January 2003
Cardiac function, SIDS, and the upper
cervical spine
by Dr. Christopher Kent
A recent article from
Germany
describes experimental
evidence that cardiac function in infants is influenced by the upper
cervical spine.(1) The study included 365 male and 330 female infants with
a diagnosis of KISS. KISS is an acronym for "kinematic imbalance due
to suboccipital strain." The infants displayed "deficits in
neuromuscular steering as well as asymmetry," as well as radiographic
abnormalities at the occipito‑atlantal articulation. KISS, used in
this context, is analogous to vertebral subluxation.
"Chiropractic therapy" was applied, consisting of
"a short, gentle thrust administered onto the suboccipital region
with the inner side of the interphalangeal portion of the second
digit." The thrust was applied to the side of the asymmetry. Changes
in heart rate were measured before and after the "impulse" was
applied. There was a decrease in the heart rate in a significant number of
cases (40.1%). Most bradycardia led to a fast recovery, followed by a
short period of tachycardia. The authors suggest, "this sequence of
events constitutes a normal and physiological response."
In response to the question of safety, the authors state,
"The chiropractic therapy has proven to be a successful technique
which can be used to treat disorders, especially cerebral disturbances of
motor patterns of various etiology (wryneck, c‑scoliosis, irritation
of the plexus brachialis), sensometric disturbances of integration ability
(retardation of sensation and coordination), as well as pain related
entities such as cry‑babies with '3‑month colic' or
hyperactivity with sleeplessness. In older children, disturbances of this
kind are known as retardation of development in motor patterns as well as
in sensory abilities...in most cases chiropractic treatment seems to be
the most successful therapy which helps to treat such disorders...Although
retrospective studies about complications for manual therapy are available
for adults, no special data about children are given...no incidence has
been reported up to now. We can report more than 20,000 children treated
without serious complications."
Finally, the authors suggest, "It will be interesting in
the future to investigate a possible relationship between asymmetry [of
the atlantooccipital region] and the occurrence of SID [sudden infant
death]."
This study is significant for many reasons. It establishes
experimental evidence that upper cervical chiropractic adjustment, which
they term "therapy," affects heart rate. The authors also offer
statements supportive of the use of such care in infants and children,
noting that they have safely used these techniques on more than 20,000
children.
While we may not agree with their use of such terms as
"therapy" and "treatment," it should be realized that
this paper originated in
Germany
, and was written by
non‑chiropractors. The authors are to be commended for their
description of the examination and adjusting techniques applied. Finally,
their conjecture concerning SIDS deserves further exploration.
More than 10 years have elapsed since the publication of
chiropractors Schneier and Burns' paper which investigated the
relationship of atlanto‑occipital hypermobility in sudden infant
death syndrome.(2) Their work involved flexion/extension radiographs of
deceased infants, which were made with the cooperation of the coroner. In
this blinded study, the authors concluded, "Relative measurements
suggested that a correlation existed between instability in the atlanto‑occipital
articulation and sudden infant death syndrome."
Several compelling questions remain unanswered. Why was the
Schneier and Burns study ignored by the chiropractic research community?
Why did it take a group of German medical doctors to explore this
phenomenon? Why aren't our college research departments and research
organizations pursuing such studies? Where's the NIH money?
While some attempt to position chiropractic as little more
than a mediocre treatment for acute mechanical back pain, children are
dying, or going through life with compromised sensory and motor
development. We must broaden our vision, and prioritize our resources.
References
1. Koch LE, Koch H, Graumann‑Brunt S, et al:
"Heart rate changes in response to mild mechanical irritation of the
high cervical spinal cord region in infants." Forensic Science
International 2002;128:168.
2. Schneier M, Burns RE: "Atlanto‑occipital
hypermobility in sudden infant death syndrome." Journal of
Chiropractic Research and Clinical Investigation 1991;7(2):33.
(Dr. Christopher Kent, president of the Council on
Chiropractic Practice, is a 1973 graduate of
Palmer
College
of Chiropractic. The
WCA's "Chiropractic Researcher of the Year" in 1994, and
recipient of that honor from the
ICA
in 1991, he was also
named
ICA
"Chiropractor of
the Year" in 1998. He is director of research and a co-founder of
Chiropractic Leadership
Alliance
. With Dr. Patrick
Gentempo, Jr., Dr.
Kent
produces a monthly
audio series, "On Purpose," covering current events in science,
politics and philosophy of vital interest to the practicing chiropractor.
For subscription information call 800/892‑6463.)
