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Background In the midst of the coronavirus pandemic, the International Chiropractors Association (ICA) posted reports claiming that chiropractic care can impact the immune system. These claims clash with recommendations from the World Health Organization and World Federation of Chiropractic. We discuss the scientific validity of the claims made in these ICA reports. Main body We reviewed the two reports posted by the ICA on their website on March 20 and March 28, 2020. We explored the method used to develop the claim that chiropractic adjustments impact the immune system and discuss the scientific merit of that claim. We provide a response to the ICA reports and explain why this claim lacks scientific credibility and is dangerous to the public. More than 150 researchers from 11 countries reviewed and endorsed our response. Conclusion In their reports, the ICA provided no valid clinical scientific evidence that chiropractic care can impact the immune system. We call on regulatory authorities and professional leaders to take robust political and regulatory action against those claiming that chiropractic adjustments have a clinical impact on the immune system.

The thesis describes the electrical activity in nerve cells (motoneurons) that control the deep back muscles in humans. The experiments were conducted using thin wire electrodes that were implanted deep in the spinal muscles in nine acute low back pain patients and in nine healthy, pain free volunteers. The main focus was on the spontaneous, free activation of the postural muscles, which was also compared with voluntary activation. We studied the activity of motoneurons when subjects stood or sat quietly and during voluntary movements. The thesis describes the overall activity, firing discharge, variability in firing and the extent of common drive signals. A main finding was that activity in individual motoneurons to some extent appears to be independent of common control signals, i.e. the nerve cells maintain their activity independently (self-sustained activity). This suggests that the nervous system is able to distribute activity and rest between motoneurons over time (rotation) in the postural muscles of the spine. We also compared the activity in healthy volunteers with the activity in acute low back pain patients before and after manipulation. The thesis describes a difference in the common drive between nerve cells on opposite sides of the spine in acute low back pain and a difference in firing variability after spinal manipulation. We also describe a different control strategy when the motoneurons fire in free activation of the postural muscles as opposed to under voluntary force production. The possible underlying neurophysiology of these findings is discussed in the thesis. List of papers. The papers are removed from the thesis due to publisher restrictions. I: Lothe LR, Raven TJL and Eken T. Single-motor-unit discharge characteristics in human lumbar multifidus muscle. (Submitted). II: Lothe LR, Raven TJL, Sandbæk G and Eken T. Single-motor-unit discharge characteristics in lumbar multifidus muscle of acute low back pain patients. (Submitted) III: Lothe LR, Raven TJL, Sandbæk G and Eken T. Single-motor-unit discharge characteristics in lumbar multifidus muscle of acute low back pain patients after spinal manipulation. (Submitted)