Structural rehabilitation of the cervical lordosis and forward head posture: a selective review of Chiropractic BioPhysics® case reports.
Paul A Oakley, Sean Z Kallan, Deed E Harrison
PMID 36337218WHAT IT FOUND
Across 60 patients, Chiropractic BioPhysics case reports showed an average 14.1° increase in cervical lordosis and a 4.9-point reduction in pain.
These improvements occurred alongside other treatments, so the specific contribution of extension traction cannot be separated.
Key findings
01Case reports documented an average 14.1° improvement in cervical lordosis and an average 4.9-point reduction in pain on an 11-point scale.
02Multiple treatments were performed concurrently on patients, which conceals which specific aspects of the regimen contributed to the improvements in lordosis and pain relief.
03Only 3 out of the 41 manuscripts presented information on more than one case, meaning the majority were single case reports.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is a review of case reports and case series, which are the lowest level of evidence for determining treatment efficacy. No statistical analysis was performed because the included studies were not controlled trials. Patients received multiple concurrent treatments (adjustments, exercises, traction), making it impossible to determine which component caused the improvement. The review was conducted by authors with financial ties to the organization promoting the technique. Outcomes were not pre-registered, and there is no control group to account for natural history or placebo effects.
Declared interests
Dr. Paul Oakley is a paid consultant for CBP NonProfit, Inc. Dr. Deed Harrison teaches chiropractic rehabilitation methods and sells products used in the manuscript. The review primarily sourced its data from the CBP NonProfit website.
The easy way to misread this
Do not interpret the average 14.1° increase in cervical lordosis or the 4.9-point pain reduction as proof that extension traction works. These patients also received spinal adjustments and exercises, and the review cannot separate the effects of these combined treatments.