Upper Cervical Chiropractic Care For A Nine-Year-Old Male With Tourette Syndrome, Attention Deficit Hyperactivity Disorder, Depression, Asthma, Insomnia, and Headaches: A Case Report
By Erin Elster, DC

[JSVR, July 12, 2003, pp. 1-11]

Objective: To review the effectiveness of chiropractic care using an upper cervical technique in the case of a nine-year old male who presented with Tourette Syndrome (TS), Attention Deficit Hyperactivity Disorder (ADHD), depression, asthma, insomnia, and headaches.

Clinical Features: This nine-year-old boy suffered from asthma and upper respiratory infections since infancy; headaches since age 6; TS, ADHD, depression and insomnia since age 7; and neck pain since age 8. His mother reported the use of forceps during his delivery. His medications included Albuterol, Depakote, Wellbutrin, and Adderall. Intervention: During the patient’s initial examination, evidence of a subluxation stemming from the upper cervical spine was found through thermographic and radiographic diagnostics. Chiropractic care using an upper cervical technique was administered to correct and stabilize the patient’s upper neck injury. Diagnostics and care were performed in accordance with the guidelines of the International Upper Cervical Chiropractic Association.

Outcome: Evaluation of the patient’s condition occurred through doctor’s observation, patient’s and parents’ subjective description of symptoms, and thermographic scans. After six weeks of care, all six conditions were no longer present and all medications were discontinued with the exception of a half-dose of Wellbutrin. At the conclusion of his case at five months, all symptoms remained absent.

Conclusion: The onset of symptoms soon after the boy’s delivery; the immediate reduction in symptoms correlating with the initiation of care; and the complete absence of symptoms within six weeks of care; suggest a link between the patient’s traumatic birth, the upper cervical subluxation, and his neurological conditions. Further investigation into upper cervical trauma as a contributing factor to Tourette Syndrome, ADHD, depression, insomnia, headaches, and asthma should be pursued.

Key Terms: upper cervical spine, chiropractic, Tourette Syndrome, depression, asthma, Attention Deficit Hyperactivity Disorder, headaches, trauma, thermography

Attention Deficit Hyperactivity Disorder and the Triad of Health
By Tracy A. Barnes, D.C., D.I.C.C.P.

Objective: To provide a literature review of the multiple etiologies for attention deficit problems in children and to examine alternative non-pharmacological treatment options for children with attention deficit hyperactivity disorder.

Method: Attention deficit hyperactivity disorder (ADHD) has been estimated to affect approximately 3.5 million American children. The primary medical intervention involves the prescription of the psychostimulant drug methylphenidate. It has been estimated that the number of children being treated with psychostimulant medication for ADHD doubles every two years. A literature review was undertaken examining recent references from the Medline database, together with other references from alternative sources, such as Chirolars database, conference proceedings and the Internet. Possible etiologies for ADHD are discussed and classified into physical, chemical and mental categories. Alternative treatment options, identified from the literature search, are discussed.

Conclusion: ADHD refers to a combination of symptoms encompassing inattention, impulsiveness, and hyperactivity. The behavior exhibited by the child with ADHD is usually seen as being disruptive and unacceptable by parents and teachers, and the child may be socially handicapped as a result. Traditionally, the treatment of ADHD had relied on behavior techniques and psychostimulant medication. In planning an appropriate treatment program for the child with ADHD, it is important to consider learning disability and hyperactivity separately. Since ADHD is strongly associated with learning disabilities, its treatment should be based on educational intervention, not drug therapy. The doctor of chiropractic can play a significant role in the care of children with ADHD by assessing all aspects of a childs problem and working to restore balance to the physical, chemical, and mental aspects of the child's life. although the doctor of chiropractic may not be an expert in all areas of care for the ADHA child, it is important to recognize this interplay of structural, chemical and mental influences to provide appropriate chiropractic evaluation and care and to consult with an interdisciplinary health care management team, when necessary. (JCCP, Volume 1, No. 2, April 1996)

Effects of diphtheria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States
By Eric L. Hurwitz, DC, PhD and Hal Morgenstern, PhD

Background: Findings from animal and human studies confirm that diphtheria and tetanus toxoids and pertussis (DTP) and tetanus vaccinations induce allergic responses; associations between childhood vaccinations and subsequent allergies have been reported recently.

Objective: The association of DTP or tetanus vaccination with allergies and allergy-related respiratory symptoms among children and adolescents in the United States was assessed.

Methods: Data were used from the Third National Health and Nutrition Examination Survey on infants aged 2 months through adolescents aged 16 years. DTP or tetanus vaccination, lifetime allergy history, and allergy symptoms in the past 12 months were based on parental or guardian recall. Logistic regression modeling was performed to estimate the effects of DTP or tetanus vaccination on each allergy.

Results: The odds of having a history of asthma was twice as great among vaccinated subjects than among unvaccinated subjects (adjusted odds ratio, 2.00; 95% confidence interval, 0.59 to 6.74). The odds of having had any allergy-related respiratory symptom in the past 12 months was 63% greater among vaccinated subjects than unvaccinated subjects (adjusted odds ratio, 1.63; 95% confidence interval, 1.05 to 2.54). The associations between vaccination and subsequent allergies and symptoms were greatest among children aged 5 through 10 years.

Conclusions: DTP or tetanus vaccination appears to increase the risk of allergies and related respiratory symptoms in children and adolescents. Although it is unlikely that these results are entirely because of any sources of bias, the small number of unvaccinated subjects and the study design limit our ability to make firm causal inferences about the true magnitude of effect. (J Manipulative Physiol Ther 2000;23:81–90)

Publishing and Reprint Information

• Eric L. Hurwitz, PhD and Hal Morgenstern, PhD - UCLA School of Public Health, Department of Epidemiology, Los Angeles, Calif.
• Eric L. Hurwitz, DC - Los Angeles College of Chiropractic, Whittier, Calif.
• Submit reprint requests to: Eric L. Hurwitz, DC, PhD, UCLA School of Public Health, Department of Epidemiology, Box 951772, Los Angeles, CA 90095-1772; ehurwitz@ucla.edu .
• © 2000 JMPT
• 0161-4754/2000/$12.00 + 0 76/1/105090
• doi:10.1067/mmt.2000.105090

Management of Pediatric Asthma & Enuresis with Probable Traumatic Etiology
By Trent R. Bachman, D.C. and Charles A. Lantz, D.C., Ph.D.

The chiropractic management of asthma and enuresis of traumatic etiology in a two-year, ten-month-old male child. In May 1987 at the age of 22 months the child was medically examined and subsequently diagnosed with asthma. In an attempt to control the asthmatic symptoms two medications were prescribed, Metaproterenal Syrup and Theodore Sprinkle. On May 20, 1988 the child was seen for chiropractic examination and evaluation, and from that date to August 3, 1991 the child received 28 chiropractic adjustive/manipulative treatments. Dramatic improvement of asthma and enuresis followed chiropractic management. The application of Gonstead adjustive/manipulative therapy and the rationale for the correction of vertebral subluxation complex in the case of childhood asthma and enuresis are discussed. (1991 Proceedings)

Key Terms: Gonstead, adjustive/manipulative, chiropractic, therapeutic goals, asthma, enuresis

Chronic pediatric asthma and chiropractic spinal manipulation: A prospective clinical series and randomized clinical pilot study
By Gert Bronfort, DC, PhD; Roni L. Evans, DC; Paul Kubic, MD, PhD; and Patty Filkin

Objectives: The first objective was to determine if chiropractic spinal manipulative therapy (SMT) in addition to optimal medical management resulted in clinically important changes in asthma-related outcomes in children. The second objective was to assess the feasibility of conducting a full-scale, randomized clinical trial in terms of recruitment, evaluation, treatment, and ability to deliver a sham SMT procedure.

Study Design: Prospective clinical case series combined with an observer-blinded, pilot randomized clinical trial with a 1-year follow-up period.

Setting: Primary contact, college outpatient clinic, and a pediatric hospital.

Patients: A total of 36 patients aged 6 to 17 years with mild and moderate persistent asthma were admitted to the study.

Outcome Measures: Pulmonary function tests; patient- and parent- or guardian-rated asthma-specific quality of life, asthma severity, and improvement; am and pm peak expiratory flow rates; and diary-based day and nighttime symptoms.

Interventions: Twenty chiropractic treatment sessions were scheduled during the 3-month intervention phase. Patients were randomly assigned to receive either active SMT or sham SMT in addition to their standardized ongoing medical management.

Results: It is possible to blind the participants to the nature of the SMT intervention, and a full-scale trial with the described design is feasible to conduct. At the end of the 12-week intervention phase, objective lung function tests and patient-rated day and nighttime symptoms based on diary recordings showed little or no change. Of the patient-rated measures, a reduction of approximately 20% in 2 bronchodilator use was seen (P = .10). The quality of life scores improved by 10% to 28% (P < .01), with the activity scale showing the most change. Asthma severity ratings showed a reduction of 39% (P < .001), and there was an overall improvement rating corresponding to 50% to 75%. The pulmonologist-rated improvement was small. Similarly, the improvements in parent- or guardian-rated outcomes were mostly small and not statistically significant. The changes in patient-rated severity and the improvement rating remained unchanged at 12-month posttreatment follow-up as assessed by a brief postal questionnaire.

Conclusion: After 3 months of combining chiropractic SMT with optimal medical management for pediatric asthma, the children rated their quality of life substantially higher and their asthma severity substantially lower. These improvements were maintained at the 1-year follow-up assessment. There were no important changes in lung function or hyperresponsiveness at any time. The observed improvements are unlikely as a result of the specific effects of chiropractic SMT alone, but other aspects of the clinical encounter that should not be dismissed readily. Further research is needed to assess which components of the chiropractic encounter are responsible for important improvements in patient-oriented outcomes so that they may be incorporated into the care of all patients with asthma. (J Manipulative Physiol Ther 2001;24:369-77)

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• Gert Bronfort, DC, PhD and Roni L. Evans, DC, Wolfe-Harris Center for Clinical Studies, Northwestern Health Sciences University, Bloomington, Minn.
• Paul Kubic, MD, PhD and Patty Filkin, Children's Health Care, St Paul, Minn.
• This study was funded by the Foundation for Chiropractic Education and Research.
• Gert Bronfort, DC, PhD, holds the Greenawalt Research Chair, funded through an unrestricted grant from Foot Levelers, Inc.
• Submit reprint requests to: Gert Bronfort, DC, PhD, Wolfe-Harris Center for Clinical Studies, Northwestern Health Sciences University, 2501 West 84th Street, Bloomington, MN 55431. Paper submitted June 5, 2000.
• In revised form September 5, 2000
• J Manipulative Physiol Ther 2001;24:369-77
• 0161-4754/2001/$35.00 +0 76/1/116417
• © 2001 JMPT
• doi:10.1067/mmt.2001.116417

A Wholistic Approach to the Treatment of Bronchial Asthma in a Chiropractic Practice
By Dean H. Lines

Three case studies involving two children and a mature adult with medically established diagnoses of bronchial asthma are presented. Management in each case involved chiropractic adjustments combined with a 'clinical ecology' approach which has been found useful in identifying food and environmental allergens that may act as triggering factors for asthma attacks. This paper suggests that such a broad-based management approach may lead to higher rates of response to chiropractic treatment of asthma, as well as providing greater long-term relief for its victims. Chiropractic J Aust 1993 Mar;23(1):4-8

Key Terms: MeSH: asthma; chiropractic; Other: clinical ecology

An Impairment Rating Analysis Of Asthmatic Children Under Chiropractic Care
By Robert L. Graham, D.C. and Richard A. Pistolese, B.S.

[JSVR, Vol 1, No. 4. p 1-8]

Abstract: A self-reported asthma-related impairment study was conducted on 81 children under chiropractic care. The intent of this study was to quantify self-reported changes in impairment experienced by the pediatric asthmatic subjects, before and after a two month period under chiropractic care. Practitioners, representing a general range of six different approaches to vertebral subluxation correction, administered a specifically designed asthma impairment questionnaire at the appropriate intervals. Subjects were categorized into two groups; 1-10 years and 11-17 years. Parents/guardians completed questionnaires for the younger group, while the older subjects self-reported their perceptions of impairment. Significantly lower impairment rating scores (improvement) were reported for 90.1% of subjects 60 days after chiropractic care when compared to the pre-chiropractic scores (p < 0.05) with an effect size of 0.96. As well, there were no significant differences across the age groups based on parent/guardian versus self rated scores. Girls reported higher (less improvement) before and after care compared to boys, although significant decreases in impairment ratings were reported for each gender. This suggested a greater clinical effect for boys which was supported by effect sizes ranging from 1.2 for boys compared to 0.75 for girls. Additionally, 25 of 81 subjects (30.9%) chose to voluntarily decrease their dosage of medication by an average of 66.5% while under chiropractic care. Moreover, information collected from patients revealed that among 24 patients reporting asthma 'attacks' in the 30 day period prior to the study, the number of 'attacks' decreased significantly by an average of 44.9% (p <.05). Based on the data obtained in this study, it was concluded that chiropractic care, for correction of vertebral subluxation, is a safe nonpharmacologic health care approach which may also be associated with significant decreases in asthma related impairment as well as a decreased incidence of asthmatic 'attacks.' The findings suggest that chiropractic care should be further investigated relative to providing the most efficacious care management regimen for pediatric asthmatics.

Key Terms: asthma, adjustment, children, chiropractic, impairment rating, pediatric, vertebral subluxation

Chiropractic Care and Behavior in Autistic Children
By Andrew Aguilar, B.S., D.C., M.B.A., John D. Grostic, D.C., and Bruce Pfleger, ph.D., M.S.

Autism is a severe behavioral and neurological disorder including gross deficits in language development. If speech is present, peculiar speech patterns such as immediate and delayed echolalia, metaphorical language, or pronominal reversal frequently will exist. A child with autism may display bizarre responses to various aspects of the environment including resistance to change, peculiar interest in or attachments to animate or inanimate objects.

A systematic series of chiropractic adjustments were administered to 26 autistic children to see if behavioral or neurological remediations would occur concomitant to the nine month care plan. The children were recruited through three local autism societies from the greater Atlanta area.

Behavioral data for the study were collected by both the classroom teachers and the children’s parent(s). Objective data were collected through Brain Stem Evoked Potential (BSEPs) recordings, pre and post x-ray films, a dual probe infrared heat recording graph instrument, and a supine leg check analysis. Student clinicians performed physicals on each child reevaluating at three month intervals. Subjective data were collected through both a Modified Autism Checklist and a Childhood Autism Rating Scale (CARS). (JCCP, Volume 5, Number 1, Spring/Summer 2000)

Key Terms: autism, pervasive developmental disorder, developmental delayed, subluxation, upper cervical technique, Grostic technique, orthospinology

Evaluation of chiropractic management of pediatric patients with low back pain: A prospective cohort study
By Jill A. Hayden, DC, Silvano A. Mior, DC, and Marja J. Verhoef, PhD

Background: Recent epidemiologic studies have estimated that the lifetime prevalence of low back pain (LBP) in children is approximately 50%, with almost 15% of children experiencing frequent or continual pain. A literature search revealed no published studies addressing conservative treatment of childhood LBP.

Objective: To describe chiropractic management of LBP in patients between the ages of 4 and 18 years, as well as outcomes and factors associated with the outcomes.

Methods: Prospective cohort study of consecutive pediatric patients with LBP seeing randomly selected chiropractors within the cities of Calgary, Alberta, and Toronto, Ontario, Canada. Follow-up data collection included the type and extent of treatment rendered and its outcome, which was measured with a 5-point subjective rating scale and a self-report pediatric visual analogue scale.

Results: Fifteen chiropractors provided data on 54 consecutive pediatric patients with LBP. The average age of the patients was 13.1 years, 57% were male, 61% were acute, with 47% attributing onset to a traumatic event (most commonly sports-related); 24% reported an episode duration of greater than 3 months. Almost 90% of cases presented with uncomplicated mechanical LBP, most frequently diagnosed as lumbar facet dysfunction or subluxation. Patients were managed with manipulation, with a minority (7.7%) receiving some form of active management. “Important” improvement was seen in 62% and 87% on the visual analogue and subjective scales, respectively, within a 6-week course of management (Kaplan-Meier survival analysis). Patients with chronic LBP were less likely to respond within the median number of treatments (relative risk = 2.1).

Conclusions: Patients responded favorably to chiropractic management, and there were no reported complications. Future investigations should establish the natural history and compare chiropractic management with other forms of treatment to gain knowledge about the effectiveness of chiropractic in managing pediatric LBP. (J Manipulative Physiol Ther 2003;26:1-8)

Publishing and Reprint Information

• Jill A. Hayden, DC, Institute for Work and Health, Toronto, Ontario, Canada, and Department of Health Policy, Management, and Evaluation, Clinical Epidemiology, University of Toronto, Toronto, Ontario, Canada.
• Silvano A. Mior, DC, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada.
• Marja J. Verhoef, PhD, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
• Sources of support (research grants): Canadian Foundation for Spinal Research, and Faculty of Medicine, University of Calgary.
• Sources of support (personal funding): Canadian Institutes of Health Research (Postdoctoral Fellowship Award to Dr Jill Hayden).
• Submit requests for reprints to: Dr Jill Hayden, Institute for Work and Health, 481 University Avenue, 8th Floor, Toronto M5G 2E9, Ontario, Canada.
• Paper submitted July 16, 2001; in revised form October 16, 2001.
• Copyright © 2003 by JMPT
• 0161-4754/2003/$35.00 + 0 76/1/11
• doi:10.1067/mmt.2003.11

Back pain reporting in children and adolescents: The impact of parents' educational level
By Charlotte Leboeuf-Yde, DC, MPH, PhD, Niels Wedderkopp, MD, PhD, Lars Bo Andersen, DMSc, Karsten Froberg, MSc, and Henrik Steen Hansen, DMSc

Background: Social class, including educational level, is a strong predictor for health-related perceptions and behavior and for health outcomes in general. It is not known whether parental education has an effect on back pain in their offspring.

Objectives: To establish whether parents' educational level is associated with back pain reporting and consequences of back pain in their children.

Design: A cross-sectional survey.

Data Collection: Information on parental education was obtained through questionnaires to parents and back pain information through standardized interviews with the children.

Participants: Children aged 8 to 10 years (n = 481) and adolescents aged 14 to 16 years (n = 325) obtained through a proportional 2-stage cluster sample.

Setting: Local schools in Odense, Denmark.

Main Outcome Measures: The strength of association and dose-response connection were studied between parental educational level (high/medium/low) and the outcome variables (back pain in the preceding month, and consequences of back pain) in their children.

Results: There was a significant modest negative association between the level of parental education and back pain in children but not in adolescents. There was no significant association between parental educational level and back pain consequences.

Conclusions: Further research in this area requires a more ingenious approach such as use of more socially heterogeneous study populations than those usually found in Denmark. (J Manipulative Physiol Ther 2002;25:216-220)

Publishing and Reprint Information

• Charlotte Leboeuf-Yde, DC, MPH, PhD, Medical Research Unit in Ringkjøbing County, Ringkøbing, Denmark
• Niels Wedderkopp, MD, PhD and Karsten Froberg, MSc, Institute of Sportsscience and Clinical Biomechanics, Odense University, Odense, Denmark
• Lars Bo Andersen, DMSc, Institute for Exercise and Sport Sciences, University of Copenhagen, Copenhagen, Denmark
• Henrik Steen Hansen, DMSc, Department of Cardiology, The Odense University Hospital, Odense, Denmark
• Submit requests for reprints to: Charlotte Leboeuf-Yde, Research Director, The Medical Research Unit in Ringkøbing County, Postbox 142, DK-6950 Ringkøbing, Denmark.
• Paper submitted November 29, 2000; in revised form March 14, 2001.
• Copyright © 2002 by JMPT
• 0161-4754/2002/$35.00 + 0 76/1/123172
• doi:10.1067/mmt.2002.123172

Chiropractic Evaluation and Treatment of Musculoskeletal Dysfunction in Infants Demonstrating Difficulty Breastfeeding
By Sharon Vallone, DC, FICCP

Objective: Breastfeeding during the first year of an infant’s life is currently supported and promoted by lactation consultants, midwives, naturopaths, chiropractors and allopathic physicians. In 1997, the American Academy of Pediatrics and in 1998, the World Health Organization published their position papers that advocated breastfeeding as the optimal form of nutrition for infants. This study was to investigate problems interfering with a successful breastfeeding experience and to see if proper lactation management, with the chiropractor acting as a member of a multidisciplinary support team, can help to assure a healthy bonding experience between mother and infant.

Methods: 25 infants demonstrating difficulties breastfeeding were evaluated for biomechanical dysfunction potentially resulting in an inability to suckle successfully. The biomechanics of 10 breastfeeding infants without complaint were also evaluated for comparison.

Results: An overview of the infants with breastfeeding difficulty revealed imbalanced musculoskeletal action as compared to the infants without difficulty breastfeeding.

Utilization of soft tissue therapies and chiropractic adjustments of the cranium and spine resulted in improved nursing in over 80% of the patients.

Conclusions: The results of this study suggest that biomechanical dysfunction based on articular or muscular integrity may influence the ability of an infant to suckle successfully and that intervention via soft tissue work, cranial therapy and spinal adjustments may have a direct result in improving the infant’s ability to suckle efficiently.

(JCCP, Volume 5, No. 1, 2004)

Key Terms: hiropractic, subluxation, vertebral subluxation complex, spinal manipulative therapy, chiropractic adjustment, craniosacral therapy, myofascial release, massage therapy, breastfeeding, lactation, latch, suckle, breastfeeding dysfunction

Resolution of suckling intolerance in a 6-month-old chiropractic patient
By David P. Holtrop, DC, DICC

Objective: To discuss the management and resolution of suckling intolerance in a 6-month-old infant.

Clinical Features: A 6-month-old boy with a 4½-month history of aversion to suckling was evaluated in a chiropractic office. Static and motion palpation and observation detected an abnormal inward dishing at the occipitoparietal junction, as well as upper cervical (C1-C2) asymmetry and fixation. These indicated the presence of cranial and upper cervical subluxations.

Intervention and Outcome: The patient was treated 5 times through use of cranial adjusting; 4 of these visits included atlas (C1) adjustment. The suckling intolerance resolved immediately after the first office visit and did not return.

Conclusion: It is possible that in the infant, a relationship between mechanical abnormalities of the cervicocranial junction and suckling dysfunction exists; further research in this area could be beneficial. Possible physiological etiologies of painful suckling are presented. (J Manipulative Physiol Ther 2000;23:615-8)

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• Private practice of chiropractic, Sheboygan, Wis.
• Submit reprint requests to: David P. Holtrop, DC, 4171 S. 15th Street, Sheboygan, WI 53081; drdave@nconnect.net
• Paper submitted October 14, 1999; in revised form December 22, 1999.
• J Manipulative Physiol Ther 2000;23:615-8
• © 2000 JMPT
• 0161-4754/2000/$12.00 + 0 76/1/110943
• doi:10.1067/mmt.2000.110943

Chiropractic Care for Infants with Dysfunctional Nursing: A Case Series
By Elise Hewitt, D.C., D.I.C.C.P.

Objective: To present the cases of two infants with dysfunctional nursing who were able to breastfeed normally after receiving chiropractic care. Physiological mechanisms are presented explaining how chiropractic care may restore normal suckling.

Clinical Features: The first case involves an 8-week-old girl unable to maintain suction while breastfeeding since birth. She was diagnosed by a chiropractor with cranial subluxations. The second infant, a 4-week-old boy, had been unable to suckle effectively since birth. He was diagnosed with spinal and cranial subluxations.

Intervention and Outcome: Each infant received diversified spinal adjusting and/or craniosacral therapy based on the clinical findings. The first was able to nurse normally after receiving 2 chiropractic adjustments over 14 days. The second infant suckled immediately following his first adjustment and received a total of 4 adjustments in 21 days.

Conclusions: This paper reports two cases in which chiropractic care was followed by immediate resolution of dysfunctional nursing. Further research is needed to determine the role of the chiropractic adjustment in normalizing neonatal suckling. (JCCP, Volume 4, Number 1, May 1999)

Key Terms: chiropractic, pediatrics, dysfunctional breastfeeding, adjustment, manipulation

Chiropractic Management of an Infant Experiencing Breastfeeding Difficulties and Colic: A Case Study
By Wesley E. Sheader, D.C., D.I.C.C.P.

Objective: To discuss chiropractic care of an infant with symptoms of colic and breastfeeding difficulties. This paper also discusses colic subsequent to the administration of the second Hepatitis vaccination.

Design: Individual case

Setting: A private chiropractic office

Outcome Measure: Improvement was determined by the observations of the mother and clinical findings of the chiropractors.

Result: Immediate improvement of infant’s symptoms following the first adjustment with complete resolution within five days. A recurrence, with exacerbated presentation, (as reported by the mother) was noted within three hours of the infant receiving his second Hepatitis B Vaccine. Immediate remission was not observed nor was the infant able to remain subluxation free during the stress-reaction phase described by Scheibner. However, complete remission of symptoms and the ability of the infant to remain subluxation free occurred once the infant was past that acute reaction phase.

Conclusion: It is impossible to generalize the results of a single case to the population of patients with colic. However, this case study raises important issues regarding the role of chiropractic care in infants with colic, and the possible complicating factors of vaccinations. (JCCP, Volume 4, Number 1, May 1999)

Key Terms: Infant, colic, breastfeeding, chiropractic, vaccination, hepatitis, adjustment, manipulation, stress-reaction

Whey Milk: The Next Best Thing to Breast Milk
By Navine Haworth, D.C., D.I.C.C.P.

Breastfeeding should always be encouraged as it provides infants with the optimum nutrition. Whey milk may be considered as a substitute for breast milk for infants where breastfeeding is not possible as it is the more compatible for the infant in composition and nutritional requirements than dairy or soy formula, and less allergenic. In this paper, the author attempts to outline the benefits of whey as an alternative for those infants where breastfeeding is not an option, especially for infants who are intolerant to formula. Its nutritional benefits, hypoallergenic status and immunogenic benefits are also considered.

Data Source: Data was extracted from two computer-based sources, Medline and Immunotec.

Conclusion: If breast milk, nature’s intended nutrient for the infant, is not available, whey milk poses as the next best alternative. Unlike other infant formulas, it appears to be as immunogenic and antigenic as breast milk. (JCCP, Volume 4, Number 1, May 1999)

Chiropractic Management of Cerebral Palsy: A Case Report
By Tracy A. Barnes, D.C.

A nine-year-old girl with medically diagnosed mild cerebral palsy wore lower extremity twister cable braces for four years. After eight months of chiropractic care, she was discharged by her orthopedic physician. Her braces were removed and she was returned to her normal activities. This patient is an example of how patients with cerebral palsy may benefit from chiropractic management. It has implications for future research into the area of chiropractic and special needs children. (1994 Proceedings)

Mandated Reporters of Child Abuse and Neglect: An Overview of Information and Issues for Chiropractors
By Jeanne Murrone, Ph.D.

In many states, chiropractors have been designated as mandated reporters of suspected incidents of child abuse or neglect. This article presents an overview of the information needed to guide a professional in making a decision to report to a child protective agency. This presentation must be generalized as laws governing mandated reporters are state-specific. While several topics and issues are addressed here, time and space necessitate brevity. It is critical for chiropractors to contact their state’s agency to obtain information about the precise mandate under which they are governed and practice. To help professionals obtain this information, the address of each state’s child protective agency has been listed at the end of this paper. (1993 Proceedings)

Chirodontics: The Importance of Structural Correlation and Management in Childhood Dental Orthodontic and TMJ Procedures
By Clayton D. Skaggs, D.C.

Included in this article are three case histories of children at different levels of maturation and treatment. They give you an introduction to the encompassing approach utilized in chirodontic diagnosis and treatment. The clinical necessity of this discipline is outlined, reviewing neurological and embryological connections. The Temporal Mandibular region is shown to be as critical, if not more so, in childhood health as in adult health. Anatomical connections clearly link dysfunction of this region (TMJ) to common childhood conditions. Brief coverage will also be given to specific criteria and protocols that have been found to be key elements in optimizing the chiropractic/dental relationship’s success. (1991 Proceedings)

Chiropractic Adjustments and Infantile Colic: A Case Study
By Christine Hyman, D.C.

A case report involving symptoms of infantile colic in a 5-week-old male infant. This case study addresses the various factors of infantile colic including the concept of vertebral subluxation, which should not be overlooked as a possible factor. The results of this study showed remarkable improvement of the infant after each chiropractic adjustment, as related by both parents. (1994 Proceedings)

Key Terms: infantile colic, vertebral subluxation, chiropractic adjustment, abdominal distress

Chiropractic Management of an Infant Patient Experiencing Colic and Difficulty Breastfeeding: A Case Report
By Janet M. Cuhel, D.C., D.I.C.C.P. and Mike Powell, D.C.

Objective: The purpose of this case study is to discuss the essential spinal and nutritional considerations in the management of infant who is experiencing colic and difficulty breastfeeding. This report also emphasizes the importance of communication between all health care providers attending to a patient.

Clinical Features: A twelve-day-old male was presented for chiropractic examination and treatment by his mother. The mother related difficulty in feeding on the right breast. She also stated that he seemed “fussy” and had been producing excess bowel gas. Twenty-four hours after delivery, a Depo-Provera injection was administered to the mother. Initial chiropractic examination of this infant included palpation and motion studies which revealed decreased movement at the right atlanto-occipital joint, and as prominent transverse process on the right side of the atlas.

Intervention and Outcome: Following history and examination, a chiropractic adjustment was performed to the atlas. Over the course of this patient’s care, additional chiropractic adjustments were performed. This course of treatment was met with limited success. The patient history was reviewed for a second time. This prompted the mother to add that an injection of Depo-Provera had been administered 24 hours after the delivery. The parent was advised that this injection may have been a contributor to the infant’s problem. Acting on this advice the mother did not receive the next injection as scheduled. Nutritional supplementation was utilized, and adjustments were continued. The infant’s pattern of breastfeeding and bowel function normalized.

Conclusion: This case involves the chiropractic management of an infant experiencing colic and difficulty breastfeeding. This case demonstrates the possible effectiveness of chiropractic intervention with this patient. It also demonstrates the importance of a thorough history and communication with other health care providers. The use of the injectable contraceptive, Depo-Provera, may have contributed to the difficulties this infant was experiencing. More research in this products’ use in breastfeeding mothers; as well as more effective communication between the manufacturer and prescribing doctor are needed. (JCCP, Volume 2, Number 2, October 1997)

Key Terms: adjustment, breastfeeding, chiropractic, coli, Depo-Provera, infant, nutrition

Chiropractic Care of Infantile Colic: A Case Study
By Lisa Z. Killinger, D.C. and Ayla Azad, D.C.

Objective: This study outlines the chiropractic care of an eleven-month-old male with severe, complicated, late onset infantile colic. The infant had been unable to consume solid foods for a period of four months, and suffered from severe constipation. In addition, this subject demonstrated extreme muscular weakness and lack of coordination. The baby was unable to crawl, stand, or walk, and was greatly unresponsive to his surroundings.

Subject: An eleven-month-old baby boy

Setting: A chiropractic college teaching and research clinic; Circa 1949

Methods: Upper Cervical Specific chiropractic adjustments for a subluxation of the first cervical vertebra.

Results: Immediate improvements in muscle strength, coordination, responsiveness, and ability to consume solid foods without vomiting. (JCCP, Volume 3, Number 1, August 1998)

Colic with Projectile Vomiting: A Case Study
By Meghan Van Loon, D.C.

Objective: The purpose of this case study is to discuss the chiropractic care of a patient who presented to the author’s office with a medical diagnosis of colic, with additional projectile vomiting. The proposed etiology, the medical approach to colic, and the chiropractic care for this infant is detailed. Also examined is the connection between birth trauma and non-spinal symptoms.

Design: A case study.

Setting: Private practice.

Patient: A three-month-old Caucasian male presenting with medically diagnosed colic. Symptoms had been increasing in severity over the previous two months despite medical intervention.

Results: The resolution of all presenting symptoms within a 2-week treatment period is detailed. Care consisted of chiropractic spinal adjustments and craniosacral therapy.

Conclusion: This case study details the chiropractic management of a three-month-old male with a medical diagnosis of colic who also exhibited projectile vomiting. Complete resolution of all symptoms was achieved. Proposed cranial and spinal etiologies are discussed, as well as the connection between birth trauma and non-spinal symptoms. (JCCP, Volume 3, Number 1, August 1998)

Key Terms: chiropractic, vertebral subluxation complex, vertebral-cranial subluxation complex, spinal adjustment, craniosacral therapy, colic, projectile vomiting

Chiropractic Treatment of a 7-Month-Old with Chronic Constipation: A Case Report
By Elise G. Hewitt, D.C.

The effect of chiropractic care on visceral conditions currently generates wide interest. Practitioners in this clinic have observed bowel function changes in patients following chiropractic treatment. This report has the added interest that it involves a 7-month-old suffering from chronic constipation since birth. The infant had a history of hard, pellet-like stools following hours of painful straining, ranging in frequency from once per day to once every three days. After receiving treatment consisting of full spine and cranial adjusting, the patient’s bowel function normalized to 1-2 soft, effortless stools per day. Results were confirmed at the eight-week follow-up visit. This response, although observed on a single subject, suggests that chiropractic care may affect pediatric visceral conditions through treatment of the spine and cranium and expresses the need for further observation. We are beginning to record such results for similar or related conditions. A major investigation into such conditions would be welcomed. (1992 Proceedings)

Longitudinal Clinical Case Study: Multi-Disciplinary Care of Child with Multiple Functional and Developmental Disorders
By Lorraine M. Golden, D.C. and Coralee Van Egmond, D.C.

The clinical course of a pediatric patient over eight years of chiropractic care with concurrent multi-disciplinary supportive intervention is reviewed. A 22-month-old non-ambulatory male with presenting diagnoses of spinal meningitis, cerebral palsy, seizures requiring medication, and physical and mental retardation undergoes comprehensive serial evaluation and treatment of multiple disorders at a multi-professional facility. Longitudinal description and analysis of findings and treatment from infancy through nine-years-old provides clinical insight on coordinating treatment of multiple health problems rendered by other health care fields while undergoing primary chiropractic care. The clinical course involves consolidation of data over longitudinal and cross-professional parameters at significant points in the patient’s progress. Compilation of clinical results through such monitored variables as repeated objective measures provides a rich data base for future investigation. In addition, this interactive data furnishes a unique opportunity for relevant assessment of chiropractically coordinated care for the multiply disordered pediatric patient. (1992 Proceedings)

Chiropractic Care of a Child with Significant Short Stature, Hypotonia, Developmental Delay, and Seizures
By Carol Parnell, D.C., D.I.C.C.P.

Objective: The purpose of this case study is to discuss the chiropractic care of a child diagnosed with congenital encephalopathy, associated hypotonia, seizures and developmental delay of unknown etiology. The medical history and management of chiropractic care for this child is detailed. Also examined is the connection between traumatic birth syndrome as a possible etiology.

Design: A case study

Setting: Private practice

Patient: A 3-year-old Caucasian female presented with the height and weight of a 12-month-old, who could not walk or talk. Also noted were facial dysmorphism and unresolved cradle cap over the frontal/parietal suture.

Results: Improved cranial facial symmetries. Marked resolution of cradle cap. Improvements in physical and cognitive development.

Conclusions: This case study details the medical evaluation and chiropractic management of a 3-year-old female with short stature and developmental delay of unknown etiology. Improvement in patient’s development while under chiropractic care is noted. Proposed cranial and spinal etiologies are discussed, as well as a hypothesized connection between traumatic birth syndrome and clinical manifestations. (JCCP, Volume 5, Number 1, Spring/Summer 2000)

Key Terms: traumatic birth syndrome, chiropractic, vertebra-cranial subluxation complex, spinal adjustment, craniosacral therapy, birth trauma, periventricular leukomalacia

Developmental - Behavioral Pediatrics: The Chiropractor’s Role
By Joan M. Fallon, D.C., F.I.C.C.P.

Behavioral-developmental pediatrics can be defined as the study of normals and variations in the sequential acquisition of fine and gross motor competencies, cognitive skills and adaptive functioning in social and non-social settings of the child.

Increasingly, children with developmental or behavioral variations or delay are finding their way to the chiropractor. It is the author’s belief that the chiropractic study and approach to pediatric care allows the chiropractor to understand and address these issues for the child in a less invasive and in many cases more effective way than most other disciplines. (JCCP, Volume 2, Number 1, January 1997)

Key Terms: behavior, developed motor skills, chiropractic, pediatrics

Epilepsy and seizure disorders: A review of literature relative to chiropractic care of children
By Richard A. Pistolese, DC

Objective: To review the currently available literature regarding chiropractic care relative to patients with epilepsy, particular emphasis being placed on those who have epilepsy as children.

Data Sources: The Index to Chiropractic Literature was searched for the years 1980 through 1998 through use of the keywords epilepsy and seizure. The MANTIS database was searched for the years 1970 through 2000 through use of the Medical Subject Heading (MeSH) keywords chiropractic, epilepsy, seizure, and child/children. In addition, a MEDLINE search of the literature was performed for the years 1966 through 2000 through use of the same subject headings.

Results: The present study reviews 17 reports of pediatric epileptic patients receiving chiropractic care. Fourteen of the 17 patients were receiving anticonvulsive medications, which had proven unsuccessful in the management of the condition. Upper cervical care to correct vertebral subluxation was administered to 15 patients, and all reported positive outcomes as a result of chiropractic care.

Conclusions: Chiropractic care may represent a nonpharmaceutical health care approach for pediatric epileptic patients. Current anecdotal evidence suggests that correction of upper cervical vertebral subluxation complex might be most beneficial. It is suggested that chiropractic care be further investigated regarding its role in the overall health care management of pediatric epileptic patients. (J Manipulative Physiol Ther 2001;24:199-205)

Publishing and Reprint Information

• Richard A. Pistolese, DC, International Chiropractic Pediatric Association, Research Department, Stone Mountain, Ga.
• This study was supported by the International Chiropractic Pediatric Association.
• Submit reprint requests to: Richard A. Pistolese, DC, Research Department, International Chiropractic Pediatric Association, 5295 Highway 78, Suite #D362, Stone Mountain, GA 30087-3414
• J Manipulative Physiol Ther 2001;24:199-205
• Paper submitted March 30, 1999; in revised form April 15, 1999.
• © 2001 JMPT
• 0161-4754/2001/$35.00 + 0 76/1/113771
• doi:10.1067/mmt.2001.113771

Chiropractic Adjustments and Erb’s Palsy: A Case Study
By Christine A. Hyman, D.C., D.I.C.C.P.

Objective: The purpose of this case study is to discuss the chiropractic care of a patient presenting to the author’s chiropractic office, with obstetrical brachial plexus injury at the level of C5-C6 nerve roots (Erb’s palsy). This article relates the proposed mechanism of injury, along with the current medical treatment available and the chiropractic care provided to the patient.

Design: A case study.

Setting: Private practice.

Patient: A two-month-old, black female presented with obstetrical brachial plexus injury (Erb’s palsy). This infant had been under the care of several medical pediatrician’s without resolution.

Outcome Measures: Resolution of this condition was determined by observation and physical examination of the infant.

Results: The progression and resolution of the infant’s condition is presented for each of the chiropractic office visits. The chiropractic office visits consisted of evaluation of the infant and chiropractic spinal adjustments. Complete resolution was noted, without any complications or residual impairments.

Conclusion: The author has presented a case study of a two-month-old, black female with obstetrical brachial plexus injury who underwent a program of chiropractic care, which was inclusive of chiropractic spinal adjustments. The infant had complete resolution of her condition with no complications or residual impairments. (JCCP, Volume 2, Number 2, October 1997)

Key Terms: chiropractic, spinal adjustments, vertebral subluxation, brachial plexus paralysis, obstetrical brachial plexus injuries, phrenic nerve injuries, peripheral nerve trauma, Erb’s palsy

Evaluation of a Pediatric Patient with a Medical Diagnosis of Failure to Thrive
By Marsha Heikkinen, D.C.

Objective: To present the importance of taking a complete case history, maternal/prenatal, birth and postnatal.

Clinical Features: A four-week-old infant girl who is suffering with failure-to-thrive symptoms.

Intervention and Outcome: Prescription of a TENS unit to wean the mother off of pain medications. Specific chiropractic adjustments to both mother and infant.

Conclusion: In this case chiropractic adjustments were secondary to the root of the failure to thrive symptoms. However, maternal case history was vital to the survival of the female infant. (1994 Proceedings)

Chiropractic Management of the Acute Febrile Paediatric Patient
By Neil J. Davies

Chiropractic management of the acute febrile paediatric patient is discussed with emphasis on differential diagnostic factors which are readily obtained and which, properly interpreted, indicate a clear need for referral to other health care providers more expert in emergency care. A case report is given to illustrate this need and a diagnostic flow plan for use when confronted by such a case is presented. J Aust Chiropr Assoc 1987 Dec;17(4):126-30

Key Terms: Febrile Disorders; Chiropractic Management; Paediatrics

Chiropractic Care of a Pediatric Glaucoma Patient: A Case Study
By Cynthia M. Conway, D.C., D.I.C.C.P.

This case study involves a 17-month-old female presenting with glaucoma and recurrent, chronic sinus infections. This study addresses the reduction of infections as well as the restoration of normal intraocular pressure to the patient using chiropractic adjustments and nutritional therapy. (JCCP, Volume 2, Number 2, October 1997)

Key Terms: glaucoma, sinus infections, intraocular pressure, chiropractic adjustments, nutritional therapy, hydropthalmos, goniotomy

Chiropractic Care of a 13-year-old with Headache and Neck Pain: A Case Report
By Elise G. Hewitt, D.C.

Headaches are the most frequent cause of visits to primary care practitioners. Standard medical care for headaches is prescription of pain relieving medication. Is chiropractic care an effective treatment for headaches in children? This report describes a 13-year-old female who had suffered from severe headache and neck pain for five days. Following a series of four chiropractic treatments over a twp-week period, her headache and neck pain resolved. A thorough search of the scholarly literature revealed no data involving chiropractic treatment of headaches in children. This patient’s response suggests chiropractic care may be effective in this area and requests further investigation. (1993 Proceedings)

Key Terms: chiropractic, headache, child, manipulation

The Role of Chiropractic Care in the Resolution of Migraine Headaches and Infertility
By Ronit Vilan, DC, DICCP

Objective: The purpose of this case study is to discuss the chiropractic care of a patient who presented with a chief complaint of migraine headaches. The association between the patient’s migraines and her medical history of infertility is discussed.

Design: A case study.

Setting: Private practice.

Patient: A 28-year-old Caucasian female.

Results: The resolution of the patient’s migraines as well as her infertility occurred after three months of chiropractic care.

Conclusion: This case study details a 28-year-old female who received chiropractic care for migraines. The patient had complete resolution of the migraines and consequently infertility. Spinal etiology appears to be associated with headaches and infertility.

(JCCP, Volume 5, No. 1, 2004)

Key Terms: migraines, infertility, chiropractic, vertebral subluxation complex, pituitary, spinal adjustments

Chronic Pediatric Migraine-Type Headaches Treated by Long-Term Inderol Prior to Chiropractic Care A Case Report
By Vickie L. Haney, D.C.

An 11-year-old pediatric female was referred to our practice by her aunt because of an eight year history of severe migraine-type headaches, and a four year history of 20 mg. intake of Inderol daily. This was prescribed for the headaches, which were still incapacitating the child approximately two times per week, despite medication. During examination it was eventually revealed that the child had been a hit and run victim at 18 months, with her first “known” headache occurring at about the age of three. Cervical and thoraco-lumbo-pelvic x-rays revealed cervical hypolordosis, C1/C2 hyperextension subluxation and pelvic unleveling. Correction was accomplished using diversified style adjustments following an applied kinesiological work-up. The patient’s initial complaint of severe headaches seems to have been resolved, follow-up x-rays show that there has been a decrease in thoracic and lumbar curvatures, she has slowly been weaned from Inderol, and is off all pain medications as well. (1993 Proceedings)

Key Terms: headaches, migraine, pediatric, inderol

Chiropractic Treatment of Childhood Migraine Headache: A Case Study
By Julia A. Cochran, D.C.

Researchers have indicated that single-subject case studies may be ov value for the doctor in clinical practice, as well as for setting up a scientific data base. The purpose of this case study is to describe the history and response of a condition (childhood migraine headache), which may or may not be commonly treated in a chiropractic practice, but which is thought by some to be responsive to chiropractic adjustment. (1994 Proceedings)

Key Terms: migraine headache, chiropractic adjustment, acute confusional migraine, prodrome, trigger

Chiropractic Care of Children with Headaches: Five Case Reports
By Elizabeth S. Anderson-Peacock, D.C., D.I.C.C.P.

In this case series, five children presented with varying types of headaches to a family-based chiropractic practice. In each case, spinal subluxations were present. Following reduction of those subluxations through chiropractic adjustments to the child’s chief complaint remissed. Adjunctive therapy (education on diet, posture and exercise) was not given until the headaches remissed. Thus it was felt that the headache reduction may have been due to the restoration of nervous system function through the chiropractic adjustment. Chiropractic management of headaches should be further researched in children. (JCCP, Volume 1, Number 1, January 1996)

Key Terms: headache, pediatric, adjustment

Post-traumatic Evaluation and Treatment of The Pediatric Patient with Head Injury: A Case Report
By H. Jason Araghi, D.C.

A 2-year-old boy suffering from vomiting and loss of energy following impact trauma to the head was found by neurologic examination and computerized axial tomography to have suffered a concussion, with no evidence of brain or spinal cord pathology. Chiropractic examination revealed upper cervical vertebral subluxation complex, along with a straightening of the cervical curve verified radiographically. Cervical curve was restored, and the patient’s symptoms resolved after a series of specific adjustments to the C0-C1 articulations. Examination and correction of the upper cervical vertebral subluxation complex is discussed. (1992 Proceedings)

EEG and CEEG Studies Before and After Upper Cervical or SOT Category II Adjustment in Children after Head Trauma, in Epilepsy and in “Hyperactivity”
By Lasca A. Hospers, Ph.D., D.C.

Localization and categorization of central nervous system dysfunction with the EEG or CEEG before and after chiropractic adjustment in case histories of five children will be presented. Conventional EEG studies demonstrate responses of two children with petit mal (absent seizures) with potential for generalizing into grand mal. Upper cervical adjustment reduced invasion of primary epileptic foci into surrounding regions of the brain and concurrently reduced the frequency of seizures over a four month period. In two cases of “hyperactivity” and attention deficit disorder, upper cervical adjustment reduced non coherence between right and left hemispheres in one child and in another, CEEG demonstrated restoration of normal incidence of the alpha frequency spectrum. Increased attention span and improvement of social behavior were reported in both cases. A child rendered hemiplegic in an automobile accident displayed predominantly delta spectrum and a deficiency of beta spectrum over the sensory motor cortex of the injured side of the brain. After adjustment, the CEEG demonstrated a decreased percentage of delta spectrum and increased beta spectrum. He was able to utilize his arm and leg contralaterally to the injured side of the brain without assistance after upper cervical adjustment. (1992 Proceedings)

The Restoration of Female Fertility in Response to Chiropractic Treatment
By Brent McNabb, D.C.

Case study of a 36-year-old white female with primary presenting complaint of almost constant lower neck and upper back pain, most pronounced on the right side. Patient also stated that for the past year and a half she had been experiencing episodes of deep lower lumbar pain which seemed to be associated with her menstrual cycle. She had just completed a year of tests and examinations for infertility. No positive findings or abnormalities were found and she was told her chance of becoming pregnant was almost nonexistent without some form of medical intervention. Chiropractic assessment included subluxation and biomechanical dysfunction primarily of the right sacroiliac, L4, T11, C2 and C1 articulations concommitant with muscular contractures related to the above motor units with suspected facet syndrome of the lumbosacral articulation. Treatment consisted of specific spinal adjustments, primarily to the above segments, soft tissue mobilization, spinal stretching exercises, and postural habits modification. The review of symptoms subsequent to care, were the following: no lower cervical nor upper thoracic pain; the chronic headache pattern had stopped with only mild headaches noted on rare occasions; no tinnitis; no deep pelvic pain; and only occasional lumbar ache noted with fatigue but not with menses. Within a year of completing treatment, the patient became pregnant by natural means and later delivered her infant son without complications. (1994 Proceedings)

Sacro Occipital Technique Management of a Thirty Four Year Old Woman with Infertility
By Martin G. Rosen, DC, CC, CSP

[JSVR, December 17, 2003, pp 1-4]

Abstract - Objective: This article presents a discussion of the response to corrective chiropractic care, specifically Sacro Occipitial Technique, in a woman with a history of infertility.

Clinical Features: On January 10, 2000, a thirty-four year old woman presented for chiropractic care. Her concerns listed a variety of conditions, including a history of infertility. With her first child, she had attempted to get pregnant naturally but was unable to. Medical treatment included fertility drugs that were unsuccessful, but she was able to conceive through in vitro fertilization. Her son was born on July 3, 1998. Approximately one year after his birth she attempted to naturally conceive a second child, but was unsuccessful. Her clinical history revealed a number of gymnastic injuries over a twelve-year period and several “minor” car accidents. She suffered from chronic back pain and spasms for years, occasional neck pain, and a chronic condition of unknown etiology that caused her hands and feet to be painful and difficult to use in the morning.

Chiropractic Care and Outcome: Sacro Occipital Technique evaluation determined a primary Category II sacro-iliac joint instability complex, and the patient committed to a six-week intensive care program. Adjustments included Category II blocking procedures for a left short leg, corrections of psoas muscle imbalance, and cervical cavitation. Upon re-evaluation after six weeks, objective findings noted marked improvement and a stabilization of her Category II subluxation complex since January 21, 2000. Subjective findings included the resolution of low back and neck pain, as well as the pain and stiffness in her hands and feet. Also, for the first time in the patient’s life conception occurred naturally, approximately 4-5 weeks into the care program. Reconstructive care was continued on a reduced frequency basis through October 2000, at which time her daughter was born.

Conclusion: This patient made no other alterations in her lifestyle or clinical situation besides the addition of chiropractic care to afford the positive outcome of increased fertility. Correlation of clinical findings support the reduction of the patient’s subluxation complex and changed neurophysiological parameters. As infertility is a growing concern, and existing medical alternatives offer limited success and while involving a myriad of concerns for the patient, it is prudent to consider other less invasive and costly approaches for dealing with interference to fertility.

Key Terms: Sacro Occipital Technique, infertility, low back pain, neck pain, chiropractic, vertebral subluxation complex

Healthy Pregnancy In A Previously Infertile Patient Following D.N.F.T. Chiropractic Care: A Case Report
By Jessica Shelley , D.C.

[JSVR, December 8, 2003, pp 1-7]

Objective: This case study describes the chiropractic care and progress of a female patient with a history of infertility; examining the relationship between D.N.F.T. specific care and the patient’s clinical improvement and ultimate success in becoming pregnant.

Clinical Features: A 32-year-old female with a history of infertility sought chiropractic care in November of 2001. She had attempted to become pregnant since August 1999, with no success. She had received conventional medical treatment, including detailed fertility testing, artificial insemination, and treatment with the fertility drug Clomid. On October 17, 2001, the patient underwent in vitro fertilization, which failed. She sought chiropractic care three weeks later and an intitial evaluation was performed on November 3, 2001. The case history revealed additional complaints, including endometriosis, low back pain, and frequent headaches. Surface EMG showed significant muscle asymmetry, with a marked elevation of muscle tension on the left side in the area of L3. Chiropractic Assessment, Intervention and Outcomes: D.N.F.T. chiropractic analysis and correction were performed over the next six weeks and during this time, the patient’s secondary complaints of low back pain and headaches improved dramatically. A re-examination was performed on December 28, 2001. Surface EMG showed a substantial improvement in muscle symmetry, as well as a reduction in the muscle tension previously noted at L3. The patient’s fertility specialists noted that her estrogen levels, endometrial thickness, and cervical mucus levels were all at more favorable levels than at the time of the first in vitro attempt. A second attempt at in vitro fertilization was made on February 17, 2002, and the patient had a positive pregnancy test on March 2, 2002. She remained under chiropractic care and was in her 34th week of pregnancy at the time of this writing.

Conclusion: The human body is designed to be healthy and to reproduce. Impairment of this ability indicates dysfunction on a fundamental level. Subluxations of the spine and the associated nervous system dysfunction can hinder proper function of body systems. This study serves to document the application of chiropractic care and the subsequent response, including restoration of proper reproductive function, in a 32 year old woman previously diagnosed as infertile.

Key Terms: chiropractic, infertility, D.N.F.T., subluxation, pregnancy, EMG

Successful Pregnancy Following Diagnosis of Infertility And Miscarriage: A Chiropractic Case Report
By Leslie Bedell, D.C.

[JSVR, December 2, 2003, pp 1-7]

Objective: This case describes the chiropractic care of a woman with a history of infertility and miscarriage.

Clinical Features: A 27 year old female presented for chiropractic care to improve her overall health, in the hope that she may ultimately be able to have a child. In the previous year she had suffered 2 miscarriages, and had been anovulatory for 9 months. She was under medical treatment for infertility and ulcerative colitis, and followed a restrictive diet. Prior to attempting to become pregnant, she had been on the birth control pill for 7 years.

Chiropractic Care and Outcome: Examination protocols of Torque Release Technique™ (TRT) were utilized to detect vertebral subluxations. Adjustments were applied with the Integrator instrument; the initial visit schedule was twice weekly for 30 days, and then one visit per week for an additional 30 days. Other therapies used included: craniosacral therapy, relaxation exercises, stretching and audio tapes. After 60 days of care, a normal ovulatory cycle occurred, and she became pregnant after her second normal cycle.

Conclusion: This case report of a woman with a history of infertility and miscarriage contributes to the growing body of literature on the response to chiropractic care among infertile women. The article discusses the impact of stress on a woman’s nervous system, and the possible associated changes in reproductive health. Further research is called for to evaluate the safety, cost, and effectiveness of chiropractic care in women’s health.

Key Terms: chiropractic, Torque Release Technique (TRT), vertebral subluxation, infertility, miscarriage

Response to Gonstead Chiropractic Care in a 27 year old Athletic Female with a 5 year history of Infertility
By Daniel D. Lyons, DC, LCP

[JSVR, November 9, 2003, pp 1-3]

Objective: This article describes the chiropractic care of a 27 year old athletic female with a 5 year history of infertility.

Clinical Features: Following a marathon, the subject experienced an unresolved injury and sought out chiropractic care. The initial chiropractic evaluation revealed a history of numerous alterations in physiological function, including low back pain, constipation, neck pain, headaches, loss of balance, tension, as well as 5 years of infertility which medical treatments had been unsuccessful for.

Chiropractic Care and Outcome: Evidence of vertebral subluxation, including dysautonomia and dysponesis, were detected at multiple levels, and chiropractic care was applied using the Gonstead System. The details of 1 month of care are described.

Conclusion: One month after the application of chiropractic care, marked reduction in dysautonomia and dysponesis is demonstrated, and while previously infertile for 5 years this woman conceived and sustained a successful pregnancy. Further research is suggested examining the application of chiropractic care and associated restoration of function, including reproductive function.

Key Terms: Chiropractic, Vertebral Subluxation, Infertility, Gonstead, Athletic Female

Female Infertility and Chiropractic Wellness Care: A Case Study on the Autonomic Nervous System Response while Under Subluxation Based Chiropractic Care and Subsequent Fertility
By Tammy M. Kaminski, D.C.

[JSVR, November 2, 2003, pp. 1-10]

Abstract - Objective: This case study describes a woman, previously diagnosed with a lazy (reproductive) system, who became pregnant after commencing subluxation-based chiropractic care.

Clinical Features: A 31 year old woman presented to have her nervous system evaluated after her husband’s encouragement. They were under medical treatment for infertility as they had been attempting to become pregnant for over 12 months, and the woman had been taking Clomiphine Citrate (clomid) for 3 months. Her previous child, three years old, had been conceived naturally.

Chiropractic Care and Outcome: The initial chiropractic examination revealed increased aberrant autonomic and motor nervous system function detected on the thermography scans and sEMG scans, respectively. For the first three months (21 visits) of care the practice member received Diversified chiropractic adjustments followed by four months (12 visits) of Torque Release adjustments. At each visit prior to structural diversified adjustments, motion and static palpation, visual observation, Deerfield leg check and cervical syndrome test were performed to detected vertebral subluxations. The Torque Release Technique (TRT) utilizes the Intergrator™, a torque and recoil release adjusting instrument and three phases comprised the evaluation. After one month of care the practice member chose to stop taking the clomid. By the third month of care she reported having normal menses for two months and drug-free ovulation by month four. Nine months after chiropractic wellness care, the practice member conceived and proceeded to experience a successful full term pregnancy.

Conclusion: After receiving wellness chiropractic care for the detection and correction of vertebral subluxations, the practice member showed marked improvement in autonomic and motor system function as demonstrated on her sEMG and thermography scans. In additon, after having great difficulty conceiving, she became pregnant nine months after commencing chiropractic care. Further studies are needed to document the relationship between infertility, autonomic nervous system function, and the response to wellness chiropractic care, including subsequent fertility.

Key Terms: infertility, chiropractic, wellness, subluxation, practice member, Torque Release Technique, Diversified Chiropractic Technique, EMG, thermography

Reduction of Vertebral Subluxation using Torque Release Technique with Changes in Fertility: Two Case Reports
By Elizabeth Anderson-Peacock, DC, DICCP

[JSVR, July 19, 2003, pp 1-6]

Abstract - Objective: This article offers a description of two women who presented with varying complaints to a family-based chiropractic practice. In each case one of the complaints was infertility.

Clinical Features: In both case histories, the women had been deemed medically infertile and artificial insemination was being considered. Upon presentation, complete chiropractic evaluations were performed which detected spinal subluxations.

Chiropractic Care and Outcome: Torque Release Technique Protocols were utilized for both evaluation and application of care. Adjustments were performed with an instrument, the Integrator, to improve spinal-neural integrity. During the course of chiropractic care both women were able to conceive.

Conclusion: Although chiropractic care is not a treatment for infertility, it is postulated that improvement of spinal neural integrity through specific chiropractic adjustments may have contributed to improved homeostasis and physiological adaptation thus allowing the body to express a greater level of health as an outcome. Various effects via the reduction of the vertebral subluxation complex are postulated.

Key Terms: Chiropractic, Infertility, Torque Release technique, Vertebral Subluxation

Insult, Interference and Infertility: An Overview of Chiropractic Research
By Madeline Behrendt, D.C.

[JSVR, May 2, 2003, p 1]

Objective: Infertility is distinct from sterility, implying potential, and therefore raises questions as to what insult or interference influences this sluggish outcome. Interference in physiological function, as viewed by the application of chiropractic principles, suggests a neurological etiology and is approached through the mechanism of detection of vertebral subluxation and subsequent appropriate and specific adjustments to promote potential and function. Parental health and wellness prior to conception influences reproductive success and sustainability, begging efficient, effective consideration and interpretation of overall state and any distortion. A discussion of diverse articles is presented, describing the response to chiropractic care among subluxated infertile women.

Clinical Features: Fourteen retrospective articles are referenced, their diversity includes: all 15 subjects are female, ages 22-65; prior pregnancy history revealed 11 none, 2 successful unassisted, 1 assisted, 1 history of miscarriage. 9 had previous treatment for infertility, 4 were undergoing infertility treatment when starting chiropractic care. Presenting concerns included: severe low back pain, neck pain, colitis, diabetes, and female dysfunction such as absent or irregular menstrual cycle, blocked fallopian tubes, endometriosis, infertility, perimenopause and the fertility window within a religiousbased lifestyle, and a poor responder undergoing multiple cycles of IVF.

Chiropractic Care and Outcome: Outcomes of chiropractic care include but are not limited to benefits regarding neuromuscular concerns, as both historical and modern research describe associations with possible increased physiological functions, in this instance reproductive function. Chiropractic care and outcome are discussed, based on protocols of a variety of arts, including Applied Kinesiology (A.K.), Diversified, Directional Non-Force Technique (D.N.F.T.), Gonstead, Network Spinal Analysis (N.S.A.), Torque Release Technique (T.R.T.), Sacro Occipital Technique (S.O.T.) and Stucky-Thompson Terminal Point Technique. Care is described over a time frame of 1 to 20 months.

Conclusion: The application of chiropractic care and subsequent successful outcomes on reproductive integrity, regardless of factors including age, history and medical intervention, are described through a diversity of chiropractic arts. Future studies that may evaluate more formally and on a larger scale, the effectiveness, safety and cost benefits of chiropractic care on both well-being and physiological function are suggested, as well as pursuit of appropriate funding.

Key Terms: chiropractic, vertebral subluxation, pregnancy, infertility, research funding,Applied Kinesiology, Diversified, Directional Non-Force Technique, Gonstead, Network Spinal Analysis, Torque Release Technique, Sacro-occipital Technique, Stucky-Thompson Terminal Point Technique

Radiologic Imaging of the Child With an Acute Limp
By Sharon Lee Mellott, D.C.

While most children with an acute onset of limping have minor soft tissue injuries which usually resolve in a few days without requiring diagnostic workup or treatment, acute or newly discovered limping does occur, for which a traumatic cause is not clearly obvious. This paper presents an overview of causes of acute limp, differential diagnosis, and appropriate radiological imaging procedures in the pediatric patient. (1993 Proceedings)

Juvenile Myasthenia Gravis: A Case Study in Chiropractic Management
By H. Jason Araghi, D.C.

A two-year-old female presented to a chiropractic clinic for symptoms related to Myasthenia Gravis. The patient had previously been diagnosed with this condition through clinical examinations and laboratory tests performed by a neurologist and pediatric opthalmologist (e.g. positive Tensilon Test). The patient’s symptoms included lethargy, weakness of the lower extremities, ptosis of the right eye, bilateral toe-in of both feet, and moderate left head tilt. The patient’s history included an automobile accident. Eight days following this trauma the patient developed otitis media and ptosis of the right eye. The patient presented for chiropractic evaluation approximately six months following the automobile accident. Clinical and roentgenological examinations were performed on the full spine. Plain films disclosed disruption of the normal contour of the sacrum at the S1-S2 level, hypolordosis of the cervical spine and a left tilt of the cervical spine in the coronal plane. The patient was diagnosed as having S2 intersegmental sacral subluxation and subluxation complexes of the occipito-atlantal and atlanto-axial motion segments. Specific chiropractic adjustments were performed in the seated position. The patient’s lethargy and ptosis improved following treatment. Post-radiological evaluation of the cervical spine demonstrates improvement of the cervical lordosis. The clinical features and diagnosis of this disorder are discussed. (1993 Proceedings)

Chiropractic Management of Neurofibromatosis (Von Recklinhausen’s Disease): A Case Study
By Leslie L. Bedell, D.C.

This is the case of a 13-year-old female patient with Neurofibromatosis. Chiropractic care was administered to reduce secondary symptomatology and improve posture. This paper emphasizes the need for Doctors of Chiropractic to be well-informed and trained to diagnose and treat this disease since there is a large probability that patients with Neurofibromatosis will come into our offices. It also addresses the role chiropractic care can play in the multifaceted symptomatic picture this disease presents as well as the limitations of working with such an un-researched condition. (1993 Proceedings)

Risk Assessment of Neurological and/or Vertebrobasilar Complications in the Pediatric Chiropractic Patient
By Richard A. Pistolese, B.Sc.

[JSVR, Vol 2, No. 2, p 1-9]

Abstract: Reports suggest that chiropractic accounts for a large percentage of visits to alternative health practitioners. Moreover, pediatric patients represent a significant proportion of these visits. In light of this trend, it is important to evaluate the risk potential to the pediatric patient presenting for chiropractic care. This paper has reviewed literature concerning the occurrence of neurological and/or vertebrobasilar (N/VB) complications in patients receiving either specific chiropractic adjustments and/or non-specific manipulations of the spine. This topic was chosen due to the potentially severe consequences of N/VB complications, regardless of etiology. The current study was conducted in a quasi-meta analysis format to derive data for the period encompassing 1977 through the first quarter of 1998, using an eclectic compilation of data from three survey sources. Based on this information, the number of pediatric visits, extrapolated to also include the periods between 1966 and 1977, was estimated to be 502,184,156. Reports of the occurrence of N/VB complications in chiropractic pediatric patients were also investigated over the same time period by searching the scientific/clinical literature. The estimate of risk due to the pediatric chiropractic patient in this category of complication was estimated to be 4.0 x 10 -7 % of all visits. Stated otherwise, there would be a chance of approximately 1 in 250 million pediatric visits that a N/VB complication would result. While some pre-existing conditions may predispose a pediatric patient to a higher incidence of such complications, the estimates derived in the present study are considered applicable to the general pediatric population. The estimates derived in the present study are intended to be an initial risk assessment. Since very few reports exist relative to the incidence of N/VB complications in children, additional studies will be necessary to confirm this risk estimate.

Key Terms: adjustment, child, children, chiropractic, complication, injury, manipulation, neural complication, risks, neurological incident, vertebrobasilar incident

Chiropractic Management of Primary Nocturnal Enuretic Children
By William R. Reed, D.C.; Scott Beavers, D.C.; Saroja K. Reddy, PhD.; Greg Kern, D.C.

A controlled clinical trial of 46 primary enuretic children was conducted over a period of 14 weeks to assist in evaluating the influence of chiropractic care. Subjects were between five and 13 years of age. There were 31 in the treatment group which received a spinal evaluation and/or adjustment at a minimum of every ten days. The remaining 15 subjects were control which came in with the same frequency but received a “sham” adjustment over an equal period of time. Chiropractic care was rendered for ten weeks, preceded and followed by a 14-day non-treatment baseline. The mean post-treatment frequency of wet nights for the treatment group was statistically significantly less than its pre-treatment frequency; while there was practically no difference between mean pre- and post-frequency for the control group. However, mean pre- to post-treatment group change in frequency of wet nights of the treatment group did not differ significantly from that of the control. Subjects receiving chiropractic care averaged a 17.9% reduction in wet night frequency compared with an actual .1% increase in frequency of wet nights for the control over the same period of time. Further investigation will be required to determine the complete effectiveness or ineffectiveness, impact, or influence of chiropractic with nocturnal enuresis. (1993 Proceedings)

Key Terms: chiropractic, enuresis, nocturnal, children

Evaluation and Chiropractic Treatment of the Pediatric Patient with Nocturnal Enuresis: A Case Report
By Diana J. Hudgins, D.C.

There are many diverse opinions as to the correct etiology of what seems to be a very commonly reported problem: nocturnal enuresis. This report gives the history of a pediatric patient with nocturnal enuresis and the results with chiropractic management of care. (1994 Proceedings)

Pediatric Nutrition
By Ronald G. Lanfranchi, D.C., Ph.D.

Just as malnutrition/dysnutrition in the womb is devastating in fetal development, the lack of essential nutrients in early life handicaps an infant’s normal physiological and emotional maturation. Studies have shown that the earlier the dysnutrition occurs and the longer it lasts, the more severe and more permanent the impairment. The major reason for these consequences is that the human brain is relatively immature at birth; its major growth spurt starts midway through gestation and lasts until two years of age. This critical period is particularly susceptible to alteration and damage from the lack of essential nutrients. There are also socio-economic factors which effect intellectual development and often cannot be separated from the nutritional aspect. However, researchers have found that dysnutrition plays a key role, independent of social status. Children suffering from dysnutrition are more illness-prone and tend to be less socially interactive than their properly nourished peers. The susceptibility to illness and its effects are exhibited at various levels of the biochemical imbalance. Physical and mental fatigue, the inability to concentrate, and low personal motivation all result in poor academic performance. Frequent illness, the most obvious physical manifestation, is a tell-tale sign of nutritional dysfunction. Recurrent illness often results in numerous absences from class, resulting in the child falling behind in schoolwork at a critical learning period. This paper presents the interrelationship of essential nutrients and their effects on a child’s health. (1992 Proceedings)

Oral Apraxia: A Case Study in Chiropractic Management
By H. Jason Araghi, D.C.

A 5-year-old female presented to a chiropractic clinic for symptoms related to oral apraxia (inability to speak). The patient was previously diagnosed with this condition through clinical examinations and laboratory tests performed by a neurologist, child psychologist, and speech therapist. The patient’s symptoms consisted of inability to speak, an abundance of energy, and deep, heavy snoring while sleeping. The patient’s history included a traumatic birth process and a fall on the head at approximately age 2. The mother stated that as the child was growing up, she could understand spoken language and could respond with sign language, but the ability to speak never developed. The child would make periodic screaming sounds. Clinical and roentgenological examinations were performed on the full spine. Loss of the cervical lordosis was noted along with postural deviations. The patient was diagnosed as having subluxation complex of the occipito-atlantal and atlanto-axial motion segments. The patient had received and continues to receive specific upper cervical adjustments in the seated position. After the first adjustment, the mother stated that the child was in a deep sleep for an unusually long period of time and no snoring was noted. Later that night, after awaking, the child reached out to the mom and said the word “apple,” meaning that she wanted apple juice. The patient’s speech continued to improve everyday over the next twelve months. She is now able to say two or three consecutive words, count numbers, and is developing her vocabulary base. Post cervical flexion radiographs indicate improved function and an increase in the cervical lordosis. The clinical features, diagnosis, treatment protocol and results are discussed. Video footage before chiropractic and after care, intermittent care, with follow-up and comments from the parents and speech therapist are also presented. (1994 Proceedings)

Acute Otitis Media in Children What is the Cause and How is it Treated?
By Peter N. Fysh, D.C.

Acute otitis media is a common disorder affecting children in the early years of life and is the most common cause of fever in this age group. According to published statistics, up to one third of the childhood population will have six or more episodes of this disorder before entering school and some otitis prone children may have between six and twelve episodes in one year. This paper examines the current medical model for diagnosis and management of acute and recurrent otitis media and reviews the literature relative to the effectiveness of this model. For several decades, antibiotics have been recommended and used as the first line of approach to the treatment of upper respiratory infection. This paper examines an apparent controversy which exists within the medical profession regarding the use of antibiotics as a form of treatment for acute otitis media. The contention that upper respiratory infection, including otitis media, may be due in part to reduced drainage of the deep cervical lymphatics is also discussed and some research evidence is presented to support this hypothesis. (1991 Proceedings)

Otitis Media in Children
By Michael A. Schmidt, B.S., C.C.N., D.C.

Otitis media is the most common pediatric disorder in the United States. For many children, earaches begin in infancy. By the age of three, over two-thirds of all children have had one or more episodes of acute otitis media, including 33 percent who have had three or more episodes. Despite dramatic increases in the use of antibiotic and surgical treatment, the incidence of otitis media has risen sharply. (1991 Proceedings)

A feasibility study of chiropractic spinal manipulation versus sham spinal manipulation for chronic otitis media with effusion in children
By Charles E. Sawyer, DC, Roni L. Evans, DC, Patrick D. Boline, DC, Richard Branson, DC, and Anne Spicer, DC

Background: Pediatric otitis media with effusion is a common and costly condition. Although chiropractors have anecdotally claimed success in treating otitis media, there is little research to support their claims.

Objective: A pilot study was undertaken for the purpose of assessing the feasibility of conducting a full-scale randomized clinical trial investigating the efficacy of chiropractic spinal manipulative therapy (SMT) for children with chronic otitis media with effusion.

Methods: This study was a prospective, parallel-group, observer-blinded, randomized feasibility study. Twenty-two patients, ages 6 months to 6 years, received either active chiropractic SMT or placebo chiropractic SMT. Otoscopy and tympanometry were used to create a middle ear status profile, and daily diaries were collected.

Results: Five newspaper advertisements over 6 months generated 105 responses. Twenty patients subsequently qualified and were randomized into the study. Collection of tympanometric and otoscopic data proved to be challenging. Compliance with the treatment and evaluation protocols and daily diaries was excellent. There were no reports of serious side effects as a result of either the active or placebo chiropractic treatments.

Conclusion: Recruitment for a randomized controlled trial is feasible and could be enhanced by medical collaboration. Patients and parents are able and willing to participate in a study comparing active SMT and placebo SMT. Parents were extremely compliant with the daily diaries, suggesting that similar quality-of-life and functional status measures can be successfully used in a larger trial. We found the objective outcomes assessment involving tympanometry and otoscopy extremely challenging and should be performed by experienced examiners in future studies. (J Manipulative Physiol Ther 1999; 22:292–8)

Publishing and Reprint Information

• Charles E. Sawyer, DC, Vice President for Academic Affairs, Northwestern College of Chiropractic, Bloomington, Minnesota.
• Roni L. Evans, DC, Assistant professor, Wolfe-Harris Center for Clinical Studies, Northwestern College of Chiropractic, Bloomington, Minnesota.
• Patrick D. Boline, DC, Assistant professor, Wolfe-Harris Center for Clinical Studies, Northwestern College of Chiropractic, Bloomington, Minnesota.
• Richard Branson, DC, Assistant professor, Wolfe-Harris Center for Clinical Studies, Northwestern College of Chiropractic, Bloomington, Minnesota.
• Anne Spicer, DC, Assistant professor, Wolfe-Harris Center for Clinical Studies, Northwestern College of Chiropractic, Bloomington, Minnesota.
• Submit reprint requests to: Charles E. Sawyer, DC, Wolfe-Harris Center for Clinical Studies, Northwestern College of Chiropractic, 2501 W 84th St, Bloomington, MN 55431.
• Paper submitted September 15, 1998.
• Supported by the Foundation for Chiropractic Education and Research by means of a restricted grant from the National Chiropractic Mutual Insurance Company.
• © 1999 JMPT
• 0161-4754/99/$8.00 + 0 76/1/98567
• doi:10.1067/mmt.1999.98567

The Role of the Chiropractic Adjustment in the Care and Treatment of 332 Children with Otitis Media
By Joan M. Fallon, D.C., F.I.C.C.P.

Objective: To conduct a pilot study of chiropractic adjustive care on children otitis media using tympanography as an objectifying measure, and to propose possible mechanisms whereby subluxation is implicated in the pathophysiology of otitis media.

Design: Case Series

Setting: Subjects presented in a private clinical practice in New Rochelle, New York. The subjects were referred by various sources including pediatricians, other MSs, chiropractors and parents.

Participants: 332 children who presented consecutively with previously diagnosed otitis media, aged 27 days to 5 years

Main outcome measures: A survey of the parent/guardian was used to determine historical data with respect to previous otitis media bouts, age of onset of initial otitis media, feeding history, history of antimicrobial therapy, referral patterns, and birth history. Otoscopic and tympanographic data was collected as well as data concerning the number of adjustments administered to produce resolution of the otitis media. Data with respect to recurrence rates over six months was also collected.

Results: