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ASTHMAAfter
3 months of combining chiropractic SMT (spinal manipulative therapy) with
optimal medical management for pediatric asthma, the children rated their
quality of life substantially higher and their asthma severity substantially
lower. These improvements were maintained at the 1-year follow-up assessment.
There were no important changes in lung function or hyperresponsiveness at any
time. Significantly lower quality of life impairment
rating scores were reported for 90.1% of children after 60 days of chiropractic
care. During this same time period the average number of asthma attacks
decreased an average of 44.9%, and asthma medication usage was decreased an
average of 66.5%. Among parents of asthmatic children who had
received chiropractic treatment, 92% considered this treatment beneficial.
Alternative treatment was more frequent among children from the higher social
classes. A tendency was observed towards less satisfaction with medical
treatment, information and general guidance concerning the illness among
families who sought alternative treatment. Patients with juvenile onset asthma are most likely
obtain a perceived benefit from chiropractic spinal adjustments. Patients
reported improvement after an average of five treatments over a one-month period
of time. While under chiropractic care 6 of 15 patient's
studied elected to voluntarily reduce their daily dose of medication. An
additional patient stopped using medication all together. This represents a
46.67% decrease in the need for medication while under chiropractic care.
However, the authors failed to recognize less need for medication as an
improvement in condition. A study was conducted on 58 patients to determine
whether the upper cervical knee chest adjustment, influenced pulmonary function.
FEV-1 and FVC were measured before care and two weeks after care on a
computerized auto-spiro spirometer. Analysis of the spirometry measurements
revealed predictable statistically significant changes in FVC and FEV-1.
Of the 58 patients, 57% of the subject population were considered to have
"abnormal" lung function before care. The abnormal group showed the
greatest increases in FVC and FEV-1 over the two-week study. Forty-two
percent of the abnormal patient population actually tested within normal limits
after the two-week study. The "normal" subject population also showed
predictable increases in tendency to return to normal was clearly observed in
just two weeks under specific chiropractic care. 76.5% of patients with bronchial asthma said they
benefited from chiropractic treatment. Peak flow rate and vital capacity
increased after the third treatment. Lung volumes were measured in 50 patients
presenting with complaints. Post treatment forced vital capacity (FVC) was found
to be greater than pre-treatment. Post-treatment forced expiratory volume in one
second (FEV-1) was found to be greater than pre-treatment FEV-1. FVC and FEV-1 both improved significantly in
asthmatic patients under chiropractic care. Over the course of the study, non-specific
bronchial hyperreactivity (n-BR) improved by 36% (P = 0.01) and patient-rated
asthma severity decreased by 34% (P = 0.0002) compared with the baseline values. Mobility and kyphosis of the thoracic spine were
correlated with lung function in 185 men and 87 women not suffering from
respiratory disease. Mobility of the thoracic spine was shown to directly effect
respiratory function. Results of epidemiological studies provide strong
evidence that exposure of children to environmental tobacco smoke is associated
with increased rates of lower respiratory illness, asthma, middle ear effusion,
and sudden infant death syndrome. Exposure during childhood may also be
associated with development of cancer during adulthood. During a 1-month follow-up period, the
tobacco-smoking group (defined as having at least 1 smoker in the home) had a
significantly greater number of symptomatic days than the nonsmoking group. Of
the children in the nonsmoking group, 82% had less than 1 symptomatic day per
week compared with 27% in the tobacco-smoking group. In patients with mild asthma, there is no obvious
advantage or major disadvantage to the regular use of inhaled albuterol. Regular treatment of patients with mild asthma with
salmeterol leads to tolerance to its protective effects against a
bronchoconstrictor stimulus, in this case inhaled methacholine, despite
well-maintained bronchodilation. This finding raises concern about the
effectiveness of prolonged therapy with long-acting beta 2-adrenoceptor agonists
in asthma. Immunotherapy for treatment of asthma, as studied
over a 30 month period in 121 children, showed that immunotherapy was of no
benefit. An increased risk of death, or near death, from
asthma has been associated with the regular use of Beta 2 Agonist
bronchodilator's fenoterol and albuterol. Regular use of inhaled (beta)2-agonist may also
result in a partial loss of the bronchoprotective effect afforded by these
agents against exercise-induced bronchoconstriction. In 70% of patients studied control was better
during placebo treatment with bronchodilator for symptom relief. Regular
inhalation of a beta agonist agent was associated with deterioration of asthma
control in the majority of subjects. The trends to use of regular, higher doses
or longer-acting inhaled beta-sympathomimetic treatment may be an important
causal factor in the worldwide increase in morbidity from asthma. In two studies, it has been reported that the
scheduled use of inhaled (beta)2-agonist was associated with more exacerbation's
of asthma, and with a decline in lung function. Although corticosteroids are commonly prescribed in
the treatment of bronchiolitis, there is no evidence on the efficacy of these
drugs in this disorder. There were no differences between the
dexamethasone and placebo-treated infants. Our findings do not
support the use of dexamethasone in the treatment of bronchiolitis in infants. Oral dexamethasone therapy does not affect the
clinical course of children hospitalized with bronchiolitis and therefore cannot
be recommended in this clinical situation. Several asthma and allergy researchers have found
that asthma and allergies were more common in children that received pertussis
vaccine than in those that were not immunized. Similar results have been
suggested by others. |
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© 1996-2003 Craig M. Anderson, D.C.
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