15 (8th October 1998)

[CONCLUSION: Physiotherapy and chiropractic manipulation had similar effects and costs, and patients receiving these treatments had only marginally better outcomes than those receiving an educational booklet]

http://content.nejm.org/cgi/content/abstract/339/15/1021

 

One-Year Follow-up Comparison of the Cost and Effectiveness of Chiropractic and Physiotherapy as Primary Management for Back Pain

Subgroup Analysis, Recurrence, and Additional Health Care Utilization

Elisabeth I. Skargren, RPT, PhD; Per G. Carlsson, PhD; Birgitta E. Oberg, RPT, DrMedSc  

Spine:23:1875-1883 (September 1998)

[CONCLUSION: Costs were similar, back problems often recurred, and additional health care was common]

http://ipsapp003.lwwonline.com/content/getfile/1140/39/16/abstract.htm

 

Chiropractic for low back pain

(Letters in response to study below)

British Medical Journal BMJ 1999;318:261 (23rd January 1999)

http://bmj.com/cgi/content/full/318/7178/261/a.

 

Chiropractic for low back pain

E. Ernst, W. J. J. Assendelft   

British Medical Journal BMJ 1998;317:160-160 (18th July 1998)

[CONCLUSION:  On the basis of current evidence, it seems uncertain whether chiropractic does more good than harm.  More and better research is required]

http://bmj.com/cgi/content/full/317/7152/160?ijkey=7wQYw2GEmLKyo

 

The Outcomes and Costs of Care for Acute Low Back Pain among Patients Seen by Primary Care Practitioners, Chiropractors, and Orthopedic Surgeons

Timothy S. Carey, M.D., M.P.H., Joanne Garrett, Ph.D., Anne Jackman, M.S.W., Curtis McLaughlin, D.B.A., John Fryer, Ph.D., Douglas R. Smucker, M.K., M.P.H., for the North Carolina Back Pain Project

The New England Journal of Medicine   Vol.333 :913-917  No.14  (5th October 1995)

[CONCLUSION:  Among patients with acute low back pain, the outcomes are similar whether they receive care from primary care practitioners, chiropractors, or orthopedic surgeons.  Primary care practitioners provide the least expensive care for acute low back pain]

http://content.nejm.org/cgi/content/abstract/333/14/913

 

Randomised comparison of chiropractic and hospital outpatient management for low back pain: results from extended follow up

T. W. Meade, Sandra Dyer, Wendy Browne, A. O. Frank   

British Medical Journal BMJ 1995; 311:349-351 (5th August 1995)

[CONCLUSION:  After three years results confirm the findings of an earlier report that patients treated by chiropractic derive more benefit and long term satisfaction]

http://bmj.com/cgi/content/full/311/7001/349

 

Low back pain of mechanical origin: randomised comparison of chiropractic and hospital outpatient treatment 

Meade TW, Dyer S, Browne W, Townsend J, Frank AO   

British Medical Journal BMJ 1990;300(6737):1431-7 (2nd June)

[CONCLUSION:  Chiropractic confers worthwhile, long term benefit in comparison with hospital outpatient management.  The benefit it seen mainly in those with chronic or severe pain.  Introducing chiropractic into NHS practice should be considered]   ABSTRACT ONLY AVAILABLE

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2143092&dopt=Abstract

 

 

ADVERSE EVENTS

 

***Chiropractic responses to literature regarding chiropractic and stroke

Journal of Vertebral Subluxation Research (JVSR) - Abstract chronological index:

http://www.jvsr.com/abstracts/ab_index_43.htm

 

***Chiropractic and the Risk of Stroke

World Chiropractic Alliance Position Paper

[CONCLUSION:  Based on the scientific evidence readily available today, it is clear that chiropractic adjustments pose no risk of strokes and are far safer in this regard than most medical treatments.  The World Chiropractic Alliance calls upon the medical establishment to provide factual data to the public and restrain from using scare tactics in a blatant attempt to continue its long-standing history of opposition to chiropractic and other disciplines which threaten its monopoly on the health care system]

http://www.worldchiropracticalliance.org/positions/stroke.htm

 

***Response to Vertebral Artery Dissection Study: Synopsis Paper by Smith et al .  Published in May 13th, 2003 Issue of Neurology  (See study below)

Anthony L. Rosner, PhD   

The Foundation for Chiropractic Education and Research (18th May 2003)

[CONCLUSION:  Vertebral artery dissection is both cumulative and spontaneous and mainly contributable to other factors]

http://www.fcer.org/html/News/neuroresp_detail.htm

 

***A press release in response to the 13th May 2003 Neurology article is also available on the General Chiropractic Council's website under Press Releases in the GCC Documents section   (See study below)

[CONCLUSION:  There is no evidence that neck manipulation causes stroke]

http://www.gcc-uk.org/

 

Spinal manipulative therapy is an independent risk factor for vertebral artery dissection

W. S. Smith, MD PhD, S. C. Johnston, MD PhD, E. J. Skalabrin, MD, M. Weaver, MS, P. Azari, G. W. Albers, MD and D. R. Gress, MD   

Neurology 2003;60:1424-1428 (13th May 2003)

[CONCLUSION:  Spinal manipulative therapy is independently associated with vertebral arterial dissection, even after controlling for neck pain]

http://www.neurology.org/cgi/content/short/60/9/1424

 

***VAD Following Cervical Manipulation: D.C. vs M.D. Experiences Affect Perception of Risk

The Foundation for Chiropractic Education and Research  (13th January 2003)

[CONCLUSION: The selection or referral bias is important in shaping the clinical opinions of the various disciplines and can distort discussion on the true incidence of complications of cervical manipulation]

http://www.fcer.org/html/News/dcmdVAD.htm

 

Spinal Manipulation: Its safety is uncertain

Edzard Ernst   

Canadian Medical Association Journal, CMAJ; 166 (1) (8th January 2002)

[CONCLUSION: Debatable whether the benefits of spinal manipulation outweigh its risks]

http://www.cmaj.ca/cgi/content/full/166/1/40

 

Unpredicatability of Cerebrovascular Ischemia Associated With cervical Spine Manipulation Therapy

Scott Haldeman, MD,PhD, FRCP, Frank J. Kohlbeck DC, Marion McGregor, DC, FCCS(C), MSc

Spine;27:49-55 (January 2002)

[CONCLUSION: Cerebrovascular accidents after manipulation appear to be unpredictable and should be considered an inherent, idiosyncratic, and rare complication of this treatment approach]

http://ipsapp002.lwwonline.com/content/getfile/1140/148/12/fulltext.htm

 

***Response to Rothwell Study in Stroke  (See study below)

Anthony L. Rosner, PhD   

The Foundation for Chiropractic Education and Research  FCER (27th June 2001)

[CONCLUSION: Until lifestyle risks are properly bundled into a study of proper design, the public will continue to misunderstand the true etiology of vertebrobasilar artery accidents]

http://www.fcer.org/html/News/Stroke.htm

 

Chiropractic Manipulation and Stroke

Deanna M. Rothwell, Msc; Susan J. Bondy, PhD; J. Ivan Williams, PhD   

Stroke;32:1054 (2001)

[CONCLUSION:  While analysis is consistent with a positive association in young adults, potential sources of bias are also discussed.  High quality research on risks and benefits is recommended]

http://stroke.ahajournals.org/cgi/content/abstract/32/5/1054?ijkey=3ekWz.pObjVjc

 

***Life-Threatening Complications from Spinal Manipulation are rare (See article below)

Joseph O. Di Duro, DC, DACNE 

Stroke;32:2440-a (2001)

[CONCLUSION:  It would appear to be of more benefit to the public if articles identified the genetic, environmental, and maladaptive factors, rather than hyping the rare life-threatening complications of chiropractic care]

http://stroke.ahajournals.org/cgi/content/full/32/10/2440-a

 

Life-Threatening Complications of Spinal Manipulation

E. Ernst, MD, PhD, FRCP(Edin)   

Stroke;32:809 (2001)

[CONCLUSION:  The incidence of life-threatening complications is unknown and previous estimates have all been based on assumptions which may or may not be true.  In matters of patients' safety more certainty is required through large, prospective studies]

http://stroke.ahajournals.org/cgi/content/full/32/3/809?ijkey=B1cBViHFXxaTk

 

Diaphragmatic Paralysis Following Cervical Chiropractic Manipulation

David J. Schram, MD; William Vosik, MD and David Cantral, MD, FCCP   

CHEST;119:639-640 (2001)

[CONCLUSION:  In all cases of idiopathic phrenic nerve paralysis, taking a careful history about previous chiropractic manipulation is recommended]

http://www.chestjournal.org/cgi/content/abstract/119/2/638

 

***New Study Puts Stroke From Neck Adjustment at Less than 1 in 5 Million Adjustments

(See study below)

The Foundation for Chiropractic Education and Research  FCER (22nd October 2001)

[CONCLUSION:  Due to the rarity of incidence of stroke associated with neck adjustments it is not possible for researchers to establish a meaningful rate of occurrence despite the high number of cervical adjustments that are performed]

http://www.fcer.org/html/News/CCPA-stroke.htm

 

Arterial dissections following cervical manipulation: the chiropractic experience

Scott Haldeman, Paul Carey, Murray Townsend and Costa Papadopoulos  

Canadian Medical Association Journal, CMAJ;165(7) (2nd October 2001)

[CONCLUSION:  (A Canadian review puts risk of arterial dissection at 1:5.85 million manipulations - significantly less than the estimates of 1:500,000-1,000,000 calculated by neurologists.)  The real incidence of dissection following cervical manipulation and the feasibility of screening patients can only be established by carrying out research in which both chiropractors and neurologists participate.  Failure to do so will result in confusing and conflicting information being given to patients and reduce the likelihood that these complications can be avoided]

http://www.cmaj.ca/cgi/content/full/165/7/905?ijkey=lDRBvw1r8O9aQ

 

Update from the Canadian Stroke Consortium

John W. Norris and Vadim Beletsky

Canadian Medical Association Journal, CMAJ;165(7)  (2nd October 2001)

[CONCLUSION:Collaboration with our chiropractic colleagues is crucial to understanding and resolving the association between sudden neck movement and stroke.  Blanket denial or distortion of our data from various quarters can only delay discovery of the necessary facts at the expense of the well-being of patients]

http://www.cmaj.ca/cgi/content/full/165/7/887

 

Neurological complications of cervical spine manipulation

C Stevinson, W Honan B Cooke and E. Ernst

Journal of the Royal Society of Medicine, Vol. 94, Issue 3 107-110 (2001)

[CONCLUSION:  Concern about the neurolgical complications following cervical spine manipulation appears to be justified.  A large long-term prospective study is required to determine the scale of the hazard]

http://www.jrsm.org/cgi/content/abstract/94/3/107?ijkey=TiZv1fhEJ.rSM

 

***Response to Vertebral Artery Dissection Study: Canadian Medical Association Journal

Anthony L. Rosner, PhD  (See study below)

The Foundation for Chiropractic Education and Research FCER  (10th April 2001)

[CONCLUSION:  Most if not all of the chiropractic incidents described probably represent movements of the artery in a select and high-risk group of patients which most likely would have occurred (or possibly did occur) during some everyday activity.  The challenge for chiropractors and medical practitioners alike is to be able to identify such high-risk patients in advance of their experiencing any number of lifestyle activities, in which spinal manipulation plays only an extremely limited role]

http://www.fcer.org/html/News/cmajresponse.htm

 

Sudden neck movement and cervical artery dissection

John W. Norris, Vadim Beletsky, Zurab G. Nadareishvili and on behalf of the Canadian Stroke Consortium

Canadian Medical Association Journal, CMAJ;163(1) (11th July 2000)

[CONCLUSION:  There is no doubt that chiropractic neck manipulation can result in dissection of the carotid or vertebral arteries leading to stroke.  Until a high-risk group can be identified, chiropractors should inform all patients of possible serious complications before neck manipulation]

http://www.cmaj.ca/cgi/content/full/163/1/38?ijkey=q0Ovkn8TsgfR.

 

***Response to Vertebral Artery Dissection Study: Canadian Journal of  Neurological Sciences

Anthonly L. Rosner, PhD.  (See study below)

The Foundation for Chiropractic Education and Research  FCER (22nd December 2000)

[CONCLUSION: Until the failure limits of vertebral arteries following various motions and activities are more directly measured, efforts to single out chiropractic manipulation as a significant source of vertebral artery dissections and stroke will most likely be conjectural at best, futile at worst]

http://www.fcer.org/html/News/canneur.htm

 

Vertebral Artery Dissection: Warning Symptoms, Clinical Features and Prognosis in 26 Patients

Abdullah Bin Saeed, Ashfaq Shuaib, Ghanem Al-Sulaiti and Derek Emery

The Canadian Journal of Neurological Sciences;27:292-296 (2000)

[CONCLUSION: Vertebral artery dissection is increasingly being diagnosed.  It mainly affects middle-aged persons and both sexes are equally affected.  Headache and/or neck pain are prominent features that may precede onset of stroke by several days.  Although the majority of patients will have excellent prognosis, this was less likely in patients presenting with subarachnoid hemorrhage or bilateral vertebral artery dissection.  Recurrence rate was low]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Ab stract&list_uids=20547305

 

Risk Factors and Precipitating Neck Movements Causing Vertebrobasilar Artery Dissection After Cervical Trauma and Spinal Manipulation

Scott Haldeman, MD,PhD, FRCP(C); Frank J. Kohlbeck, DC; Marion McGregor, DC; (C), MSc

Spine;24:785 (April 1999)

[CONCLUSION: Given the current status of the literature, it is impossible to advise patients or physicians about how to avoid vertebrobasilar artery dissection when considering cervical manipulation or about specific sports or exercises that result in neck movement or trauma]

http://ipsapp003.lwwonline.com/content/getfile/1140/4/10/abstract.htm

 

Dissection of the internal carotid artery after chiropractic maniupulation of the neck

M Peters, J Bohl, F Thomke K J Kallen, K Mahzahn, E Wandel and K H Meyer zum Buschenfelde

Neurology Vol.45, Issue 12 2284-2286 (1995)

[CONCLUSION:  We hypothesize that mediolytic arteriopathy was a predisposing factor for the dissection of the internal carotid artery after chiropractic manipulations in our patient]

http://www.neurology.org/cgi/content/abstract/45/12/2284?ijkey=onHjFPZk0NAEA

 

Neurologic complications following chiropractic manipulation: a survey of California neurologists

KP Lee, W G Carlini, GF McCormick and GW Albers

Neurology Vol 45. Issue 6 1213-1215 (1995)

[CONCLUSION:  Patients, physicians and chiropractors should be aware of the risk of neurologic complications associated with chiropractic manipulation]

http://www.neurology.org/cgi/content/abstract/45/6/1213?ijkey=QI55DumqYnDb2

 

 

SCREENING

 

Guidance for pre-manipulative testing of the cervical spine for vertebrobasilar insufficiency

Barker, S. MCSP Kesson M MCSP Ashmore J MCSP Turner G, MCSP,Conway J MCSP Stevens D MCSP

Physiotherapy 2001;87:318-22   Society of Orthopaedic Medicine article  (updated 14th April 2003) 

[CONCLUSION: A pre-manipulation test which is recognised by an appropriate teaching body should be applied at each treatment session which is to include cervical manipulation.  Informed consent should be gained before the testing procedure and manipulation are applied]

http://www.soc-ortho-med.org/vba.htm

 

 

CHIROPRACTIC RESEARCH

 

The Foundation for Chiropractic Education and Research (FCER)

http://www.fcer.org/Default.asp

 

Research at the Institute of Musculoskeletal Research and Clinical Implementation (IMRCI)

http://www.imrci.ac.uk/Research/research.html

 

AECC Research Projects

http://www.aecc.ac.uk/Research/proj/proj.htm

 

Dept. of Complementary Medicine, University of Exeter, UK

Complementary Medicine:  The Evidence So Far and Future Research Projects

http://www.ex.ac.uk/sshs/compmed/research/research.htm

 

 

UK CHIROPRACTIC EDUCATION

 

Anglo European College of Chiropractic

http://www.aecc.ac.uk/

 

McTimoney College

http://www.mctimoney-chiropractic.org/

 

Surrey University

http://www.surrey.ac.uk/

 

Glamorgan University

http://www.glam.ac.uk/

 

College of Chiropractors

http://www.colchiro.org.uk/index.html

 

 

UK CHIROPRACTIC REGULATORY BODY

 

General Chiropractic Council

http://www.gcc-uk.org/

 

 

UK CHIROPRACTIC ASSOCIATIONS

 

British Chiropractic Association

http://www.chiropractic-uk.co.uk/

 

Scottish Chiropractic Association

http://www.sca-chiropractic.org/index2.htm

 

McTimoney Chiropractic Association

http://www.mctimoney-chiropractic.org/

 

 

MISCELLANEOUS CHIROPRACTIC WEBSITES/ARTICLES

 

121 chiropractic articles

http://www.chiropracticresearch.org/Chiroinfo.htm

 

Subluxation

 

A Scientific Test of Chiropractic's Subluxation Theory

http://www.chirobase.org/02Research/crelin.html

 

UK Chiropractors elect new General Chiropractic Council members

http://www.thechiropracticchoice.com/TCC_June_2002/united_kingdom.htm

 

Example of a UK vitalistic subluxation-oriented chiropractor

http://www.familychiropractic.co.uk/

 

Example of a UK musculoskelatal medically-oriented chiropractor

http://www.glam.ac.uk/saps/staff/ByfieldDavid.php

 

Vaccination

 

World Chiropractic Alliance: Vaccinations and Freedom of Choice in Health Care

http://www.worldchiropracticalliance.org/Positions/vaccines.htm

 

UK Chiropractic Vaccination website

http://www.vaccination.co.uk/

 

Chiropractors Vaccination: A Historical Perspective

James B. Campbell, PhD, Jason, W. Busse, DC, MSc, and H. Stephen Injeyan, DC

Pediatrics  Vol.105 No.4 p.e43   (April 2000)

http://pediatrics.aappublications.org/cgi/content/full/105/4/e43

 

Other links

 

ChiroWatch

http://www.chirowatch.com/chiropractic-watch.html

 

Chirobase

'A Skeptical Guide to Chiropractic History, Theories, and Current Practices'

http://www.chirobase.org/

 

Chirolinks

http://www.geocities.com/healthbase/chirolinks.html

 

Chiropractic News Digest

http://www.chirobase.org/cgi-bin/mfs/25/home/sbchiro/public_html/18CND/03/index.html?11#mfs

 

 

 

MISCELLANEOUS COMPLEMENTARY THERAPIES

 

Osteopathy

 

Osteopathy in the United Kingdom (including the General Osteopathic Council)

http://www.osteopathy.org.uk/

 

Cranialsacral Therapy

 

Cranialsacral Therapy Association of the UK

http://www.craniosacral.co.uk/

 

Interexaminer Reliability and Cranial Osteopathy

Steve E. Hartman, PhD and James M. Norton PhD, College of Osteopathic Medicine, University of New England

The Scientific Reveiw of Alternative Medicine  Vol.6. No.1 (Winter 2002)

[CONCLUSION:   The assessment of the health treatment regime labeled "cranial osteopathy" or "cranialsacral therapy".  Previously published findings suggest that the proposed mechanism for cranial osteopathy is invalid and that interexaminer (and, therefore, diagnostic) reliability is approximately zero.  Since no properly randomized, blinded, and placebo-controlled outcome studies have been published, (we conclude that) cranial osteopathy should be removed from curricula of colleges of osteopathic medicine and from osteopathic licensing examinations]

http://faculty.une.edu/com/shartman/sram.pdf

 

Intraexaminer and interexaminer reliability for palpation of the cranial rhythmic impulse at the head and sacrum

Robert W. Moran, Peter Gibbons, MB, BS, DO, DM-SMed

Journal of Manipulative and Physiological Therapeutics  JMPT Vol.24, No.3 (March/April 2001)

[CONCLUSION:  The results fail to support the construct validity of the "core-link" hypothesis as it is traditionally held by proponents of cranialsacral therapy and osteopathy in the cranial field (J. Manipulative Physiol. Ther;24:183-90)]

http://www2.us.elsevierhealth.com/scripts/om.dll/serve?retrieve=/pii/S0161475401627118&

 

Homeopathy

 

British Homeopathic Association

http://www.trusthomeopathy.org/trust/tru_over.html

 

British Homeopathic Association FAQs

http://www.trusthomeopathy.org/trust/tru_faq.html

 

Faculty of Homeopathy

http://www.trusthomeopathy.org/faculty/fac_over.html

 

The Case for Homeopathy

http://www.trusthomeopathy.org/case/cas_over.html

 

A systematic review of systematic reveiws of homeopathy

E. Ernst 

British Journal of Clinical Pharmacology  Vol.54, Issue 6, Page 577   (December 2002)

[CONCLUSION:  It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice]

http://www.blackwell-synergy.com/links/doi/10.1046/j.1365-2125.2002.01699.x/abs/

 

Homeopathy use in the NHS not justified 

(News)  British Medical Journal  BMJ 2002:324:565  (9th March 2002)

http://bmj.com/cgi/content/abridged/324/7337/565/a

 

 

Acupuncture

 

British Acupuncture Council

http://www.acupuncture.org.uk/

 

Acupuncture

Andrew Vickers, Catherine Zollman

British Medical Journal  BMJ 1999;319:973-976  (9th October 1999)

[CLINICAL REVIEW]

http://bmj.com/cgi/content/full/319/7215/973

 

Other links

 

The British Complementary Medicine Association

http://www.bcma.co.uk/

 

Alternative Medicine

'The Internet's larget database of alternative medical information'

http://www.alternativemedicine.com/

 

HealthWatch

http://www.healthwatch-uk.org/

 

Quackwatch

http://www.quackwatch.org/

 

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