title: Manual therapy for patients with stable angina pectoris: a nonrandomized open prospective trial.
abstract: OBJECTIVE
  To examine if participants with chest pain originating from the spine would benefit from manual therapy.
  
  
  METHODS
  A nonrandomized, open, prospective trial was performed at a tertiary hospital. Patients who were referred for coronary angiography because of known or suspected stable angina pectoris were invited to participate in this study. A total of 275 took part, 50 were diagnosed as cervicothoracic angina (CTA)-positive (chest pain from the cervicothoracic spine) and 225 as CTA-negative. The intervention performed was manual therapy according to chiropractic standards. Patient self reported questionnaires at baseline and 4-week follow-up, including pain measured with an 11-point box scale, Short Form 36 (quality of life), and perceived improvement.
  
  
  RESULTS
  Approximately 75% of CTA-positive patients reported improvement of pain and of general health after treatment, compared with 22% to 25% of CTA-negative patients (P < .0001). Pain intensity decreased in both groups with consistently larger decreases for all measures of pain among CTA-positive patients. Short Form 36 scores increased in the CTA-positive group in 5 of 8 scales and remained unchanged in the CTA-negative group.
  
  
  CONCLUSIONS
  This study suggested that patients with known or suspected angina pectoris and a diagnosis of CTA may benefit from chiropractic manual therapy. Methodologically, sound randomized clinical trials are needed to corroborate our results.
authors.affiliation: Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark. h.wulff@nikkb.dk
authors.forename: Henrik W
authors.initials: HW
authors.lastname: Christensen
authors.forename: Werner
authors.initials: W
authors.lastname: Vach
authors.forename: Anthony
authors.initials: A
authors.lastname: Gichangi
authors.forename: Claus
authors.initials: C
authors.lastname: Manniche
authors.forename: Torben
authors.initials: T
authors.lastname: Haghfelt
authors.forename: Poul F
authors.initials: PF
authors.lastname: Høilund-Carlsen
mesh_terms: D000787:Angina Pectoris / Q000145:classification / Q000628:therapy*; D006801:Humans; D026882:Manipulation, Chiropractic / Q000379:methods*; D010146:Pain / Q000209:etiology*; D059408:Pain Management; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome