There’s an idiom in chiropractic circles that gets repeated a bit: that we aim to add years to life and life to years. For a long time, this is a statement that was aspirational in its nature but more recently, the focus of research has shifted to measuring quality of life. Case reports are an excellent way of getting an individualised, qualitative look at the difference chiropractic can make. We need research and data, but at the end of it all, humans are at the centre of our practice. How subluxation impacts their ability to interact with and express life is, in a way, proof of concept.
In the recently published edition of the Asia Pacific Chiropractic Journal, a new tranche of case reports examining functional health and quality of life measures landed. Among them, a particularly moving tale of chiropractic care in the case of a Cerebral Palsy sufferer who was seeking assistance with symptoms relating to her condition.
We know that Cerebral Palsy (CP) is a lifelong condition for sufferers, and that health modalities are brought in to assist with muscle spasticity and other associated symptoms. These can range from fine and gross motor skills, balance, muscle tone, speech difficulties, tremors, and difficulties with eating, among other things. The condition can be mild to severe and may even include seizures or continence problems.
This particular case sat at the more severe end of the CP spectrum. When she came in for chiropractic care at an Advanced Biostructural Correction-based clinic, she was using a wheelchair. She had experienced difficulties in getting good care and staying under care for extended periods, as many health practitioners could not promise improvement.
At the time of her presentation, she was 52 years old with a long medical history of symptoms related to the condition. She could walk as a child, but was now restricted to a wheelchair. She now had only very limited movement and was dependent on support workers even for basic activities like house chores, dressing and toileting. She was able to speak with little restriction, but her pain and disability was constant and significant.
When she began care, she was unable to stand, so the chiropractor had to amend the examination protocol, and then use a lift to transfer her to the adjusting table. At the beginning of care, she was in a rigid kyphotic posture, which made it impossible to even lie flat. While some people with CP tend towards low muscle tone, she was hypertonic, in a constant state of restriction.
Her initial reasons for care where low back, neck and shoulder pain, for which she sought care twice weekly. However, over the course of time (and subluxation-based chiropractic care) balance, posture and resolution of faecal and urinary incontinence became secondary aims.
As her care plan played out, she became able to lie flat on the adjusting table – a significant improvement in and of itself. But this occurred alongside other significant changes too – improvements in balance, mobility and the ability to self-manage her body. This included decreases in pain and muscle spasticity, and improvements in continence. She was able to sit comfortably in her chair, and her subluxations improved alongside her spinal curvatures. Even though she was not walking, the chiropractor still adjusted her tarsals in line with the ABC protocol and noted that this would consistently reduce her lumbar rotation.
All of this culminated in significant functional and life differences for the patient. One of her major goals was to continue living independently, but she required so much help on a daily basis at the onset of care. Thus, all of these changes that occurred under care had a significant impact on the trajectory of her life in terms of quality, independence, and more. She characterised this as life-changing.
Her chiropractor noted that when she dipped below two visits per week, there was an impact on her health. And so, over time, it was decided that it was best to keep her on a twice-weekly care plan. This provides interesting insight in terms of care frequency. Under many circumstances, chiropractors aim to decrease care frequency over time. However, this is one of several case reports in which chronic or life-long conditions respond best to a constant frequency of care.
This raises the importance of working with the patient and their goals over a long period of time, and keeping a careful eye on how their nervous system and functional health responds over time.
Quality of life isn’t just about pain and suffering. It’s about dignity, independence and getting the most out of life. Many people are able to take that for granted. But for some it is a fight. In this case, it seems that the chiropractor was indeed, and remains to be, a powerful ally.
