Advertisement

Effect of Chiropractic Care on Heart Rate Variability and Pain in a Multisite Clinical Study

      Objective

      The purpose of this study is to investigate the effect of chiropractic care in a multiclinic setting on sympathetic and parasympathetic nervous system activities using heart rate variability (HRV) analysis.

      Methods

      Physicians of chiropractic in private practice were provided with an HRV device to perform analysis before and after chiropractic adjustments on 10 subjects. At each site, 8 subjects were monitored before and after a single chiropractic adjustment, and 2 additional patients were followed for a 4-week period with 2 HRV recordings per week. Patient information forms and a visual analog scale (VAS) questionnaire were completed both before and after each chiropractic adjustment.

      Results

      Data from 96 physicians were divided into single-visit and 4-week groups. After 1 chiropractic adjustment, pain as analyzed by VAS was reduced significantly from 3.7 ± 2.2 to 2.1 ± 2.0 (P < .001). The mean heart rate reduced from 76.7 ± 12.7 to 74.3 ± 12.4 (P < .01), the SD of normal-to-normal QRS increased from a range of 55.8 to 44.6 to a range of 60.6 to 47.2 (P < .001), the high-frequency component increased from 359 ± 968 to 444 ± 1069 (P < .01), the low-frequency component increased from 403 ± 753 to 465 ± 755 (P < .05), and the total power increased from 1063 ± 1886 to 1265 ± 2048 (P < .01). After 4 weeks of chiropractic adjustments, pain measured by the VAS was reduced significantly before and after each visit as analyzed by t tests, but the significant changes were not found using analysis of variance analysis. The reduction of pain from each treatment was not maintained over the 4 weeks of study period. The analysis of variance on the HRV 4-week data found that changes in the SD of normal-to-normal QRS, total power, and low-frequency components reached statistically significant levels (P < .05). The heart rate and the high-frequency component did not change significantly (P > .05).

      Conclusion

      In this study, HRV and VAS changed in patients as a result of chiropractic care.

      Key Indexing Terms

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Manipulative & Physiological Therapeutics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Vallejo M
        • Marquez MF
        • Borja-Aburto VH
        • Cardenas M
        • Hermosillo AG
        Age, body mass index, and menstrual cycle influence young women's heart rate variability—a multivariable analysis.
        Clin Auton Res. 2005; 15: 292-298
        • Longin E
        • Schaible T
        • Lenz T
        • Konig S
        Short term heart rate variability in healthy neonates: normative data and physiological observations.
        Early Hum Dev. 2005; 81: 663-671
        • Manfrini O
        • Pizzi C
        • Trere D
        • Fontana F
        • Bugiardini R
        Parasympathetic failure and risk of subsequent coronary events in unstable angina and non–ST-segment elevation myocardial infarction.
        Eur Heart J. 2003; 24: 1560-1566
        • Akselrod S
        • Gordon D
        • Ubel FA
        • Shannon DC
        • Barger AC
        • Conen RJ
        Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control.
        Science. 1981; 213: 220-222
        • Sandercock GR
        • Bromley PD
        • Brodie DA
        The reliability of short-term measurements of heart rate variability.
        Int J Cardiol. 2005; 103: 238-247
        • Kleiger RE
        • Stein PK
        • Bosner MS
        • Rottman JN
        Time domain measurements of heart rate variability.
        Cardiol Clin. 1992; 10: 487-498
        • Su CF
        • Kuo TB
        • Kuo JS
        • Lai HY
        • Chen HI
        Sympathetic and parasympathetic activities evaluated by heart-rate variability in head injury of various severities.
        Clin Neurophysiol. 2005; 116: 1273-1279
        • Yeragani VK
        • Pohl R
        • Berger R
        • Balon R
        • Ramesh C
        • Glitz D
        • et al.
        Decreased HRV in panic disorder patients: a study of power-spectral analysis of heart rate.
        Psychiatry Res. 1993; 46: 89-103
        • Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology
        Heart rate variability standards of measurement, physiological interpretation, and clinical use.
        Circulation. 1996; 93: 1043-1065
        • Javorka M
        • Javorkova J
        • Tonhajzerova I
        • Javorka K
        Parasympathetic versus sympathetic control of the cardiovascular system in young patients with type 1 diabetes mellitus.
        Clin Physiol Funct Imaging. 2005; 25: 270-274
        • Kikuchi Y
        • Sato Y
        • Ichihashi K
        • Shiraishi H
        • Momoi MY
        Autonomic function in Kawasaki disease with myocardial infarction: usefulness of monitoring heart rate variability.
        Pediatr Int. 2003; 45: 407-409
        • Kuch B
        • Parvanov T
        • Hense HW
        • Axmann J
        • Bolte HD
        Short-period heart rate variability in the general population as compared to patients with acute myocardial infarction from the same source population.
        Ann Noninvasive Electrocardiol. 2004; 9: 113-120
        • Driscoll D
        • Dicicco G
        The effects of metronome breathing on the variability of autonomic activity measurements.
        J Manipulative Physiol Ther. 2000; 23: 610-614
        • Zhang Q
        Short-term power spectrum analysis of heart rate variability of chiropractic students in college.
        Chiropr Res J. 2000; 7: 70-77
        • Koscielniak-Nielsen ZJ
        • Rasmussen H
        • Nielsen PT
        Patients' perception of pain during axillary and humeral blocks using multiple nerve stimulations.
        Reg Anesth Pain Med. 2004; 29: 328-332
        • Goddard G
        • Karibe H
        • McNeill C
        Reproducibility of visual analog scale (VAS) pain scores to mechanical pressure.
        Cranio. 2004; 22: 250-266
        • Jurca R
        • Church TS
        • Morss GM
        • Jordan AN
        • Earnest CP
        Eight weeks of moderate-intensity exercise training increases heart rate variability in sedentary postmenopausal women.
        Am Heart J. 2004; 147: e21
        • Haas M
        • Goldberg B
        • Aickin M
        • Ganger B
        • Attwood M
        A practice-based study of patients with acute and chronic low back pain attending primary care and chiropractic physicians: two-week to 48-month follow-up.
        J Manipulative Physiol Ther. 2004; 27: 160-169
        • Boal RW
        • Gillette RG
        Central neuronal plasticity, low back pain and spinal manipulative therapy.
        J Manipulative Physiol Ther. 2004; 27: 314-326
        • Diez F
        Chiropractic management of patients with bilateral congenital hip dislocation with chronic low back and leg pain.
        J Manipulative Physiol Ther. 2004; 27: E6