Background: An ever-increasing demand to evaluate the effect of dietary supplements on specific health conditions using a "significant scientific" standard has prompted the publication of this study.
Objective: To study the effect of megadose vitamin C in preventing and relieving cold and flu symptoms in a test group compared to a control group.
Design: Prospective, controlled study of students in a technical training facility.
Subjects: A total of 463 students ranging in age from 18 to 32 years of age comprised the control group. A total of 252 students ranging in age from 18 to 30 years comprised the experimental or test group.
Method: Investigators tracked the number of reports of cold and flu symptoms among the 1991 test population of the facility compared to the reports of like symptoms among the 1990 control population. Those in the control population reporting symptoms were treated with pain relievers and decongestants; those in the test population reporting symptoms were treated with hourly doses of 1000 mg of vitamin C for the first six hours and thrice daily thereafter. Those not reporting symptoms in the test group were also administered 1000 mg doses thrice daily.
Results: Overall, there was an 85 percent decrease in reported flu and cold symptoms in the test group compared to the control group after administration of megadose vitamin C.
Conclusion: Vitamin C in megadoses administered before or after the appearance of cold and flu symptoms relieved and prevented the symptoms in the test population when compared to the control group.
Key Indexing Terms: Vitamin C; Cold; Preventive Medicine; Dietary Supplements.
The potential role of brain asymmetry in the development of adolescent idiopathic scoliosis: a hypothesis. Wieslaw Niesluchowski, MD; Anna Dabrowska, MD; Krzysztof Kedzior, MSc, PhD; and Tomasz Zagrajek, MSc, PhD.
Background: The size asymmetry of cerebral hemispheres may predispose to head tilt and asymmetrical blocking of the zygapophyseal joints, potentially leading to the development of compensatory curvatures in the lower segments of the spine.
Objective: To analyze the effects of spinal manipulation, maintained by an exercise program, on the progression of idiopathic adolescent scoliosis in children aged six and 10.
Clinical Feature: 16 and 60 degrees if scoliosis were found, respectively.
Intervention and Outcome: For diagnosis and monitoring of therapy, we recorded qualitative parameters of shoulder asymmetry, axillary line asymmetry and scapular angle position. Manual treatment consisted of the examinations of all sliding motion in zygapophyseal joints and both sacroiliac joints, and removal of limitations of the sliding motions according to the method of Karl Lewit. The treatment procedure consisted of three or four manipulations within 17 months and an exercise program. The manipulation effects were maintained by the exercise program. The exercises were done in two or three sessions weekly for a year. In both patients we observed that scoliosis decompensation was successfully stopped, and effects of the correction persisted for 10 years.
Conclusion: Brain and head asymmetry may be only a transient state, predisposing to asymmetrical blocking at the atlanto-occipital level. Removal of blocking may prevent curve progression in children who developed adolescent idiopathic scoliosis. Manipulative therapy may also have a promising effect on retarding curve progression when used in skeletally immature patients.
Key Indexing Terms: Scoliosis; Chiropractic Manipulation; Brain; Spine.
Interexaminer reliability in physical examination of the cervical spine. Ann Fjellner, MD; Catharina Bexander; Ragnar Faleij; and Lars-Erik Strender, MD, PhD.
Background: Most of the studies of physical examinations of the cervical spine have shown poor reliability.
Purpose: To assess the interexaminer reliability in physical examinations of the cervical spine.
Subjects: Forty-eight subjects, age range 18-63 years.
Methods: Two physiotherapists independently evaluated a number of clinical tests of the passive general and intersegmental movement.
Results: Acceptable kappa/kappa (w) values were obtained in several of the clinical tests of the passive, general-motion range, but in few of the clinical tests of the passive, intersegmental movement. There were more clinical tests with acceptable reliability and less bias in symptomatic subjects compared to asymptomatic.
Conclusion: Many of the clinical tests of the passive, general-motion range were shown to be reliable. The increased number of acceptable kappa (w) values obtained in the symptomatic subjects indicates that further studies of the reliability of the clinical tests of the passive, intersegmental movement should be performed on patients.
Key Indexing Terms: Reliability; Cervical Spine; Physical Examination; Movement.
The Bournemouth questionnaire: a short-form comprehensive outcome measure. I. Psychometric properties in back pain patients. Jennifer E. Bolton, PhD and Alan C. Breen, DC, PhD.
Objective: To develop and test a short-form comprehensive outcome measure for back pain.
Design: Prospective longitudinal study of three consecutive cohorts of back pain patients.
Setting: Anglo-European College of Chiropractic outpatient clinic and several field chiropractic practices.
Method: Domains judged important in the back pain model and responsive to clinical change were identified from the literature. Items were scored on an 11-point global rating scale. The instrument was psychometrically tested using those tests relevant to an evaluative measure.
Results: Seven dimensions of the back pain model were included in the questionnaire. Having established face validity, the instrument was shown to demonstrate high internal consistency (Cronbach's alpha=0.9) and good test-retest reliability (ICC=0.95). All items were retained on the basis that they contributed to the overall score (item-corrected total score correlations) as well as to the instrument's responsiveness to clinical change (item change-corrected total change score correlations). The instrument demonstrated acceptable construct and longitudinal construct validity with established external measures. The effect size of the instrument was high (1.29) and comparable with established measures.
Conclusion: A reliable, valid and responsive instrument has been developed for use in back pain patients. It is practical for use in investigations of both the efficacy and effectiveness of back pain treatments.
Key Indexing Terms: Back Pain; Outcome Measure; Psychometric Testing.
A proposed etiology of cervicogenic headache: the neurophysiological basis and anatomic relationship between the dura mater and the rectus posterior capitis minor muscle. Matthew E. Alix and Deanna K. Bates, DC.
Objective: To examine the neurophysiological basis and anatomic relationship between the dura mater and the rectus capitis posterior minor muscle in the etiological proposition of cervicogenic headache.
Data Sources: Online searches in Medline and the Index to Chiropractic Literature, manual citation searches and peer inquiries.
Results: Connective tissue bridges were noted at the atlanto-occipital junction between the rectus capitis posterior minor muscle and the dorsal spinal dura. The perpendicular arrangement of these fibers appears to restrict dural movement toward the spinal cord. The ligamentum nuchae was found to be continuous with the posterior cervical spinal dura and the lateral portion of the occipital bone. Anatomical structures innervated by cervical nerves C1-C3 have the potential to cause headache pain. Included are the joint complexes of the upper three cervical segments, the dura mater, and spinal cord.
Conclusion: A sizable body of clinical studies note the effect of manipulation on headache. These results support its effectiveness. The dura-muscular and dura-ligamentous connections in the upper cervical spine and occipital areas may provide anatomical and physiological answers to the etiology of the cervicogenic headache. This proposal would further explain manipulation's efficacy in the treatment of cervicogenic headache. Further studies in this area are warranted to better define the mechanisms of this anatomic relationship.
Key Indexing Terms: Headache; Chiropractic Manipulation; Cervical Vertebrae.
A survey of the accessibility of chiropractic clinics to the disabled. Kevin A. Rose, DC.
Objective: To determine to what degree chiropractic clinics are complying with the Americans with Disabilities Act (ADA), which mandates that health care clinics be accessible to the disabled.
Methods: A survey was developed and mailed to 200 chiropractic clinics in Orange and LA counties. The survey asked about the essential necessities for health care clinics to be accessible to the wheelchair-bound, the blind and the deaf. It also sought to discover how many disabled patients these clinics were treating, and the attitudes of practitioners and staff towards this population.
Results: The response rate was 50.5%. Accessibility for the wheelchair-bound was high. Accessibility for the blind was limited by a lack of Braille signs. Accessibility to the deaf was limited by lack of telecommunications device for the deaf or utilization of sign language interpreters. Most clinics were treating few or no disabled patients, and did not perceive a need to become more accessible.
Conclusion: There appears to be poor compliance with the ADA in chiropractic clinics in LA and Orange counties. Although data are lacking, it appears likely that the disabled population is being under-served by the chiropractic profession. Education for chiropractors on the rights and needs of the disabled population is necessary to give this group equable chiropractic health care.
Key Indexing Terms: Chiropractic; Disabled; Deafness; Blindness; Wheelchairs; Health Services Accessibility.
The short term effect of spinal manipulation in the treatment of infantile colic. A randomized controlled clinical trial with a blinded observer. Jesper M. M. Wiberg, DC, Jan Nordsteen, DC, and Niels Nilsson, DC, MD, PhD.
Objective: To determine if there is a short term effect of spinal manipulation in the treatment of infantile colic.
Design: A randomized controlled trial.
Setting: A private chiropractic practice and the National Health Service's health visitor nurses in the suburb Ballerup (Copenhagen, Denmark).
Subjects: Infants seen by the health visitor nurses, who fulfilled the diagnostic criteria for infantile colic.
Intervention: One group received spinal manipulation for 2 weeks, the other was treated with the drug dimethicone for 2 weeks.
Outcome measure: Changes in daily hours of crying as registered in a colic diary.
Results: By trial days 4-7, hours of crying was reduced by 1 hour in the dimethicone group compared to 2.4 hours in the manipulation group (p=.04). On days 8-11, crying was reduced by 1 hour for the dimethicone group whereas the manipulation group was reduced by 2.7 hours (p=.004). From trial day 5 onwards the manipulation group did significantly better that the dimethicone group.
Conclusion: Spinal manipulation is effective in relieving infantile colic.
Key Indexing Terms: Infantile Colic; Chiropractic Manipulation.
Dynamic Chiropractic editorial staff members research, investigate and write articles for the publication on an ongoing basis. To contact the Editorial Department or submit an article of your own for consideration, email
.