Chiropractic care for nonmusculoskeletal conditions: a systematic review with implications for whole systems research

  • Hawk C
  • Khorsan R
  • Lisi A
 et al. 
  • 1

    Readers

    Mendeley users who have this article in their library.
  • N/A

    Citations

    Citations of this article.

Abstract

OBJECTIVES: (1) To evaluate the evidence on the effect of chiropractic care, rather than spinal manipulation only, on patients with nonmusculoskeletal conditions; and (2) to identify shortcomings in the evidence base on this topic, from a Whole Systems Research perspective. DESIGN: Systematic review. METHODS: Databases included were PubMed, Ovid, Mantis, Index to Chiropractic Literature, and CINAHL. Search restrictions were human subjects, peer-reviewed journal, English language, and publication before May 2005. All randomized controlled trials (RCTs) were evaluated using the Scottish Intercollegiate Guidelines Network (SIGN) and Jadad checklists; a checklist developed from the CONSORT (Consolidated Standards of Reporting Trials) guidelines; and one developed by the authors to evaluate studies in terms of Whole Systems Research (WSR) considerations. RESULTS: The search yielded 179 papers addressing 50 different nonmusculoskeletal conditions. There were 122 case reports or case series, 47 experimental designs, including 14 RCTs, 9 systematic reviews, and 1 a large cohort study. The 14 RCTs addressed 10 conditions. Six RCTs were rated "high" on the 3 conventional checklists; one of these 6 was rated "high" in terms of WSR considerations. CONCLUSIONS: (1) Adverse effects should be routinely reported. For the few studies that did report, adverse effects of spinal manipulation for all ages and conditions were rare, transient, and not severe. (2) Evidence from controlled studies and usual practice supports chiropractic care (the entire clinical encounter) as providing benefit to patients with asthma, cervicogenic vertigo, and infantile colic. Evidence was promising for potential benefit of manual procedures for children with otitis media and elderly patients with pneumonia. (3) The RCT design is not necessarily incompatible with WSR. RCTs could improve generalizability by basing protocols on usual practice. (4) Case reports could contribute more to WSR by increasing their emphasis on patient characteristics and patient-based outcomes. (5) Chiropractic investigators, practitioners, and funding agencies should increase their attention to observational designs

Author-supplied keywords

  • 1
  • Acute Disease
  • Asthma
  • CARE
  • CASE REPORT
  • CASE SERIES
  • CHIROPRACTIC
  • CONTROLLED TRIAL
  • CONTROLLED TRIALS
  • Chronic Disease
  • Cohort Studies
  • Colic
  • Controlled
  • Controlled Clinical Trials as Topic
  • Elderly
  • Evidence-Based Medicine
  • Follow-Up Studies
  • Guidelines
  • HUMANS
  • IN
  • INDEX
  • IS
  • Language
  • Large
  • METHODS
  • Manipulation,Chiropractic
  • OUTCOMES
  • PATIENT
  • PATIENT CHARACTERISTICS
  • PERSPECTIVE
  • Paper
  • RANDOMIZED CONTROLLED TRIAL
  • RANDOMIZED CONTROLLED TRIALS
  • RESEARCH
  • Restriction
  • SPINAL MANIPULATION
  • Sign
  • Support
  • Systematic reviews
  • TO
  • TRIAL
  • TRIALS
  • Vertigo
  • adverse
  • adverse effects
  • age
  • attention
  • children
  • clinical
  • effect
  • effects
  • evidence
  • experimental
  • human
  • im
  • manipulation
  • method
  • outcome
  • physical examination
  • potential
  • rct
  • research design
  • review
  • spinal
  • standards
  • system
  • systematic review
  • systems
  • the
  • therapy
  • thi

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document

  • PMID: 17604553

Authors

  • C Hawk

  • R Khorsan

  • A J Lisi

  • R J Ferrance

  • M W Evans

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free