A Method to Assess Neurological Effectiveness of a Spinal Adjustment for an Individual Patient: A Descriptive Study


  • John Hart Sherman College of Chiropractic, P.O. Box 1452, Spartanburg, SC 29304, USA




Resting pulse rate, biostatistics, chiropractic adjustment


Introduction: A hallmark in health care research is comparison, typically done by comparing groups of patients, e.g., intervention group versus no intervention group. The clinician may be interested in bringing these research methods to the level of the individual patient in practice. Such is done in the present study, where the neurological indicator of resting pulse rate (RPR) is compared pre versus post spinal adjustment, and also compared to instances of no adjustment – for one individual patient. Research indicates that a lower RPR is healthier than a higher RPR.

Methods: Neurological disturbance was operationally defined in the present study as at least two increases in RPR on consecutive visits. Based on this criterion, the patient, over hundreds of RPR measures observed over approximately 2 years, had 16 instances of neurological disturbance; in one of these instances a chiropractic spinal adjustment was given. The 15 other instances were used to estimate a predicted post RPR, which was compared to the observed post-adjustment RPR.

Results: Post-adjustment RPR was 67.5 beats per minute (BPM) which was only slightly lower than the average predicted post RPR of 68.1 BPM.

Conclusion: The method described may help clinicians determine if their intervention was neurologically effective. The method also provides normative RPR data for future comparisons of adjustment versus no adjustment. In the present case, the chiropractic adjustment post RPR was better (lower) than the predicted post RPR, but only slightly so.


Palmer DD. Text-Book on the Science, Art, and Philosophy of Chiropractic. Portland, OR: Portland Printing House 1910.

Association of Chiropractic Colleges [Internet page]. Chiropractic paradigm. The subluxation. Accessed on December 16, 2015 from: http://www.chirocolleges.org/ paradigm_scope_practice.html

Sherman College of Chiropractic [Internet page]. Sherman College focuses on vertebral subluxation. Accessed on January 29, 2016 from: http://www.sherman.edu/? page_id=2335

Mensink GBM, Hoffmeister H. The relationship between resting heart rate and all-cause, cardiovascular and cancer mortality. Eur Heart J 1997; 18: 1404-1410. http://dx.doi.org/10.1093/oxfordjournals.eurheartj.a015465 DOI: https://doi.org/10.1093/oxfordjournals.eurheartj.a015465

Hsia J, Larson JC, Ockene JK, Sarto GE, Allison MA, Hendrix SL, Robinson JG, LaCroix AZ, Manson JE. Resting heart rate as a low tech predictor of coronary events in women: prospective cohort study. Brit Med J 2009; 338: 577-580. http://dx.doi.org/10.1136/bmj.b219 DOI: https://doi.org/10.1136/bmj.b219

Paul L, Hastie CE, Li WS, Harrow C, Muir S, Connell J, Dominiczak AF, McInnes GT, Padmanabhan S. Resting heart rate pattern during follow-up and mortality in hypertensive patients. Hypertension 2010; 55(part 2): 567-574. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.109.144808

Jouven X, Empana JP, Escolano S, Buyck JF, Tafflet M, Desnos M, Ducimetiere P. Relation of heart rate at rest and long term (> 20 years) death rate in initially healthy middle –aged men. Am J Cardiol 2009; 103: 279-283. http://dx.doi.org/10.1016/j.amjcard.2008.08.071 DOI: https://doi.org/10.1016/j.amjcard.2008.08.071

Erikssen J, Rodahl K. Resting heart rate in apparently healthy middle-aged men. Eur J Appl Physiol O 1979; 42(1): 61-69. http://dx.doi.org/10.1007/BF00421105 DOI: https://doi.org/10.1007/BF00421105

Hart J. Association between heart rate variability and manual pulse rate. J Can Chiropr Assoc 2013; 57(3): 243-250.

Hart J. Reduction of resting pulse rate following chiropractic adjustment of atlas subluxation. Ann Vert Sublux Res 2014; March 3: 16-21.

Zhang J, Dean D, Nosco D, Strathopulos D, Floros M. Effect of chiropractic care on heart rate variability and pain in a multisite clinical study. J Manip Physiol Ther 2006; 29: 267-274. http://dx.doi.org/10.1016/j.jmpt.2006.03.010 DOI: https://doi.org/10.1016/j.jmpt.2006.03.010

Hart J. Comparison of resting pulse rates in chiropractic students versus the general population. Top Integr Health Care 2012; 3(4): ID 3.4005.

Zaiontz C [Internet page]. Real statistics using Excel. Accessed on April 2, 2016 from: http://www.real-statistics.com/regression/confidence-and-prediction-intervals/

Acock A. A gentle introduction to Stata. 3rd Edition. College Station, TX: Stata Corp 2010.

American Heart Association [Internet page]. Study backs guidelines: People with hypertension should get top number below 140. Accessed on April 3, 2016 from: http://news.heart.org/study-backs-guidelines-people-with-hypertension-should-get-top-number-below-140/




How to Cite

Hart, J. (2016). A Method to Assess Neurological Effectiveness of a Spinal Adjustment for an Individual Patient: A Descriptive Study. International Journal of Statistics in Medical Research, 5(3), 168–174. https://doi.org/10.6000/1929-6029.2016.05.03.2



Special Issue - Inference in Clinical Experiments