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The effects of 4 weeks of chiropractic spinal adjustments on motor function in people with stroke: a randomized controlled trial
Holt K, Niazi IK, Amjad I, Kumari N, Rashid U, Duehr J, Navid MS, Shafique M, Haavik H
Brain Sciences 2021 Jun;11(6):676
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Chiropractic spinal adjustments have been shown to result in short-term increases in muscle strength in chronic stroke patients, however, the effect of longer-term chiropractic spinal adjustments on people with chronic stroke is unknown. This exploratory study assessed whether 4 weeks of chiropractic spinal adjustments, combined with physical therapy (chiro+PT), had a greater impact than sham chiropractic with physical therapy (sham+PT) did on motor function (Fugl Meyer Assessment, FMA) in 63 subacute or chronic stroke patients. Secondary outcomes included health-related quality of life and other measures of functional mobility and disability. Outcomes were assessed at baseline, 4 weeks (post-intervention), and 8 weeks (follow-up). Data were analyzed using linear mixed-effects models or generalized linear mixed models. A post-hoc responder analysis was performed to investigate the clinical significance of findings. At 4 weeks, there was a larger effect of chiro+PT, compared with sham+PT, on the FMA (difference 6.1, p = 0.04). The responder analysis suggested the improvements in motor function seen following chiropractic spinal adjustments may have been clinically significant. There was also a robust improvement in both groups in most measures from baseline to the 4- and 8-week assessments, but between-group differences were no longer significant at the 8-week assessment. Four weeks of chiro+PT resulted in statistically significant improvements in motor function, compared with sham+PT, in people with subacute or chronic stroke. These improvements appear to be clinically important. Further trials, involving larger group sizes and longer follow-up and intervention periods, are required to corroborate these findings and further investigate the impacts of chiropractic spinal adjustments on motor function in post-stroke survivors. ClinicalTrials.gov identifier NCT03849794.

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