Reduction in Resting Heart Rate Following Chiropractic Adjustment and Exercise: A Case Study

Introduction: Resting heart rate (RHR) is a simple but powerful predictor of autonomic health which can be used on a visit-by-visit basis for an individual patient to conveniently assess his or her neurological progress. This case report provides an example of this approach. The method incorporates outlier analysis for a total of five measurements over a 6 week period that included chiropractic care and exercise. Methods: An adult female patient with elevated RHR received chiropractic care from the author. She also began an exercise program during this time. Approximately six weeks later she experienced a substantial reduction (improvement) in RHR on a follow-up visit. Inter-quartile outlier analysis was applied to determine if the improvement was statistically unusual. The advantage of doing this analysis is that it would give an indication of whether the change occurred by chance alone. This in turn provides a level of clinical certainty regarding progress of the patient. Results: The first two RHR measurements, four days apart were 81.6 beats per minute (BPM) and 81.9 BPM respectively. Follow-up RHR measurements (in BPM) were 79.5, 77.8, and 66.3. This last reading, 66.3 BPM was detected as an extreme outlier. Conclusion: This case study shows how RHR and outlier analysis can be used to determine neurological progress on a given visit for an individual patient. In this case there was such progress following chiropractic care and exercise. Further study with other patients and longer follow-up periods will be a good next step.