DESIGN: Cohort, nonrandomized retrospective study.
SETTING: Private chiropractic practice in a Minneapolis suburb.
PARTICIPANTS: Forty-six children aged 5 yr and under.
INTERVENTION: All treatments were done by a single chiropractor, who adjusted the subluxations found and paid particular attention to the cervical vertebrae and occiput. Sacral Occipital Technique-style pelvic blocking and the doctor's own modified applied kinesiology were also used. Typical treatment regimen was three treatments per week for 1 wk, then two treatments per week for 1 wk, then one treatment per week. However, treatment regimen was terminated when there was improvement.
OUTCOME MEASURE: Improvement was based on parental decision (they stated that the child had no fever, no signs of ear pain, and was totally asymptomatic), and/or the child seemed to be asymptomatic to the treating DC and/or the parent stated that the child's MD judged the child to be improved. A data abstraction form was used to determine number of treatments used and presence of factors possibly associated with early improvement.
RESULTS: 93% of all episodes improved, 75% in 10 days or fewer and 43% with only one or two treatments. Young age, no history on antibiotic use, initial episode (vs. recurrent) and designation of an episode as discomfort rather than ear infection were factors associated with improvement with the fewest treatments.
CONCLUSION: Although there were several limitations to this study (mostly because of its retrospection but also, significantly, because very little data was found regarding the natural course of ear infections), this study's data indicate that limitation of medical intervention and the addition of chiropractic care may decrease the symptoms of ear infection in young children.
Froehle RM. Ear infection: a retrospective study examining improvement from chiropractic care and analyzing for influencing factors. J Manipulative Physiol Ther 19 (3): 169-177 (Mar 1996)
Design: A case series.
Setting: Private practice. Patients: Selection of patients (n=5) was determined by age (0 to 5 years), and an existing diagnosis of chronic recurrent otitis media. Selected patients must also have been under the regular care of their medical pediatrician for this condition, for at least 6 months, without resolution.
Outcome Measures: Resolution of the condition was determined by normal otoscopic examination findings, including pneumatic otoscopy and reduction of fever.
Results: For each case, the clinical results of a short series of chiropractic spinal adjustments are presented. Each of the 5 children selected for this study responded favorably to the treatment provided. Response time for each case was recorded as 4 days, 3 days, 8 days, 8 weeks and 3 weeks, respectively. None of the cases required more than 5 treatment sessions. No complications were noted and no tympanostomy procedures were performed.
Conclusion: The author has presented a case series of five patients with chronic recurrent otitis media who underwent a program of chiropractic case management, including specific spinal adjustments. All patients had excellent outcomes with no residual morbidity or complications. Hypothetical mechanisms for the putative effects of spinal adjustments at areas exhibiting signs of subluxation, in patients with otitis media, are presented. The relative effectiveness of the various treatments used in case management, including adjustments and lymphatic massage, was not addressed in this case series. More formalized experimental designs, including randomized controlled trials, are needed to fully address the scientific issues, in order to determine if the clinical results seen in this case series can be generalized to other patients. The associated morbidity of current medical and surgical options for OME, coupled with a lack of rigorous experimental designs in some reports, further necessitates the exploration of alternative approaches to case management.
FYSH, PN Chronic Recurrent Otitis Media: Case Series of Five Patients With Recommendations for Case Management. JOURNAL OF CLINICAL CHIROPRACTIC PEDIATRICS. 1996 . 1(2). pp 66