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"The preponderance of the scientific literature supports a direct cause-and-effect mechanism between spinal manipulation and stroke. The therapeutic benefit of spinal manipulation in acute neck pain remains unproven. The [American] public deserves to be provided a thorough informed consent by practitioners of spinal manipulation prior to any treatment being rendered. Further research into informed consent, stroke caused by spinal manipulation, and the therapeutic benefit of the procedure, if any, needs further investigation." Article by Preston Long, PhD, Journal of Quality Healthcare (2004) [pdf]