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21679

Title

Qualitative study on chiropractic patients’ personal perception of the audible release and cavitation

URL

http://dx.doi.org/doi:10.1016/j.clch.2011.01.002

Journal

Clin Chiropr. 2011 Mar;14(1):8-16

Author(s)

Subject(s)

Peer Review

Yes

Publication Type

Article

Abstract/Notes

Objective: It has been demonstrated that the ‘audible release’ is not necessarily an indicator of a successful chiropractic adjustment. However, it seems widely believed that patients attribute a therapeutic value to the cracking noise. The objective of this study is to understand the patient opinion on the mechanism and perceived therapeutic value of joint cavitation, and associated audible release.

Design: A qualitative semi-structured interview study.

Setting: Interviews were carried out on a one to one basis at the Anglo-European College of Chiropractic (AECC).

Subjects: Eight patients were recruited from the AECC clinic reception. Patients were invited to participate in the study if they had been suffering from a long-standing problem treated with manipulative chiropractic care and had attended the AECC clinic for a minimum of 4 months. Students from the AECC were excluded.

Methods: Signed informed consent was gained. Interviews were recorded and transcribed verbatim. The eight transcripts were then analysed through a process of thematic analysis.

Results: Patients perceived the audible release as resulting from bones being moved, or the sound to a release of gas bubbles from the joint space. Patients showed a divergence of opinion as to whether the audible release guaranteed a successful adjustment.

Conclusion: Patients do not need to have a deep understanding of the mechanisms for the sound they hear. The majority of the patients associate the crack with a physical feeling of release; therefore they assume that the sound is proof of a well-achieved adjustment. Nevertheless, patients do not discard the therapeutic benefit of an adjustment that did not achieve the audible release. This appears to be due to their past experiences and their trust in the chiropractor.

This abstract is reproduced with the permission of the publisher; full text by subscription.

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