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WCA counters unfounded Stroke report

Once again, the medical establishment has tried to link chiropractic with an increased risk of stroke.

The May issue of Stroke, a publication of the American Stroke Association (a division of the American Heart Association) published a research report claiming that the patients they studied -- 582 persons admitted to Ontario hospitals after a vertebrobasilar accident -- were five times more likely to have seen a chiropractor within one week before having the stroke.

The story's implication was, of course, that receiving chiropractic care for neck problems could increase the risk of this type of stroke.

The World Chiropractic Alliance (WCA) immediately countered the article with a press release
pointing out the severe weakness of the study and emphasizing the safety of chiropractic.

In addition, WCA President Terry A. Rondberg, D.C., was interviewed for a WebMD article and provided ample information to refute the findings.

"The implication that chiropractic care is linked to stroke is totally unsupported by clinical research," the organization declared in the release that went to major wire services catering to science and medical reporters around the world.

"The Stroke article was so littered with erroneous assumptions and speculation that it has no scientific value," stated Dr. Rondberg.

Of the 582 people studied, nine "had a cervical manipulation within 1 week of their VBA," the report noted. However, in the WebMD interview, lead researcher Deanna M. Rothwell, MSc. admitted, "We don't actually know that spinal manipulation was performed during the chiropractic visit. It's quite possible to go in with a neck complaint and not have a manipulation done. Some patients go to a chiropractor without a neck complaint and have a neck manipulation done... we can only infer based on the timing of events."

In the WCA press release, Christopher Kent, D.C., president of the Council on Chiropractic Practice (CCP) argued forcefully that, "The fact that a temporal relationship exists between two events does not mean that one caused the other." Also, referring to the panel that developed the CCP Guidelines, he noted, "After evaluating the available literature, an expert panel found no competent evidence that specific chiropractic adjustments cause strokes."

The study was so flawed that even the researchers had to admit they based their conclusions on assumptions and estimates.

"This study design does not permit us to estimate the number of cases that are truly the result of trauma sustained during manipulation," they wrote. "Positive validation of the type of stroke would require diagnostic imaging and invasive testing well beyond the scope of the current study," they conceded elsewhere in the paper.

Additionally, the study noted that cervical manipulations are performed by medical practitioners, osteopaths, and physiotherapists, as well as doctors of chiropractic.

However, the WCA press release explained that chiropractors are the only providers trained in the use of the adjustment, the specific application of force to help correct nerve interference and that manipulation is the forceful passive movement of a joint beyond its active limit of motion.

"Since it doesn't imply the use of precision, specificity or the correction of nerve interference, it is not synonymous with chiropractic adjustment," the WCA clarified.

In emphasizing the safety factor, the release also noted that numerous published scientific and medical studies have shown that the incidence of stroke associated with chiropractic care is estimated at between one and three per million adjustments -- a number so small as to be statistically insignificant.

Matthew McCoy, D.C., editor of the peer-reviewed Journal of Vertebral Subluxation Research (JVSR), also quoted in the release stated: "The vast preponderance of research clearly shows that chiropractic is safe and not associated with any adverse events. It would be unfortunate if a flawed study discouraged anyone from getting necessary chiropractic care."

In order to show that chiropractors aren't the only ones to recognize the fallacy of associating chiropractic with strokes, the WCA press release quoted Philip Lee, M.D. -- a co-investigator of a research survey presented at the American Heart Association's 19th International Joint Conference on Stroke and Cerebral Circulation -- who has stated, "... most interventions by allopathic physicians have a higher complication rate than chiropractic interventions."

The WCA's position paper on strokes, which includes abstracts of numerous scientific studies, is available at on the WCA website.

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