Chronic asthma and chiropractic spinal manipulation: a randomized clinical trial

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Abstract
Summary: The purpose of this randomized patient‐ and observer‐blinded cross‐over trial was to evaluate the efficacy of chiropractic treatment in the management of chronic asthma when combined with pharmaceutical maintenance therapy. The trial was conducted at the National University Hospital's Out‐patient Clinic in Copenhagen, Denmark. Thirty‐one patients aged 18–44 years participated, all suffering from chronic asthma controlled by bronchodilators and/or inhaled steroids. Patients, or who had received chiropractic treatment for asthma within the last 5 years, who received oral steroids and immunotherapy, were not eligible. Patients were randomized to receive either active chiropractic spinal manipulative treatment or sham chiropractic spinal manipulative treatment twice weekly for 4 weeks, and then crossed over to the alternative treatment for another 4 weeks. Both phases were preceded and followed by a 2‐week period without chiropractic treatment. The main outcome measurements were forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), daily use of inhaled bronchodilators, patient‐rated asthma severity and non‐specific bronchial reactivity (n‐BR). Using the cross‐over analysis, no clinically important or statistically significant differences were found between the active and sham chiropractic 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) improved by 36% (P= 0.01) and patient‐rated asthma severity decreased by 34% (P= 0.0002) compared with the baseline values. The results do not support the hypothesis that chiropractic spinal manipulative therapy is superior to sham spinal manipulation in the management of pharmaceutically controlled chronic asthma in adults when administered twice weekly for 4 weeks.

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