> Please describe this possible variant of normal asthma in a small
sample and
> how spinal manipulation can alter its natural history
?
> Preston H. Long
I can't because I have not seen it. I believe that there are three
reasonable explanations for how an asthma patient can appear to have a
positive outcome after manipulative care.
1. As you had suggested a temporary remission that is natural
history.
2. Placebo
3. A variant of normal asthma that does respond to
manipulation.
Maybe there is another explanation but there are cases that chiropractors,
osteopaths, and medical doctors who use manipulation have described of patients
seemingly "cured" of asthma after manipulation. I suspect that the
responders (if there is such a group) are very small percentage of the asthma
population. I do not believe that there is a way, at this point in time,
to determine who these patients are prior to treatment. I believe that
this is worthy of research to determine if these patients actually do respond to
manipulation or instead just spontaneously go into temporary or permanent
remission or respond to placebo.
Although there have been a few studies which have found that
manipulation is no better than placebo (1-3). I know that others are
underway.
Remember this was started by my question how does one convince both doctor
and patient that the effect that they believe they have observed (profound
improvement in symptoms and elimination of any medication to control the asthma)
that this is only placebo or natural history.
1. Bronfort G, Evans RL, Kubic P, Filkin P. Chronic pediatric asthma and
chiropractic spinal manipulation: A prospective clinical series and randomized
clinical pilot study. J Manipulative Physiol Ther 2001;24(6):369-77.
2. Balon J, Aker PD, Crowther ER, Danielson C, Cox PG, O'Shaughnessy D, et
al. A comparison of active and simulated chiropractic manipulation as adjunctive
treatment for childhood asthma. N Engl J Med 1998;339(15):1013-20.
3. Nielsen N, Bronfort G, Bendix T, Madsen F, Weeke B. Chronic asthma and
chiropractic spinal manipulation: a randomized clinical trial. Clin Exper
Allergy 1995;25:80-88.
_____________________________________________
Stephen M. Perle, D.C.
Associate Professor of Clinical Sciences
University of Bridgeport College of Chiropractic
Bridgeport, CT 06601
www.bridgeport.edu/~perle
______________________________________________
"Be ashamed to die until
you have achieved some
victory for humanity."
Horace Mann