REDUCED ANXIETY SYMPTOMS IN A PATIENT SCREENED WITH THE PHQ4 RECEIVING CHIROPRACTIC CARE: A CASE REPORT AND REVIEW OF THE LITERATURE
Main Article Content
Keywords
Physical Functioning; Range of Motion; Vertebral Subluxation; Low Back Pain; Neck Pain; Posture; PHQ-4, Anxiety
Abstract
Objective: To chronicle the improvement in mental health, physical functioning and life enjoyment in a 38-year-old female receiving Torque Release Technique (TRT) for the assessment and correction of vertebral subluxation.
Clinical features: A 38-year-old female presented for chiropractic care with a 3-month history of anxiety and panic attacks, and chronic low back and neck discomfort. Depression and anxiety were screened for using the PHQ-4 instrument. Postural alterations and reduction in cervical and lumbar ranges of motion (ROM) were found in conjunction with indicators of vertebral subluxation throughout the spine.
Intervention & Outcomes: Chiropractic care using TRT was provided for the assessment and correction of vertebral subluxations over 12-visits. The patient reported subjective improvement in musculoskeletal discomfort, mental health, and physical functioning as screened for with the PHQ-4 and Health Wellness and Quality of Life questionnaires. Objective improvement in posture, spinal ROM, surface electromyography and paraspinal thermography studies, and reduction of indicators of vertebral subluxation were recorded.
Conclusion: A course of chiropractic care, using TRT for the assessment and correction of vertebral subluxation, was associated with resolution of subjectively reported musculoskeletal discomfort, improvement in measured mental health and physical function in a 38-year-old female.
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References
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3. Hurwitz EL, Randhawa K, Yu H, Côté P, Haldeman S. The Global Spine Care Initiative: a summary of the global burden of low back and neck pain studies. European Spine J 2018; 1-6. 27:796-801 10.1007/s00586-017-5432-9
4. GBD 2015. The burden of mental disorders in the Eastern Mediterranean region, 1990-2015: Findings from the global burden of disease 2015 study. Int J Public Health 2018;63(1):25-37
5. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators (2016) Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388:1545–1602. doi:10. 1016/S0140-6736(16)31678-6).
6. Kassebaum NJ, Arora M, Barber RM, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet 2016; 388:1603–1658
7. Merriam-Webster.com (homepage on the Internet). “Anxiety”; 2016. Available from: http://www.merriam-webster.com/. (Accessed October 16, 2018)
8. Sharma A, Kudesia P, Shi Q, Gandhi R. Anxiety and depression in patients with osteoarthritis: impact and management challenges. Open Access Rheumatology: research and reviews. 2016;8:103
9. Nail JE, Christofferson J, Ginsburg GS, Drake K, Kendall PC et al. Academic impairment and impact of treatments among youth with anxiety disorders. In Child Youth Care Forum 2015; 44(3):327-342
10. Moore THM, Kapur N, Hawton K, Richards A, Metcalfe C, et al. Interventions to reduce the impact of unemployment and economic hardship on mental health in the general population: a systematic review. Psychol Med 2017;47(6):1062-1084
11. Bryans R, Decina P, Descarreaux M, Duranleau M, Marcoux H et al. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. J Manipulative Physiol Ther 2014;37(1):42-63
12. Blanchette M-A, Stochkendahl MJ, Borges Da Silva R, Boruff J, Harrison P et al. Effectiveness and economic evaluation of chiropractic care for the treatment of low back pain: a systematic review of pragmatic studies. PLoS ONE 2016;11(8): e0160037
13. Yates GR, Lamping DL, Abram NL, Wright C. Effects of chiropractic treatment on blood pressure and anxiety: A randomized, controlled trial. J Manipulative Physiol Ther 1988;11(6):484-488
14. Brockman S. The role of chiropractic manipulation in promoting an individual’s perception of psychological well being. Clin Chiropr 2007;10:8-23
15. Kroenke K, Spitzer RL, Williams JB, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics 2009;50(6):613-21
16. Blanks R, Schuster T, Dobson M. A retrospective assessment of network care using a survey of self-rated health, wellness and quality of life. J Vertebral Subluxation Res 1997;1:15–27
17. Marino M, Langrell P. Longitudinal assessment of chiropractic care using a survey of self-rated health, wellness and quality of life: a preliminary study. J Vertebral Subluxation Res 1999;3:1–9
18. Lachtman DS, Bartha DA, Beltran MM, Dominguez DN, Messerli AR, Miller SE, Davis AM, Nelson-Wong E. Rater reliability and concurrent validity of single and dual bubble inclinometry to assess cervical lateral flexion. J Manipulative Physiol Ther 2015 Oct;38(8):572-80
19. Triano J, Budgell B, Bagnulo A et al. Review of methods used by chiropractors to determine the site for applying manipulation. Chiropr Man Ther 2013;21(36):1-29
20. Holt K, Russell D, Cooperstein R, Young M, Sherson M, et al. Interexaminer reliability of a multidimensional battery of tests used to assess for vertebral subluxation. Chiropr J Aust 2018; 6(1):100-117
21. Walker BF, Buchbinder R. Most commonly used methods of detecting spinal subluxation and the preferred term for its description: a survey of chiropractors in Victoria, Australia. J Manipulative Physiol Ther 1997;20(9):583-589
22. Owens E. Chiropractic subluxation assessment: What the research tells us J Can Chiro Assoc 2002;46(4):215-220
23. Currie SJ, Myers CA, Durso C, Enebo BA, Davidson BS. The neuromuscular response to spinal manipulation in the presence of pain. J Manipulative Physiol Ther 2016;39(4):288-293
24. Kelly S, Boone WR. The clinical application of surface electromyography as an objective measure of change in the chiropractic assessment of patient progress: a pilot study. J. Vertebral Subluxation Res 1998;2(4):1-7
25. Kent C: Surface electromyography in the assessment of changes in muscle activity associated with vertebral subluxation: a review. J. Vertebral Subluxation Res 1997;1(3):1-8
26. McCoy M, Campbell I, Stone P, Fedorchuk C, Wijayawardana S et al. Intra-examiner and inter-examiner reproducibility of paraspinal thermography. PLoS One. 2011;6(2):e16535
27. Mansholt BA, Vining RD, Long CR, Goertz CM. Inter-examiner reliability of the interpretation of paraspinal thermographic pattern analysis. J Can Chiropr Assoc 2015;59(2):157-164
28. Owens EF, Hart JF, Donofrio JJ, Haralambous J, Mierzejewski E. Paraspinal skin temperature patterns: An interexaminer and intraexaminer reliability study. J Manipulative Physiol Ther 2004;27:155-159
29. Nadler A, Holder JM, Talsky MA. Torque Release Technique (TRT): A technique model for chiropractic's second century. Canadian Chiropr 1998;3(1)
30. Fletcher D. Tonal Solution for Subluxation Patterns: Torque Release Technique analyzes cranial-spinal meningeal functional unit. Canadian Chiropr 2004;9(2):20-24
31. Davidson J, Feltner D, Dugar A. Management of generalized anxiety disorder in primary care: identifying the challenges and unmet needs. Prim Care Companion J Clin Psychiatry 2010;12(2)
32. Hansen AH, Kristoffersen AE. The use of CAM providers and psychiatric outpatient services in people with anxiety/depression: a cross-sectional survey. BMC Compl Alternative Med 2016;16:461
33. Spinks J, Hollingsworth B. Policy Implications of complementary and alternative medicine use in Australia: data from the National Health Survey. J Altern Compl Med 2012;18(4):371–378
34. Druss BG, Rosenheck RA. Use of practitioner-based complementary therapies by persons reporting mental conditions in the United States. Arch Gen Psych 2000;57(7):708–714
35. Kessler RC, Soukup J, Davis RB, et al. The use of complementary and alternative therapies to treat anxiety and depression in the United States. Am J Psych 2001;158(2):289–294
36. G Elkins , Rajab MH, Marcus J. Complementary and alternative medicine use by psychiatric inpatients. Psychol Reports, 2005;96:163-166
37. Jamison J. Chiropractic management: Beyond manual care. J Manipulative Physiol Ther 2002;25:e4
38. Kent C. Chiropractic and mental health: history and review of putative neurobiological mechanisms. Jou Neuro Psy An Brain Res 2018;JNPB-103
39. Roth L, Zelman D, Clum L, Roth J. Upper cervical chiropractic care as a complementary strategy for depression and anxiety: a prospective case series analysis. J. Upper Cervical Chiropr Res 2013;June 20:49-59
40. Polkinghorn BS. Colloca CJ. Chiropractic management of chronic chest pain using mechanical force, manually assisted short-lever adjusting procedures. J Manipulative Physiol Ther 2003;26:108-115
41. Behrendt M, Olsen N. The impact of subluxation correction on mental health: reduction of anxiety in a female patient under chiropractic care. J Vertebral Subluxation Res September 20, 2004:1-10
42. Teytelbaum M. Improvement in symptoms related to depression, anxiety and pain in a patient undergoing subluxation based chiropractic care. A Vertebral Subluxation Res August 29, 2011:84-91
43. Prater-Manor S, Clifton E, York A. Resolution of anxiety & hypertension in a 60-year-old male following subluxation based chiropractic care: a case study & review of the literature. A Vertebral Subluxation Res August 3, 2015:146-153
44. Labelle S, Steiner M. Resolution of anxiety, depression, insomnia, scoliosis & cluster headaches, in a patient with opioid addiction undergoing chiropractic care to reduce subluxations: a case study & review of the literature. A Vertebral Subluxation Res October 4, 2017:176-188
45. Ochsner A, DelVicario J. Resolution of anxiety and depression along with decreased medication usage in a 30-year-old female undergoing chiropractic care: Case report & review of literature. A Vertebral Subluxation Res. November 12, 2018:152-159
46. Haavik H, Holt K, Murphy B. Exploring the neuromodulatory effects of vertebral subluxation and chiropractic care. Chiropr J Aust 2010;40(1):37-44
47. World Health Organization. WHO guidelines on basic safety and training in chiropractic. Geneva: World Health Organization; 2005
48. Association of Chiropractic Colleges. The Association of Chiropractic Colleges Position Paper # 1. July 1996. ICA Rev. 1996; November/December.
49. World Federation of Chiropractic. Definitions of Chiropractic 2015 (Available from: https://www.wfc.org/website/index.php?option=com_content&view=article&id=90&Itemid=110 (accessed 17 October 2018)
50. Russell D. The assessment and correction of vertebral subluxation is central to chiropractic Practice: Is there a gap in the clinical evidence? J Contemporary Chiropr 2019;2:4-17
51. The Australian Spinal Research Foundation. The Vertebral Subluxation: Conceptual Definition for Research and Practice. (Online) Available at: https://spinalresearch.com.au/wp-content/uploads/2017/06/The-Vertebral-Subluxation.pdf: The Australian Spinal Research Foundation, 2017:6 (accessed 17 October 2018)
52. Lantz CA. The subluxation complex. Foundations of chiropractic subluxation. Mosby; St. Louis, MO; 1995
53. Kent C. Heart rate variability to assess the changes in autonomic nervous system function associated with vertebral subluxation. Res Reviews: Neuroscience. 2017;1(3):14-21
54. Mahanidis T, Russell D. Improvement in quality of life in a patient with depression undergoing chiropractic care using Torque Release Technique: a case study. J Vertebral Subluxation Res January 31;2010;1-6
55. Carney CL, MacCarthy M, Girdis C. Resolution of post-traumatic anosmia following network spinal analysis care: a case study. A Vertebral Subluxation Res February 27;2017:8-14
56. Schuster TL, Dobson M, Jauregui M, Blanks RH. Wellness lifestyles II: modeling the dynamic of wellness, health lifestyle practices, and Network Spinal Analysis. J Alt Compl Med 2004;10(2):357-367
57. Russell D. Resolution of lower limb sensory polyneuropathy in a 63-year-old male receiving Activator Methods Chiropractic Technique for the correction of vertebral subluxation: A case report. Chiropr J Australia 2017;45(3):217-228
58. Senzon SA. Successful in vitro fertilization in a poor responder while under Network Spinal Analysis care: A case report. J Vertebral Subluxation Res September 14;2003;1-6
59. Desaulniers AMJ. Effect of subluxation-based chiropractic care on quality of life in a patient with major depression. J Vertebral Subluxation Res April 23, 2008; 1-7
60. Pauli Y. Quality of life improvements and spontaneous lifestyle changes in a patient undergoing subluxation-centered chiropractic care: a case study. J Vertebral Subluxation Res October 11, 2006;1-15
61. McAllister W, Boone WR, Power K, Hart J, Xiong T, Westbrook M. Chiropractic care and changes in physical state and self-perceptions in domains of health among public safety personnel: a longitudinal follow up study J Vertebral Subluxation Res May 15, 2009:1-11
62. Boone WR, Oswald P, Holt K, Beck R, Singh K, Ashton A. Physical, physiological, and immune status changes, coupled with self-perceptions of health and quality of life, in subjects receiving chiropractic care: A pilot study. J Vertebral Subluxation Res July 5, 2006:1-6
63. Russell D, Glucina T. Improvement in quality of life in a female patient with Crohn’s disease following chiropractic care for the correction of vertebral subluxation: a case report. Chiropr J Aust 2018;46(1):1-10
64. Ujdur N, Russell D. Improvement in physical functioning, overall quality of life & drug reduction in a 75-year-old female with neuropathy, insomnia & vertebral subluxations: a case report. A Vertebral Subluxation Res 23 April, 2018.77-83
65. Russell D, Doyle M. Resolution of lower limb neuropathy and improved physical functioning in an 18-year-old male cricketer receiving chiropractic care: A case report. Chiropr J Aust 2018;46(2):123-133
2. Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990– 2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016;388:1545–1602
3. Hurwitz EL, Randhawa K, Yu H, Côté P, Haldeman S. The Global Spine Care Initiative: a summary of the global burden of low back and neck pain studies. European Spine J 2018; 1-6. 27:796-801 10.1007/s00586-017-5432-9
4. GBD 2015. The burden of mental disorders in the Eastern Mediterranean region, 1990-2015: Findings from the global burden of disease 2015 study. Int J Public Health 2018;63(1):25-37
5. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators (2016) Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388:1545–1602. doi:10. 1016/S0140-6736(16)31678-6).
6. Kassebaum NJ, Arora M, Barber RM, et al. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet 2016; 388:1603–1658
7. Merriam-Webster.com (homepage on the Internet). “Anxiety”; 2016. Available from: http://www.merriam-webster.com/. (Accessed October 16, 2018)
8. Sharma A, Kudesia P, Shi Q, Gandhi R. Anxiety and depression in patients with osteoarthritis: impact and management challenges. Open Access Rheumatology: research and reviews. 2016;8:103
9. Nail JE, Christofferson J, Ginsburg GS, Drake K, Kendall PC et al. Academic impairment and impact of treatments among youth with anxiety disorders. In Child Youth Care Forum 2015; 44(3):327-342
10. Moore THM, Kapur N, Hawton K, Richards A, Metcalfe C, et al. Interventions to reduce the impact of unemployment and economic hardship on mental health in the general population: a systematic review. Psychol Med 2017;47(6):1062-1084
11. Bryans R, Decina P, Descarreaux M, Duranleau M, Marcoux H et al. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. J Manipulative Physiol Ther 2014;37(1):42-63
12. Blanchette M-A, Stochkendahl MJ, Borges Da Silva R, Boruff J, Harrison P et al. Effectiveness and economic evaluation of chiropractic care for the treatment of low back pain: a systematic review of pragmatic studies. PLoS ONE 2016;11(8): e0160037
13. Yates GR, Lamping DL, Abram NL, Wright C. Effects of chiropractic treatment on blood pressure and anxiety: A randomized, controlled trial. J Manipulative Physiol Ther 1988;11(6):484-488
14. Brockman S. The role of chiropractic manipulation in promoting an individual’s perception of psychological well being. Clin Chiropr 2007;10:8-23
15. Kroenke K, Spitzer RL, Williams JB, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics 2009;50(6):613-21
16. Blanks R, Schuster T, Dobson M. A retrospective assessment of network care using a survey of self-rated health, wellness and quality of life. J Vertebral Subluxation Res 1997;1:15–27
17. Marino M, Langrell P. Longitudinal assessment of chiropractic care using a survey of self-rated health, wellness and quality of life: a preliminary study. J Vertebral Subluxation Res 1999;3:1–9
18. Lachtman DS, Bartha DA, Beltran MM, Dominguez DN, Messerli AR, Miller SE, Davis AM, Nelson-Wong E. Rater reliability and concurrent validity of single and dual bubble inclinometry to assess cervical lateral flexion. J Manipulative Physiol Ther 2015 Oct;38(8):572-80
19. Triano J, Budgell B, Bagnulo A et al. Review of methods used by chiropractors to determine the site for applying manipulation. Chiropr Man Ther 2013;21(36):1-29
20. Holt K, Russell D, Cooperstein R, Young M, Sherson M, et al. Interexaminer reliability of a multidimensional battery of tests used to assess for vertebral subluxation. Chiropr J Aust 2018; 6(1):100-117
21. Walker BF, Buchbinder R. Most commonly used methods of detecting spinal subluxation and the preferred term for its description: a survey of chiropractors in Victoria, Australia. J Manipulative Physiol Ther 1997;20(9):583-589
22. Owens E. Chiropractic subluxation assessment: What the research tells us J Can Chiro Assoc 2002;46(4):215-220
23. Currie SJ, Myers CA, Durso C, Enebo BA, Davidson BS. The neuromuscular response to spinal manipulation in the presence of pain. J Manipulative Physiol Ther 2016;39(4):288-293
24. Kelly S, Boone WR. The clinical application of surface electromyography as an objective measure of change in the chiropractic assessment of patient progress: a pilot study. J. Vertebral Subluxation Res 1998;2(4):1-7
25. Kent C: Surface electromyography in the assessment of changes in muscle activity associated with vertebral subluxation: a review. J. Vertebral Subluxation Res 1997;1(3):1-8
26. McCoy M, Campbell I, Stone P, Fedorchuk C, Wijayawardana S et al. Intra-examiner and inter-examiner reproducibility of paraspinal thermography. PLoS One. 2011;6(2):e16535
27. Mansholt BA, Vining RD, Long CR, Goertz CM. Inter-examiner reliability of the interpretation of paraspinal thermographic pattern analysis. J Can Chiropr Assoc 2015;59(2):157-164
28. Owens EF, Hart JF, Donofrio JJ, Haralambous J, Mierzejewski E. Paraspinal skin temperature patterns: An interexaminer and intraexaminer reliability study. J Manipulative Physiol Ther 2004;27:155-159
29. Nadler A, Holder JM, Talsky MA. Torque Release Technique (TRT): A technique model for chiropractic's second century. Canadian Chiropr 1998;3(1)
30. Fletcher D. Tonal Solution for Subluxation Patterns: Torque Release Technique analyzes cranial-spinal meningeal functional unit. Canadian Chiropr 2004;9(2):20-24
31. Davidson J, Feltner D, Dugar A. Management of generalized anxiety disorder in primary care: identifying the challenges and unmet needs. Prim Care Companion J Clin Psychiatry 2010;12(2)
32. Hansen AH, Kristoffersen AE. The use of CAM providers and psychiatric outpatient services in people with anxiety/depression: a cross-sectional survey. BMC Compl Alternative Med 2016;16:461
33. Spinks J, Hollingsworth B. Policy Implications of complementary and alternative medicine use in Australia: data from the National Health Survey. J Altern Compl Med 2012;18(4):371–378
34. Druss BG, Rosenheck RA. Use of practitioner-based complementary therapies by persons reporting mental conditions in the United States. Arch Gen Psych 2000;57(7):708–714
35. Kessler RC, Soukup J, Davis RB, et al. The use of complementary and alternative therapies to treat anxiety and depression in the United States. Am J Psych 2001;158(2):289–294
36. G Elkins , Rajab MH, Marcus J. Complementary and alternative medicine use by psychiatric inpatients. Psychol Reports, 2005;96:163-166
37. Jamison J. Chiropractic management: Beyond manual care. J Manipulative Physiol Ther 2002;25:e4
38. Kent C. Chiropractic and mental health: history and review of putative neurobiological mechanisms. Jou Neuro Psy An Brain Res 2018;JNPB-103
39. Roth L, Zelman D, Clum L, Roth J. Upper cervical chiropractic care as a complementary strategy for depression and anxiety: a prospective case series analysis. J. Upper Cervical Chiropr Res 2013;June 20:49-59
40. Polkinghorn BS. Colloca CJ. Chiropractic management of chronic chest pain using mechanical force, manually assisted short-lever adjusting procedures. J Manipulative Physiol Ther 2003;26:108-115
41. Behrendt M, Olsen N. The impact of subluxation correction on mental health: reduction of anxiety in a female patient under chiropractic care. J Vertebral Subluxation Res September 20, 2004:1-10
42. Teytelbaum M. Improvement in symptoms related to depression, anxiety and pain in a patient undergoing subluxation based chiropractic care. A Vertebral Subluxation Res August 29, 2011:84-91
43. Prater-Manor S, Clifton E, York A. Resolution of anxiety & hypertension in a 60-year-old male following subluxation based chiropractic care: a case study & review of the literature. A Vertebral Subluxation Res August 3, 2015:146-153
44. Labelle S, Steiner M. Resolution of anxiety, depression, insomnia, scoliosis & cluster headaches, in a patient with opioid addiction undergoing chiropractic care to reduce subluxations: a case study & review of the literature. A Vertebral Subluxation Res October 4, 2017:176-188
45. Ochsner A, DelVicario J. Resolution of anxiety and depression along with decreased medication usage in a 30-year-old female undergoing chiropractic care: Case report & review of literature. A Vertebral Subluxation Res. November 12, 2018:152-159
46. Haavik H, Holt K, Murphy B. Exploring the neuromodulatory effects of vertebral subluxation and chiropractic care. Chiropr J Aust 2010;40(1):37-44
47. World Health Organization. WHO guidelines on basic safety and training in chiropractic. Geneva: World Health Organization; 2005
48. Association of Chiropractic Colleges. The Association of Chiropractic Colleges Position Paper # 1. July 1996. ICA Rev. 1996; November/December.
49. World Federation of Chiropractic. Definitions of Chiropractic 2015 (Available from: https://www.wfc.org/website/index.php?option=com_content&view=article&id=90&Itemid=110 (accessed 17 October 2018)
50. Russell D. The assessment and correction of vertebral subluxation is central to chiropractic Practice: Is there a gap in the clinical evidence? J Contemporary Chiropr 2019;2:4-17
51. The Australian Spinal Research Foundation. The Vertebral Subluxation: Conceptual Definition for Research and Practice. (Online) Available at: https://spinalresearch.com.au/wp-content/uploads/2017/06/The-Vertebral-Subluxation.pdf: The Australian Spinal Research Foundation, 2017:6 (accessed 17 October 2018)
52. Lantz CA. The subluxation complex. Foundations of chiropractic subluxation. Mosby; St. Louis, MO; 1995
53. Kent C. Heart rate variability to assess the changes in autonomic nervous system function associated with vertebral subluxation. Res Reviews: Neuroscience. 2017;1(3):14-21
54. Mahanidis T, Russell D. Improvement in quality of life in a patient with depression undergoing chiropractic care using Torque Release Technique: a case study. J Vertebral Subluxation Res January 31;2010;1-6
55. Carney CL, MacCarthy M, Girdis C. Resolution of post-traumatic anosmia following network spinal analysis care: a case study. A Vertebral Subluxation Res February 27;2017:8-14
56. Schuster TL, Dobson M, Jauregui M, Blanks RH. Wellness lifestyles II: modeling the dynamic of wellness, health lifestyle practices, and Network Spinal Analysis. J Alt Compl Med 2004;10(2):357-367
57. Russell D. Resolution of lower limb sensory polyneuropathy in a 63-year-old male receiving Activator Methods Chiropractic Technique for the correction of vertebral subluxation: A case report. Chiropr J Australia 2017;45(3):217-228
58. Senzon SA. Successful in vitro fertilization in a poor responder while under Network Spinal Analysis care: A case report. J Vertebral Subluxation Res September 14;2003;1-6
59. Desaulniers AMJ. Effect of subluxation-based chiropractic care on quality of life in a patient with major depression. J Vertebral Subluxation Res April 23, 2008; 1-7
60. Pauli Y. Quality of life improvements and spontaneous lifestyle changes in a patient undergoing subluxation-centered chiropractic care: a case study. J Vertebral Subluxation Res October 11, 2006;1-15
61. McAllister W, Boone WR, Power K, Hart J, Xiong T, Westbrook M. Chiropractic care and changes in physical state and self-perceptions in domains of health among public safety personnel: a longitudinal follow up study J Vertebral Subluxation Res May 15, 2009:1-11
62. Boone WR, Oswald P, Holt K, Beck R, Singh K, Ashton A. Physical, physiological, and immune status changes, coupled with self-perceptions of health and quality of life, in subjects receiving chiropractic care: A pilot study. J Vertebral Subluxation Res July 5, 2006:1-6
63. Russell D, Glucina T. Improvement in quality of life in a female patient with Crohn’s disease following chiropractic care for the correction of vertebral subluxation: a case report. Chiropr J Aust 2018;46(1):1-10
64. Ujdur N, Russell D. Improvement in physical functioning, overall quality of life & drug reduction in a 75-year-old female with neuropathy, insomnia & vertebral subluxations: a case report. A Vertebral Subluxation Res 23 April, 2018.77-83
65. Russell D, Doyle M. Resolution of lower limb neuropathy and improved physical functioning in an 18-year-old male cricketer receiving chiropractic care: A case report. Chiropr J Aust 2018;46(2):123-133
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Feb 11, 2019
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Russell, D., & Glucina, T. (2019). REDUCED ANXIETY SYMPTOMS IN A PATIENT SCREENED WITH THE PHQ4 RECEIVING CHIROPRACTIC CARE: A CASE REPORT AND REVIEW OF THE LITERATURE. Journal of Contemporary Chiropractic, 2(1), 41–48. Retrieved from https://journal.parker.edu/index.php/jcc/article/view/53
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