1

Prospective, Longitudinal Outcomes Study of Pregnant Women and Children Undergoing Subluxation Based Chiropractic Care

Dr. Matthew McCoy, DC, MPH, Dr. Pamela Stone, DC, CACCP,

Christie Kwon, MS, Maggie Ashworth, BS

Report on Initial Evaluation of Project

Report Prepared by: Maggie Ashworth BS

Student Clinician 302 Augusta Dr. Marietta, GA 30067

mashworth@student.life.edu 434-251-8409

Advisor: Dr. Matthew McCoy

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ABSTRACT

Objective: A prospective study of subluxation based chiropractic care for pediatric and

pregnant patients of varying complaints is discussed. Patient demographic data, history,

subluxation information, quality of life survey, and outcomes were documented.

Clinical Features: Nine pediatric patients and twenty-five pregnant patients presented for care

to one chiropractic office. Pediatric patients included three female patients and six male patients

aged 6 months to 9 years old. Pediatric complaints included: right ear infection; plagiocephaly

and torticollis; reduced left neck rotation; three cases of motor vehicle accidents; sinus and

asthma complaints; two cases of low back pain; and two cases of wellness care. Pregnancy

patients age ranged from 23 to 39 and included: four complaints of sacroiliac pain; three

complaints of mid back pain; ten complaints of low back pain; one complaint of a fetus being in

the transverse presentation; two complaints of breech presentation; one complaint of frank

breech presentation; one complaint of migraine; one complaint of knee pain; two complaints of

hip pain; one complaint of asthma; one complaint of coccyx pain; one complaint of asthma; one

complaint of shoulder pain; one complaint of sciatica; two complaints of neck pain; one case of a

motor vehicle accident; and the cases of wellness or maintenance care.

Intervention and Outcome: Pediatric patients were administered adjustments consisting of

high velocity, low-amplitude full spine Diversified adjustments, while pregnancy patients were

administered Webster Technique and Diversified adjustments.

Conclusions: Chiropractic care has been shown as a safe and effective in addressing various

complaints of pediatric and pregnant patients to pediatric and pregnant patient care. Further

research in the quality of life of patients undergoing subluxation based healthcare is warranted.

Key words: Pediatric, Pregnancy, Chiropractic, Health Outcomes, Subluxation

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INTRODUCTION

Chiropractic is an alternative healthcare model to allopathic medicine. The chiropractic

model of healthcare focuses on spinal alignment and the removal of neurological interference in

the form of subluxations. Chiropractic care is the most frequently sought alternative form of

healthcare in pediatric patients.1 Lee reported that in 1997 more patients were seeking care from

complementary and alternative medicine providers than from primary healthcare providers.1 In

1997 it was extrapolated that there was roughly 30 million pediatric patient visits to chiropractors

and 60 million pediatric visits in 2007.1-3 The most common pediatric complaints for seeking

chiropractic care include: wellness or prevention; ear, nose, and throat problems; digestive

disorders; respiratory problems; musculoskeletal complaints; behavioral or neurosensory

disorders; allergies; scoliosis; injuries; and post birth checkups.2,4-5 Chiropractic care has been

documented as a safe, non-allopathic healthcare that has demonstrated a high rate of

improvement in the child’s overall presenting complaint.2

Pregnancy patients often seek chiropractic care to help with musculoskeletal complaints;

as well as, to help facilitate in the labor and delivery process.6 During pregnancy change within

the load distribution occur within the lumbar spine, sacral spine, as well as, the sacroiliac joints.

The change in the weight distribution may cause increased pressure on the spine and nerve roots,

thus causing associated pain and spinal biomechanical dysfunction.6 Increased spinal pressure

and spinal biomechanical dysfunctions may lead to increased external pressure on the developing

fetus, thus causing intrauterine constraint within the pregnancy patient. The intrauterine

constraint may hinder the normal movement of the fetus and cause a breech presentation of the

fetus.6 The breech presentation is one in which the fetus presents in a caudal presentation (feet

or buttock presenting at the birth canal) rather than the cephalic positions (head first).7

Approximately 3-5% of pregnancies result in the breech presentation.7 The utilization of

4

chiropractic care has been shown to be beneficial for pregnancy patients presenting with

musculoskeletal and breech presentation complaints.6-20

The following study documents the prospective, longitudinal chiropractic care of

pediatric and pregnant patients. The presenting study documents the progression of subluxation

based chiropractic care of the patients entering into a single office. The care was provided by

one chiropractor that specializes in pediatric and pregnancy patients. Within the study the

assessment of the vertebral subluxation, as well as the healthcare assessment outcomes of the

presenting pregnancy and pediatric patients will be analyzed and discussed.

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METHODS

The study was conducted over 9 consecutive months to analyze and collect data from two

groups: pediatric patients and pregnant patients. Participants in the study included new pediatric

and pregnant patients entering into a single private chiropractic office, as well as, existing female

patients that became pregnant during the course of their chiropractic care. Each group completed

a quality of life health survey at the onset of chiropractic care. The pregnant patients completed

a 36 item short-form health survey (SF-36). The SF-36 included a multiple item scale to assess

eight health concepts: physical functioning, role activities associated with physical activity,

bodily pain, general mental health, vitality, social functioning, role activities associated with

emotional activity, and health perceptions.21 Children aged zero to two years old completed a

pre-school children quality of life questionnaire (TAPQOL). The TAPQOL consists of 43 items

that are divided over 12 multi-item scales.22 Components of the TAPQOL assess areas of

physical, social, cognitive, and emotional domains.22 Pediatric patients aged 2-4 completed the

pediatric quality of life inventory (PedsQL). The PedsQL for children aged 2-4 covers 21 health

related quality of life domains of physical, emotional, social, and school functioning.23 The

PedsQL compromises five response alternatives of: 0= never a problem; 1=almost never;

2=sometimes a problem; 3=often a problem; 4=almost always a problem.23 Children aged five to

eighteen completed a Child Health Questionnaire (PF 28). The PF 28 survey is a 28 item

questionnaire evaluating 13 areas of a child’s well-being that include: physical functioning;

role/social physical; general health; bodily pain; parental impact in terms of time; emotional

impact; family organization; family activities; social, emotional, and behavioral; self-esteem;

mental health; global behavior; and the child’s overall health.24 The health surveys were

repeated every thirty days to analyze the progression of the patient’s care.

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Nine pediatric patients entered into one local chiropractic office. For the pediatric

patients in the study demographic data, chief complaints, past health history, birthing history,

and presenting subluxation components were collected. Demographic data of date of birth, sex,

race, education level was taken on the pediatric patient. Past health history information included:

congenital disorders; musculoskeletal disorders; cerebrovascular problems; nervous system

complications; endocrine disorders; genitourinary complaints; digestive problems; reproductive

complaints; respiratory problems; eye, ears, or nose problems; neurological problems; trauma;

broken bones; hospitalizations; developmental milestones; immunizations; antibiotic use; and

prenatal care. Subluxation information was collected for initial exam and each consecutive 30

day re-examination. Information on subluxations included levels of spinal tenderness,

misalignments, and abnormal range of motion. Other subluxation components collected were

taken in the form of skin temperature measurements, muscle tension, and heart rate variability on

the presenting patients. Paraspinal skin temperatures were analyzed for asymmetry utilizing

thermographic readings from Insight Millenium Subluxatoin Station®. The Insight was also

utilized to record surface electromyographic (sEMG) readings to determine any muscle tension

asymmetry. Heart rate variability was recorded in the form of autonomic activity index and

autonomic balance index using Insight technology. The three variables of thermography, sEMG,

and heart rate variability were used to calculate a Neuro Spinal Functioning index (NSFi score).

Pediatric patients were delivered a full spine diversified technique adjustment. Diversified

technique is described as a high velocity, low amplitude thrust to a specific spinal or extraspinal

segment that has been identified as a segment of dysfunction.5

Twenty-five pregnant patients entered into one local chiropractic office. Information on

the pregnant patients included: demographic data, past and current history, subluxation

information, and pregnancy outcome information. Demographic data for the pregnant patient

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included: date of birth, race, highest level of education, occupation, and marital status. History

on the pregnant patient included: chief complaint; pregnancy complications; medications during

pregnancy; musculoskeletal disorders; cerebrovascular problems; nervous system complications;

endocrine disorders; genitourinary complaints; digestive problems; reproductive complaints;

respiratory problems; eye, ears, or nose problems; neurological problems; previous number of

times pregnant; previous number of times the patient has given birth; previous c-sections and

reason for c-section; previous vaginal deliveries; adjustments prior to pregnancy; and

adjustments in the presenting office. Subluxation information included levels of spinal

tenderness, levels of misalignments, and levels of altered range of motions. Insight readings of

thermographic data, sEMG data, heart rate variability; and NSFi score were also collected for the

pregnant patients. Pregnancy outcome information collected included: how many weeks

pregnant the patient was at the start of care, how many weeks of chiropractic care the patient was

under before pregnancy, if the patient was diagnosed as infertile, if the fetus presented as breech,

how many adjustments the patient received while pregnant, whether the patient ceased care

before birth, how the baby was born, whether the labor was induced, whether an epidural or

other medication was utilized, type of provider to deliver baby, type of birth, whether the patient

was able to have a vaginal birth after a previous c-section, segments adjusted while pregnant,

other care utilized during pregnancy, and any complications experienced while undergoing

chiropractic care. Pregnant patients were delivered a full spine Diversified Technique

adjustment when needed to the cervical, thoracic, lumbar, and pelvic spinal regions. The

Webster Technique was also utilized to determine if the pregnant patients had any intrauterine

constraint and an adjustment was delivered based on the analysis. The first part of the analysis

consists of determining the presence of any posterior sacral rotation causing utero-sacral

ligament stress and sacroiliac joint subluxation.7 To determine the presence of a posterior

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rotated sacrum the patient lies prone, while the chiropractor flexes the knees of the patient

toward the pelvis to determine the presence of any leg lag.7 The side of restricted motion

causing leg lag indicates posterior sacral rotation to the opposite side of restricted leg

movement.7 A low force adjustment was then delivered in the line of correction to the

determined posterior rotated sacral. The second part of the Webster analysis is determine the

presence of any trigger points along the round ligament that are defined as a palpable nodule

causing torque on the uterus, which leads to intrauterine constraint.7 Once any palpable nodules

were identified along the round ligament of the uterus a sustained pressure was held on each

separate trigger point for one minute, three separate times moving in a lateral to medial direction

along the round ligament.7

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RESULTS

A total of nine pediatric patients presented into a local chiropractic office. The children

ranged from the age of 6 months to 9 years old with an average age of 2.6. The pediatric patients

included three female patients and six male patients. The patients presented into the

chiropractor’s office for the following reasons: right ear infection; plagiocephaly and torticollis;

reduced left neck rotation; three cases of motor vehicle accidents; sinus and asthma complaints;

two cases of low back pain; and two cases of wellness care. Patient chiropractic visits ranged

from 1 visit to 27 visits, with an average of 7 visits. Three of the presenting patients have

dropped out of care. This is currently an ongoing study with data continually being collected.

Twenty-five pregnant patients presented to the same local chiropractic office. The age

ranges for the pregnancy patients was 23 to 39 with an average age of 30.56. Patient entered the

office with reasons that include: four complaints of sacroiliac pain; three complaints of mid

back pain; ten complaints of low back pain; one complaint of a fetus being in the transverse

presentation; two complaints of breech presentation; one complaint of frank breech presentation;

one complaint of migraine; one complaint of knee pain; two complaints of hip pain; one

complaint of asthma; one complaint of coccyx pain; one complaint of asthma; one complaint of

shoulder pain; one complaint of sciatica; two complaints of neck pain; one case of a motor

vehicle accident; and the cases of wellness or maintenance care. The presenting pregnant

patients included 8 patients that have previously been under chiropractic care in the current

office and 17 patients that have not been under care in this office. The patients in the study

consisted of 22 married women, two were single, and one patient was unspecified. Patient visits

ranged from 1 visit to 23 visits, with an average of 8.48 visits. Currently, nine patients have

dropped out of the study, one patient moved away, and eight patients have delivered their baby.

Of the deliveries, five of the patients delivered vaginally and 3 delivered via c-section. The

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reasons for deliveries via c-section included: one emergency c-section, one planned, and one

unspecified. The current study is presently ongoing with additional information to be collected

and added. Of the 4 fetal malpresentations, two of the fetuses turned to the appropriate delivery

positions, one was unable to turn, and one is unknown. The delivery for the fetal

malpresentations included one vaginal birth, one unknown, and two c-section deliveries, with

one being an emergency c-section.

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DISCUSSION

Pediatrics

Chiropractic care has been shown to be a safe complementary and alternative medicine

for children.2,25 Alcantara et al reported that based on a survey on the safety and effectiveness of

pediatric chiropractic care that chiropractors reported that 0.51% of pediatric patients or one in

1,812 patients resulted in a minor adverse event.2 Miller completed a review in 2009 detailing

the safety of manual therapy in pediatric patients.26 In the review Miller divide adverse reactions

to spinal manipulative therapy into mild, moderate, and severe.26 The review reported that in

2007 less than one percent of children experienced a mild side effect, such as irritability,

soreness, or stiffness.26 Only two moderate side effects (headache, stiff neck, and acute lumbar

pain) and four severe side effects (dysmetria, blindness, paraplegia, decrease coordination,

drowsiness, and unsteady gait) have been reported during a 59 year period with an estimate of 30

million chiropractic treatments per year.26 Alcantara et al reported that common reasons for

seeking chiropractic care include: wellness care; musculoskeletal complaints; throat problems;

neurological problems; colic; digestion/elimination problems; immune dysfunction; and trauma.2

Neurological complaints that have caused parents of pediatric patients to seek

chiropractic care include: attention deficit disorder, developmental delay syndromes, motor tics,

seizures, and autistic behaviors.27-33 Improvements in attention, behavior, and focus with a

decrease in hyperactivity have been noted in two separate case studies of a 3 year old male and a

10 year old male while receiving chiropractic care, nutritional advice, and proprioceptive

exercises.27,28 Brown reported that chiropractic care can be a complementary approach to

children suffering from seizures.33

Alcantara et al discussed a case study of a six year old with a medical diagnosis of

transient motor tic disorder. The patient presented with bilateral eye blinking and eye rolling in

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multiple directions before the onset of chiropractic care. The patient’s history revealed a

previous fall from her bicycle and a fall from her bed one week prior to the onset of involuntary

eye movements. The patient received Toggle adjustments to the cervical spine and Gonstead

Technique to the pelvis for 6 visits with a resulting resolution of the motor tic disorder.30 The

patient began experiencing complaints of eye blinking and involuntary movement 2 ½ months

later following an ice-skating fall. The patient was managed with the same protocol with

resolution of the complaints.30

Developmental assessment is an important component of the pediatric patient

examination. Components of the developmental assessment of the pediatric patient consists of

measuring weight, height, milestones, social development, motor development, emotional

development, sensory processing, and language.33

A case report documents a 2 year old fraternal twin female delivered by c-section due to

breech presentation. The patient presented with plagiocephaly, frequent rages, furious temper,

tantrums, nightmares, and slower intellectual and emotional development than her twin brother

that was born vaginally. The child was treated with chiropractic care and a multi-mineral

supplementation. After her 1st adjustment the patient had leveling of the head, shoulder and

pelvis. The patient began experiencing stability within her family and pre-school environment

and stopped walking on her toes after her 5th adjustment. The patient continued yearly follow-

ups and is now 7 years old and at the same developmental stage as her twin brother.29

Lerner completed a case study on a 4 year old male that had a history of learning

disorder and speech delay. The patient was seen for 44 visits utilizing Pettibon and Diversified

chiropractic adjustments. Following chiropractic care there was noted improvement in clarity of

speech, comprehension of verbal directions, improvement of emotional development and

behavior, and improvement in child’s attention.32 A case of a 30 month old, diagnosed to be

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within the Autistic spectrum, received full spine and cranial adjustments and demonstrated

improvements in social behavior and receptive language abilities after one month of care.31

Chiropractic care for gastrointestinal issues had been documented in cases of colic, acid

reflux, and constipation.35-42 Infantile colic affects 20% to 39% of infants within the first three

weeks after birth to the 3rd or 4th month of life.40 Six cases of 12 patients have demonstrated the

resolution of infantile colic following chiropractic care.35-40 A retrospective study of 16 infants

demonstrated a causal link between birth trauma-induced upper cervical injury and the onset of

acid reflux and colic. The retrospective study demonstrated a resolution of nine cases of acid

reflux and seven cases of infant colic following upper cervical chiropractic care.36

Approximately 3% of pediatric outpatient visits and 25% of pediatric gastrointestinal

visits are related to complaints associated with defecation.41 As suggested by the current

chiropractic literature, symptoms of pediatric constipation may be successful managed utilizing

chiropractic care.42 Two case studies have demonstrated resolution of constipation and

gastrointestinal complaints following chiropractic care.37,40

Nocturnal enuresis currently affects approximately 10-20.4% of children up to 7 years

old.43 The occurrence of bedwetting for males is 15-22% and 7-15% for females at age 7 years

old with a reduction to 1-2% during teenage years.43 Two case reports of a 9 year old boy and an

11 year old boy demonstrated a reduction in nocturnal enuresis following high velocity, low-

amplitude adjustments.43-44

Ear, nose, throat, sinus, allergy, and asthma complaints commonly affect children. Otitis

media accounts for over 35% of all pediatric visits in the United States and is the second most

common diagnosed childhood infection, after the common cold.45,46 Fallon completed a case

series of 332 children that had been diagnosed with otitis media at ages 27 days to 5 years and

found that there is a strong correlation between chiropractic adjustments and the resolution of

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otitis media.46 Fedorchuk reported a case study on a 8 year old female that experienced a

decrease in chronic otitis media, neck pain, headaches, and sinus infections following mirror

image adjustments, exercises, and traction to the cervical spine.45 Alcantara et al completed a

case study on a 7 year old male who suffered from asthma, allergies, and chronic colds.47

Following subluxation based care including specific low-force adjustments utilizing Activator

care the patient was able to discontinue allergy and asthma medications and the use of his

nebulizer.47 A case study documented a 17 month old female that presented with glaucoma due

top increase in intraocular pressure since birth.48 The patient had underwent 13 eye surgeries

before the age of 15 months and had an increase susceptibility to sinus infections.48 The patient

experienced a reduction in sinus infections and the restoration of normal intraocular pressure

following Activator and Craniosacral adjustments.48 An 11 year old patient presented for

chiropractic care following complaints of chronic sinus infection and a loss of olfaction that was

restored following three months of chiropractic care.49

Alcantara et al reported out of 577 surveyed patient reports that 26% of the patient

complaints were musculoskeletal related.2 Torticollis is a musculoskeletal condition that is

defined as a unilateral contracture of the sternocleidomastoid muscle (SCM).50 Torticollis can

affect infants for a variety of reasons that may include stretching of the SCM during delivery that

can result in a pseudotumor, subluxation of the upper cervical vertebra from fetal positioning, or

a difficult delivery.50 Pseudotumor and upper cervical subluxation represent the most common

etiologies of neonatal torticollis.50 Fetal malpositions such as posterior or breech presentation

account for a large amount of torticollis in neonates.50 The atlanto-axial motor unit has been

identified as the most common area of subluxation in congenital torticollis.50 Subluxations of the

lower cervical and thoracic spine has also been identified in the etiology of cases of torticollis.50

A case study presented a 10 year old boy with complaints of acute onset of torticollis, neck pain

15

and subluxation that was managed with Torque Release Technique, Activator Methods,

interferential and moist heat to the cervical and thoracic spine.3 The patient was pain free, had

improved posture, and an increase in range of motion following 12 chiropractic visits.3

Cervical dysfunction has been a proposed cause of migraine. It has been proposed that

upper cervical dysfunction can lead to pressure on the trigeminal afferent nerve, which can cause

the perception of pain associated with migraines. In a case of a 12 year old boy with complaints

of neck pain, migraine, and associated vertigo the patient was able to experience a cessation of

symptoms following chiropractic care.51

Recent studies have estimated the prevalence of low back pain in children to be

approximately 50% with roughly 15% experiencing frequent or constant pain. Fifty-four

children presented with complaints of low back pain and were treated with chiropractic care.

The results of the chiropractic care were favorable in reduction of pain with no reported

complications.52

The following study presented pediatric patients entering into a local chiropractic office

with complaints of ear pain, torticollis, neck pain, asthma, allergies, and low back pain.

Reduction in subluxation findings has been shown to assist in the resolution of such symptoms.

Based on the previous discussed literature chiropractic care has been shown favorable in cases of

these complaints.

Pregnancy

It has been reported by the National Board of Chiropractic Examiners that chiropractors

co-manage 72.1% of pregnant patients.53 A chiropractic survey by Stuber identified that of

surveyed chiropractors 94% felt that spinal manipulative therapy is a appropriate treatment for

pregnant patients experiencing low back pain, mid-back pain, neck pain, and headache.54 Stuber

documented the percentage of chiropractors that would manage pregnant patients with the

16

following co-morbidities: multiple pregnancy (83%), gestational diabetes (56%), hypertension

(39%), pre-eclampsia (22%), ectopic pregnancy (11%), blood disorders (11%), and excessive,

unexplained spotting (0%).54 Ninety-four percent of surveyed chiropractors indicated that

chiropractic care for pregnancy patients is somewhat safe and two-thirds of those surveyed

indicated that spinal manipulative therapy was extremely safe for the pregnant patient.54 The

safety of chiropractic in pregnant patients is shown in a case series of 17 patients receiving

chiropractic care.17 In the case series 16 of the17 patients experienced clinical improvement

after an average of 4.5 chiropractic visits with no adverse effects reported to care.17 Chiropractic

care has also been shown as a safe and effective treatment for pregnancy patients suffering from

headaches.19 For the pregnancy patient certain circumstances indicate a contraindication for

chiropractic care and warrant a referral. Contraindications for chiropractic care include, but not

limited to: vaginal bleeding, ruptured amniotic membrane, cramping, sudden onset of pelvic

pain, premature labor, placenta previa, placenta abruption, ectopic pregnancy, and moderate to

severe toxemia.6

Approximately 48% to 56% of pregnant patients experience pregnancy related

lumbopelvic pain.10 It has been stated that women who experience pregnancy related

lumbopelvic pain during pregnancy are more likely to experience pain in that region during

delivery.10 It has been reported that 72% of pregnant patients experiencing low back pain would

likely benefit from chiropractic care.6 Four case studies of presenting pregnancy patients

experiencing low back pain was effectively reduced utilizing chiropractic care.8,9,11,13 In one of

the previous case studies a radiating component into bilateral hips and the right leg was also

relieved following Cox flexion and distraction technique.8

A prospective study on pregnancy related lumbopelvic pain documents the care of 115

patients. The study depicts that 57% of the 115 patients experienced an excellent or good

17

improvement, 51% experienced clinically significant improvements in disability, and 67% of

patients experienced a clinically significant improvement in pain after the onset of care. The

study completed follow-up data on 61 patients for an average of 11 months. The follow-up data

revealed that 85.5% of the patients rated their improvement as excellent or good, 73% reported a

clinically significant improvement in disability, and 82% experienced a clinically significant

improvement in pain.10

Borggren states that pregnancy patients seek chiropractic care “to assure the patient a

comfortable pregnancy and to aid in an uncomplicated labor and delivery”.6 A case study details

chiropractic care during the delivery of a baby girl in a 26 year old nulliparious female.12 After

23 hours of labor the patient was only 7 cm dilated with significantly diminished frequency and

duration of contractions and a noted decrease fetal heart tone.12 Chiropractic care was utilized at

this time via the Webster Technique to patient’s left posterior rotated sacrum and the pregnancy

psoas release technique to the right psoas.12 Following the chiropractic care the attending

midwife reported improvement in labor progression.12 At 34 hours of labor the chiropractor

performed the psoas release technique again, half an hour later the patient was in full cervical

dilation, and at 35 hours the baby was born.12

Increased external force that obstructs fetal movement can result in intrauterine

constraint.6 Intrauterine constraint has been related to increased incidents of fetal malpositions,

such as a transverse (perpendicular position) or breech presentation (buttock or foot presentation)

of the fetus, and structural defects to the peripheral and craniofacial skeleton.6,15 The occurrence

of perinatal mortality is four times higher in a breech presentation than in a normal vertex

position.15 Malposition of the fetus, such as a breech presentation, can hinder a vaginal birth,

thus necessitating a c-section. Approximately 13% of performed c-sections are due to breech

presentation.15

18

The Webster Technique has been shown to balance the pelvis and the corresponding

muscles and ligaments to alleviate intrauterine constraint.6 The reduction of intrauterine

constraint allows for decrease pressure on the uterus to enhance a favorable environment for the

fetus to assume the appropriate position.6 A survey administered to chiropractors involved in the

International Chiropractic Pediatric Association indicated that 82% utilize the Webster

Technique with a 92% success rate in alleviating intrauterine constraint.15 Five reporting studies

discuss the alleviation of intrauterine constraint and successful transitions of the fetus to the

vertex positions in twelve pregnancy cases utilizing Webster Technique.7,14,16,18,20 In one of the

five reporting studies the Webster Technique was utilized with the Activator Adjusting

Instrument to reduce the sacral subluxation to allow for a decrease in intrauterine constraint.18

The following survey documented 25 pregnancy patients that entered into one

chiropractic office with complaints of fetal malposition and musculoskeletal complaints.

Chiropractic care has been documented as a successful management in cases of breech

presentation and musculoskeletal complaints such as low back pain and headaches as a result of

removal of subluxations presenting in a patient. 6-20

19

CONCLUSION

A safe and effective alternative healthcare for pediatric patients has been shown to be

chiropractic care. Following correction of subluxations, through chiropractic care, patients

reported improved symptomatology associated with: musculoskeletal problems; ear, nose, and

throat problems; neurological complications; gastrointestinal complaints; and genitourinary

problems following the removal of neurological interference due to spinal biomechanical

alteration. Symptoms associated with musculoskeletal complaints and fetal malposition has been

shown to reduce following subluxation based chiropractic care. Quality of life measurements

were taken and analyzed based on the progression of subluxation based care. Due to the limited

amount of research on pediatric and pregnant patients and those patient’s quality of life

measurements further research in this area is warranted.

20

ACKNOWLEDGEMENTS

The author of this paper would like to thank Dr. Matthew McCoy for the guidance and

opportunity to participate in this study. Special thanks is also given to Dr. Pamela Stone for

providing the subluxation based chiropractic care and to Christie Kwon for direction and support

during the duration of this study.

21

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