{"id":3815,"date":"2001-05-01T00:00:00","date_gmt":"2001-05-01T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/chiropractic-manipulation-and-stroke-a-population-based-case-control-study\/"},"modified":"2023-06-14T20:01:42","modified_gmt":"2023-06-15T00:01:42","slug":"chiropractic-manipulation-and-stroke-a-population-based-case-control-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/chiropractic-manipulation-and-stroke-a-population-based-case-control-study\/","title":{"rendered":"Chiropractic manipulation and stroke: a population-based case-control study"},"content":{"rendered":"<p><span class=\"bold\">Background and Purpose<\/span> &#x2014; Several reports have linked chiropractic manipulation of the neck to dissection or occlusion of the vertebral artery. However, previous studies linking such strokes to neck manipulation consist primarily of uncontrolled case series. We designed a population-based nested case-control study to test the association.<\/p>\n<p><strong>Methods<\/strong> &#x2014; Hospitalization records were used to identify vertebrobasilar accidents (VBAs) in Ontario, Canada, during 1993&#x2013;1998. Each of 582 cases was age and sex matched to 4 controls from the Ontario population with no history of stroke at the event date. Public health insurance billing records were used to document use of chiropractic services before the event date.<\/p>\n<p><strong>Results<\/strong> &#x2014; Results for those aged &lt;45 years showed VBA cases to be 5 times more likely than controls to have visited a chiropractor within 1 week of the VBA (95% CI from bootstrapping, 1.32 to 43.87). Additionally, in the younger age group, cases were 5 times as likely to have had &#x2265;3 visits with a cervical diagnosis in the month before the case&#x2019;s VBA date (95% CI from bootstrapping, 1.34 to 18.57). No significant associations were found for those aged &#x2265;45 years.<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; While our analysis is consistent with a positive association in young adults, potential sources of bias are also discussed. The rarity of VBAs makes this association difficult to study despite high volumes of chiropractic treatment. Because of the popularity of spinal manipulation, high-quality research on both its risks and benefits is recommended. <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background and Purpose &#x2014; Several reports have linked chiropractic manipulation of the neck to dissection or occlusion of the vertebral artery. However, previous studies linking such strokes to neck manipulation consist primarily of uncontrolled case series. We designed a population-based nested case-control study to test the association. Methods &#x2014; Hospitalization records were used to identify [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[40],"migration-helper-qa-sample-set":[],"class_list":["post-3815","journal_article","type-journal_article","status-publish","hentry","topic-cardiovascular-disease"],"acf":{"citation":"Rothwell DM, Bondy SJ, Williams JI. <em>Stroke<\/em>. 2001; 32(5):1054-60.","source_url":"http:\/\/stroke.ahajournals.org\/content\/32\/5\/1054.long","ices_scientist":[1179,1134],"site":[6733],"research_program":[6744],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"E4AED33F-3713-4B36-9A73-C5F718EDB5E0","sitecore_item_name":"Chiropractic-manipulation-and-stroke-a-population-based-case-control-study","sitecore_field_values":"{\n  \"Title\": \"Chiropractic manipulation and stroke: a population-based case-control study\",\n  \"Short title\": \"Chiropractic manipulation and stroke: a\",\n  \"Citation\": \"<p>Rothwell DM, Bondy SJ, Williams JI. <em>Stroke<\/em>. 2001; 32(5):1054-60.<\/p>\",\n  \"Abstract\": \"<p><span class=\"bold\">Background and Purpose<\/span> &mdash; Several reports have linked chiropractic manipulation of the neck to dissection or occlusion of the vertebral artery. However, previous studies linking such strokes to neck manipulation consist primarily of uncontrolled case series. We designed a population-based nested case-control study to test the association.<\/p>n<p><strong>Methods<\/strong> &mdash; Hospitalization records were used to identify vertebrobasilar accidents (VBAs) in Ontario, Canada, during 1993&ndash;1998. Each of 582 cases was age and sex matched to 4 controls from the Ontario population with no history of stroke at the event date. Public health insurance billing records were used to document use of chiropractic services before the event date.<\/p>n<p><strong>Results<\/strong> &mdash; Results for those aged &lt;45 years showed VBA cases to be 5 times more likely than controls to have visited a chiropractor within 1 week of the VBA (95% CI from bootstrapping, 1.32 to 43.87). Additionally, in the younger age group, cases were 5 times as likely to have had &ge;3 visits with a cervical diagnosis in the month before the case&rsquo;s VBA date (95% CI from bootstrapping, 1.34 to 18.57). No significant associations were found for those aged &ge;45 years.<\/p>n<p><strong>Conclusions<\/strong> &mdash; While our analysis is consistent with a positive association in young adults, potential sources of bias are also discussed. The rarity of VBAs makes this association difficult to study despite high volumes of chiropractic treatment. Because of the popularity of spinal manipulation, high-quality research on both its risks and benefits is recommended. <\/p>n<p><a href=\"http:\/\/stroke.ahajournals.org\/content\/32\/5\/1054.long\" title=\"External link opens\">View full text<\/a><\/p>\",\n  \"Keywords\": \"{E35EA75E-2C35-42CC-90D1-00302436CB1C}\",\n  \"Research Programs\": \"{DD981CF2-C2A6-457A-9917-A8DD64CCF7D6}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{13D37538-C133-4F27-B8FC-0BBCA8EEF8EF}|{BAE8C689-AC7A-45F8-BFA6-7494B4DC885F}\",\n  \"Posted Date\": \"20010501T000000\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2001\/January\/Chiropractic-manipulation-and-stroke-a-population-based-case-control-study"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Chiropractic manipulation and stroke: a population-based case-control study<\/title>\n<meta name=\"description\" content=\"Background and Purpose &#x2014; 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