title: Self-reported nonmusculoskeletal responses to chiropractic intervention: a multination survey.
abstract: OBJECTIVE
  To replicate a previous study of nonmusculoskeletal responses to chiropractic intervention and to establish whether such responses are influenced by the country of study, chiropractors' attitudes, and information to patients, patients' demographic profiles, and treatment regimens.
  
  
  METHODS
  Information obtained through questionnaires by chiropractors and patients on return visit within 2 weeks of previous treatment from chiropractic practices in Canada, United States, Mexico, Hong-Kong, Japan, Australia, and South Africa. In all, 385 chiropractors collected valid data on 5607 patients. Spinal manipulation with or without additional therapy was the intervention provided by chiropractors. Outcome measures included self-reported improved nonmusculoskeletal reactions (allergy, asthma, breathing, circulation, digestion, hearing, heart function, ringing in the ears, sinus problems, urination, and others).
  
  
  RESULTS
  The results from the previous study were largely reproduced. Positive reactions were reported by 2% to 10% of all patients and by 3% to 27% of those who reported to have such problems. Most common were improved breathing (27%), digestion (26%), and circulation (21%). Some variables were identified that somewhat influenced the outcome: patients informed that such reactions may occur (odds ratio [OR] 1.5), treatment to the upper cervical spine (OR 1.4), treatment to lower thoracic spine (OR 1.3), and female sex (OR 1.3). However, these had a very small "explanatory" value (pseudo R2 3%).
  
  
  CONCLUSIONS
  A minority of patients with self-reported nonmusculoskeletal symptoms report definite improvement after chiropractic care, and very few report definite worsening. Future studies should use stringent criteria to investigate a possible treatment effect and concentrate on specific diagnostic subgroups such as digestive problems and tinnitus.
authors.affiliation: Back Research Center, Backcenter Funen, Denmark. chyd@shf.fyns-amt.dk
authors.forename: Charlotte
authors.initials: C
authors.lastname: Leboeuf-Yde
authors.forename: Eva N
authors.initials: EN
authors.lastname: Pedersen
authors.forename: Peter
authors.initials: P
authors.lastname: Bryner
authors.forename: David
authors.initials: D
authors.lastname: Cosman
authors.forename: Ray
authors.initials: R
authors.lastname: Hayek
authors.forename: William C
authors.initials: WC
authors.lastname: Meeker
authors.forename: Junaid
authors.initials: J
authors.lastname: Shaik
authors.forename: Octavio
authors.initials: O
authors.lastname: Terrazas
authors.forename: John
authors.initials: J
authors.lastname: Tucker
authors.forename: Max
authors.initials: M
authors.lastname: Walsh
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D026882:Manipulation, Chiropractic; D008875:Middle Aged; D015999:Multivariate Analysis; D011795:Surveys and Questionnaires; D016896:Treatment Outcome