Psychoneuroimmunological changes in adults with obesity receiving chiropractic care: a single-arm pilot trial

Psychoneuroimmunology (PNI) is an interdisciplinary framework that merges Q7 psychology, neurology, and immunology. Obesity, a condition of increasing global prevalence, is associated with elevated risk of PNI dysfunction. The primary aim of this single-arm pilot trial was to assess the feasibility of a PNI-focused assessment battery in combination with community-based chiropractic care in adults (18-65 years) with obesity. Additionally, we explored potential changes in PNI-related outcomes.

Eighteen participants (12 females; mean age 48.7 ± 9.0 years) were enrolled and assigned to 6 weeks of chiropractic care. Assessments conducted at baseline, 2 weeks, and 6 weeks consisted of patient-reported outcomes (PROs), electrocardiography, impedance cardiography, and saliva collection via passive drool. Primary outcomes were eligibility, compliance, tolerability, adherence, and retention, with progression criteria based on the traffic light approach (i.e., red, amber, green). Secondary outcomes included changes in PRO scores, heart rate variability, pre-ejection period, and secretory immunoglobulin A.

Results indicated that our design is feasible with revisions. Although no causal inferences can be made, self-reported autonomic nervous system functioning and perceived stress levels demonstrated the largest within-group improvements among the PNI-related outcomes assessed.

Informed by these findings, we are planning a future definitive controlled trial to investigate the efficacy of chiropractic care on PNI-related outcomes in adults with obesity. This trial was prospectively registered on www.clinicaltrials.gov (NCT06208163) and funded by a seeding research grant from the Australian Spinal Research Foundation (SRG 2023-2 Perez).