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Top Research of 2020

Top Research of 2020

By: Dr. Jonathan Verderame


Correlation may not imply causation, but correlation does imply association. Contrarily, causation can imply association, but not necessarily correlation. Furthermore, a strong correlation warrants further investigation. Take for example the hot topic this year of chiropractic and immunity. The mechanists in our profession were quick to denounce any claims and throw their colleagues under the bus, stating there is not any evidence and only correlation. This is not only fallacious and unethical, it is bordering the lines of ignorance and malpractice to denounce the neuroimmune system.


When the segmental and global spinal allostatic load overcomes the bodies internal ability to modify itself, then a state of dis-ease occurs. The neuroimmune system can no longer regulate optimally via biochemical and electrophysiological interactions and we are left unprotected from pathogens. The central nervous system is the primary link in the adaptive expression of our genes to the stressors in the environment.


There is insurmountable evidence, both historical, clinical and published in both high indexed medical and chiropractic journals, that show a very strong correlation (and in some articles causation), between chiropractic and immune function. Neuroanatomy and basic science text amongst the plethora of published researched we provided at the beginning of the year in our immunity paper, provides a robust argument that shouldn’t be ignored by members of our profession.


Nonetheless, it is important to note that our goal as chiropractors is not to treat symptoms or disease, nor is it our job to provide therapy or stimulate the immune system. This is the job of the innate intelligence of the body. Our goal, objective, focus and unique clinical value is in the location, analysis and correction of vertebral subluxation, because they are detrimently to the homeodynamics and genetic potential of the organism.


The below articles are in many respects non-chiropractic articles, and the word subluxation is not even mentioned in many of the papers. Still, they provide evidence, association, and one step closer to showing causation in improving dis-ease, and our innate genetic potential in both subclinical and diseased clients following chiropractic care.


Enjoy and please share!



10. Effects of Chiropractic Care on Strength, Balance, and Endurance in Active-Duty U.S. Military Personnel with Low Back Pain: A Randomized Controlled Trial. J Altern Complement Med 2020 Jul;26(7):592-601.

The so called “gold standard” of research (a RCT) showed that chiropractic care improved strength and endurance, and of course it also reduced low back pain. It's great to see research looking at performance and disability instead of the treatment of pain.


The research was conducted at the Naval Hospital in Pensacola Florida. Outcomes were measured at baseline and 4 weeks. It was found that the” mean maximum pulling strength in the chiropractic group increased by 5.08 kgs and decreased by 7.43 kgs in the wait-list group” It also found a statistically significant difference in trunk muscle endurance and balance with eyes closed. 



9. Endocannabinoids release after Osteopathic Manipulative Treatment. A brief review. J Complement Integr Med 2020 Jun 18

Endocannabinoids are endogenous neurotransmitters that bind to cannabinoid receptors and are involved in many disease processes. No you won’t get high from chiropractic care, but it is a profound outcome measure to investigate. Although article was attempting a connection between disease and osteopathic care, it is nonetheless profound research that’s applicable to the body of evidence that we live our life through our nerve system, and thus a properly functioning spine give the patient a chance at optimal function.


This research looked at 22 articles and 13 established positive effects on CB increasing post spinal correction. The article concluded that spinal correction “seems to be a valid and effective instrument for the treatment of a series of pathologies such as chronic low back pain, fibromyalgia, spinal cord lesions, myofascial graft point, migraine, GI tract dysfunctions, and depression.”



8. Neurobiological basis of chiropractic manipulative treatment of the spine in the care of major depression. Acta Biomed. 2020 Nov 9;91(13-S)

"What happens in the vagus doesn’t stay in the vagus.” -Amy Hass DC PhD


“Chiropractic and spinal manipulative therapies along with vagal nerve stimulation may therefore be regarded as treatment options for depression.” Although I would disagree strongly that our goal is to treat depression, it is once again a profound finding in a high indexed journal.


The research found that chiropractic can "regulate the autonomic nervous system..In particular, they may activate the parasympathetic system to counterbalance the activity of the sympathetic system.”


7. Spinal Manipulative Therapy Alters Brain Activity in Patients With Chronic Low Back Pain: A Longitudinal Brain fMRI Study. Front Integr Neurosci2020 Nov 19;14:534595.

Its all in the brain! Chiropractic has a round affect on the brain as Heidi Haavik et el have repeatedly shown in their research. Adding to the body of evidence is this piece from the well respected journal of Frontiers in Integrative Neuroscience: “After the first SMT session (TP2), Group 1 showed significantly greater brain activity in the right parahippocampal gyrus, right dorsolateral prefrontal cortex, and left precuneus compared to Group 2 (P < 0.05). After the sixth SMT session (TP3), Group 1 showed significantly greater brain activity in the posterior cingulate gyrus and right inferior frontal gyrus compared to Group 2 (P < 0.05). 

 

6. Feasibility and effectiveness of thoracic spine mobilization on sympathetic/parasympathetic balance in a healthy population - a randomized. Arch Physiother 2019 Dec 9;9:15. controlled double-blinded pilot study


An important read to better understand the relationship and balance of the autonomic nerve system. We often think in linear terms, but the research shows a "trade-off" of activity of the sympathetic and parasympathetic activity. The goal therefor is not a simulation or inhibition, rather a balance of the two.


“A sympathetic/parasympathetic balance (SPB) is needed to guarantee body homeostasis. However, body homeostasis is seldom considered as an aim of the treatment from the perspective of most physiotherapists.”


The research was only performed over two consecutive days, and it looked at the anterior vs. prone adjustments on T6 – T12. the outcome parameters included HRV, BP, HR, segmental skin perfusion and erythema. (Similar to David Fletchers Insight Subluxation Station that we use in all of our clinics in Norway).


“The results of this pilot study suggest that PAM (prone adjustments) can reduce HRV HF and HRV ratio LF/HF and increase HR.”


 

5. The effect of spinal manipulation on brain neurometabolites in chronic nonspecific low back pain patients: a randomized clinical trial. Ir J Med Sci. 2020 May;189(2):543-550.


Taking the affects of chiropractic on the brain even further, our number 5 article evaluated brain metabolite changes after chiropractic using proton magnetic resonance spectroscopy. Even more proof of Reggie Golds chemistry of Life?


“After treatment, N-acetyl aspartate (NAA) in thalamus, insula, dorsolateral prefrontal cortex (DLPFC) regions, as well as choline (Cho) in the thalamus, insula, and somatosensory cortex (SSC) regions, had increased significantly in the treatment group compared with the sham group.”


“Spinal manipulation affects the central nervous system and changes the brain metabolites. Consequently, pain and functional disability are reduced.”




4. Death of the ALARA Radiation Protection Principle as Used in the Medical Sector. Dose Response. 2020 Apr-Jun; 18(2)

Following the onslaught and sell out of the ACA regarding our ability as chiropractors to take spirographic images to evaluate the spine, this timely and powerful article from Deed Harrison and Paul Oakley was profound and useful. I even used it in defence with my local imaging senter.


ALARA stand for “As Low As Reasonably Achievable.” The article concluded that this is an outdated, erroneous and unnecessary, and is founded faulty principles that lessen our ability to deliver high-quality care which has lead to so called “radiophobia”. The article states: “the dose threshold for leukemia is higher than previously thought. A low-dose radiation exposure from medical imaging will likely upregulate the body’s adaptive protection systems leading to the prevention of future cancers.”



3. Investigating the Effects of Chiropractic Spinal Manipulation on EEG in Stroke Patients. Brain Sci2020 Apr 27;10(5):253.

This article was selected in our top 3 because it turns that entire Stroke and Chiropractic conversion in reverse. Not only does chiropractic not cause stroke, it actually helps stroke patients.


“EEG was recorded before and after each intervention during rest and stimulation of the non-paretic median nerve.  Following spinal manipulation, the N30 amplitude increased by 39%, which was a significant increase compared to the control intervention. “


For all those that criticise Heidis research for not including the words subluxation, in this article along with many others actually does include it. You just have to read beyond the abstract.


2. Scoping Review of Chiropractic, Vertebral Subluxation and Immune Function with Implications for Development of a Protocol for Measurement of Immune Biomarkers in Chiropractic Research & the Development of Related Policy. Annals of Vertebral Subluxation Research.


Coming in at number 2, arguably the most timely and important article of 2020, the importance and documented connection between chiropractic and immune function. In the beginning of the pandemic Axiom put together an exhaustive list of research that researched over 30k, that clearly shows the role of chiropractic in immunity. Following the utterly pathetic article in May “A united statement of the global chiropractic research community against the pseudoscientific claim that chiropractic care boosts immunity” (Chiropr Man Therap2020 May 4;28(1):21.), that attempted to condemn and actively encourage regulatory bodies to take action against chiropractors who talk about immunity and chiropractic, this profound research from Matthew McCoy DC, MPH, Christopher Kent DC, JD and Axiom speaker Christie Kwon DC, MS, MPH writes:


“This is a scoping review of the literature regarding chiropractic and its relationship to neuroimmunology. It is intended to inform a larger project and give that team as much background as possible in a short period of time. The results of the already available research demands that we further explore the neuro-immuno-regulatory effects of chiropractic, adjustment and spinal manipulation and it provides a starting point for doing so. While adjustments reduce pain and inflammation, they also improve immune-regulatory function. “



1. Autonomic balance determines the severity of COVID-19 courses. Bioelectronic Medicine. 6 (22).

Do Chiropractors treat COVID? Absolutely not, but with the never ending story that is told that we need to prevent and stop the spread, no one is talking about how we increase our ability to fight infection and prevent disease from within, by giving the body the best chance to adapt.


Therefor at our number 1 spot, from the Journal Bioelectronic Medicine, they concluded that  “depressed vagal tone critically determines the severity of COVID-19.” The article states: “Elderly patients and patients with cardiovascular, respiratory, or metabolic disorders, as well as patients with cancer are most likely to have a severe course of COVID-19…All these predisposing medical conditions have an imbalance of the autonomic nervous system (ANS) in common.”


Of course there are many ways to increase vagal tone and balance the autonomic nerve system, namely Yoga, muscle therapy, omega 3 fatty acids and breathing techniques (Brain Stimulation 2019), but arguably the most powerful and effective is chiropractic care.


A systematic review from 2019 showed that spinal correction improves vagal tone and parasympathetic function (J Bodyw Mov Ther. 2018).


The goal of chiropractic is to restore balance and harmony, thereby allowing that organism to best adapt to stressors in the environment. This is accomplished by correcting and maintaining neural-integrity.


Of course it pains me that I have to make this obvious statement clear, but we don’t treat covid. This is because we don’t treat or cure anything at all. Our job it to locate, analyse and correct vertebral subluxation, in order to improve our life, function, performance, and overall human experience.



Dr Jonathan Verderame

Founder of Axiom

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