CHRONIC ASTHMA AND CHIROPRACTIC SPINAL MANIPULATION - A RANDOMIZED CLINICAL-TRIAL

The purpose of this randomized patient- and observer-blinded cross-ove r trial was to evaluate the efficacy of chiropractic treatment in the management of chronic asthma when combined with pharmaceutical mainten ance therapy. The trial was conducted at the National University Hospi tal's Out-patient Clinic in Copenhagen, Denmark. Thirty-one patients a ged 18-44 years participated, all suffering from chronic asthma contro lled by bronchodilators and/or inhaled steroids. Patients, or who had received chiropractic treatment for asthma within the last 5 years, wh o received oral steroids and immunotherapy, were not eligible. Patient s were randomized to receive either active chiropractic spinal manipul ative treatment or sham chiropractic spinal manipulative treatment twi ce weekly for 4 weeks, and then crossed over to the alternative treatm ent for another 4 weeks. Both phases were preceded and followed by a 2 -week period without chiropractic treatment. The main outcome measurem ents were forced expiratory volume in the first second (FEV(1)), force d vital capacity (FVC), daily use of inhaled bronchodilators, patient- rated asthma severity and non-specific bronchial reactivity (n-BR). Us ing the cross-over analysis, no clinically important or statistically significant differences were found between the active and sham chiropr actic interventions on any of the main or secondary outcome measures. Objective lung function did not change during the study, but over the course of the study, non-specific bronchial hyperreactivity (n-BR) imp roved by 36% (P = 0.01) and patient-rated asthma severity decreased by 34% (P = 0.0002) compared with the baseline values. The results do no t support the hypothesis that chiropractic spinal manipulative therapy is superior to sham spinal manipulation in the management of pharmace utically controlled chronic asthma in adults when administered twice w eekly for 4 weeks.