UPFRONT | Roundup RESEARCH New study finds low risk of stroke after spinal manipulation An analysis of Medicare claims data from older Americans who sought care for neck pain from chiroprac-tors suggests that cervical spine manipulation is un-likely to cause stroke. This new study was pub-lished in the February 2015 edition of the Journal of Ma-nipulative and Physiological Therapeutics. According to a web post by the National Center for Complementary and Inte-grative Health (NCCIH), an agency of the U.S. National Institutes of Health, this is the first population-based study in the U.S. to examine the risk of stroke after spinal manipulation and the first such study on older adults. The study was conducted by researchers from Dartmouth College and the Southern California University of Health Sciences, and was supported by the NCCIH. The purpose of the study was to quantify risk of stroke after chiropractic spinal ma-nipulation, as compared to evaluation by a primary care physician, for Medicare ben-eficiaries aged 66 to 99 years with neck pain. The safety of cervical spinal manipulation (i.e., manipulation of the verte-brae in the neck) for neck pain has been questioned because previous observa-tional research found an association between visits to a health-care practitioner and subsequent ver te-brobasilar stroke (VBS). VBS is an uncommon type of stroke involving the ar-teries that supply blood to the back of the brain. Although those research-ers ultimately attributed the association between health-care visits and VBS to the likelihood that people with torn vertebrobasilar arteries seek care for related head-ache and neck pain before their stroke, controversy regarding the safety of cer-vical spinal manipulation persists. In this new study, re-searchers analyzed Medi-care claims on more than 1.1 million people aged 66 to 99 who visited a chiro-practor or primary care physician to treat neck pain. They then noted the occur-rence of first stroke after the office visit and compared the hazard of stroke within 30 days for the two groups: patients visiting chiroprac-tors and those visiting pri-mary care physicians. The specific incidence of VBS was too small to report, according to the study. The researchers found that the incidence of any type of stroke among all patients was extremely low. For patients who saw a chiropractor, the risk of stroke was significantly lower at seven days com-pared to those patients who saw a primary care physician (1.2 per 1,000 vs. 1.4 per 1,000); but at 30 days, there was a slight elevation in risk for the chiropractic patients (5.1 per 1,000 vs. 2.8 per 1,000). However, the researchers noted that these small differ-ences in risk were of doubt-ful clinical significance. INFRASTRUCTURE UBC gets $5 million for new sport, exercise medicine centre Dr. Chan Gunn, a pioneering Vancouver physician in the field of pain relief, is giving $5 million to the University of British Columbia for construction of a new building devoted to exercise and sport medicine teaching, research and patient care. Gunn and his wife Peggy made the gift in recognition of UBC’s efforts to investigate, apply and teach intramuscular stimulation (IMS). IMS is a non-surgical, non-pharmaceutical technique developed by Gunn for alleviating pain resulting from nerve damage. A blend of acupuncture and western medicine, it involves inserting a needle deep into muscle, causing www.canadianchiropractor.ca it to relax and relieve pressure on pain-causing nerves. The 13,480-square-foot building, to be named the Chan Gunn Pavilion, will be the new home for UBC’s sport and exercise medicine centre – one of the first academic sports medicine units in the world, and the first in Canada. “Having a connection to UBC is very important for teaching and research into IMS,” Gunn said. “IMS will have a permanent home to grow.” UBC will commit $2.25 million for the first phase of the building, which will house space for community care and research activity, including IMS. UBC will continue fundraising for a second phase, which will provide additional space to conduct research. “The Chan Gunn Pavilion will create capacity to integrate IMS into the Division of Sports Medicine, and to expand research, teaching, and care into that technique and other therapies for sports injury and exercise-related health care,” said Dr. Gavin Stuart, dean of the Faculty of Medicine and UBC’s vice provost, health. The new building will be located next to the Doug Mitchell Thunderbird Sports Centre on Wesbrook Mall. Construction is scheduled to start in December 2015, following final approvals, and is expected to take two years. The centre will temporarily relocate to the Djavad Mowafaghian Centre for Brain Health in July until construction is complete. The centre’s current home for the past 35 years, situated in the middle of UBC’s athletic fields, will be torn down this summer to make way for the National Soccer Development Centre. Gunn’s donation forms part of UBC’s start an evolution campaign, the most ambitious fundraising and alumni engagement campaign in Canadian history. May 2015 Canadian Chiropractor 11
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