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Top Research of 2019

By: Dr. Jonathan Verderame

Its that time of year again! Youtube has there yearly “rewind” and so do we! Ive scoured the published literature once again so that you too are up to date, and dont have to (although I implore you to not only read the abstracts!).

This year brought more fascinating articles from the indexed literature, that reveal the importance of the neural integrity and the detrimental effects of spinal allostasis. Lets be clear, this is a list of the top published RESEARCH and not the top “chiropractic research.” These are the studies of 2019 that I see as having clinical and professional significance. If you are not already a subscriber of McCoy Press, you should be. This is the number 1 place to get chiropractic research.

https://www.vertebralsubluxationresearch.com/

With that, lets dive in!

10.”Spinal Manipulative Therapy Effects in Autonomic Regulation and Exercise Performance in Recreational Healthy Athletes A Randomized Controlled Trial” Spine.

It is great to see a non pain treatment article focused on performance. This is the type of direction chiropractic research should head. Chiropractic research should focus primarily on  ergogenic effects (performance enhancing) rather than pain treatment. Although a small sample size, this was a  randomized, double blind, parallel groups, sham-controlled trial using heart rate variability and looking at handgrip strength, jumping ability, and cycling performance. From the conclusion: “A single pre-exercise SMT session induced an acute shift toward parasympathetic dominance and slightly impaired performance in recreational healthy athletes.”

9.Maternal Report of Outcomes of Chiropractic Care for Infants. JMPT

With the controversy in Australia concerning the care of children heating up, this article was very timely. Coming out of the AECC of all places, they investigated 16 clinic in the UK with a total of 2001 completed questioners. Im not sure why its only mothers that take there children to the chiropractor, or if this is of some significance, nonetheless they concluded: “mothers reported that chiropractic care for their infants was effective, safe, and cost-effective.”  “82% reported definite improvement”

8. Proposed Neurobiological Processes Associated with Models of Vertebral Subluxation: Dysafferentation,Dyskinesia, Dysponesis, Dysautonomia, Neuroplasticity and Ephaptic Transmission. Archives in Neurology & Neuroscience

The author is none other then the legend Dr. Christopher Kent. It is a breath of fresh air to see an actual CHIROPRACTIC article published in the indexed literature focusing on the salutogenic aspects of chiropractic. A well written article that even references Stephenson. Check out the conclusion, wow!

“Correction or reduction of vertebral subluxation facilitates the restoration of proper tone throughout the nervous system. Alterations in the tone of the somatic system may be objectively evaluated using surface EMG. Altered autonomic tone may be evaluated using skin temperature measurements. Changes in ranges of motion may be measured to assess dyskinesia. Such objective assessments have the potential to make correction of vertebral subluxation an important strategy in salutogenic healthcare. Additional research in this area may lead to improved

clinical strategies.”

7. Effect of cervical manipulation on vertebral artery and cerebral haemodynamics in patients with chronic neck pain: a crossover randomised controlled trial. British Medical Journal

This MRI comparison study investigated the continued false rhetoric of a causal relationship with chiropractic adjustments and cerebrovascular accidents. An absolutely ridiculous article was published last year in the Korean J. Neurotrauma, claiming posterior Inferior Cerebellar Artery Infarction after cervical chiropractic adjustment. The letter to the editor published this year brought light to the issue. The continued problem I see with these claims is that most of these accidents are not even performed by chiropractors. Read the response HERE.

The BMJ article for our number 7 spot above writes that: “changes observed were found to not be clinically meaningful and suggests that cervical manipulation may not increase the risk of cerebrovascular events through a haemodynamic mechanism.”

6. Effect of chiropractic manipulative therapy on reaction time in special operations forces military personnel: a randomized controlled trial.

This is an impressive study. It is another performance based invstigation, on asymptomatic patients from Palmer College. 77 active US military special operation forces participated in this study. The outcomes measured included simple hand/foot reaction time, choice reaction time, and whole-body response time. While very few adjustment were delivered in total, they found that: “A single session of CMT was shown to have an immediate effect of reducing the time required for asymptomatic SOF qualified personnel to complete a complex whole-body motor response task.”

5.The effects of a single session of chiropractic care on strength, cortical drive, and spinal excitability in stroke patients. Scientific Reports

Drs. Kelly Holt and Heidi Haavik did it again! This is an absolutely incredible article, as it flips the entire fraudulent chiropractic stroke myth on its head. “The objective of this study was to investigate whether a single session of chiropractic care could increase strength in weak plantar flexor muscles in chronic stroke patients.” They discovered that plantarflexion muscle strength increased by 64.2% following a chiropractic care session. The word subluxation was even used twice in this study!

4.Increase in cerebral blood flow indicated by increased cerebral arterial area and pixel intensity on brain magnetic resonance angiogram following correction of cervical lordosis. Brain Circulation

The lead authors Drs. Evan and Seana Katz have produced outstanding work in this piece of literature. Using magnetic resonance angiogram they discovered that “correction of cervical lordosis may be associated with an immediate increase in cerebral blood flow.” So while blood flow in the vertebral artery is not effected, cerebral flow is increased.

3. Spinal manipulation therapy: Is it all about the brain? A current review of the neurophysiological effects of manipulation. Journal of Integrative Medicine.

This article is a very well written overview of many of the pathways, mechanisms and theories on just how spinal correction affects the brain. Specifically neuromuscular, autonomic, neuroendocrine and hypoalgesic topics were reviewed. Of course they ar suggesting that a long-term double-blind randomized trial with sham interventions and/or placebo as control are required, but when is enough research going to be enough?

2. Repeat Radiography in Monitoring Structural Changes in the Treatment of Spinal Disorders in Chiropractic and Manual Medicine Practice: Evidence and Safety. Dose Response

The importance of imaging in chiropractic cannot be stressed enough and I cannot fathom not utlizing spinal imaging in my practice. Its great to see the word subluxation being publlished in high indexed medical journals! Perhaps we wont be afraid of the “S” word anymore? Great work from the CBP crew and Axiom presenter Dr. Deed Harrison!

From the article:  “Low-dose radiation from repeated X-ray imaging in treating subluxated patients is substantially below the known threshold for harm and is within background radiation exposures…It is safe when used in a repeated fashion for quantifying pre–post spine and postural subluxation and deformity patterns in the practice of structural correction methods by chiropractic and other manual medicine practices.”

1. The Chiropractic Vertebral Subluxation Part 1: Introduction. J. Chiropractic Humanities

This was a great year for Dr. Simon Senzon! We are grateful for his contributions to the literature. The 10 part series offers width and depth to the interpretation of history and development of chiropractic vertebral subluxation theories. This is a comprehensive overview of the Chiropractic Vertebral Subluxation from 1897, and dives into a range of issues and early theories, and how it is applicable to current investigations.

“Some suggest that CVS should be a historical term only. I suggest that this may be a difficult position to maintain because a majority of practitioners are content to keep the term, and many chiropractors state that they address CVS in practice. For example, 62% of students in North America sampled in 1 study agreed that the emphasis of chiropractic practice is to eliminate CVS. Several institutions support definitions of CVS. Some are actively researching and publishing on CVS. It is the diagnosis chiropractors in the United States use for Medicare billing, and textbooks from the last decade use the term subluxation. At least 2 consensus statements were developed in the 1990s, embracing CVS as a foundation of the profession.

I propose that some of the arguments against the use of CVS terminology are based on references that may contain factual errors and literature oversights”

Honourable Mentions

Molecular foundations of chiropractic therapy. Acta Biomed

“Today chiropractic care is available in over 100 countries, most of which have established national chiropractic associations. To the best of our knowledge, no studies regarding inter-action between neurotrophin gene polymorphisms and chiropractic  have  been  published;  such  studies  could  be interesting for understanding whether certain poly-morphisms  predispose  for  response  to  chiropractic… Different authors suggest that individuals with genetic variants  associated  with  neuroplasticity  may  respond  better to therapies involving neuroplastic processes than individuals without such variants”

The Scoliosis Quandary: Are Radiation Exposures From Repeated X-Rays Harmful? Dose Response

“Since data indicate reduced cancer rates in a cohort receiving a total radiation dose between 50 and 300 mGy, it is unlikely that scoliosis patients would get cancer from repeated X-rays. Moreover, since the threshold for leukemia is about 1100 mGy, scoliosis patients will not likely develop cancers from spinal X-rays. Scoliosis patients likely have long-term health consequences, including cancers, from the actual disease entity itself and not from protracted X-ray radiation exposures that are essential and indeed safe.”

Self Manipulated Cervical Spine Leads to Posterior Disc Herniation and Spinal Stenosis. Brain Sciences

“The authors report a case in which a 38-year-old male who presented himself to the emergency department with a chief complaint of cervical neck pain and paresthesia radiating from the right pectoral region down his distal right arm following self-manipulation of the patient’s own cervical vertebrae”

Was not happy with the conclusion on this one, but could provide evidence that specificity is important!

Pilot comparative study on the health of vaccinated and unvaccinated 6- to 12-year-old U.S. children. Journal of Translational Science

“(V)accinated homeschool children were found to have a higher rate of allergies and NDD than unvaccinated homeschool children”

This is a historic article for the first time I am aware of that is comparing the 2 groups, as all previous attempts have stated it is unethical to perform such study. The vaccine topic was hot this year, and it was great to see Dr. Liam Schubel on the front lines. This is not a chiropractic issue, rather a human issues, and the reason this is included in the honourable mentions is that vaccines have been discussed at length by our founder. Furthermore, you should be up to date on current evidence, and although I never discuss vaccines with my patients I do from time to time when asked to have them read certain articles so they are informed.

Cost-Efficiency and Effectiveness of Including Doctors of Chiropractic to Offer Treatment Under Medicaid: A Critical Appraisal of Missouri Inclusion of Chiropractic Under Missouri Medicaid. J Chiropr Humanit.

“Policymakers may unintentionally rely on flawed assumptions and methodologies such as static scoring, which we propose results in flawed conclusions…we found that (1) chiropractic care provides better outcomes at lower cost, (2) chiropractic treatment and care leads to a reduction in cost of spinal surgery, and (3) chiropractic care leads to cost savings from reduced use and abuse of opioid prescription drugs.”

Reflex Responses of Neck, Back, and Limb Muscles to High-Velocity, Low-Amplitude Manual Cervical and Upper Thoracic Spinal Manipulation of Asymptomatic Individuals-A Descriptive Study. J Manipulative Physiol Ther.

The power of upper cervical!

“Reflex responses were greatest after upper cervical SMT and lowest with thoracic SMT”

Chiropractic maintenance care - what's new? A systematic review of the literature. Chiropr Man Therap.

“There is reasonable consensus among chiropractors on what Maintenance Care is, how it should be used, and its indications. Presently, Maintenance Care can be considered an evidence-based method”

Increased Voluntary Activation of the Elbow Flexors Following a Single Session of Spinal Manipulation in a Subclinical Neck Pain Population. Brain Sci.

“Voluntary activation of the elbow flexors increased immediately after one session of spinal manipulation in participants with subclinical neck pain. A decrease in the amplitude of superimposed twitch during elbow flexion MVC following spinal manipulation suggests a facilitation of motor cortical output.”

Exposure to a Motor Vehicle Collision and the Risk of Future Neck Pain: A Systematic Review and Meta-Analysis. PM R

Spinal Manipulation Therapy Improves Tactile Allodynia and Peripheral Nerve Functionality and Modulates Blood Oxidative Stress Markers in Rats Exposed to Knee-Joint Immobilization. J Manipulative Physiol Ther.

Dr. Jonathan Verderame

Founder Axiom Seminar