• Dougherty P

• Association of Chiropractic Colleges / congresses

Objective: To assess the safety of spinal manipulation in a frail older adult population in a University affiliated long-term care facility who were subjects in a pilot clinical trial to assess the efficacy of manual therapies for chronic obstructive pulmonary disease.

Methods: Eight patients consented to participate in the research study, which was evaluating the role of manual therapies in Chronic Obstructive Pulmonary Disease. The patients received a four-week course of thoracic spinal manipulative therapy, a total of 12 manipulative sessions per patient. This spinal manipulative therapy consisted of high velocity low amplitude manipulation of the thoracic spine, as well as rib mobilization and mechanically assisted manipulation. At each treatment visit, the patients were asked to describe any adverse events from the previous treatment session and to grade the severity of the adverse event on an 11-point pain scale (0 = no pain and 10= worst pain imaginable). Institutional Review Boards of New York Chiropractic College and the University Affiliated Hospital approved the project. Each patient signed an informed consent form.

Results: The patients ranged in age from 68 to 89 years old. The patients included seven females and one male. One patient did not report any adverse events during the course of the four-week intervention. Of the remaining seven patients, the number of adverse events ranged from 2 to 8 per patient. \ The average VAS score per patient ranged from 2.0 to 5.9. All adverse events were mild transient events with none lasting longer than 24 hours. It must be emphasized that none of patients reported any serious adverse events, including fracture or significant bruising.

Conclusion: This small case series suggests that high velocity low amplitude spinal manipulation, rib mobilization and mechanically assisted manipulation may be safe procedures in the frail older adult with chronic obstructive pulmonary disease. There is a need for future studies involving greater numbers of patients to make more definitive statements about the safety of high velocity low amplitude manipulation in older adults in general and frail adults specifically.

This abstract is reproduced with the permission of the publisher.