title: Chiropractic manipulation in adolescent idiopathic scoliosis: a pilot study.
abstract: BACKGROUND
  Adolescent idiopathic scoliosis (AIS) remains the most common deforming orthopedic condition in children. Increasingly, both adults and children are seeking complementary and alternative therapy, including chiropractic treatment, for a wide variety of health concerns. The scientific evidence supporting the use chiropractic intervention is inadequate. The purpose of this study was to conduct a pilot study and explore issues of safety, patient recruitment and compliance, treatment standardization, sham treatment refinement, inter-professional cooperation, quality assurance, and outcome measure selection.
  
  
  METHODS
  Six patients participated in this 6-month study, 5 of whom were female. One female was braced. The mean age of these patients was 14 years, and the mean Cobb angle was 22.2 degrees. The study design was a randomized controlled clinical trial with two independent and blinded observers. Three patients were treated by standard medical care (observation or brace treatment), two were treated with standard medical care plus chiropractic manipulation, and one was treated with standard medical care plus sham manipulation. The primary outcome measure was Cobb, and the psychosocial measure was Scoliosis Quality of Life Index.
  
  
  RESULTS
  Orthopedic surgeons and chiropractors were easily recruited and worked cooperatively throughout the trial. Patient recruitment and compliance was good. Chiropractic treatments were safely employed, and research protocols were successful.
  
  
  CONCLUSIONS
  Overall, our pilot study showed the viability for a larger randomized trial. This pilot confirms the strength of existing protocols with amendments for use in a full randomized controlled trial.
  
  
  BACKGROUND
  This trial has been assigned an international standard randomized controlled trial number by Current Controlled Trials, Ltd. http://www.controlled-trials.com/isrctn/. The number is ISRCTN41221647.
authors.affiliation: Kalamazoo Center of Medical Studies, Michigan State University, 1000 Oakland Drive, Kalamazoo, Michigan, USA. rowe@kcms.msu.edu
authors.forename: Dale E
authors.initials: DE
authors.lastname: Rowe
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Feise
authors.forename: Edward R
authors.initials: ER
authors.lastname: Crowther
authors.forename: Jaroslaw P
authors.initials: JP
authors.lastname: Grod
authors.forename: J Michael
authors.initials: JM
authors.lastname: Menke
authors.forename: Charles H
authors.initials: CH
authors.lastname: Goldsmith
authors.forename: Michael R
authors.initials: MR
authors.lastname: Stoline
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Souza
authors.forename: Brandon
authors.initials: B
authors.lastname: Kambach