BACKGROUND: In the midst of the coronavirus pandemic, the International Chiropractors Association (ICA) posted reports claiming that chiropractic care can impact the immune system. These claims clash with recommendations from the World Health Organization and World Federation of Chiropractic. We discuss the scientific validity of the claims made in these ICA reports. MAIN BODY: We reviewed the two reports posted by the ICA on their website on March 20 and March 28, 2020. We explored the method used to develop the claim that chiropractic adjustments impact the immune system and discuss the scientific merit of that claim. We provide a response to the ICA reports and explain why this claim lacks scientific credibility and is dangerous to the public. More than 150 researchers from 11 countries reviewed and endorsed our response. CONCLUSION: In their reports, the ICA provided no valid clinical scientific evidence that chiropractic care can impact the immune system. We call on regulatory authorities and professional leaders to take robust political and regulatory action against those claiming that chiropractic adjustments have a clinical impact on the immune system.
In: Côté , P , Bussières , A , Cassidy , J D , Hartvigsen , J , Kawchuk , G N , Leboeuf-Yde , C , Mior , S , Schneider , M & 140 signatories# call for an end to pseudoscientific claims on the effect of chiropractic care on immune function 2020 , ' A united statement of the global chiropractic research community against the pseudoscientific claim that chiropractic care boosts immunity ' , Chiropractic and Manual Therapies , vol. 28 , no. 1 , 21 . https://doi.org/10.1186/s12998-020-00312-x
Background: In the midst of the coronavirus pandemic, the International Chiropractors Association (ICA) posted reports claiming that chiropractic care can impact the immune system. These claims clash with recommendations from the World Health Organization and World Federation of Chiropractic. We discuss the scientific validity of the claims made in these ICA reports. Main body: We reviewed the two reports posted by the ICA on their website on March 20 and March 28, 2020. We explored the method used to develop the claim that chiropractic adjustments impact the immune system and discuss the scientific merit of that claim. We provide a response to the ICA reports and explain why this claim lacks scientific credibility and is dangerous to the public. More than 150 researchers from 11 countries reviewed and endorsed our response. Conclusion: In their reports, the ICA provided no valid clinical scientific evidence that chiropractic care can impact the immune system. We call on regulatory authorities and professional leaders to take robust political and regulatory action against those claiming that chiropractic adjustments have a clinical impact on the immune system.
LAY SUMMARY Spinal pain is responsible for a large proportion of pain and disability in the Canadian Armed Forces (CAF). The authors developed and implemented a program of care (PoC) that included communication strategies and care pathways supporting chiropractic care for CAF personnel with spine-related problems. The authors tested the feasibility of implementing the PoC on two select CAF bases and found that it was feasible to implement, with a high rate of completion of patient outcomes, adherence to clinical pathways, and enhanced interprofessional communication and reporting. Participants reported satisfaction with the program. Successful implementation of a PoC could provide guidance and support for interprofessional collaborative care for CAF personnel with spine-related pain.
In: Côté , P , Hartvigsen , J , Leboeuf-Yde , C , Corso , M , Shearer , H , Wong , J , Marchand , A-A , French , S , Kawchuk , G N , Mior , S , Poulsen , E , Srbely , J , Ammendolia , C , Blanchette , M-A , Busse , J W , Bussières , A , Cancelliere , C , Christensen , H W , De Carvalho , D , De Luca , K , Du Rose , A , Eklund , A , Engel , R , Goncalves , G , Hebert , J , Hincapié , C A , Kimpton , A , Lauridsen , H H , Innes , S , Meyer , A-L , Newell , D , O'Neill , S , Pagé , I , Passmore , S , Perle , S M , Quon , J , Rezai , M , Stupar , M , Swain , M , Vitello , A , Weber , K , Young , K J & Yu , H 2021 , ' The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature ' , Chiropractic & Manual Therapies , vol. 29 , 8 . https://doi.org/10.1186/s12998-021-00362-9
Background: A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial. Objectives: We convened a Global Summit of international scientists to conduct a systematic review of the literature to determine the efficacy and effectiveness of SMT for the primary, secondary and tertiary prevention of non-musculoskeletal disorders. Global summit: The Global Summit took place on September 14–15, 2019 in Toronto, Canada. It was attended by 50 researchers from 8 countries and 28 observers from 18 chiropractic organizations. At the summit, participants critically appraised the literature and synthesized the evidence. Systematic review of the literature: We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health, and the Index to Chiropractic Literature from inception to May 15, 2019 using subject headings specific to each database and free text words relevant to manipulation/manual therapy, effectiveness, prevention, treatment, and non-musculoskeletal disorders. Eligible for review were randomized controlled trials published in English. The methodological quality of eligible studies was assessed independently by reviewers using the Scottish Intercollegiate Guidelines Network (SIGN) criteria for randomized controlled trials. We synthesized the evidence from articles with high or acceptable methodological quality according to the Synthesis without Meta-Analysis (SWiM) Guideline. The final risk of bias and evidence tables were reviewed by researchers who attended the Global Summit and 75% (38/50) had to approve the content to reach consensus. Results: We retrieved 4997 citations, removed 1123 duplicates and screened 3874 citations. Of those, the eligibility of 32 articles was evaluated at the Global Summit and 16 articles were included in our systematic review. Our synthesis included six randomized controlled trials with acceptable or high methodological quality (reported in seven articles). These trials investigated the efficacy or effectiveness of SMT for the management of infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. None of the trials evaluated the effectiveness of SMT in preventing the occurrence of non-musculoskeletal disorders. Consensus was reached on the content of all risk of bias and evidence tables. All randomized controlled trials with high or acceptable quality found that SMT was not superior to sham interventions for the treatment of these non-musculoskeletal disorders. Six of 50 participants (12%) in the Global Summit did not approve the final report. Conclusion: Our systematic review included six randomized clinical trials (534 participants) of acceptable or high quality investigating the efficacy or effectiveness of SMT for the treatment of non-musculoskeletal disorders. We found no evidence of an effect of SMT for the management of non-musculoskeletal disorders including infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. This finding challenges the validity of the theory that treating spinal dysfunctions with SMT has a physiological effect on organs and their function. Governments, payers, regulators, educators, and clinicians should consider this evidence when developing policies about the use and reimbursement of SMT for non-musculoskeletal disorders.
Abstract Background A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial. Objectives We convened a Global Summit of international scientists to conduct a systematic review of the literature to determine the efficacy and effectiveness of SMT for the primary, secondary and tertiary prevention of non-musculoskeletal disorders. Global summit The Global Summit took place on September 14–15, 2019 in Toronto, Canada. It was attended by 50 researchers from 8 countries and 28 observers from 18 chiropractic organizations. At the summit, participants critically appraised the literature and synthesized the evidence. Systematic review of the literature We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health, and the Index to Chiropractic Literature from inception to May 15, 2019 using subject headings specific to each database and free text words relevant to manipulation/manual therapy, effectiveness, prevention, treatment, and non-musculoskeletal disorders. Eligible for review were randomized controlled trials published in English. The methodological quality of eligible studies was assessed independently by reviewers using the Scottish Intercollegiate Guidelines Network (SIGN) criteria for randomized controlled trials. We synthesized the evidence from articles with high or acceptable methodological quality according to the Synthesis without Meta-Analysis (SWiM) Guideline. The final risk of bias and evidence tables were reviewed by researchers who attended the Global Summit and 75% (38/50) had to approve the content to reach consensus. Results We retrieved 4997 citations, removed 1123 duplicates and screened 3874 citations. Of those, the eligibility of 32 articles was evaluated at the Global Summit and 16 articles were included in our systematic review. Our synthesis included six randomized controlled trials with acceptable or high methodological quality (reported in seven articles). These trials investigated the efficacy or effectiveness of SMT for the management of infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. None of the trials evaluated the effectiveness of SMT in preventing the occurrence of non-musculoskeletal disorders. Consensus was reached on the content of all risk of bias and evidence tables. All randomized controlled trials with high or acceptable quality found that SMT was not superior to sham interventions for the treatment of these non-musculoskeletal disorders. Six of 50 participants (12%) in the Global Summit did not approve the final report. Conclusion Our systematic review included six randomized clinical trials (534 participants) of acceptable or high quality investigating the efficacy or effectiveness of SMT for the treatment of non-musculoskeletal disorders. We found no evidence of an effect of SMT for the management of non-musculoskeletal disorders including infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. This finding challenges the validity of the theory that treating spinal dysfunctions with SMT has a physiological effect on organs and their function. Governments, payers, regulators, educators, and clinicians should consider this evidence when developing policies about the use and reimbursement of SMT for non-musculoskeletal disorders.
In: Côté , P , Bussières , A , Cassidy , J D , Hartvigsen , J , Kawchuk , G N , Leboeuf-Yde , C , Mior , S , Schneider , M , Aillet , L , Ammendolia , C , Arnbak , B , Axen , I , Baechler , M , Barbier-Cazorla , F , Barbier , G , Bergstrøm , C , Beynon , A , Blanchette , M A , Bolton , P S , Breen , A , Brinch , J , Bronfort , G , Brown , B , Bruno , P , Konner , M B , Burrell , C , Busse , J W , Byfield , D , Campello , M , Cancelliere , C , Carroll , L , Cedraschi , C , Chéron , C , Chow , N , Christensen , H W , Claussen , S , Corso , M , Davis , M A , Demortier , M , De Carvalho , D , De Luca , K , De Zoete , A , Doktor , K , Downie , A , Du Rose , A , Eklund , A , Engel , R , Erwin , M , Eubanks , J E , Evans , R , Evans , W , Fernandez , M , Field , J , Fournier , G , French , S , Fuglkjaer , S , Gagey , O , Giuriato , R , Gliedt , J A , Goertz , C , Goncalves , G , Grondin , D , Gurden , M , Haas , M , Haldeman , S , Harsted , S , Hartvigsen , L , Hayden , J , Hincapié , C , Hébert , J J , Hesby , B , Hestbæk , L , Hogg-Johnson , S , Hondras , M A , Honoré , M , Howarth , S , Injeyan , H S , Innes , S , Irgens , P M , Jacobs , C , Jenkins , H , Jenks , A , Jensen , T S , Johhansson , M , Kongsted , A , Kopansky-Giles , D , Kryger , R , Lardon , A , Lauridsen , H H , Leininger , B , Lemeunier , N , Le Scanff , C , Lewis , E A , Linaker , K , Lothe , L , Marchand , A A , McNaughton , D , Meyer , A L , Miller , P , Mølgaard , A , Moore , C , Murphy , D R , Myburgh , C , Myhrvold , B , Newell , D , Newton , G , Nim , C , Nordin , M , Nyiro , L , O'Neill , S , Øverås , C , Pagé , I , Pasquier , M , Penza , C W , Perle , S M , Picchiottino , M , Piché , M , Poulsen , E , Quon , J , Raven , T , Rezai , M , Roseen , E J , Rubinstein , S , Salmi , L R , Schweinhardt , P , Shearer , H M , Sirucek , L , Sorondo , D , Stern , P J , Stevans , J , Stochkendahl , M J , Stuber , K , Stupar , M , Srbely , J , Swain , M , Teodorczyk-Injeyan , J , Théroux , J , Thiel , H , Uhrenholt , L , Verbeek , A , Verville , L , Vincent , K , Dan Wang , A L , Weber , K A , Whedon , J M , Wong , J , Wuytack , F , Young , J , Yu , H & Ziegler , D 2020 , ' A united statement of the global chiropractic research community against the pseudoscientific claim that chiropractic care boosts immunity ' , Chiropractic and Manual Therapies , vol. 28 , no. 1 , 21 . https://doi.org/10.1186/s12998-020-00312-x
Background: In the midst of the coronavirus pandemic, the International Chiropractors Association (ICA) posted reports claiming that chiropractic care can impact the immune system. These claims clash with recommendations from the World Health Organization and World Federation of Chiropractic. We discuss the scientific validity of the claims made in these ICA reports. Main body: We reviewed the two reports posted by the ICA on their website on March 20 and March 28, 2020. We explored the method used to develop the claim that chiropractic adjustments impact the immune system and discuss the scientific merit of that claim. We provide a response to the ICA reports and explain why this claim lacks scientific credibility and is dangerous to the public. More than 150 researchers from 11 countries reviewed and endorsed our response. Conclusion: In their reports, the ICA provided no valid clinical scientific evidence that chiropractic care can impact the immune system. We call on regulatory authorities and professional leaders to take robust political and regulatory action against those claiming that chiropractic adjustments have a clinical impact on the immune system.
