title: Effect of chiropractic care on heart rate variability and pain in a multisite clinical study.
abstract: OBJECTIVE
  The purpose of this study is to investigate the effect of chiropractic care in a multiclinic setting on sympathetic and parasympathetic nervous system activities using heart rate variability (HRV) analysis.
  
  
  METHODS
  Physicians of chiropractic in private practice were provided with an HRV device to perform analysis before and after chiropractic adjustments on 10 subjects. At each site, 8 subjects were monitored before and after a single chiropractic adjustment, and 2 additional patients were followed for a 4-week period with 2 HRV recordings per week. Patient information forms and a visual analog scale (VAS) questionnaire were completed both before and after each chiropractic adjustment.
  
  
  RESULTS
  Data from 96 physicians were divided into single-visit and 4-week groups. After 1 chiropractic adjustment, pain as analyzed by VAS was reduced significantly from 3.7 +/- 2.2 to 2.1 +/- 2.0 (P < .001). The mean heart rate reduced from 76.7 +/- 12.7 to 74.3 +/- 12.4 (P < .01), the SD of normal-to-normal QRS increased from a range of 55.8 to 44.6 to a range of 60.6 to 47.2 (P < .001), the high-frequency component increased from 359 +/- 968 to 444 +/- 1069 (P < .01), the low-frequency component increased from 403 +/- 753 to 465 +/- 755 (P < .05), and the total power increased from 1063 +/- 1886 to 1265 +/- 2048 (P < .01). After 4 weeks of chiropractic adjustments, pain measured by the VAS was reduced significantly before and after each visit as analyzed by t tests, but the significant changes were not found using analysis of variance analysis. The reduction of pain from each treatment was not maintained over the 4 weeks of study period. The analysis of variance on the HRV 4-week data found that changes in the SD of normal-to-normal QRS, total power, and low-frequency components reached statistically significant levels (P < .05). The heart rate and the high-frequency component did not change significantly (P > .05).
  
  
  CONCLUSIONS
  In this study, HRV and VAS changed in patients as a result of chiropractic care.
authors.affiliation: Logan College of Chiropractic, Chesterfield, MO 63017, USA. john.zhang@logan.edu
authors.forename: John
authors.initials: J
authors.lastname: Zhang
authors.forename: Douglas
authors.initials: D
authors.lastname: Dean
authors.forename: Dennis
authors.initials: D
authors.lastname: Nosco
authors.forename: Dennis
authors.initials: D
authors.lastname: Strathopulos
authors.forename: Minas
authors.initials: M
authors.lastname: Floros
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology; D001416:Back Pain / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D026882:Manipulation, Chiropractic; D008875:Middle Aged