Secondary analysis of a dataset to estimate the prevalence of vertebral subluxation and its implications for health promotion and prevention Open Access

Abstract

Objective 

Vertebral subluxation (VS) is a clinical entity defined as the misalignment of the spine affecting biomechanical and neurological function. The identification and correction of VS is the primary focus of the chiropractic profession. The purpose of this study is to estimate the prevalence of VS using a sample of individuals presenting for chiropractic care and to explore the public health implications. 

Methods

A brief review of the literature was conducted to support an operational definition for VS that incorporated neurologic and kinesiologic exam components. A retrospective, quantitative analysis of a multi-clinic dataset was then performed using this operational definition. Patient demographic data included age, gender, and past health history characteristics. In addition to estimating overall prevalence of VS, age- and gender-stratified estimates in the different clinics were calculated to allow for potential variations. 

Results

A total of 1,851 patient records from 7 chiropractic clinics in 4 states were obtained. The mean age of patients was 43.48 (SD = 16.8, range: 18-91 years). There were more females (n = 927, 64.6%) than males presented for chiropractic care. Patients reported various spinal or extremity pain, numbness, or tingling; headaches; ear, nose, and throat-related issues; visceral symptoms; mental health concerns; neurocognitive issues; and concerns about general health as well as overall wellness as their reasons for seeking chiropractic care. The overall prevalence was 78.55% (95% CI: 76.68-80.42). Female and male prevalence were 77.17% and 80.15%, respectively; notably, all per-clinic, age, or gender-stratified prevalence were >50%.

Conclusion

Albeit nonrandom, the sample has a broad geographic distribution. The results of this study suggest a high rate of prevalence of VS in a sample of individuals who sought chiropractic care. Further investigation into the epidemiology of vertebral subluxation and its role in health promotion and prevention is warranted.

Table of Contents

Chapter1: Introduction..............................................................................................................1

Background & Theoretical Framework...................................................................................... 1

Problem Statement ...................................................................................................................... 2

Purpose Statement ...................................................................................................................... 3

Chapter 2: Review of Literature ................................................................................................ 4

Clinical significance of VS.......................................................................................................... 4

Methods of evaluation for VS...................................................................................................... 7

Methods of analysis for neurological dysfunction.................................................................. 8

Methods of radiographic analysis of biomechanical dysfunction......................................... 10

Chapter3: Methods...................................................................................................................11

Introduction............................................................................................................................... 11

Ethics Statement........................................................................................................................ 12

Variables of Interest.................................................................................................................. 14

Analysis ..................................................................................................................................... 16

Chapter 4: Results...................................................................................................................... 17

Characteristics of the Sample ................................................................................................... 17

Key Findings ............................................................................................................................. 19

Summary Findings .................................................................................................................... 20

Chapter 5: Conclusions, Implications, and Recommendations ............................................. 22

Study Summary.......................................................................................................................... 22

Discussion ................................................................................................................................. 22

Strengths and Limitations ......................................................................................................... 25

Conclusions............................................................................................................................... 27

References.................................................................................................................................... 28

List of Tables and Figures

Figure 1 - Flow Diagram............................................................................................................... 13

Figure 2 - Vertebral Subluxation Prevalence Algorithm .............................................................. 15

Figure 3 - Prevalence of Vertebral Subluxation by Gender.......................................................... 21

Table 1 - Patient Demographics and Reason for Chiropractic Care............................................. 18

Table 2 - Prevalence of Vertebral Subluxation............................................................................. 19

Table 3 - Prevalence of Vertebral Subluxation, per clinic and age-stratified............................... 20

Supplemental Figure 1 - The Spinal Nerves ................................................................................... 6

Supplemental Figure 2 - Gross Anatomy of the Cervical Spine and Dorsal Root Ganglion.......... 8 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Executive Masters of Public Health - MPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	prevalence chiropractic epidemiology prevention science vertebral subluxation
Committee Chair / Thesis Advisor	Jose Binongo, PhD, Emory University
Committee Members	Matthew McCoy DC, MPH, Foundation for Vertebral Subluxation

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