Work Type




Faculty Advisor

Robert Boyles, PT, DSc


Purpose: Perform a systematic review to determine if spinal manipulation (SM) is an effective treatment for non-musculoskeletal disorders.

Subjects: Four studies from peer-reviewed journals that met inclusion/exclusion criteria were reviewed.

Materials & Methods: Pubmed, PEDro, Chiropractic Literature, CINAHL, Cochrane were searched between March and April 2014. In order to assess methodological quality, three raters applied the PEDro scale to included studies.

Results: The initial search yielded 2,324 articles covering 45 non-musculoskeletal conditions. Four randomized control trials (RCTs), met inclusion criteria. The conditions covered included: inner ear infection, infantile colic, asthma, and chronic obstructive pulmonary disease. Pedro scores ranged from 6-8, with a mean score of 7.25±.957, indicating fair to good methodological quality. Two studies reported significant improvement between groups for forced vital capacity, 6MWT and dyspnea scores for individuals with COPD and self-reported quality of life and symptom severity for individuals with asthma. Two studies found no statistically significant changes in physiologic or self-reported outcomes.

Conclusions: Although, there were significant improvements in some outcome measures, the applicability of these results is limited by the poor methodological design of the studies, making it impossible to attribute these improvements to SM, alone. Therefore, there is no conclusive evidence that supports the use of SM as a treatment for non-musculoskeletal disorders.

Clinical Relevance: It is imperative to investigate the possible benefits of SM in order to provide evidence based treatment to individuals with non-musculoskeletal conditions. This reviews illuminates the need for higher quality research when examining the effect of SM on non-musculoskeletal disorders.


University of Puget Sound