title: Spinal manipulative therapy for elderly patients with chronic obstructive pulmonary disease: a case series.
abstract: OBJECTIVE
  The objective of this case series is to report the results of spinal manipulative therapy (SMT) for people with chronic obstructive pulmonary disease (COPD) who were older than 65 years.
  
  
  METHODS
  The study design was a prospective case series. Six patients of a long-term care center who were older than 65 years and having COPD underwent a course of 12 SMT sessions over a 4-week period. Each SMT session consisted of manually applied spinal manipulation and instrument-assisted spinal manipulation delivered by a doctor of chiropractic. Lung function measurements were recorded at baseline and at 2 and 4 weeks. The occurrence and type of any adverse events (AEs) related to SMT were recorded at each SMT session.
  
  
  RESULTS
  One male and 5 female patients took part in the study. The average age was 79.1 years (range, 68-89 years). There was a clinically significant increase in forced expiratory volume in the first second after SMT in 4 of the 6 patients at 2 weeks. This was sustained in only 1 patient at 4 weeks. No clinically significant changes were observed for forced vital capacity at 2 or 4 weeks. One hundred forty-four manually applied spinal manipulations and 72 instrument-assisted spinal manipulations were administered during the intervention period. No major or moderate AEs were reported. Only minor AEs were reported after 29% of the intervention sessions, with 1 AE being reported for each patient. All AEs resolved within 48 hours.
  
  
  CONCLUSIONS
  This case series offers preliminary evidence that SMT may have the potential to benefit lung function in patients with COPD who are older than 65 years.
authors.affiliation: New York Chiropractic College, Seneca Falls, NY 13148, USA. pdougherty@nycc.edu
authors.forename: Paul E
authors.initials: PE
authors.lastname: Dougherty
authors.forename: Roger M
authors.initials: RM
authors.lastname: Engel
authors.forename: Subramanyam
authors.initials: S
authors.lastname: Vemulpad
authors.forename: Jeanmarie
authors.initials: J
authors.lastname: Burke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000628:therapy*; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome