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Sample records for chiropractic

  1. History of Chiropractic Care

    MedlinePLUS

    ... influential results, which have changed, shaped and molded perceptions of chiropractic care. The report, Chiropractic in New ... basic chiropractic curriculum is to provide an in-depth understanding of the structure and function of the ...

  2. Frequently Asked Questions about Chiropractic

    MedlinePLUS

    ... Doctors of chiropractic are educated in orthopedics, neurology, physiology, human anatomy, clinical diagnosis including laboratory procedures, diagnostic imaging, exercise, nutrition rehabilitation and more. Because chiropractic care includes ...

  3. Chiropractic Clinical Lab Sciences

    E-print Network

    Deng, Bo

    Chiropractic Clinical Lab Sciences Clinical Perfusion Science Cytotechnology Dentistry Dental Hygiene Medicine Mortuary Science Nursing Occupational Therapy Optometry Pharmacy Physical and be Pre-Clinical Laboratory Science at NEBRASKA! Pre-Clinical Laboratory Science is one of sixteen

  4. Chiropractic Students and Research

    PubMed Central

    Weber II, Kenneth A.; He, Xiaohua

    2010-01-01

    Purpose: To continue positive professional growth and boost research endeavors, chiropractic institutions need to develop a research-oriented foundation and produce a larger body of researchers. The purpose of this study was to provide a current analysis of the research culture among students at Palmer College of Chiropractic Florida. This study will gain insight toward the research contributions of the next generation of chiropractors and identify the difficulties toward participation. This will help modify current academic programs to better foster research and ensure a promising, credible future for the chiropractic profession. Methods: Participants were students at Palmer College of Chiropractic Florida enrolled in quarters 1 through 12 during the 2008 summer term. To evaluate the research culture, participants were asked to complete a 33-item web-based survey. Results: A total of 303 students completed the survey. Forty-four percent were female, and the mean age was 26 (SD = 4.2). Ninety-nine percent of respondents agreed that research was necessary for positive growth within the chiropractic profession. A majority of students reported having research experience, and 58% planned to participate in research activities prior to graduation. Technical writing was reported as the most challenging aspect of research, and heavy academic workload was reported as the greatest deterrent to participation. Conclusion: This study expresses possibilities for building a strong research culture at the college. Students were aware of the necessity for research and were openly interested in conducting research. Modification of current academic policies will allow for greater student research opportunities and the development of tomorrow's researchers. PMID:20480013

  5. Early chiropractic education in Oregon

    PubMed Central

    Keating, Joseph C

    2002-01-01

    Chiropractic education in the northwestern United States has its origins in the Marsh School & Cure in 1904. Most of the early schools were located in Portland, Oregon, including the D.D. Palmer College of Chiropractic (1908-1910), and several of these had merged by 1912 or 1913 to form the Pacific Chiropractic College, forerunner of today's Western States College. The latter was organized as a non-profit institution during the Great Depression, and struggled not only to survive but to create a higher standard. The early broad-scope of chiropractic training in the state probably encouraged the liberal scope of practice enjoyed in Oregon to this day. ImagesFigure 2Figure 3Figure 4Figure 6Figure 7Figure 8Figure 9Figure 11Figure 12Figure 13Figure 14Figure 15Figure 16Figure 18Figure 19Figure 20Figure 21Figure 22Figure 24

  6. Chiropractic: A Safe Treatment Option

    MedlinePLUS

    ... 2003, edition of the journal Spine found that manual manipulation provides better short-term relief of chronic ... at greater risk of serious injury from a car accident than from your chiropractic visit. It is ...

  7. Depressive Symptoms in Chiropractic Students

    PubMed Central

    Kinsinger, Stuart; Puhl, Aaron Anthony; Reinhart, Christine J.

    2011-01-01

    Background: The intensive training associated with health care education has been suggested to have unintended negative consequences on students’ mental or emotional health that may interfere with the development of qualities deemed essential for proficient health care professionals. This longitudinal study examined the prevalence and severity of depressive symptoms among students at a chiropractic educational institution. Methods: Chiropractic students at all levels of training were surveyed at Canadian Memorial Chiropractic College during the academic years of 2000/2001, 2001/2002, and 2002/2003. The measurement tool employed was the Beck Depression Inventory, 2nd edition (BDI-II). Previously established BDI-II cutoff scores were used to assess the severity of reported depression symptoms, and these were compared by sex and year of training. Results: The survey was completed by 1303 students (70%) over the 3 years of the study. The prevalence of depressive symptoms was nearly 25%, with 13.7% of respondents indicating a rating of mild depression, 7.1% indicating moderate depressive symptoms, and 2.8% indicating severe symptoms. Significant differences were found between years of training, with 2nd-year students having the highest prevalence of depressive symptoms, and sex, with females having a higher rate of symptoms. Conclusions: Chiropractic students surveyed at Canadian Memorial Chiropractic College had high rates of depression similar to those measured in other health care profession students. Chiropractic educational institutions should be aware of this situation and are encouraged to emphasize students’ awareness of their own personal health and well-being and their access to appropriate care, in addition to the same concerns for their future patients. PMID:22069339

  8. Dr. Tom Lawrence: a life in chiropractic

    PubMed Central

    Keating, Joseph C

    2005-01-01

    He dwelt within the chiropractic orbit from the cradle to the grave. Second-generation chiropractor Tom Lawrence was a successful professional and family man who followed in his father’s footsteps and fought the good fight to improve chiropractic within his state and nation. His passing closes a chapter of living memory of the middle years of the first chiropractic century. PMID:17549212

  9. Craniocervical chiropractic procedures – a précis of upper cervical chiropractic

    PubMed Central

    Woodfield, H. Charles; York, Craig; Rochester, Roderic P.; Bales, Scott; Beebe, Mychal; Salminen, Bryan; Scholten, Jeffrey N.

    2015-01-01

    Presented here is a narrative review of upper cervical procedures intended to facilitate understanding and to increase knowledge of upper cervical chiropractic care. Safety, efficacy, common misconceptions, and research are discussed, allowing practitioners, chiropractic students, and the general public to make informed decisions regarding utilization and referrals for this distinctive type of chiropractic care. Upper cervical techniques share the same theoretical paradigm in that the primary subluxation exists in the upper cervical spine. These procedures use similar assessments to determine if spinal intervention is necessary and successful once delivered. The major difference involves their use of either an articular or orthogonal radiograph analysis model when determining the presence of a misalignment. Adverse events following an upper cervical adjustment consist of mild symptomatic reactions of short-duration (< 24-hours). Due to a lack of quality and indexed references, information contained herein is limited by the significance of literature cited, which included non-indexed and/or non-peer reviewed sources. PMID:26136610

  10. Craniocervical chiropractic procedures - a précis of upper cervical chiropractic.

    PubMed

    Woodfield, H Charles; York, Craig; Rochester, Roderic P; Bales, Scott; Beebe, Mychal; Salminen, Bryan; Scholten, Jeffrey N

    2015-06-01

    Presented here is a narrative review of upper cervical procedures intended to facilitate understanding and to increase knowledge of upper cervical chiropractic care. Safety, efficacy, common misconceptions, and research are discussed, allowing practitioners, chiropractic students, and the general public to make informed decisions regarding utilization and referrals for this distinctive type of chiropractic care. Upper cervical techniques share the same theoretical paradigm in that the primary subluxation exists in the upper cervical spine. These procedures use similar assessments to determine if spinal intervention is necessary and successful once delivered. The major difference involves their use of either an articular or orthogonal radiograph analysis model when determining the presence of a misalignment. Adverse events following an upper cervical adjustment consist of mild symptomatic reactions of short-duration (< 24-hours). Due to a lack of quality and indexed references, information contained herein is limited by the significance of literature cited, which included non-indexed and/or non-peer reviewed sources. PMID:26136610

  11. Is chiropractic care primary health care?

    PubMed Central

    Coulter, ID

    1992-01-01

    The following paper sets out to examine three issues: primary health care, chiropractic care, and the challenges to both in the next decade. The current crisis of primary health within the health care system provides chiropractic with an opportunity to choose between functioning as primary care or primary contact care. Chiropractic has seldom met its potential, or its own rhetoric, with regard to holistic health care which would make the case for being primary health care much stronger. There have been numerous social and political factors that have influenced this but part of the problem is that chiropractic has failed to clearly articulate itself as primary health care, and in some instances, has denied that it was. New opportunities and challenges will force chiropractors to resolve the issue of whether chiropractic is a general model of health care, or a form of health specialty (the neuromusculoskeletal practitioner verses the primary health practitioner).

  12. Evidence-Based Practice and Chiropractic Care

    PubMed Central

    LeFebvre, Ron; Peterson, David; Haas, Mitchell

    2013-01-01

    Evidence-based practice has had a growing impact on chiropractic education and the delivery of chiropractic care. For evidence-based practice to penetrate and transform a profession, the penetration must occur at 2 levels. One level is the degree to which individual practitioners possess the willingness and basic skills to search and assess the literature. Chiropractic education received a significant boost in this realm in 2005 when the National Center for Complementary and Alternative Medicine awarded 4 chiropractic institutions R25 education grants to strengthen their research/evidence-based practice curricula. The second level relates to whether the therapeutic interventions commonly employed by a particular health care discipline are supported by clinical research. A growing body of randomized controlled trials provides evidence of the effectiveness and safety of manual therapies. PMID:23875117

  13. Constructing a philosophy of chiropractic: evolving worldviews and premodern roots?

    PubMed Central

    Senzon, Simon A.

    2011-01-01

    Objective The philosophy of chiropractic can be framed as an attempt to correct the problems inherited from the Western Enlightenment. Its origins can be found in the long tradition of Western philosophy. The purpose of this article is to describe in a broad context chiropractic’s roots in premodernity and establish the structural and hermeneutical differences between chiropractic’s original philosophical ideas and those of premodern philosophers. Discussion The worldview or cultural mindset the philosophy arose from must be situated in the context of its time, the birth of the unique postmodern worldview, aperspectival consciousness, and the modern sense of self. This is accomplished by exploring several metatheories about the development of the self through history, with an emphasis on the premodern roots to the chiropractic terms; Universal Intelligence and Innate Intelligence. By contextualizing the philosophy of chiropractic in terms of a structural genealogy of the self and of ideas, a new approach to philosophy in chiropractic emerges. Conclusion Without accounting for chiropractic’s origins as a reflection of the unique time, place, and culture, in terms of the evolution of worldviews through history, any approach to construct or reconstruct a philosophy of chiropractic will potentially miss the seminal feature of chiropractic’s emergence. PMID:22693478

  14. Chiropractic

    MedlinePLUS

    ... to heal itself. They may also use other treatments including Heat and ice Electrical stimulation Relaxation techniques Rehabilitative and general exercise Counseling about diet, weight loss, and other lifestyle ... visit chiropractors for treatment of low back pain, neck pain, and headaches. ...

  15. The necessary future of chiropractic education: a North American perspective

    PubMed Central

    Wyatt, Lawrence H; Perle, Stephen M; Murphy, Donald R; Hyde, Thomas E

    2005-01-01

    The chiropractic educational system in North America is currently in a state of flux. The attempted conversion of some chiropractic schools into "universities" and the want of university affiliation for chiropractic schools suggests that we are searching for a better alternative to the present system. In the early 20th century, the Flexner Report helped transform modern medical education into a discipline that relies on scientific and clinical knowledge. Some have wondered if it is time for a Flexner-type report regarding the education of doctors of chiropractic. This article outlines the current challenges within the chiropractic educational system and proposes positive changes for that system. PMID:16001976

  16. Chiropractic as spine care: a model for the profession

    PubMed Central

    Nelson, Craig F; Lawrence, Dana J; Triano, John J; Bronfort, Gert; Perle, Stephen M; Metz, R Douglas; Hegetschweiler, Kurt; LaBrot, Thomas

    2005-01-01

    Background More than 100 years after its inception the chiropractic profession has failed to define itself in a way that is understandable, credible and scientifically coherent. This failure has prevented the profession from establishing its cultural authority over any specific domain of health care. Objective To present a model for the chiropractic profession to establish cultural authority and increase market share of the public seeking chiropractic care. Discussion The continued failure by the chiropractic profession to remedy this state of affairs will pose a distinct threat to the future viability of the profession. Three specific characteristics of the profession are identified as impediments to the creation of a credible definition of chiropractic: Departures from accepted standards of professional ethics; reliance upon obsolete principles of chiropractic philosophy; and the promotion of chiropractors as primary care providers. A chiropractic professional identity should be based on spinal care as the defining clinical purpose of chiropractic, chiropractic as an integrated part of the healthcare mainstream, the rigorous implementation of accepted standards of professional ethics, chiropractors as portal-of-entry providers, the acceptance and promotion of evidence-based health care, and a conservative clinical approach. Conclusion This paper presents the spine care model as a means of developing chiropractic cultural authority and relevancy. The model is based on principles that would help integrate chiropractic care into the mainstream delivery system while still retaining self-identity for the profession. PMID:16000175

  17. Lasers and their therapeutic application in chiropractic

    PubMed Central

    Fitz-Ritson, Don

    2001-01-01

    The purpose of this paper is to review some of the applications of laser therapy and its reported effects on tissue healing, pain relief and other effects. Several musculoskeletal and low back pain studies are highlighted to show the efficacy of laser therapy and its' applicability as an adjunct to chiropractic treatment. Information is also presented which highlights the necessary information the clinician should be aware of in order to develop specific protocols for musculoskeletal pathologies. The parameters, which are now available on lasers, include power, frequency, duty cycle and cadence. When these are manipulated, different effects are achieved on tissues, which may enhance chiropractic treatment. Imagesp34-a

  18. Teaching chiropractic principles through patient centered problems

    PubMed Central

    Gatterman, Meridel I

    1997-01-01

    Introduction: Large class size (148) and limited resources preclude application of the standard small group problem based learning that has generated both student and faculty satisfaction. An innovative method of teaching chiropractic philosophical foundations was developed and implemented utilizing cooperative learning, patient centered problem solving, and group presentations. Objectives: The objectives of this study were: 1) to measure the impact of an innovative method of cooperative learning on student satisfaction and class attendance: 2) to incorporate philosophical principles of chiropractic into patient centered problems; and, 3) to promote cooperative and self directed learning. Methods: A class of 148 students was divided into groups of four students. Each group was assigned a patient centered problem based on clinical practice, and three to four questions related to the philosophical or “first” principles of chiropractic. The students working in the assigned groups prepared a paper addressing the questions in the context of a patient centered practice. Each group gave a thirty minute presentation followed by fifteen minutes of class interaction. Conclusions: Using cooperative student centered learning to teach chiropractic principles through patient centered problem solving generated high levels of student satisfaction and attendance in this large group.

  19. CHIROPRACTIC AND ACUPUNCTURE COVERAGE CAM BENEFITS

    E-print Network

    Leistikow, Bruce N.

    : Covers treatment of pain related to acute neuromusculoskeletal conditions such as dysfunction of the neck neuromusculoskeletal conditions such as low back pain, sprains and strains, headaches, neck pain and muscle spasms ·Electroacupuncture ·Moxibustion ·Acupressure ·Cupping CHIROPRACTIC BENEFIT: Covers treatment of pain related to acute

  20. Risk of Vertebrobasilar Stroke and Chiropractic Care

    PubMed Central

    Boyle, Eleanor; Côté, Pierre; He, Yaohua; Hogg-Johnson, Sheilah; Silver, Frank L.; Bondy, Susan J.

    2008-01-01

    Study Design Population-based, case-control and case-crossover study. Objective To investigate associations between chiropractic visits and vertebrobasilar artery (VBA) stroke and to contrast this with primary care physician (PCP) visits and VBA stroke. Summary of Background Data Chiropractic care is popular for neck pain and headache, but may increase the risk for VBA dissection and stroke. Neck pain and headache are common symptoms of VBA dissection, which commonly precedes VBA stroke. Methods Cases included eligible incident VBA strokes admitted to Ontario hospitals from April 1, 1993 to March 31, 2002. Four controls were age and gender matched to each case. Case and control exposures to chiropractors and PCPs were determined from health billing records in the year before the stroke date. In the case-crossover analysis, cases acted as their own controls. Results There were 818 VBA strokes hospitalized in a population of more than 100 million person-years. In those aged <45 years, cases were about three times more likely to see a chiropractor or a PCP before their stroke than controls. Results were similar in the case control and case crossover analyses. There was no increased association between chiropractic visits and VBA stroke in those older than 45 years. Positive associations were found between PCP visits and VBA stroke in all age groups. Practitioner visits billed for headache and neck complaints were highly associated with subsequent VBA stroke. Conclusion VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.

  1. Chiropractic management of a patient with persistent headache

    PubMed Central

    West, Jason; Phillips, Reed B.

    2013-01-01

    Objective The purpose of this case report is to describe chiropractic care of a patient with persistent headache treated using chiropractic manipulative therapy and adjunct treatments. Clinical features A 54-year-old multiparous woman had chronic debilitating headaches for 11 months. Previous care from a variety of specialties had brought no appreciable relief. Intervention and outcome The patient was managed with chiropractic manipulative therapy, injections, and electromagnetic therapy. Five treatments over 6 weeks brought resolution of the headaches. Conclusion This patient with persistent headache responded favorably to a course of chiropractic and adjunctive care. PMID:24396331

  2. Nitric oxide: a challenge to chiropractic

    PubMed Central

    Morgan, Lon

    2000-01-01

    The 1998 Nobel Prize in Physiology or Medicine recognized the biological significance of nitric oxide. Nitric oxide is derived from the amino acid arginine. It is intimately involved with circulatory vessel dilation where, for example, it protects against heart attacks, and is the basis for new medications such as Sildenafil (Viagra). Nitric oxide acts as a neurotransmitter and can modulate many neurological reactions. The immune system uses nitric oxide to destroy pathogens by interfering with key enzymes. Nitric oxide is responsible for both osteoclastic and osteoblastic responses in bone and is a key player in the degenerative aspects of arthritis. The process of apoptosis employs nitric oxide in the orderly removal of unneeded cells. There is clear evidence that major signaling and control mechanisms exist in the body apart from the nervous system. Chiropractic is thus faced with the challenge of how to incorporate this new knowledge which conflicts with traditional chiropractic concepts.

  3. Diversity in the chiropractic profession: preparing for 2050.

    PubMed

    Johnson, Claire D; Green, Bart N

    2012-01-01

    As the diversity of the United States (US) population continues to change, concerns about minority health and health disparities grow. Health professions must evolve to meet the needs of the population. The purpose of this editorial is to review current trends in the diversity of chiropractic students, faculty, and practitioners in the United States. This editorial was informed by a search of the literature, to include PubMed, using the terms chiropractic and diversity, minority, and cultural competency. Demographic information for the chiropractic profession was obtained from the National Board of Chiropractic Examiners and The Chronicle of Higher Education. These data were compared to diversity data for medical doctors and the national and state populations from the American Association of Medical Colleges and the US Census, respectively. Surprisingly little has been published in the peer-reviewed literature on the topic of diversity in the chiropractic profession. For the variables available (sex and race), the data show that proportions in the US chiropractic profession do not match the population. State comparisons to associated chiropractic colleges show similar relationships. No reliable data were found on other diversity characteristics, such as gender identity, religion, and socioeconomic status. The chiropractic profession in the United States currently does not represent the national population with regard to sex and race. Leaders in the profession should develop a strategy to better meet the changing demographics of the US population. More attention to recruiting and retaining students, such as underrepresented minorities and women, and establishing improved cultural competency is needed. PMID:22778525

  4. Suggested Courses: Majors for Pre-Chiropractic Students

    E-print Network

    Saldin, Dilano

    to the body's muscular, nervous, and skeletal system, particularly the spine. They view their patients of Chiropractic degree (DC). Most D.C. programs operate on the trimester system and are 3 1/3 years long. Students

  5. The origins and early history of the National Chiropractic Association

    PubMed Central

    Keating, Joseph C; Rehm, William S

    1993-01-01

    Early organization in chiropractic was prompted by the profession’s need to promote itself and to defend against the onslaught of political medicine and organized osteopathy. The first priorities were legal defense against prosecution for unlicensed practice and malpractice insurance. The Universal Chiropractors’ Association (UCA), organized at the Palmer School of Chiropractic (PSC) in 1906, sought to meet these needs by insuring its members and by developing a legal department under the supervision of attorney Tom Morris, one time lieutenant governor of Wisconsin. The public relations and marketing needs of chiropractors were largely served by the PSC and its legendary leader. However, as chiropractors increasingly sought to avoid prosecution by passage of chiropractic laws, Palmer’s efforts to direct this legislation so as to limit chiropractors’ scope of practice increasingly alienated many in the profession. The American Chiropractic Association (ACA) was founded in 1922 to provide a broadscope alternative to BJ’s UCA. With Palmer’s departure from the UCA following the neurocalometer debacle, ACA and UCA sought amalgamation. Simultaneously, organized medicine renewed its attack on the profession by introducing basic science legislation, which prompted chiropractors to try to upgrade and standardize chiropractic education. Early efforts to bring about the needed consensus were centered in the International Chiropractic Congress (ICC), particularly its division of state examining boards. In 1930 the ACA and UCA combined to form the National Chiropractic Association (NCA), and by 1934 the ICC had merged with the NCA to form part of its council structure. With this modicum of solidarity the NCA began the process of educational boot-strapping at its 1935 convention in Los Angeles, when its Committee on Education, a forerunner of today’s Council on Chiropractic Education, was proposed by C.O. Watkins of Montana. ImagesFigure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 9

  6. A History of The Journal of Chiropractic Education

    PubMed Central

    Green, Bart N.; Jacobs, Grace E.; Johnson, Claire D.; Phillips, Reed B.

    2011-01-01

    Purpose: The Journal of Chiropractic Education celebrates its 25th anniversary in the year 2011. The purpose of this article is to chronicle the history of the journal, which is unreported at this time. Methods: The entire collection of the journal was reviewed and information pertaining to important events and changes in the format, personnel, and processes of the journal were extracted. This information was used to create a chronology of the journal. The chronology was complemented with information obtained from people who were involved in the evolution of the journal and the Association of Chiropractic Colleges Educational Conferences. Results: Starting as a humble newsletter in 1987 and produced for a small cadre of readers primarily from the United States, the journal is now a full-sized and bound peer-reviewed international journal. Initially cataloged by the Index to Chiropractic Literature and MANTIS, the indexing expanded to interdisciplinary indexing systems such as CINAHL and ultimately PubMed. The journal has grown to serve the needs of chiropractic educators from around the world with representatives on the editorial board from 39 colleges and universities from 15 different countries. The journal has grown in tandem with the profession’s leading education and research conference and has been the primary repository for the scholarship of chiropractic education. Conclusion: The history of the journal represents a significant milestone in the development of the chiropractic profession, particularly the discipline of chiropractic education. The journal has had an interesting history and the future promises to bring more opportunities and challenges to the field of chiropractic education and to the journal. PMID:22069342

  7. Potential unique causes of burnout for chiropractic professionals

    PubMed Central

    Williams, Shawn

    2011-01-01

    Objective The objective of this narrative review is to discuss the potential for burnout in chiropractic practitioners. This discussion is grounded in the job demands-resource model, the conservation of resources model, the unique profession-specific stressors experienced by chiropractors, and information from similar health care professions. Methods A search using both the indexed (PubMed and PsychLit) and nonindexed psychosocial literature was used. Other resources included the Cochrane Library, articles from governing bodies of the chiropractic profession, trade magazines, and research conferences and symposium proceedings. Articles were analyzed following the grounded theory principles: open coding and memos for conceptual labeling, axial coding and memos for category building, and selective coding for model building. Results Potential stressors unique to doctors of chiropractic include factors associated with physical workload, role stress, and mental and emotional demands. Conclusions There are unique chiropractic-specific occupational characteristics that possibly contribute to burnout in the chiropractic professionals. These findings emphasize the need for assessing and measuring burnout and attrition within the chiropractic profession. PMID:22693483

  8. Plastination: a modern approach to chiropractic teaching

    PubMed Central

    Grondin, Gilles

    1998-01-01

    Plastination is a unique method for the preservation of biological material for teaching and research. The plastinated specimens are dry, odorless, non-toxic and durable. They can be manipulated by teachers and students without protective equipment like gloves. Invented in 1978 by Doctor Gunther von Hagens from the University of Heidelberg, this technique, that involves the replacement of water by a curable polymer, has spread rapidly all around the world and is actually used in over 250 universities and colleges. To our knowledge, the Université du Québec à Trois-Rivières, is the first institution to use plastinated specimens for teaching anatomy, neuroanatomy, pathology and radiology to students in chiropractic. This paper describes the various steps of the method (fixation, dehydration, impregnation and curing) and presents some examples of the utilization of plastinated specimens. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6

  9. Chiropractic Professionalization and Accreditation: An Exploration of the History of Conflict Between Worldviews Through the Lens of Developmental Structuralism

    PubMed Central

    Senzon, Simon A.

    2014-01-01

    Objective The purpose of this commentary is to describe the conflicts in the history of chiropractic’s professionalization and conflict through the path of increasing educational standards and accreditation using the lens of developmental structuralism. Discussion Within the story of chiropractic’s professionalization and accreditation lie the battles between competing worldviews. Gibbons proposed 4 periods of chiropractic’s educational history; this article proposes a fifth period along with a new methodological approach to explore the complexity of chiropractic’s history. The methodology draws upon constructive developmental psychology and proposes 5 levels of thinking common to the individuals from chiropractic’s history. By using a psychological framework to analyze historical events, it appears that the battle within chiropractic education continues at present. Several important issues are explored: the Council on Chiropractic Education's origins in the medical paradigm and rational thinking, the pre-rational, rational, and post-rational critics of the Council on Chiropractic Education, the schools of thought that were reified or emerged from the history, as well as the more recent legal, economic, and social pressures, which helped to shape chiropractic's accreditation and professionalization. Conclusion A transrational approach, one that includes the partial truths of all perspectives, is a first step to allow for a richer understanding of how the interior worldviews, individual actions, and the exterior forces (legal, economic, political, and educational) brought forth the chiropractic clashes together. Viewing the conflicts within chiropractic from this approach may foster new educational structures to evolve. PMID:25431541

  10. Curriculum mapping within an Australian master of chiropractic program: Congruence between published evidence for chiropractic and student assessment tasks

    PubMed Central

    Gorrell, Lindsay; Beirman, Robyn L.; Vemulpad, Subramanyam R.

    2015-01-01

    Objective This study sought to determine congruence between student assessment tasks within the master of chiropractic curriculum at Macquarie University and 2 separate but related domains: (1) disorders commonly presenting to chiropractors and (2) musculoskeletal conditions for which there is published evidence that chiropractic treatment is effective. Methods A literature review was undertaken to determine which musculoskeletal disorders commonly present to chiropractors and the conditions for which there is published evidence that chiropractic treatment is effective. These 2 domains were then mapped to the assessment tasks within the curriculum and analyzed. The proportion of time allocated to theory versus skill acquisition was also determined. Results Assessment tasks within the curriculum specifically focus on low back pain, neck pain, lower extremity pain, thoracic pain, and adhesive capsulitis. This curriculum mapping demonstrates congruence between the student assessment tasks and published evidence for chiropractic. The assessments also contain an appropriate balance between theory and skills acquisition. Conclusion There is congruence between the assessment tasks within the curriculum and the 2 domains against which it was mapped. Thus, completion of the curriculum provides training relevant to conditions that commonly present to chiropractors and musculoskeletal conditions for which chiropractic treatment is effective. PMID:25162981

  11. Vertebral artery dissection and cerebellar infarction following chiropractic manipulation

    PubMed Central

    Chen, W?L; Chern, C?H; Wu, Y?L; Lee, C?H

    2006-01-01

    Vertebral artery dissection (VAD) associated with chiropractic cervical manipulation is a rare but potentially disabling condition. In this report, we present a young patient manifesting with repeated vertigo. Owing to the initial misdiagnosis, the patient later developed cerebellar stroke with inability to stand or walk. Vertigo and disequilibrium are the usual presenting symptoms of this condition, which can result from inner ear or vestibular nerve dysfunction, vertebrobasilar insufficiency, and even lethal cerebellar infarction or haemorrhage; these last two, although rarely seen in young adults, can be caused by traumatic or spontaneous arterial injury, including injury secondary to chiropractic cervical manipulation. A number of cases of VAD associated with chiropractic cervical manipulation have been reported, but rarely in the emergency medicine literature. We present a case of this rare occurrence, and discuss the diagnostic pitfalls. PMID:16373786

  12. Knowledge and opinions of Downsview physicians regarding the chiropractic profession

    PubMed Central

    Newton-Leo, Linda; King-Isaacs, Debra; Lichti, Janice

    1994-01-01

    This study was a preliminary investigation into the knowledge of and current attitudes towards the chiropractic profession by medical practitioners with varying years of clinical experience. A questionnaire was designed and mailed to seventy general practitioners in Downsview, Ontario who agreed to participate in the study. Twenty-six were returned for a response rate of 37%. The data were analyzed and responses from doctors with differing years of practice experience were compared using the chi square statistic. When comparing attitudes towards the chiropractic profession between medical practitioners with greater and less than 15 years of clinical experience a statistically significant difference was found (p = 0.0005). However, no significant differences were observed in terms of their interaction with or knowledge of the chiropractic profession. Further, 88% of respondents reported that they had referred a patient to a chiropractor. The limitations of the study and suggestions for improvement are discussed.

  13. Attitudes towards chiropractic: an analysis of written comments from a survey of north american orthopaedic surgeons

    PubMed Central

    2011-01-01

    Background There is increasing interest by chiropractors in North America regarding integration into mainstream healthcare; however, there is limited information about attitudes towards the profession among conventional healthcare providers, including orthopaedic surgeons. Methods We administered a 43-item cross-sectional survey to 1000 Canadian and American orthopaedic surgeons that inquired about demographic variables and their attitudes towards chiropractic. Our survey included an option for respondants to include written comments, and our present analysis is restricted to these comments. Two reviewers, independantly and in duplicate, coded all written comments using thematic analysis. Results 487 surgeons completed the survey (response rate 49%), and 174 provided written comments. Our analysis revealed 8 themes and 24 sub-themes represented in surgeons' comments. Reported themes were: variability amongst chiropractors (n = 55); concerns with chiropractic treatment (n = 54); areas where chiropractic is perceived as effective (n = 43); unethical behavior (n = 43); patient interaction (n = 36); the scientific basis of chiropractic (n = 26); personal experiences with chiropractic (n = 21); and chiropractic training (n = 18). Common sub-themes endorsed by surgeon's were diversity within the chiropractic profession as a barrier to increased interprofessional collaboration, endorsement for chiropractic treatment of musculoskeletal complaints, criticism for treatment of non-musculoskeletal complaints, and concern over whether chiropractic care was evidence-based. Conclusions Our analysis identified a number of issues that will have to be considered by the chiropractic profession as part of its efforts to further integrate chiropractic into mainstream healthcare. PMID:21970333

  14. Contemporary chiropractic practice in the UK: a field study of a chiropractor and his patients in a suburban chiropractic clinic

    PubMed Central

    2013-01-01

    Background Two recent surveys of chiropractors in Great Britain suggest that there are discrepancies between chiropractic practice as defined in regulatory guidelines and day-to-day chiropractic clinical practice and there is in general a paucity of information regarding the characteristics of contemporary chiropractic practice in the United Kingdom. This field study describes the daily practice of a contemporary British UK-trained chiropractor. Methods The fieldwork took place during the spring and summer of 2008 when the author spent one day per week observing consultations and interviewing patients in a chiropractic clinic. The chiropractor was subjected to interviews on two occasions. The author also registered as a patient. Field notes were taken by the author, interviews were recorded and the transcripts were corrected and analysed by the author. Results A total of 25 patients took part in the study. The interaction that took place between patients and staff in reception could be considered as a prelude to consultation facilitating the transformation from individual to patient and back to individual. Coupled with the continuous physical contact between the chiropractor and each patient there was a substantial amount of verbal and non-verbal communication throughout treatment visits. The patients presented with predominantly musculo-skeletal pain and the majority had consulted the chiropractor as a result of recommendations from others in their close social environment. The majority of the interviewed patients had either an inaccurate or at best rudimentary understanding of the mechanisms of chiropractic treatment. A few of the interviewed patients indicated that they had at first experienced concerns about the nature of chiropractic treatment or getting undressed. The author was able to gain some insight into how the chiropractor's experiences, opinions and beliefs had shaped his approach to chiropractic treatment and how this formed the basis of his clinical modus operandi. Conclusion Although no robust conclusions should be drawn from this small scale field study it does show that the clinical chiropractic practice as carried out by this UK trained British chiropractor contains a number of elements described in earlier qualitative studies in the United States, Canada, and Australia. PMID:23927011

  15. Chiropractic management of postpartum pubic symphysis diastasis: A case report.

    PubMed

    Henry, Lucian

    2015-03-01

    This case report describes the chiropractic management of a 30-year-old female patient with severe postpartum pelvic pain secondary to pubic symphysis diastasis. No literature was found on the chiropractic management of postpartum symphysis pubis diastasis. The existing literature concerning chiropractic care for symphysis pubis dysfunction during pregnancy is limited and indicates a potential benefit. Separation of the pubic symphysis may include ligamentous injury to the sacroiliac joints and may lead to chronic pain. Pubic symphysis separation of 17 millimeters was present on digital radiograph. Management consisted of chiropractic adjustments, trigger point release, electrical stimulation, moist heat, sacroiliac belt, and specific stabilizing exercises. The patient's pain improved immediately following treatment on the initial visit. Pain was reduced from 8/10 VAS at the first visit to 2/10 at the fourth visit. She was able to resume normal activities and reached a final pain level of 1/10. The diastasis was reduced by 7 millimeters at 14-weeks post radiograph for a final separation of just under 10 millimeters. Collaboration between obstetricians, midwives and chiropractors may be warranted. PMID:25729083

  16. The Early Years of Organized Chiropractic Orthopedics, 1954–1973: A Social History

    PubMed Central

    Green, Bart N.; Johnson, Claire D.

    2009-01-01

    Objective: This paper presents the origins and development of the organized chiropractic orthopedics movement in the United States from 1954–1973. Methods: Hand searches of early periodicals were performed and information was organized chronologically to create a timeline. Context for the timeline was provided by extracting pertinent information from audio recordings of interviews. Relevant background information was located using the cumulative index of the journal Chiropractic History and searching the MANTIS database. Historical Features: After World War I, The advent of third party reimbursement for health care created a new environment for health care practitioners. For doctors of chiropractic, this event provided the impetus to begin the postgraduate chiropractic orthopedics program over 50 years ago. In 1954, Alvin A. Hancock, DC and F. Maynard Lipe, DC successfully launched an active orthopedics movement after several earlier attempts failed during the 1940s and early 1950s. The movement generated from the desire to train and certify chiropractors to manage personal injury and workers’ compensation low back injuries. In addition to developing interdisciplinary educational programs, the chiropractic orthopedics group was responsible for producing a research agenda, some of the profession’s early orthopedic-focused research, and for starting the National Council on Chiropractic Orthopedics of the National Chiropractic Association, which later became the American Chiropractic Association Council on Orthopedics. These organizations produced thousands of specialists in chiropractic orthopedics, later known as Diplomates of the American Board of Chiropractic Orthopedists. Conclusion: Several orthopedics interest groups were formed and credentialing processes were created to qualify doctors as recognized chiropractic orthopedics specialists. The popularity of this movement resulted in the inclusion of orthopedics into core chiropractic college curricula and the production of various research studies before the development of the modern science of chiropractic. PMID:19488411

  17. Australian chiropractic sports medicine: half way there or living on a prayer?

    PubMed Central

    Pollard, Henry; Hoskins, Wayne; McHardy, Andrew; Bonello, Rod; Garbutt, Peter; Swain, Mike; Dragasevic, George; Pribicevic, Mario; Vitiello, Andrew

    2007-01-01

    Sports chiropractic within Australia has a chequered historical background of unorthodox individualistic displays of egocentric treatment approaches that emphasise specific technique preference and individual prowess rather than standardised evidence based management. This situation has changed in recent years with the acceptance of many within sports chiropractic to operate under an evidence informed banner and to embrace a research culture. Despite recent developments within the sports chiropractic movement, the profession is still plagued by a minority of practitioners continuing to espouse certain marginal and outlandish technique systems that beleaguer the mainstream core of sports chiropractic as a cohesive and homogeneous group. Modern chiropractic management is frequently multimodal in nature and incorporates components of passive and active care. Such management typically incorporates spinal and peripheral manipulation, mobilisation, soft tissue techniques, rehabilitation and therapeutic exercises. Externally, sports chiropractic has faced hurdles too, with a lack of recognition and acceptance by organized and orthodox sports medical groups. Whilst some arguments against the inclusion of chiropractic may be legitimate due to its historical baggage, much of the argument appears to be anti-competitive, insecure and driven by a closed-shop mentality.sequently, chiropractic as a profession still remains a pariah to the organised sports medicine world. Add to this an uncertain continuing education system, a lack of protection for the title 'sports chiropractor', a lack of a recognized specialist status and a lack of support from traditional chiropractic, the challenges for the growth and acceptance of the sports chiropractor are considerable. This article outlines the historical and current challenges, both internal and external, faced by sports chiropractic within Australia and proposes positive changes that will assist in recognition and inclusion of sports chiropractic in both chiropractic and multi-disciplinary sports medicine alike. PMID:17880724

  18. Addressing the issue of cataloging and making accessible chiropractic literature: Part II. Pilot software development program.

    PubMed

    Curl, D D; Antovich, T J

    1990-01-01

    Health science journals are a principle source of new knowledge for chiropractors, chiropractic faculty, and students. Regrettably, clinically or educationally relevant articles (appearing in the nearly 20,000 journals annually) are often overlooked due to access difficulties. Innovations are needed to assist the reader to select articles relevant to chiropractic and reduce the time spent sorting through the volumes of literature. A solution to those problems of accessing, obtaining, and storing article citations from the chiropractic literature come from a pilot computerized program developed for use on the Los Angeles College of Chiropractic (LACC) campus. The Chiropractic Literature Archive and Search Program (CLASP) is dedicated to chiropractic literature. It provides rapid access to the literature and directs the user to one of the participating chiropractic campuses where the article can be found. Because of its ease of operation, the program is a useful tool for nearly all areas of chiropractic, ranging from education and research to clinical patient management. The program would be inexpensive to fully implement, and the hardware needed is minimal. Important protocols have been developed for database input, use and maintenance. Testing of this program on the LACC campus reveals that such a program is capable of making citations of the chiropractic literature available within days of their publication. PMID:2203861

  19. Chiropractic management of elbow tendinopathy following a sports related trauma

    PubMed Central

    Gliedt, Jordan A.; Daniels, Clinton J.

    2014-01-01

    Objective: This report describes chiropractic management of a case of sub-acute elbow pain and swelling with Active Release Technique® and acupuncture. Case presentation: A 41-year-old male presented to a chiropractic clinic with a primary complaint of elbow pain and swelling following a fall while playing basketball five weeks prior. Intervention and Outcome: Treatment consisted of two sessions of needle acupuncture and one treatment of Active Release Techniques® (ART) applied to the left elbow region. Conclusions: The patient’s outcomes indicated a quick resolution of subjective complaints and objective findings with the chosen treatment. Further research is needed to demonstrate safety, clinical effectiveness, and cost effectiveness when compared to other treatments. PMID:24587497

  20. Constructing a philosophy of chiropractic: evolving worldviews and modern foundation?

    PubMed Central

    Senzon, Simon A.

    2011-01-01

    Objective The purpose of this article is to trace the foundations of DD Palmer's sense of self and philosophy of chiropractic to its sources in modern Western philosophy as well as current metatheories about modernity. Discussion DD Palmer's sense of self was indicative of a modern self. A modern self is characterized as a self that developed after the Western Enlightenment and must come to terms with the insights of modernity such as Cartesian dualism, Spinoza's substance, Rousseau's expressivism, and Kant's critiques. It is argued that Palmer's philosophy can be viewed as part of the this tradition alongside his involvement in the 19th century American metaphysical religious culture, which was itself a response to these challenges of the modern self of modernity. Conclusion Palmer's development of chiropractic and its philosophy was a reaction to the challenges and promises of modernity. PMID:22693479

  1. The Five Eras of Chiropractic & the future of chiropractic as seen through the eyes of a participant observer

    PubMed Central

    2012-01-01

    Chiropractic has endured a turbulent history, marked by tremendous advances in areas such as education and licensing while marred by interprofessional conflict and a poor public image. The prolonged interprofessional conflict was instrumental in shaping the culture of chiropractic. These obstacles have long-since been removed although there are lingering effects from them. This article examines the chiropractic profession's history by dividing it into five Eras and suggests that there are three options available for the future of the profession. One: maintaining the status quo. Two: uniting under an evidence based scientific approach as partners in the health care delivery system that has buried the "one-cause, one-cure" sacred cow. The steps required to achieve this outcome are outlined. Three: openly dividing the profession into evidence based practitioners and subluxation based practitioners. Adopting this option would allow each branch of the profession to move forward in the health care delivery system unhindered by the other. It is unclear which option the profession will choose and whether the profession is mature enough to follow option two remains to be seen. What is evident is that the time to act is now. PMID:22260381

  2. Chiropractic at the crossroads or are we just going around in circles?

    PubMed Central

    2011-01-01

    Background Chiropractic in Australia has seen many changes over the past 30 years. Some of these changes have advanced the professional status of chiropractic, improved undergraduate training and paved the way for a research culture. Unfortunately, other changes or lack of changes, have hindered the growth, public utilisation and professional standing of chiropractic in Australia. This article explores what influences have impacted on the credibility, advancement and public utilisation of chiropractic in Australia. Discussion The 1970's and 1980's saw a dramatic change within the chiropractic profession in Australia. With the advent of government regulation, came government funded teaching institutions, quality research and increased public acceptance and utilisation of chiropractic services. However, since that time the profession appears to have taken a backward step, which in the author's opinion, is directly linked to a shift by sections of the profession to the fundamentalist approach to chiropractic and the vertebral subluxation complex. The abandonment, by some groups, of a scientific and evidenced based approach to practice for one founded on ideological dogma is beginning to take its toll. Summary The future of chiropractic in Australia is at a crossroads. For the profession to move forward it must base its future on science and not ideological dogma. The push by some for it to become a unique and all encompassing alternative system of healthcare is both misguided and irrational. PMID:21599991

  3. Straight chiropractic philosophy as a barrier to Medicare compliance: a discussion of 5 incongruent issues

    PubMed Central

    Seaman, David R.; Soltys, Jonathan R.

    2013-01-01

    Objective The purpose of this commentary is to discuss potential 5 factors within straight chiropractic philosophy and practice that may prevent Medicare compliance. Discussion The national Medicare Benefit Policy Manual and the Florida Local Coverage Determination were reviewed to identify documentation and conceptual issues regarding chiropractic practice. Five Medicare positions were contrasted with tenets of straight chiropractic philosophy. Based on Medicare’s documentation requirements, Medicare defines subluxation and chiropractic practice from the perspective of treating spinal pain and related functional disability. In contrast, traditional straight chiropractic philosophy is not based on the treatment of spinal pain and disability or other symptomatic presentations. In this context, 5 potential areas of conflict are discussed. Conclusion The Medicare version of chiropractic practice is not consistent with traditional straight chiropractic philosophy, which may play a role in preventing Medicare compliance. The chiropractic profession may need to consider the fashion in which “philosophy” as it relates to technique and practice is presented to students and doctors to facilitate compliance with the documentation requirements of Medicare. PMID:25067928

  4. Chiropractic care of a 47-year-old woman with chronic Bell's palsy: a case study

    PubMed Central

    Cotton, Brad A.

    2011-01-01

    Objective The purpose of this case study is to describe the effect of chiropractic care on a patient with chronic Bell's palsy. Clinical Features A 47-year-old woman with medically diagnosed Bell's palsy presented for chiropractic care. She had experienced right sinus pressure and congestion, lack of facial tone on the right, and intermittent tingling of the right side of her face. Interventions and Outcomes The patient received high-velocity, low-amplitude chiropractic manipulation (adjustments) to the cervical and thoracic spine, interferential muscle stimulation, and hydroculation on the trapezius muscles bilaterally. Reduction in symptoms occurred following the initial visit and continued over the next 9 weeks of care. After the course of a year of chiropractic care, the patient reached 90% improvement. Conclusions For this patient, chiropractic care reduced Bell's palsy symptoms. PMID:22654687

  5. Laboratory diagnosis in Ontario and the need for reform relative to the profession of chiropractic

    PubMed Central

    Gotlib, Allan C; Injeyan, H Stephen; Crawford, John P

    1997-01-01

    The purpose of this paper is to provide an historical review of the progression of events within the jurisdiction of the province of Ontario related to the issue of laboratory diagnosis and the profession of chiropractic. The provisions of relevant legislation, task forces, Councils, reviews, consensus statements, Commissions and committees, are highlighted and discussed during respective time periods. Chiropractors had entitlement to order and perform laboratory tests until 1972 when a regulatory amendment, made without consultation with the chiropractic profession, precluded their continuing entitlement. Chiropractic patients require access to diagnostic laboratory services and equitable access to necessary laboratory services should be restored and preserved. This is consistent with the academic institutional accreditation standards of chiropractic education and the jurisdictional regulatory mechanisms of chiropractic practice and is consistent with both protecting and enhancing the public interest.

  6. Addressing the issue of cataloging and making chiropractic literature accessible: Part I: Defining the problem.

    PubMed

    Curl, D D; Antovich, T J

    1990-06-01

    Health science journals are a principle source of new knowledge for chiropractors, chiropractic faculty and students. Regrettably, clinically or educationally relevant articles (appearing in the nearly 20,000 journals annually) are often overlooked due to access difficulties. Innovations are needed to assist the reader to select articles relevant to chiropractic and reduce the time spent sorting through the volumes of literature. A review of the literature shows there is a trend toward database management for cataloging and accessibility of other, nonchiropractic, literature. Most notable of these is an endeavor by National Technical Information Service, commonly referred to as MEDLARS (Medline). It is interesting to note that a computer-assisted library database program does not exist on any chiropractic campus. This is in contrast with the trend on campuses of other health care fields. Manual search strategies within the chiropractic literature are time consuming, subject to a high failure rate, and even if the search produces citations, there is no assurance the journal can be accessed unless a chiropractic campus is nearby. Furthermore, difficulties exist when a chiropractic literature search is attempted in any computerized database, e.g., MEDLARS (Medline). Journals/articles that are unique to chiropractic (national, international or on the state level) are not specifically included in these computerized databases. Aside from these difficulties, there exists the problem of finding those articles that contain valid and relevant information from among those that are less valid or informative. PMID:2198323

  7. Chiropractic and social justice: a view from the perspective of Beauchamp's principles.

    PubMed

    Green, Bart N; Johnson, Claire

    2010-01-01

    Social justice in public health involves the process and product of a community acting to fairly distribute advantages and burdens to improve the health of its population and to reasonably take care of the disadvantaged. Although publications are available about chiropractic public health history, programs, and policy, the potential role of chiropractic in social justice has received little attention. This article discusses Beauchamp's 4 principles of social justice and suggests actions that the chiropractic profession may consider to participate in the practice of social justice in the field of public health. PMID:20732576

  8. Menorrhagia: A synopsis of management focusing on herbal and nutritional supplements, and chiropractic.

    PubMed Central

    Livdans-Forret, Anna B.; Harvey, Phyllis J.; Larkin-Thier, Susan M.

    2007-01-01

    Introduction To make chiropractors more aware of menorrhagia and how they can serve a role in their patient’s care and education since women make up 60% of the population seeking chiropractic care. Method A review of the biomedical literature on menorrhagia was conducted. Items that were retrieved were synthesized and interpreted in order to give the best information to practicing chiropractors. Discussion Most of the information available relative to menorrhagia is medically oriented. Other treatment options can include: chiropractic, various types of herbs, and nutritional supplements. Conclusion Knowledge of medical treatment, nutritional supplements, along with chiropractic treatment options may be beneficial to doctors in their practice. PMID:18060009

  9. Chiropractic spinal manipulative treatment of cervicogenic dizziness using Gonstead method: a case study

    PubMed Central

    Chaibi, Aleksander; Tuchin, Peter J.

    2011-01-01

    Objective The purpose of this case report is to present the response of a patient with chronic nonresponsive cervicogenic dizziness to chiropractic care. Case report A 29-year-old man had a 10-year history of progressive cervicogenic dizziness with symptoms including a sensation of excessive motion, imbalance, and spinning associated with neck pain and stiffness. After treatment, he reported a reduction in pain and dizziness and an improved quality of life following Gonstead method of chiropractic spinal manipulative therapy. Conclusion This case study suggests that a patient with nonresponsive cervicogenic dizziness might respond to chiropractic spinal manipulative therapy approach using Gonstead method. PMID:22014910

  10. Laboratory Pre-Participation Screening Examination in a Chiropractic College

    PubMed Central

    Funk, Matthew F.; Cantito, Albert A.

    2011-01-01

    Introduction: Chiropractic students often serve as subjects in laboratories where they and their classmates practice examinations, various soft tissue techniques, physiological therapeutic modalities, and active rehabilitation. There are contraindications and risks associated with these procedures. This article describes how a procedure was developed to identify potential health concerns and risks that students may face while serving as subjects or performing procedures in clinical skills laboratories. Methods: Screening questions and examination procedures were developed through a consensus process. Findings from the screening process determine whether students may engage in full participation or limited participation (precautions) or are prohibited from receiving certain procedures (contraindications). Skills laboratory students and their instructors are informed of any identifiable precautions or contraindications to participation. Results: Since its implementation, precautions regarding delivery of manual therapies were found in 4% of those examined and precautions regarding receiving manual therapies in 11.5%. Contraindications to receiving specified manual therapies were found in 8%, and 4% had contraindications to certain physiological therapeutic modalities. Discussion: Further work is necessary to improve compliance with follow-up regarding diagnosis of conditions revealed or suspected. Future efforts should address how well students adhered to precautions and contraindications, the nature and frequency of injuries sustained within the laboratories, and what specific measures were taken by faculty to help students with special needs. Conclusion: This chiropractic college now has a method to describe potential risks, explain rules of laboratory participation, and obtain consent from each student. PMID:21677869

  11. Teaching, leadership, scholarly productivity, and level of activity in the chiropractic profession: a study of graduates of the Los Angeles College of Chiropractic radiology residency program

    PubMed Central

    Young, Kenneth J.; Siordia, Lawrence

    2012-01-01

    Objective The purpose of this study was to track the graduates of the Los Angeles College of Chiropractic (LACC) radiology residency program, review their scholarly productivity, and report those involved in teaching and leadership positions. Methods Former LACC residents’ career information was identified through publicly available electronic documents including Web sites and social media. PubMed and the Index to Chiropractic Literature databases were searched for chiropractic graduate job surveys, and proportional comparisons were made between the career paths of LACC radiology residency graduates and those of non–residency-trained chiropractors. Results Of 47 former LACC residents, 28 (60%) have or previously had careers in tertiary (chiropractic) education; and 12 (26%) have attained a department chair position or higher at tertiary teaching institutions. Twenty-two (47%) have or previously had private radiology practices, whereas 11 (23%) have or previously had clinical chiropractic practices. Often, residency graduates hold or have held 2 of these positions at once; and one, all 3. Chapters or books were authored by 13 (28%). Conclusion Radiology residency LACC graduates are professionally active, particularly in education, and demonstrate scholarly productivity. PMID:23966885

  12. Improving Our Nation's Health Care System: Inclusion of Chiropractic in Patient-Centered Medical Homes and Accountable Care Organizations

    PubMed Central

    Meeker, William C.; Watkins, R.W.; Kranz, Karl C.; Munsterman, Scott D.; Johnson, Claire

    2014-01-01

    Objective This report summarizes the closing plenary session of the Association of Chiropractic Colleges Educational Conference—Research Agenda Conference 2014. The purpose of this session was to examine patient-centered medical homes and accountable care organizations from various speakers’ viewpoints and to discuss how chiropractic could possibly work within, and successfully contribute to, the changing health care environment. Discussion The speakers addressed the complex topic of patient-centered medical homes and accountable care organizations and provided suggestions for what leadership strategies the chiropractic profession may need to enhance chiropractic participation and contribution to improving our nation’s health. Conclusion There are many factors involved in the complex topic of chiropractic inclusion in health care models. Major themes resulting from this panel included the importance of building relationships with other professionals, demonstrating data and evidence for what is done in chiropractic practice, improving quality of care, improving health of populations, and reducing costs of health care. PMID:25431542

  13. Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

    PubMed Central

    2012-01-01

    A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE) immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature. PMID:23254252

  14. Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews

    PubMed Central

    Salehi, Alireza; Hashemi, Neda; Imanieh, Mohammad Hadi; Saber, Mahboobeh

    2015-01-01

    Chiropractic is a complementary medicine that has been growing increasingly in different countries over recent decades. It addresses the prevention, diagnosis and treatment of the neuromusculoskeletal system disorders and their effects on the whole body health. This study aims to evaluate the effectiveness of chiropractic in the treatment of different diseases. To gather data, scientific electronic databases, such as Cochrane, Medline, Google Scholar, and Scirus were searched and all systematic reviews in the field of chiropractic were obtained. Reviews were included if they were specifically concerned with the effectiveness of chiropractic treatment, included evidence from at least one clinical trial, included randomized studies and focused on a specific disease. The research data including the article’s first author’s name, type of disease, intervention type, number and types of research used, meta-analysis, number of participants, and overall results of the study, were extracted, studied and analyzed. Totally, 23 chiropractic systematic reviews were found, and 11 articles met the defined criteria. The results showed the influence of chiropractic on improvement of neck pain, shoulder and neck trigger points, and sport injuries. In the cases of asthma, infant colic, autism spectrum disorder, gastrointestinal problems, fibromyalgia, back pain and carpal tunnel syndrome, there was no conclusive scientific evidence. There is heterogeneity in some of the studies and also limited number of clinical trials in the assessed systematic reviews. Thus, conducting comprehensive studies based on more reliable study designs are highly recommended. PMID:26448951

  15. Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews.

    PubMed

    Salehi, Alireza; Hashemi, Neda; Imanieh, Mohammad Hadi; Saber, Mahboobeh

    2015-10-01

    Chiropractic is a complementary medicine that has been growing increasingly in different countries over recent decades. It addresses the prevention, diagnosis and treatment of the neuromusculoskeletal system disorders and their effects on the whole body health. This study aims to evaluate the effectiveness of chiropractic in the treatment of different diseases. To gather data, scientific electronic databases, such as Cochrane, Medline, Google Scholar, and Scirus were searched and all systematic reviews in the field of chiropractic were obtained. Reviews were included if they were specifically concerned with the effectiveness of chiropractic treatment, included evidence from at least one clinical trial, included randomized studies and focused on a specific disease. The research data including the article's first author's name, type of disease, intervention type, number and types of research used, meta-analysis, number of participants, and overall results of the study, were extracted, studied and analyzed. Totally, 23 chiropractic systematic reviews were found, and 11 articles met the defined criteria. The results showed the influence of chiropractic on improvement of neck pain, shoulder and neck trigger points, and sport injuries. In the cases of asthma, infant colic, autism spectrum disorder, gastrointestinal problems, fibromyalgia, back pain and carpal tunnel syndrome, there was no conclusive scientific evidence. There is heterogeneity in some of the studies and also limited number of clinical trials in the assessed systematic reviews. Thus, conducting comprehensive studies based on more reliable study designs are highly recommended. PMID:26448951

  16. Chiropractic care of the older person: developing an evidence-based approach

    PubMed Central

    Gleberzon, Brian J.

    2001-01-01

    Geriatric care has assumed a more dominant position in the health care delivery system. This article discusses the results of a literature search on geriatric chiropractic care with the ultimate goal of promoting a“best practice” approach. Fifty nine articles were found that discussed geriatric chiropractic education (N = 3), demographic and epidemiological studies (N = 9), case studies (N = 25), clinical trials (N = 4) and clinical guidelines (N = 18). The literature revealed that chiropractic pedagogy has recognized the importance of geriatric education, and epidemiological studies reported an increase in utilization rates of chiropractic care by older persons, along with greater acceptance within the medical community. Most older persons sought out chiropractic care for neuromusculoskeletal (NMS) conditions, with several studies reporting the successful resolution of these conditions with spinal manipulative therapy as well as an eclectic group of other treatment interventions. Many older persons enter a maintenance care program, which they believe to be important to their health. Although the results of this article are encouraging, it underscores the need for continued research, especially in the areas of chiropractic maintenance care and the management of non-NMS conditions.

  17. Assessing the attitudes, knowledge and perspectives of medical students to chiropractic

    PubMed Central

    Wong, Jessica J.; Di Loreto, Luciano; Kara, Alim; Yu, Kavan; Mattia, Alicia; Soave, David; Weyman, Karen; Kopansky-Giles, Deborah

    2013-01-01

    Objective: To assess second-year medical students’ views on chiropractic. Methods: A three-step triangulation approach was designed, comprising a 53-item survey, nine key informant interviews and one focus group of 8 subjects. ANOVA was used to assess attitude-response survey totals over grouping variables. Constant comparison method and NVivo was used for thematic analysis. Results: 112 medical students completed the survey (50% response rate). Subjects reporting no previous chiropractic experience/exposure or interest in learning about chiropractic were significantly more attitude-negative towards chiropractic. Thematically, medical students viewed chiropractic as an increasingly evidence-based complementary therapy for low back/chronic pain, but based views on indirect sources. Within formal curriculum, they wanted to learn about clinical conditions and benefits/risks related to treatment, as greater understanding was needed for future patient referrals. Conclusion: The results highlight the importance of exposure to chiropractic within the formal medical curriculum to help foster future collaboration between these two professions. PMID:23482682

  18. Vertebral artery dissection in evolution found during chiropractic examination.

    PubMed

    Futch, Dan; Schneider, Michael J; Murphy, Donald; Grayev, Allison

    2015-01-01

    A 30-year-old woman presented to an emergency department with sudden onset of transient loss of left peripheral vision. Owing to a history of migraine headaches, she was released with a diagnosis of ocular migraine. Two days later, she sought chiropractic care for the chief symptom of severe neck pain. The chiropractor suspected the possibility of vertebral artery dissection (VAD). No manipulation was performed; instead, MR angiography (MRA) of the neck was obtained, which revealed an acute left VAD with early thrombus formation. The patient was placed on aspirin therapy. Repeat MRA of the neck 3?months later revealed resolution of the thrombus, without progression to stroke. This case illustrates the importance for all healthcare providers who see patients with neck pain and headache to be attentive to the symptomatic presentation of possible VAD in progress. PMID:26564115

  19. Constructing a philosophy of chiropractic: evolving worldviews and postmodern core?

    PubMed Central

    Senzon, Simon A.

    2011-01-01

    Objective The purpose of this article is to explore the postmodern, postrational, and postconventional core of DD Palmer's self-sense and philosophy. Discussion DD Palmer's self and philosophy can be viewed as a reaction to the self of modernity and its challenges of a fracture between mind and body, spirit, and nature. It is argued that Palmer's solution to these vexing problems facing the modern self was to use postrational and postconventional logic to overcome the dualisms. His philosophy resonates with similar postrational approaches, most notably, the German idealist Schelling. Conclusion It is argued that Palmer was one of the first postrational individuals in America and that chiropractic was an attempt at the first postrational health profession. PMID:22693480

  20. Chiropractic leadership in the eradication of sexual abuse

    PubMed Central

    Kinsinger, F. Stuart; Sutton, Wendy

    2012-01-01

    Health practitioners work under fiduciary constraint, and are obligated to favour patient needs over all others and in particular their own. The principles of professionalism demand that professionals take great care to ensure that boundaries are maintained safely to provide an optimal setting in facilitating patient care. Boundary violations cause serious harm to the patient. Any romantic or sexual activity between parties is the most serious form of boundary violation. The chiropractic profession is included in the list of disciplines which are at an increased risk for boundary violations. The authors propose a four stage protocol which is designed to offer all parties maximal protection beginning with undergraduate professional education and then mandatory continuing education for registrants in professional practice. The protocol would affect all aspects of professional life including training in boundaries and jurisdictional regulation. PMID:22457543

  1. Saskatchewan’s Joint Chiropractic Professional Review Committee

    PubMed Central

    Grier, AR

    1995-01-01

    Saskatchewan’s Joint Chiropractic Professional Review Committee functions to ensure that clinically necessary services are provided to patients. The committee which has both government (payer) and professional representation is created by the Medical Care Insurance Act in Saskatchewan. Examples of committee concerns include frequent visits by individual patients, high number of patients treated per day, poor record keeping, high service per discrete patient value. The article concludes with some suggestions for how to determine if a practitioner’s pattern of practice is unusual and how to respond if contacted by the committee. The strengths of this form of review process include: the committee has a majority of chiropractors, patterns of practice are compared to that of peers, evaluation of patterns of practice uses random sampling of files to be analysed, and guidelines for practice are set by peers using a consensus process.

  2. A web-based survey of the motivations and challenges faced by emerging researchers in the chiropractic profession

    PubMed Central

    de Luca, Katie; Tuchin, Peter; Bonello, Rod

    2015-01-01

    Objective To investigate the motivations, challenges and perceptions of the educational environment of emerging researchers in chiropractic. Methods A descriptive web-based survey of higher-degree chiropractic research students was performed between October and November 2013. The survey consisted of open and closed questions and the Dundee Ready Education Environment Measure. Results Twenty-two students currently enrolled in a higher-degree research program participated. Students were most commonly enrolled in a doctor of philosophy program at a part-time rate. Motivations of research were desire to improve the clinical care aspects of chiropractic for the public and belief that chiropractic research is lacking. The greatest challenges were the negative attitudes towards chiropractic, finding enough time to do everything required, and feelings of isolation. The higher-degree research educational environment was perceived to be more positive than negative, with the stimulating nature of research a positive feature. A negative feature of the educational environment was poor undergraduate preparation for higher-degree research. Conclusion This study is the first study to describe higher-degree chiropractic research students. Primary motivations included building research, while challenges included not only negative attitudes toward the chiropractic profession but also negative attitudes toward researchers from within the profession. The higher-degree research educational environment was perceived to be positive. By acknowledging the issues that surround emerging researchers in chiropractic, the profession is better placed to foster academics and build research capacity. PMID:26090697

  3. Before Nugent took charge: early efforts to reform chiropractic education, 1919-1941

    PubMed Central

    Keating, Joseph C

    2003-01-01

    John J. Nugent, D.C. is remembered by many as either the “Abraham Flexner of Chiropractic” or the “anti-Christ of Chiropractic.” From 1941 until his forced retirement in 1959, the Irish-born Palmer graduate was one of the most important factors in the profession's educational reforms. Yet Nugent's work as the National Chiropractic Association's (NCA's) director of research was not the beginning of the campaign to upgrade chiropractic education. This paper looks at earlier influences and events which set the stage for Nugent's campaign. Among these were the introduction of licensure for chiropractors, the self-defeating actions of B.J. Palmer, the introduction of basic science legislation, the lethargy of the schools, and the struggle for control of education between the schools, on the one hand, and the NCA and the Council of State Chiropractic Examining Boards on the other ImagesFigure 1Figure 3Figure 4Figure 5Figure 6Figure 7Figure 9Figure 10Figure 11Figure 12Figure 13Figure 14Figure 15Figure 16Figure 17Figure 18Figure 19Figure 20Figure 21Figure 22Figure 23Figure 24Figure 25Figure 26Figure 28Figure 29Figure 30Figure 31Figure 32Figure 33Figure 34Figure 35Figure 36Figure 37Figure 38

  4. Colorado workers' compensation: medical vs chiropractic costs for the treatment of low back pain

    PubMed Central

    Gilkey, David; Caddy, Laine; Keefe, Thomas; Wahl, George; Mobus, Richard; Enebo, Brian; Duvall, Kirby; Griffiths, Kimberly

    2008-01-01

    Abstract Objective Low back disorders (LBDs) are the most common complaint among workers; therefore, many questions arise about cost-effective treatment approaches. This investigation evaluated the differences in cost-related factors among a population of patients selecting chiropractic vs allopathic care for the treatment of nonspecific LBDs. The study hypothesis was that chiropractic care would be more cost-effective or equivalent to allopathic care for the noncomplicated LBDs. Methods Cases were extracted from an insurance company database of patients reporting work-related low back injuries who were treated with either chiropractic or allopathic approaches. Cases were matched using the International Classification of Diseases, Ninth Revision, codes 722 (intervertebral disk disorders), 724 (other and unspecified disorders of the back), and 847 (sprains and strains of other and unspecified parts). The data set included 76 chiropractic cases and 2386 medical cases. Results The total amount paid by the insurance company was 1.7 times higher for patients treated by doctors of chiropractic (DCs) compared with those treated by medical doctors (MDs), and the cost of clinical treatment was 3.3 times higher for the DCs than MDs. Conclusion The cost for treatment by DCs was greater than that of MDs for similarly classified conditions affecting the low back. The amount paid by the insurance company was primarily related to the number of services given by each provider. PMID:19646374

  5. A narrative review of the published chiropractic literature regarding older patients from 2001–2010

    PubMed Central

    Gleberzon, Brian J.

    2011-01-01

    Introduction: The purpose of this article was to perform a narrative review of the chiropractic literature regarding older patients between 2001 and 2010. Methods: A three step search strategy of the literature involved electronic searching, hand searching and reference tracking. Results: One hundred and eighty eight articles germane to chiropractic geriatric practice and education were retrieved. Discussion: Compared to the review of the literature conducted prior to 2000, the number of references on chiropractic geriatric education increased from 3 to 11, the number of demographic studies increased from 9 to 18, the number of case reports increased from 25 to 83, the number of clinical trials increased from 4 to 21 (only two RCTs found) and the number of references on clinical guidelines and general clinical information increased from 18 to 55. Conclusion: This review found 188 retrievable articles available to practitioners to effectively care plan for their older patients, a better than three fold increase in the number of references found during a similar review conducted at the end of the previous decade. However, there is clearly a gap in the evidence base of chiropractic geriatric care, particularly the under-representation of clinical trials of all kinds involving older chiropractic patients. PMID:21629461

  6. Test anxiety and academic performance in chiropractic students*

    PubMed Central

    Zhang, Niu; Henderson, Charles N. R.

    2014-01-01

    Objective We assessed the level of students' test anxiety, and the relationship between test anxiety and academic performance. Methods We recruited 166 third-quarter students. The Test Anxiety Inventory (TAI) was administered to all participants. Total scores from written examinations and objective structured clinical examinations (OSCEs) were used as response variables. Results Multiple regression analysis shows that there was a modest, but statistically significant negative correlation between TAI scores and written exam scores, but not OSCE scores. Worry and emotionality were the best predictive models for written exam scores. Mean total anxiety and emotionality scores for females were significantly higher than those for males, but not worry scores. Conclusion Moderate-to-high test anxiety was observed in 85% of the chiropractic students examined. However, total test anxiety, as measured by the TAI score, was a very weak predictive model for written exam performance. Multiple regression analysis demonstrated that replacing total anxiety (TAI) with worry and emotionality (TAI subscales) produces a much more effective predictive model of written exam performance. Sex, age, highest current academic degree, and ethnicity contributed little additional predictive power in either regression model. Moreover, TAI scores were not found to be statistically significant predictors of physical exam skill performance, as measured by OSCEs. PMID:24350946

  7. A Case of Central Retinal Artery Occlusion after Chiropractic Manipulation of the Neck

    PubMed Central

    Jang, Young-Jun; Chun, Jun-Woo; Lee, Seung-Woo

    2012-01-01

    Here we report a case of central retinal artery occlusion after chiropractic manipulation on the neck. A 49-year old man presented at the hospital because of sudden visual loss in his right eye after chiropractic neck manipulation. He had received chiropractic manipulation of the neck by a chiropractor eight days prior. When he first visited us, his best corrected visual acuity in his right eye was hand motion. A full ophthalmic examination was performed. There was cherry-red spot in the macula in his right eye. We performed a fluorescein angiogram and cervical color Doppler. The arterio-venous transit time in the fluorescein angiogram was delayed, and we detected stenosis of the right internal carotid artery with diffuse atherosclerotic plaques in the right common carotid artery. We prescribed ginko biloba extract (Tanamin). Three years after his first visit, the best corrected visual acuity of his right eye was 20 / 200. PMID:22511840

  8. What effect does chiropractic treatment have on gastrointestinal (GI) disorders: a narrative review of the literature

    PubMed Central

    Angus, Katherine; Asgharifar, Sepideh; Gleberzon, Brian

    2015-01-01

    The purpose of this study was to provide a narrative review of the literature of studies describing the management of disorders of the gastro-intestinal (GI) tract using ‘chiropractic therapy’ broadly defined here as spinal manipulation therapy, mobilizations, soft tissue therapy, modalities and stretches. Search limiters include access to full text studies published between 1980 and November 2012 in peer-reviewed journals, English language only involving human subjects. Twenty-one articles were found that met our inclusion criteria. Retrievable articles varied from case reports to clinical trials to review articles of management options. The majority of articles chronicling patient experiences under chiropractic care reported they demonstrated mild to moderate improvements in presenting symptoms. No adverse side effects were reported. This suggests chiropractic care can be considered as an adjunctive therapy for patients with various GI conditions providing there are no co-morbidities. PMID:26136604

  9. On Vaccination & Chiropractic: when ideology, history, perception, politics and jurisprudence collide.

    PubMed

    Gleberzon, Brian; Lameris, Marlee; Schmidt, Catherine; Ogrady, Jillian

    2013-09-01

    The Palmers espoused anti-vaccination opinions in the early part of the 20(th) century, rejecting the germ theory of disease in favor of a worldview that a subluxation-free spine, achieved by spinal adjustments, would result in an unfettered innate intelligence; this, along with other healthful lifestyle choices, would allow a person to thwart disease by marshaling the body's natural recuperative abilities. Some chiropractors continue to staunchly champion the Palmer postulates, while others do not. At the national level, advocacy organizations publish conflicting position statements. We explore how this divisiveness has impacted chiropractic ideology, perceptions among students and practitioners, politics and issues of jurisprudence as reflected by the evolution of a standard of chiropractic practice in at least one Canadian province (Ontario). We opine that the chiropractic profession should champion a health promotion and disease prevention approach to vaccination, which would allow it to align itself with the broader healthcare community while not abandoning its traditional tenets. PMID:23997246

  10. "Research" and "science" in the first half of the chiropractic century.

    PubMed

    Keating, J C; Green, B N; Johnson, C D

    1995-01-01

    In the first 50 years of the chiropractic profession, a variety of unorthodox meanings for the terms "research," "science" and related words were in evidence. In harmony with popular conceptions of the day, science was constructed as a relatively static body of knowledge and was thought to reflect the will of God. Research was an ill-defined activity, and acquisition of new knowledge did not involve the experimental methodology that increasingly took hold in biology and medicine in the twentieth century. Chiropractors often viewed science and research as marketing strategies. Clinical data collection, when it occurred at all, was not described in sufficient detail to permit replication. Results were enthusiastically interpreted as indisputable proof of investigators' a priori assumptions about the effectiveness of chiropractic methods. A few in the profession recognized the general lack of understanding of the scientific method and sought reform from within. However, the colleges were unwilling to introduce coursework in research methods. At the end of World War II, the broad-scope national association of chiropractors in the United States established a nonprofit foundation for the purpose of raising funds for chiropractic research and education. Research plans were poorly conceived and grandiose: the first major initiative of the Chiropractic Research Foundation involved a nationwide publicity and fund-raising campaign modeled after the March of Dimes. When these efforts failed and the possibility of establishing free-standing research centers collapsed, the Foundation sought to shift responsibility for research to the schools. The poverty-stricken chiropractic colleges lacked the research sophistication for this task. Several more decades would pass before a sustained research effort and interest in clinical experimentation would become evident in chiropractic. PMID:7595110

  11. Chiropractic Management of Infantile Torticollis With Associated Abnormal Fixation of One Eye: A Case Report

    PubMed Central

    Hobaek Siegenthaler, Mette

    2015-01-01

    Objective The purpose of this case report is to describe the chiropractic management of a child with abnormal fixation of one eye and torticollis. Clinical Features A mother presented with a concern regarding her 23-month-old son who had a history of torticollis and an abnormal fixation of the right eye. She noticed the head tilt when he was about 7 months old and abnormal alignment of the right eye when the boy was 18 months old. At 15 months when he took his first steps, his head tilt became worse. At 21 months old, a neurological and orthopedic examination at the regional university children`s hospital ruled out presence of a tumor of the cervical spine or posterior fossa. The orthopedist sent the baby for chiropractic evaluation and treatment. Chiropractic exam found decreased active and passive range of motion in the cervical spine and no evidence of mass or contracture of the sternocleidomastoid muscle. Segmental palpation showed a decreased joint play and pain reaction at level C1/C2 on the right. Intervention and Outcome The chiropractic treatment consisted of spinal manipulative therapy of the cervical spine in addition to massage and stretching of the neck muscles. Within a period of 4 weeks (3 chiropractic treatments) the torticollis was nearly resolved and the abnormal fixation of the right eye was no longer apparent. No relapse of the symptomatology was observed at a follow-up consultation at 26 months. Conclusion The patient responded favorably to chiropractic care, showing a possible mechanical spinal cause for his torticollis and for the secondarily developed abnormal fixation of the right eye. PMID:26693217

  12. Characterization of side effects sustained by chiropractic students during their undergraduate training in technique class at a chiropractic college: a preliminary retrospective study

    PubMed Central

    Macanuel, Kim; Deconinck, Amy; Sloma, Katie; LeDoux, Monique; Gleberzon, Brian J

    2005-01-01

    Introduction The purpose of this study was to characterize the type, nature and frequency of injuries sustained by chiropractic students during their undergraduate training. Methods Chiropractic students in their second, third and fourth year of study at a chiropractic college were asked to complete a questionnaire that chronicled and described the occurrence of any side effects they may have sustained at the hands of their peers during technique class. Students were also asked to record their anthropomorphic characteristic. Results Of 450 questionnaires distributed, 292 were completed and returned to the authors. Of the 292 respondents, 127 reported to have experienced an injury, although the total number of injuries was 161. The most common site of injury was the lumbopelvic region. Students reported that it was during their second year of study that they experienced the highest number of injuries. Symptoms occurred the same day as the event in 85% of cases. The most common characteristic of symptoms reported was pain, followed by local stiffness, headache, dizziness, fatigue, diffuse stiffness and cramps. Two thirds of students described the extent of their injuries from ‘light’ to ‘a fair bit’. Three quarters of injuries resolved within the first 72 hours of the event. No treatment was sought by 89 (55%) of the respondents. More than half of students reported that their activities of daily living were either ‘not’ or ‘somewhat’ affected. There were three reports of long-term complaints. No statistically significant differences were found between the group of students reporting to be injured compared to those students not injured with respect to their age, gender, weight or height. Conclusion Chiropractic students experience side effects during their undergraduate training that are very similar to those experienced by patients under clinical care. PMID:17549151

  13. Pregnant Students in the Gross Anatomy Laboratory: Policies and Practices at Chiropractic Colleges

    ERIC Educational Resources Information Center

    Duray, Stephen M.; Mekow, Craig L.

    2011-01-01

    Chiropractic and medical colleges have experienced a significant increase in the number of female applicants in recent years, a percentage of whom are pregnant or become pregnant following admission. It is therefore important to ask the question: How do institutions that educate future health care providers address the issue of pregnancy and the…

  14. Lyman C. Johnston, DC, FICC, FCCS(C): Canadian chiropractic's postural research pioneer and inventive entrepreneur

    PubMed Central

    Brown, Douglas M.

    2001-01-01

    This paper profiles Dr. Lyman Johnston and his contributions in the field of chiropractic research. Postural concepts, diagnostic instruments, therapeutic devices and treatment protocols are reviewed. Set out and briefly discussed are the Posturometer, Pyramidal Man, anterior-posterior gravity line, Postural Spinal Index, tension master, Spine Power Belt and the Mini-Gym. ImagesFigure 1

  15. The philosophy of chiropractic: an action research model of curriculum review

    PubMed Central

    Waalen, David; Watkins, Terry; Saranchuk, Ron

    1999-01-01

    The philosophy of chiropractic has always been regarded as an integral and indispensable component of the curriculum at chiropractic colleges. This study describes a review process in which instruments were designed to survey students and faculty to obtain information concerning curricular aspects of philosophy at the Canadian Memorial Chiropractic College. Approximately one half of the student body (N = 292) and sixty percent of the full-time and part-time faculty members (N = 66) responded to the surveys. The students who were surveyed indicated that philosophy was a very important part of their chiropractic education and they felt that their needs in this regard were not being met by the present program. Further, they perceived most faculty as being unappreciative of philosophy. The results from the faculty survey were at odds with the students’ perceptions and indicated that the faculty members were favourably disposed towards philosophy and felt that it should be an integral part of the students’ educational experience. The information gained from these surveys was subsequently used as a catalyst to stimulate discussion in a series of student/faculty focus groups on philosophy. These discussions helped to clarify some curricular philosophical issues and resulted in specific modifications to the philosophy program in the areas of content, format, faculty, and evaluation methods.

  16. Chiropractic Management of Pubic Symphysis Shear Dysfunction in a Patient With Overactive Bladder

    PubMed Central

    Cooperstein, Robert; Lisi, Anthony; Burd, Andrew

    2014-01-01

    Objective The purpose of this case report is to describe chiropractic management of a patient with overactive bladder (OAB) and to describe an hypothetical anatomical basis for a somato-vesical reflex and possible clinical link between pelvic and symphysis pubis dysfunction to OAB. Clinical features A 24-year-old nulliparous female with idiopathic OAB, with a primary complaint of nocturia presented for chiropractic care. Her sleep was limited to 2 consecutive hours due to bladder urgency. Pubic symphysis shear dysfunction was observed on physical examination. Intervention and outcomes The primary treatment modality used was chiropractic side-posture drop-table manipulation designed to reduce pubic shear dysfunction. After 8 treatments in 1 month, the pubic shear gradually reduced while nocturia diminished and consecutive sleep hours increased from 2 to 7. At 1-year follow-up, the nocturia remained resolved. Conclusion The patient reported in this case responded favorably to chiropractic care, which resulted in reduced nocturia and increased sleep continuity. PMID:25685115

  17. Outcomes of a mentored research competition for authoring pediatric case reports in chiropractic

    PubMed Central

    Pohlman, Katherine A.; Vallone, Sharon; Nightingale, Lia M.

    2013-01-01

    Objective A chiropractic pediatric specialist often encounters novel clinical findings not reported currently in the literature. This project matched board certified chiropractic pediatric specialists with a mentor experienced in scientific writing to co-author a research paper to add to the literature base available on chiropractic pediatric practice. Methods Clinicians who had received their Diplomate in Clinical Chiropractic Pediatrics and mentors in scientific writing were teamed up. Two surveys were conducted to collect quantitative data, and focus groups were held to gather qualitative data about the overall experience of the mentor and mentee (clinicians) participating in the study. The first survey was sent to the clinicians to gather information about their research idea and their experience in research. The second survey was conducted upon project completion by clinicians and mentors. A project wiki was used as a communication strategy. Results Ten reports were submitted by authorship teams. Time spent on this project was an average of 58 hours by clinicians and 36 hours by the mentors. Mentors aided by adding content material, editing manuscripts, and educating the clinicians in the art of writing a paper. Improvements for this project included clearer mentoring guidelines and not using the wiki as a communication venue. Conclusion The project ultimately fulfilled the goal of using a mentorship model to facilitate scientific writing education and ease the anxiety of authoring a first publication. The overall experience was “good”; however, there are opportunities for improvement. PMID:23519131

  18. Extending ICPC-2 PLUS terminology to develop a classification system specific for the study of chiropractic encounters

    PubMed Central

    2013-01-01

    Background Typically a large amount of information is collected during healthcare research and this information needs to be organised in a way that will make it manageable and to facilitate clear reporting. The Chiropractic Observation and Analysis STudy (COAST) was a cross sectional observational study that described the clinical practices of chiropractors in Victoria, Australia. To code chiropractic encounters COAST used the International Classification of Primary Care (ICPC-2) with the PLUS general practice clinical terminology to code chiropractic encounters. This paper describes the process by which a chiropractic-profession specific terminology was developed for use in research by expanding the current ICPC-2 PLUS system. Methods The coder referred to the ICPC-2 PLUS system when coding chiropractor recorded encounter details (reasons for encounter, diagnoses/problems and processes of care). The coder used rules and conventions supplied by the Family Medicine Research Unit at the University of Sydney, the developers of the PLUS system. New chiropractic specific terms and codes were created when a relevant term was not available in ICPC-2 PLUS. Results Information was collected from 52 chiropractors who documented 4,464 chiropractor-patient encounters. During the study, 6,225 reasons for encounter and 6,491 diagnoses/problems were documented, coded and analysed; 169 new chiropractic specific terms were added to the ICPC-2 PLUS terminology list. Most new terms were allocated to diagnoses/problems, with reasons for encounter generally well covered in the original ICPC 2 PLUS terminology: 3,074 of the 6,491 (47%) diagnoses/problems and 274 of the 6,225 (4%) reasons for encounter recorded during encounters were coded to a new term. Twenty nine new terms (17%) represented chiropractic processes of care. Conclusion While existing ICPC-2 PLUS terminology could not fully represent chiropractic practice, adding terms specific to chiropractic enabled coding of a large number of chiropractic encounters at the desired level. Further, the new system attempted to record the diversity among chiropractic encounters while enabling generalisation for reporting where required. COAST is ongoing, and as such, any further encounters received from chiropractors will enable addition and refinement of ICPC-2 PLUS (Chiro). More research is needed into the diagnosis/problem descriptions used by chiropractors. PMID:23311664

  19. The search for Alma Arnold: chiropractic's forgotten woman pioneer, 1903-1938.

    PubMed

    Gibbons, R W

    1996-12-01

    Alma Cusian Arnold (1871-19??) was one of the first woman chiropractors, having graduated from Langsworthy's American School in 1903. Within the next decade, she would establish dual practices in Washington and New York with a patient constituency which included members of Congress, a Vice President and Clara Barton, the founder of the American Red Cross. She authored a book, was president of two schools of chiropractic and was arrested and imprisoned for her advocacy of the new profession. Engaging in critical dialogue over her technique with both Palmers, Arnold would establish a "Healtharium" with Terrance V. Powderly, the most prominent labor leader of the late 19th century and later Commissioner of Immigration. Her story is a personification of the exceptional men and women who formulated early chiropractic. PMID:11619052

  20. The West Family Chiropractic Dynasty: celebrating a century of accomplishment in Canada

    PubMed Central

    Brown, Douglas M.

    2010-01-01

    This historical treatise documents the unbroken legacy of the West family of chiropractors which has flourished in Canada for over 100 years. Part I, unearths the origins, development and careers of Archibald West, the founder of this dynasty, his son Samuel and grandson Stephen. Part II, not yet ready for publication, will delve into the lives of Archibald’s brother Samson and his chiropractic progeny, as well as a nephew of Stephen and another relative of Frederick West. PMID:20808618

  1. A theoretical basis for maintenance spinal manipulative therapy for the chiropractic profession

    PubMed Central

    Taylor, David N.

    2011-01-01

    Object The purpose of this article is to discuss a theoretical basis for wellness chiropractic manipulative care and to develop a hypothesis for further investigation. Methods A search of PubMed and of the Manual, Alternative, and Natural Therapy Index System was performed with a combination of key words: chiropractic, maintenance and wellness care, maintenance manipulative care, preventive spinal manipulation, hypomobility, immobility, adhesions, joint degeneration, and neuronal degeneration. Articles were collected, and trends were identified. Results The search revealed surveys of doctors and patients, an initial clinical pilot study, randomized control trials, and laboratory studies that provided correlative information to provide a framework for development of a hypothesis for the basis of maintenance spinal manipulative therapy. Maintenance care optimizes the levels of function and provides a process of achieving the best possible health. It is proposed that this may be accomplished by including chiropractic manipulative therapy in addition to exercise therapy, diet and nutritional counseling, and lifestyle coaching. Conclusions It is hypothesized that because spinal manipulative therapy brings a joint to the end of the paraphysiological joint space to encourage normal range of motion, routine manipulation of asymptomatic patients may retard the progression of joint degeneration, neuronal changes, changes in muscular strength, and recruitment patterns, which may result in improved function, decreased episodes of injuries, and improved sense of well-being. PMID:22693482

  2. The implementation of problem-based learning in collaborative groups in a chiropractic program in Malaysia

    PubMed Central

    Win, Ni Ni; Nadarajah, Vishna Devi V; Win, Daw Khin

    2015-01-01

    Purpose: Problem-based learning (PBL) is usually conducted in small-group learning sessions with approximately eight students per facilitator. In this study, we implemented a modified version of PBL involving collaborative groups in an undergraduate chiropractic program and assessed its pedagogical effectiveness. Methods: This study was conducted at the International Medical University, Kuala Lumpur, Malaysia, and involved the 2012 chiropractic student cohort. Six PBL cases were provided to chiropractic students, consisting of three PBL cases for which learning resources were provided and another three PBL cases for which learning resources were not provided. Group discussions were not continuously supervised, since only one facilitator was present. The students’ perceptions of PBL in collaborative groups were assessed with a questionnaire that was divided into three domains: motivation, cognitive skills, and perceived pressure to work. Results: Thirty of the 31 students (97%) participated in the study. PBL in collaborative groups was significantly associated with positive responses regarding students’ motivation, cognitive skills, and perceived pressure to work (P<0.05). The students felt that PBL with learning resources increased motivation and cognitive skills (P<0.001). Conclusion: The new PBL implementation described in this study does not require additional instructors or any additional funding. When implemented in a classroom setting, it has pedagogical benefits equivalent to those of small-group sessions. Our findings also suggest that students rely significantly on available learning resources. PMID:25961676

  3. Chiropractic management of a 47-year–old firefighter with lumbar disk extrusion

    PubMed Central

    Schwab, Matthew J.

    2008-01-01

    Abstract Objective This case report describes the effect of exercise-based chiropractic treatment on chronic and intractable low back pain complicated by lumbar disk extrusion. Clinical Features A 47-year–old male firefighter experienced chronic, unresponsive low back pain. Pre- and posttreatment outcome analysis was performed on numeric (0-10) pain scale, functional rating index, and the low back pain Oswestry data. Secondary outcome assessments included a 1-rep maximum leg press, balancing times, push-ups and sit-ups the patient performed in 60 seconds, and radiographic analysis. Intervention and Outcome The patient was treated with Pettibon manipulative and rehabilitative techniques. At 4 weeks, spinal decompression therapy was incorporated. After 12 weeks of treatment, the patient's self-reported numeric pain scale had reduced from 6 to 1. There was also overall improvement in muscular strength, balance times, self-rated functional status, low back Oswestry scores, and lumbar lordosis using pre- and posttreatment radiographic information. Conclusion Comprehensive, exercise-based chiropractic management may contribute to an improvement of physical fitness and to restoration of function, and may be a protective factor for low back injury. This case suggests promising interventions with otherwise intractable low back pain using a multimodal chiropractic approach that includes isometric strengthening, neuromuscular reeducation, and lumbar spinal decompression therapy. PMID:19646377

  4. Chiropractic management of a patient with ulnar nerve compression symptoms: a case report

    PubMed Central

    Illes, Jennifer D.; Johnson, Theodore L.

    2013-01-01

    Objective The purpose of this case report is to describe chiropractic management of a patient with arm and hand numbness and who was suspected to have ulnar nerve compression. Clinical Features A 41-year-old woman presented with hand weakness and numbness along the medial aspect of her right forearm and the 3 most medial fingers. The onset of symptoms presented suddenly, 3 weeks prior, when she woke up in the morning and assumed she had “slept wrong.” The patient’s posture showed protracted shoulders and moderate forward head carriage. Orthopedic assessment revealed symptomatic right elevated arm stress test, grip strength asymmetry, and a Tinel sign at the right cubital tunnel. Intervention and Outcome The patient was treated using chiropractic care, which consisted of manipulative therapy, myofascial therapy, and elastic therapeutic taping. Active home care included performing postural exercises and education about workstation ergonomics. She demonstrated immediate subjective improvement of her numbness and weakness after the first treatment. Over a series of 11 treatments, her symptoms resolved completely; and she was able to perform work tasks without dysfunction. Conclusion Chiropractic treatment consisting of manipulation, soft tissue mobilizations, exercise, and education of workstation ergonomics appeared to reduce the symptoms of ulnar nerve compression symptoms for this patient. PMID:24294148

  5. Effects of Biofreeze and chiropractic adjustments on acute low back pain: a pilot study?

    PubMed Central

    Zhang, John; Enix, Dennis; Snyder, Brian; Giggey, Kristan; Tepe, Rodger

    2008-01-01

    Abstract Objective This randomized controlled study was designed to determine the pain-relieving effect of Biofreeze (Performance Health Inc., Export, PA) body surface application and chiropractic adjustments on subjects with acute low back pain (LBP). Methods The data were collected at the baseline, 2 weeks after treatment, and 4 weeks after treatment for final analyses. Diversified manual adjustments were provided by licensed chiropractors twice a week for 4 weeks to both control and experimental groups. Biofreeze was applied to the lower back area 3 times a day for 4 weeks in the experimental group. Outcome assessments included visual analog scale, Roland Morris Disability Questionnaire, heart rate variability for stress, and electromyography for low back muscle activity. Results A total of 36 subjects were recruited in the study (25 male). The average age was 34 years. Significant pain reduction was found after each week of treatment in the experimental group (P < .05). The Roland Morris Disability Questionnaire did not show significant changes in both groups. There were no significant differences for pain reduction in the control group. Heart rate variability analysis showed no significant change (P > .05) in the experimental group after 4 weeks of Biofreeze and chiropractic adjustments. There were no statistically significant changes in the electromyography readings between the 2 groups. Conclusion Biofreeze combined with chiropractic adjustment showed significant reduction in LBP. PMID:19674721

  6. OVERCOMING BARRIERS To DIVERSITY IN CHIROPRACTIC PATIENT AND PRACTITIONER POPULATIONS: A COMMENTARY.

    PubMed

    Young, Kenneth J

    2015-01-01

    Increasing the diversity of practitioner and patient populations has been identified as a worthy goal in the chiropractic profession, which has predominantly white male practitioners and white female patients in the USA. Toward that end, 'diversity' has been the topic of several papers and was the theme of a 2012 conference of chiropractic educators. However, generally just the microcosm of the interactions of practitioners with patients or teachers with students has been discussed. The macrocosm of larger societal issues and government policies has not been broached. Examples of issues and policies that affect diversity within a profession include portrayals of, and value judgements on diversity by the media and politicians, as well as public funding for healthcare and education. Diversity was defined in this paper to mean differences in race, sex, sexual orientation, economic status, ethnicity, religion and other life circumstances in a population. The purpose of this paper is to raise awareness of evidence that social issues and government policy affect the diversity of practitioners and patients, and to suggest that the barriers to diversity present in these realms be addressed with a cogent, profession-wide effort in order to help increase the diversity of people involved with chiropractic. PMID:26647486

  7. On Vaccination & Chiropractic: when ideology, history, perception, politics and jurisprudence collide

    PubMed Central

    Gleberzon, Brian; Lameris, Marlee; Schmidt, Catherine; Ogrady, Jillian

    2013-01-01

    The Palmers espoused anti-vaccination opinions in the early part of the 20th century, rejecting the germ theory of disease in favor of a worldview that a subluxation-free spine, achieved by spinal adjustments, would result in an unfettered innate intelligence; this, along with other healthful lifestyle choices, would allow a person to thwart disease by marshaling the body’s natural recuperative abilities. Some chiropractors continue to staunchly champion the Palmer postulates, while others do not. At the national level, advocacy organizations publish conflicting position statements. We explore how this divisiveness has impacted chiropractic ideology, perceptions among students and practitioners, politics and issues of jurisprudence as reflected by the evolution of a standard of chiropractic practice in at least one Canadian province (Ontario). We opine that the chiropractic profession should champion a health promotion and disease prevention approach to vaccination, which would allow it to align itself with the broader healthcare community while not abandoning its traditional tenets. PMID:23997246

  8. Chiropractic management of postoperative spine pain: a report of 3 cases

    PubMed Central

    Coulis, Christopher M.; Lisi, Anthony J.

    2013-01-01

    Objective The purpose of this case series is to describe chiropractic care including spinal manipulation for 3 patients with postsurgical spine pain. Clinical features Three patients with postsurgical spine pain (1 cervical fusion, 1 lumbar discectomy, and 1 lumbar laminectomy) presented for chiropractic treatment at a major US medical center. Treatment included spinal manipulation and/or flexion-distraction mobilization based on patient response to joint loading strategies. Intervention and outcomes Two patients were treated with high-velocity, low-amplitude spinal manipulation; and 1 patient was treated with flexion-distraction mobilization. Treatment frequency and duration were 4 treatments over 4 weeks for case 1, 17 treatments over 7 years for case 2, and 5 treatments over 5 weeks for case 3. Subjective improvement was noted using numeric pain scores and functional changes; and upon completion, the patients reported being “satisfied” with their overall outcome. One episode of transient benign soreness was noted by 1 patient. No additional adverse events or effects were noted. Conclusion In these 3 cases, patients with postsurgical spine pain responded positively to chiropractic care. Spinal manipulation/mobilization was tolerated without significant adverse effects. PMID:24396317

  9. Chiropractic physicians: toward a select conceptual understanding of bureaucratic structures and functions in the health care institution

    PubMed Central

    Fredericks, Marcel; Kondellas, Bill; Hang, Lam; Fredericks, Janet; Ross, Michael WV

    2011-01-01

    Objective The purpose of this article is to present select concepts and theories of bureaucratic structures and functions so that chiropractic physicians and other health care professionals can use them in their respective practices. The society-culture-personality model can be applied as an organizational instrument for assisting chiropractors in the diagnosis and treatment of their patients irrespective of locality. Discussion Society-culture-personality and social meaningful interaction are examined in relationship to the structural and functional aspects of bureaucracy within the health care institution of a society. Implicit in the examination of the health care bureaucratic structures and functions of a society is the focus that chiropractic physicians and chiropractic students learn how to integrate, synthesize, and actualize values and virtues such as empathy, integrity, excellence, diversity, compassion, caring, and understanding with a deep commitment to self-reflection. Conclusion It is essential that future and current chiropractic physicians be aware of the structural and functional aspects of an organization so that chiropractic and other health care professionals are able to deliver care that involves the ingredients of quality, affordability, availability, accessibility, and continuity for their patients. PMID:22693481

  10. Current understanding of the relationship between cervical manipulation and stroke: what does it mean for the chiropractic profession?

    PubMed Central

    2010-01-01

    The understanding of the relationship between cervical manipulative therapy (CMT) and vertebral artery dissection and stroke (VADS) has evolved considerably over the years. In the beginning the relationship was seen as simple cause-effect, in which CMT was seen to cause VADS in certain susceptible individuals. This was perceived as extremely rare by chiropractic physicians, but as far more common by neurologists and others. Recent evidence has clarified the relationship considerably, and suggests that the relationship is not causal, but that patients with VADS often have initial symptoms which cause them to seek care from a chiropractic physician and have a stroke some time after, independent of the chiropractic visit. This new understanding has shifted the focus for the chiropractic physician from one of attempting to "screen" for "risk of complication to manipulation" to one of recognizing the patient who may be having VADS so that early diagnosis and intervention can be pursued. In addition, this new understanding presents the chiropractic profession with an opportunity to change the conversation about CMT and VADS by taking a proactive, public health approach to this uncommon but potentially devastating disorder. PMID:20682039

  11. Chiropractic management of a patient with breast cancer metastases to the brain and spine: a case report.

    PubMed

    Kanga, Ismat; Steiman, Igor

    2015-09-01

    Cancers of the breast, kidney, lungs, prostate and thyroid metastasize to the musculoskeletal system in the majority of patients with malignancy. This report chronicles the case of a 65-year-old female with a known history of breast cancer who presented to a chiropractic clinic. Once metastasis was ruled out as the cause of her complaint, the patient was treated with manual therapies and exercises. As the patient's treatments progressed and her pain improved, she presented with a new complaint of 'pressure' in her head. Advanced imaging revealed metastasis to the brain and subsequently to the spine. The aim of this case is to heighten awareness of the presentation of metastasis to the brain and the spine in a chiropractic patient, and to demonstrate the benefit of chiropractic care in the management of such patients. PMID:26500361

  12. Chiropractic management of a patient with breast cancer metastases to the brain and spine: a case report

    PubMed Central

    Kanga, Ismat; Steiman, Igor

    2015-01-01

    Cancers of the breast, kidney, lungs, prostate and thyroid metastasize to the musculoskeletal system in the majority of patients with malignancy. This report chronicles the case of a 65-year-old female with a known history of breast cancer who presented to a chiropractic clinic. Once metastasis was ruled out as the cause of her complaint, the patient was treated with manual therapies and exercises. As the patient’s treatments progressed and her pain improved, she presented with a new complaint of ‘pressure’ in her head. Advanced imaging revealed metastasis to the brain and subsequently to the spine. The aim of this case is to heighten awareness of the presentation of metastasis to the brain and the spine in a chiropractic patient, and to demonstrate the benefit of chiropractic care in the management of such patients. PMID:26500361

  13. Predictors of performance of students in biochemistry in a doctor of chiropractic curriculum.

    PubMed

    Shaw, Kathy; Rabatsky, Ali; Dishman, Veronica; Meseke, Christopher

    2014-01-01

    Objective : This study investigated the effect of completion of course prerequisites, undergraduate grade point average (GPA), undergraduate degree, and study habits on the performance of students in the biochemistry course at Palmer College of Chiropractic Florida. Methods : Students self-reported information regarding academic preparation at the beginning of the semester using a questionnaire. Final exam grade and final course grade were noted and used as measures of performance. Multivariate analysis of variance was used to determine if number of prerequisites completed, undergraduate GPA, undergraduate degree, hours spent studying in undergraduate study, and hours spent studying in the first quarter of the chiropractic program were associated significantly with the biochemistry final exam grade or the final grade for the biochemistry course. Results : The number of prerequisites completed, undergraduate degree, hours spent studying in undergraduate study, and hours spent studying in the first quarter of the chiropractic program did not significantly affect the biochemistry final exam grade or the final grade for the biochemistry course, but undergraduate GPA did. Subsequent univariate analysis and Tukey's post hoc comparisons revealed that students with an undergraduate GPA in the 3.5 to 3.99 range earned significantly higher final course grades than students with an undergraduate GPA in the 2.5 to 2.99 range. Conclusion : No single variable was determined to be a factor that determines student success in biochemistry. The interrelationship between the factors examined warrants further investigation to understand fully how to predict the success of a student in the biochemistry course. PMID:24295362

  14. Comminuted scapular body fractures: A report of three cases managed conservatively in chiropractic settings

    PubMed Central

    Scarano, Julie Lynn; Richardson, Matthew; Taylor, John A.

    2013-01-01

    Fractures of the scapula are relatively uncommon. Fractures specific to the scapular body comprise 35–65% of these fractures. Currently, 99% of all isolated scapular body fractures are being treated nonoperatively with an immobilizing sling or brace and some form of manual therapy with an 86% success rate. We present the conservative management of three patients with comminuted fractures involving the scapular body that were managed in chiropractic settings. Residual disabilities in these three patients as measured by a standardized outcome tool were 2%, 5% and 23% after 3 years, 2 years, and 6 years respectively. PMID:23754863

  15. The academic legitimization of chiropractic: the case of CMCC and York University

    PubMed Central

    Grayson, J Paul

    2002-01-01

    Despite the fact that chiropractic has been accepted by more and more Canadians and Americans, it has yet to gain a foothold on a large American or Canadian university campus. In Canada, the primary chiropractic educational institution, the Canadian Memorial Chiropractic College (CMCC), has attempted to affiliate with many universities including the University of Victoria, Brock University, the University of Waterloo, and, most recently, York University. The benefits of association with a university include eligibility for many research grants and academic legitimacy for the profession. While chiropractic has been denied university affiliation, other “subordinate” health occupations, such as nursing and midwifery, are currently taught in Ontario universities. The objective of the current research is to analyse the reasons for the failure of the CMCC to affiliate with York University. The major focus of the investigation is whether CMCC's lack of success can be viewed as a manifestation of the dominance of a medical model at York or whether arguments similar to those raised against CMCC are common in mergers in higher education. The first possibility is consistent with closure theory in general in which professions attempt to limit competition for scarce resources (in this case patients and status), and to the notions of medical dominance and medical sovereignty that are related to closure theory. The second explanation is consistent with “mutual-growth merger theory” in which it is postulated that mergers in higher education are successful when they are of benefit to both parties and a series of steps have been taken ranging from institutional self-assessment, that may involve conducting surveys of the university community, to post-merger consolidation and community building. Overall, it will be argued that the failure of the proposed affiliation is best explained by reference to closure theory, as manifested in medical dominance and medical sovereignty. Because of medical dominance and sovereignty. Because of medical dominance and sovereignty, even if steps consistent with mutual growth merger theory had been followed at York, it is questionable that affiliation would have been successful.

  16. Inappropriate use of the title 'chiropractor' and term 'chiropractic manipulation' in the peer-reviewed biomedical literature

    PubMed Central

    Wenban, Adrian B

    2006-01-01

    Background The misuse of the title 'chiropractor' and term 'chiropractic manipulation', in relation to injury associated with cervical spine manipulation, have previously been reported in the peer-reviewed literature. The objectives of this study were to - 1) Prospectively monitor the peer-reviewed literature for papers reporting an association between chiropractic, or chiropractic manipulation, and injury; 2) Contact lead authors of papers that report such an association in order to determine the basis upon which the title 'chiropractor' and/or term 'chiropractic manipulation' was used; 3) Document the outcome of submission of letters to the editors of journals wherein the title 'chiropractor', and/or term 'chiropractic manipulation', had been misused and resulted in the over-reporting of chiropractic induced injury. Methods One electronic database (PubMed) was monitored prospectively, via monthly PubMed searches, during a 12 month period (June 2003 to May 2004). Once relevant papers were located, they were reviewed. If the qualifications and/or profession of the care provider/s were not apparent, an attempt was made to confirm them via direct e-mail communication with the principal researcher of each respective paper. A letter was then sent to the editor of each involved journal. Results A total of twenty four different cases, spread across six separate publications, were located via the monthly PubMed searches. All twenty four cases took place in one of two European countries. The six publications consisted of four case reports, each containing one patient, one case series, involving twenty relevant cases, and a secondary report that pertained to one of the four case reports. In each of the six publications the authors suggest the care provider was a chiropractor and that each patient received chiropractic manipulation of the cervical spine prior to developing symptoms suggestive of traumatic injury. In two of the four case reports contact with the principal researcher revealed that the care provider was not a chiropractor, as defined by the World Federation of Chiropractic. The authors of the other two case reports did not respond to my communications. In the case series, which involved twenty relevant cases, the principal researcher conceded that the term chiropractor had been inappropriately used and that his case series did not relate to chiropractors who had undergone appropriate formal training. The author of the secondary report, a British Medical Journal editor, conceded that he had misused the title chiropractor. Letters to editors were accepted and published by all four journals to which they were sent. To date one of the four journals has published a correction. Conclusion The results of this year-long prospective review suggests that the words 'chiropractor' and 'chiropractic manipulation' are often used inappropriately by European biomedical researchers when reporting apparent associations between cervical spine manipulation and symptoms suggestive of traumatic injury. Furthermore, in those cases reported here, the spurious use of terminology seems to have passed through the peer-review process without correction. Additionally, these findings provide further preliminary evidence, beyond that already provided by Terrett, that the inappropriate use of the title 'chiropractor' and term 'chiropractic manipulation' may be a significant source of over-reporting of the link between the care provided by chiropractors and injury. Finally, editors of peer-reviewed journals were amenable to publishing 'letters to editors', and to a lesser extent 'corrections', when authors had inappropriately used the title 'chiropractor' and/or term 'chiropractic manipulation'. PMID:16925822

  17. Restructuring of the jurisprudence course taught at the Canadian Memorial Chiropractic College

    PubMed Central

    Gleberzon, Brian J.

    2010-01-01

    Introduction: The process by which the jurisprudence course was restructured at the Canadian Memorial Chiropractic College is chronicled. Method: A Delphi process used to restructure the course is described, and the results of a student satisfaction survey are presented. Results: When asked “I think this material was clinically relevant,” over 81% of the 76 students who respondents strongly agreed or agreed with this statement; 100% of students agreed or strongly agreed that scope of practice; marketing, advertising and internal office promotion; record keeping; fee schedules; malpractice issues and; professional malpractice issues and negligence was clinically relevant. When asked “I think this material was taught well,” a minimum of 89% of students agreed or strongly agreed with this statement. Discussion: This is the first article published that described the process by which a jurisprudence course was developed and assessed by student survey. Summary: Based on a survey of student perceptions, restructuring of the jurisprudence course was successful in providing students with clinically relevant information in an appropriate manner. This course may serve as an important first step in development a ‘model curriculum’ for chiropractic practice and the law courses in terms of content, format and assessment strategies. PMID:20195427

  18. Chiropractic Management of a 24-Year-Old Woman With Idiopathic, Intermittent Right-Sided Hemiparesthesia

    PubMed Central

    Bova, Joseph; Sergent, Adam

    2014-01-01

    Objective The purpose of this case report is to describe the chiropractic management of a patient with idiopathic, intermittent right-sided hemiparesthesia. Clinical Features A 24-year-old woman presented with a 2-year history of intermittent idiopathic right arm paresthesia. She also had a 3-month history of intermittent idiopathic right leg/face paresthesia. These symptoms were strongest at night and caused insomnia and worsened over time. She rated her discomfort at 5/10 on a numeric scale. Intervention and Outcome Care included vibration stimulation therapy, spinal manipulation and cold laser therapy. She had a noticeable reduction in her paresthesia both subjectively and objectively. She showed improvement in paresthesia on the right side of her body after the first visit. The following week, after 2 visits she returned and stated that she was symptom free with 0/10 discomfort on a numeric scale. Conclusion This patient's symptoms of idiopathic, intermittent right-sided hemi-paresthesia seemed to improve with a short course of chiropractic care using manipulation, vibration therapy and cold laser therapy. PMID:25435843

  19. An Overview of the Identification and Management of the Metabolic Syndrome in Chiropractic Practice

    PubMed Central

    Seaman, David R.; Palombo, Adam D.

    2014-01-01

    Objective This article presents an overview of metabolic syndrome (MetS), which is a collection of risk factors that can lead to diabetes, stroke, and heart disease. The purposes of this article are to describe the current literature on the etiology and pathophysiology of insulin resistance as it relates to MetS and to suggest strategies for dietary and supplemental management in chiropractic practice. Methods The literature was searched in PubMed, Google Scholar, and the Web site of the American Heart Association, from the earliest date possible to May 2014. Review articles were identified that outlined pathophysiology of MetS and type 2 diabetes mellitus (T2DM) and relationships among diet, supplements, and glycemic regulation, MetS, T2DM, and musculoskeletal pain. Results Metabolic syndrome has been linked to increased risk of developing T2DM and cardiovascular disease and increased risk of stroke and myocardial infarction. Insulin resistance is linked to musculoskeletal complaints both through chronic inflammation and the effects of advanced glycosylation end products. Although diabetes and cardiovascular disease are the most well-known diseases that can result from MetS, an emerging body of evidence demonstrates that common musculoskeletal pain syndromes can be caused by MetS. Conclusions This article provides an overview of lifestyle management of MetS that can be undertaken by doctors of chiropractic by means of dietary modification and nutritional support to promote blood sugar regulation. PMID:25225471

  20. Application of lead-acrylic compensating filters in chiropractic full spine radiography: a technical report

    SciTech Connect

    Buehler, M.T.; Hrejsa, A.F.

    1985-09-01

    X-raying the entire spinal column in the standing position in a single exposure (mainly the AP projection) is an often-used chiropractic radiography procedure which has also found some application in medical scoliosis screening program. Aside from any controversy of clinical objectives or medical necessity, the primary agreed-upon requisite for such procedure is twofold; achieving the best possible film image quality with the least amount of radiation exposure to the patient. A popular method of accomplishing this objective is by the use of collimator-attached devices designed to selectively filter the primary x-ray beam in accordance with regional variations of body thickness and/or density. This study was conducted to evaluate the use of a new lead-acrylic filter system under specialized chiropractic conditions. In comparison to other available systems, it was concluded that this new system; a) is generally equivalent in its radiation dose reduction capabilities; b) is capable of producing full spine radiographs with good to above average image quality; and c) is appreciably easier to use.

  1. Chiropractic wellness on the web: the content and quality of information related to wellness and primary prevention on the Internet

    PubMed Central

    2011-01-01

    Background The Internet has become a common source of information for patients wishing to learn about health information. Previous studies found information related to back pain poor and often contradictory to current guidelines. Wellness has become a common topic in the field of chiropractic and accrediting agencies have standards on delivery of wellness-based content in college curricula as well as directives for clinical applications. The purpose of this study was to evaluate the quality of the information on the Internet using the terms "chiropractic wellness," or "wellness chiropractic". Methods Five commonly used search engines were selected and the first 10 sites found using the strategy above were evaluated by two raters. Demographic assessments of the sites were made along with whether they were Health on the Net Foundation (HON) certified, contained standard wellness content, mentioned any Healthy People Focus Areas, and other chiropractic topics. Kappa statistics compared inter-rater agreement. Results Potential patients appeared to be the audience 87% of the time and a private doctor of chiropractic appeared to be the typical site owner. The sites usually promoted the provider. No sites displayed HON certification logo nor did any appear to meet the HON certification criteria. Twenty-six sites (55%) promoted regular physical activity in some manner and 18 (38%) had information on health risks of tobacco. Four (9%) had mental health or stress-reduction content but none had information supportive of vaccination. Some had information contradictory to common public health measures. Conclusions Patients searching the Internet for chiropractic wellness information will often find useless information that will not help them maintain health or become well. Most simply market the chiropractic practice or allow for a patients to provide personal information in exchange for more 'wellness' information. More research should be done on how providers determine site content, pay any attention to the details on their sites, or agree with content as some appear to be prefabricated sites. Website content could be enhanced by sharing of information from reputable sources like US Centers for Disease Control, the National Institutes of Health and other authoritative sources. HON certification should also be sought. PMID:21288336

  2. Evaluation of Publicly Available Documents to Trace Chiropractic Technique Systems That Advocate Radiography for Subluxation Analysis: A Proposed Genealogy

    PubMed Central

    Young, Kenneth J.

    2014-01-01

    Objective The purpose of this study was to evaluate publicly available information of chiropractic technique systems that advocate radiography for subluxation detection to identify links between chiropractic technique systems and to describe claims made of the health effects of the osseous misalignment component of the chiropractic subluxation and radiographic paradigms. Methods The Internet and publicly available documents were searched for information representing chiropractic technique systems that advocate radiography for subluxation detection. Key phrases including chiropractic, x-ray, radiography, and technique were identified from a Google search between April 2013 and March 2014. Phrases in Web sites and public documents were examined for any information about origins and potential links between these techniques, including the type of connection to BJ Palmer, who was the first chiropractor to advocate radiography for subluxation detection. Quotes were gathered to identify claims of health effects from osseous misalignment (subluxation) and paradigms of radiography. Techniques were grouped by region of the spine and how they could be traced back to B.J Palmer. A genealogy model and summary table of information on each technique were created. Patterns in year of origination and radiographic paradigms were noted, and percentages were calculated on elements of the techniques’ characteristics in comparison to the entire group. Results Twenty-three techniques were identified on the Internet: 6 full spine, 17 upper cervical, and 2 techniques generating other lineage. Most of the upper cervical techniques (14/16) traced their origins to a time when the Palmer School was teaching upper cervical technique, and all the full spine techniques (6/6) originated before or after this phase. All the technique systems’ documents attributed broad health effects to their methods. Many (21/23) of the techniques used spinal realignment on radiographs as one of their outcome measures. Conclusion Chiropractic technique systems in this study (ie, those that advocate for radiography for subluxation misalignment detection) seem to be closely related by descent, their claims of a variety of health effects associated with chiropractic subluxation, and their radiographic paradigms. PMID:25431540

  3. Patient with signs and symptoms of myocardial infarction, presenting to a chiropractic office: a case report

    PubMed Central

    Erfanian, Parham

    2001-01-01

    A 53-year-old female presented to a chiropractic office with signs and symptoms of heart attack (myocardial infarction). Although she was complaining of neck and upper back pain, the cause of her condition was due to an incident of acute myocardial infarction (MI). Other than anterior chest pain, patients with MI could experience pain over lower jaw and teeth, both arms, shoulders, neck, upper back and epigastrium. Recognizing the possible underlying cause of the patient's complaints, and directing them toward the appropriate venues of therapy is essential. Due to the fact that heart attacks are underestimated in women within a certain age group, their detection is also less frequent. To emphasize this fact, presentation, incidence, epidemiology, examination, laboratory findings, and risk factors for the myocardial infarction (MIs) are discussed in this paper.

  4. The reliability and potential value of a specific ècentre of pressure locatoré in chiropractic practice

    PubMed Central

    De Camillis, David; Carr, Robin

    2000-01-01

    This study assessed the reliability and potential value of a specific Centre of Pressure Locator (COPL) for the initial diagnosis of spinal mal-alignments and for the measurement of change in weight distribution resulting from clinical intervention. Basic validation of the equipment with standard weights showed it to be very precise, reliable and accurate at noting changes in the position of the centre of pressure. Control subjects were used to develop interim norms for COP position and sway. R-L COP position among both controls and patients was found to be too variable to be a useful tool for diagnosis or for the measurement of the effects of intervention. However, the equipment shows promise for the measurement of A-P and R-L postural sway; potentially important variables to consider within chiropractic practice.

  5. Attitudes of Australian chiropractic students toward whole body donation: a cross-sectional study.

    PubMed

    Alexander, Michelle; Marten, Mathew; Stewart, Ella; Serafin, Stanley; Štrkalj, Goran

    2014-01-01

    Cadavers play an important role in anatomy education. In Australia, bodies for anatomy education are acquired only through donations. To gain insight into educational dynamics in an anatomy laboratory as well as to facilitate body donation programs and thanksgiving ceremonies, it is important to understand students' attitudes toward body donation. In this cross-sectional study, the attitudes of Macquarie University's first, second, and fifth year chiropractic students toward body donation were investigated. Macquarie University chiropractic students have a four semester long anatomy program, which includes cadaver-based instruction on prosected specimens. A questionnaire was used to record respondents' demographics and attitudes toward body donation: personal, by a relative, and by a stranger. It was found that ethnicity and religion affect attitudes toward body donation, with Australian students being more willing to donate a stranger's body and atheists and agnostics being more willing to donate in general. Furthermore, willingness to donate one's own or a family member's body decreases as year of study increases, suggesting a possible negative impact of exposure to cadavers in the anatomy laboratory. This was only true, however, after controlling for age. Thus, the impact of viewing and handling prosected specimens, which is the norm in anatomy classes in Australia, may not be as strong as dissecting cadavers. It is suggested that anatomists and educators prepare students for cadaver-based instruction as well as exhibit sensitivity to cultural differences in how students approach working with cadavers, when informing different communities about body donation programs and in devising thanksgiving ceremonies. PMID:23861139

  6. A narrative review of medical, chiropractic, and alternative health practices in the treatment of primary dysmenorrhea

    PubMed Central

    Spears, Lolita G.

    2005-01-01

    Abstract Objective Primary dysmenorrhea and related issues are discussed as they influence the gynecological and social health of females during adolescence, adulthood, and senior maturity. Health practitioners are exposed to multiple approaches towards the management of menstrual pain. Clinical and social viewpoints target the causation, development, diagnosis, manifestation and management of primary dysmenorrhea. This narrative review includes the topic of the doctor-patient relationship in efforts of cultivating effectively communicative health practitioners. Controversial topics related to primary dysmenorrhea and the quality of life for women are addressed. Data Sources A search for literature reviews, case studies, laboratory research, and clinical trials from 1985–2004 was performed using the MEDLINE database. Sources of additional information included textbooks, national organizational literature and contemporary articles. Discussion Menstrual pain is a prevalent experience yet it is socially taboo for conversation; as such, it poses a hindrance to its management. The communication between the doctor and patient is a critical barrier point between establishing a diagnosis and determining an appropriate treatment plan. A multi-disciple treatment plan varies as much as patients themselves vary in personal experiences, needs, and preferences. Conclusions Medicinal prophylactics, physical therapeutics, non-acidic diets, herbal supplements, eastern therapies and the chiropractic manual adjustments of the spine are effective methods for the management of primary dysmenorrhea. The non-invasive management of primary dysmenorrhea includes the chiropractic adjustment with complimentary modalities, and other alternative health care practices. Medicinal prophylactics are invasive and pose a higher risk to long-term chemical exposure, side effects or irreversible conditions. PMID:19674650

  7. A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder

    PubMed Central

    DeVocht, James W.; Goertz, Christine M.; Hondras, Maria A.; Long, Cynthia R.; Schaeffer, Wally; Thomann, Lauren; Spector, Michael; Stanford, Clark M.

    2014-01-01

    Background Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). Methods The authors assigned 80 participants randomly into one of the following four groups, all of which included a comprehensive self-care program: reversible interocclusal splint therapy (RIST), Activator Method Chiropractic Technique (AMCT) (Activator Methods International, Phoenix), sham AMCT and self-care only. They made assessments at baseline and at month 2 and month 6, including use of the Research Diagnostic Criteria for Temporomandibular Disorders. Results The authors screened 721 potential participants and enrolled 80 people; 52 participants completed the six-month assessment. The adjusted mean change in current pain over six months, as assessed on the 11-point numerical rating scale, was 2.0 (95 percent confidence interval, 1.1-3.0) for RIST, 1.7 (0.9-2.5) for self-care only, 1.5 (0.7-2.4) for AMCT and 1.6 (0.7-2.5) for sham AMCT. The authors also assessed bothersomeness and functionality. Conclusions The authors found the study design and methodology to be manageable. They gained substantial knowledge to aid in conducting a larger study. AMCT, RIST and self-care should be evaluated in a future comparative effectiveness study. Practical Implications. This pilot study was a necessary step to prepare for a larger study that will provide clinicians with information that should be helpful when discussing treatment options for patients with TMD. PMID:24080932

  8. Chiropractic care using a functional neurologic approach for idiopathic cervical dystonia in a 59-year-old woman

    PubMed Central

    Bova, Joseph A.; Sergent, Adam W.

    2013-01-01

    Objective The purpose of this case report is to describe the care and outcomes of a patient with cervical dystonia who was treated using chiropractic and other alternative medicine interventions. Clinical Features A 59-year-old woman had an 11-year history of cervical dystonia. She had an uncontrollable 60° leftward head rotation upon shutting her eyes and had spasmodic contractions that caused fatigue. Intervention and Outcome The management consisted of blue-lensed glasses, vibration stimulation, spinal manipulation, and eye-movement exercises. Within the first week of treatment, she had a reduction in symptoms, which was documented using a functional numeric scale, and improved posture, which was assessed using measurements from her midsternal line to the center of her chin. Conclusion This patient with cervical dystonia responded to the use of conservative, nonpharmacological treatment procedures that consisted of chiropractic care using a functional neurologic approach aimed at improving her spasmodic contractions and function. PMID:24294147

  9. Chiropractic Research

    MedlinePLUS

    ... trials involving patients with neck pain and/or neck dysfunction and headache.” -- McCrory, Penzlen, Hasselblad, Gray (2001), Duke Evidence Report “The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. . . Four weeks after cessation of treatment . . . the ...

  10. Chiropractic and self-care for back-related leg pain: design of a randomized clinical trial

    PubMed Central

    2011-01-01

    Background Back-related leg pain (BRLP) is a common variation of low back pain (LBP), with lifetime prevalence estimates as high as 40%. Often disabling, BRLP accounts for greater work loss, recurrences, and higher costs than uncomplicated LBP and more often leads to surgery with a lifetime incidence of 10% for those with severe BRLP, compared to 1-2% for those with LBP. In the US, half of those with back-related conditions seek CAM treatments, the most common of which is chiropractic care. While there is preliminary evidence suggesting chiropractic spinal manipulative therapy is beneficial for patients with BRLP, there is insufficient evidence currently available to assess the effectiveness of this care. Methods/Design This study is a two-site, prospective, parallel group, observer-blinded randomized clinical trial (RCT). A total of 192 study patients will be recruited from the Twin Cities, MN (n = 122) and Quad Cities area in Iowa and Illinois (n = 70) to the research clinics at WHCCS and PCCR, respectively. It compares two interventions: chiropractic spinal manipulative therapy (SMT) plus home exercise program (HEP) to HEP alone (minimal intervention comparison) for patients with subacute or chronic back-related leg pain. Discussion Back-related leg pain (BRLP) is a costly and often disabling variation of the ubiquitous back pain conditions. As health care costs continue to climb, the search for effective treatments with few side-effects is critical. While SMT is the most commonly sought CAM treatment for LBP sufferers, there is only a small, albeit promising, body of research to support its use for patients with BRLP. This study seeks to fill a critical gap in the LBP literature by performing the first full scale RCT assessing chiropractic SMT for patients with sub-acute or chronic BRLP using important patient-oriented and objective biomechanical outcome measures. Trial Registration ClinicalTrials.gov NCT00494065 PMID:21426558

  11. Name techniques in Canada: current trends in utilization rates and recommendations for their inclusion at the Canadian Memorial Chiropractic College

    PubMed Central

    Gleberzon, Brian J.

    2000-01-01

    Since its establishment in 1945, the Canadian Memorial Chiropractic College (CMCC) has predominately adhered to a Diversified model of chiropractic technique in the core curriculum; however, many students and graduates have voiced a desire for greater exposure to chiropractic techniques other than Diversified at CMCC. A course structure is presented that both exposes students to a plethora of different “Name techniques” and provides students with a forum to appraise them critically. The results of a student survey suggested that both of these learning objectives have been successfully met. In addition, an assignment was designed that enabled students to recommend which, if any, “Name techniques” should be included in the curriculum of the College. The recommendations from these assignments were compiled since the 1996/97 academic year. The results indicated an overwhelming demand for the inclusion of Thompson Terminal Point, Gonstead, Activator Methods, Palmer HIO and Active Release Therapy techniques either as part of the core curriculum or in an elective program. These recommendations parallel the practice activities of Canadian chiropractors. Imagesp168-ap168-bp168-cp168-dp168-e

  12. Chiropractic Name techniques in Canada: a continued look at demographic trends and their impact on issues of jurisprudence

    PubMed Central

    Gleberzon, Brain J

    2002-01-01

    In a previous article, the author reported on the recommendations gathered from student projects between 1996 and 1999 investigating their preferences for including certain chiropractic Name technique systems into the curriculum at the Canadian Memorial Chiropractic College (CMCC). These results were found to be congruent with the professional treatment technique used by Canadian chiropractors. This article reports on the data obtained during the 2000 and 2001 academic years, comparing these results to those previously gathered. In addition, because of the implementation of a new curriculum during this time period, there was unique opportunity to observe whether or not student perceptions differed between those students in the `old' curricular program, and those students in the `new' curricular program. The results gathered indicate that students in both curricular programs show an interest in learning Thompson Terminal Point, Activator Methods, Gonstead, and Active Release Therapy techniques in the core curriculum, as an elective, or during continuing educational programs provided by the college. Students continue to show less interest in learning CranioSacral Therapy, SacroOccipital Technique, Logan Basic, Applied Kinesiology and Chiropractic BioPhysics. Over time, student interest has moved away from Palmer HIO and other upper cervical techniques, and students show a declining interest in being offered instruction in either Network Spinal Analysis or Torque Release Techniques. Since these findings reflect the practice activities of Canadian chiropractors they may have implications not only towards pedagogical decision-making processes at CMCC, but they may also influence professional standards of care.

  13. Presentation of an 85-Year-Old Woman With Musculoskeletal Pain to a Chiropractic Clinic: A Case of Ischemic Stroke

    PubMed Central

    Liebich, Julia M.; Reinke, Tari S.

    2014-01-01

    Objective The purpose of this case is to describe a patient who had a stroke preceding a chiropractic appointment and was unaware that the cerebrovascular event had occurred. Clinical features An 85-year-old established patient presented for chiropractic treatment of pain in the left side of the neck, hip, and low back associated with known advanced degenerative spinal disease and lumbar stenosis. On the day of presentation, the patient reported morning nausea, double vision, and right-sided vision loss; she related that she had collided into a car while driving to the appointment. Review of her medical history divulged residual neurological deficits related to a previous subdural hematoma, resulting in craniotomy. Examination revealed a right inferior quadrantanopia in the right eye and right nasal hemianopia in the left eye. Nystagmus was present in the left eye with saccadic intrusion on pursuit right to left. Intervention and outcome The patient was transported immediately to an emergency room,where diagnosis of an Acute infarct in the left cerebrum at the junction of the left occipital, parietal and temporal lobes in the watershed area was confirmed. Conclusion Patients with signs and symptoms of stroke in progress may occasionally present for chiropractic care. It is imperative to complete a thorough history and examination prior to care. PMID:24711785

  14. The modulation of upper extremity musculoskeletal disorders for a knowledge worker with chiropractic care and applied ergonomics: a case study

    PubMed Central

    Sherrod, Charles W.; Casey, George; Dubro, Robert E.; Johnson, Dale F.

    2013-01-01

    Objective This report describes the case management of musculoskeletal disorders for an employee in a college work environment using both chiropractic care and applied ergonomics. Clinical Findings A 54-year-old male office worker presented with decreased motor function in both wrists; intermittent moderate-to-severe headaches; and pain or discomfort in the neck, both shoulders, left hand and wrist, and lumbosacral region resulting from injuries sustained during recreational soccer and from excessive forces and awkward postures when interacting with his home and office computer workstations. Intervention and Results Ergonomic training, surveillance, retrofitted equipment with new furniture, and an emphasis on adopting healthy work-style behaviors were applied in combination with regular chiropractic care. Baseline ergonomic job task analysis identified risk factors and delineated appropriate control measures to improve the subject's interface with his office workstation. Serial reevaluations at 3-month, 1-year, and 2-year periods recorded changes to the participant's pain, discomfort, and work-style behaviors. At end of study and relative to baseline, pain scale improved from 4/10 to 2/10; general disability improved from 4 to 0; and hand grip strength (pounds) increased from 20 to 105 (left) and 45 to 100 (right). Healthy work habits and postures adopted in the 3-month to 1-year period regressed to baseline exposures for 3 of 6 risk priorities identified in the ergonomic job task analysis. Conclusion The patient responded positively to the intervention of chiropractic care and applied ergonomics. PMID:23997724

  15. Inclusion of chiropractic care in multidisciplinary management of a child with Prader-Willi syndrome: a case report?

    PubMed Central

    Wittman, Rebekah A.; Vallone, Sharon A.

    2009-01-01

    Abstract Objective The purpose of this paper is to present a case of a child with Prader-Willi syndrome and the observed improvement in the degree of scoliosis, immune function, and behavior documented during the course of her treatment. Clinical Features A 7-year-old girl presented to Kentuckiana Children's Center with a 15° lumbar levoscoliosis and diagnosis of Prader-Willi syndrome. Intervention and Outcome The treatment plan consisted of chiropractic adjustments, craniosacral therapy, movement therapy, and nutritional therapy. Over the course of treatment, her muscle strength, tone, and motor activity increased. She improved in coordination of gait and balance. Over the course of 3 years, her scoliosis decreased to 4° to 5°. Improvements in immune function and a reduction in anxiety type behaviors were documented by the parents and doctor of chiropractic over the course of 5 years. Conclusions This case report describes the improvements and progression of one female child with Prader-Willi syndrome under chiropractic and multidisciplinary care. PMID:19948310

  16. Chiropractic Management of Low Back Pain in a 75-Year-Old Man With Bilateral Developmental Hip Dysplasia

    PubMed Central

    Murray, Kelvin J.; Azari, Michael F.

    2015-01-01

    Objective The purpose of this case report is to describe chiropractic management of an elderly man with untreated bilateral hip joint dysplasia presenting with mild acute mechanical low back pain. Clinical Features A 75-year-old man presented with an insidious-onset intermittent low back pain of 3 days’ duration. Physical examination findings supported a mechanical cause for mild acute low back pain. Plain radiography revealed dysplasia of hip joints with absence of femoral heads and necks and bilateral high dislocation. Intervention and Outcome Chiropractic management included vibration, mobilization, light drop-piece adjustments of the lower lumbar and sacroiliac joints, and recommendation of the use of heat at home. Treatments were given 3 times over the course of 1 week. The low back pain intensity over this period dropped from 5 to 0 on an 11-point numerical rating scale, and the patient was discharged. Conclusion This patient with substantial postural and gait abnormalities as a result of severe bilateral hip dysplasia associated with an unusual pattern of osteoarthritic change in the spine responded favorably to a short course of chiropractic care.

  17. Treatment of a patient with posterior cortical atrophy (PCA) with chiropractic manipulation and Dynamic Neuromuscular Stabilization (DNS): A case report

    PubMed Central

    Francio, Vinicius T.; Boesch, Ron; Tunning, Michael

    2015-01-01

    Objective: Posterior cortical atrophy (PCA) is a rare progressive neurodegenerative syndrome which unusual symptoms include deficits of balance, bodily orientation, chronic pain syndrome and dysfunctional motor patterns. Current research provides minimal guidance on support, education and recommended evidence-based patient care. This case reports the utilization of chiropractic spinal manipulation, dynamic neuromuscular stabilization (DNS), and other adjunctive procedures along with medical treatment of PCA. Clinical features: A 54-year-old male presented to a chiropractic clinic with non-specific back pain associated with visual disturbances, slight memory loss, and inappropriate cognitive motor control. After physical examination, brain MRI and PET scan, the diagnosis of PCA was recognized. Intervention and Outcome: Chiropractic spinal manipulation and dynamic neuromuscular stabilization were utilized as adjunctive care to conservative pharmacological treatment of PCA. Outcome measurements showed a 60% improvement in the patient’s perception of health with restored functional neuromuscular pattern, improvements in locomotion, posture, pain control, mood, tolerance to activities of daily living (ADLs) and overall satisfactory progress in quality of life. Yet, no changes on memory loss progression, visual space orientation, and speech were observed. Conclusion: PCA is a progressive and debilitating condition. Because of poor awareness of PCA by physicians, patients usually receive incomplete care. Additional efforts must be centered on the musculoskeletal features of PCA, aiming enhancement in quality of life and functional improvements (FI). Adjunctive rehabilitative treatment is considered essential for individuals with cognitive and motor disturbances, and manual medicine procedures may be consider a viable option. PMID:25729084

  18. Chiropractic management of a postoperative complete anterior cruciate ligament rupture using a multimodal approach: a case report

    PubMed Central

    Solecki, Thomas J.; Herbst, Elizabeth M.

    2011-01-01

    Objective The purpose of this case report is to describe the chiropractic management of a patient who had postoperative reconstructive surgery for an anterior cruciate ligament (ACL) tear. Clinical Features A 25-year-old man experienced a rupture of his left ACL, as well as a bucket-handle tear of the medial meniscus and full-thickness tear within the posterior horn of the lateral meniscus, following direct-contact trauma while playing basketball. Intervention and Outcome Postoperative care included a 12-week functional chiropractic rehabilitation program along with Active Release Technique, Graston Technique, and Kinesio Taping. Following treatment, the patient recorded a 0/10 on the Numeric Pain Scale, recorded improvement on the Patient Specific Functional and Pain Scales, returned to play with no complications, and had complete restoration of range of motion and lower extremity muscle strength. At 1-year follow-up, the patient reported no pain and was fully functional. Conclusion A multimodal approach to the treatment of a postsurgical ACL repair was successful in restoring functional ability, as well as complete subjective pain relief. Chiropractic care may be a beneficial addition to the care of postoperative patients. PMID:22027208

  19. Chiropractic clinical practice guideline: evidence-based treatment of adult neck pain not due to whiplash

    PubMed Central

    Anderson-Peacock, Elizabeth; Blouin, Jean-Sébastien; Bryans, Roland; Danis, Normand; Furlan, Andrea; Marcoux, Henri; Potter, Brock; Ruegg, Rick; Gross Stein, Janice; White, Eleanor

    2005-01-01

    OBJECTIVE To provide an evidence-based clinical practice guideline for the chiropractic cervical treatment of adults with acute or chronic neck pain not due to whiplash. This is a considerable health concern considered to be a priority by stakeholders, and about which the scientific information was poorly organized. OPTIONS Cervical treatments: manipulation, mobilization, ischemic pressure, clinic- and home-based exercise, traction, education, low-power laser, massage, transcutaneous electrical nerve stimulation, pillows, pulsed electromagnetic therapy, and ultrasound. OUTCOMES The primary outcomes considered were improved (reduced and less intrusive) pain and improved (increased and easier) ranges of motion (ROM) of the adult cervical spine. EVIDENCE An “extraction” team recorded evidence from articles found by literature search teams using 4 separate literature searches, and rated it using a Table adapted from the Oxford Centre for Evidence-based Medicine. The searches were 1) Treatment; August, 2003, using MEDLINE, CINAHL, AMED, MANTIS, ICL, The Cochrane Library (includes CENTRAL), and EBSCO, identified 182 articles. 2) Risk management (adverse events); October, 2004, identified 230 articles and 2 texts. 3) Risk management (dissection); September, 2003, identified 79 articles. 4) Treatment update; a repeat of the treatment search for articles published between September, 2003 and November, 2004 inclusive identified 121 articles. VALUES To enable the search of the literature, the authors (Guidelines Development Committee [GDC]) regarded chiropractic treatment as including elements of “conservative” care in the search strategies, but not in the consideration of the range of chiropractic practice. Also, knowledge based only on clinical experience was considered less valid and reliable than good-caliber evidence, but where the caliber of the relevant evidence was low or it was non-existent, unpublished clinical experience was considered to be equivalent to, or better than the published evidence. REPORTED BENEFITS, HARMS AND COSTS The expected benefits from the recommendations include more rapid recovery from pain, impairment and disability (improved pain and ROM). The GDC identified evidence-based pain benefits from 10 unimodal treatments and more than 7 multimodal treatments. There were no pain benefits from magnets in necklaces, education or relaxation alone, occipital release alone, or head retraction-extension exercise combinations alone. The specificity of the studied treatments meant few studies could be generalized to more than a minority of patients. Adverse events were not addressed in most studies, but where they were, there were none or they were minor. The theoretic harm of vertebral artery dissection (VAD) was not reported, but an analysis suggested that 1 VAD may occur subsequent to 1 million cervical manipulations. Costs were not analyzed in this guideline, but it is the understanding of the GDC that recommendations limiting ineffective care and promoting a more rapid return of patients to full functional capacity will reduce patient costs, as well as increase patient safety and satisfaction. For simplicity, this version of the guideline includes primarily data synthesized across studies (evidence syntheses), whereas the technical and the interactive versions of this guideline (http://ccachiro.org/cpg) also include relevant data from individual studies (evidence extractions). RECOMMENDATIONS The GDC developed treatment, risk-management and research recommendations using the available evidence. Treatment recommendations addressing 13 treatment modalities revolved around a decision algorithm comprising diagnosis (or assessment leading to diagnosis), treatment and reassessment. Several specific variations of modalities of treatment were not recommended. For adverse events not associated with a treatment modality, but that occur in the clinical setting, there was evidence to recommend reconsideration of treatment options or referral to the appropriate health services. For adverse eve

  20. Advertising in chiropractic, 1939-1944: an introspective look at the early years of the Chirogram.

    PubMed

    Johnson, C D; Green, B N

    1996-12-01

    The Chirogram was a popular and widespread chiropractic journal that was reborn in 1939 and lasted for 40 years. With 8,000 copies circulated for the debut May 1939 issue, the journal grew steadily to 11,000 copies per month by December 1944. As one of the largest journals of its time, the Chirogram was well supported by vendors that supplied chiropractors with products and services. By reviewing the advertisements, one can see through the eyes of early doctors; they saw the trends, fads, common remedies and popular treatments of the time. A manual search was conducted through the Chirogram from May 1939 to December 1944, and the advertisements were organized into categories. Each of the vendors were recorded and tallied for the year and month that they appeared. This quantitative study utilizes frequency counts and graphs of the data to provide insight into trends in advertising and practice styles of chiropractors in the early 1940s and relate them to then current events in the United States. PMID:11619055

  1. Reassessing the educational environment among undergraduate students in a chiropractic training institution: A study over time

    PubMed Central

    Palmgren, Per J.; Sundberg, Tobias; Laksov, Klara Bolander

    2015-01-01

    Objective The aim of the study was twofold: (1) to compare the perceived educational environment at 2 points in time and (2) to longitudinally examine potential changes in perceptions of the educational environment over time. Methods The validated Dundee Ready Educational Environment Measure (DREEM), a 50-item, self-administered Likert-type inventory, was used in this prospective study. Employing convenience sampling, undergraduate chiropractic students were investigated at 2 points in time: 2009 (n = 124) and 2012 (n = 127). An analysis of 2 matching samples was performed on 27% (n = 34) of the respondents in 2009. Results A total of 251 students (79%) completed the inventory, 83% (n = 124) in 2009 and 75% (n = 127) in 2012. The overall DREEM scores in both years were excellent: 156 (78%) and 153 (77%), respectively. The students' perceptions of teachers differed significantly between the 2 cohort years, decreasing from 77% to 73%. Three items received deprived scores: limited support for stressed students, authoritarian teachers, and an overemphasis on factual learning; the latter significantly decreased in 2012. In the longitudinal sample these items also displayed scores below the expected mean. Conclusion Students viewed the educational environment as excellent both in 2009 and 2012. The perceptions of teachers declined with time; however, this could be attributed to teachers' new roles. Certain aspects of the educational environment factored prominently during the comparative points in time, as well as longitudinally, and these ought to be further investigated and addressed to provide an enhanced educational environment. PMID:26023892

  2. A health care system in transformation: making the case for chiropractic

    PubMed Central

    2012-01-01

    There are a number of factors that have conspired to create a crisis in healthcare. In part, the successes of medical science and technologies have been to blame, for they have led to survival where lives would previously have been cut short. An informed public, aware of these technological advances, is demanding access to the best that healthcare has to offer. At the same time the burden of chronic disease in an increasing elderly population has created a marked growth in the need for long term care. Current estimates for expenditure predict a rapid escalation of healthcare costs as a proportion of the GDP of developed nations, yet at the same time a global economic crisis has necessitated dramatic cuts in health budgets. This unsustainable position has led to calls for an urgent transformation in healthcare systems. This commentary explores the present day healthcare crisis and looks at the opportunities for chiropractors as pressure intensifies on politicians and leaders in healthcare to seek innovative solutions to a failing model. Amidst these opportunities, it questions whether the chiropractic profession is ready to accept the challenges that integration into mainstream healthcare will bring and identifies both pathways and potential obstacles to acceptance. PMID:23216921

  3. Is there a chilly climate? An educational environmental mixed method study in a chiropractic training institution

    PubMed Central

    Palmgren, Per J.; Chandratilake, Madawa; Nilsson, Gunnar H.; Laksov, Klara Bolander

    2013-01-01

    Objective The attitude towards gender in an educational environment has a significant impact on a student's behavior, sense of well-being, and academic performance. Our study aimed to explore the presence and extent of gender-related issues in a chiropractic undergraduate learning environment, which has been a scarcely researched topic in the literature. Methods The Perceived Chilly Climate Scale (PCCS) was used as the initial tool for screening the gender issues among undergraduates. The issues identified were explored further with a series of focus group interviews. Results The PCCS had an 83% response rate. The PCCS score (105/196) indicated the nonexistence of alarming gender-related issues. However, the PCCS score was significantly higher among female than male subjects, immigrants than nonimmigrants, and minorities than majority ethnic groups. Despite high ratings on the questionnaire quantitative findings, the focus groups indicated a good sense of equality, oppression-free environment, and no obvious signs of discrimination. Conclusion The educational environment of the institution concerned was conducive to equality. However, subtle but important gender-, ethnic-, and minority-related issues could be addressed to provide an enhanced educational environment to learners. PMID:23518905

  4. Paraplegia in a chiropractic patient secondary to atraumatic dural arteriovenous fistula with perimedullary hypertension: case report

    PubMed Central

    2013-01-01

    Intracranial dural arteriovenous fistulas are abnormal communications between higher-pressure arterial circulation and lower-pressure venous circulation. This abnormal communication can result in important and frequently misdiagnosed neurological abnormalities. A case of rapid onset paraplegia following cervical chiropractic manipulation is reviewed. The patient’s generalized spinal cord edema, lower extremity paraplegia and upper extremity weakness, were initially believed to be a complication of the cervical spinal manipulation that had occurred earlier on the day of admission. Subsequent diagnostic testing determined the patient suffered from impaired circulation of the cervical spinal cord produced by a Type V intracranial arteriovenous fistula and resultant venous hypertension in the pontomesencephalic and anterior spinal veins. The clinical and imaging findings of an intracranial dural arteriovenous fistula with pontomesencephalic venous congestion and paraplegia are reviewed. This case report emphasizes the importance of thorough and serial diagnostic imaging in the presence of sudden onset paraplegia and the potential for error when concluding atypical neurological presentations are the result of therapeutic misadventure. PMID:23830411

  5. Chiropractic management of a patient with lumbar spine pain due to synovial cyst: a case report

    PubMed Central

    Cox, James M.

    2012-01-01

    Introduction The purpose of this study is to report the findings resulting from chiropractic care using flexion distraction spinal manipulation for a patient with low back and radicular pain due to spinal stenosis caused by a synovial cyst. Case Report A 75-year-old man presented with low back pain radiating to the right anterior thigh and down the left posterior leg of 3 years' duration. Physical and imaging examinations showed a synovial cyst–induced spinal stenosis at the right L3-L4 level and bilateral L4-L5 spinal stenosis. Intervention and Outcomes Flexion distraction spinal manipulation and physiological therapeutics were applied at the levels of stenosis. After 4 visits, the patient noted total absence of the right and left lower extremity pain and no adverse reaction to treatment. After 3 months of treatment and 16 visits, his low back and buttock pain were minimal; and he had no leg pain. Conclusion Lumbar synovial cyst and stenosis–generated low back and radicular pain was 80% relieved in a 75-year-old man following Cox flexion distraction spinal manipulation. PMID:22942836

  6. Laboratory Tests Ordered By a Chiropractic Sports Physician on Elite Athletes Over a 1-Year Period

    PubMed Central

    Nabhan, Dustin C.; Moreau, William J.; Barylski, Chad

    2015-01-01

    Objective The purpose of this study is to describe and discuss laboratory tests ordered on elite athletes in an interdisciplinary sports medicine clinic by a doctor of chiropractic over 1 calendar year. Methods A retrospective review of laboratory tests ordered during routine clinical practice as standard screening and diagnostic tests from November 1, 2009, to November 1, 2010 was performed. Data were collected during clinical encounters at one sports medicine clinic and entered into a database for analysis. Descriptive and frequency statistics were used to describe the tests ordered and the frequency of abnormal findings. Results Five hundred and thirty-nine studies were ordered for diagnostic and routine screenings on 137 athlete patients (86 males, 51 females), representing 49 types of tests. Sample sources included blood, urine, skin lesions, and fecal matter. The most commonly ordered tests were complete blood count, comprehensive metabolic panel, serum ferritin, creatine kinase, serum iron and total iron binding capacity, total cortisol, thyroid stimulating hormone, and lipid panels. There were 217 studies (40%) flagged as abnormal by the reporting laboratory. Conclusion This report provides greater insight into the diverse array of laboratory studies ordered over a 1-year period for diagnosis and screening of elite athletes. A high percentage of the results were flagged as abnormal by the laboratory. These findings show that the unique physiology of the elite athlete must be considered when interpreting laboratory findings in this population. PMID:26257590

  7. Stress in chiropractic education: a student survey of a five-year course

    PubMed Central

    Hester, Hilary; Cunliffe, Christina; Hunnisett, Adrian

    2013-01-01

    Objective Stress encompasses academic issues, such as time management, increased work load, and new subject matter, but cannot be separated from stressors, such as social adjustment and financial pressure. Our study investigated whether perceived level of academic or practical attainment and the method of study were associated with the amount of perceived stress during students” studies. Methods A semi-structured self–administered questionnaire was piloted and distributed to 134 students at a chiropractic college at the end of a lecture. Results The survey had a response rate of 81%. Students in their fourth year consistently reported the highest perceived levels of stress, with 81% feeling that their ability to study was affected by their financial situation and 56% felt overwhelmed at their ability to cope with their college workload. All year groups were stressed during their course of studies, but the stressor varies depending on the year of study. Conclusions Year 4 consistently demonstrated the highest levels of stress. All students, regardless of year group, experienced varying degrees of stress while studying and the central stressor changed depending on the time position within the course. PMID:23957319

  8. Use of the measure your medical outcome profile (MYMOP2) and W-BQ12 (Well-Being) outcomes measures to evaluate chiropractic treatment: an observational study

    PubMed Central

    2011-01-01

    Background The objective was to assess the use of the Measure Yourself Medical Outcome Profile (MYMOP2) and W-BQ12 well-being questionnaire for measuring clinical change associated with a course of chiropractic treatment. Methods Chiropractic care of the patients involved spinal manipulative therapy (SMT), mechanically assisted techniques, soft tissue therapy, and physiological therapeutic devices. Outcome measures used were MYMOP2 and the Well-Being Questionnaire 12 (W-BQ12). Results Statistical and clinical significant changes were demonstrated with W-BQ12 and MYMOP2. Conclusions The study demonstrated that MYMOP2 was responsive to change and may be a useful instrument for assessing clinical changes among chiropractic patients who present with a variety of symptoms and clinical conditions. PMID:21418608

  9. Attributes of Non-Hispanic Blacks That Use Chiropractic Health Care: A Survey of Patients in Texas and Louisiana

    PubMed Central

    Ward, John; Humphries, Kelley; Coats, Jesse; Whitfield, Paige

    2015-01-01

    Objective The purpose of this study was to describe non-Hispanic blacks that use chiropractic health care to better understand this underserved demographic. Methods E-mail and telephone calls were used to recruit doctors of chiropractic (DCs) in Texas and Louisiana to distribute anonymous surveys to their non-Hispanic black patients. Twenty doctors volunteered to participate. Each was sent 10 surveys and self-addressed envelopes to distribute. All doctors were given at least 3 months to distribute surveys to as many non-Hispanic black patients that they had. The survey contained 20 questions designed to develop a profile of non-Hispanic black patients that used chiropractic care. Descriptive statistics were used to summarize demographic and other patient attributes. Results Two-hundred surveys were distributed and 44 were completed, yielding a response rate of 22%. Non-Hispanic black patients were more likely to be female (54.5%), be older than 50 years (56.8%), be a college graduate (59.1%), be employed (61.9%), report not receiving public assistance in the past 5 years (81.4%), report a household income of $20 000 to $60 000 a year (48.8%), and born in the United States (83.7%). Participants reported that there was a DC within 30 minutes of their address (81.4%), their DC always explained things to them in an easy-to-understand manner (81.8%), their DC always showed respect for what they had to say (88.6%), and their DC always cared about them as a person (86.4%). Conclusions In the sample surveyed, non-Hispanic black patients tended to be female, be older, be college educated, be employed, and have a positive viewpoint on their interactions with their DC.

  10. Resolution of low back and radicular pain in a 40-year-old male United States Navy Petty Officer after collaborative medical and chiropractic care?

    PubMed Central

    Lillie, Gregory R.

    2010-01-01

    Objective The aim of this study is to describe the interdisciplinary care, including chiropractic services, in a military health care facility of an active duty member of the United States Navy with low back pain, leg pain, and foot numbness. Clinical Features A 40-year-old patient developed low back pain, leg pain, and foot numbness after moving furniture. The patient described his symptoms as pain in the right low back, pain shooting into the right lateral thigh and lower leg, and numbness into the right lateral foot. Magnetic resonance imaging confirmed disk extrusion at L4/L5 occupying the lateral recess and abutting the exiting right L5 nerve root. Intervention and Outcome Providers, including primary care, chiropractic, and orthopedics, in an established multidisciplinary health care system contributed to the case management. The patient received 11 chiropractic treatments (spinal manipulation, flexion-distraction, abdominal rehab exercises) over 72 days. Subjective complaints resolved, and the patient was released back to full duty. Conclusion Integrative care, using medical and chiropractic services, was successful in the conservative management of a patient with low back pain and radicular symptoms secondary to disk extrusion. PMID:21629394

  11. Mixed-Methods Research in a Complex Multisite VA Health Services Study: Variations in the Implementation and Characteristics of Chiropractic Services in VA

    PubMed Central

    Cohen, Angela B.; Lisi, Anthony J.; Smith, Monica M.; Delevan, Deborah; Armstrong, Courtney; Mittman, Brian S.

    2013-01-01

    Maximizing the quality and benefits of newly established chiropractic services represents an important policy and practice goal for the US Department of Veterans Affairs' healthcare system. Understanding the implementation process and characteristics of new chiropractic clinics and the determinants and consequences of these processes and characteristics is a critical first step in guiding quality improvement. This paper reports insights and lessons learned regarding the successful application of mixed methods research approaches—insights derived from a study of chiropractic clinic implementation and characteristics, Variations in the Implementation and Characteristics of Chiropractic Services in VA (VICCS). Challenges and solutions are presented in areas ranging from selection and recruitment of sites and participants to the collection and analysis of varied data sources. The VICCS study illustrates the importance of several factors in successful mixed-methods approaches, including (1) the importance of a formal, fully developed logic model to identify and link data sources, variables, and outcomes of interest to the study's analysis plan and its data collection instruments and codebook and (2) ensuring that data collection methods, including mixed-methods, match study aims. Overall, successful application of a mixed-methods approach requires careful planning, frequent trade-offs, and complex coding and analysis. PMID:24489589

  12. Chiropractic Care of a Patient With Neurogenic Heterotopic Ossification of the Anterior Longitudinal Ligament After Traumatic Brain Injury: A Case Report

    PubMed Central

    Morgan, William E.; Morgan, Clare P.

    2014-01-01

    Objective The purpose of this case report is to describe the use of chiropractic care for a patient with neurogenic heterotopic ossification of the anterior longitudinal ligament in the cervical spine and soft tissues of the right hip after a traumatic brain injury and right femur fracture. Clinical Features A 25-year-old military officer was referred to a hospital-based chiropractic clinic with complaints of pain and stiffness of the neck and back along with reduced respiratory excursions that began several months after a motor vehicle accident in which he had a traumatic brain injury. The patient had a fractured right femur from the accident, which had since been treated surgically, but had complications of heterotopic ossification in the soft tissues of the hip. His overall pain level was 3 of 10 on a verbal pain scale during use of oxycodone HCL/acetaminophen. Chest excursion was initially measured at .5 cm. Intervention and Outcome With the intent to restore respiratory chest motion and to reduce the patient's back and neck pain, the patient was placed on a program of chiropractic and myofascial manipulation, exercise therapy, and respiratory therapy. After a year of care, the patient rated overall pain at 3 of 10 verbal pain scale level but was no longer taking medications for pain and an increase in respiratory chest excursions measured at 3.5 cm. Conclusion This case demonstrated that chiropractic treatment provided benefit to a patient with heterotopic ossification concurrent with musculoskeletal pain. PMID:25435839

  13. Intra- and inter-observer reliability of the Cobb measurement by chiropractic interns using digital evaluation methods

    PubMed Central

    Cracknell, Jesse; Lawson, Douglas M.; Taylor, John A.

    2015-01-01

    Introduction: It is important to create a body of evidence surrounding the reliability of certain diagnostic criteria. While the reliability of the Cobb measurement is well established with various licensed health care professionals, this study aims to determine the inter- and intra-observer reliability of the Cobb Measurement among chiropractic interns. Methods: Fourteen chiropractic interns analyzed 10 pre-selected digital spinal radiographs on a Picture Archiving and Communication System (PACS) in two separate rounds of observation. The participants indicated their choice of end vertebra and Cobb Measurement in each round of observation. Agreement on vertebral levels selected was estimated using percentage agreement. Intra-observer reliability was estimated using the Pearson r correlation coefficient, and inter-observer correlation was estimated using the Inter-Class Coefficient (ICC). Results: The range of percentage agreement on vertebral level selection was 0.36 – 0.79. The Pearson r correlation coefficient for round 1 and round 2 was 0.79. The ICC (3,1) was 0.79 (round 1), and 0.70 (round 2). Conclusion: Less than optimal agreement on end vertebrae selection was found between observers. Intra- and inter-observer reliability of the Cobb Measurement was ‘excellent’ (round 1) and ‘good’ (round 2). PMID:26500360

  14. Sexual harassment of female chiropractors by their patients: a pilot survey of faculty at the Canadian Memorial Chiropractic College

    PubMed Central

    Gleberzon, Brian; Statz, Rachel; Pym, Matthew

    2015-01-01

    Background: The purpose of this study was to survey a group of female chiropractors and inquire as to whether or not they had been sexually harassed by their patients. Methods: An online questionnaire was emailed via Survey Monkey to 47 female faculty members at the Canadian Memorial Chiropractic College (CMCC). Respondents were asked if they had been sexual harassed and, if so, the characteristics of the incident(s), their response to it, how serious they perceived the problem to be and whether or not they felt prepared to deal with it. Results: Nineteen of 47 questionnaires were completed and returned. Of these 19, eight respondents reported being sexually harassed by a patient (all male), most commonly within the first 5 years of practice and most commonly involving a ‘new’ patient. It was rarely anticipated. The nature of the harassment varied and respondents often ignored the incident. Most respondents perceive this to be a problem facing female chiropractors. Discussion: Although this is the first survey of its kind, this is a significant problem facing other healthcare professionals. Conclusions: Among this group of respondents, sexual harassment by patients was a common occurrence. More training on how to handle it, during either a student’s chiropractic education or offered as a continuing education program, may be warranted. PMID:26136603

  15. Feasibility of Using the Patient-Reported Outcomes Measurement Information System in Academic Health Centers: Case Series Design on Pain Reduction After Chiropractic Care

    PubMed Central

    Burke, Jeanmarie R.

    2014-01-01

    Objective The purpose of this study was to test the utility of Patient-Reported Outcomes Measurement Information System (PROMIS) as a resource for collecting data on patient-reported outcomes (PRO) within academic health centers at a chiropractic college; and, to describe changes in PRO following pragmatic chiropractic care incorporating instrument-assisted soft tissue mobilization (IASTM) on pain symptoms. Methods This was a pre-post intervention design without a control group (case series) involving 25 patients (14 females and 11 males; 40.5 ± 16.39 years, range 20-70 years) who completed their chiropractic care and their baseline and post-treatment pain assessments. The pragmatic chiropractic care intervention included both spinal manipulation and IASTM to treat pain symptoms. PRO’s were collected using PROMIS to measure pain behavior, pain interference and pain intensity. Results The average pre-post assessment interval was 33 ± 22.5 days (95% CI, 23-42 days). The durations of treatments ranged from one week to 10 weeks. The median number of IASTM treatments was six. Pre-post decreases in T-scores for pain behavior and pain interference were 55.5 to 48.4 and 57.7 to 48.4, respectively (P < .05). Only 12 patients had a baseline T-score for pain intensity greater than 50. The pre-post decrease in pain intensity T-scores for these 12 patients was from 53.4 to 40.9. Conclusion Within the limitations of a case series design, these data provide initial evidence on the utility of PROMIS instruments for clinical and research outcomes in chiropractic patients. PMID:25225465

  16. Acupuncture and chiropractic care for chronic pain in an integrated health plan: a mixed methods study

    PubMed Central

    2011-01-01

    Background Substantial recent research examines the efficacy of many types of complementary and alternative (CAM) therapies. However, outcomes associated with the "real-world" use of CAM has been largely overlooked, despite calls for CAM therapies to be studied in the manner in which they are practiced. Americans seek CAM treatments far more often for chronic musculoskeletal pain (CMP) than for any other condition. Among CAM treatments for CMP, acupuncture and chiropractic (A/C) care are among those with the highest acceptance by physician groups and the best evidence to support their use. Further, recent alarming increases in delivery of opioid treatment and surgical interventions for chronic pain--despite their high costs, potential adverse effects, and modest efficacy--suggests the need to evaluate real world outcomes associated with promising non-pharmacological/non-surgical CAM treatments for CMP, which are often well accepted by patients and increasingly used in the community. Methods/Design This multi-phase, mixed methods study will: (1) conduct a retrospective study using information from electronic medical records (EMRs) of a large HMO to identify unique clusters of patients with CMP (e.g., those with differing demographics, histories of pain condition, use of allopathic and CAM health services, and comorbidity profiles) that may be associated with different propensities for A/C utilization and/or differential outcomes associated with such care; (2) use qualitative interviews to explore allopathic providers' recommendations for A/C and patients' decisions to pursue and retain CAM care; and (3) prospectively evaluate health services/costs and broader clinical and functional outcomes associated with the receipt of A/C relative to carefully matched comparison participants receiving traditional CMP services. Sensitivity analyses will compare methods relying solely on EMR-derived data versus analyses supplementing EMR data with conventionally collected patient and clinician data. Discussion Successful completion of these aggregate aims will provide an evaluation of outcomes associated with the real-world use of A/C services. The trio of retrospective, qualitative, and prospective study will also provide a clearer understanding of the decision-making processes behind the use of A/C for CMP and a transportable methodology that can be applied to other health care settings, CAM treatments, and clinical populations. Trial registration ClinicalTrials.gov: NCT01345409 PMID:22118061

  17. Annotated bibliography of the biomedical literature pertaining to chiropractic, pediatrics and manipulation in relation to the treatment of health conditions

    PubMed Central

    Gotlib, Allan C; Beingessner, Melanie

    1995-01-01

    Biomedical literature retrieval, both indexed and non-indexed, with respect to the application of manipulative therapy with therapeutic intent and pediatric health conditions (ages 0 to 17 years) yielded 66 discrete documents which met specified inclusion and exclusion criteria. There was one experimental study (RCT’s), 3 observational (cohort, case control) studies and 62 descriptive studies (case series, case reports, surveys, literature reviews). An independent rating panel determined consistency with a modified quality of evidence scale adopted from procedure ratings system 1 of Clinical Guidelines for Chiropractic Practice in Canada. Results indicate minimal Class 1 and Class 2 and some Class 3 evidence for a variety of pediatric conditions utilizing the application of manipulation with therapeutic intent.

  18. Differentiating intraprofessional attitudes toward paradigms in health care delivery among chiropractic factions: results from a randomly sampled survey

    PubMed Central

    2014-01-01

    Background As health care has increased in complexity and health care teams have been offered as a solution, so too is there an increased need for stronger interprofessional collaboration. However the intraprofessional factions that exist within every profession challenge interprofessional communication through contrary paradigms. As a contender in the conservative spinal health care market, factions within chiropractic that result in unorthodox practice behaviours may compromise interprofessional relations and that profession’s progress toward institutionalization. The purpose of this investigation was to quantify the professional stratification among Canadian chiropractic practitioners and evaluate the practice perceptions of those factions. Methods A stratified random sample of 740 Canadian chiropractors was surveyed to determine faction membership and how professional stratification could be related to views that could be considered unorthodox to current evidence-based care and guidelines. Stratification in practice behaviours is a stated concern of mainstream medicine when considering interprofessional referrals. Results Of 740 deliverable questionnaires, 503 were returned for a response rate of 68%. Less than 20% of chiropractors (18.8%) were aligned with a predefined unorthodox perspective of the conditions they treat. Prediction models suggest that unorthodox perceptions of health practice related to treatment choices, x-ray use and vaccinations were strongly associated with unorthodox group membership (X2 =13.4, p?=?0.0002). Conclusion Chiropractors holding unorthodox views may be identified based on response to specific beliefs that appear to align with unorthodox health practices. Despite continued concerns by mainstream medicine, only a minority of the profession has retained a perspective in contrast to current scientific paradigms. Understanding the profession’s factions is important to the anticipation of care delivery when considering interprofessional referral. PMID:24512507

  19. Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA): study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Low back pain is a prevalent and debilitating condition that affects the health and quality of life of older adults. Older people often consult primary care physicians about back pain, with many also receiving concurrent care from complementary and alternative medicine providers, most commonly doctors of chiropractic. However, a collaborative model of treatment coordination between these two provider groups has yet to be tested. The primary aim of the Collaborative Care for Older Adults Clinical Trial is to develop and evaluate the clinical effectiveness and feasibility of a patient-centered, collaborative care model with family medicine physicians and doctors of chiropractic for the treatment of low back pain in older adults. Methods/design This pragmatic, pilot randomized controlled trial will enroll 120 participants, age 65 years or older with subacute or chronic low back pain lasting at least one month, from a community-based sample in the Quad-Cities, Iowa/Illinois, USA. Eligible participants are allocated in a 1:1:1 ratio to receive 12 weeks of medical care, concurrent medical and chiropractic care, or collaborative medical and chiropractic care. Primary outcomes are self-rated back pain and disability. Secondary outcomes include general and functional health status, symptom bothersomeness, expectations for treatment effectiveness and improvement, fear avoidance behaviors, depression, anxiety, satisfaction, medication use and health care utilization. Treatment safety and adverse events also are monitored. Participant-rated outcome measures are collected via self-reported questionnaires and computer-assisted telephone interviews at baseline, and at 4, 8, 12, 24, 36 and 52 weeks post-randomization. Provider-rated expectations for treatment effectiveness and participant improvement also are evaluated. Process outcomes are assessed through qualitative interviews with study participants and research clinicians, chart audits of progress notes and content analysis of clinical trial notes. Discussion This pragmatic, pilot randomized controlled trial uses a mixed method approach to evaluate the clinical effectiveness, feasibility, and participant and provider perceptions of collaborative care between medical doctors and doctors of chiropractic in the treatment of older adults with low back pain. Trial registration This trial registered in ClinicalTrials.gov on 04 March 2011 with the ID number of NCT01312233. PMID:23324133

  20. Symptomatic reactions, clinical outcomes and patient satisfaction associated with upper cervical chiropractic care: A prospective, multicenter, cohort study

    PubMed Central

    2011-01-01

    Background Observational studies have previously shown that adverse events following manipulation to the neck and/or back are relatively common, although these reactions tend to be mild in intensity and self-limiting. However, no prospective study has examined the incidence of adverse reactions following spinal adjustments using upper cervical techniques, and the impact of this care on clinical outcomes. Methods Consecutive new patients from the offices of 83 chiropractors were recruited for this practice-based study. Clinical outcome measures included 1) Neck pain disability index (100-point scale), 2) Oswestry back pain index (100-point scale), 3) 11-point numerical rating scale (NRS) for neck, headache, midback, and low back pain, 4) treatment satisfaction, and 5) Symptomatic Reactions (SR). Data were collected at baseline, and after approximately 2 weeks of care. A patient reaching sub-clinical status for pain and disability was defined as a follow-up score <3 NRS and <10%, respectively. A SR is defined as a new complaint not present at baseline or a worsening of the presenting complaint by >30% based on an 11-point numeric rating scale occurring <24 hours after any upper cervical procedure. Results A total of 1,090 patients completed the study having 4,920 (4.5 per patient) office visits requiring 2,653 (2.4 per patient) upper cervical adjustments over 17 days. Three hundred thirty- eight (31.0%) patients had SRs meeting the accepted definition. Intense SR (NRS ?8) occurred in 56 patients (5.1%). Outcome assessments were significantly improved for neck pain and disability, headache, mid-back pain, as well as lower back pain and disability (p <0.001) following care with a high level (mean = 9.1/10) of patient satisfaction. The 83 chiropractors administered >5 million career upper cervical adjustments without a reported incidence of serious adverse event. Conclusions Upper cervical chiropractic care may have a fairly common occurrence of mild intensity SRs short in duration (<24 hours), and rarely severe in intensity; however, outcome assessments were significantly improved with less than 3 weeks of care with a high level of patient satisfaction. Although our findings need to be confirmed in subsequent randomized studies for definitive risk-benefit assessment, the preliminary data shows that the benefits of upper cervical chiropractic care may outweigh the potential risks. PMID:21974915

  1. Chiropractic spinal manipulative therapy for a geriatric patient with low back pain and comorbidities of cancer, compression fractures, and osteoporosis

    PubMed Central

    Roberts, Jan A.; Wolfe, Tristy M.

    2012-01-01

    Objective The purpose of this report is to describe the response of a geriatric patient with low back pain and a history of leukemia, multiple compression fractures, osteoporosis, and degenerative joint disease using Activator chiropractic technique. Case Report An 83-year-old man who is the primary caretaker for his disabled wife had low back pain after lifting her into a truck. The patient had a history of leukemia, multiple compression fractures, osteoporosis, and degenerative joint disease. His Revised Oswestry Low Back Pain Disability Questionnaire was 26%, with a 10/10 pain rating at its worst on the Numeric Pain Scale. The patient presented with a left head tilt, right high shoulder, and right high ilium with anterior translation and flexion of the torso and spasm and tenderness from the lower thoracic spine to lumbar spine. Intervention and Outcome The patient was cared for using Activator Methods protocol. After 8 treatments, the patient was stable and remained stable for 4 months without spasm or tenderness in his spine. His Revised Oswestry score dropped to 6%, with a 4/10 Numeric Pain Scale pain rating when at its worst; and the patient reported being able to take care of his wife. Conclusion The findings of this case suggest that Activator-assisted spinal manipulative therapy had a positive effect on low back pain and function in an elderly patient with a complex clinical history. PMID:22942837

  2. Rehabilitation — a valuable consideration in acute and chronic neck and low back pain in addition to standard chiropractic management: a case study

    PubMed Central

    Mizel, Dennis H

    1999-01-01

    A case of chronic neck and low back pain, resistant to standard chiropractic management of manipulation/adjustment and verbal exercise instruction is presented. Identification of psychosocial factors and deconditioning, with a subsequent three month program of in-office rehabilitation including supervised progressive/resistance exercises and behavioural therapy was administered in conjunction with spinal manipulation/adjustment and passive modalities. The program proved effective in reducing the patient’s neck and low back pain. The beneficial effect of supervised exercises and behavioural therapy in patient management is illustrated.

  3. Chiropractic spinal manipulative therapy for migraine: a study protocol of a single-blinded placebo-controlled randomised clinical trial

    PubMed Central

    Chaibi, Aleksander; Šaltyt? Benth, J?rat?; Tuchin, Peter J; Russell, Michael Bjørn

    2015-01-01

    Introduction Migraine affects 15% of the population, and has substantial health and socioeconomic costs. Pharmacological management is first-line treatment. However, acute and/or prophylactic medicine might not be tolerated due to side effects or contraindications. Thus, we aim to assess the efficacy of chiropractic spinal manipulative therapy (CSMT) for migraineurs in a single-blinded placebo-controlled randomised clinical trial (RCT). Method and analysis According to the power calculations, 90 participants are needed in the RCT. Participants will be randomised into one of three groups: CSMT, placebo (sham manipulation) and control (usual non-manual management). The RCT consists of three stages: 1?month run-in, 3?months intervention and follow-up analyses at the end of the intervention and 3, 6 and 12?months. The primary end point is migraine frequency, while migraine duration, migraine intensity, headache index (frequency x duration x intensity) and medicine consumption are secondary end points. Primary analysis will assess a change in migraine frequency from baseline to the end of the intervention and follow-up, where the groups CSMT and placebo and CSMT and control will be compared. Owing to two group comparisons, p values below 0.025 will be considered statistically significant. For all secondary end points and analyses, a p value below 0.05 will be used. The results will be presented with the corresponding p values and 95% CIs. Ethics and dissemination The RCT will follow the clinical trial guidelines from the International Headache Society. The Norwegian Regional Committee for Medical Research Ethics and the Norwegian Social Science Data Services have approved the project. Procedure will be conducted according to the declaration of Helsinki. The results will be published at scientific meetings and in peer-reviewed journals. Trial registration number NCT01741714. PMID:26586317

  4. The development of vaccination perspectives among chiropractic, naturopathic and medical students: a case study of professional enculturation.

    PubMed

    McMurtry, Angus; Wilson, Kumanan; Clarkin, Chantalle; Walji, Rishma; Kilian, Brendan C; Kilian, Carney C; Lohfeld, Lynne; Alolabi, Bashar; Hagino, Carol; Busse, Jason W

    2015-12-01

    An important influence on parents' decisions about pediatric vaccination (children under 6 years of age) is the attitude of their health care providers, including complementary and alternative medicine (CAM) providers. Very limited qualitative research exists, however, on how attitudes towards vaccination develop among healthcare professionals in-training. We explored perspective development among three groups of students: medical, chiropractic, and naturopathic. We conducted focus group sessions with participants from each year of study at three different healthcare training programs in Ontario, Canada. Semi-structured and open-ended questions were used to elicit dynamic interaction among participants and explore how they constructed their attitudes toward vaccination at the beginning and part way through their professional training. Analyses of verbatim transcripts of audiotaped interviews were conducted both inductively and deductively using questions structured by existing literature on learning, professional socialization and interprofessional relations. We found five major themes and each theme was illustrated with representative quotes. Numerous unexpected insights emerged within these themes, including students' general open-mindedness towards pediatric vaccination at the beginning of their training; the powerful influence of both formal education and informal socialization; uncritical acceptance of the vaccination views of senior or respected professionals; students' preference for multiple perspectives rather than one-sided, didactic instruction; the absence of explicit socio-cultural tensions among professions; and how divergences among professional students' perspectives result from differing emphases with respect to lifestyle, individual choice, public health and epidemiological factors-rather than disagreement concerning the biomedical evidence. This last finding implies that their different perspectives on pediatric vaccination may be complementary rather than irreconcilable. Our findings should be considered by developers of professional and interprofessional educational curricula and public health officials formulating policy on pediatric vaccination. PMID:25805358

  5. Factors Associated with Changes in Knowledge and Attitude towards Public Health Concepts among Chiropractic College Students Enrolled in a Community Health Class

    PubMed Central

    Rose, Kevin A.; Ayad, Samir

    2008-01-01

    Purpose: This survey was conducted to identify factors that may be associated with changes in knowledge and attitudes towards basic health promotion and public health concepts among chiropractic students enrolled in a course in community health. Methods: Anonymous surveys were conducted of students before and after a second-year chiropractic college course in community health. Results were analyzed using percentages and Chi Square statistics as appropriate. Results: Students' knowledge of health promotion and public health concepts improved significantly by the end of the course. Students' attitudes towards these also improved, although to a lesser degree. Students indicated that they had a favorable impression of the importance of utilizing health promotion in practice and working with other public health professionals. However, vaccinations were still looked upon unfavorably by half of the students by the end of the course. Pre-class, a positive attitude towards public health concepts was associated with being female, older, Latino, having children, having a poorer perceived health status, conservative politically and religious. These differences tended to lessen by the end of the course. Conclusion: A course in community health was successful in adding to students' knowledge and positive attitudes towards health promotion and public health. However, additional educational strategies are needed to ensure changes in future practice behavior, particularly in the area of vaccinations PMID:19043533

  6. A comparative analysis of chiropractic and general practitioner patients in North America: Findings from the joint Canada/United States survey of health, 2002–03

    PubMed Central

    Hurwitz, Eric L; Chiang, Lu-May

    2006-01-01

    Background Scientifically rigorous general population-based studies comparing chiropractic with primary-care medical patients within and between countries have not been published. The objective of this study is to compare care seekers of doctors of chiropractic (DCs) and general practitioners (GPs) in the United States and Canada on a comprehensive set of sociodemographic, quality of life, and health-related variables. Methods Data are from the Joint Canada/U.S. Survey of Health (JCUSH), 2002–03, a random sample of adults in Canada (N = 3505) and the U.S. (N = 5183). Respondents were categorized according to their pattern of health-care use in the past year. Distributions, percentages, and estimates (adjusted odds ratios) weighted to reflect the complex survey design were produced. Results Nearly 80% of respondents sought care from GPs; 12% sought DC care. Compared with GP only patients, DC patients in both countries tend to be under 65 and white, with arthritis and disabling back or neck pain. U.S. DC patients are more likely than GP only patients to be obese and to lack a regular doctor; Canadian DC patients are more likely than GP only patients to be college educated, to have higher incomes, and dissatisfied with MD care. Compared with seekers of both GP and DC care, DC only patients in both countries have fewer chronic conditions, take fewer drugs, and have no regular doctor. U.S. DC only patients are more likely than GP+DC patients to be uninsured and dissatisfied with health care; Canadian DC only patients are more likely than GP+DC patients to be under 45, male, less educated, smokers, and not obese, without disabling back or neck pain, on fewer drugs, and lacking a regular doctor. Conclusion Chiropractic and GP patients are dissimilar in both Canada and the U.S., with key differences between countries and between DC patients who do and do not seek care from GPs. Such variation has broad and potentially far-reaching health policy and research implications. PMID:16600038

  7. The rationale for primary spine care employing biopsychosocial, stratified and diagnosis-based care-pathways at a chiropractic college public clinic: a literature review

    PubMed Central

    2013-01-01

    Current management practices for low back pain have led to rising costs without evidence of improvement in the quality of care. Low back pain remains a diagnostic and management challenge for practitioners of many types and is now thought to be a leading global cause of disability. Beyond many published clinical practice guidelines, there are emerging, evidence-based care-pathways including stratification according to the patient's prognosis, classification-based management, diagnosis-based clinical decision guides and biopsychosocial models of care. A proposed solution for successfully addressing low back pain is to train residents at a chiropractic college public clinic to function as primary spine care practitioners, employing evidence-based care-pathways. The rationale for such is described with expected benefits to patient care, improved financial health of medical delivery systems and the training of chiropractors to successfully fill a niche in the healthcare system. PMID:23758900

  8. The rationale for primary spine care employing biopsychosocial, stratified and diagnosis-based care-pathways at a chiropractic college public clinic: a literature review.

    PubMed

    Russell, Robb

    2013-01-01

    Current management practices for low back pain have led to rising costs without evidence of improvement in the quality of care. Low back pain remains a diagnostic and management challenge for practitioners of many types and is now thought to be a leading global cause of disability. Beyond many published clinical practice guidelines, there are emerging, evidence-based care-pathways including stratification according to the patient's prognosis, classification-based management, diagnosis-based clinical decision guides and biopsychosocial models of care. A proposed solution for successfully addressing low back pain is to train residents at a chiropractic college public clinic to function as primary spine care practitioners, employing evidence-based care-pathways. The rationale for such is described with expected benefits to patient care, improved financial health of medical delivery systems and the training of chiropractors to successfully fill a niche in the healthcare system. PMID:23758900

  9. Nature versus nurture segues to choice versus circumstance in the new millennium: one consideration for an integrative biopsychosocial philosophy, art, and science of chiropractic

    PubMed Central

    Smith, Monica

    2010-01-01

    Objective This commentary discusses the evolving sociocultural roles and sociocultural authority of chiropractic. Discussion The complex interconnectivity of the biological, psychological, and social aspects of our individual and collective well-being has occupied centuries of “nature versus nurture” philosophical debate, creative art, and scientific work. What has emerged is a better understanding of how our human development is affected by the circumstances of what we are born with (ie, nature) and how we are shaped by the circumstances that we are born into (ie, nurture). Conclusion In the new millennium, a cumulative challenge to the emerging integrative biopsychosocial health care disciplines is one of reconciling “circumstance versus choice”; that is, advancing individually and collectively the fullest actualization of human potential through the philosophy, art, and science of autonomy and empowerment. PMID:22693464

  10. Sports chiropractic management of concussions using the Sport Concussion Assessment Tool 2 symptom scoring, serial examinations, and graded return to play protocol: a retrospective case series

    PubMed Central

    Shane, Eric R.; Pierce, Kevin M.; Gonzalez, Jannet K.; Campbell, Nathan J.

    2013-01-01

    Objective The purpose of this case series is to report how the symptom section of the Sport Concussion Assessment Tool 2 (SCAT2) was used to manage athletes with concussions in a high school training room setting and to address the need for SCAT2 baseline measurements. Clinical features During a 4-month period, 3 doctors of chiropractic with certification from the American Chiropractic Board of Sports Physicians managed 15 high school athletes with concussions in a multidisciplinary setting. Fourteen athletes were male American football players, and one was a female volleyball player. Intervention and outcome Of the 15 athletes, 3 athletes had baseline SCAT2 documentation. Athletes were evaluated and returned to play with a graded return to play protocol using the SCAT2 symptoms and serial physical examinations. Once participants were asymptomatic, they began a graded return to play process. A total of 47 SCAT2 tests were performed on the 15 athletes, averaging 3.13 SCAT2 evaluations per patient. Of the 15 athletes evaluated, 6 were managed and cleared for return to play; 2 of the athletes sustained concussions in the last week of the season, thus ending their season; and 3 athletes were cleared by medical doctors. None of the athletes under care reported an adverse event. Conclusion The utilization of the SCAT2 with serial physical examinations provided objective measures for athlete’s injuries, allowing the practitioners to evaluate concussions. More efforts are needed to collect baseline SCAT2 to compare these scores with subsequent SCAT2 scores following athletic injuries. PMID:24396327

  11. American Chiropractic Association

    MedlinePLUS

    ... employees; search for or sell equipment and more Health Care Reform Video Update The ACA Government Relations Team provides the latest legislative news What to Expect on Your First Visit to a Doctor of ... health care needs. Reimbursement ACA offers members a wide ...

  12. Chiropractic: An Introduction

    MedlinePLUS

    ... Use in the United States Treatment What the Science Says Safety Practitioners: Education and Licensure If You Are Thinking About Seeking ... the following individuals for their technical expertise and review of this ... Northwestern Health Sciences University; Joel Pickar, D.C., Ph.D., Palmer ...

  13. Recognition of Spontaneous Vertebral Artery Dissection Preempting Spinal Manipulative Therapy: A Patient Presenting With Neck Pain and Headache for Chiropractic Care

    PubMed Central

    Mattox, Ross; Smith, Linda W.; Kettner, Norman W.

    2014-01-01

    Objective The purpose of this case report is to describe a patient who presented to a chiropractic physician for evaluation and treatment of neck pain and headache. Clinical features A 45-year-old otherwise healthy female presented for evaluation and treatment of neck pain and headache. Within minutes, non-specific musculoskeletal symptoms progressed to neurological deficits, including limb ataxia and cognitive disturbances. Suspicion was raised for cerebrovascular ischemia and emergent referral was initiated. Intervention and outcome Paramedics were immediately summoned and the patient was transported to a local hospital with a working diagnosis of acute cerebrovascular ischemia. Multiplanar computed tomographic and magnetic resonance imaging with contrast revealed vertebral artery dissection of the V2 segment in the right vertebral artery. Anticoagulation therapy was administered and the patient was discharged without complications after 5 days in the hospital. Conclusion This case highlights the potential for patients with vertebral artery dissection to present with nonspecific musculoskeletal complaints. Neurological symptoms may not manifest initially, but their sudden onset indicates the possibility of an ischemic cerebrovascular event. We suggest that early recognition and emergent referral for this patient avoided potential exacerbation of an evolving pre-existing condition and resulted in timely anticoagulation treatment. PMID:25685116

  14. Association of worker characteristics and early reimbursement for physical therapy, chiropractic and opioid prescriptions with workers’ compensation claim duration, for cases of acute low back pain: an observational cohort study

    PubMed Central

    Busse, Jason W; Ebrahim, Shanil; Heels-Ansdell, Diane; Wang, Li; Couban, Rachel; Walter, Stephen D

    2015-01-01

    Objective To assess the association between early reimbursement for physiotherapy, chiropractic and opioid prescriptions for acute low back pain (LBP) with disability claim duration. Design Observational cohort study. Setting and participants From a random sample of 6665 claims for acute, uncomplicated LBP approved by the Ontario Workplace Safety and Insurance Board (WSIB) in 2005, we analysed 1442 who remained on full benefits at 4?weeks after claim approval. Primary outcome measure Our primary outcome was WSIB claim duration. Results We had complete data for all but 3 variables, which had <15% missing data, and we included missing data as a category for these factors. Our time-to-event analysis was adjusted for demographic, workplace and treatment factors, but not injury severity, although we attempted to include a sample with very similar, less-severe injuries. Regarding significant factors and treatment variables in our adjusted analysis, older age (eg, HR for age ?55 vs <25=0.52; 99% CI 0.36 to 0.74) and WSIB reimbursement for opioid prescription in the first 4?weeks of a claim (HR=0.68; 99% CI 0.53 to 0.88) were associated with longer claim duration. Higher predisability income was associated with longer claim duration, but only among persistent claims (eg, HR for active claims at 1?year with a predisability income >$920 vs ?$480/week=0.34; 99% CI 0.17 to 0.68). Missing data for union membership (HR=1.27; 99% CI 1.01 to 1.59), and working for an employer with a return-to-work programme were associated with fewer days on claim (HR=1.78; 99% CI 1.45 to 2.18). Neither reimbursement for physiotherapy (HR=1.01; 99% CI 0.86 to 1.19) nor chiropractic care (HR for active claims at 60?days=1.15; 99% CI 0.94 to 1.41) within the first 4?weeks was associated with claim duration. Our meta-analysis of 3 studies (n=51?069 workers) confirmed a strong association between early opioid use and prolonged claim duration (HR=0.57, 95% CI 0.48 to 0.69; low certainty evidence). Conclusions Our analysis found that early WSIB reimbursement for physiotherapy or chiropractic care, in claimants fully off work for more than 4?weeks, was not associated with claim duration, and that early reimbursement for opioids predicted prolonged claim duration. Well-designed randomised controlled trials are needed to verify our findings and establish causality between these variables and claim duration. PMID:26310398

  15. The effect of a sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized controlled trial

    PubMed Central

    2010-01-01

    Background Hamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol provided in addition to the current best practice management could prevent the occurrence of and weeks missed due to hamstring and other lower-limb injuries at the semi-elite level of Australian football. Methods Sixty male subjects were assessed for eligibility with 59 meeting entry requirements and randomly allocated to an intervention (n = 29) or control group (n = 30), being matched for age and hamstring injury history. Twenty-eight intervention and 29 control group participants completed the trial. Both groups received the current best practice medical and sports science management, which acted as the control. Additionally, the intervention group received a sports chiropractic intervention. Treatment for the intervention group was individually determined and could involve manipulation/mobilization and/or soft tissue therapies to the spine and extremity. Minimum scheduling was: 1 treatment per week for 6 weeks, 1 treatment per fortnight for 3 months, 1 treatment per month for the remainder of the season (3 months). The main outcome measure was an injury surveillance with a missed match injury definition. Results After 24 matches there was no statistical significant difference between the groups for the incidence of hamstring injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051) and primary non-contact knee injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051). The difference for primary lower-limb muscle strains was significant (OR:0.097, 95%CI:0.011-0.839, p = 0.025). There was no significant difference for weeks missed due to hamstring injury (4 v14, ?2:1.12, p = 0.29) and lower-limb muscle strains (4 v 21, ?2:2.66, p = 0.10). A significant difference in weeks missed due to non-contact knee injury was noted (1 v 24, ?2:6.70, p = 0.01). Conclusions This study demonstrated a trend towards lower limb injury prevention with a significant reduction in primary lower limb muscle strains and weeks missed due to non-contact knee injuries through the addition of a sports chiropractic intervention to the current best practice management. Trial registration The study was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12608000533392). PMID:20374662

  16. Chiropractic care for back pain

    MedlinePLUS

    ... Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. ...

  17. Stability: from biomechanical concept to chiropractic practice

    PubMed Central

    McGill, Stuart M

    1999-01-01

    This paper formalizes stability in a clinician-friendly way and then discusses ways for chiropractors to ensure stability of spinal joints that may have their stability compromized from manipulation. ImagesFigure 1Figure 4Figure 5Figure 6Figure 7

  18. Clinical competency evaluation of Brazilian chiropractic interns

    PubMed Central

    Facchinato, Ana Paula A.; Benedicto, Camila C.; Mora, Aline G.; Cabral, Dayane M.C.; Fagundes, Djalma J.

    2015-01-01

    Objective This study compares the results of an objective structured clinical examination (OSCE) between 2 groups of students before an internship and after 6 months of clinical practice in an internship. Methods Seventy-two students participated, with 36 students in each cohort. The OSCEs were performed in the simulation laboratory before the participants' clinical practice internship and after 6 months of the internship. Students were tested in 9 stations for clinical skills and knowledge. The same procedures were repeated for both cohorts. The t test was used for unpaired parametric samples and Fisher's exact test was used for comparison of proportions. Results There was no difference in the mean final score between the 2 groups (p = .34 for test 1; p = .08 for test 2). The performance of the students in group 1 was not significantly different when performed before and after 6 months of clinical practice, but in group 2 there was a significant decrease in the average score after 6 months of clinical practice. Conclusions There was no difference in the cumulative average score for the 2 groups before and after 6 months of clinical practice in the internship. There were differences within the cohorts, however, with a significant decrease in the average score in group 2. Issues pertaining to test standardization and student motivation for test 2 may have influenced the scores. PMID:25588200

  19. Donald Campbell Sutherland — chiropractic statesman and diplomat

    PubMed Central

    Vear, Herbert J; Keating, Joseph C

    1999-01-01

    This paper chronicles the 50 year career of Dr. Donald Sutherland DC. Described are his political, clinical, legislative and administrative achievements accomplished during that time period. The authors’ hope that this paper will foster more Canadian historic manuscripts recognizing and documenting the significant profession building contributions made by pioneering chiropractors of the 20th century. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7

  20. Chiropractic is a health care profession

    E-print Network

    Sibille, Etienne

    to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, and pain Speaking Complex Problem Solving Time Management Judgment and Decision Making Writing Science Social and Counseling Administration and Management Psychology Clerical Education and Training Personnel and Human

  1. The chiropractic management of two cases of cervical spondylotic radiculopathy

    PubMed Central

    Dufton, John A.; Giantomaso, Tony

    2003-01-01

    Cervical spondylotic radiculopathy (CSR) is one of the potential sources of radiculopathy, particularly in patients aged 40 to 60 years. The hallmark sign of cervical-brachial pain presents in the majority of the cases, however a definitive clinical diagnosis is often difficult in the absence of reliable and valid diagnostic tests. Two cases of presumed CSR illustrate the usefulness of applying a comprehensive mechanical assessment that guides the patient's rehabilitation regardless of the traditional anatomical diagnosis. A brief overview of the epidemiology, clinical presentation, and management of CSR is also presented.

  2. Chiropractic management of abdominal aortic aneurysm: a case report

    PubMed Central

    Weston, JP

    1995-01-01

    Aortic dilatation is a common and potentially life-threatening condition with which a patient may present to the chiropractor. It is most often detected in males over 50, particularly in association with hypertensive disease. This case illustrates the classic clinical and radiologic features of a large (13cms) abdominal aortic aneurysm. The manipulative management of patients with abdominal aortic aneurysm is discussed. ImagesFigure 1(a)Figure 1(b)

  3. Chiropractic and Neck Pain: Conservative Care of Cervical Pain, Injury

    MedlinePLUS

    ... that causes pain. Your doctor will feel your spine, note its curvature and alignment, and feel for muscle spasm. A check of your shoulder area is also in order. During the neurological exam, your ... to improve the mobility of the spine and to restore range of motion; it can ...

  4. Ross E. Baker, DC: A Canadian chiropractic survivor

    PubMed Central

    Brown, Douglas M.

    2014-01-01

    This paper is an historical biography of a fortunate man. It begins with a glimpse of Ross E. Baker’s origins in south-western Ontario, watches him going to school and working in Hamilton before joining the Canadian Army and shipping off to Europe to fight in the Second World War. At War’s end, the article picks up Dr. Baker as he comes home, starts a family, becomes a chiropractor and sustains a viable practice. Now in the twilight of life, the good doctor is last seen content with his retirement, spending days at his cottage property, reviewing his memoirs and reflecting on the tumult, terror and eventual triumph of the D-Day landing at Normandy. PMID:24587499

  5. Colin A. Greenshields, DC: the Canadian Memorial Chiropractic College’s first graduate

    PubMed Central

    Brown, Douglas M.

    2012-01-01

    This biographical study investigates the complex tribulations and impressive accomplishments of Dr. Colin Greenshields. Part I (the Formative Years) goes back to his ancestors in Great Britain and forward to his graduation from CMCC in 1948. Part II (the Professional Years) begins with the opening of Colin’s office in St. Catharines, ON, and proceeds through his professional career and multiple leadership roles to his retirement in 1986. PMID:22675227

  6. 78 FR 22901 - United States v. Chiropractic Associates, Ltd. of South Dakota Proposed Final Judgment and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ... and Competitive Impact Statement Notice is hereby given pursuant to the Antitrust Procedures and Penalties Act, 15 U.S.C. 16(b)-(h), that a proposed Final Judgment, Stipulation, and Competitive Impact.... Copies of the Complaint, proposed Final Judgment, and Competitive Impact Statement are available...

  7. Tuberculosis of the neuromusculoskeletal system: a review of two cases presenting as chiropractic patients

    PubMed Central

    Kanga, Ismat; Taylor, John A.; Jacobs, Craig; Outerbridge, Geoff

    2015-01-01

    Tuberculosis caused by Mycobacterium tuberculosis is a major public heath problem world-wide, particularly in low-income countries. Increased number of immunocompromised patients and immigration from countries where tuberculosis is endemic has resulted in increased number of cases in high-income countries. Tuberculosis can affect any organ system, but is of particular interest to chiropractors when it affects the neuromusculoskeletal system. Patients with tuberculosis of the neuromusculoskeletal system can present with mechanical low back pain or with complex neurologic deficits. The aim of this paper is to highlight the importance of considering a diagnosis of tuberculosis in susceptible populations and the devastating consequences of the disease. The epidemiology, clinical features and management of tuberculosis will also be presented to facilitate early diagnosis, appropriate referral and multidisciplinary care of these patients. PMID:25729081

  8. Comparison of chiropractic student scores before and after utilizing active learning techniques in a classroom setting

    PubMed Central

    Guagliardo, Joseph G.; Hoiriis, Kathryn T.

    2013-01-01

    Objective We report the differences in final examination scores achieved by students at the culmination of two different teaching strategies in an introductory skills course. Methods Multiple choice examination scores from six consecutive academic calendar sessions over 18 months (n = 503) were compared. Two groups were used: Cohort A (n = 290) represented students who were enrolled in the course 3 consecutive academic sessions before an instructional change and Cohort B (n = 213) included students who were enrolled in 3 consecutive academic sessions following the instructional change, which included a more active learning format. Statistical analyses used were 2-tailed independent t-test, one-way ANOVA, Tukey's honestly significant difference (HSD), and effect size. Results The 2-tailed independent t-test revealed a significant difference between the two groups (t = ?3.71, p < .001; 95% confidence interval [CI] 1.29–4.20). Significant difference was found in the highest performing subgroup compared to the lowest performing subgroup in Cohort A (F = 3.343, p = .037). For Cohort A subgroups 1 and 2, Tukey's HSD was p < .028. In Cohort B, no difference was found among subgroups (F = 1.912, p = .150, HSD p > .105). Conclusion Compared to previous versions of the same course taught by the same instructor, the students in the new course design performed better, suggesting that using active learning techniques helps improve student achievement. PMID:23964739

  9. 78 FR 22901 - United States v. Chiropractic Associates, Ltd. of South Dakota Proposed Final Judgment and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ...Enforcement Policy in Health Care available at http://www...with any physician, about any refusal to contract, threatened refusal to contract, recommendation...process between payers and health- care providers. Messenger...

  10. The Development of Vaccination Perspectives among Chiropractic, Naturopathic and Medical Students: A Case Study of Professional Enculturation

    ERIC Educational Resources Information Center

    McMurtry, Angus; Wilson, Kumanan; Clarkin, Chantalle; Walji, Rishma; Kilian, Brendan C.; Kilian, Carney C.; Lohfeld, Lynne; Alolabi, Bashar; Hagino, Carol; Busse, Jason W.

    2015-01-01

    An important influence on parents' decisions about pediatric vaccination (children under 6 years of age) is the attitude of their health care providers, including complementary and alternative medicine (CAM) providers. Very limited qualitative research exists, however, on how attitudes towards vaccination develop among healthcare professionals…

  11. 78 FR 48904 - United States v. Chiropractic Associates, Ltd. of South Dakota; Public Comment and Response on...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ...have held that: [t]he balancing of competing social and political interests affected by a proposed antitrust consent decree...assessed. With all the recent revelations of corruption, scandals and cover- ups in our government, now more than ever...

  12. 78 FR 48904 - United States v. Chiropractic Associates, Ltd. of South Dakota; Public Comment and Response on...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ... principals for their conduct and fraud. It affixes no fine or penalty other than I assume court costs... revelations of corruption, scandals and cover- ups in our government, now more than ever due the citizens...

  13. Increasing research capacity in the chiropractic profession: A case study and evaluation of an innovative research program in Norway

    PubMed Central

    Lothe, Lise R.; Bolton, Jennifer E.

    2013-01-01

    Objective The subject of research methods is not commonly covered in continuing professional development (CPD) courses in spite of its emphasis in undergraduate education. This initiative aimed to develop postgraduate research competency and recruit chiropractors to musculoskeletal research. Methods The program was delivered as a university-based program with 20 credits over seven contact weekends covering topics of evidence-based practice, research methods, statistics, ethics, resources, and funding. Students were assessed through assignments showing competency in critical literature review, case report writing, and production of a research protocol as the final assessment. Non-student participation for CPD points was possible. A student evaluation survey was completed after the end of the academic year. Results There were 26 participants: 16 as students handing in assignments, 10 as non-student participants for up to 94 CPD points. Three submitted a final protocol and two registered at a university PhD program. A network of research clinics was established for data collection for future multicenter studies. Conclusions The program was well received by the participants and gave them the tools and resources to perform research. The two-level attendance system afforded a basis for setting up a network of research clinics with a fundamental understanding of optimal data collection. This initiative has shown that research skills can be revisited through CPD programs as part of evidence-based lifelong learning. PMID:23519168

  14. National Center for Complementary and Integrative Health

    MedlinePLUS

    ... National Survey Finds People Use Dietary Supplements and Yoga for Wellness Reasons, Chiropractic for Treating a Condition ( ... National Survey Finds People Use Dietary Supplements and Yoga for Wellness Reasons, Chiropractic for Treating a Condition ( ...

  15. A Randomized Trial of Chiropractic Manipulation and Mobilization for Patients With Neck Pain: Clinical Outcomes From the UCLA Neck-Pain Study

    PubMed Central

    Hurwitz, Eric L.; Morgenstern, Hal; Harber, Philip; Kominski, Gerald F.; Yu, Fei; Adams, Alan H.

    2002-01-01

    Objectives. This study compared the relative effectiveness of cervical spine manipulation and mobilization for neck pain. Methods. Neck-pain patients were randomized to the following conditions: manipulation with or without heat, manipulation with or without electrical muscle stimulation, mobilization with or without heat, and mobilization with or without electrical muscle stimulation. Results. Of 960 eligible patients, 336 enrolled in the study. Mean reductions in pain and disability were similar in the manipulation and mobilization groups through 6 months. Conclusions. Cervical spine manipulation and mobilization yield comparable clinical outcomes. PMID:12356613

  16. The Implementation of Virtual Instruction in Relation to X-ray Anatomy and Positioning in a Chiropractic Degree Program: A Descriptive Paper.

    PubMed

    Rush, Perry O; Boone, William R

    2009-01-01

    This article provides information regarding the introduction of virtual education into classroom instruction, wherein a method of classroom instruction was developed with the use of a computer, digital camera, and various software programs. This approach simplified testing procedures, thus reducing institutional costs substantially by easing the demand for manpower, and seemed to improve average grade performance. Organized files with hundreds of digital pictures have created a range of instructor resources. Much of the new course materials were organized onto compact disks to complement course notes. Customizing presentations with digital technology holds potential benefits for students, instructors and the institution. PMID:19390682

  17. Clear Thinking about Alternative Therapies

    MedlinePLUS

    ... acupuncture, aromatherapy, biofeedback, chiropractic, guided imagery, herbal medicine, homeopathy, hypnosis, hypnotherapy, macrobiotics, naturopathy, reflexology, relaxation techniques, traditional ...

  18. 76 FR 11492 - Notice for Request for Nominations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-02

    ...underserved areas [cir] Other Disciplines and Expertise Allied health Chiropractic medicine Clinical social work Graduate clinical psychology Podiatric medicine (preventive and primary care) Professional counseling Geriatrics...

  19. 42 CFR 60.50 - Which schools are eligible to be HEAL schools?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Osteopathic Medicine Doctor of Dentistry or equivalent degree Bachelor or Master of Science in Pharmacy or... of Chiropractic or equivalent degree Doctoral degree of Clinical Psychology Masters or...

  20. 42 CFR 60.50 - Which schools are eligible to be HEAL schools?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Osteopathic Medicine Doctor of Dentistry or equivalent degree Bachelor or Master of Science in Pharmacy or... of Chiropractic or equivalent degree Doctoral degree of Clinical Psychology Masters or...

  1. 42 CFR 60.50 - Which schools are eligible to be HEAL schools?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Osteopathic Medicine Doctor of Dentistry or equivalent degree Bachelor or Master of Science in Pharmacy or... of Chiropractic or equivalent degree Doctoral degree of Clinical Psychology Masters or...

  2. Recent advances in lumbar mechanics with relevance to clinicians

    PubMed Central

    McGill, Stuart M

    1989-01-01

    Perhaps the singular, most important impediment to universal recognition of chiropractic as a legitimate and mature health care alternative is the absence of a developed mechanical knowledge of chiropractic techniques. The purpose of this review paper was to describe, and to some extent critique, some recent research pertaining to mechanics of the lumbar spine and to illustrate the relevance to clinical chiropractic. Specific contentious issues addressed include discussion of the mechanical relationship of intra-abdominal pressure, the lumbodorsal fascia, muscle-ligament interplay and the abdominal musculature with the lumbar spine. Directions or future research are proposed given the pressing need to provide a rationale for, and explanation of, specific chiropractic treatment.

  3. The Homewood influence in Canada and beyond

    PubMed Central

    Keating, Joseph C

    2006-01-01

    If there is any one individual who stands out in the saga of the early growth and development of the Canadian Memorial Chiropractic College, it must be Albert Earl Homewood (1916–1990). His contributions included steering the institution through the lean 1950s, coping with the metropolitan transit authorities’ devastating incursion upon the first campus, and arranging the construction and financing of the school’s second campus. Along the way, this feisty gentleman and respected instructor, “chiropractic’s Mr. Chips,” raised the standard for scholarship among DCs and assisted in the administration of several additional chiropractic colleges (Lincoln and Los Angeles). PMID:17549169

  4. 42 CFR 60.1 - What is the HEAL program?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... the fields of medicine, osteopathic medicine, dentistry, veterinary medicine, optometry, podiatric medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The...

  5. 42 CFR 60.1 - What is the HEAL program?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... the fields of medicine, osteopathic medicine, dentistry, veterinary medicine, optometry, podiatric medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The...

  6. 42 CFR 60.1 - What is the HEAL program?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the fields of medicine, osteopathic medicine, dentistry, veterinary medicine, optometry, podiatric medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The...

  7. Summary of Compensation, Benefits and Pension Contribution Changes for Senior Research Associates and Research Associates (Limited Term)

    E-print Network

    Toronto, University of

    Benefits a) Chiropractic / Physiotherapy / Registered Massage Therapy Benefit: Move from the current provisions of Registered Massage Therapy up to $500 / person / year and Physiotherapy at $12.20 / visit to a combined Chiropractic / Physiotherapy / Registered Massage Therapy benefit at $500 / person / year

  8. 42 CFR 60.10 - How much can be borrowed?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... school of public health, pharmacy, chiropractic, or a graduate program in health administration, clinical...-month period. (3) An eligible nonstudent in the field of pharmacy, public health, chiropractic, health administration, or clinical psychology may borrow up to $50,000 under this part including loans obtained...

  9. 42 CFR 60.10 - How much can be borrowed?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... school of public health, pharmacy, chiropractic, or a graduate program in health administration, clinical...-month period. (3) An eligible nonstudent in the field of pharmacy, public health, chiropractic, health administration, or clinical psychology may borrow up to $50,000 under this part including loans obtained...

  10. 42 CFR 60.10 - How much can be borrowed?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... school of public health, pharmacy, chiropractic, or a graduate program in health administration, clinical...-month period. (3) An eligible nonstudent in the field of pharmacy, public health, chiropractic, health administration, or clinical psychology may borrow up to $50,000 under this part including loans obtained...

  11. 42 CFR 60.10 - How much can be borrowed?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... school of public health, pharmacy, chiropractic, or a graduate program in health administration, clinical...-month period. (3) An eligible nonstudent in the field of pharmacy, public health, chiropractic, health administration, or clinical psychology may borrow up to $50,000 under this part including loans obtained...

  12. Allan M. Freedman, LLB: a lawyer’s gift to Canadian chiropractors

    PubMed Central

    Brown, Douglas M.

    2007-01-01

    This paper reviews the leadership role, contributions, accolades, and impact of Professor Allan Freedman through a 30 year history of service to CMCC and the chiropractic profession in Canada. Professor Freedman has served as an educator, philanthropist and also as legal counsel. His influence on chiropractic organizations and chiropractors during this significant period in the profession is discussed. PMID:18060008

  13. 42 CFR 60.5 - Who is an eligible student borrower?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree in Clinical Psychology Masters or doctoral degree in Health Administration (c) He or she must be carrying or plan to carry, during...

  14. 42 CFR 60.50 - Which schools are eligible to be HEAL schools?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree of Clinical Psychology Masters or doctoral degree in Health Administration For the purposes of this section, the term “State”...

  15. 42 CFR 60.50 - Which schools are eligible to be HEAL schools?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree of Clinical Psychology Masters or doctoral degree in Health Administration For the purposes of this section, the term “State”...

  16. 42 CFR 60.10 - How much can be borrowed?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...or a graduate program in health administration, clinical psychology, or allied health may borrow up to $50,000 under this...health, chiropractic, health administration, or clinical psychology may borrow up to $50,000 under this part including...

  17. 42 CFR 60.1 - What is the HEAL program?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...veterinary medicine, optometry, podiatric medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The basic purpose of the program is to encourage lenders to make loans to students in these fields who desire to...

  18. 42 CFR 60.5 - Who is an eligible student borrower?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree in Clinical Psychology Masters or doctoral degree in Health Administration (c) He or she must be carrying or plan to carry, during...

  19. 42 CFR 60.10 - How much can be borrowed?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...or a graduate program in health administration, clinical psychology, or allied health may borrow up to $50,000 under this...health, chiropractic, health administration, or clinical psychology may borrow up to $50,000 under this part including...

  20. 42 CFR 60.1 - What is the HEAL program?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...veterinary medicine, optometry, podiatric medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The basic purpose of the program is to encourage lenders to make loans to students in these fields who desire to...

  1. 42 CFR 60.1 - What is the HEAL program?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...veterinary medicine, optometry, podiatric medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The basic purpose of the program is to encourage lenders to make loans to students in these fields who desire to...

  2. 42 CFR 60.5 - Who is an eligible student borrower?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree in Clinical Psychology Masters or doctoral degree in Health Administration (c) He or she must be carrying or plan to carry, during...

  3. 42 CFR 60.10 - How much can be borrowed?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...or a graduate program in health administration, clinical psychology, or allied health may borrow up to $50,000 under this...health, chiropractic, health administration, or clinical psychology may borrow up to $50,000 under this part including...

  4. 42 CFR 60.50 - Which schools are eligible to be HEAL schools?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree of Clinical Psychology Masters or doctoral degree in Health Administration For the purposes of this section, the term “State”...

  5. Commission for the Accreditation of Birth Centers

    MedlinePLUS

    ... therapy Massage or therapeutic touch Sterile water papules Heat or cold therapy Supplemental chiropractic care Herbal and ... plan for transferring to a hospital, including the transfer of records and care. In 98% of transfers ...

  6. Use of Complementary and Alternative Medicine in the United States

    MedlinePLUS

    ... adults. Use has increased for several therapies, including deep breathing exercises, meditation A conscious mental process using ... Ayurveda* Biofeedback* Chelation therapy* Chiropractic or osteopathic manipulation* Deep breathing exercises Diet-based therapies Atkins diet Macrobiotic ...

  7. Time to Talk: 5 Tips on Safety of Mind and Body Practices for Children and Teens

    MedlinePLUS

    ... X Y Z 5 Tips on Safety of Mind and Body Practices for Children and Teens Share: Nearly 12 ... such as chiropractic care, deep breathing, and yoga. Mind and body interventions are physical techniques usually administered by a ...

  8. Alternative Therapies

    MedlinePLUS

    ... classes, or trained individuals. Bodywork includes myofascial release (Smith, 1997) , various types of massage, craniosacral therapy, chiropractic ... 1987) ; therapeutic touch, developed in nursing (Gerber, 1988; Smith, 1997) ; and reiki and polarity (Goldberg, 1995) . All ...

  9. Autoimmune Diseases

    MedlinePLUS

    ... of CAM are herbal products, chiropractic , acupuncture , and hypnosis . If you have an autoimmune disease, you might ... help you to feel your best. Meditation, self-hypnosis, and guided imagery, are simple relaxation techniques that ...

  10. Cancer Alternative Therapies

    MedlinePLUS

    You have many choices to make about your cancer treatment. One choice you might be thinking about ... are acupuncture, chiropractic, and herbal medicines. People with cancer may use CAM to Help cope with the ...

  11. Headaches and Complementary Health Approaches

    MedlinePLUS

    ... Chiropractic: An Introduction. More information on spinal manipulation Tai Chi Tai chi, which originated in China, combines meditation with slow, ... and relaxation. One small randomized study has evaluated tai chi for tension headaches. Some evidence of improvements in ...

  12. 42 CFR 411.12 - Charges imposed by an immediate relative or member of the beneficiary's household.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...or more physicians and is operated for the purpose of conducting the practice of medicine, osteopathy dentistry, podiatry, optometry, or chiropractic, or is owned by other health care professionals as authorized by State law. (c) Applicability of...

  13. 42 CFR 410.21 - Limitations on services of a chiropractor.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... adequate courses of study in the subjects of anatomy, physiology, symptomatology and diagnosis, hygiene and... approved by the State's chiropractic examiners and including at least 4,000 hours in courses in...

  14. 42 CFR 410.21 - Limitations on services of a chiropractor.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... adequate courses of study in the subjects of anatomy, physiology, symptomatology and diagnosis, hygiene and... approved by the State's chiropractic examiners and including at least 4,000 hours in courses in...

  15. 42 CFR 410.21 - Limitations on services of a chiropractor.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... adequate courses of study in the subjects of anatomy, physiology, symptomatology and diagnosis, hygiene and... approved by the State's chiropractic examiners and including at least 4,000 hours in courses in...

  16. 42 CFR 410.21 - Limitations on services of a chiropractor.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... adequate courses of study in the subjects of anatomy, physiology, symptomatology and diagnosis, hygiene and... approved by the State's chiropractic examiners and including at least 4,000 hours in courses in...

  17. 42 CFR 410.21 - Limitations on services of a chiropractor.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... adequate courses of study in the subjects of anatomy, physiology, symptomatology and diagnosis, hygiene and... approved by the State's chiropractic examiners and including at least 4,000 hours in courses in...

  18. State of Tennessee Employee Discount Program (State only)

    E-print Network

    Davis, Lloyd M.

    . These include gym memberships (FitnessBlue), LASIK eye surgery, massage therapy, hearing aids, regional on alternative care like acupuncture, massage and chiropractic care. Gym memberships: Members can save 60

  19. 42 CFR 60.5 - Who is an eligible student borrower?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree in Clinical Psychology Masters or doctoral degree in Health Administration (c) He or she must be carrying or plan to carry, during...

  20. 42 CFR 60.1 - What is the HEAL program?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...veterinary medicine, optometry, podiatric medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The basic purpose of the program is to encourage lenders to make loans to students in these fields who desire to...

  1. 42 CFR 60.50 - Which schools are eligible to be HEAL schools?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree of Clinical Psychology Masters or doctoral degree in Health Administration For the purposes of this section, the term “State”...

  2. 42 CFR 60.10 - How much can be borrowed?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...or a graduate program in health administration, clinical psychology, or allied health may borrow up to $50,000 under this...health, chiropractic, health administration, or clinical psychology may borrow up to $50,000 under this part including...

  3. 42 CFR 60.5 - Who is an eligible student borrower?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree in Clinical Psychology Masters or doctoral degree in Health Administration (c) He or she must be carrying or plan to carry, during...

  4. 42 CFR 60.1 - What is the HEAL program?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...veterinary medicine, optometry, podiatric medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The basic purpose of the program is to encourage lenders to make loans to students in these fields who desire to...

  5. 78 FR 18988 - Agency Information Collection Activities; Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ...pharmacy, public health, allied health, or chiropractic, and graduate students in health administration or clinical psychology through September 30, 1998. Eligible lenders, such as banks, savings and loan associations, credit unions, pension...

  6. 78 FR 35286 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-12

    ...pharmacy, public health, allied health, or chiropractic, and graduate students in health administration or clinical psychology through September 30, 1998. Eligible lenders, such as banks, savings and loan associations, credit unions, pension...

  7. 42 CFR 60.50 - Which schools are eligible to be HEAL schools?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree of Clinical Psychology Masters or doctoral degree in Health Administration For the purposes of this section, the term “State”...

  8. 75 FR 30407 - Agency Information Collection Activities: Proposed Collection: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-01

    ...pharmacy, public health, allied health, or chiropractic, and graduate students in health administration or clinical psychology through September 30, 1998. Eligible lenders, such as banks, savings and loan associations, credit unions, pension...

  9. 42 CFR 60.10 - How much can be borrowed?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...or a graduate program in health administration, clinical psychology, or allied health may borrow up to $50,000 under this...health, chiropractic, health administration, or clinical psychology may borrow up to $50,000 under this part including...

  10. 75 FR 16136 - Agency Information Collection Activities: Proposed Collection: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-31

    ...pharmacy, public health, allied health, or chiropractic, and graduate students in health administration or clinical psychology through September 30, 1998. Eligible lenders, such as banks, savings and loan associations, credit unions, pension...

  11. A Note on Complementary Medicines

    MedlinePLUS

    ... Photo: iStock Herbal supplements, meditation, chiropractic manipulation, and acupuncture are types of complementary and alternative medicine (CAM) ... effective. For example, NCCAM studies have shown that: Acupuncture can provide pain relief and improve function for ...

  12. Questions about Neck Manipulation?

    MedlinePLUS

    ... several million treatments, based upon clinical reports and scientific studies. If you are visiting your doctor of chiropractic ... or it could be seriously debilitating. While recent scientific studies have found that there are useful treatments for ...

  13. The activity of Rubisco's molecular chaperone, Rubisco activase, in leaf extracts

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Rubisco frequently undergoes unproductive interactions with its sugar-phosphate substrate that stabilize active sites in an inactive conformation. Restoring catalytic competence to these sites requires the “molecular chiropractic” activity of Rubisco activase (activase). To make the study of activas...

  14. Special Section: Complementary and Alternative Medicine (CAM):Quiz on Complementary and Alternative Medicine

    MedlinePLUS

    ... Special Section CAM Quiz on Complementary and Alternative Medicine Past Issues / Winter 2009 Table of Contents For ... low back pain. True False Complementary and alternative medicine (CAM) includes: Meditation Chiropractic Use of natural products, ...

  15. Alternative Treatments for Ankylosing Spondylitis

    MedlinePLUS

    ... a chiropractor? Download our free educational brochure >>> . Chiropractic Management of Low Back Disorders: Report From a Consensus ... on long-term treatment of ankylosing spondylitis with integrated traditional Chinese and western medicine. Zhongguo Zhong XiYi ...

  16. 75 FR 24437 - Medicare and Medicaid Programs; Changes in Provider and Supplier Enrollment, Ordering and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ...medicine and osteopathy, optometry, podiatry, dental medicine, dental surgery, and chiropractic. Referring physicians...laboratories for testing. Doctors of dental medicine or dental surgery are considered physicians and we require...

  17. Where We Stand—CMA Position Papers: • Abortion • Acupuncture • Chiropractic • Confidentiality • Cost of Care • Drug Abuse • Environmental Health • Health Education for the Public • Health in the United States • Health Quackery • Health Maintenance Organizations and Prepaid Health Plans • Health Manpower • National Health Insurance • Physician's Assistants • Physician Unions • Professional Standards Review Organizations • Quality Medical Care

    PubMed Central

    1973-01-01

    To serve the interests of members and to function in the public interest, the California Medical Association must set policies and take positions on current issues affecting the health care of Californians. These policies then guide the activities of the Association in fulfilling its leadership role and its responsibility to the public. Delegates, elected by the membership of CMA's component medical societies, meet annually to deliberate and determine the policies and courses of action for the Association. Between meetings of these Delegates, the CMA Councilors, elected by their district membership, implement the directives of the Delegates and set interim policies. By this democratic process, the membership governs the CMA. Association members must be informed if they are to participate effectively in the affairs of their medical organizations. To disseminate better understanding of CMA's activities, position papers on current issues have been developed. They are based on House of Delegates resolutions and Council actions. Entitled “Where We Stand on Medical and Health Issues,” these papers represent the current policy positions of CMA. Each paper is annotated to give the reference source of the policy actions. As with any organization, CMA policies are subject to timely revision. When policies are amended or new policies are adopted, new papers will be developed. PMID:4148533

  18. William D. Harper, Jr, MS, DC: Anything Can Cause Anything

    PubMed Central

    Keating, Joseph C.

    2008-01-01

    Trained as an engineer and a chiropractor, William D. Harper, Jr. made his career in the healing arts as instructor, writer and president of the Texas Chiropractic College (TCC). A native of Texas who grew up in various locales in the Lone Star State, in Mexico and in the Boston area, he took his bachelor’s and master’s degree in engineering in 1933 and 1934 from the Massachusetts Institute of Technology, and his chiropractic degree at TCC in 1942. Dissatisfied with the “foot-on-the-hose” concept of subluxation syndrome (D.D. Palmer’s second theory), Dr. Harper studied and wrote about aberrant neural irritation as an alternative explanation for disease and for the broad clinical value he perceived in the chiropractic art. In this he paralleled much of D.D. Palmer’s third theory of chiropractic. His often reprinted textbook, Anything Can Cause Anything, brought together much of what he had lectured and written about in numerous published articles. He was well prepared for the defense of chiropractic that he offered in 1965 in the trial of the England case in federal district court in Louisiana. The case was lost when the court ruled that the legislature rather than the judiciary should decide whether to permit chiropractors to practice, but Harper’s performance was considered excellent. He went on to guide the TCC as president from 1965 through 1976, its first 11 years after relocating from San Antonio to Pasadena, Texas. Harper built the school – its faculty, staff and facilities – from very meager beginnings to a small but financially viable institution when he departed. Along the way he found fault with both chiropractic political camps that vied for federal recognition as the accrediting agency for chiropractic colleges in the United States. Dr. Bill Harper was a maverick determined to do things his way, and in many respects he was successful. He left a mark on the profession that merits critical analysis. PMID:18327301

  19. James F. McGinnis, D.C., N.D., C.P. (1873-1947): spinographer, educator, marketer and bloodless surgeon.

    PubMed

    Keating, J C

    1998-12-01

    Perhaps best remembered for his contributions to B.J. Palmer's earliest developments in spinography, James F. McGinnis also pioneered in marketing methods while a straight chiropractic practitioner in Iowa. His advertising brought him to the attention of organized medicine, which sought his prosecution. Relocating to California in the early 1920s, he broadened his scope of practice and earned a naturopathic doctorate. In the 1930s he became one of the best known of several chiropractic bloodless surgeons and traveled around the nation to teach his methods. Although initially a passionate member of the Universal Chiropractors Association and receptive to Palmer's introduction of the neurocalometer, McGinnis eventually changed his political allegiance and became an active member of the National Chiropractic Association. He died in 1947 while on a teaching tour of Claifornia's San Joaquin Valley. PMID:11623684

  20. Adhesive capsulitis: a case report

    PubMed Central

    Kazemi, Mohsen

    2000-01-01

    Adhesive capsulitis or frozen shoulder is an uncommon entity in athletes. However, it is a common cause of shoulder pain and disability in the general population. Although it is a self limiting ailment, its rather long, restrictive and painful course forces the affected person to seek treatment. Conservative management remains the mainstay treatment of adhesive capsulitis. This includes chiropractic manipulation of the shoulder, therapeutic modalities, mobilization, exercise, soft tissue therapy, nonsteroidal anti-inflammatory drugs, and steroid injections. Manipulation under anesthesia is advocated when the conservative treatment fails. A case of secondary adhesive capsulitis in a forty-seven-year-old female recreational squash player is presented to illustrate clinical presentation, diagnosis, radiographic assessment and conservative chiropractic management. The patient’s shoulder range of motion was full and pain free with four months of conservative chiropractic care. ImagesFigure 1Figure 2Figure 3

  1. Robert M. Wingfield, dc: A conscientious chiropractor.

    PubMed

    Brown, Douglas M

    2015-09-01

    "I slept and dreamed that life was beauty. I woke - and found that life was duty." This quote from the poet Ellen Sturgis Hooper, could be attributed to Robert Wingfield, who has persevered in his quest for personal and professional excellence. This historical biography begins with his genealogy, going back to the 11(th) century in Merry England and ends in 2015, with his relatively quiet existence still centred in Ontario. The essay scrutinizes Dr. Wingfield's accomplishments for the Ontario Chiropractic Association (OCA), Canadian Chiropractic Association (CCA) and Ontario Board of Directors of Chiropractic (BDC). Moreover, it attempts to give the reader a glimpse into his personal endeavours, to help us fathom how he tackles (as William Shakespeare would say) "the thousand natural shocks that flesh is heir to." PMID:26500366

  2. Robert M. Wingfield, dc: A conscientious chiropractor

    PubMed Central

    Brown, Douglas M.

    2015-01-01

    “I slept and dreamed that life was beauty. I woke – and found that life was duty.” This quote from the poet Ellen Sturgis Hooper, could be attributed to Robert Wingfield, who has persevered in his quest for personal and professional excellence. This historical biography begins with his genealogy, going back to the 11th century in Merry England and ends in 2015, with his relatively quiet existence still centred in Ontario. The essay scrutinizes Dr. Wingfield’s accomplishments for the Ontario Chiropractic Association (OCA), Canadian Chiropractic Association (CCA) and Ontario Board of Directors of Chiropractic (BDC). Moreover, it attempts to give the reader a glimpse into his personal endeavours, to help us fathom how he tackles (as William Shakespeare would say) “the thousand natural shocks that flesh is heir to.” PMID:26500366

  3. Evidence-based protocol for structural rehabilitation of the spine and posture: review of clinical biomechanics of posture (CBP®) publications

    PubMed Central

    Oakley, Paul A.; Harrison, Donald D.; Harrison, Deed E.; Haas, Jason W.

    2005-01-01

    BACKGROUND Although practice protocols exist for SMT and functional rehabilitation, no practice protocols exist for structural rehabilitation. Traditional chiropractic practice guidelines have been limited to acute and chronic pain treatment, with limited inclusion of functional and exclusion of structural rehabilitation procedures. OBJECTIVE (1) To derive an evidence-based practice protocol for structural rehabilitation from publications on Clinical Biomechanics of Posture (CBP®) methods, and (2) to compare the evidence for Diversified, SMT, and CBP®. METHODS Clinical control trials utilizing CBP® methods and spinal manipulative therapy (SMT) were obtained from searches in Mantis, CINAHL, and Index Medicus. Using data from SMT review articles, evidence for Diversified Technique (as taught in chiropractic colleges), SMT, and CBP® were rated and compared. RESULTS From the evidence from Clinical Control Trials on SMT and CBP®, there is very little evidence support for Diversified (our rating = 18), as taught in chiropractic colleges, for the treatment of pain subjects, while CBP® (our rating = 46) and SMT for neck pain (rating = 58) and low back pain (our rating = 202) have evidence-based support. CONCLUSIONS While CBP® Technique has approximately as much evidence-based support as SMT for neck pain, CBP® has more evidence to support its methods than the Diversified technique taught in chiropractic colleges, but not as much as SMT for low back pain. The evolution of chiropractic specialization has occurred, and doctors providing structural-based chiropractic care require protocol guidelines for patient quality assurance and standardization. A structural rehabilitation protocol was developed based on evidence from CBP® publications. PMID:17549209

  4. Canadian Chiropractors are not alone: external advocacy in Ontario, 1902–2012

    PubMed Central

    Brown, Douglas M.

    2013-01-01

    This article focuses primarily on Ontario, identifying a number of the profession’s allies and their advocacy effectiveness, under two main headings: The Ontario Chiropractic Association; and the Canadian Memorial Chiropractic College during the period of 1902 to 2012. While part of our success in gaining recognition has been attributed to intense lobbying by the profession, here the public support of several labour unions is reviewed. The part played by various politicians, educators, entrepreneurs, legal counsel, academic administrators and historians is also discussed. PMID:23482916

  5. Heuristic exploration of how leg checking procedures may lead to inappropriate sacroiliac clinical interventions

    PubMed Central

    Cooperstein, Robert

    2010-01-01

    Several primary studies have shown that an anatomical short leg predicts anterior rotation of the ipsilateral ilium, whereas anatomical long leg predicts posterior rotation of the ilium on the long leg side. At the same time, in chiropractic and other manual therapy professions, it is widely believed that the leg check finding of a short leg is associated with posterior ilium rotation, and a long leg with anterior ilium rotation. The purpose of this commentary is to explore the consequences of this paradox for the manual therapy professions, insofar as leg checking procedures are commonly used to derive appropriate vectors for chiropractic manipulation/adjustive procedures. PMID:22027038

  6. Back in Shape & Pain Free: Exercises to Safeguard Your Back

    MedlinePLUS

    ... back pain, select low-impact activities that burn calories, but won’t place undue stress on your joints. Also, before beginning a vigorous ... org American Chiropractic Association Type of Exercise ... a shallow pool can provide weightless conditioning, which minimizes stress on the back. However, for some patients swimming ...

  7. Back Pain

    MedlinePLUS

    ... least 6 months. Other studies are comparing different health care approaches to the management of acute low back pain (standard care versus chiropractic, acupuncture, or massage therapy). These studies are measuring ... changes in health-related quality of life among patients suffering from ...

  8. Kinesiology Prestigious

    E-print Network

    Peak, Derek

    in pursuing a second degree: chiropractic medicine nursing occupational therapy physical therapyCollegeofKinesiology Careers in motion Are you interested in working in a health profession, teaching or coaching, program planning, recreation, sharing your love of physical activity with children, adults and seniors or working

  9. The Comprehensive Health Assessment.

    ERIC Educational Resources Information Center

    Eastern Iowa Community Coll. District, Davenport.

    This report contains information from a fall 1991 health occupations assessment of 1,021 health-related employers in Eastern Iowa and the Illinois Quad Cities area. Twelve chapters present comprehensive results of all surveys; results of 10 labor market survey instruments developed for chiropractic offices, dentists' offices, emergency medical…

  10. Dean's Office for Undergraduates and Student Advising

    E-print Network

    -Chiropractic Pre-Pharmacy Pre-Nutrition Pre-Nursing Pre-Dental Hygiene Pre-Respiratory Therapy Office Directory for details. Health Professions Pre-Professional: Pre-Medical Pre-Physical Therapy Pre-Dental Pre-Optometry Pre-Veterinary Pre-Podiatry Pre-Physician Assistant Pre-Occupation Therapy Allied Health: Pre

  11. Dean's Office for Undergraduates and Student Advising General Academic Building, Room 220

    E-print Network

    -Dental Hygiene Pre-Respiratory Therapy Office Directory Name Location Phone Web Address Dean's Office-Professional: Pre-Medical Pre-Physical Therapy Pre-Dental Pre-Optometry Pre-Veterinary Pre-Podiatry Pre-Physician Assistant Pre-Occupation Therapy Allied Health: Pre-Chiropractic Pre-Pharmacy Pre-Nutrition Pre-Nursing Pre

  12. Spinal Manipulation for Low-Back Pain

    MedlinePLUS

    ... NCCIH fact sheet Chiropractic: An Introduction . What the Science Says About Spinal Manipulation for Low-Back Pain Overall, studies have shown that spinal manipulation is one of several options—including exercise, massage, and physical therapy—that can provide mild- ...

  13. 34 CFR 668.2 - General definitions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ) National Science and Mathematics Access to Retain Talent Grant...life, or computer sciences, mathematics, technology, or engineering...D.M.D.), Veterinary Medicine (D.V.M.), Chiropractic...L.L.B. or J.D.), Medicine (M.D.),...

  14. 34 CFR 668.2 - General definitions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ) National Science and Mathematics Access to Retain Talent Grant...life, or computer sciences, mathematics, technology, or engineering...D.M.D.), Veterinary Medicine (D.V.M.), Chiropractic...L.L.B. or J.D.), Medicine (M.D.),...

  15. 34 CFR 668.2 - General definitions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... ) National Science and Mathematics Access to Retain Talent Grant...life, or computer sciences, mathematics, technology, or engineering...D.M.D.), Veterinary Medicine (D.V.M.), Chiropractic...L.L.B. or J.D.), Medicine (M.D.),...

  16. 34 CFR 668.2 - General definitions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... ) National Science and Mathematics Access to Retain Talent Grant...life, or computer sciences, mathematics, technology, or engineering...D.M.D.), Veterinary Medicine (D.V.M.), Chiropractic...L.L.B. or J.D.), Medicine (M.D.),...

  17. 34 CFR 668.2 - General definitions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... ) National Science and Mathematics Access to Retain Talent Grant...life, or computer sciences, mathematics, technology, or engineering...D.M.D.), Veterinary Medicine (D.V.M.), Chiropractic...L.L.B. or J.D.), Medicine (M.D.),...

  18. Bodywork Abstracts. 1989 Edition.

    ERIC Educational Resources Information Center

    van Why, Richard P., Comp.

    This comprehensive bibliography of research and writings on massage therapy for chronic illness, disabilities, and general health, is addressed to students of therapeutic bodywork, massage therapists, osteopathic and chiropractic physicians, as well as schools and research centers for health professionals. The work draws its citations from…

  19. Shades of Grey: An Exploration of the Student Learning Experience in Diagnostic Imaging Education

    ERIC Educational Resources Information Center

    Linaker, Kathleen Linda

    2012-01-01

    Diagnostic radiology education is a specialty within healthcare education and encompasses education at both the undergraduate and resident level. There is little research regarding what constitutes effective radiology education. The broad purpose of this study was to investigate through the student perspective how chiropractic students learned…

  20. Wm. Lloyd Stackhouse & Robert E. Kinsman: A tale of two chiropractors

    PubMed Central

    Brown, Douglas M.

    2013-01-01

    This paper reviews the story of two childhood friends, Dr. Wm. Lloyd Stackhouse and Dr. Robert E. Kinsman, who attended the Canadian Memorial Chiropractic College (CMCC) together, graduated in 1953 to form an enduring partnership that included their immediate relatives, and to this day persists as a supportive tribe. PMID:23997249

  1. 42 CFR 60.5 - Who is an eligible student borrower?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Medicine or equivalent degree Bachelor or Master of Science in Pharmacy or equivalent degree Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree in Clinical...)(1) In the case of a pharmacy student, he or she must have satisfactorily completed 3 years...

  2. 42 CFR 60.5 - Who is an eligible student borrower?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Medicine or equivalent degree Bachelor or Master of Science in Pharmacy or equivalent degree Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree in Clinical...)(1) In the case of a pharmacy student, he or she must have satisfactorily completed 3 years...

  3. 42 CFR 60.5 - Who is an eligible student borrower?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Medicine or equivalent degree Bachelor or Master of Science in Pharmacy or equivalent degree Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree in Clinical...)(1) In the case of a pharmacy student, he or she must have satisfactorily completed 3 years...

  4. 42 CFR 60.5 - Who is an eligible student borrower?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Medicine or equivalent degree Bachelor or Master of Science in Pharmacy or equivalent degree Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree in Clinical...)(1) In the case of a pharmacy student, he or she must have satisfactorily completed 3 years...

  5. PRE-MEDICAL PROFESSIONS Medical professional schools

    E-print Network

    PRE-MEDICAL PROFESSIONS Medical professional schools encourage students to develop the broadest requirements required for application to the following medical professional schools include: chiropractic medicine programs, as well as other programs in the medical field. A Bachelor's degree is required

  6. Nutritional intervention for cancer minimization

    PubMed Central

    Jamison, Jennifer R

    1987-01-01

    Diet has been linked to the pathogenesis of one in three cancers. Cancer remains a leading cause of death in contemporary society. Alteration to dietary habits may be helpful in reducing an individual’s risk of neoplasia. This paper examines how nutritional advice may be used as a cancer preventive measure in chiropractic clinics.

  7. 78 FR 74229 - Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, Clinical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-10

    ....Dennis@ cms.hhs.gov , for issues related to therapy caps. Darlene Fleischmann, (410) 786-2357 or cms.hhs... Physician Fee Schedule I. Therapy Caps J. Requirements for Billing ``Incident to'' Services K. Chronic Care... center CMT Chiropractic manipulative treatment CORF Comprehensive outpatient rehabilitation facility...

  8. Integrating naturopathy: can we move forward?

    PubMed

    Elder, Charles R

    2013-01-01

    Although acupuncture and chiropractic care have achieved some measure of acceptance within mainstream medicine, the integrative role for naturopathy has yet to be well specified. This essay provides a discussion of the potential benefits of naturopathic medicine, as well as an overview of current obstacles to its integration. Action steps toward improving communication between allopathic and naturopathic physicians are suggested. PMID:24361025

  9. Integrating Naturopathy: Can We Move Forward?

    PubMed Central

    Elder, Charles R

    2013-01-01

    Although acupuncture and chiropractic care have achieved some measure of acceptance within mainstream medicine, the integrative role for naturopathy has yet to be well specified. This essay provides a discussion of the potential benefits of naturopathic medicine, as well as an overview of current obstacles to its integration. Action steps toward improving communication between allopathic and naturopathic physicians are suggested. PMID:24361025

  10. Use of Complementary Medicine in Older Americans: Results from the Health and Retirement Study

    PubMed Central

    Ness, Jose; Cirillo, Dominic J.; Weir, David R.; Nisly, Nicole L.; Wallace, Robert B.

    2006-01-01

    Purpose The correlates of Complementary and Alternative Medicine (CAM) utilization among elders have not been fully investigated. This study was designed to identify such correlates in a large sample of older adults, thus generating new data relevant to consumer education, medical training and health practice and policy. Design and Methods A subsample from the 2000 wave of the Health and Retirement Study (n=1099) aged 52 or older were surveyed regarding use of CAM (chiropractic, alternative practitioners, dietary and herbal supplements, and personal practices). Results 88% of respondents over 65 years used CAM, with dietary supplements and chiropractic most commonly reported (65% and 46%, respectively). Users of alternate practitioners and dietary supplements reported having more out-of-pocket expenses on health than non-users of these modalities. Age correlated positively with use of dietary supplements and personal practices and inversely with alternative practitioner use. Men reported less CAM use than women, except for chiropractic and personal practices. Blacks and Hispanics used less chiropractic and dietary supplements, but reported more personal practices than Caucasians. Advanced education correlated with fewer chiropractic visits and more dietary and herbal supplement and personal practices use. Higher income, functional impairment, alcohol use and frequent physician visits correlated with more alternative practitioner use. There was no association between CAM and number of chronic diseases. Implications The magnitude and patterns of CAM use among elders lend considerable importance to this field in public health policy-making and suggest a need for further epidemiological research and ongoing awareness efforts for both patients and providers. PMID:16051914

  11. A replication of the study ‘Adverse effects of spinal manipulation: a systematic review’

    PubMed Central

    2012-01-01

    Objective To assess the significance of adverse events after spinal manipulation therapy (SMT) by replicating and critically reviewing a paper commonly cited when reviewing adverse events of SMT as reported by Ernst (J Roy Soc Med 100:330–338, 2007). Method Replication of a 2007 Ernst paper to compare the details recorded in this paper to the original source material. Specific items that were assessed included the time lapse between treatment and the adverse event, and the recording of other significant risk factors such as diabetes, hyperhomocysteinemia, use of oral contraceptive pill, any history of hypertension, atherosclerosis and migraine. Results The review of the 32 papers discussed by Ernst found numerous errors or inconsistencies from the original case reports and case series. These errors included alteration of the age or sex of the patient, and omission or misrepresentation of the long term response of the patient to the adverse event. Other errors included incorrectly assigning spinal manipulation therapy (SMT) as chiropractic treatment when it had been reported in the original paper as delivered by a non-chiropractic provider (e.g. Physician). The original case reports often omitted to record the time lapse between treatment and the adverse event, and other significant clinical or risk factors. The country of origin of the original paper was also overlooked, which is significant as chiropractic is not legislated in many countries. In 21 of the cases reported by Ernst to be chiropractic treatment, 11 were from countries where chiropractic is not legislated. Conclusion The number of errors or omissions in the 2007 Ernst paper, reduce the validity of the study and the reported conclusions. The omissions of potential risk factors and the timeline between the adverse event and SMT could be significant confounding factors. Greater care is also needed to distinguish between chiropractors and other health practitioners when reviewing the application of SMT and related adverse effects. PMID:22998971

  12. Joshua N Haldeman, DC: the Canadian Years, 1926-1950

    PubMed Central

    Keating, Joseph C; Haldeman, Scott

    1995-01-01

    Born in 1902 to the earliest chiropractor known to practice in Canada, Joshua Norman Haldeman would develop national and international stature as a political economist, provincial and national professional leader, and sportsman/adventurer. A 1926 graduate of the Palmer School of Chiropractic, he would maintain a lifelong friendship with B.J. Palmer, and served in the late 1940s as Canada’s representative to the Board of Control of the International Chiropractors’ Association. Yet, he would also maintain strong alliances with broad-scope leaders in Canada and the United States, including the administrators of the National and Lincoln chiropractic schools. Haldeman, who would practice chiropractic in Regina for at least 15 years, was instrumental in obtaining, and is credited with composing the wording of, Saskatchewan’s 1943 Chiropractic Act. He served on the province’s first board of examiners and the provincial society’s first executive board. The following year Dr. Haldeman represented Saskatchewan in the deliberations organized by Walter Sturdy, D.C. that gave rise to the Dominion Council of Canadian Chiropractors, forerunner of today’s Canadian Chiropractic Association. As a member of the Dominion Council he fought for inclusion of chiropractors as commissioned officers during World War II, and participated in the formation of the Canadian Memorial Chiropractic College, which he subsequently served as a member of the first board of directors. Dr. Haldeman also earned a place in the political history of Canada, owing to his service as research director for Technocracy, Inc. of Canada, his national chairmanship of the Social Credit Party during the second world war, and his unsuccessful bid for the national parliament. His vocal opposition to Communism during the war briefly landed him in jail. His 1950 relocation of his family and practice to Pretoria, South Africa would open a new page in his career: once again as professional pioneer, but also as aviator and explorer. Although he died in 1974, the values he instilled in his son, Scott Haldeman, D.C., Ph.D., M.D. continue to influence the profession. ImagesFigure 1Figure 2Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10

  13. Collaborative care for a patient with complex low back pain and long-term tobacco use: a case report

    PubMed Central

    Seidman, Michael B.; Vining, Robert D.; Salsbury, Stacie A.

    2015-01-01

    Few examples of interprofessional collaboration by chiropractors and other healthcare professionals are available. This case report describes an older adult with complex low back pain and longstanding tobacco use who received collaborative healthcare while enrolled in a clinical trial. This 65 year-old female retired office worker presented with chronic back pain. Imaging findings included disc extrusion and spinal stenosis. Multiple co-morbidities and the complex nature of this case substantiated the need for multidisciplinary collaboration. A doctor of chiropractic and a doctor of osteopathy provided collaborative care based on patient goal setting and supported by structured interdisciplinary communication, including record sharing and telephone consultations. Chiropractic and medical interventions included spinal manipulation, exercise, tobacco reduction counseling, analgesic use, nicotine replacement, dietary and ergonomic recommendations, and stress reduction strategies. Collaborative care facilitated active involvement of the patient and resulted in decreased radicular symptoms, improvements in activities of daily living, and tobacco use reduction. PMID:26500355

  14. Successful management of acute-onset torticollis in a giraffe (Giraffa camelopardalis reticulata).

    PubMed

    Dadone, Liza I; Haussler, Kevin K; Brown, Greg; Marsden, Melanie; Gaynor, James; Johnston, Matthew S; Garelle, Della

    2013-03-01

    A 2-yr-old male reticulated giraffe (Giraffa camelopardalis reticulata) presented with severe midcervical segmental torticollis upon arrival as an incoming shipment. Despite initial medical management, the giraffe developed marked neck sensitivity, focal muscle spasms, and decreased cervical range of motion. Using operant conditioning to assist patient positioning and tolerance to cervical manipulation, a series of manually applied chiropractic treatments were applied to the affected cervical vertebrae in an effort to restore normal cervical mobility. Laser therapy and cervical range of motion exercises were also used to reduce cervical muscle hypertonicity. The combined application of these nontraditional therapies produced marked clinical improvement. This case highlights the potential benefits of combining traditional medical management with chiropractic treatment and physical therapy techniques for management of severe acute-onset torticollis in a giraffe. PMID:23505724

  15. Defining Quackery: An examination of the Manitoba Medical Profession and the early development of professional unity

    PubMed Central

    Scalena, Adam

    2006-01-01

    In the early 1920s, the Manitoba medical profession reached a pinnacle in its opposition to alternative medicine, waging an aggressive four-year campaign against chiropractic and osteopathy to “protect” the public from the dangers of alternative forms of healing and prevent “irregulars” from establishing their practices. It was during these same years that the Manitoba medical profession was able to successfully overcome many internal problems of consensus and external problems of legitimacy. Examining the years leading up to, during, and following the campaign, this paper demonstrates how the Manitoba medical profession’s militant reaction to osteopathy and chiropractic during these years helped strengthen and differentiate orthodox practitioners as a group, thus reinforcing their authority within the public realm. PMID:17549158

  16. Beyond the Spine: A New Clinical Research Priority

    PubMed Central

    Donovan, James; Cassidy, J. David; Cancelliere, Carol; Poulsen, Erik; Stochkendahl, Mette Jensen; Kilsgaard, Jørgen; Blanchette, Marc-André; Hartvigsen, Jan

    2015-01-01

    Over the past two decades, clinical research within the chiropractic profession has focused on the spine and spinal conditions, specifically neck and low back pain. However, there is now a small group of chiropractors with clinical research training that are shifting their focus away from traditional research pursuits towards new and innovative areas. Specifically, these researchers are now delving into areas such as brain injury, work disability prevention, undifferentiated chest pain, hip osteoarthritis, and prevention of pain in children and adolescents to name a few. In this paper, we highlight recent research in these new areas and discuss how clinical research efforts in musculoskeletal areas beyond the spine can benefit patient care and the future of the chiropractic profession. PMID:25729080

  17. Learning From a Lifetime of Leading Effective Change

    PubMed Central

    Johnson, Claire; Clum, Gerard; Lassiter, Wright L.; Phillips, Reed; Sportelli, Louis; Hunter, James C.

    2014-01-01

    Objective The purpose of this article is to report on the opening plenary session of the Association of Chiropractic Colleges Educational Conference—Research Agenda Conference (ACC-RAC) 2014, “Aiming for Effective Change: Leadership in Chiropractic Education, Research and Clinical Practice.” Discussion Speakers with extensive backgrounds with implementing substantial change on a broad level shared personal examples from their experiences in education, research, political organizations, and clinical practice. They described efforts, challenges, and opportunities that are encountered in order to implement effective change and shared their personal thoughts on leadership. Conclusion Each of the speakers shared their diverse, unique insights and personal experiences to convey the process and meaning of leadership. PMID:25431543

  18. Real-time force feedback during flexion-distraction procedure for low back pain: A pilot study

    PubMed Central

    Gudavalli, Maruti Ram; Cox, James M.

    2014-01-01

    A form of chiropractic procedure known as Cox flexion-distraction is used by chiropractors to treat low back pain. Patient lies face down on a specially designed table having a stationery thoracic support and a moveable caudal support for the legs. The Doctor of Chiropractic (DC) holds a manual contact applying forces over the posterior lumbar spine and press down on the moving leg support to create traction effects in the lumbar spine. This paper reports on the development of real-time feedback on the applied forces during the application of the flexion-distraction procedure. In this pilot study we measured the forces applied by experienced DCs as well as novice DCs in using this procedure. After a brief training with real-time feedback novice DCs have improved on the magnitude of the applied forces. This real-time feedback technology is promising to do systematic studies in training DCs during the application of this procedure. PMID:24932023

  19. Chiropractors as Primary Spine Care Providers: precedents and essential measures.

    PubMed

    Erwin, W Mark; Korpela, A Pauliina; Jones, Robert C

    2013-12-01

    Chiropractors have the potential to address a substantial portion of spinal disorders; however the utilization rate of chiropractic services has remained low and largely unchanged for decades. Other health care professions such as podiatry/chiropody, physiotherapy and naturopathy have successfully gained public and professional trust, increases in scope of practice and distinct niche positions within mainstream health care. Due to the overwhelming burden of spine care upon the health care system, the establishment of a 'primary spine care provider' may be a worthwhile niche position to create for society's needs. Chiropractors could fulfill this role, but not without first reviewing and improving its approach to the management of spinal disorders. Such changes have already been achieved by the chiropractic profession in Switzerland, Denmark, and New Mexico, whose examples may serve as important templates for renewal here in Canada. PMID:24302774

  20. Adverse effects potentially associated with the use of mechanical adjusting devices: a report of three cases

    PubMed Central

    Nykoliation, Jim; Mierau, Dale

    1999-01-01

    As the popularity of mechanical adjusting devices (MADs) increases within the chiropractic profession, it is evident that adverse effects associated with the provision of this intervention can occur. This paper describes three such cases, along with a discussion about their circumstances. The use of MADs may cause both direct and indirect complications for chiropractic patients. The notion that MADs might be safer than conventional articular manipulation procedures might not be accurate. The use of improper force by the practitioner, and/or the lack of a “fail-safe” mechanism on the MAD might contribute to adverse effects and/or injuries from MADs. These findings should not be interpreted as conclusive because they are based on a small number of case reports.

  1. Innate intelligence: its origins and problems

    PubMed Central

    Morgan, Lon

    1998-01-01

    Animal Magnetism and Radionics were among several occult practices used during the 19th century for the treatment of disease. D.D. Palmer was exposed to these teachings and derived many of his ideas about health from the folk medicine practices of his time. As a ‘magnetic healer’ Palmer believed he was correcting an undefined fifth force in the body that is otherwise unknown to science. Palmer believed he could influence this fifth force, termed Innate Intelligence, and that it was the explanation for the presence or absence of health. Today, Innate Intelligence remains an untestable enigma that isolates chiropractic and impedes its acceptance as a legitimate health science. The concept of Innate is derived directly from the occult practices of another era. It carries a high penalty in divisiveness and lack of logical coherence. The chiropractic profession must decide whether the concept of Innate should be retained.

  2. Chiropractors as Primary Spine Care Providers: precedents and essential measures

    PubMed Central

    Erwin, W. Mark; Korpela, A. Pauliina; Jones, Robert C.

    2013-01-01

    Chiropractors have the potential to address a substantial portion of spinal disorders; however the utilization rate of chiropractic services has remained low and largely unchanged for decades. Other health care professions such as podiatry/chiropody, physiotherapy and naturopathy have successfully gained public and professional trust, increases in scope of practice and distinct niche positions within mainstream health care. Due to the overwhelming burden of spine care upon the health care system, the establishment of a ‘primary spine care provider’ may be a worthwhile niche position to create for society’s needs. Chiropractors could fulfill this role, but not without first reviewing and improving its approach to the management of spinal disorders. Such changes have already been achieved by the chiropractic profession in Switzerland, Denmark, and New Mexico, whose examples may serve as important templates for renewal here in Canada. PMID:24302774

  3. Pain Research in Complementary and Alternative Medicine in Australia: A Critical Review

    PubMed Central

    Xue, Charlie C.L.

    2013-01-01

    Abstract Background Sixty percent (60%) to 80% of patients who visit chiropractic, osteopathic, or Chinese medicine practitioners are seeking pain relief. Objectives This article aimed to identify the amount, quality, and type of complementary and alternative medicine (CAM) pain research in Australia by systematically and critically reviewing the literature. Methods PubMed, Scopus, Australasian Medical Index, and Cochrane library were searched from their inception to July 2009. Australian and New Zealand Clinical Trial Registration and National Health and Medical Research Council databases were searched for human studies yet to be completed. Predefined search terms and selection criteria were used for data identification. Results Of 204 studies selected, 54% were on chiropractic, 27% on Chinese medicine, 15% about multitherapy, and 4% on osteopathy. Chronic spinal pain was the most studied condition, with visceral pain being the least studied. Half of the articles in Chinese medicine or multitherapy were systematic reviews or randomized control trials. In comparison, only 5% of chiropractic and none of osteopathy studies were in these categories. Government funding was rare, and most studies were self-funded or internally funded. All chiropractic, osteopathic, and Chinese herbal medicine studies were conducted by the researchers of the professions. In contrast, half of the acupuncture studies and all t'ai chi studies were conducted by medical doctors or physiotherapists. Multidisciplinary collaboration was uncommon. Conclusions The quantity and the quality of CAM pain research in Australia are inconsistent with the high utilization of the relevant CAM therapies by Australians. A substantial increase in government funding is required. Collaborative research examining the multimodality or multidisciplinary approach is needed. PMID:22891634

  4. Therapeutic interventions employed by Greater Toronto Area chiropractors on pregnant patients: results of a cross-sectional online survey

    PubMed Central

    Yuen, Tammy; Wells, Kayla; Benoit, Samantha; Yohanathan, Sahila; Capelletti, Lauren; Stuber, Kent

    2013-01-01

    Introduction: Due to different biomechanical, nutritional, and hormonal considerations, it is possible that chiropractors may employ different therapeutic interventions and recommendations for pregnant patients than non-pregnant ones. The objective of this study was to determine the therapeutic interventions that chiropractors who are members of the Ontario Chiropractic Association in the Greater Toronto Area most commonly provide to pregnant patients. Methods: An introductory e-mail was sent in October 2011 to 755 members of the Ontario Chiropractic Association within the Greater Toronto Area five days prior to a 15 question survey being distributed via e-mail. Reminder e-mails were sent 13 days and 27 days later. Using descriptive statistics, demographic information was reported along with reported use of different treatments and recommendations for pregnant patients Results: A response rate of 23% was obtained. The majority of the respondents (90%) reported using the Diversified technique on pregnant patients, followed by soft tissue therapy (62%) and Activator (42%). The most common adjunctive therapy recommended to pregnant patients was referral to massage therapy (90%). Most of the respondents (92%) indicated that they prescribe stretching exercises to pregnant patients and recommend a multivitamin (84%) or folic acid (81%) to pregnant patients. Conclusion: In agreement with previous research on chiropractic technique usage on non-pregnant patients, the majority of respondents indicated treating pregnant patients with the Diversified technique, with other chiropractic techniques being utilized at varying rates on pregnant patients. Most respondents indicated prescribing exercise, and making adjunctive and nutritional recommendations frequently for their pregnant patients. PMID:23754858

  5. Spinal manipulation under anesthesia: a narrative review of the literature and commentary

    PubMed Central

    2013-01-01

    As exhibited throughout the medical literature over many decades, there is a lack of uniformity in the manner in which spine pain patients have historically qualified for and received manipulation under anesthesia (MUA). Also, for different professions that treat the same types of spinal conditions via the same means, fundamental MUA decision points vary within the published protocols of different professional associations. The more recent chiropractic literature communicates that the evidence to support the efficacy of MUA of the spine remains largely anecdotal. In addition, it has been reported that the types of spinal conditions most suitable for MUA are without clear-cut consensus, with various indications for MUA of the low back resting wholly upon the opinions and experiences of MUA practitioners. This article will provide a narrative review of the MUA literature, followed by a commentary about the current lack of high quality research evidence, the anecdotal and consensus basis of existing clinical protocols, as well as related professional, ethical and legal concerns for the chiropractic practitioner. The limitations of the current medical literature related to MUA via conscious/deep sedation need to be recognized and used as a guide to clinical experience when giving consideration to this procedure. More research, in the form of controlled clinical trials, must be undertaken if this procedure is to remain a potential treatment option for chronic spine pain patients in the chiropractic clinical practice. PMID:23672974

  6. Cranial Treatment and Spinal Manipulation for a Patient With Low Back Pain: A Case Study

    PubMed Central

    Powell, Wayne; Knaap, Simone F.C.

    2015-01-01

    Objective The purpose of this case study is to present chiropractic management of a patient with chronic low back pain by focusing on the craniomandibular system. Clinical Features A 37-year-old man consulted a chiropractor for pain in the lumbosacral area with radiation down the anterolateral side of the upper left leg. The symptoms started after a fall the previous year. Examination showed a post-traumatic chronic L4-L5 facet dysfunction and left sacro-iliac joint dysfunction. Chiropractic spinal manipulation to the lumbar spine and pelvis gave only temporary relief from the pain. Intervention and Outcome A year later a bone scintigraphy was conducted, in which a lesion was found over the right sphenoid area. Cranial treatment of this area was added to the chiropractic treatment plan. After this treatment, the patient reported that he was pain free and could return to normal activities of daily living. Conclusion The clinical progress of this case suggests that for some patients, adding craniosacral therapy may be helpful in patients with low back symptoms. PMID:26644786

  7. Use of Provider-Based Complementary and Alternative Medicine by Adult Smokers in the United States: Comparison From the 2002 and 2007 NHIS Survey

    PubMed Central

    Hamm, Eric; Muramoto, Myra L.; Howerter, Amy; Floden, Lysbeth; Govindarajan, Lubna

    2015-01-01

    Purpose To provide a snapshot of provider-based complementary and alternative medicine (pbCAM) use among adult smokers and assess the opportunity for these providers to deliver tobacco cessation interventions. Design Cross-sectional analysis of data from the 2002 and 2007 National Health Interview Surveys. Setting Nationally representative sample. Subjects A total of 54,437 (31,044 from 2002; 23,393 from 2007) adults 18 years and older. Measures The analysis focuses on 10 types of pbCAM, including acupuncture, Ayurveda, biofeedback, chelation therapy, chiropractic care, energy therapy, folk medicine, hypnosis, massage, and naturopathy. Analysis The proportions of current smokers using any pbCAM as well as specific types of pbCAM in 2002 and 2007 are compared using SAS SURVEYLOGISTIC. Results Between 2002 and 2007, the percentage of recent users of any pbCAM therapy increased from 12.5% to 15.4% (p = .001). The largest increases occurred in massage, chiropractic, and acupuncture. Despite a decrease in the national average of current smokers (22.0% to 19.4%; p = .001), proportions of smokers within specific pbCAM disciplines remained consistent. Conclusion Complementary and alternative medicine (CAM) practitioners, particularly those in chiropractic, acupuncture, and massage, represent new cohorts in the health care community to promote tobacco cessation. There is an opportunity to provide brief tobacco intervention training to CAM practitioners and engage them in public health efforts to reduce the burden of tobacco use in the United States. PMID:24359177

  8. Manual therapy as a conservative treatment for adolescent idiopathic scoliosis: a systematic review

    PubMed Central

    Romano, Michele; Negrini, Stefano

    2008-01-01

    Background The treatment of adolescent idiopathic scoliosis is contingent upon many variables. Simple observation is enough for less serious curvatures, but for very serious cases surgical intervention could be proposed. Between these there is a wide range of different treatments. Manual therapy is commonly used: the aim of this paper is to verify the data existing in the literature on the efficacy of this approach. Methods A systematic review of the scientific literature published internationally has been performed. We have included in the term manual therapy all the manipulative and generally passive techniques performed by an external operator. In a more specific meaning, osteopathic, chiropractic and massage techniques have been considered as manipulative therapeutic methods. We performed our systematic research in Medline, Embase, Cinhal, Cochrane Library, Pedro with the following terms: idiopathic scoliosis combined with chiropractic; manipulation; mobilization; manual therapy; massage; osteopathy; and therapeutic manipulation. The criteria for inclusion were as follows: Any kind of research; diagnosis of adolescent idiopathic scoliosis; patients treated exclusively by one of the procedures established as a standard for this review (chiropractic manipulation, osteopathic techniques, massage); and outcome in Cobb degrees. Results We founded 145 texts, but only three papers were relevant to our study. However, no one of the three satisfied all the required inclusion criteria because they were characterized by a combination of manual techniques and other therapeutic approaches. Conclusion The lack of any kind of serious scientific data does not allow us to draw any conclusion on the efficacy of manual therapy as an efficacious technique for the treatment of Adolescent idiopathic scoliosis. PMID:18211702

  9. Femoral neck stress fracture in a female athlete: a case report

    PubMed Central

    Avrahami, Daniel; Pajaczkowski, Jason A.

    2012-01-01

    Objective The purpose of this case report is to describe chiropractic rehabilitation of a master's-level athlete with proximal femoral stress fracture and provide a brief discussion of stress fracture pathology. Clinical Features A 41-year-old female master's-level endurance athlete presented with chronic groin pain later diagnosed and confirmed by magnetic resonance imaging as a stress fracture of the femoral neck. After diagnosis, the patient was referred to a doctor of chiropractic at week 1 of the non–weight-bearing physical rehabilitation process. At that time, the patient presented with sharp and constant groin pain rated 6/10 on a numeric rating scale. Intervention and Outcome This patient avoided weight-bearing activity for 8 weeks while cross-training and was able to return to her sport after this period. The patient was progressed through a series of non–weight-bearing strengthening exercises for the lower extremity. Myofascial release therapy was performed on the gluteal, hip flexor, and groin muscle groups to improve range of motion. Motion palpation testing the lumbar and sacroiliac joints was performed during each session, and manipulative therapy was performed when necessary. The patient was seen once a week for 8 weeks. Reevaluation was performed at week 8; at that time, the patient reported no groin pain (0/10). The patient was discharged from care and referred back to the supervising physician for clearance to return to sporting activities. One month after discharge, she reported that she was pain free and had fully returned to sport activities. Conclusion This case report demonstrates the importance of a through clinical history, physical examination, and magnetic resonance imaging in the accurate diagnosis of a patient with chronic groin pain and that chiropractic care can contribute to rehabilitation programs for these injuries. PMID:23843760

  10. Complementary health care services: a survey of general practitioners' views.

    PubMed Central

    Goldszmidt, M; Levitt, C; Duarte-Franco, E; Kaczorowski, J

    1995-01-01

    OBJECTIVE: To determine the referral practices, perceived usefulness, knowledge, prior training and desire for training of general practitioners (GPs) in Quebec with regard to complementary health care services such as acupuncture, chiropractic and hypnosis. DESIGN: Cross-sectional mail survey. SETTING: Province of Quebec. PARTICIPANTS: Random sample of 200 GPs. Of the 146 who responded, 25 were excluded because they were no longer in practice; this left 121 (83%). OUTCOME MEASURES: Self-reported referral practices for complementary health care services, perceived usefulness and self-assessed knowledge of such services, and prior training and desire for training in these services. RESULTS: Sixty percent (72/121) of the GPs knew at least one practitioner of a complementary health care service for referral; 59% (70/119) reported referring patients to physicians who practise such services and 68% (80/118) to nonmedical practitioners. At least one of the three services studied were regarded as having some use by 83% (101/121). Overall, self-reported knowledge was poor: the proportions of GPs who reported knowing a lot about acupuncture, chiropractic and hypnosis were 11% (13/121), 10% (12/121) and 8% (10/121) respectively. Prior training was also lacking: only 8% (9/118) of the GPs had received previous training in acupuncture, 2% (2/111) in chiropractic and 3% (3/103) in hypnosis. In all, 48% (57/118) indicated that they would like further training in at least one of the services studied, and 13% (16/121) indicated that they currently provided one service. CONCLUSIONS: Referral of patients by GPs to practitioners of complementary health care services is common in Quebec. Although self-assessed knowledge about such services is relatively poor, interest in learning more about them is high. These findings identify a demand for future educational initiatives. PMID:7796373

  11. Effect of Sampling Rates on the Quantification of Forces, Durations, and Rates of Loading of Simulated Side Posture High-Velocity, Low-Amplitude Lumbar Spine Manipulation?

    PubMed Central

    Gudavalli, Maruti Ram; DeVocht, James; Tayh, Ali; Xia, Ting

    2013-01-01

    Objective Quantification of chiropractic high-velocity, low-amplitude spinal manipulation (HVLA-SM) may require biomechanical equipment capable of sampling data at high rates. However, there are few studies reported in the literature regarding the minimal sampling rate required to record the HVLA-SM force-time profile data accurately and precisely. The purpose of this study was to investigate the effect of different sampling rates on the quantification of forces, durations, and rates of loading of simulated side posture lumbar spine HVLA-SM delivered by doctors of chiropractic. Methods Five doctors of chiropractic (DCs) and 5 asymptomatic participants were recruited for this study. Force-time profiles were recorded during (i) 52 simulated HVLA-SM thrusts to a force transducer placed on a force plate by 2 DCs and (ii) 12 lumbar side posture HVLA-SM on 5 participants by 3 DCs. Data sampling rate of the force plate remained the same at 1000 Hz, whereas the sampling rate of the force transducer varied at 50, 100, 200, and 500 Hz. The data were reduced using custom-written MATLAB (Mathworks, Inc, Natick, MA) and MathCad (version 15; Parametric Technologies, Natick, MA) programs and analyzed descriptively. Results The average differences in the computed durations and rates of loading are smaller than 5% between 50 and 1000 Hz sampling rates. The differences in the computed preloads and peak loads are smaller than 3%. Conclusions The small differences observed in the characteristics of force-time profiles of simulated manual HVLA-SM thrusts measured using various sampling rates suggest that a sampling rate as low as 50 to 100 Hz may be sufficient. The results are applicable to the manipulation performed in this study: manual side posture lumbar spine HVLA-SM. PMID:23790603

  12. Chiropractors’ characteristics associated with their number of workers’ compensation patients

    PubMed Central

    Blanchette, Marc-André; Cassidy, J. David; Rivard, Michèle; Dionne, Clermont E.

    2015-01-01

    Study design: A cross-sectional survey. Objective: The purpose of this study was to identify characteristics of Canadian doctors of chiropractic (DCs) associated with their number of workers’ compensation patients. Summary of background data: It has been previously hypothesized that DCs that treat a relatively high volume of workers’ compensation cases may have different characteristics than the general chiropractic community. Methods: Secondary data analyses were performed on data collected in the 2011 survey of the Canadian Chiropractic Resources Databank (CCRD). The CCRD survey included 81 questions concerning the practice and concerns of DCs. Of the 6,533 mailed questionnaires, 2,529 (38.7%) were returned. Of these, 652 respondents did not meet our inclusion criteria, and our final study sample included 1,877 respondents. Bivariate analyses were conducted between predetermined independent variables and the annual number of workers’ compensation patients. A negative binomial multivariate regression was performed to identify significant factors associated with the number of workers’ compensation patients. Results: On average, DCs received 10.3 (standard deviation (SD) = 17.6) workers’ compensation cases and nearly one-third did not receive any such cases. The type of clinic (other than sole provider), practice area population (smaller than 500,000), practice province (other than Quebec), number of practice hours per week, number of treatments per week, main sector of activity (occupational/ industrial), care provided to patients (electrotherapy, soft-tissue therapy), percentage of patients with neuromusculoskeletal conditions, and percentage of patients referred by their employer or a physician were associated with a higher annual number of workers’ compensation cases. Conclusion: Canadian DCs who reported a higher volume of workers’ compensation patients had practices oriented towards the treatment of injured workers, collaborated with other health care providers, and facilitated workers’ access to care. PMID:26500354

  13. Subluxation: dogma or science?

    PubMed Central

    Keating, Joseph C; Charlton, Keith H; Grod, Jaroslaw P; Perle, Stephen M; Sikorski, David; Winterstein, James F

    2005-01-01

    Subluxation syndrome is a legitimate, potentially testable, theoretical construct for which there is little experimental evidence. Acceptable as hypothesis, the widespread assertion of the clinical meaningfulness of this notion brings ridicule from the scientific and health care communities and confusion within the chiropractic profession. We believe that an evidence-orientation among chiropractors requires that we distinguish between subluxation dogma vs. subluxation as the potential focus of clinical research. We lament efforts to generate unity within the profession through consensus statements concerning subluxation dogma, and believe that cultural authority will continue to elude us so long as we assert dogma as though it were validated clinical theory. PMID:16092955

  14. Pancreatic cancer and chronic thoracic back pain: a case report

    PubMed Central

    Yurkiw, Dennis J

    1995-01-01

    A male with persistent thoracic spine pain and clinical symptoms suggesting a more grave condition than mechanical back pain is presented. The patient had previously been attended to by a medical doctor and a chiropractor. The symptom picture and the ineffectiveness of previously administered chiropractic care suggests a medical referral with further investigation. The importance of history taking is emphasized. An accurate diagnosis and administration of the appropriate treatment is paramount because the prognosis of detected pancreatic cancer is poor. ImagesFigure 1Figure 2

  15. Abdominal aortic aneurysms: case report

    PubMed Central

    Hadida, Camille; Rajwani, Moez

    1998-01-01

    A 71-year-old male presented to a chiropractic clinic with subacute low back pain. While the pain appeared to be mechanical in nature, radiographic evaluation revealed an abdominal aortic aneurysm, which required the patient to have vascular surgery. This case report illustrates the importance of the history and physical examination in addition to a thorough knowledge of the features of abdominal aortic aneurysms. The application of spinal manipulative therapy in patients with (AAA) is also discussed. ImagesFigure 1Figure 2Figure 3

  16. Acute pancreatitis presenting as back pain: a case report

    PubMed Central

    Decina, Philip A; Vallee, Dwight; Mierau, Dale

    1992-01-01

    A man with acute back pain presented to a chiropractic clinic with clinical symptoms and signs suggesting abdominal disease rather than mechanical spine pain. He was referred to a local hospital emergency where a diagnosis of acute pancreatitis secondary to chronic cholecystitis was made. The diagnostic images are compared to normal studies. The characteristic clinical examination findings found with back pain due to acute pancreatitis are compared to those typically seen with mechanical spine pain. ImagesFigure 1Figure 2aFigure 2bFigure 3Figure 4aFigure 4bFigure 5aFigure 5b

  17. Use of McKenzie cervical protocol in the treatment of radicular neck pain in a machine operator

    PubMed Central

    Rathore, Sundeep

    2003-01-01

    A case of mechanical neck pain with radiation into the upper extremity in a 53-year-old man is presented. The use of standard chiropractic manipulative therapy was not an option due to patient apprehension. A reduction of symptoms was reported with certain spinal movements. This made the patient a candidate for the use of spinal loading strategies as described by McKenzie. The application of McKenzie cervical therapy resulted in improved symptoms and function in this individual. The McKenzie protocol, and its use in the management of neck pain, is discussed. ImagesFigure 1Figure 2Figure 3

  18. PubMed Central

    Kobrossi, T.; Steiman, I.

    1990-01-01

    A case is presented with clinical, thermographic and radiographic evaluations of concurrent dorsalgia and abdominal symptoms. The radiographs demonstrated the presence of a duodenal ulcer, and the thermographs were interpreted as confirming the presence of thoracic and abdominal dysfunction. The patient’s chiropractic management is outlined. The possible inter-relationship between the visceral pathology and spinal dysfunction is discussed. The case allows exploration of the unresolved issues of the clinical significance of somatovisceral/viscerosomatic reflex pathways and of their assessment by thermography. ImagesFigure 2Figure 2

  19. Alternative medicines for the geriatric veterinary patient.

    PubMed

    Kidd, J Randy

    2012-07-01

    Over the past several decades, alternative medicines have gained in popularity for use in both humans and animals. While they are not without controversy, client interest and usage dictate that even those practitioners who do not want to practice any of them in their own hospital or clinic should at least be aware of their common use, safety, and efficacy. The author briefly discusses some of the more popular alternative medicines—acupuncture, chiropractic, herbal, homeopathic, and flower essences—with respect to some of the basics that every practitioner should know about them. PMID:22720815

  20. Reimbursement for complimentary/alternative medicine by California HMOs.

    PubMed

    Hughes, A; Penner, M

    2001-01-01

    Beginning in the 1990s, researchers indicate a growing acceptance of complementary/alternative medicine in America. In this 1999 study, we surveyed California HMOs to determine the extent they reimburse for the following complementary/alternative therapies: nutrition counseling, chiropractic, acupuncture, massage and herbal medicine, as well as whether they require these providers to be licensed or otherwise credentialed. As hypothesized, California HMOs are more likely to reimburse for each of these therapies vs. an aggregate of 13 western U.S. states of which California is one. California's huge and competitive HMO market may be a factor. PMID:11813452

  1. An unusual case of vertebral arteriovenous fistula treated with electrodetachable coil embolization.

    PubMed

    Briganti, F; Tortora, F; Elefante, A; Volpe, A; Bruno, M C; Panagiotopoulos, K

    2004-12-01

    Vertebral arteriovenous fistulas (VAF) are rare clinical entities. Most are post-traumatic in origin, following direct injury, or iatrogenic. Treatment options include endovascular occlusion or direct surgical closure. We present a rare case of a spontaneous VAF, presenting with cervical and upper limb pain in a patient with previous chiropractic manipulations, successfully treated with electrodetachable coil embolization. While the natural history of the VAFs is still to be settled, endovascular occlusion appears to be a safe and reliable method to deal with such lesions, mainly in symptomatic cases. The use of electrically detachable coils may be considered as an effective alternative for the endovascular occlusion of these fistulas. PMID:15674760

  2. The perils of complementary alternative medicine.

    PubMed

    Bayme, Michael J; Geftler, Alex; Netz, Uri; Kirshtein, Boris; Glazer, Yair; Atias, Shahar; Perry, Zvi

    2014-07-01

    More than 11,000 articles lauding alternative medicine appear in the PubMed database, but there are only a few articles describing the complications of such care. Two patients suffering from complications of alternative medicine were treated in our hospital: one patient developed necrotizing fasciitis after acupuncture, and the second developed an epidural hematoma after chiropractic manipulation. These complications serve as a clarion call to the Israeli Health Ministry, as well as to health ministries around the world, to include complementary medicine under its inspection and legislative authority. PMID:25120919

  3. The Perils of Complementary Alternative Medicine

    PubMed Central

    Bayme, Michael J.; Geftler, Alex; Netz, Uri; Kirshtein, Boris; Glazer, Yair; Atias, Shahar; Perry, Zvi

    2014-01-01

    More than 11,000 articles lauding alternative medicine appear in the PubMed database, but there are only a few articles describing the complications of such care. Two patients suffering from complications of alternative medicine were treated in our hospital: one patient developed necrotizing fasciitis after acupuncture, and the second developed an epidural hematoma after chiropractic manipulation. These complications serve as a clarion call to the Israeli Health Ministry, as well as to health ministries around the world, to include complementary medicine under its inspection and legislative authority. PMID:25120919

  4. Robert Goddard Young, DC, ND: Searching for a better way.

    PubMed

    Brown, Douglas M

    2009-08-01

    This biographical study tracks the life of Robert Goddard Young; a member of the Canadian Memorial Chiropractic College's (CMCC) Class of 1950. The paper begins with an overview of Robert Young's origins, his childhood and early training, moves to his tour of duty in World War II, followed by his education at CMCC, before converging on the core of this matter; Robert Young's professional career, which spanned over half a century. Now in his twilight years, the paper ends with a discussion on the substance of Dr. Young's largely-forgotten contributions. PMID:19714235

  5. Campuses of the LACC.

    PubMed

    Siordia, Lawrence; Keating, Joseph C

    2005-06-01

    In its 94 years the Los Angeles College of Chiropractic (LACC) has occupied at least nine main campuses, exclusive of "satellite" facilities and the campuses of the dozen or more schools which have amalgamated with the LACC over the years. The longest serving of these properties have been in Glendale (1950-1981), Whittier (1981-present), and on Venice Boulevard in Los Angeles (1924-1950). This paper reviews these several locations and the efforts involved in acquiring and refurbishing them for College purposes. Additionally, we note two prospective campuses that never quite materialized: in Burbank, 1930 and in Los Gatos, 1975-76. PMID:17549200

  6. The role of alternative medicine in rhinology.

    PubMed

    Roehm, Corrie E; Tessema, Belachew; Brown, Seth M

    2012-02-01

    Complementary and alternative medicine (CAM) includes treatments from traditional Chinese medicine, homeopathy, naturopathy, herbal medicine, Ayurvedic medicine, mind-body medicine, chiropractic or osteopathic manipulations, and massage. More than 40% of patients in the United States use CAM, with 17% of CAM use related to otolaryngology diagnoses, but nearly half of CAM users do not communicate their use of these medications to their physicians. Perioperative risk of bleeding is a particular concern in surgical specialties, and knowledge of these therapies and their potential adverse effects is critical. PMID:22099619

  7. Regional Variation in Use of Complementary Health Approaches by U.S. Adults

    PubMed Central

    Peregoy, Jennifer A.; Clarke, Tainya C.; Jones, Lindsey I.; Stussman, Barbara J.; Nahin, Richard L.

    2015-01-01

    Complementary health approaches are defined as “a group of diverse medical and health care interventions, practices, products, or disciplines that are not generally considered part of conventional medicine” (1). They range from practitioner-based approaches, such as chiropractic manipulation and massage therapy, to predominantly self-care approaches, such as nonvitamin, nonmineral dietary supplements, meditation, and yoga. This report presents estimates of the four most commonly used complementary health approaches among adults aged 18 and over in nine geographic regions, using data from the 2012 National Health Interview Survey adult alternative medicine supplement (2). PMID:24750666

  8. Robert Goddard Young, DC, ND: Searching for a better way

    PubMed Central

    Brown, Douglas M.

    2009-01-01

    This biographical study tracks the life of Robert Goddard Young; a member of the Canadian Memorial Chiropractic College’s (CMCC) Class of 1950. The paper begins with an overview of Robert Young’s origins, his childhood and early training, moves to his tour of duty in World War II, followed by his education at CMCC, before converging on the core of this matter; Robert Young’s professional career, which spanned over half a century. Now in his twilight years, the paper ends with a discussion on the substance of Dr. Young’s largely-forgotten contributions. PMID:19714235

  9. Conservative treatment of a rock climber with a SLAP lesion: a case report

    PubMed Central

    Blanchette, Marc-André; Pham, Ai-Thu; Grenier, Julie-Marthe

    2015-01-01

    This case report describes the clinical presentation and conservative treatment of a patient who suffered from a superior labrum anteroposterior (SLAP) tear of the shoulder after a rock climbing session. The 26 year old man had injured his right shoulder while trying to reach a distant socket with his shoulder 90° abducted and in extreme external rotation. After initial treatment failure in chiropractic, the patient sought an orthopaedist and physiotherapy care. A contrast magnetic resonance examination revealed a SLAP lesion. Awaiting orthopaedic consultation and in the absence of clinical improvement the patient sought care from a second chiropractor. Clinical examination revealed a mild winging of the right scapula and the presence of trigger points in the rotator cuff muscles, biceps, rhomboids and serratus anterior. The chiropractic treatment then included soft tissue mobilization and the prescription of strengthening exercises of the serratus anterior and rotator cuff muscles. After 4 sessions, the patient did not feel any pain and gradually resumed all his recreational activities. Clinicians should be aware that SLAP lesions are difficult to identify clinically and that manual therapy might be an important component of conservative treatment of SLAP lesions. PMID:26500357

  10. Multimodal and interdisciplinary management of an isolated partial tear of the posterior cruciate ligament: a case report

    PubMed Central

    Fernandez, Matthew; Pugh, David

    2012-01-01

    Objective The purpose of this case report is to describe the evaluation and conservative management of an isolated posterior cruciate ligament (PCL) tear. Clinical Features A 32-year-old man with a traumatic right knee injury after tripping was initially diagnosed with medial patellar retinaculum tear at a multidisciplinary clinic. The patient received physiotherapy but reinjured the knee after returning to the sports field 3 weeks later. Subsequent clinical testing and magnetic resonance imaging confirmed a grade II isolated PCL tear. Intervention and Outcome Following the PCL tear diagnosis, a multimodal treatment approach over the course of 8 weeks consisting of chiropractic lumbopelvic manipulation, physiotherapy, and an exercise program emphasizing eccentric muscle action was implemented. Lunges, 1-leg squats, and trunk stabilization exercises were extensively used. Three months postinjury, the patient successfully returned to sports activity with no further complications. Conclusion The patient in this case report demonstrated successful return to preinjury functional status. This case highlights a multidisciplinary approach through the utilization of chiropractic, physiotherapy, and exercise therapies. PMID:23204951

  11. Diagnosis, management and post-surgical rehabilitation of an Achilles tendon rupture: a case report

    PubMed Central

    Ramelli, Frank D.

    2003-01-01

    Chiropractors, as primary contact practitioners, assess a wide variety of musculoskeletal related complaints. Among these, a certain percentage of patients, generally small, will present for assessment and treatment of extremity injuries. Spontaneous Achilles tendon rupture (ATR), although a relatively common extremity injury, can sometimes present as a clinical diagnostic challenge. Failure to establish an early diagnosis and immediate referral for further assessment and appropriate rehabilitation can impair recovery, decrease functional capacity and increase the rate of re-rupture. The author presents the case of a 25-year-old male presenting to a chiropractic office for assessment, treatment and rehabilitation of an acute left ATR. Physical examination characteristically reveals swelling, tenderness, loss of true gastrocnemius and soleus resisted plantar flexion, weak or absent Achilles reflex, a palpable gap in the tendon and a positive Thompson test. The challenge associated with the diagnosis of an ATR is discussed. The debate surrounding surgical versus conservative management of this condition is compared. Chiropractic treatment, case management and rehabilitation protocols are reviewed and highlighted. ImagesFigure 1Figure 2

  12. Interactive Atlas of Histology

    PubMed Central

    Goubran, Emile Z.; Vinjamury, Sivarama P.

    2007-01-01

    Purpose: An interactive atlas of histology was developed for online use by chiropractic students to enable them to practice and self-assess their ability to identify various histological structures. This article discusses the steps in the development, implementation, and usefulness of an interactive atlas of histology for students who take histology examinations. Methods: The atlas was developed by digitizing images imported through a video-microscope using actual microscope slides. Leica EWS 2100 and PowerPoint software were used to construct the atlas. The usefulness of the atlas was assessed through a comparison of histology exam scores between four classes before and four classes after the use of the atlas. Analysis of admissions data, including overall grade point average (GPA), science and nonscience GPA, and a number of course units, was done initially to avoid any identifiable differences in the academic competency between the two being compared. A survey of the students was also done to assess atlas usefulness and students' satisfaction with the atlas. Results: Analysis of histology exam scores showed that the average scores in the lab exam were significantly higher for the classes that used the atlas. Survey results showed a high level of student satisfaction with the atlas. Conclusion: The development and use of an online interactive atlas of histology for chiropractic students helped to improve lab exams scores. In addition, students were satisfied with the features and usefulness of this atlas. PMID:18483638

  13. Tuning fork test utilization in detection of fractures: a review of the literature

    PubMed Central

    Kazemi, Mohsen

    1999-01-01

    A review of the literature was conducted to find relevant publications on the validity, reliability and utilization of the tuning fork test in detection of stress and simple fractures. Medline 1966-1998, Cumulative Index to Nursing and Allied Health Literature (CINAHL) 1982-1997, Science Citation Index 1961-1997, Index to chiropractic literature 1980-1998 and Chiropractic Research Archives Collection 1984-1990 data bases were searched. Key words such as tuning fork, vibration, diapason, fracture, stress fracture were used. The literature regarding the utilization of the tuning fork test in detection of fractures is very scarce. There was no study found in the above data bases on the validity and or reliability of the tuning fork test in detection of simple acute fractures. This review of the literature indicates the necessity of such a study since the tuning fork test has been used on the field for diagnosis of simple acute fractures. Imagesp124-ap124-bp124-cp124-dp124-e

  14. Ulnar nerve neuropraxia after extracorporeal shock wave lithotripsy: a case report

    PubMed Central

    Konczak, Clark R

    2005-01-01

    A case is presented that illustrates and discusses the clinical presentation, diagnosis and chiropractic management of a 50-year-old male presenting with a case of ulnar neuropraxia following extracorporal shockwave lithotripsy. Onset is believed to be due to the patient’s arm position in full abduction and external rotation during the lithotripsy procedure. Motor abnormalities related to the ulnar nerve were noted in the absence of distinct sensory findings. Chiropractic treatment focused on relief of the patient’s pain during the course of the condition. Treatment may have helped in the rapid and complete resolution of his symptoms in this case. Poor patient positioning on hard surfaces, for extended periods may place pressure on superficial nerves resulting in nerve injury. In this case, the outcome was excellent, with complete resolution of symptoms less than one week later. The prognosis for this type of neuropraxia is usually good with conservative management. The patient history and chronological clinical course strongly suggest a causal association between the patient’s position during the procedure and the development of the ulnar neuropraxia. PMID:17549150

  15. Conservative treatment of a rock climber with a SLAP lesion: a case report.

    PubMed

    Blanchette, Marc-André; Pham, Ai-Thu; Grenier, Julie-Marthe

    2015-09-01

    This case report describes the clinical presentation and conservative treatment of a patient who suffered from a superior labrum anteroposterior (SLAP) tear of the shoulder after a rock climbing session. The 26 year old man had injured his right shoulder while trying to reach a distant socket with his shoulder 90° abducted and in extreme external rotation. After initial treatment failure in chiropractic, the patient sought an orthopaedist and physiotherapy care. A contrast magnetic resonance examination revealed a SLAP lesion. Awaiting orthopaedic consultation and in the absence of clinical improvement the patient sought care from a second chiropractor. Clinical examination revealed a mild winging of the right scapula and the presence of trigger points in the rotator cuff muscles, biceps, rhomboids and serratus anterior. The chiropractic treatment then included soft tissue mobilization and the prescription of strengthening exercises of the serratus anterior and rotator cuff muscles. After 4 sessions, the patient did not feel any pain and gradually resumed all his recreational activities. Clinicians should be aware that SLAP lesions are difficult to identify clinically and that manual therapy might be an important component of conservative treatment of SLAP lesions. PMID:26500357

  16. The use of spinal manipulative therapy for pediatric health conditions: a systematic review of the literature

    PubMed Central

    Gleberzon, Brian J.; Arts, Jenna; Mei, Amanda; McManus, Emily L.

    2012-01-01

    Introduction This study had two purposes. These were: (i) to conduct a search of the literature between 2007 and 2011 investigating the use of spinal manipulative therapy (SMT) for pediatric health conditions and (ii) to perform a systematic review of eligible retrieved clinical trials. Methods The Index of Chiropractic Literature and PubMed were electronically searched using appropriate search words and MeSH terms, respectively, as well as reference tracking of previous reviews. Studies that met the inclusion criteria were evaluated using an instrument that assessed their methodological quality. Results Sixteen clinical trials were found that met the inclusion criteria and were scored. Discussion Six clinical trials investigated the effectiveness of SMT on colic, two each on asthma and enuresis, and one each on hip extension, otitis media, suboptimal breastfeeding, autism, idiopathic scoliosis and jet lag. None investigated the effectiveness of SMT on spinal pain. Conclusion Studies that monitored both subjective and objective outcome measures of relevance to both patients and parents tended to report the most favorable response to SMT, especially among children with asthma. Many studies reviewed suffered from several methodological limitations. Further research is clearly required in this area of chiropractic health care, especially with respect to the clinical effectiveness of SMT on pediatric back pain. PMID:22675226

  17. Radiographic disk height increase after a trial of multimodal spine rehabilitation and vibration traction: a retrospective case series

    PubMed Central

    Horseman, Ian; Morningstar, Mark W.

    2008-01-01

    Abstract Objective Although spinal decompression therapy has been touted as an effective treatment of disk pathologies, there is little existing research that specifically uses disk parameters as an outcome measure after a course of spinal decompression therapy. Our study presents multidimensional outcomes after a structured protocol of multimodal chiropractic rehabilitation and uses a radiographic parameter of disk disease as an indication of the effects of a vibration traction decompression-type table. Clinical Features Patients selected for this retrospective cohort reported a medical history of lumbar herniated or bulging disk verified by previous magnetic resonance imaging/computed tomography, history of paresthesia in one or both lower extremities, pain level reported as a minimum of 8/10, and/or history of sciatica or other radicular pain finding. Intervention and Outcome A total of 6 patients' outcomes are reported in this study. All patients received a multimodal spinal rehabilitation treatment with vibration traction therapy. Positive and statistically significant outcomes were obtained in radiographic disk height, functional rating index, numeric pain rating, spirometry, and patient height. All patients achieved improved outcomes after treatment. Conclusion The multidimensional outcomes reported here were achieved after a structured protocol of multimodal chiropractic rehabilitation. It is unknown which, if any, of these procedures were responsible for the observed improvements. PMID:19646376

  18. CEREBROSPINAL FLUID STASIS AND ITS CLINICAL SIGNIFICANCE

    PubMed Central

    Whedon, James M.; Glassey, Donald

    2010-01-01

    We hypothesize that stasis of the cerebrospinal fluid (CSF) occurs commonly and is detrimental to health. Physiologic factors affecting the normal circulation of CSF include cardiovascular, respiratory, and vasomotor influences. The CSF maintains the electrolytic environment of the central nervous system (CNS), influences systemic acid-base balance, serves as a medium for the supply of nutrients to neuronal and glial cells, functions as a lymphatic system for the CNS by removing the waste products of cellular metabolism, and transports hormones, neurotransmitters, releasing factors, and other neuropeptides throughout the CNS. Physiologic impedance or cessation of CSF flow may occur commonly in the absence of degenerative changes or pathology and may compromise the normal physiologic functions of the CSF. CSF appears to be particularly prone to stasis within the spinal canal. CSF stasis may be associated with adverse mechanical cord tension, vertebral subluxation syndrome, reduced cranial rhythmic impulse, and restricted respiratory function. Increased sympathetic tone, facilitated spinal segments, dural tension, and decreased CSF flow have been described as closely related aspects of an overall pattern of structural and energetic dysfunction in the axial skeleton and CNS. Therapies directed at affecting CSF flow include osteopathic care (especially cranial manipulation), craniosacral therapy, chiropractic adjustment of the spine and cranium, Network Care (formerly Network Chiropractic), massage therapy (including lymphatic drainage techniques), yoga, therapeutic breathwork, and cerebrospinal fluid technique. Further investigation into the nature and causation of CSF stasis, its potential effects upon human health, and effective therapies for its correction is warranted. PMID:19472865

  19. PubMed Central

    Decina, Philip A; McGregor, Marion; Hagino, Carol

    1990-01-01

    This study set out to determine whether healthy lifestyle attitudes are different for students in different years of the chiropractic education process. The results of the FANTASTIC Lifestyle Assessment Questionnaire administered to chiropractic students enrolled in first, second and fourth years of study are presented. Significant differences in scores attained were found between the three years of study in question. A minimum sample size (N) of 81 students was used. First year subjects were significantly different from both second year and fourth year subjects’ scores (p = .012 and p < 0.001, respectively). Mean scores decreased with every year of study. The variables ‘year of study’ and ‘age’ had the most pronounced effect on outcome of scores (p < 0.001 and p < 0.001, respectively). Analyses of variance were performed to determine effect of the variables involved. A two-tailed paired t-test was used to check first year students for changes after six months of school. It is still undetermined whether the significant difference in scores between each year of study are due to the year of study, to increasing average age of the classes, or to societal attitudes about wellness. Suggestions for future study are also presented.

  20. High hamstring tendinopathy in 3 female long distance runners

    PubMed Central

    White, Kristin E.

    2011-01-01

    Objective The purpose of this case report is to describe and discuss the clinical presentation, diagnosis, and management of 3 female long distance runners with high hamstring tendinopathy. Clinical Features Three female runners presented to a chiropractic office with proximal hamstring pain that was aggravated by running. Increasing mileage, hills, and/or interval training preceded the onset of symptoms in each case. The subjects all displayed weakness of the hip abductors, pelvic joint dysfunction, hamstring tightness, and ischial tuberosity tenderness. Other clinical findings included overpronation, proprioceptive weakness, and lumbar dysfunction. Intervention and Outcome All 3 patients were treated with Graston Instrument Assisted Soft Tissue Mobilization, lumbopelvic manipulation, and electrical muscle stimulation with ultrasound. Active exercise focused on hamstring stretching and strengthening, gluteal strengthening, and proprioceptive training. The 3 runners seen in this clinic had resolution of hamstring pain in an average of 13 treatments and were able to continue competing without restriction. Conclusion Runners with high hamstring tendinopathy may respond favorably to conservative chiropractic treatment and active rehabilitation with minimal time off of training. PMID:22014863

  1. Guidelines for the practice and performance of manipulation under anesthesia

    PubMed Central

    2014-01-01

    Background There are currently no widely accepted guidelines on standards for the practice of chiropractic or manual therapy manipulation under anesthesia, and the evidence base for this practice is composed primarily of lower-level evidence. The purpose of this project was to develop evidence-informed and consensus-based guidelines on spinal manipulation under anesthesia to address the gaps in the literature with respect to patient selection and treatment protocols. Methods An expert consensus process was conducted from August-October 2013 using the Delphi method. Panelists were first provided with background literature, consisting of three review articles on manipulation under anesthesia. The Delphi rounds were conducted using the widely-used and well-established RAND-UCLA consensus process methodology to rate seed statements for their appropriateness. Consensus was determined to be reached if 80% of the 15 panelists rated a statement as appropriate. Consensus was reached on all 43 statements in two Delphi rounds. Results The Delphi process was conducted from August-October 2013. Consensus was reached on recommendations related to all aspects of manipulation under anesthesia, including patient selection; diagnosis and establishing medical necessity; treatment and follow-up procedures; evaluation of response to treatment; safety practices; appropriate compensation considerations; and facilities, anesthesia and nursing standards. Conclusions A high level of agreement was achieved in developing evidence-informed recommendations about the practice of chiropractic/manual therapy manipulation under anesthesia. PMID:24490957

  2. Improvement in chronic low back pain in an aviation crash survivor with adjacent segment disease following flexion distraction therapy: a case study

    PubMed Central

    Greenwood, Dean M.

    2012-01-01

    Objective The purpose of this case study is to describe the chiropractic management of chronic low back pain in a patient with adjacent segment disease. Clinical Features The patient was a 30-year-old man with a 3-year history of chronic nonspecific low back pain following a lumbar disk herniation. Two years before this incident, he had severe lumbar fractures and cauda equina injury due to an aviation accident that required multilevel lumbar fusion surgery, vertebrectomy, and cage reconstruction. Intervention and Outcome The patient received chiropractic management using Cox Flexion Distraction over a 4-week period. A complete reduction of symptoms to 0/10 on a verbal numerical rating scale was achieved within 4 weeks. At 3 months, the patient was able to work 8 to 9 hours per day in his dental practice with no pain. At 9 months, the patient continued to report a complete reduction of symptoms. Conclusions This report describes the successful management of a patient with chronic low back pain associated with adjacent segment disease using Cox Flexion Distraction protocols. PMID:23843764

  3. A survey of Australian chiropractors’ attitudes and beliefs about evidence-based practice and their use of research literature and clinical practice guidelines

    PubMed Central

    2013-01-01

    Background Research into chiropractors’ use of evidence in clinical practice appears limited to a single small qualitative study. The paucity of research in this area suggests that it is timely to undertake a more extensive study to build a more detailed understanding of the factors that influence chiropractors’ adoption of evidence-based practice (EBP) principles. This study aimed to identify Australian chiropractors’ attitudes and beliefs towards EBP in clinical practice, and also examine their use of research literature and clinical practice guidelines. Methods We used an online questionnaire about attitudes, beliefs and behaviours towards the use of EBP in clinical practice that had been developed to survey physiotherapists and modified it to ensure that it was relevant to chiropractic practice. We endeavoured to survey all registered Australian chiropractors (n?=?4378) via email invitation distributed by Australian chiropractic professional organisations and the Chiropractic Board of Australia. Logistic regression analyses were conducted to examine univariate associations between responses to items measuring attitudes and beliefs with items measuring: age; years since registration; attention to literature; and use of clinical practice guidelines. Results Questionnaires were returned by 584 respondents (response rate approximately 13%). The respondents’ perceptions of EBP were generally positive: most agreed that the application of EBP is necessary (77.9%), literature and research findings are useful (80.2%), EBP helps them make decisions about patient care (66.5%), and expressed an interest in learning or improving EBP skills (74.9%). Almost half of the respondents (45.1%) read between two to five articles a month. Close to half of the respondents (44.7%) used literature in the process of clinical decision making two to five times each month. About half of the respondents (52.4%) agreed that they used clinical practice guidelines, and around half (54.4%) agreed that they were able to incorporate patient preferences with clinical practice guidelines. The most common factor associated with increased research uptake was the perception that EBP helps make decisions about patient care. Conclusions Most Australian chiropractors hold positive attitudes towards EBP, thought EBP was useful, and were interested in improving EBP skills. However, despite the favourable inclination towards EBP, many Australian chiropractors did not use clinical practice guidelines. Our findings should be interpreted cautiously due to the low response rate. PMID:24345082

  4. Are chiropractors in the uk primary healthcare or primary contact practitioners?: a mixed methods study

    PubMed Central

    2010-01-01

    Background One of the debates regarding the role of chiropractors is whether or not they should be considered as primary healthcare practitioners. Primary care is often used to describe chiropractic but without any definition of what is meant by the term. Primary healthcare itself has many definitions and this adds to the problem. Existing research literature, based mostly in the USA, suggests that the use of the title "primary healthcare professional" by chiropractors is central to the identity of the profession. It has also been suggested that the concept of primary care is misused by chiropractors because they have not examined the concept in detail and thus do not understand it. For the sake of quality of patient care and for the legitimacy of the profession, chiropractors in the UK need to agree on their healthcare role. This study aimed to examine the opinions of chiropractors towards the use of the term primary healthcare when applied to chiropractic practice within the UK. Methods A sequential study of exploratory design was used; this model is characterised by an initial phase of qualitative data collection and analysis that precedes and informs the quantitative phase of data collection and analysis. In this study, interviews with members of chiropractic teaching faculty were used to inform the development of a questionnaire used to survey the opinions of chiropractors in the UK. Results There was a general consensus of opinion that chiropractors are primary contact practitioners, who work in a primary healthcare setting and that to be able to fulfil this healthcare role, chiropractors must be able to diagnose patients and refer when required. Participants did not feel that chiropractors are able to treat all of the most common medical conditions that present in a primary healthcare setting. Conclusions The findings of this study suggest that chiropractors in the UK view their role as one of a primary contact healthcare practitioner and that this view is held irrespective of the country in which they were educated or the length of time in practice. Further research needs to be developed to evaluate the findings of the current study within a wider healthcare context. In particular the opinions of other healthcare professionals towards the role of chiropractors in healthcare, need to be examined in more detail. PMID:20979615

  5. Prevention of low back pain: effect, cost-effectiveness, and cost-utility of maintenance care – study protocol for a randomized clinical trial

    PubMed Central

    2014-01-01

    Background Low back pain (LBP) is a prevalent condition and a socioeconomic problem in many countries. Due to its recurrent nature, the prevention of further episodes (secondary prevention), seems logical. Furthermore, when the condition is persistent, the minimization of symptoms and prevention of deterioration (tertiary prevention), is equally important. Research has largely focused on treatment methods for symptomatic episodes, and little is known about preventive treatment strategies. Methods/Design This study protocol describes a randomized controlled clinical trial in a multicenter setting investigating the effect and cost-effectiveness of preventive manual care (chiropractic maintenance care) in a population of patients with recurrent or persistent LBP. Four hundred consecutive study subjects with recurrent or persistent LBP will be recruited from chiropractic clinics in Sweden. The primary outcome is the number of days with bothersome pain over 12 months. Secondary measures are self-rated health (EQ-5D), function (the Roland Morris Disability Questionnaire), psychological profile (the Multidimensional Pain Inventory), pain intensity (the Numeric Rating Scale), and work absence. The primary utility measure of the study is quality-adjusted life years and will be calculated using the EQ-5D questionnaire. Direct medical costs as well as indirect costs will be considered. Subjects are randomly allocated into two treatment arms: 1) Symptom-guided treatment (patient controlled), receiving care when patients feel a need. 2) Preventive treatment (clinician controlled), receiving care on a regular basis. Eligibility screening takes place in two phases: first, when assessing the primary inclusion/exclusion criteria, and then to only include fast responders, i.e., subjects who respond well to initial treatment. Data are collected at baseline and at follow-up as well as weekly, using SMS text messages. Discussion This study investigates a manual strategy (chiropractic maintenance care) for recurrent and persistent LBP and aims to answer questions regarding the effect and cost-effectiveness of this preventive approach. Strict inclusion criteria should ensure a suitable target group and the use of frequent data collection should provide an accurate outcome measurement. The study utilizes normal clinical procedures, which should aid the transferability of the results. Trial registration Clinical trials.gov; NCT01539863, February 22, 2012. The first patient was randomized into the study on April 13th 2012. PMID:24690201

  6. Femoroacetabular impingement syndrome: a narrative review for the chiropractor

    PubMed Central

    Emary, Peter

    2010-01-01

    Objective: To familiarize the chiropractic clinician with the clinical presentation, radiographic features, and conservative versus surgical treatment options for managing femoroacetabular impingement (FAI) syndrome. Background: FAI syndrome is a relatively new clinical entity to be described in orthopedics, and has been strongly linked with pain and early osteoarthritis of the hip in young adults. Hip joint radiographs in these patients often appear normal at first—particularly if the clinician is unfamiliar with FAI. The role of conservative therapy in managing this disorder is questionable. Surgical treatment ultimately addresses any acetabular labral or articular cartilage damage, as well as the underlying osseous abnormalities associated with FAI. The most commonly used approach is open surgical hip dislocation; however, more recent surgical procedures also involve arthroscopy. Conclusion: In FAI syndrome—a condition unknown to many clinicians (including medical)—chiropractors can play an important role in its diagnosis and referral for appropriate management. PMID:20808616

  7. An evidence-based diagnostic classification system for low back pain

    PubMed Central

    Vining, Robert; Potocki, Eric; Seidman, Michael; Morgenthal, A. Paige

    2013-01-01

    Introduction: While clinicians generally accept that musculoskeletal low back pain (LBP) can arise from specific tissues, it remains difficult to confirm specific sources. Methods: Based on evidence supported by diagnostic utility studies, doctors of chiropractic functioning as members of a research clinic created a diagnostic classification system, corresponding exam and checklist based on strength of evidence, and in-office efficiency. Results: The diagnostic classification system contains one screening category, two pain categories: Nociceptive, Neuropathic, one functional evaluation category, and one category for unknown or poorly defined diagnoses. Nociceptive and neuropathic pain categories are each divided into 4 subcategories. Conclusion: This article describes and discusses the strength of evidence surrounding diagnostic categories for an in-office, clinical exam and checklist tool for LBP diagnosis. The use of a standardized tool for diagnosing low back pain in clinical and research settings is encouraged. PMID:23997245

  8. Active and passive characteristics of muscle tone and their relationship to models of subluxation/joint dysfunction

    PubMed Central

    Knutson, Gary A; Owens, Edward F

    2003-01-01

    The relationship of muscles to the causes and effects of the pathophysiologic entity referred to as chiropractic subluxation or joint dysfunction is critical. Part I of this paper reviews complexities of skeletal muscle in regards to anatomy, active and passive tone, detection of muscle tone, neurophysiology, and how muscle function fits into a variety of subluxation/joint dysfunction models. The review culminates in Part II with a hypothesis to describe and explain varying degrees of muscle tone that may be encountered clinically. It is hoped that knowledge of the differing levels of muscle tone and their causes will help the clinician to better determine the underlying cause of a neuro-musculoskeletal problem allowing application of necessary and proper intervention. Imagesp179-a

  9. Piriformis syndrome: an annotated bibliography

    PubMed Central

    Caldwell, Sylvia G; Hurwitz, Eric L; Adams, Alan

    1999-01-01

    Objective: To review the literature on Piriformis Syndrome, including signs, symptoms, diagnosis, differential diagnosis, treatment and management. Design: An annotated bibliography. Methods: A literature search of MEDLINE from January 1987 to November 1996, MANTIS from 1990 to 1997, EMBASE from January 1986 to December 1996, and Index to Chiropractic Literature from 1985 to 1994. The key words utilized in the search were Piriformis, Piriformis Syndrome, and Piriformis Muscle. Only English language articles were selected. Results: This annotated bibliography identifies twelve case reports, four case series, nine commentaries, and one quasi experiment. Twenty of the articles were published in peer-reviewed journals. Conclusions: Future research should address diagnostic criteria, treatment protocols, and effectiveness of therapeutic options.

  10. Benign intracranial hypertension

    PubMed Central

    Crowther, Edward R

    1993-01-01

    Benign intracranial hypertension (BIH) is a syndrome characterized by papilledema and elevated intracranial pressure in the absence of hydrocephalus or intracranial mass. The condition is found most often in obese females in the fourth decade of life. Etiology remains unclear but a wide variety of medications, disease states and altered physiology have been associated with its onset. The complaints of headache and disturbed visual acuity are those directly related to increased intracranial pressure. The most serious sequelae of untreated BIH is permanent, partial visual deficit. Early diagnosis and referral is important if visual loss is to be minimized or prevented. The case of a 33-year-old female with BIH presenting to a chiropractic office is described. The limited role of the chiropractor in diagnosis and monitoring of the condition is reviewed. ImagesFigure 1Figure 1

  11. B-Cell lymphoma presenting as mechanical low-back pain with leg pain: the importance of the physical and ultrasound examination of the buttock in patients with low-back and leg pain: a case report

    PubMed Central

    Guben, Jason N.; Van Der Mark, Robin L.J.; Yeghiayan, Edouard

    2001-01-01

    Malignancies are an important, although rare, cause of back pain which must be a consideration in patients with certain historical factors, or in patients who do not respond to treatment. This case report emphasizes the importance of performing a thorough examination of any unexplained complaint of low back, buttock or hip pain, the need for continual re-evaluation and modification of the initial diagnosis, and the importance of diagnostic ultrasound when clinically indicated. The decision to refer the patient for further evaluation, including medical imaging techniques, may not become apparent until a regimen of care has been provided and a follow-up exam performed. A case report is presented in which a clarification of the patients symptoms and a thorough re-evaluation following a regimen of conservative chiropractic care led to a referral for diagnostic ultrasound imaging studies and ultimately the diagnosis of B-Cell lymphoma. ImagesFigure 1Figure 2

  12. Cervical Artery Dissection: Emerging Risk Factors

    PubMed Central

    Micheli, S; Paciaroni, M; Corea, F; Agnelli, G; Zampolini, M; Caso, V

    2010-01-01

    Cervical artery dissection (CAD) represents an increasingly recognized cause of stroke and the most common cause of ischemic stroke in young adults. Many factors have been identified in association with CAD such as primary disease of arterial wall (fibrodysplasia) and other non-specific diseases related to CAD like Ehlers Danlos-syndrome IV, Marfan’s syndrome, vessel tortuosity. Moreover, an underlying arteriopathy which could be in part genetically determined, has been suspected. The rule of emerging risk factors for CAD such as recent respiratory tract infection, migraine and hyperhomocysteinemia are still a matter of research. Other known risks factors for CAD are major head/neck trauma like chiropractic maneuver, coughing or hyperextension injury associated to car. We examined emerging risks factors for CAD detected in the last years, as CAD pathogenesis is still not completely understood and needs further investigations. PMID:21270941

  13. Vertebral artery dissection after a chiropractor neck manipulation.

    PubMed

    Jones, Jeremy; Jones, Catherine; Nugent, Kenneth

    2015-01-01

    The differential diagnosis for ischemic central nervous system infarcts in young patients includes paradoxic emboli through cardiac shunts, vasculitis, and vascular trauma. We report a young woman who developed headache, vomiting, diplopia, dizziness, and ataxia following neck manipulation by her chiropractor. A computed tomography scan of the head revealed an infarct in the inferior half of the left cerebellar hemisphere and compression of the fourth ventricle causing moderate acute obstructive hydrocephalus. Magnetic resonance angiography revealed severe narrowing and low flow in the intracranial segment of the left distal vertebral artery. The patient was treated with mannitol and a ventriculostomy and had an excellent functional recovery. This report illustrates the potential hazards associated with neck trauma, including chiropractic manipulation. The vertebral arteries are at risk for aneurysm formation and/or dissection, which can cause acute stroke. PMID:25552813

  14. Vertebral artery dissection after a chiropractor neck manipulation

    PubMed Central

    Jones, Jeremy; Nugent, Kenneth

    2015-01-01

    The differential diagnosis for ischemic central nervous system infarcts in young patients includes paradoxic emboli through cardiac shunts, vasculitis, and vascular trauma. We report a young woman who developed headache, vomiting, diplopia, dizziness, and ataxia following neck manipulation by her chiropractor. A computed tomography scan of the head revealed an infarct in the inferior half of the left cerebellar hemisphere and compression of the fourth ventricle causing moderate acute obstructive hydrocephalus. Magnetic resonance angiography revealed severe narrowing and low flow in the intracranial segment of the left distal vertebral artery. The patient was treated with mannitol and a ventriculostomy and had an excellent functional recovery. This report illustrates the potential hazards associated with neck trauma, including chiropractic manipulation. The vertebral arteries are at risk for aneurysm formation and/or dissection, which can cause acute stroke. PMID:25552813

  15. Paracondylar process: a rare cause of craniovertebral fusion — a case report

    PubMed Central

    Nolet, Paul S; Friedman, Lawrence; Brubaker, Deloss

    1999-01-01

    A 21-year-old female presented to a chiropractic clinic with chronic neck and headache pain. She had an osseous torticollis and abnormal range of neck motion on rotation to the left. Radiographic examination revealed a unilateral paracondylar process of the occiput fusing to the lateral transverse process of the atlas. A paracondylar process is classified as an occipital vertebra. It is an enlarged bony process of the cranial base which projects caudally towards the transverse process of the atlas. She was treated with spinal manipulation below the level of fusion which resulted in a marked decrease in headache and neck pain. The embryology, frequency, radiographic appearance and clinical implications of a paracondylar process are discussed in this paper. ImagesFigure 1Figure 2Figure 3Figure 4

  16. Humeral Lateral Epicondylitis Complicated by Hydroxyapatite Dihydrite Deposition Disease: A Case Report

    PubMed Central

    Marchand, Andrée-Anne; O’Shaughnessy, Julie; Descarreaux, Martin

    2014-01-01

    Objective The aim of this case report is to differentiate the recovery timeline expected for patients with simple lateral epicondylitis from an abnormal recovery period, in which case an underlying condition should be suspected. Clinical features A 49-year-old woman presented to a chiropractic clinic with posterolateral right elbow pain. The history included chronic recurrent lateral elbow pain, followed by a traumatic event leading to sustained pain and disability. Intervention and outcomes Following a trial of conservative therapy including activity restrictions, soft tissue therapy, joint mobilizations, and therapeutic ultrasonography that led to no significant improvement, the patient was referred for diagnostic imaging that revealed hydroxyapatite dihydrite deposition disease. Conclusion This report describes a case for which lateral epicondylitis symptoms failed to resolve because of an underlying condition (hydroxyapatite dihydrite deposition disease). This case emphasizes that primary care practitioners treating lateral epicondylitis should consider referral for further investigations when positive results are not achieved. PMID:24711788

  17. Trends in the use of complementary and alternative medicine in the United States: 2002-2007.

    PubMed

    Su, Dejun; Li, Lifeng

    2011-02-01

    In this study we seek to assess recent trends in complementary and alternative medicine (CAM) use based on a comparative analysis of data from the 2002 and 2007 National Health Interview Survey (NHIS). The findings suggest that CAM use, in particular the use of provider-based CAM therapies such as chiropractic care, massage, and acupuncture, have grown significantly in the U.S. This growth was more pronounced among non-Hispanic Whites than among racial and ethnic minorities, increasing an already existing White-minority gap in CAM use. Findings from this study also reveal that CAM use becomes more likely when access to conventional care has been restricted. In both 2002 and 2007, having unmet needs in medical care or having delayed care due to cost were associated with a higher chance of CAM use. PMID:21317523

  18. Active and passive characteristics of muscle tone and their relationship to models of subluxation/joint dysfunction

    PubMed Central

    Knutson, Gary A.; Owens, Edward F.

    2003-01-01

    The relationship of muscles to the causes and effects of the pathophysiologic entity referred to as chiropractic subluxation or joint dysfunction is critical. Part I of this paper reviewed the complexities of skeletal muscle in regards to anatomy, active and passive tone, detection of muscle tone, neurophysiology, and how muscle function fits into a variety of subluxation/joint dysfunction models. The concluding part of the review culminates in a hypothesis to describe and explain varying degrees of muscle tone that may be encountered clinically. It is hoped that knowledge of the differing levels of muscle tone and their causes will help the clinician to better determine the underlying cause of a neuromusculoskeletal problem allowing application of necessary and proper intervention.

  19. The horse that was a zebra: primary lymphoma of bone mimicking shoulder strain in an elderly male

    PubMed Central

    Keyes, Warren J; Morgan, Christopher; Pulinec, Andrew

    2000-01-01

    Primary malignant tumours of the extremities are rarely seen in chiropractic clinics. A case is presented of an eighty year old male who had complained of pain in the right shoulder of several days duration. History and clinical examination were consistent with mechanical joint pain. Following an appropriate course of conservative care the patient continued to improve until a re-injury occurred 3 months later. At that time, radiographs revealed an ill-defined moth-eaten lesion in the proximal humeral head. Subsequent evaluation demonstrated it to be a rare histologic sub-type of lymphoma. This case highlights several important issues ranging from clinical presentation to case management. ImagesFigure 1Figure 2

  20. Neuromusculoskeletal disorders following SARS: a case series

    PubMed Central

    Stainsby, Brynne; Howitt, Scott; Porr, Jason

    2011-01-01

    Objective: To detail the presentation of three health care workers diagnosed with sudden acute respiratory syndrome (SARS) who later presented to a CMCC teaching clinic with neuromusculoskeletal sequelae and underwent conservative treatments. This case series aims to inform practitioners of the potential pathogenesis of these neuromuscular complaints and describes their treatment in a chiropractic practice. Clinical Features: Three patients presented with a variety of neurological, muscular and joint findings. Conservative treatment was aimed at decreasing hypertonic muscles, increasing joint mobility, and improving ability to perform activities of daily living. Intervention and Outcome: The conservative treatment approach utilized in these cases involved spinal manipulative therapy, soft tissue therapy, modalities, and rehabilitation. Outcome measures included subjective pain ratings, disability indices, and return to work. Conclusion: Three patients previously diagnosed with SARS presented with neuromusculoskeletal complaints and subjectively experienced intermittent relief of pain and improvement in disability status after conservative treatments. PMID:21403780

  1. Introducing the Neurocalometer: a view from the Fountain Head

    PubMed Central

    Keating, Joseph C

    1991-01-01

    A review and analysis of the 1924 introduction of the neurocalometer (NCM), a heat-sensing instrument purported to detect “nerve interference” (subluxation), is presented. Included are the origins of the device, the terms and expense of B.J. Palmer’s leasing program for the NCM, the role of the NCM as centrepiece in a “back to straight chiropractic” movement, the development of competitive instruments and BJ’s method of dealing with “infringers”, claims made for the clinical value of the NCM and the profession’s response to the NCM-movement. It is suggested that the NCM’s introduction provides a model of unethical promotions in health care. ImagesFigure 1

  2. [The use of complementary and alternative treatment in patients with asthma].

    PubMed

    Tokem, Yasemin

    2006-01-01

    Complementary and alternative medicine (CAM) therapies such as herbal therapy, acupuncture, yoga, chiropractic, relaxation techniques, nutrition and dietary supplements, continue to gain popularity as modalities for treatment of asthma. A number of study in this area has shown frequently used CAM therapies by patients with asthma. It has found that parents who have children with asthma preferred commonly CAM therapies such as massage, relaxation techniques, diet and vitamin and that adult patients with asthma used commonly nutrition and diet supplements, herbal therapies and homeopathy. Because of many studies had weak methodology and small sample; it hasn't exposed entirely effectiveness of CAM therapies in asthma treatment. In this respect, it is required qualitative researchs with strong methodology. Furthermore; it is suggested that health professionals have to much knowledge about CAM therapies in asthma and they have to an active role in development guidelines related to CAM interventions. PMID:16924579

  3. Headache and the cervical spine: a critical review.

    PubMed

    Pöllmann, W; Keidel, M; Pfaffenrath, V

    1997-12-01

    Headache related to the cervical spine is often misdiagnosed and treated inadequately because of confusing and varying terminology. Primary headaches such as tension-type headache and migraine are incorrectly categorized as "cervicogenic" merely because of their occipital localization. Cervicogenic headache as described by Sjaastad presents as a unilateral headache of fluctuating intensity increased by movement of the head and typically radiates from occipital to frontal regions. Definition, pathophysiology; differential diagnoses and therapy of cervicogenic headache are demonstrated. Ipsilateral blockades of the C2 root and/or greater occipital nerve allow a differentiation between cervicogenic headache and primary headache syndromes such as migraine or tension-type headache. Neither pharmacological nor surgical or chiropractic procedures lead to a significant improvement or remission of cervicogenic headache. Pains of various anatomical regions possibly join into a common anatomical pathway, then present as cervicogenic headache, which should therefore be understood as a homogeneous but also unspecific pattern of reaction. PMID:9453267

  4. Prevalence of use of complementary/alternative medicine: a systematic review.

    PubMed Central

    Ernst, E.

    2000-01-01

    Reported are the results of a systematic review of the prevalence of use of complementary/alternative medicine. Computerized literature searches were carried out in four databases. Twelve surveys thus found were selected because they dealt with the utilization of complementary/alternative medicine in random or representative samples of the general population. Data were extracted in a predefined, standardized way. Prevalence of use of complementary/alternative medicine ranged from 9% to 65%. Even for a given form of treatment such as chiropractic, as used in the USA, considerable discrepancies emerged. The data suggest that complementary/alternative therapies are used frequently and increasingly. Prevalence of use seemed to depend critically on factors that were poorly controlled in surveys of complementary/alternative medicine. The true prevalence of use of complementary/alternative medicine in the general population remains uncertain. PMID:10743298

  5. Competencies for public health and interprofessional education in accreditation standards of complementary and alternative medicine disciplines.

    PubMed

    Brett, Jennifer; Brimhall, Joseph; Healey, Dale; Pfeifer, Joseph; Prenguber, Marcia

    2013-01-01

    This review examines the educational accreditation standards of four licensed complementary and alternative medicine (CAM) disciplines (naturopathic medicine, chiropractic health care, acupuncture and oriental medicine, and massage therapy), and identifies public health and other competencies found in those standards that contribute to cooperation and collaboration among the health care professions. These competencies may form a foundation for interprofessional education. The agencies that accredit the educational programs for each of these disciplines are individually recognized by the United States Department (Secretary) of Education. Patients and the public are served when healthcare practitioners collaborate and cooperate. This is facilitated when those practitioners possess competencies that provide them the knowledge and skills to work with practitioners from other fields and disciplines. Educational accreditation standards provide a framework for the delivery of these competencies. Requiring these competencies through accreditation standards ensures that practitioners are trained to optimally function in integrative clinical care settings. PMID:24021473

  6. Interprofessional competencies in the curriculum: Interpretations of educators from five health professions.

    PubMed

    Grace, Sandra

    2015-09-01

    Interprofessional (IP) practice embraces a range of collaborations among health professionals that includes referral networks, case management, and simultaneous co-management models of healthcare. How IP competencies are interpreted and enacted in the curriculum falls to health educators. The aim of this research was to examine health educators' interpretations of IP competencies in five health professions (chiropractic, naturopathy, osteopathy, physiotherapy, and podiatry) in Australia. Semi-structured interviews were conducted with six educators. Transcripts were analysed using constant comparison to identify emergent themes. A number of interpretations of IP practice were evident (e.g. knowing professional scopes of practice and when to refer, and co-assessing and co-managing patients). Lack of resources limited IP practice enactment in the curriculum, including complementary medicine participation in IP teams. PMID:25533851

  7. Demographic, Behavioral, and Health Correlates of Complementary and Alternative Medicine and Prayer Use among Midlife Women: 2002

    PubMed Central

    Dye, Claire E.; Chyu, Laura; Gold, Ellen B.; Greendale, Gail A.

    2010-01-01

    Abstract Objective This study investigated the demographic, behavioral, and health correlates of the most frequently used types of complementary and alternative medicine (CAM) therapy and the use of prayer for health among midlife women. We also examined the extent to which women used CAM for treatment of health conditions, including menopausal symptoms, and for general health and well-being. Methods Data from the 2002 National Health Interview Survey (NHIS), a cross-sectional, household survey representative of the U.S. civilian adult population, were used. Midlife women aged 40–59 years (n?=?5849) were analyzed. Bivariate prevalence estimates were obtained, and binomial logistic regression models were estimated; all analyses were weighted. Results Overall, 46% of midlife women used any type of CAM in the past 12 months, and 54% reported using prayer for health reasons. The top five specific CAM therapies used were herbs and natural products; relaxation techniques; chiropractic care; yoga, tai chi, or qi gong; and massage. Multivariate results demonstrated different patterns of association between demographic, health, and behavioral characteristics and specific CAM therapies. A higher percentage of women used chiropractic care for an existing health condition than those using relaxation techniques, and few women used CAM specifically for menopausal symptoms. Conclusions CAM and prayer are frequently used by midlife women, and herbs and natural supplements are the mostly frequently used. The findings underscore the importance, particularly in the clinical setting, of asking women about their use of individual CAM therapies. Such clinical assessment is also important because of the potential for interactions of CAM therapies with prescribed therapies. PMID:20088655

  8. The effect of spinal manipulative therapy (SMT) on pain reduction and range of motion in patients with acute unilateral neck pain: a pilot study

    PubMed Central

    Pikula, John R

    1999-01-01

    Objective: This experiment evaluated the response of acute neck pain patients to an intervention utilizing a single manipulation to either a) the same side of pain (ipsilateral) or b) opposite side (contralateral) and compared the results to a placebo group. Design: In this pre-test — post-test study, 36 subjects were randomly allocated to one of the three groups: (1) SMT applied to the same side as the pain (ipsilateral) (2) SMT applied to the side opposite the pain (contralateral) (3) A placebo group receiving only detuned ultrasound therapy Subjects: In a private chiropractic office, patients with acute unilateral neck pain and stiffness were studied. Inclusion criteria included the presence of acute unilateral neck pain, no prior similar history, no history of trauma, and no neurological deficit. Subjects had no previous chiropractic treatment of the cervical spine. Intervention: Patients in the two manipulation groups received a single cervical manipulation. Patients in the placebo group received detuned ultrasound therapy over the area of pain. Main Outcome Measures: There were two outcome measures. Pain intensity was rated on the 100 mm. visual analog scale (VAS) prior to and immediately following the intervention. Pre and Post test measurements of cervical spine range of motion utilizing the CROM instrument were also taken. Results: Degrees of ipsilateral lateral flexion, contralateral flexion, and VAS improved when ipsilateral versus contralateral spinal manipulative therapy was applied. Conclusions: Immediately following a single manipulation to acute neck pain patients there is less pain intensity and a greater range of motion when spinal manipulative therapy is applied to the side of neck pain versus manipulation on the side opposite the pain or to a placebo group.

  9. Effects of test stress during an objective structured clinical examination

    PubMed Central

    Zhang, Niu; Rabatsky, Ali

    2015-01-01

    Objective The existence of test stress has been widely reported among professional students. To our knowledge, no studies exist that explore student stress response to objective structured clinical examinations. The aim of this study was to evaluate possible correlations between stress and objective structured clinical examination performance in a sample of chiropractic students. Methods A total of 116 students completed a 2-part questionnaire to assess test stress and the physiological symptoms and signs of stress. Heart rate, systolic blood pressure, and diastolic were measured during the physical examination laboratory class within the first 3 weeks and then again just prior to their objective structured clinical examination in week 5. Statistical tests were then performed for questionnaire data, heart rate and blood pressure differences, and correlation between the objective structured clinical examination grade and symptoms and signs. Results Questionnaire results showed that 5.1%–22.4% of students sometimes or often felt a certain degree of stress. More than 50% had 1 or more physiological symptoms and signs of stress. The objective structured clinical examination heart rate (75.23 ± 11.20 vs 68.16 ± 8.82, p < .001), systolic blood pressure (120.43 ± 9.59 vs 114.97 ± 11.83, p < .001), and diastolic blood pressure (73.00 ± 7.93 vs 69.32 ± 7.76, p < .001) were significantly higher than baseline. There were also negative linear correlations between objective structured clinical examination grades and physiological symptoms and signs and between objective structured clinical examination grades and feeling statement score. Conclusion The results support our hypothesis that chiropractic students experience stress when performing the objective structured clinical examination and that high levels of stress had a negative impact on performance. PMID:25806413

  10. A survey of chiropractors practicing in Germany: practice characteristics, professional reading habits, and attitudes and perceptions toward research

    PubMed Central

    Schwarz, Ilke; Hondras, Maria A

    2007-01-01

    Background In 2004, a survey conducted by the European Chiropractor's Union among member countries reported that "there appears to be little interest in research among chiropractors in Germany." However, no research has tested this statement. The objective of this study was to explore the attitudes and perceptions of practicing chiropractors in Germany regarding research, to look at their reading and research habits, and to gather demographic and practice data. Methods A questionnaire was developed and distributed among participants at a seminar held by the German Chiropractors' Association in 2005. The questionnaire was mailed to any members of the association who did not attend the seminar. Results A total of 49 (72%) of 68 distributed questionnaires were returned. Forty-five (92%) respondents stated they would support research efforts in Germany and 15 (31%) declared interest in participating in practiced based research. An average of three hours per week were reportedly spent reading scientific literature by 44 (85%) respondents. However, few journals listed by respondents were peer-reviewed and indexed; most were newsletters of chiropractic organizations or free publications. Most participants agreed on the importance of research for the profession, but when asked about the most pressing issue for chiropractic in Germany, legislation and recognition of the profession were the dominant themes. Conclusion The results of this survey show that there is a general interest in supporting and participating in research activities among chiropractors practicing in Germany. Next steps could consist of educating practitioners about the resources available to read and interpret the scientific literature and thus further the understanding of research. PMID:17480221

  11. Conservative management of a type III acromioclavicular separation: a case report and 10-year follow-up

    PubMed Central

    Robb, Andrew J.; Howitt, Scott

    2011-01-01

    Objective The purpose of this study is to present a 10-year prospective case of a right incomplete type III acromioclavicular (AC) separation in a 26-year-old patient. Clinical Features A 26-year-old male patient fell directly on his right shoulder with the arm in an outstretched and overhead position. Pain and swelling were immediate and were associated with a “step deformity.” The patient had limited right shoulder range of motion (ROM), strength, and function. Radiographic findings confirmed a type III AC separation on the right. At 1-year follow-up, the patient did not report any deficits in ROM or function, but did note a prominent distal clavicle on the right. At 3-, 5-, 7-, and 10-year follow-up, the patient did not report changes from 1 year. The radiographic findings at the 10-year follow-up indicated mild degenerative joint disease in both AC joints and mild elevation of the distal clavicle on the right. Intervention and Outcome The patient received chiropractic care to control for pain, swelling, and loss of ROM. The patient received acupuncture, joint mobilizations, palliative adhesive taping of the AC joint, Active Release Technique, and progressive resisted exercises. Radiographic study was done at the time of the injury and at 10 years to observe for any osseous changes in the AC joint. Conclusion The patient yielded excellent results from conservative chiropractic management that was reflected in a prompt return to work 19 days after the injury. Follow-up at 1, 3, 5, 7, and 10 years exhibited absence of residual deficits in ROM and function. The “step deformity” was still present after the injury on the right. PMID:22654684

  12. Immediate Changes Following Manual Therapy in Resting State Functional Connectivity As Measured By Magnetic Resonance Imaging (fMRI) In Subjects With Induced Low Back Pain

    PubMed Central

    Gay, Charles W.; Robinson, Michael E.; George, Steven Z.; Perlstein, William M.; Bishop, Mark D.

    2014-01-01

    Objective The purpose of this study was to use functional magnetic resonance imaging (fMRI) to investigate the immediate changes in functional connectivity (FC) between brain regions that process and modulate the pain experience following 3 different types of manual therapies (MT) and to identify reductions in experimentally induced myalgia and changes in local and remote pressure pain sensitivity. Methods Twenty-four participants (17 females, mean age ± SD = 21.6 ± 4.2 years), who completed an exercise-injury protocol to induce low back pain, were randomized into 3 groups: chiropractic spinal manipulation (n=6), spinal mobilization (n=8) or therapeutic touch (n=10). The primary outcome was the immediate change in FC as measured on fMRI between the following brain regions: somatosensory cortex, secondary somatosensory cortex, thalamus, anterior and posterior cingulate cortices, anterior and poster insula, and periaqueductal grey. Secondary outcomes were immediate changes in pain intensity measured with a 101-point numeric rating scale, and pain sensitivity, measured with a hand-held dynamometer. Repeated measures ANOVA models and correlation analyses were conducted to examine treatment effects and the relationship between within-person changes across outcome measures. Results Changes in FC were found between several brain regions that were common to all 3 manual therapy interventions. Treatment-dependent changes in FC were also observed between several brain regions. Improvement was seen in pain intensity following all interventions (p<0.05) with no difference between groups (p>0.05). There were no observed changes in pain sensitivity, or an association between primary and secondary outcome measures. Conclusion These results suggest that manual therapies (chiropractic spinal manipulation, spinal mobilization, and therapeutic touch) have an immediate effect on the FC between brain regions involved in processing and modulating the pain experience. This suggests that neurophysiological changes following MT may be an underlying mechanism of pain relief. PMID:25284739

  13. Effect of spinal manipulative therapy with stretching compared with stretching alone on full-swing performance of golf players: a randomized pilot trial?

    PubMed Central

    Costa, Soraya M.V.; Chibana, Yumi E.T.; Giavarotti, Leandro; Compagnoni, Débora S.; Shiono, Adriana H.; Satie, Janice; Bracher, Eduardo S.B.

    2009-01-01

    Abstract Objective There has been a steady growth of chiropractic treatment using spinal manipulative therapy (SMT) that aims to increase the performance of athletes in various sports. This study evaluates the effect of SMT by chiropractors on the performance of golf players. Methods Golfers of 2 golf clubs in São Paulo, Brazil, participated in this study. They were randomized to 1 of 2 groups: Group I received a stretch program, and group II received a stretch program in addition to SMT. Participants in both groups performed the same standardized stretching program. Spinal manipulative therapy to dysfunctional spinal segments was performed on group II only. All golfers performed 3 full-swing maneuvers. Ball range was considered as the average distance for the 3 shots. Treatment was performed after the initial measurement, and the same maneuvers were performed afterward. Each participant repeated these procedures for a 4-week period. Student t test, Mann-Whitney nonparametric test, and 1-way analysis of variance for repeated measures with significance level of 5% were used to analyze the study. Results Forty-three golfers completed the protocol. Twenty participants were allocated to group I and 23 to group II. Average age, handicap, and initial swing were comparable. No improvement of full-swing performance was observed during the 4 sessions on group I (stretch only). An improvement was observed at the fourth session of group II (P = .005); when comparing the posttreatment, group II had statistical significance at all phases (P = .003). Conclusions Chiropractic SMT in association with muscle stretching may be associated with an improvement of full-swing performance when compared with muscle stretching alone. PMID:19948307

  14. Immediate effects of lower cervical spine manipulation on handgrip strength and free-throw accuracy of asymptomatic basketball players: a pilot study

    PubMed Central

    Humphries, Kelley M.; Ward, John; Coats, Jesse; Nobert, Jeannique; Amonette, William; Dyess, Stephen

    2013-01-01

    Objective The purpose of this pilot study was to collect preliminary information for a study to determine the immediate effects of a single unilateral chiropractic manipulation to the lower cervical spine on handgrip strength and free-throw accuracy in asymptomatic male recreational basketball players. Methods For this study, 24 asymptomatic male recreational right-handed basketball players (age = 26.3 ± 9.2 years, height = 1.81 ± 0.07 m, body mass = 82.6 ± 10.4 kg [mean ± SD]) underwent baseline dominant handgrip isometric strength and free-throw accuracy testing in an indoor basketball court. They were then equally randomized to receive either (1) diversified left lower cervical spine chiropractic manipulative therapy (CMT) at C5/C6 or (2) placebo CMT at C5/C6 using an Activator adjusting instrument on zero force setting. Participants then underwent posttesting of isometric handgrip strength and free-throw accuracy. A paired-samples t test was used to make within-group pre to post comparisons and between-group pre to post comparisons. Results No statistically significant difference was shown between either of the 2 basketball performance variables measured in either group. Isometric handgrip strength marginally improved by 0.7 kg (mean) in the CMT group (P = .710). Free-throw accuracy increased by 13.2% in the CMT group (P = .058). The placebo CMT group performed the same or more poorly during their second test session. Conclusions The results of this preliminary study showed that a single lower cervical spine manipulation did not significantly impact basketball performance for this group of healthy asymptomatic participants. A slight increase in free-throw percentage was seen, which deserves further investigation. This pilot study demonstrates that a larger study to evaluate if CMT affects handgrip strength and free-throw accuracy is feasible. PMID:24396315

  15. Diagnosis and treatment of musculoskeletal chest pain: design of a multi-purpose trial

    PubMed Central

    Stochkendahl, Mette J; Christensen, Henrik W; Vach, Werner; Høilund-Carlsen, Poul Flemming; Haghfelt, Torben; Hartvigsen, Jan

    2008-01-01

    Background Acute chest pain is a major health problem all over the western world. Active approaches are directed towards diagnosis and treatment of potentially life threatening conditions, especially acute coronary syndrome/ischemic heart disease. However, according to the literature, chest pain may also be due to a variety of extra-cardiac disorders including dysfunction of muscles and joints of the chest wall or the cervical and thoracic part of the spine. The diagnostic approaches and treatment options for this group of patients are scarce and formal clinical studies addressing the effect of various treatments are lacking. Methods/Design We present an ongoing trial on the potential usefulness of chiropractic diagnosis and treatment in patients dismissed from an acute chest pain clinic without a diagnosis of acute coronary syndrome. The aims are to determine the proportion of patients in whom chest pain may be of musculoskeletal rather than cardiac origin and to investigate the decision process of a chiropractor in diagnosing these patients; further, to examine whether chiropractic treatment can reduce pain and improve physical function when compared to advice directed towards promoting self-management, and, finally, to estimate the cost-effectiveness of these procedures. This study will include 300 patients discharged from a university hospital acute chest pain clinic without a diagnosis of acute coronary syndrome or any other obvious cardiac or non-cardiac disease. After completion of the clinic's standard cardiovascular diagnostic procedures, trial patients will be examined according to a standardized protocol including a) a self-report questionnaire; b) a semi-structured interview; c) a general health examination; and d) a specific manual examination of the muscles and joints of the neck, thoracic spine, and thorax in order to determine whether the pain is likely to be of musculoskeletal origin. To describe the patients status with regards to ischemic heart disease, and to compare and indirectly validate the musculoskeletal diagnosis, myocardial perfusion scintigraphy is performed in all patients 2–4 weeks following discharge. Descriptive statistics including parametric and non-parametric methods will be applied in order to compare patients with and without musculoskeletal chest pain in relation to their scintigraphic findings. The decision making process of the chiropractor will be elucidated and reconstructed using the CART method. Out of the 300 patients 120 intended patients with suspected musculoskeletal chest pain will be randomized into one of two groups: a) a course of chiropractic treatment (therapy group) of up to ten treatment sessions focusing on high velocity, low amplitude manipulation of the cervical and thoracic spine, mobilisation, and soft tissue techniques. b) Advice promoting self-management and individual instructions focusing on posture and muscle stretch (advice group). Outcome measures are pain, physical function, overall health, self-perceived treatment effect, and cost-effectiveness. Discussion This study may potentially demonstrate that a chiropractor is able to identify a subset of patients suffering from chest pain predominantly of musculoskeletal origin among patients discharged from an acute chest pain clinic with no apparent cardiac condition. Furthermore knowledge about the benefits of manual treatment of patients with musculoskeletal chest pain will inform clinical decision and policy development in relation to clinical practice. Trial registration NCT00462241 and NCT00373828 PMID:18377636

  16. DISCLOSURE TO PHYSICIANS OF CAM USE BY BREAST CANCER PATIENTS: FINDINGS FROM THE WOMEN’S HEALTHY EATING AND LIVING STUDY

    PubMed Central

    Saxe, Gordon A.; Madlensky, Lisa; Kealey, Sheila; Wu, David P.; Freeman, Karen L.; Pierce, John P.

    2009-01-01

    Background Physician awareness of their patients’ use of complementary and alternative medicine (CAM) is crucial, particularly in the setting of a potentially life-threatening disease such as cancer. The potential for harmful treatment interactions may be greatest when a patient sees a CAM practitioner – perceived as a physician-like authority figure – but does not disclose this to their physician. We therefore investigated the extent of nondisclosure in a large cohort of cancer patients. Methods We investigated CAM use in participants of the UCSD Women’s Healthy Eating and Living (WHEL) Study, a multicenter study of the effect of diet and lifestyle on disease-free and overall survival in women ages 18–70 who had completed treatment for invasive breast cancer between 1995 and 2000. Data regarding CAM use and disclosure was collected via a telephone-administered questionnaire in 2003–2004. This questionnaire asked about different CAM modalities including those requiring a “skilled CAM practitioner” (acupuncturist, chiropractor, homeopath, or naturopath) for administration. Demographic data was obtained at the WHEL baseline clinic interview. Modality-specific disclosure rates were determined and a comparison of demographic variables of disclosers versus nondisclosers was conducted using Chi-squared tests for categorical variables, and t-tests for continuous variables. Results Of 3088 total WHEL participants, 2527 completed the CAM questionnaire. Of these, 2017 reported using some form of CAM. Of these, 300 received treatment from an acupuncturist, chiropractor, homeopath, or naturopath and also provided information on whether or not they disclosed this care to their conventional physician. The highest disclosure rate was for naturopathy (85%), followed by homeopathy (74%), acupuncture (71%), and chiropractic (47%). Among demographic characteristics, only education (p = 0.047) and study site (p=0.039) were associated with disclosure. College graduates and postgraduates, in particular, were more likely to disclose CAM use to their physicians than those with lesser education. Conclusion Overall, we observed moderately high rates of physician disclosure of CAM use for all modalities except chiropractic. Education and study site associations suggest that disclosure may be greater when CAM use is more prevalent and possibly more socially accepted. These findings underscore the importance of open, destigmatized patient-physician communication regarding CAM use. PMID:18956493

  17. MULTIPLE CHANNEL RECORDING OF THE ARTICULAR CRACK ASSOCIATED WITH MANIPULATION OF THE METACARPOPHALANGEAL JOINT

    PubMed Central

    Reggars, John W.

    1999-01-01

    Background: The audible release or cracking sound associated with spinal manipulation is familiar to practitioners of spinal manipulative therapy. Furthermore, some authors believe the articular crack to be at least in part responsible for the therapeutic benefits derived from spinal manipulative therapy. Although some research has been directed towards the investigation of some aspects of this phenomenon, little research has be conducted in order to establish from which side and vertebral level the audible release occurs during the manipulative process. Objective: To assess the reliability and accuracy of multiple surface mounted microphones to detect the audible release of the target joint during manipulation of the third metacarpophalangeal joint. Design: Observational study. Setting: Private practice of chiropractic, Ringwood, Victoria, Australia. Participants: Twenty volunteers recruited from staff and patients of the private practice of chiropractic. Method: Eight omnidirectional microphones were affixed to the palmar surface of the hand. Microphone No.1 was positioned directly over the third metacarpophalangeal joint while the remaining microphones were arranged in a uniform pattern over the palmar surface of the hand. Manipulation in the form of long axis traction was then applied to the third metacarpophalangeal joint. Where an audible release was associated with the manipulation the resultant signals were captured via computer and stored for later analysis. Main Outcome Measure: A difference of greater than one volt in peak amplitude between the microphone positioned over the target joint and the other microphones. The student's t-test was then applied to the data in order to determine if the mean output of the target joint microphone was statistically different to the mean output of the other microphones. Results: A total of eighteen manipulations resulted in nineteen audible release signals. The mean voltage of channel 1 was consistently greater than all the other channels in this group of subjects. This difference was statistically significant for all the channels. Conclusion: This research suggests that multiple surface mounted microphones are capable of consistently detecting the audible release from the target joint, with manipulation directed to the third MCP joint. It is hoped that this method will be able to be applied to the audible release associated with spinal manipulative therapy and a better understanding of the manipulative process will ensue. PMID:17987189

  18. UK Back pain Exercise And Manipulation (UK BEAM) trial – national randomised trial of physical treatments for back pain in primary care: objectives, design and interventions [ISRCTN32683578

    PubMed Central

    2003-01-01

    Background Low back pain has major health and social implications. Although there have been many randomised controlled trials of manipulation and exercise for the management of low back pain, the role of these two treatments in its routine management remains unclear. A previous trial comparing private chiropractic treatment with National Health Service (NHS) outpatient treatment, which found a benefit from chiropractic treatment, has been criticised because it did not take treatment location into account. There are data to suggest that general exercise programmes may have beneficial effects on low back pain. The UK Medical Research Council (MRC) has funded this major trial of physical treatments for back pain, based in primary care. It aims to establish if, when added to best care in general practice, a defined package of spinal manipulation and a defined programme of exercise classes (Back to Fitness) improve participant-assessed outcomes. Additionally the trial compares outcomes between participants receiving the spinal manipulation in NHS premises and in private premises. Design Randomised controlled trial using a 3 × 2 factorial design. Methods We sought to randomise 1350 participants with simple low back pain of at least one month's duration. These came from 14 locations across the UK, each with a cluster of 10–15 general practices that were members of the MRC General Practice Research Framework (GPRF). All practices were trained in the active management of low back pain. Participants were randomised to this form of general practice care only, or this general practice care plus manipulation, or this general practice care plus exercise, or this general practice care plus manipulation followed by exercise. Those randomised to manipulation were further randomised to receive treatment in either NHS or private premises. Follow up was by postal questionnaire one, three and 12 months after randomisation. The primary analysis will consider the main treatment effects before interactions between the two treatment packages. Economic analysis will estimate the cost per unit of health utility gained by adding either or both of the treatment packages to general practice care. PMID:12892566

  19. PubMed Central

    Marcotte, Justin; Normand, Martin C

    2001-01-01

    Scientific literature on the dynamic palpation test in chiropractic usually indicates that it is not very reliable and clinically insufficient. The frequent references to the unreliability of this test may be due to the lack of sufficient standardization in performing the test. The multiple nature of the test may be the cause: the test is actually a group of six tests peformed in six directions at each intervertebral level. The palpation pressure and the interpretive aspects of the examiner's tactile perception are other elements to be standardized. In addition, using students without a history of mechanical problems of the spine as subjects is not representative of the usual clinical clientele and could lead to a search for injuries that are too subtle. This pilot-study performed on typical patients, limits the test to the cervical region in only one direction of movement and also standardizes the other parameters of the test. This results in greater reliability between examiners than demonstrated until now. Statistical significance tables established for this type of testing have revealed reliability from moderate to very strong. In the final analysis, the author's observations clearly illustrate the significant effect of standardization of the test on results obtained outside the study.

  20. Quantification de la palpation dynamique : une étude de fidélité pour la rotation cervicale

    PubMed Central

    Marcotte, Justin

    2005-01-01

    BACKGROUND Motion palpation has been used as a diagnostic tool for vertebral subluxation, even though its reliability is questionable. Standardisation of palpation has proven substantially more reliable. A scale of assessment of a standardized palpation has not yet been tested for reliability. OBJECTIVE The measure of intraexaminer and interexaminer reliability of a scale of assessment for the standardized palpation of cervical rotation. DESIGN Intraexaminer study: Twelve chiropractic students were assessed by a blindfolded experienced clinician. Interexaminer study: Twelve regular patients with a history of neck problem were assessed by two chiropractors in a clinical setting. RESULTS Data analysis shows fair to strong reliability (k = 0.34 and 0.65) for the scale of assessment that was used. The results are comparable to other assessment scales used currently in practice. CONCLUSION The utilisation of a scale of assessment for standardised motion palpation may prove a useful clinical tool, as other common testing measures (tendon reflex, muscle tone, muscle strength) which use similar scale of assessment. PMID:17549135

  1. A critical analysis of randomised clinical trials on neck pain and treatment efficacy. A review of the literature.

    PubMed

    Kjellman, G V; Skargren, E I; Oberg, B E

    1999-09-01

    The efficacy of physiotherapy or chiropractic treatment for patients with neck pain was analysed by reviewing 27 randomised clinical trials published 196-1995. Three different methods were employed: systematic analyses of; methodological quality; comparison of effect size; analysis of inclusion criteria, intervention and outcome according to The Disablement Process model. The quality of most of the studies was low; only one-third scored 50 or more of a possible 100 points. Positive outcomes were noted for 18 of the investigations, and the methodological quality was high in studies using electromagnetic therapy, manipulation, or active physiotherapy. High methodological quality was also noted in studies with traction and acupuncture, however, the interventions had either no effect or a negative effect on outcome. Pooling data and calculation of effect size showed that treatments used in the studies were effective for pain, range of motion, and activities of daily living. Inclusion criteria, intervention, and outcome were based on impairment in most of the analysed investigations. Broader outcome assessments probably would have revealed relationships between treatment effect and impairment, functional limitation and disability. PMID:10458312

  2. [History of conservative spinal therapy].

    PubMed

    Kladny, B

    2015-12-01

    Hippocrates was the first to intensively describe and document the principles for the treatment of injuries and diseases of the spine. His principles for abrupt treatment of the "hunchback" were followed by physicians even up to the end of the nineteenth century. The non-operative treatment of scoliosis was improved in the beginning of the sixteenth century by the introduction of mechanical devices that started the development of corsets which are still in use in modern scoliosis treatment. Stretching beds were only in temporary use. With the beginning of the nineteenth century gymnastics and physiotherapy became more and more important. Manual therapy was exercised by physicians until the late Middle Ages. After a long period of time in which bonesetters and other laymen performed manual therapy it was professionalized at the end of the nineteenth century again by the introduction of osteopathy and chiropractic. In Germany the development and introduction of manual treatment started relatively late in the twentieth century, predominantly as manual medicine. PMID:26542053

  3. Differential effects of honey, sucrose, and fructose on blood sugar levels.

    PubMed

    Shambaugh, P; Worthington, V; Herbert, J H

    1990-01-01

    It is now recognized that dietary carbohydrate components influence the prevalence and severity of common degenerative diseases such as dental problems, diabetes, heart disease and obesity. Fructose and sucrose have been evaluated and compared to glucose using glucose tolerance tests, but few such comparisons have been performed for a "natural" sugar source such as honey. In this study, 33 upper trimester chiropractic students volunteered for oral glucose tolerance testing comparing sucrose, fructose and honey during successive weeks. A 75-gm carbohydrate load in 250 ml of water was ingested and blood sugar readings were taken at 0, 30, 60, 90, 120 and 240 minutes. Fructose showed minimal changes in blood sugar levels, consistent with other studies. Sucrose gave higher blood sugar readings than honey at every measurement, producing significantly (p less than .05) greater glucose intolerance. Honey provided the fewest subjective symptoms of discomfort. Given that honey has a gentler effect on blood sugar levels on a per gram basis, and tastes sweeter than sucrose so that fewer grams would be consumed, it would seem prudent to recommend honey over sucrose. PMID:2394949

  4. Spinal Manipulative Therapy for Chronic Lower Back Pain in Older Veterans

    PubMed Central

    Karuza, Jurgis; Dunn, Andrew S.; Savino, Dorian; Katz, Paul

    2014-01-01

    Introduction: Chronic lower back pain (CLBP) is problematic in older veterans. Spinal manipulative therapy (SMT) is commonly utilized for CLBP in older adults, yet there are few randomized placebo-controlled trials evaluating SMT. Methods: The purpose of the study was to compare the effectiveness of SMT to a sham intervention on pain (Visual Analogue Scale, SF-36 pain subscale), disability (Oswestry Disability Index), and physical function (SF-36 subscale, Timed Up and Go) by performing a randomized placebo-controlled trial at 2 Veteran Affairs Clinics. Results: Older veterans (? 65 years of age) who were naive to chiropractic were recruited. A total of 136 were included in the study with 69 being randomly assigned to SMT and 67 to sham intervention. Patients were treated 2 times per week for 4 weeks assessing outcomes at baseline, 5, and 12 weeks postbaseline. Both groups demonstrated significant decrease in pain and disability at 5 and 12 weeks. At 12 weeks, there was no significant difference in pain and a statistically significant decline in disability scores in the SMT group when compared to the sham intervention group. There were no significant differences in adverse events between the groups. Conclusions: The SMT did not result in greater improvement in pain when compared to our sham intervention; however, SMT did demonstrate a slightly greater improvement in disability at 12 weeks. The fact that patients in both groups showed improvements suggests the presence of a nonspecific therapeutic effect. PMID:26246937

  5. Use of complementary and alternative medicine by the adult membership of a large northern California health maintenance organization, 1999.

    PubMed

    Gordon, Nancy P; Lin, Teresa Y

    2004-01-01

    Data from general health surveys completed by random samples of adult members of a large Northern California health maintenance organization in 1996 and 1999 were used to investigate (a) the prevalence of use of 15 complementary and alternative medicine (CAM) modalities by adult members in 1999, (b) how prevalence varied by age group and gender, and (c) which modalities were increasing in popularity. While Northern California is not representative of the nation as a whole, it tends to be a harbinger of trends to come. The most widely used modalities in 1999 were herbal and other nonvitamin/nonmineral nutritional supplements, prayer/spiritual healing done by oneself, chiropractic, massage therapy, and mind-body medicine modalities. However, use of the different modalities varied significantly by age and gender, and rates of use of nutritional supplements and the manipulatives were approximately doubled, when restricted to subpopulations at high risk, for use because of relevant health conditions. There appeared to be a statistically significant, but modest increase in CAM use, mostly due to a large increase in use of nutritional supplements. Implications for how CAM use should be tracked for ambulatory care populations and the importance of addressing nutritional supplement use in ambulatory clinical care are discussed. PMID:14717461

  6. Racial and Ethnic Profiles of Complementary and Alternative Medicine Use Among Young Adults in the United States: Findings From the National Longitudinal Study of Adolescent Health

    PubMed Central

    Upchurch, Dawn M.; Wexler Rainisch, Bethany K.

    2013-01-01

    This study describes complementary and alternative medicine use among a national sample of young adults, with an emphasis on characterizing racial and ethnic differences, highlighting variation across subgroups of Hispanics. The authors examined young adults ages 18 to 27 years (n = 14 128) from wave III (2001–2002) of the National Longitudinal Study of Adolescent Health. Prevalence estimates and logistic regression results were weighted and adjusted for complex sample design. The study examined recent complementary and alternative medicine use in the past 12 months, recent use for each of 15 specific complementary and alternative medicine modalities, and the 5 most commonly used modalities (herbs, massage, chiropractic, relaxation, and vitamins). Results showed that 29% of young adults aged 18 to 27 years recently used complementary and alternative medicine. Prevalence was highest among Cuban Americans (42%) and lowest among blacks (22%). Young adults used a diversity of complementary and alternative medicine modalities and there were substantial differences in use across racial and ethnic groups. PMID:23869288

  7. Efficacy of glucosamine, chondroitin, and methylsulfonylmethane for spinal degenerative joint disease and degenerative disc disease: a systematic review

    PubMed Central

    Stuber, Kent; Sajko, Sandy; Kristmanson, Kevyn

    2011-01-01

    Background: Nutritional supplements are commonly used for a variety of musculoskeletal conditions, including knee and hip degenerative joint disease. Although these supplements are occasionally recommended for patients with degenerative disc disease and spinal degenerative joint disease, the evidence supporting this use is unknown. Objective: To systematically search and assess the quality of the literature on the use of glucosamine, chondroitin sulfate, and methylsulfonylmethane for the treatment of spinal osteoarthritis / degenerative joint disease, and degenerative disc disease. Data Sources: The Index of Chiropractic Literature, AMED, Medline, and CINAHL were searched for randomized controlled trials in English from 1984 to July 2009. Data Extraction and Synthesis: Data from studies meeting the inclusion criteria was extracted and reviewed by three reviewers. The Jadad scale was used to assess study quality. No attempts were made at meta-analysis due to variation in study design. Results: Two articles met the inclusion criteria. One study was found to have good quality but reported negative results for the supplemented group compared with placebo, the other study had low quality but reported significant positive results for the supplemented group when compared with a no intervention control group. Conclusion: There was little literature found to support the use of common nutritional supplements for spinal degeneration, making it difficult to determine whether clinicians should recommend them. PMID:21403782

  8. Assessment of Consistency Between the Arm-Fossa Test and Gillet Test: A Pilot Study

    PubMed Central

    Cooperstein, Robert; Blum, Charles; Cooperstein, Elaine C.

    2015-01-01

    Objective The purpose of this pilot study was to test methods needed to conduct a study with adequate power to investigate consistency between the arm-fossa test (AFT) and the Gillet test. Methods A convenience sample of chiropractic college students enrolled in a weekend Sacro-Occipital Technique seminar participated. Each was tested with AFT and sacroiliac orthopedic tests, including the Gillet test. Statistical testing included calculation of ? for consistency of the AFT and Gillet test and their diagnostic efficiency. Results This study recruited 14 participants. Important issues arose in gathering and recording data, the standardization of examiner methods, and the flow of participants to examination stations. ? for AFT and Gillet test consistency = 0.55, corresponding to “moderate.” Conclusion This pilot suggests that the future study should include a mix of symptomatic and asymptomatic participants; record trichotomous data, where appropriate; use washout periods between diagnostic tests; and refine the selection of orthopedic tests deployed besides the AFT. The preliminary data are consistent with but do not establish due to the very small sample size and experimental design issues, that a positive AFT may be consistent with a negative Gillet test. PMID:26693214

  9. Use of and interest in alternative therapies among adult primary care clinicians and adult members in a large health maintenance organization.

    PubMed Central

    Gordon, N P; Sobel, D S; Tarazona, E Z

    1998-01-01

    During spring 1996, random samples of adult primary care physicians, obstetrics-gynecology physicians and nurse practitioners, and adult members of a large northern California group practice model health maintenance organization (HMO) were surveyed by mail to assess the use of alternative therapies and the extent of interest in having them incorporated into HMO-delivered care. Sixty-one percent (n = 624) of adult primary care physicians, 70% (n = 157) of obstetrics-gynecology clinicians, and 50% (2 surveys, n = 1,507 and n = 17,735) of adult HMO members responded. During the previous 12 months, 25% of adults reported using and nearly 90% of adult primary care physicians and obstetrics-gynecology clinicians reported recommending at least 1 alternative therapy, primarily for pain management. Chiropractic, acupuncture, massage, and behavioral medicine techniques such as meditation and relaxation training were most often cited. Obstetrics-gynecology clinicians used herbal and homeopathic medicines more often than adult primary care physicians, primarily for menopause and premenstrual syndrome. Two thirds of adult primary care physicians and three fourths of obstetrics-gynecology clinicians were at least moderately interested in using alternative therapies with patients, and nearly 70% of young and middle-aged adult and half of senior adult members were interested in having alternative therapies incorporated into their health care. Adult primary care physicians and members were more interested in having the HMO cover manipulative and behavioral medicine therapies than homeopathic or herbal medicines. PMID:9771154

  10. Endovascular Treatment of Basilar Artery Thrombosis Secondary to Bilateral Vertebral Artery Dissection with Symptom Onset Following Cervical Spine Manipulation Therapy

    PubMed Central

    Mikkelsen, Ronni; Dalby, Rikke Beese; Hjort, Niels; Simonsen, Claus Ziegler; Karabegovic, Sanja

    2015-01-01

    Patient: Female, 37 Final Diagnosis: Vertebral artery dissection Symptoms: Neck pain and focal neurological deficits Medication: No previous Clinical Procedure: Endovascular thrombectomy Specialty: Neurology Objective: Rare disease Background: Vertebral artery (VA) dissection (VAD) has been described following neck injury and can be associated with stroke, but the causal association with cervical spine manipulation therapy (cSMT) is controversial. The standard treatment for VAD is antithrombotic medical therapy. To highlight the considerations of an endovascular approach to VAD, we present a critical case of bilateral VAD causing embolic occlusion of the basilar artery (BA) in a patient with symptom debut following cSMT. Case Report: A 37-year-old woman presented with acute onset of neurological symptoms immediately following cSMT in a chiropractic facility. Acute magnetic resonance imaging (MRI) showed ischemic lesions in the right cerebellar hemisphere and occlusion of the cranial part of the BA. Angiography depicted bilateral VAD. Symptoms remitted after endovascular therapy, which included dilatation of the left VA and extraction of thrombus from the BA. After 6 months, the patient had minor sensory and cognitive deficits. Conclusions: In severe cases, VAD may be complicated by BA thrombosis, and this case highlights the importance of a fast diagnostic approach and advanced intravascular procedure to obtain good long-term neurological outcome. Furthermore, this case underlines the need to suspect VAD in patients presenting with neurological symptoms following cSMT. PMID:26647210

  11. Guyon Canal Syndrome: lack of management in a case of unresolved handlebar palsy

    PubMed Central

    Brown, Courtney K.; Stainsby, Brynne; Sovak, Guy

    2014-01-01

    Objective: To present the clinical diagnostic features including management of Guyon canal syndrome in a case with unresolved sensory deficits in a young female cyclist. Clinical Presentation: After 14 days of cycling across Canada, a 23-year old female experienced sensory loss, followed by atrophy and a “claw” hand appearance of her left hand. Intervention and Outcome: Treatment included cervical chiropractic manipulation, soft tissue therapy and the use of cycling gloves. Seven years after the initial injury a lack of sensation in the ulnar nerve distribution of her left hand has persisted. Discussion: This case demonstrates that a lack of proper management can lead to permanent sensory loss and is worth highlighting. Various therapists evaluated the patient’s symptoms and provided minimal care. No diagnosis was given, nor were appropriate measures taken for her to understand the risks of continuing to ride. Summary: Although treatment for Guyon Canal Syndrome can be as easy as cessation from cycling until symptoms subside, other treatment options could be utilized to help manage ulnar nerve compression injuries in cyclists. PMID:25550666

  12. A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome

    PubMed Central

    Lauche, Romy; Cramer, Holger; Häuser, Winfried; Dobos, Gustav; Langhorst, Jost

    2015-01-01

    Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety. PMID:26246841

  13. Adherence to clinical practice guidelines among three primary contact professions: a best evidence synthesis of the literature for the management of acute and subacute low back pain

    PubMed Central

    Amorin-Woods, Lyndon G.; Beck, Randy W.; Parkin-Smith, Gregory F.; Lougheed, James; Bremner, Alexandra P.

    2014-01-01

    Aim: To determine adherence to clinical practice guidelines in the medical, physiotherapy and chiropractic professions for acute and subacute mechanical low back pain through best-evidence synthesis of the healthcare literature. Methods: A structured best-evidence synthesis of the relevant literature through a literature search of relevant databases for peer-reviewed papers on adherence to clinical practice guidelines from 1995 to 2013. Inclusion of papers was based on selection criteria and appraisal by two reviewers who independently applied a modified Downs & Black appraisal tool. The appraised papers were summarized in tabular form and analysed by the authors. Results: The literature search retrieved 23 potentially relevant papers that were evaluated for methodological quality, of which 11 studies met the inclusion criteria. The main finding was that no profession in the study consistently attained an overall high concordance rating. Of the three professions examined, 73% of chiropractors adhered to current clinical practice guidelines, followed by physiotherapists (62%) and then medical practitioners (52%). Conclusions: This review showed that quality papers in this area of research are very limited. Notwithstanding, chiropractors appear to adhere to clinical practice guidelines more so than physiotherapists and medical practitioners, although there is scope for improvement across all three professions. PMID:25202150

  14. A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome.

    PubMed

    Lauche, Romy; Cramer, Holger; Häuser, Winfried; Dobos, Gustav; Langhorst, Jost

    2015-01-01

    Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety. PMID:26246841

  15. Use of Complementary Health Approaches Among Children Aged 4–17 Years in the United States: National Health Interview Survey, 2007–2012

    PubMed Central

    Black, Lindsey I.; Clarke, Tainya C.; Barnes, Patricia M.; Stussman, Barbara J.; Nahin, Richard L.

    2015-01-01

    Objective This report presents national estimates of the use of complementary health approaches among children aged 4–17 years in the United States. Selected modalities are compared for 2007 and 2012 to examine changes over time. Methods Data from the 2007 and 2012 National Health Interview Survey (NHIS) were analyzed for this report. The combined sample included 17,321 interviews with knowledgeable adults about children aged 4–17 years. Point estimates and estimates of their variances were calculated using SUDAAN software to account for the complex sampling design of NHIS. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. Results The use of complementary health approaches among children did not change significantly since 2007 (from 12.0% in 2007 to 11.6% in 2012). However, one approach, the use of traditional healers, showed a statistically significant decrease in use, from 1.1% in 2007 to 0.1% in 2012. No other significant decreases were identified. An increase in the use of yoga was observed during this period (from 2.3% in 2007 to 3.1% in 2012). Nonvitamin, nonmineral dietary supplements; chiropractic or osteopathic manipulation; and yoga, tai chi, or qi gong were the most commonly used complementary health approaches in both 2007 and 2012. Also consistent between 2007 and 2012 was that complementary health approaches were most frequently used for back or neck pain, head or chest cold, anxiety or stress, and other musculoskeletal conditions. PMID:25671583

  16. Cox Decompression Manipulation and Guided Rehabilitation of a Patient With a Post Surgical C6-C7 Fusion With Spondylotic Myelopathy and Concurrent L5-S1 Radiculopathy

    PubMed Central

    Joachim, George C.

    2014-01-01

    Objective The purpose of this case report is to describe combined treatment utilizing Cox distraction manipulation and guided rehabilitation for a patient with spine pain and post-surgical C6-7 fusion with spondylotic myelopathy and L5-S1 radiculopathy. Clinical features A 38-year-old man presented to a chiropractic clinic with neck pain and a history of an anterior cervical spine plate fusion at C6-7 after a work related accident 4 years earlier. He had signs and symptoms of spondolytic myelopathy and right lower back, right posterior thigh pain and numbness. Intervention and outcome The patient was treated with Cox technique and rehabilitation. The patient experienced a reduction of pain on a numeric pain scale from 8/10 to 3/10. The patient was seen a total of 12 visits over 3 months. No adverse effects were reported. Conclusions A patient with a prior C6-7 fusion with spondylotic myelopathy and concurrent L5-S1 radiculopathy improved after a course of rehabilitation and Cox distraction manipulation. Further research is needed to establish its efficiency. PMID:25685119

  17. Non-pharmacological interventions for sleep quality and insomnia during pregnancy: A systematic review

    PubMed Central

    Hollenbach, Dana; Broker, Riley; Herlehy, Stacia; Stuber, Kent

    2013-01-01

    Objective: To systematically review the literature regarding non-pharmacological inteventions for improving sleep quality and insomnia during pregnancy. Methods: An electronic search strategy was conducted using several online databases (CINAHL, PubMed, Medline, Index to Chiropractic Literature) from inception to March 2013. Inclusion criteria consisted of studies evaluating non-pharmacological interventions, published in English in a peer reviewed journal, and assessed sleep quality or insomnia. The full text of suitable articles was reviewed by the authors, and scored using a risk of bias assessment. Results: 160 articles were screened and seven studies met the inclusion criteria in the form of three prospective RCTs, one prospective longitudinal trial, one experimental pilot study, and two prospective quasi-randomized trials. Quality scores ranged from five to eight out of twelve on the risk of bias scoring criteria. Conclusions: Exercise, massage, and acupuncture may be associated with improved sleep quality during pregnancy, however, due to the low quality and heterogeneity of the studies yielded, a definitive recommendation cannot be made. Further higher quality research is indicated. PMID:23997252

  18. Health Care Utilization and Costs Associated with Adherence to Clinical Practice Guidelines for Early Magnetic Resonance Imaging among Workers with Acute Occupational Low Back Pain

    PubMed Central

    Graves, Janessa M; Fulton-Kehoe, Deborah; Jarvik, Jeffrey G; Franklin, Gary M

    2014-01-01

    Objective To estimate health care utilization and costs associated with adherence to clinical practice guidelines for the use of early magnetic resonance imaging (MRI; within the first 6 weeks of injury) for acute occupational low back pain (LBP). Data Sources Washington State Disability Risk Identification Study Cohort (D-RISC), consisting of administrative claims and patient interview data from workers’ compensation claimants (2002–2004). Study Design In this prospective, population-based cohort study, we compared health care utilization and costs among workers whose imaging was adherent to guidelines (no early MRI) to workers whose imaging was not adherent to guidelines (early MRI in the absence of red flags). Data Collection/Extraction Methods We identified workers (age >18) with work-related LBP using administrative claims. We obtained demographic, injury, health, and employment information through telephone interviews to adjust for baseline differences between groups. We ascertained health care utilization and costs from administrative claims for 1 year following injury. Principal Findings Of 1,770 workers, 336 (19.0 percent) were classified as nonadherent to guidelines. Outpatient and physical/occupational therapy utilization was 52–54 percent higher for workers whose imaging was not adherent to guidelines compared to workers with guideline-adherent imaging; utilization of chiropractic care was significantly lower (18 percent). Conclusions Nonadherence to guidelines for early MRI was associated with increased likelihood of lumbosacral injections or surgery and higher costs for out-patient, inpatient, and nonmedical services, and disability compensation. PMID:23910019

  19. Use of histomorphometry in the assessment of fatal vertebral artery dissection.

    PubMed Central

    Johnson, C P; Lawler, W; Burns, J

    1993-01-01

    AIM--To assess morphometrically the structural changes, which occur with ageing, along the length of the vertebral artery. METHODS--A series of 36 vessels were removed at necropsy from subjects aged between 9 months and 86 years. Image analysis was used to measure the medial width, the circumference, the intimal: medial area ratio and the adventitial: medial area ratio along each artery. The artery from a case of fatal vertebral artery dissection, which occurred after a game of cricket and then chiropractic neck manipulation, was also examined in the same manner. The proteoglycan accumulation in the media was quantified using an eyepiece graticule. RESULTS--The vertebral arteries were, on average, larger around the origin of the vessel from the subclavian artery, and the adventitia were relatively thicker at this point, and also after piercing the dura mater. The media were much thinner within the intracranial segment and pronounced intimal thickening occurred with increasing age. The dissected artery showed undoubtable pre-existent structural abnormalities, in the form of massive proteoglycan accumulation, which predisposes an artery to dissection. CONCLUSIONS--These data should help pathologists faced with the task of assessing the underlying structural integrity of the vessel wall in cases of vertebral artery injury. Images PMID:8254085

  20. Development of a Student Mentored Research Program between a Complementary and Alternative Medicine University and a Traditional, Research Intensive University

    PubMed Central

    Sullivan, Barbara M.; Furner, Sylvia E.; Cramer, Gregory D.

    2014-01-01

    The global need to develop clinician-scientists capable of using research in clinical practice, translating research knowledge into practice, and carrying out research that affects the quality, efficacy, and efficiency of health care is well-documented. The complementary and alternative medicine (CAM) professions embrace the call to develop physician-researchers to carry out translational and applied research for CAM modalities. CAM universities face unique challenges when implementing research training compared to traditional, research intensive (TRI) universities and medical centers where the majority of medical research is carried out. The authors present the development and outcomes of a mentored research program (MRP) between a CAM and a TRI institution, the National University of Health Sciences and the University of Illinois at Chicago School of Public Health, between 2006 and 2012. CAM pre-doctoral students engaged in a full-immersion semester at the TRI, including didactic courses and active research with a TRI faculty research mentor. Half of the participating doctor of chiropractic (DC) students continued on to PhD programs and half established integrative medicine, primary care clinical careers. Establishing rigorous criteria for mentors and mentees, communicating expectations, developing solid relationships between the mentor, mentee, and home school advisor, responding quickly to impediments, and providing adequate support from CAM and TRI investigators were key to the MRP success. To sustain research opportunities, coordinated degree programs for the DC and master of public health (DC/MPH) and master of clinical and translational research (DC/MS CTS) were established. PMID:24988423

  1. Management of a 59-year-old female patient with adult degenerative scoliosis using manipulation under anesthesia

    PubMed Central

    Morningstar, Mark W.; Strauchman, Megan N.

    2010-01-01

    Objective Manipulation under anesthesia (MUA) is an outpatient procedure that is performed to restore normal joint kinematics and musculoskeletal function. This article presents a case of a patient with idiopathic lumbar degenerative scoliosis who developed intractable pain as an adult and reports on the outcomes following a trial of MUA. Clinical Features A 59-year-old female patient presented to a chiropractic office with primary subjective symptoms of lower back and bilateral hip pain. Numerical pain rating scores were reported at 8 of 10 for the lower back and 9 of 10 for the sacroiliac joint/gluteal region. A disability score using a functional rating index demonstrated a score of 26 of 40 (or 64% disability). Over the preceding 5 years, the patient had tried a number of conservative therapies to relieve her pain without success. Intervention and Outcome The patient was evaluated for MUA. The patient was scheduled for a serial MUA over 3 days. Numerical pain rating scores 8 weeks after the MUA were 1 of 10 for the lower back and 3 of 10 for the sacroiliac joint. Her disability rating decreased to 11 of 40 (28%). Radiological improvements were also observed. These outcomes were maintained at 6-month follow-up. Conclusion Pain, functional, and radiographic outcomes demonstrated improvements immediately following treatment for this patient. PMID:21629554

  2. Adolescent idiopathic scoliosis: Indications and efficacy of nonoperative treatment

    PubMed Central

    Canavese, Federico; Kaelin, André

    2011-01-01

    The strategy for the treatment of idiopathic scoliosis depends essentially upon the magnitude and pattern of the deformity, and its potential for progression. Treatment options include observation, bracing and/or surgery. During the past decade, several studies have demonstrated that the natural history of adolescent idiopathic scoliosis can be positively affected by nonoperative treatment, especially bracing. Other forms of conservative treatment, such as chiropractic or osteopathic manipulation, acupuncture, exercise or other manual treatments, or diet and nutrition, have not yet been proven to be effective in controlling spinal deformity progression, and those with a natural history that is favorable at the completion of growth. Observation is appropriate treatment for small curves, curves that are at low risk of progression, and those with a natural history that is favorable at the completion of growth. Indications for brace treatment are a growing child presenting with a curve of 25°–40° or a curve less than 25° with documented progression. Curves of 20°–25° in patients with pronounced skeletal immaturity should also be treated. The purpose of this review is to provide information about conservative treatment of adolescent idiopathic scoliosis. Indications for conservative treatment, hours daily wear and complications of brace treatment as well as brace types are discussed. PMID:21221217

  3. Pathophysiological model for chronic low back pain integrating connective tissue and nervous system mechanisms.

    PubMed

    Langevin, Helene M; Sherman, Karen J

    2007-01-01

    Although chronic low back pain (cLBP) is increasingly recognized as a complex syndrome with multifactorial etiology, the pathogenic mechanisms leading to the development of chronic pain in this condition remain poorly understood. This article presents a new, testable pathophysiological model integrating connective tissue plasticity mechanisms with several well-developed areas of research on cLBP (pain psychology, postural control, neuroplasticity). We hypothesize that pain-related fear leads to a cycle of decreased movement, connective tissue remodeling, inflammation, nervous system sensitization and further decreased mobility. In addition to providing a new, testable framework for future mechanistic studies of cLBP, the integration of connective tissue and nervous system plasticity into the model will potentially illuminate the mechanisms of a variety of treatments that may reverse these abnormalities by applying mechanical forces to soft tissues (e.g. physical therapy, massage, chiropractic manipulation, acupuncture), by changing specific movement patterns (e.g. movement therapies, yoga) or more generally by increasing activity levels (e.g. recreational exercise). Non-invasive measures of connective tissue remodeling may eventually become important tools to evaluate and follow patients with cLBP in research and clinical practice. An integrative mechanistic model incorporating behavioral and structural aspects of cLBP will strengthen the rationale for a multidisciplinary treatment approach including direct mechanical tissue stimulation, movement reeducation, psychosocial intervention and pharmacological treatment to address this common and debilitating condition. PMID:16919887

  4. Daily activity patterns of an adult experiencing lower back pain undergoing electro-acupuncture: a case study.

    PubMed

    Koski, Bonnie L; Dunn, Karen S; Shebuski, Mark R

    2009-12-01

    In the United States, adults experiencing lower back pain (LBP) have reported using alternative health care to manage symptoms. Chiropractic techniques, relaxation, and massage have been cited as the most commonly used alternative therapies. Electro-acupuncture (EA), along with conventional health care, has been found to be a useful complementary and alternative medicine (CAM) modality in alleviating the disability associated with LBP. The purpose of this single-subject case study was to evaluate the daily activity pattern effects of EA and CAM modality usage on pain intensity levels and functional status of an adult experiencing LBP. Activity patterns and pain intensity ratings were recorded for two consecutive weeks through the use of a daily pain diary in natural environments. Results from the data analyses revealed daily LBP intensity ratings ranging from slight to moderate pain. On average, the participant reported using approximately ten CAM modalities per day. The participant reported decreases in pain intensity levels, increases in energy levels, and feeling better after EA and acupuncture treatments, maintaining an exercise and weight loss regimen, taking megavitamins, drinking teas, praying, singing, and using humor, distraction, and relaxation techniques. Use of herbs and too much exercise were the least effective. Findings suggest that for this patient, EA and certain CAM modalities were effective interventions that promoted well-being and self-healing. In addition, the daily pain diary was found to provide rich research and assessment data. PMID:19944374

  5. Intradiscal Pressure Changes during Manual Cervical Distraction: A Cadaveric Study

    PubMed Central

    Gudavalli, M. R.; Potluri, T.; Carandang, G.; Havey, R. M.; Voronov, L. I.; Cox, J. M.; Rowell, R. M.; Kruse, R. A.; Joachim, G. C.; Patwardhan, A. G.; Henderson, C. N. R.; Goertz, C.

    2013-01-01

    The objective of this study was to measure intradiscal pressure (IDP) changes in the lower cervical spine during a manual cervical distraction (MCD) procedure. Incisions were made anteriorly, and pressure transducers were inserted into each nucleus at lower cervical discs. Four skilled doctors of chiropractic (DCs) performed MCD procedure on nine specimens in prone position with contacts at C5 or at C6 vertebrae with the headpiece in different positions. IDP changes, traction forces, and manually applied posterior-to-anterior forces were analyzed using descriptive statistics. IDP decreases were observed during MCD procedure at all lower cervical levels C4-C5, C5-C6, and C6-C7. The mean IDP decreases were as high as 168.7 KPa. Mean traction forces were as high as 119.2 N. Posterior-to-anterior forces applied during manual traction were as high as 82.6 N. Intraclinician reliability for IDP decrease was high for all four DCs. While two DCs had high intraclinician reliability for applied traction force, the other two DCs demonstrated only moderate reliability. IDP decreases were greatest during moving flexion and traction. They were progressevely less pronouced with neutral traction, fixed flexion and traction, and generalized traction. PMID:24023587

  6. Adventure racing: Roles and protocols for the sports chiropractor

    PubMed Central

    Kohler, Michael K.

    2003-01-01

    Abstract Objective To describe and discuss the health care needs within the sport of adventure racing, specifically relating to the parameters for sports chiropractors serving at such events, and to help further develop these in a scholarly format to assist in overcoming the paucity of such information. Methods A review of the diminutive literature base available pertaining to adventure racing was used in conjunction with a retrospective analysis of injury statistics from a multi-day adventure race. Discussion Adventure racing is an ultra-endurance, multi-discipline, team sport. Races typically cover great distances, often under brutal conditions and circumstances. Training for and competing in such events frequently causes deleterious health consequences and sports chiropractors are uniquely qualified to provide treatment for most of these problems. Specific preparatory and participatory parameters are discussed to assist the sports chiropractor in his or her health care service role within the sport of adventure racing. Conclusion Adventure racing is a new and expanding sport, and so is chiropractic's role of involvement. Few published papers exist in peer-reviewed journals relative to what health care providers can expect at adventure races, and how they can most effectively participate. This paper adds published material to the scientific literature regarding the health care needs and the treatment parameters within the sport of adventure racing. PMID:19674588

  7. Infectious Diseases Physicians' Attitudes and Practices Related to Complementary and Integrative Medicine: Results of a National Survey

    PubMed Central

    Shere-Wolfe, Kalpana D.; Tilburt, Jon C.; D'Adamo, Chris; Berman, Brian; Chesney, Margaret A.

    2013-01-01

    Background. Complementary and alternative medicine (CAM) and integrative medicine (IM) modalities are widely used by patients, including those with infectious diseases (ID). Methods. One thousand randomly selected ID practitioners were surveyed. The survey was divided into domains related to familiarity and recommendation, beliefs and attitudes, and use of CAM/IM modalities. Results. The response rate was 31%. ID physicians were most familiar with vitamin and mineral supplementation (83%), massage (80%), acupuncture (79%), chiropractic (77%), yoga (74%), and herbal medicine (72%). ID physicians most recommended vitamin and mineral supplementation (80%) and massage (62%). Yoga, meditation, and acupuncture were recommended by 52%, 45%, and 46%, respectively. Drug interactions, clinical research, and knowledge of CAM/IM modalities were factors that were considered a major influence. Almost 80% of respondents indicated an interest in IM versus 11% for CAM. Most respondents (75%) felt that IM modalities are useful, and more than 50% believed that they could directly affect the immune system or disease process. Conclusion. ID physicians expressed a markedly greater interest for IM versus CAM. They appear to be familiar and willing to recommend some CAM/IM modalities and see a role for these in the management of certain infectious diseases. Data regarding clinical efficacy and safety appear to be important factors. PMID:23935658

  8. Can formative quizzes predict or improve summative exam performance?*

    PubMed Central

    Zhang, Niu; Henderson, Charles N.R.

    2015-01-01

    Objective Despite wide use, the value of formative exams remains unclear. We evaluated the possible benefits of formative assessments in a physical examination course at our chiropractic college. Methods Three hypotheses were examined: (1) Receiving formative quizzes (FQs) will increase summative exam (SX) scores, (2) writing FQ questions will further increase SE scores, and (3) FQs can predict SX scores. Hypotheses were tested across three separate iterations of the class. Results The SX scores for the control group (Class 3) were significantly less than those of Classes 1 and 2, but writing quiz questions and taking FQs (Class 1) did not produce significantly higher SX scores than only taking FQs (Class 2). The FQ scores were significant predictors of SX scores, accounting for 52% of the SX score. Sex, age, academic degrees, and ethnicity were not significant copredictors. Conclusion Our results support the assertion that FQs can improve written SX performance, but students producing quiz questions didn't further increase SX scores. We concluded that nonthreatening FQs may be used to enhance student learning and suggest that they also may serve to identify students who, without additional remediation, will perform poorly on subsequent summative written exams. PMID:25517737

  9. Interdisciplinary Management of Deep Vein Thrombosis During Rehabilitation of Acute Rupture of the Anterior Cruciate Ligament: A Case Report

    PubMed Central

    Reckelhoff, Kenneth E.; Miller, Anthony

    2014-01-01

    Objective The purpose of this case report is to describe a patient who experienced deep venous thrombosis (DVT) during pre-operative rehabilitation of an acute rupture of an anterior cruciate ligament (ACL) reconstruction graft, to increase awareness of DVT occurring in a healthy individual after periodic immobilization, and to describe the interdisciplinary management for this patient. Clinical features A 30-year-old male was referred to a chiropractic clinic for presurgical treatment of a left ACL rupture and medial meniscus tear confirmed at magnetic resonance imaging. During the course of preoperative rehabilitation, the patient became limited in ambulation and presented for a routine rehabilitation visit. During this visit, he experienced increased leg swelling, pain and tenderness. The patient was assessed for DVT and was referred to the local emergency department for further evaluation where multiple DVTs were found in the left popliteal, posterior tibial, and peroneal veins. Intervention/outcome The patient was treated with a 17-week course of warfarin during which time the clinical signs and symptoms of DVT resolved. Meanwhile, the patient completed the rehabilitation treatment plan in preparation for ACL reconstruction without further complications. Conclusions This case raises awareness that DVT may occur in a healthy individual after periodic immobilization. While there may be controversy regarding the appropriate application of pharmaceutical anticoagulants in patients with DVT of the leg, the most risk averse strategy is for a short duration prescription medication with compression stockings. Through interdisciplinary management, the patient experienced a successful outcome. PMID:25685121

  10. Active functional restoration and work hardening program returns patient with 2½-year-old elbow fracture-dislocation to work after 6 months: a case report

    PubMed Central

    Teperman, Lorne J

    2002-01-01

    The rehabilitation of elbow fracture and dislocation is not generally considered a mainstream chiropractic concern. The clinician who is able to successfully manage the elbow articulation will rely upon his/her knowledge of functional anatomy, pathobiomechanics, history and examination principles, when selecting the appropriate treatment available. A case is presented of an individual that sustained a radial head fracture and dislocation following a motor vehicle accident. Subsequent to receiving 1½ years of physiotherapy for post-surgical complications (decreased range of motion, pain, stiffness and tingling to the 4th and 5th fingers), the patient was referred to a multidisciplinary clinic for a Work Hardening/Conditioning Program. This article discusses the need for active functional restoration vs. passive therapy, work hardening regimens and outcome measures. After 6 months of rehabilitation and 3 years following his motor vehicle accident, the patient has successfully returned to his previous work environment. A summary of the sequential steps in providing appropriate management has been provided.

  11. Weight gain as a consequence of living a modern lifestyle: a discussion of barriers to effective weight control and how to overcome them

    PubMed Central

    Seaman, David R.

    2013-01-01

    Objective The purpose of this commentary is to discuss modern lifestyle factors that promote weight gain and to suggest methods for clinicians to more effectively educate patients about weight management. Discussion Most adults in the United States are overweight or obese. Multiple factors related to the modern lifestyle appear to play causal roles. In general, the population maintains sedentary lives and overconsumes calorie-dense foods. In particular, refined carbohydrates negatively impact metabolism and stimulate neural addiction mechanisms, which facilitate weight gain. As adipose tissue mass accumulates, satiation centers in the hypothalamus become resistant to insulin and leptin, which leads to increased caloric consumption. Several behavior issues further augment weight gain, such as eating too quickly, a lack of sleep, high stress levels, and a lack of exercise. Finally, adipose tissue accumulation alters the body weight set point, which leads to metabolic changes that function to resist weight loss efforts. Each of these factors may work together to augment weight gain and promote obesity. Health care providers, such as chiropractic physicians, who educate patients on wellness, prevention, and lifestyle changes are well positioned to address these issues. Conclusion People need to be educated about the modern lifestyle factors that prevent effective weight management. Without this knowledge and the associated practical application of lifestyle choices that prevent weight gain, becoming overweight or obese appears to be an unavoidable consequence of living a modern lifestyle. PMID:25067929

  12. [Complementary medicine--the facts].

    PubMed

    Grossman, Ehud

    2011-08-01

    The popularity of complementary medicine in the western world continues to grow. Complementary medicine has a wide scope of topics including acupuncture, hypnosis, meditation, chiropractic manipulation, tai chi, yoga, botanical and herbal supplements and many other undefined modalities such as copper bracelets, magnets, holy water etc. For most modalities the mechanism of action is unknown and the evidence of benefit is poor. Some modalities such as acupuncture, hypnosis and tai chi may improve pain and other subjective complains. It seems that most of the beneficial effects of complementary medicine are placebo effects. Complementary treatment may be associated with side effects and should not be an alternative to the conventional medicine. Complementary medicine can be used as an adjunct to the conventional medicine and should be used in full agreement with and under the supervision of the attending physician. Patients should be informed about the existing evidence and what to expect from complementary medicine. Further meticulous research should be conducted to expand our knowledge in complementary medicine. PMID:21939118

  13. Clinical efficacy, mechanisms of action, and adverse effects of complementary and alternative medicine therapies for asthma.

    PubMed

    Bielory, Leonard; Russin, Jonathan; Zuckerman, Gary B

    2004-01-01

    Complementary and Alternative Medicine (CAM) therapies such as herbal therapy, acupuncture, yoga, homeopathy, chiropractic medicine, and massage therapy, continue to gain popularity as modalities for the treatment of asthma. In the Chinese, Japanese, Korean, Indian, and Western cultures, herbal therapies appear to be commonly used for allergies. Although well-controlled scientific studies have not been performed on many of the Asian herbal therapies and some basic studies have been performed on various herbal components (active ingredients), more needs to be done to assess the composite effects of many herbal remedies. An important part of the assessment of CAM modalities is the therapeutic-toxicologic safety profile (risk-benefit ratio), and further research evaluating the clinical efficacy and mechanism of action of various CAM interventions for asthma is greatly needed. This paper focuses on clinical and laboratory research regarding various CAM therapies that have been used in the treatment of asthma. The references cited are confined to literature originally published or translated into English. PMID:15603200

  14. R + C Factors and Sacro Occipital Technique Orthopedic Blocking: a pilot study using pre and post VAS assessment

    PubMed Central

    Blum, Charles L.

    2015-01-01

    Introduction: The concept of a systematic or predictive relationship between distant vertebral levels distinct from accumulative functional compensatory mechanisms, such as in scoliosis, has been perpetuated within chiropractic technique systems based on clinical observation and experience. This study seeks to investigate this relationship between the cervical and lumbar vertebrae. Methods: Patients (experimental group n=26 and control group n=12) were selected from the patient base of one office, and were limited to patients that had sensitivity at specific cervical reflex points. Using a pre and post outcome measurement and sacro occipital technique R + C protocols, the related lumbar vertebra was adjusted in the direction indicated by the cervical vertebral sensitivity. Results: Statistical analysis revealed there was a statistically significant difference between pre- and post-VAS measurements and found that the notable difference in mean change in VAS scores were statistically significantly different between the experimental and control groups (p < .001). Conclusion: The findings of this study suggest that further research into cervical and lumbar vertebra interrelationships, and the efficacy of orthopedic block treatment, may be warranted. Further studies are needed to confirm whether a causal relationship exists between lumbar manipulation and decreased cervical spine sensitivity. PMID:26136605

  15. Infantile Colic: Recognition and Treatment.

    PubMed

    Johnson, Jeremy D; Cocker, Katherine; Chang, Elisabeth

    2015-10-01

    Infantile colic is a benign process in which an infant has paroxysms of inconsolable crying for more than three hours per day, more than three days per week, for longer than three weeks. It affects approximately 10% to 40% of infants worldwide and peaks at around six weeks of age, with symptoms resolving by three to six months of age. The incidence is equal between sexes, and there is no correlation with type of feeding (breast vs. bottle), gestational age, or socioeconomic status. The cause of infantile colic is not known; proposed causes include alterations in fecal microflora, intolerance to cow's milk protein or lactose, gastrointestinal immaturity or inflammation, increased serotonin secretion, poor feeding technique, and maternal smoking or nicotine replacement therapy. Colic is a diagnosis of exclusion after a detailed history and physical examination have ruled out concerning causes. Parental support and reassurance are key components of the management of colic. Simethicone and proton pump inhibitors are ineffective for the treatment of colic, and dicyclomine is contraindicated. Treatment options for breastfed infants include the probiotic Lactobacillus reuteri (strain DSM 17938) and reducing maternal dietary allergen intake. Switching to a hydrolyzed formula is an option for formula-fed infants. Evidence does not support chiropractic or osteopathic manipulation, infant massage, swaddling, acupuncture, or herbal supplements. PMID:26447441

  16. Oswald Hall, PhD: Pioneer Canadian Sociologist; 1924–1976

    PubMed Central

    Brown, Douglas M.

    2006-01-01

    At ninety-eight (2006), Oswald Hall is Canada’s senior, distinguished sociologist. For several decades Dr. Hall’s colleagues have acknowledged his abiding “contributions to the growth of sociology in Canada and his loyalty to the profession.”1 The prime purpose of this paper is to document Dr. Hall’s legacy. It begins by briefly looking at Dr. Hall’s origins and early training. Then it investigates his graduate and postgraduate education and delves into his varied roles as a teacher, researcher, civil servant, and administrator, as well as his appointments to various advisory bodies, enquiries, boards and associations and concludes with a commentary on Oswald Hall’s accomplishments. Throughout the paper, Dr. Hall’s major publications are reviewed chronologically. This study does not include Hall’s twenty-seven year involvement with the chiropractic profession (1976 to 1998) because that era has been covered extensively in the December 2005 issue of the JCCA.2 Much of the article is based on testimony from colleagues and friends, as well as quotes from some of Hall’s unpublished writings and manuscripts. Unpublished Hall quotes are identified in the references by their titles and/or dates. PMID:17549188

  17. Subtle clinical signs of a meningioma in an adult: a case report

    PubMed Central

    2014-01-01

    Background Meningiomas are the most common brain tumor in the adult population. This case report describes the epidemiology, the clinical presentation as well as the current treatment options for this condition. Case presentation A 49 year-old man attended a chiropractic clinic with non-specific chronic low back pain. Upon the history taking and the systems review, he reported a loss of both smell and taste for which investigations conducted by two different otolaryngologists did not yield a specific diagnosis. The patient was referred to a neurologist who ordered a computer tomography scan that eventually revealed a compression brain tumor. Brain tumors can produce a large variety of clinical presentations, such as upper motor neuron lesion symptoms, altered consciousness or vital functions which are easy to identify. However, subtle signs, such as those presented in this case, can be neglected. Conclusion Clinicians should be aware of uncommon clinical presentations including cranial nerve or neurological dysfunction and refer their patient to a specialist when detected. PMID:24490991

  18. Diagnostic and treatment methods used by chiropractors: A random sample survey of Canada’s English-speaking provinces

    PubMed Central

    Puhl, Aaron A.; Reinhart, Christine J; Injeyan, H. Stephen

    2015-01-01

    Objective: It is important to understand how chiropractors practice beyond their formal education. The objective of this analysis was to assess the diagnostic and treatment methods used by chiropractors in English-speaking Canadian provinces. Methods: A questionnaire was created that examined practice patterns amongst chiropractors. This was sent by mail to 749 chiropractors, randomly selected and stratified proportionally across the nine English-speaking Canadian provinces. Participation was voluntary and anonymous. Data were entered into an Excel spreadsheet, and descriptive statistics were calculated. Results: The response rate was 68.0%. Almost all (95.1%) of respondents reported performing differential diagnosis procedures with their new patients; most commonly orthopaedic testing, palpation, history taking, range of motion testing and neurological examination. Palpation and painful joint findings were the most commonly used methods to determine the appropriate joint to apply manipulation. The most common treatment methods were manual joint manipulation/mobilization, stretching and exercise, posture/ergonomic advice and soft-tissue therapies. Conclusions: Differential diagnosis is a standard part of the assessment of new chiropractic patients in English-speaking Canadian provinces and the most common methods used to determine the site to apply manipulation are consistent with current scientific literature. Patients are treated with a combination of manual and/or manipulative interventions directed towards the joints and/or soft-tissues, as well as exercise instruction and postural/ergonomic advice. PMID:26500362

  19. An integrative treatment approach of a patient with cervical radiculitis: A case report

    PubMed Central

    Apfelbeck, Leanne

    2005-01-01

    Abstract Objective To describe a case report of the use of 3 treatment methods for treatment of cervical radiculitis; manual intermittent traction, instrumental chiropractic spinal manipulation, and interferential therapy. Clinical Features A 54-year-old man experienced neck and left arm pain with positive orthopedic tests indicating cervical spinal nerve root involvement; he was diagnosed with cervical radiculitis Intervention and Outcome The patient received 10 treatments over a period of 8 weeks. Instrumental spinal manipulation, manual intermittent traction, and interferential therapy were integrated as a treatment plan for the patient. The patient's condition appeared to resolve. Outcome measures were evaluated at baseline, weeks 3, 5, and 8. Neck Disability Index scores were 32%, 14%, 8%, and 4% respectively, and the Visual Analog Scales were 8.5/10, 2.0/10, 1.0/10, and 0.5/10. The symptoms of cervical radiculitis was resolved in an 8 week period after 10 treatments. Conclusion The integration of instrumental spinal manipulation, manual intermittent traction, and interferential may work well together for patients with similar signs and symptoms as presented in this case. PMID:19674652

  20. Interprofessional Competencies in Integrative Primary Healthcare.

    PubMed

    Kligler, Benjamin; Brooks, Audrey J; Maizes, Victoria; Goldblatt, Elizabeth; Klatt, Maryanna; Koithan, Mary S; Kreitzer, Mary Jo; Lee, Jeannie K; Lopez, Ana Marie; McClafferty, Hilary; Rhode, Robert; Sandvold, Irene; Saper, Robert; Taren, Douglas; Wells, Eden; Lebensohn, Patricia

    2015-09-01

    In October 2014, the National Center for Integrative Primary Healthcare (NCIPH) was launched as a collaboration between the University of Arizona Center for Integrative Medicine and the Academic Consortium for Integrative Health and Medicine and supported by a grant from the Health Resources and Services Administration. A primary goal of the NCIPH is to develop a core set of integrative healthcare (IH) competencies and educational programs that will span the interprofessional primary care training and practice spectra and ultimately become a required part of primary care education. This article reports on the first phase of the NCIPH effort, which focused on the development of a shared set of competencies in IH for primary care disciplines. The process of development, refinement, and adoption of 10 "meta-competencies" through a collaborative process involving a diverse interprofessional team is described. Team members represent nursing, the primary care medicine professions, pharmacy, public health, acupuncture, naturopathy, chiropractic, nutrition, and behavioral medicine. Examples of the discipline-specific sub-competencies being developed within each of the participating professions are provided, along with initial results of an assessment of potential barriers and facilitators of adoption within each discipline. The competencies presented here will form the basis of a 45-hour online curriculum produced by the NCIPH for use in primary care training programs that will be piloted in a wide range of programs in early 2016 and then revised for wider use over the following year. PMID:26421232

  1. Pilot study of the impact sacroiliac joint manipulation has on walking kinematics using motion analysis technology

    PubMed Central

    Ward, John S.; Coats, Jesse; Sorrels, Kenneth; Walters, Mathew; Williams, Trevor

    2013-01-01

    Objective The purpose of this study was to evaluate the feasibility of engaging in a series of larger studies measuring the effect of sacroiliac joint manipulation on walking kinematics using motion analysis technology. Methods Twelve college students engaged in a baseline 90-second gait analysis at 1.5 mph using infrared VICON cameras. Following this, they underwent a prone heel comparison test for functional leg length inequality. Upon examination, participants were then classified as follows: left short leg, right short leg, or no short leg. Participants in each of the 2 short leg branches of this study were then randomized to receive either chiropractic manipulative therapy to the posterior superior iliac spine on the short limb side or no manipulation. Recruitment was ongoing for this pilot study until 1 participant was recruited in each of the following 5 comparative study groups: left short leg—manipulation, left short leg—no manipulation (control 1), right short leg—manipulation, right short leg—no manipulation (control 2), and no short leg (control 3). All participants then underwent another 90-second gait analysis. Data were then grouped and submitted to a blinded biomechanist to determine if there were any unique biomechanical differences between the groups. Results No statistically significant differences were measured because of this being a pilot study with a small sample size. Conclusions The data from this study indicate that a series of larger studies with this design is feasible. PMID:24396314

  2. Conservative therapy for plantar fasciitis: a narrative review of randomized controlled trials

    PubMed Central

    Stuber, Kent; Kristmanson, Kevyn

    2006-01-01

    A narrative literature review of RCTs only, was conducted to ascertain which conservative treatments provide the best results for plantar fasciitis patients. Stretching, prefabricated and custom-made orthotics and night splints have all been scrutinized in numerous studies with mixed results. Chiropractic manipulative therapy has been examined in one study, with favorable results. Therapeutic ultrasound and low intensity laser therapy have been examined in one study apiece with unsatisfactory results. Based on the trials reviewed a trial of therapy beginning with low-cost, patient-centered treatments is recommended, particularly stretching, over-the-counter orthotics, and patient education. Several (but not all) of the reviewed articles indicated that custom-made orthoses are more beneficial for plantar fasciitis than over-the-counter orthotics. In the event these treatments do not provide satisfactory results, use of night splints should be considered. Based on this review, there is no support for the use of magnetic insoles for plantar fasciitis. Most of the studies were found to have at least one methodological flaw, including inadequate sample sizes, high drop-out rates, comparing multiple interventions to multiple interventions (thus making it difficult to determine the effect of each individual intervention) and lack of long-term follow-up. Outcome measure use between studies was inconsistent. PMID:17549177

  3. Endovascular Treatment of Basilar Artery Thrombosis Secondary to Bilateral Vertebral Artery Dissection with Symptom Onset Following Cervical Spine Manipulation Therapy.

    PubMed

    Mikkelsen, Ronni; Dalby, Rikke Beese; Hjort, Niels; Simonsen, Claus Ziegler; Karabegovic, Sanja

    2015-01-01

    BACKGROUND Vertebral artery (VA) dissection (VAD) has been described following neck injury and can be associated with stroke, but the causal association with cervical spine manipulation therapy (cSMT) is controversial. The standard treatment for VAD is antithrombotic medical therapy. To highlight the considerations of an endovascular approach to VAD, we present a critical case of bilateral VAD causing embolic occlusion of the basilar artery (BA) in a patient with symptom debut following cSMT. CASE REPORT A 37-year-old woman presented with acute onset of neurological symptoms immediately following cSMT in a chiropractic facility. Acute magnetic resonance imaging (MRI) showed ischemic lesions in the right cerebellar hemisphere and occlusion of the cranial part of the BA. Angiography depicted bilateral VAD. Symptoms remitted after endovascular therapy, which included dilatation of the left VA and extraction of thrombus from the BA. After 6 months, the patient had minor sensory and cognitive deficits. CONCLUSIONS In severe cases, VAD may be complicated by BA thrombosis, and this case highlights the importance of a fast diagnostic approach and advanced intravascular procedure to obtain good long-term neurological outcome. Furthermore, this case underlines the need to suspect VAD in patients presenting with neurological symptoms following cSMT. PMID:26647210

  4. Low back pain radiating to the leg: an atypical cause.

    PubMed

    Gialanella, B; Prometti, P; Ferlucci, C

    2013-01-01

    This study reports the case of a 47-year old female with low back pain radiating to groin and anterior regions of the left thigh and leg. At symptoms onset, electromyography showed left L3-L4 radiculopathy, and nuclear magnetic resonance revealed disc protrusion at the same level with impingement of the spinal nerve root. The clinical symptoms were ascribed to lumbar disco-radicular conflict. The patient underwent steroidal anti-inflammatory treatment with epidural steroid injections, chiropractic spinal manipulations and rehabilitation program, with no relief. Thirteen months after the onset of pain, a computed tomography of sacroiliac joints showed osteolytic lesion in the iliac bone of left joint, and a bone scintigraphy highlighted foci of intense uptake at left iliac bone and left proximal extremity of the femur. The bone biopsy and pathological examinations showed findings consistent with large B-cell non-Hodgkin lymphoma. This case report highlights the fact that in making differential diagnosis of low back pain radiating to the leg we have to consider the rare possibility that pain can be due to non-Hodgkin lymphoma that involves simultaneously the iliac bone and proximal extremity of the femur. PMID:24217828

  5. Development of a student-mentored research program between a complementary and alternative medicine university and a traditional, research-intensive university.

    PubMed

    Sullivan, Barbara M; Furner, Sylvia E; Cramer, Gregory D

    2014-09-01

    The global need to develop clinician-scientists capable of using research in clinical practice, translating research knowledge into practice, and carrying out research that affects the quality, efficacy, and efficiency of health care is well documented. The complementary and alternative medicine (CAM) professions embrace the call to develop physician-researchers to carry out translational and applied research for CAM modalities. CAM universities face unique challenges when implementing research training compared with traditional, research-intensive (TRI) universities and medical centers where the majority of medical research is carried out.The authors present the development and outcomes of a mentored research program (MRP) between a CAM and a TRI institution, the National University of Health Sciences and the University of Illinois at Chicago School of Public Health, between 2006 and 2012. CAM predoctoral students engaged in a full-immersion semester at the TRI, including didactic courses and active research with a TRI faculty research mentor. Half of the participating doctor of chiropractic (DC) students continued on to PhD programs, and half established integrative medicine, primary care clinical careers.Establishing rigorous criteria for mentors and mentees, communicating expectations, developing solid relationships between the mentor, mentee, and home school advisor, responding quickly to impediments, and providing adequate support from CAM and TRI investigators were key to the MRP's success. To sustain research opportunities, coordinated degree programs for the DC and master of public health and master of clinical and translational research were established. PMID:24988423

  6. Inter-examiner reliability of the interpretation of paraspinal thermographic pattern analysis

    PubMed Central

    Mansholt, Barbara A.; Vining, Robert D.; Long, Cynthia R.; Goertz, Christine M.

    2015-01-01

    Introduction: A few spinal manipulation techniques use paraspinal surface thermography as an examination tool that informs clinical-decision making; however, inter-examiner reliability of this interpretation has not been reported. The purpose of this study was to report inter-examiner reliability for classifying cervical paraspinal thermographic findings. Methods: Seventeen doctors of chiropractic self-reporting a minimum of 2 years of experience using thermography classified thermographic scans into categories (full pattern, partial +, partial, partial ?, and adaptation). Kappa statistics (k) were calculated to determine inter-examiner reliability. Results: Overall inter-examiner reliability was fair (k=0.43). There was good agreement for identifying full pattern (k=0.73) and fair agreement for adaptation (k=0.55). Poor agreement was noted in partial categories (k=0.05–0.22). Conclusion: Inter-examiner reliability demonstrated fair to good agreement for identifying comparable (full pattern) and disparate (adaptation) thermographic findings; agreement was poor for those with moderate similarity (partial). Further research is needed to determine whether thermographic findings should be used in clinical decision-making for spinal manipulation. PMID:26136608

  7. US Spending On Complementary And Alternative Medicine During 2002–08 Plateaued, Suggesting Role In Reformed Health System

    PubMed Central

    Davis, Matthew A.; Martin, Brook I.; Coulter, Ian D.; Weeks, William B.

    2013-01-01

    Complementary and alternative medicine services in the United States are an approximately $9 billion market each year, equal to 3 percent of national ambulatory health care expenditures. Unlike conventional allopathic health care, complementary and alternative medicine is primarily paid for out of pocket, although some services are covered by most health insurance. Examining trends in demand for complementary and alternative medicine services in the United States reported in the Medical Expenditure Panel Survey during 2002–08, we found that use of and spending on these services, previously on the rise, have largely plateaued. The higher proportion of out-of-pocket responsibility for payment for services may explain the lack of growth. Our findings suggest that any attempt to reduce national health care spending by eliminating coverage for complementary and alternative medicine would have little impact at best. Should some forms of complementary and alternative medicine—for example, chiropractic care for back pain—be proven more efficient than allopathic and specialty medicine, the inclusion of complementary and alternative medicine providers in new delivery systems such as accountable care organizations could help slow growth in national health care spending. PMID:23297270

  8. Complementary, Alternative, and Mainstream Service use Among Families with Young Children with Multiple Disabilities: Family Costs to Access Choices.

    PubMed

    Bourke-Taylor, Helen; Cotter, Claire; Stephan, Rebecca

    2014-11-01

    ABSTRACT Families raising a young child with multiple disabilities are charged with significant responsibilities such as learning about their child's condition and navigating mainstream and alternative services. Aim: Describe service choices, costs, out of pocket expenses, and the impact on families. Methods: Survey design using a custom questionnaire was used to collect extensive retrospective and current data. Purposive sampling (N = 29) occurred from one early intervention facility specialized in servicing children with cerebral palsy (CP) and, or multiple disabilities in Australia. Descriptive statistics were used for analysis of data. Results: Twenty-three (79%) families reported caring for a child with CP. Twenty-three families reported using at least one complementary/alternative intervention. Out-of-pocket amounts were reported including: chiropractic services (10 families); naturopathy (9 families); point percussion therapy (7 families), and Chinese medicine (6 families). Expenses resulted in families reporting forgoing clothing items, family entertainment, recreation/hobbies for parents (55%); family holidays (59%); time for parents alone (66%); and health services for parents (38%). Conclusions: Families of young children with multiple disabilities select a wide range of services for their child, with consequential out of pocket expenses. Early intervention professionals can be an important resource for families as they evaluate their choices and select interventions for their child. PMID:25365470

  9. Classification of complementary and alternative medical practices: Family physicians' ratings of effectiveness.

    PubMed

    Fries, Christopher J

    2008-11-01

    ABSTRACTOBJECTIVETo develop a classification of complementary and alternative medicine (CAM) practices widely available in Canada based on physicians' effectiveness ratings of the therapies.DESIGNA self-administered postal questionnaire asking family physicians to rate their "belief in the degree of therapeutic effectiveness" of 15 CAM therapies.SETTINGProvince of Alberta.PARTICIPANTSA total of 875 family physicians.MAIN OUTCOME MEASURESDescriptive statistics of physicians' awareness of and effectiveness ratings for each of the therapies; factor analysis was applied to the ratings of the 15 therapies in order to explore whether or not the data support the proposed classification of CAM practices into categories of accepted and rejected.RESULTSPhysicians believed that acupuncture, massage therapy, chiropractic care, relaxation therapy, biofeedback, and spiritual or religious healing were effective when used in conjunction with biomedicine to treat chronic or psychosomatic indications. Physicians attributed little effectiveness to homeopathy or naturopathy, Feldenkrais or Alexander technique, Rolfing, herbal medicine, traditional Chinese medicine, and reflexology. The factor analysis revealed an underlying dimensionality to physicians' effectiveness ratings of the CAM therapies that supports the classification of these practices as either accepted or rejected.CONCLUSIONThis study provides Canadian family physicians with information concerning which CAM therapies are generally accepted by their peers as effective and which are not. PMID:19005130

  10. Importance of holographic light in the emerging field of mind-body healing

    NASA Astrophysics Data System (ADS)

    Booth, Roberta

    2000-10-01

    Healing with color has been researched and documented worldwide for centuries. Every single part of the brain and every cell in the body is effected by light. Chinese and Russian scientists demonstrated that the acupuncture meridians transmit light. Dr. Peter Mandel, German chiropractic physician and acupuncturist, states that the acupuncture points are especially sensitive to electromagnetic waves within the spectrum of visible light and microwave energy, and all cells constantly emit and absorb small pockets of electromagnetic radiation or light, called biophotons. The harmony or disharmony of cells has been documented. Kirlian photography, to photography the aura was invented by Russians Semyon and Valentina Kirlian. Photo therapy and light research are being practiced worldwide. In the United States, Dr. Jacob Lieberman has written an influential book Light Medicine of the Future. In 1992 the first Light Years Ahead conference was held. (#5 1996) Dr. Brian Breiling and Dr. Lee Hartley brought together experts in the field to discuss the many potentials of light therapy. My present research in this area has focused on narrow band frequencies through the use of holography. Its therapeutic applications of color healing in this research are both critical and fundamental. My current work, The Chakras, seven reflection holograms on silver halide, relate to the wheels of light described in the earliest recorded Indian history. I will discus the chakras, this ancient metaphysical system under the new light of popular western metaphors and visionary art, how the chakras relate to the seven colors of the rainbow, the electromagnetic waves, and the connection to color holography in healing light therapy. I will be citing concurrent research in color healing, and the important areas of research that are necessary to have significant impact on future directions. Holography in the future will constitute a major frontier in discovery.

  11. Limited Health Knowledge as a Reason for Non-Use of Four Common Complementary Health Practices

    PubMed Central

    2015-01-01

    Background Complementary health practices are an important element of health/healthcare seeking behavior among adults in the United States. Reasons for use include medical need, prevention and wellness promotion, and cultural relevance. Survey studies published over the past several decades have provided important information on the use of complementary health practices, such as acupuncture and yoga. A review of the literature, however, reveals an absence of studies looking specifically at who does not use these approaches, and why not. Methods To explore this issue two samples were created using data from the 2007 National Health Interview Survey Complementary and Alternative Medicine supplement. Of particular interest was the relationship between lack of health knowledge, as a reason for non-use, and key independent variables. The first sample was comprised of individuals who had never used any of four common complementary health practices -- acupuncture, chiropractic, natural products, and yoga. The second was a subset of those same non-users who had also reported low back pain, the most frequently cited health concern related to use of complementary therapies. Results A hypothesized association between lack of health knowledge, lower educational attainment, and other key socioeconomic indicators was supported in the findings. Although it was hypothesized that low back pain would be associated with greater information seeking, regardless of level of education, that hypothesis was not supported. Conclusion Lack of knowledge was found to affect utilization of common complementary health practices, regardless of the potentially motivating presence of back pain. Disparities in the utilization of complementary medicine, related to educational attainment and other socioeconomic factors, may negatively affect quality of care for many Americans. Creative approaches are needed to help reduce inequities in understanding and improve access to care for underserved populations. PMID:26083564

  12. Changes in Complementary and Alternative Medicine Use Across Cancer Treatment and Relationship to Stress, Mood, and Quality of Life

    PubMed Central

    McArdle, Traci; Suh, Yeonok

    2014-01-01

    Objectives: Complementary and alternative medicine (CAM) use is prevalent, but specific use of CAM across cancer treatment is underinvestigated. The objectives of this study were to assess changes in CAM use across cancer treatment; specific reasons for and satisfaction with specific types of CAM used; and associations of CAM use with stress, mood, and quality of life (QOL) in women with newly diagnosed breast cancer. Design and setting: Seventy-seven women with early-stage breast cancer who underwent active cancer treatment participated in the study. Data were collected three times: shortly after cancer diagnosis and 2 months and 6 months after the start of adjuvant cancer therapy. Outcome measures: CAM Questionnaire, Impact of Event Scale (stress), Profile of Mood State (mood), and Functional Assessment of Cancer Therapy-Breast Cancer (QOL). Results: Mean age was 52.4 years, and 94%–97% of women used on average five to six CAMs across three time points. Women largely started CAM use before cancer diagnosis and continued across cancer treatment. The five most common CAMs were prayer (88.3%), multivitamin use, massage, and vitamins E and C, followed by music, meditation, green tea, chiropractic care, and vitamin A, with little changes in types of CAM use across cancer treatment. Satisfaction was high, and satisfaction with prayer was the highest. Prayer, meditation, and music were used specifically for a feeling of control, whereas vitamins were used to improve the immune system, showing clear patterns. Stress, mood disturbance, and QOL declined significantly over time, p<0.001–0.04, but the number of CAMs used was unrelated to these variables. Conclusions: CAM use was highly prevalent with multiple CAMs and continued throughout cancer treatment. Prayer was the most common CAM; it had the highest satisfaction rating and the perception of being most helpful. The effect of long-term CAM use requires further investigation on psychological and biobehavioral outcomes with consideration of demographic and clinical characteristics. PMID:25343303

  13. Pediatric Vaccination and Vaccine-Preventable Disease Acquisition: Associations with Care by Complementary and Alternative Medicine Providers

    PubMed Central

    Tyree, Patrick T.; Huebner, Colleen E.; Lafferty, William E.

    2010-01-01

    This study investigated provider-based complementary/alternative medicine use and its association with receipt of recommended vaccinations by children aged 1–2 years and with acquisition of vaccine-preventable disease by children aged 1–17 years. Results were based on logistic regression analysis of insurance claims for pediatric enrollees covered by two insurance companies in Washington State during 2000–2003. Primary exposures were use of chiropractic, naturopathy, acupuncture, or massage practitioner services by pediatric enrollees or members of their immediate families. Outcomes included receipt by children aged 1–2 years of four vaccine combinations (or their component vaccines) covering seven diseases, and acquisition of vaccine-preventable diseases by enrollees aged 1–17 years. Children were significantly less likely to receive each of the four recommended vaccinations if they saw a naturopathic physician. Children who saw chiropractors were significantly less likely to receive each of three of the recommended vaccinations. Children aged 1–17 years were significantly more likely to be diagnosed with a vaccine-preventable disease if they received naturopathic care. Use of provider-based complementary/alternative medicine by other family members was not independently associated with early childhood vaccination status or disease acquisition. Pediatric use of complementary/alternative medicine in Washington State was significantly associated with reduced adherence to recommended pediatric vaccination schedules and with acquisition of vaccine-preventable disease. Interventions enlisting the participation of complementary/alternative medicine providers in immunization awareness and promotional activities could improve adherence rates and assist in efforts to improve public health. PMID:19760163

  14. CAM practitioners in the Australian health workforce: an underutilized resource

    PubMed Central

    2012-01-01

    Background CAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM) little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity. Discussion Increasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research. Summary Marginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health workforce shortages, particularly for the prevention and management of chronic health conditions and for health promotion. PMID:23116374

  15. Demographic and Clinical Characteristics of New Patients Presenting to a Community Teaching Clinic

    PubMed Central

    Lishchyna, Natalia; Mior, Silvano

    2012-01-01

    Purpose: We compare patient populations attending chiropractors in the field to those in teaching clinics to allow educational institutions to determine if students are exposed to a similar case mix. The purpose of our study was to describe and compare descriptively the clinical case mix of a recently opened community-based teaching clinic to previously published practice data. Methods: A retrospective descriptive cross-sectional study was conducted using new patient records completed at a clinic. Data were extracted using a specifically designed abstraction form. Results: We manually abstracted 649 files. A total of 580 new patient files was included in the analysis, among which 57.7% included female patients with a mean age of 43 years (SD 18), and 42.1% presented with a chief complaint of more than one year in duration. The vast majority of patients complained of spinal pain (81.4%), most commonly low back pain. Almost 92% of the diagnoses were classified as simple (sprain/strain). The average number of visits per patient was 7.4 (SD 11.3); 54.7% received spinal manipulation on their first visit. The majority of patients were referred by the treating intern (64.8%) and about 24% of patients were local residents. Conclusions: Our study contributed to the few studies detailing patients attending chiropractic academic teaching clinics. It provided benchmark demographic and clinical data that may be used for operational planning. Our study suggested that the case mix of this teaching clinic provides interns with appropriate learning opportunities to achieve entry to practice competencies. PMID:23362363

  16. Osteochondral lesion of the talus in a recreational athlete: a case report

    PubMed Central

    deGraauw, Chris

    1999-01-01

    A 23-year-old recreational male athlete presented with intermittent pain of three weeks duration, localized to the left ankle. Pain was aggravated by walking, although his symptoms had not affected the patient’s jogging activity which was performed three times per week. Past history revealed an inversion sprain of the left ankle, sustained fifteen months previously. Examination showed mild swelling anterior to the ankle mortise joint while other tests including range of motion, strength and motion palpation of specific joints of the ankle were noted to be unremarkable. Radiographic findings revealed a defect in the medial aspect of the talus. An orthopaedic referral was made for further evaluation. Tomography revealed a Grade III osteochondral lesion of the talus. It was determined that follow-up views be taken in three months to demonstrate if the lesion was progressing or healing. Within the three month period, activity modifications and modalities for pain control were indicated. Surgery was considered a reasonable option should conservative measures fail. The present case illustrates an osteochondral lesion of the talus, a condition which has not previously been reported in the chiropractic literature. A review of the pertinent orthopaedic literature has indicated an average delay of three years in diagnosing the existence of this lesion. Although considered rare, the diagnostic frequency of the condition appears to be on the rise due to increased awareness and the use of bone and CT scans. The osteochondral lesion of the talus deserves particular consideration by practitioners working with athletes due to its higher incidence within this group. This diagnosis should be considered in patients presenting with chronic ankle pain particularly when a history of an inversion sprain exists. The purpose of this report is to increase awareness of this condition, and review diagnosis and management strategies. ImagesFigure 1Figure 2

  17. The relationship of whiplash injury and temporomandibular disorders: a narrative literature review?

    PubMed Central

    Fernandez, Charles E.; Amiri, Abid; Jaime, Joseph; Delaney, Paul

    2009-01-01

    Abstract Objective The purpose of this article is to offer a narrative review and discuss the possible relationship between temporomandibular disorders (TMDs) and whiplash injuries. Methods Databases from 1966 to present were searched including PubMed; Manual, Alternative, and Natural Therapy Index System; and Cumulative Index for Nursing and Allied Health Literature. Search terms used included whiplash injury, temporomandibular disorders and craniomandibular disorders. Inclusion criteria consisted of studies on orofacial pain of a musculoskeletal origin addressing the following topics: posttraumatic temporomandibular disorder (pTMD) incidence and prevalence, mechanism of injury, clinical findings and characteristics, prognosis (including psychologic factors). Excluded were studies of orofacial pain from nontraumatic origin, as well as nonmusculoskeletal causes including neurologic, vascular, neoplastic, or infectious disease. Results Thirty-two studies describing the effects of whiplash on TMD were reviewed based on inclusion/exclusion criteria. The best evidence from prospective studies indicates a low to moderate incidence and prevalence. Only 3 studies addressed mechanism of injury theories. Most studies focusing on clinical findings and characteristics suggest significant differences when comparing pTMD to idiopathic/nontraumatic patients. Regarding prognosis, most studies suggest a significant difference when comparing pTMD to idiopathic/nontraumatic TMD patients, with pTMD having a poorer prognosis. Conclusions There is conflicting evidence regarding the effects of whiplash on the development of TMD. Furthermore, because of lack of homogeneity in the study populations and lack of standardization of data collection procedures and outcomes measured, this review cannot conclusively resolve the controversies that exist concerning this relationship. This review of the literature is provided to clarify the issues and to provide useful clinical information for health care providers managing TMD such as doctors of chiropractic, physical therapists, dentists, and medical doctors. PMID:19948308

  18. The presence of extensor digiti medii muscle—anatomical variant

    PubMed Central

    Carlos, Jonathan S.; Goubran, Emile; Ayad, Samir

    2011-01-01

    Objective This study reports the presence of the extensor digiti medii muscle (EDM) in a population of cadavers dissected by students at a chiropractic college anatomy laboratory and determines its frequency, bilaterality, innervation, and sex differences. Methods Dissection of upper extremities of 47 human cadavers (24 males, 23 females) was conducted. Both upper extremities were examined for bilaterality. The long extensor tendons were exposed, separated, and cut to expose the EDM. Identifying the innervation of the variant muscle was attempted. The specimens were then photographed. Results In this report, the prevalence of EDM is at 7.4%. The EDM was discovered in 5 male cadavers and 1 female cadaver (5:1 ratio). It also revealed that the EDM was prevalent on the left forearm than on the right forearm at a ratio of 5:2. Out of the 47 cadavers studied in this report, only one was observed to have EDM bilaterally (2.1%). In 2 cadavers, the EDM appeared to be supplied by the posterior interosseous nerve. The branch piercing through the extensor indicis muscle continued to give off a small branch entering the belly of the EDM. Conclusion The findings obtained in this report support previous observations regarding its prevalence in males more than females. The report also shows that the EDM occurs more in the left forearm than the right forearm as opposed to other reports of equal incidence between left and right forearms. This report also supports one previous study showing that the posterior interosseous nerve innervates the EDM. PMID:22014864

  19. Searching for Controlled Trials of Complementary and Alternative Medicine: A Comparison of 15 Databases

    PubMed Central

    Cogo, Elise; Sampson, Margaret; Ajiferuke, Isola; Manheimer, Eric; Campbell, Kaitryn; Daniel, Raymond; Moher, David

    2011-01-01

    This project aims to assess the utility of bibliographic databases beyond the three major ones (MEDLINE, EMBASE and Cochrane CENTRAL) for finding controlled trials of complementary and alternative medicine (CAM). Fifteen databases were searched to identify controlled clinical trials (CCTs) of CAM not also indexed in MEDLINE. Searches were conducted in May 2006 using the revised Cochrane highly sensitive search strategy (HSSS) and the PubMed CAM Subset. Yield of CAM trials per 100 records was determined, and databases were compared over a standardized period (2005). The Acudoc2 RCT, Acubriefs, Index to Chiropractic Literature (ICL) and Hom-Inform databases had the highest concentrations of non-MEDLINE records, with more than 100 non-MEDLINE records per 500. Other productive databases had ratios between 500 and 1500 records to 100 non-MEDLINE records—these were AMED, MANTIS, PsycINFO, CINAHL, Global Health and Alt HealthWatch. Five databases were found to be unproductive: AGRICOLA, CAIRSS, Datadiwan, Herb Research Foundation and IBIDS. Acudoc2 RCT yielded 100 CAM trials in the most recent 100 records screened. Acubriefs, AMED, Hom-Inform, MANTIS, PsycINFO and CINAHL had more than 25 CAM trials per 100 records screened. Global Health, ICL and Alt HealthWatch were below 25 in yield. There were 255 non-MEDLINE trials from eight databases in 2005, with only 10% indexed in more than one database. Yield varied greatly between databases; the most productive databases from both sampling methods were Acubriefs, Acudoc2 RCT, AMED and CINAHL. Low overlap between databases indicates comprehensive CAM literature searches will require multiple databases. PMID:19468052

  20. Evaluation of three different methods of distance learning for postgraduate diagnostic imaging education: A pilot study

    PubMed Central

    Poirier, Jean-Nicolas; Cooley, Jeffrey R.; Wessely, Michelle; Guebert, Gary M.; Petrocco-Napuli, Kristina

    2014-01-01

    Objective The purpose of this study was to evaluate the perceived effectiveness and learning potential of 3 Web-based educational methods in a postgraduate radiology setting. Methods Three chiropractic radiology faculty from diverse geographic locations led mini-courses using asynchronous discussion boards, synchronous Web conferencing, and asynchronous voice-over case presentations formatted for Web viewing. At the conclusion of each course, participants filled out a 14-question survey (using a 5-point Likert scale) designed to evaluate the effectiveness of each method in achieving specified course objectives and goals and their satisfaction when considering the learning potential of each method. The mean, standard deviation, and percentage agreements were tabulated. Results Twenty, 15, and 10 participants completed the discussion board, Web conferencing, and case presentation surveys, respectively. All educational methods demonstrated a high level of agreement regarding the course objective (total mean rating >4.1). The case presentations had the highest overall rating for achieving the course goals; however, all but one method still had total mean ratings >4.0 and overall agreement levels of 70%–100%. The strongest potential for interactive learning was found with Web conferencing and discussion boards, while case presentations rated very low in this regard. Conclusions The perceived effectiveness in achieving the course objective and goals was high for each method. Residency-based distance education may be a beneficial adjunct to current methods of training, allowing for international collaboration. When considering all aspects tested, there does not appear to be a clear advantage to any one method. Utilizing various methods may be most appropriate. PMID:24779546

  1. Elongated Styloid Processes and Calcified Stylohyoid Ligaments in a Patient With Neck Pain: Implications for Manual Therapy Practice12

    PubMed Central

    Green, Bart N.; Browske, LCDR Kristin M.; Rosenthal, CAPT Michael D.

    2014-01-01

    Objective The purpose of this paper is to present a case of a patient with neck pain, tinnitus, and headache in the setting of bilateral elongated styloid processes (ESP) and calcified stylohyoid ligaments (CSL), how knowledge of this anatomical variation and symptomatic presentation affected the rehabilitation management plan for this patient, and to discuss the potential relevance of ESPs and CSLs to carotid artery dissection. Clinical features A 29-year-old male military helicopter mechanic presented for chiropractic care for chronic pain in the right side of his neck and upper back, tinnitus, and dizziness with a past history of right side parietal headaches and tonsillitis. Conventional radiographs showed C6 and C7 spinous process fractures, degenerative disc disease at C6/7, and an elongated right styloid process with associated calcification of the left stylohyoid ligament. Volumetric computerized tomography demonstrated calcification of the stylohyoid ligaments bilaterally. Intervention and outcome Given the proximity of the calcified stylohyoid apparatus to the carotid arteries, spinal manipulation techniques were modified to minimize rotation of the neck. Rehabilitation also included soft tissue mobilization and stretching, corrective postural exercises, and acupuncture. An otolaryngologist felt that the symptoms were not consistent with Eagle syndrome and the tinnitus was associated with symmetric high frequency hearing loss, likely due to occupational noise exposure. Initially, the patient's symptoms improved but plateaued by the fifth visit. Conclusion Neck pain in the presence of ESPs and CSLs can be associated with Eagle syndrome, which can include ipsilateral head and neck pain, odynophagia, dysphagia, and cerebrovascular symptoms. This case, initially thought to be Eagle syndrome, highlights proper diagnostic workup for this condition and presents potential contraindications to consider with regard to cervical spine manipulation in such patients. Manual therapy precautions pertaining to cervical spine manipulation may be appropriate in cases involving ESPs and calcified stylohyoid ligaments. PMID:25685122

  2. Withdrawal rates as a consequence of disclosure of risk associated with manipulation of the cervical spine

    PubMed Central

    2010-01-01

    Background The risk associated with cervical manipulation is controversial. Research in this area is widely variable but as yet the risk is not easily quantifiable. This presents a problem when informing the patient of risks when seeking consent and information may be withheld due to the fear of patient withdrawal from care. As yet, there is a lack of research into the frequency of risk disclosure and consequent withdrawal from manipulative treatment as a result. This study seeks to investigate the reality of this and to obtain insight into the attitudes of chiropractors towards informed consent and disclosure. Methods Questionnaires were posted to 200 UK chiropractors randomly selected from the register of the General Chiropractic Council. Results A response rate of 46% (n = 92) was achieved. Thirty-three per cent (n = 30) respondents were female and the mean number of years in practice was 10. Eighty-eight per cent considered explanation of the risks associated with any recommended treatment important when obtaining informed consent. However, only 45% indicated they always discuss this with patients in need of cervical manipulation. When asked whether they believed discussing the possibility of a serious adverse reaction to cervical manipulation could increase patient anxiety to the extent there was a strong possibility the patient would refuse treatment, 46% said they believed this could happen. Nonetheless, 80% said they believed they had a moral/ethical obligation to disclose risk associated with cervical manipulation despite these concerns. The estimated number of withdrawals throughout respondents' time in practice was estimated at 1 patient withdrawal for every 2 years in practice. Conclusion The withdrawal rate from cervical manipulation as a direct consequence of the disclosure of associated serious risks appears unfounded. However, notwithstanding legal obligations, reluctance to disclose risk due to fear of increasing patient anxiety still remains, despite acknowledgement of moral and ethical responsibility. PMID:20977721

  3. Scoliosis treatment using spinal manipulation and the Pettibon Weighting System™: a summary of 3 atypical presentations

    PubMed Central

    Morningstar, Mark W; Joy, Timothy

    2006-01-01

    Background Given the relative lack of treatment options for mild to moderate scoliosis, when the Cobb angle measurements fall below the 25–30° range, conservative manual therapies for scoliosis treatment have been increasingly investigated in recent years. In this case series, we present 3 specific cases of scoliosis. Case presentation Patient presentation, examination, intervention and outcomes are detailed for each case. The types of scoliosis presented here are left thoracic, idiopathic scoliosis after Harrington rod instrumentation, and a left thoracic scoliosis secondary to Scheuermann's Kyphosis. Each case carries its own clinical significance, in relation to clinical presentation. The first patient presented for chiropractic treatment with a 35° thoracic dextroscoliosis 18 years following Harrington Rod instrumentation and fusion. The second patient presented with a 22° thoracic levoscoliosis and concomitant Scheuermann's Disease. Finally, the third case summarizes the treatment of a patient with a primary 37° idiopathic thoracic levoscoliosis. Each patient was treated with a novel active rehabilitation program for varying lengths of time, including spinal manipulation and a patented external head and body weighting system. Following a course of treatment, consisting of clinic and home care treatments, post-treatment radiographs and examinations were conducted. Improvement in symptoms and daily function was obtained in all 3 cases. Concerning Cobb angle measurements, there was an apparent reduction in Cobb angle of 13°, 8°, and 16° over a maximum of 12 weeks of treatment. Conclusion Although mild to moderate reductions in Cobb angle measurements were achieved in these cases, these improvements may not be related to the symptomatic and functional improvements. The lack of a control also includes the possibility of a placebo effect. However, this study adds to the growing body of literature investigating methods by which mild to moderate cases of scoliosis can be treated conservatively. Further investigation is necessary to determine whether curve reduction and/or manipulation and/or placebo was responsible for the symptomatic and functional improvements noted in these cases. PMID:16409627

  4. Student Attitudes, Satisfaction, and Learning in a Collaborative Testing Environment*

    PubMed Central

    Meseke, Christopher A.; Nafziger, Rita; Meseke, Jamie K.

    2010-01-01

    Introduction: This study examined the effect of collaborative testing on student learning, attitude toward testing, and course satisfaction at a chiropractic college. Methods: The study compared testing performance between two cohorts of students taking an advanced neuroanatomy course: a control group (n = 78) and an experimental group (n = 80). Scores examined for each cohort included sums of quizzes, examination scores, and a comprehensive final examination. The control cohort completed weekly quizzes as individuals, while the experimental cohort completed the quizzes collaboratively in small groups. Both cohorts completed three unit examinations and the comprehensive final examination as individuals. Additionally, pretest–posttest and delayed posttest scores were examined. Multivariate analysis of variance (MANOVA) and multivariate analysis of covariance (MANCOVA) (including repeated measures MANCOVA) were used for statistical analysis. Results: The experimental cohort scored significantly higher compared to the control cohort on all quizzes (F = 217.761; df = 1,156; p < .05) and overall course grades (F = 16.099; df = 1,156; p < .05). There were no significant differences in either the comprehensive final (posttest) (F = 3.138; df = 1,122; p > .05) or the delayed posttest (taken 5 weeks after the end of the course) (F = 0.431; df = 1,122; p > .05) between the two cohorts. The overall scores for both cohorts on the delayed posttest were significantly lower than the posttest scores (F = 4.660; df = 1,122; p < .05). Conclusions: This project extends previous findings that students using collaborative testing have significantly increased short-term course performance compared with those students using traditional testing. No differences in learning or retention were noted. PMID:20480011

  5. Adjunctive use of combination of super-pulsed laser and light-emitting diodes phototherapy on nonspecific knee pain: double-blinded randomized placebo-controlled trial.

    PubMed

    Leal-Junior, Ernesto Cesar Pinto; Johnson, Douglas Scott; Saltmarche, Anita; Demchak, Timothy

    2014-11-01

    Phototherapy with low-level laser therapy (LLLT) and light-emitting diode therapy (LEDT) has arisen as an interesting alternative to drugs in treatments of musculoskeletal disorders. However, there is a lack of studies investigating the effects of combined use of different wavelengths from different light sources like lasers and light-emitting diodes (LEDs) in skeletal muscle disorders. With this perspective in mind, this study aimed to investigate the effects of phototherapy with combination of different light sources on nonspecific knee pain. It was performed a randomized, placebo-controlled, double-blinded clinical trial. Eighty-six patients rated 30 or greater on the pain visual analogue scale (VAS) were recruited and included in study. Patients of LLLT group received 12 treatments with active phototherapy (with 905 nm super-pulsed laser and 875 and 640 nm LEDs, Manufactured by Multi Radiance Medical, Solon, OH, USA) and conventional treatment (physical therapy or chiropractic care), and patients of placebo group were treated at same way but with placebo phototherapy device. Pain assessments (VAS) were performed at baseline, 4th, 7th, and 10th treatments, after the completion of treatments and at 1-month follow-up visit. Quality of life assessments (SF-36®) were performed at baseline, after the completion of treatments and at 1-month follow-up visit. Our results demonstrate that phototherapy significantly decreased pain (p?

  6. CAM Use in Pediatric Neurology: An Exploration of Concurrent Use with Conventional Medicine

    PubMed Central

    Galicia-Connolly, Elaine; Adams, Denise; Bateman, Justin; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W. James; Vohra, Sunita

    2014-01-01

    Background Previous studies have found that up to 60% of children with neurologic conditions have tried complementary and alternative medicine (CAM). Objective To assess the use of CAM among patients presenting to neurology clinics at two academic centers in Canada. Methods A survey instrument was developed to inquire about use of CAM products and therapies, including reasons for use, perceived helpfulness, and concurrent use with conventional medicine, and administered to patients or their parents/guardians at the Stollery Children's Hospital in Edmonton and the Children's Hospital of Eastern Ontario (CHEO) in Ottawa. Results Overall CAM use at the Stollery was 78%, compared to 48% at CHEO. The most common CAM products used were multi-vitamins (84%), vitamin C (37%), homeopathic remedies (24%), and fish oil/omega 3 s (22%). The most common CAM practices used were massage (47%), chiropractic (37%), faith healing (18%), aromatherapy (16%), homeopathy (16%), and relaxation (16%). Many patients used CAM products at the same time as conventional medicine but just over half (57%) discussed this concurrent use with their physician. Conclusion CAM use is common in pediatric neurology patients and most respondents felt that it was helpful, with few or no harms associated. However, this use is often undisclosed, increasing possibility of interactions with conventional drugs. We urge clinicians to inquire about CAM use during routine history taking at every patient visit. Parents would clearly like more information about CAM from their specialty clinics; such information would be easier to share if more primary data were available about the safety and effectiveness of commonly used therapies. PMID:24736474

  7. Complementary and alternative medicine use in Gilles de la Tourette syndrome.

    PubMed

    Kompoliti, Katie; Fan, Wenqin; Leurgans, Sue

    2009-10-15

    The aim of this study was to describe the use of complementary and alternative medicine (CAM) in patients with Tourette syndrome (TS) and explore associations with CAM use. In recent years CAM use has increased, but rates of CAM use in TS patients are not reported. Consecutive TS patients or their parent(s), seen in an academic movement disorder center, completed a questionnaire regarding their use of CAM. One hundred TS patients or parents completed the questionnaire, mean age 21.5 +/- 13.5, 76 males, 87 Caucasians. Sixty four patients had used at least one CAM modality. CAM treatments used were prayer (28), vitamins (21), massage (19), dietary supplements (15), chiropractic manipulations (12), meditation (10), diet alterations (nine), yoga (nine), acupuncture (eight), hypnosis (seven), homeopathy (six), and EEG biofeedback (six). Fifty six percent of patients using CAM reported some improvement. Users paid out of pocket for 47% of treatments pursued, and 19% of these payers received partial reimbursement by third party payer. Users and non-users did not differ in age, gender, race, income, educational level, general health, tic severity, medication use for TS, current satisfaction from medications or experience of side effects from medications. CAM use was associated with the presence of affective disorder (P = 0.004), but not with either ADHD or OCD. Among CAM users, 80% initiated CAM without informing their doctor. CAM is commonly used in children and adults with TS, and often without the neurologist's knowledge. Physicians should inquire about CAM to understand the spectrum of interventions that patients with TS use. PMID:19705358

  8. Pilot study: an investigation of the relationship between external cervical measurements and the preference of cervical pillow thickness

    PubMed Central

    Erfanian, Parham; Hagino, Carol; Guerriero, Rocco C

    1998-01-01

    Objective: To assess whether external measurements of the subject’s neck are predictive of the preferred thickness of cervical pillow, given a choice of four different contour thicknesses. Design: Preliminary correlational study. Subjects: The subjects consisted of asymptomatic adults between the ages of 18-45 years, and were drawn from student and faculty populations of the Canadian Memorial Chiropractic College (CMCC). Sample size: A total of 105 eligible adults were recruited, of which 53 were male and 52 were female. Outcome Measures: Subjects were assessed using the following measurements of the cervical spine: (1) the external occipital protuberance (EOP) to the seventh cervical spinous process posteriorly (2) the mastoid to the acromioclavicular joint laterally, and (3) neck girth measured at the fourth cervical vertebra. Subjects were asked to choose one of the four possible thicknesses with respect to comfort over a short period of time (i.e. about 10 minutes). Statistical Analysis: Results were analyzed at the 0.10 level of significance using the Pearson’s Product Moment Correlation Coefficient. Analyses were stratified by gender. Results: This study found no statistically or clinically significant correlation between neck dimensions and pillow size preference (r < 0.7, p > 0.02). Conclusion: The results of this study suggest that the three specifically outlined cervical measurements may not serve as good predictors for size preference for this type of cervical pillow. The results of this study also do not suggest “one-size” pillow fits all. Patients may still require a selection of cervical pillow thicknesses. Pending further investigation of this important clinical problem, it may be prudent to continue recommending double-contoured or other variably-sized pillows. ImagesFigure 1Figure 2Figure 3Figure 4

  9. Magnetic Resonance Imaging Zygapophyseal Joint Space Changes (Gapping) in Low Back Pain Patients following Spinal Manipulation and Side Posture Positioning: A Randomized Controlled Mechanisms Trial with Blinding

    PubMed Central

    Cramer, Gregory D.; Cambron, Jerrilyn; Cantu, Joe A; Dexheimer, Jennifer M.; Pocius, Judith D; Gregerson, Douglas; Fergus, Michael; McKinnis, Ray; Grieve, Thomas J

    2013-01-01

    Objective The purpose of this study was to quantify lumbar zygapophyseal (Z) joint space separation (gapping) in low back pain (LBP) subjects after spinal manipulative therapy (SMT) or side-posture positioning (SPP). Methods This was a controlled mechanisms trial with randomization and blinding. Acute LBP subjects (N=112, four n=28 MRI protocol groups) had 2 magnetic resonance imaging (MRI) appointments (initial enrollment [M1] and following 2 weeks of chiropractic treatment [M2]; receiving 2 MRI scans of the L4/L5 and L5/S1 Z joints at each MRI appointment. After the first MRI scan of each appointment, subjects were randomized (M1 appointment) or assigned (M2 appointment) into SPP (non-manipulation), SMT (manipulation), or control MRI protocol groups. After SPP or SMT, a second MRI was taken. The central anterior-posterior (A-P) joint space was measured. Difference between most painful side A-P measurements taken post- and pre-intervention was the Z joint “gapping difference.” Gapping differences were compared (ANOVA) among protocol groups. Secondary measures of pain visual analog scale (VAS), verbal numeric pain rating scale (VNPRS), and function Bournemouth questionnaire (BQ) were assessed. Results Gapping differences were significant at the first (adjusted, p=0.01; SPP=0.66 +0.48mm; SMT=0.23 +0.86; control=0.18 +0.71) and second (adjusted, p=0.0005; SPP=0.65 +0.92mm, SMT=0.89 +0.71; control=0.35 +0.32) MRI appointments. VNPRS differences were significant at first MRI appointment (p=0.04) with SMT showing the greatest improvement. VAS and BQ improved after two weeks of care in all groups (both p<0.0001). Conclusions SPP showed greatest gapping at baseline. After two weeks, SMT resulted in greatest gapping. SPP appeared to have additive therapeutic benefit to SMT. PMID:23648055

  10. Missed appendicitis diagnosis: A case report

    PubMed Central

    Cox, Jocelyn; Sovak, Guy

    2015-01-01

    Objective: The purpose of this case report is to highlight and emphasize the need for an appropriate and thorough list of differential diagnoses when managing patients, as it is insufficient to assume cases are mechanical, until proven non-mechanical. There are over 250,000 cases of appendicitis annually in the United States. Of these cases, <50% present with classic signs and symptoms of pain in the right lower quadrant, mild fever and nausea. It is standard for patients who present with appendicitis to be managed operatively with a laparoscopic appendectomy within 24 hours, otherwise the risk of complications such as rupture, infection, and even death increases dramatically. Clinical Features: This is a retrospective case report following a 27-year-old male with missed appendicitis, who presented to a chiropractor two-weeks after self-diagnosed food poisoning. On assessment, he was tender with resisted lumbar rotation. Psoas Sign, McBurney’s Point, vascular exam, hip exam, were negative. A diagnosis of an abdominal strain was provided. Two weeks later, he returned to the chiropractor without an improvement of symptoms. Intervention & Outcome: The patient was sent to the hospital, where he was provided a diagnosis of missed appendicitis. He required a hemicolonectomy due to the associated phlegmonous mass. Summary: When a patient presents to a chiropractic clinic with symptoms of abdominal pain, having a comprehensive list of non-mechanical differential diagnoses as well as mechanical differentials is crucial. Appropriate assessment and management of abdominal cases decreases the risk to patients, as missed diagnoses often require more invasive interventions. PMID:26500364

  11. Lateral and syndesmotic ankle sprain injuries: a narrative literature review

    PubMed Central

    Dubin, Joshua C.; Comeau, Doug; McClelland, Rebecca I.; Dubin, Rachel A.; Ferrel, Ernest

    2011-01-01

    Objective The purpose of this article is to review the literature that discusses normal anatomy and biomechanics of the foot and ankle, mechanisms that may result in a lateral ankle sprain or syndesmotic sprain, and assessment and diagnostic procedures, and to present a treatment algorithm based on normal ligament healing principles. Methods Literature was searched for years 2000 to 2010 in PubMed and CINAHL. Key search terms were ankle sprain$, ankle injury and ankle injuries, inversion injury, proprioception, rehabilitation, physical therapy, anterior talofibular ligament, syndesmosis, syndesmotic injury, and ligament healing. Discussion Most ankle sprains respond favorably to nonsurgical treatment, such as those offered by physical therapists, doctors of chiropractic, and rehabilitation specialists. A comprehensive history and examination aid in diagnosing the severity and type of ankle sprain. Based on the diagnosis and an understanding of ligament healing properties, a progressive treatment regimen can be developed. During the acute inflammatory phase, the goal of care is to reduce inflammation and pain and to protect the ligament from further injury. During the reparative and remodeling phase, the goal is to progress the rehabilitation appropriately to facilitate healing and restore the mechanical strength and proprioception. Radiographic imaging techniques may need to be used to rule out fractures, complete ligament tears, or instability of the ankle mortise. A period of immobilization and ambulating with crutches in a nonweightbearing gait may be necessary to allow for proper ligament healing before commencing a more active treatment approach. Surgery should be considered in the case of grade 3 syndesmotic sprain injuries or those ankle sprains that are recalcitrant to conservative care. Conclusion An accurate diagnosis and prompt treatment can minimize an athlete's time lost from sport and prevent future reinjury. Most ankle sprains can be successfully managed using a nonsurgical approach. PMID:22014912

  12. Pediatric vaccination and vaccine-preventable disease acquisition: associations with care by complementary and alternative medicine providers.

    PubMed

    Downey, Lois; Tyree, Patrick T; Huebner, Colleen E; Lafferty, William E

    2010-11-01

    This study investigated provider-based complementary/alternative medicine use and its association with receipt of recommended vaccinations by children aged 1-2 years and with acquisition of vaccine-preventable disease by children aged 1-17 years. Results were based on logistic regression analysis of insurance claims for pediatric enrollees covered by two insurance companies in Washington State during 2000-2003. Primary exposures were use of chiropractic, naturopathy, acupuncture, or massage practitioner services by pediatric enrollees or members of their immediate families. Outcomes included receipt by children aged 1-2 years of four vaccine combinations (or their component vaccines) covering seven diseases, and acquisition of vaccine-preventable diseases by enrollees aged 1-17 years. Children were significantly less likely to receive each of the four recommended vaccinations if they saw a naturopathic physician. Children who saw chiropractors were significantly less likely to receive each of three of the recommended vaccinations. Children aged 1-17 years were significantly more likely to be diagnosed with a vaccine-preventable disease if they received naturopathic care. Use of provider-based complementary/alternative medicine by other family members was not independently associated with early childhood vaccination status or disease acquisition. Pediatric use of complementary/alternative medicine in Washington State was significantly associated with reduced adherence to recommended pediatric vaccination schedules and with acquisition of vaccine-preventable disease. Interventions enlisting the participation of complementary/alternative medicine providers in immunization awareness and promotional activities could improve adherence rates and assist in efforts to improve public health. PMID:19760163

  13. Diversity and consistency: the challenge of maintaining quality in a multidisciplinary workforce.

    PubMed

    Cooper, Richard; Stoflet, Sandra

    2004-01-01

    Non-physician clinicians have become prominent providers of patient services within the practice of medicine. They include nurse practitioners and clinical nurse specialists, physician assistants, the alternative and complementary disciplines (chiropractic, naturopathy and acupuncture), mental health providers (psychologists, clinical social workers, counsellors and therapists) and specialty disciplines (optometrists, podiatrists, nurse anaesthetists and nurse-midwives). Although these various disciplines have differing histories and philosophic frameworks, which create distinctive approaches to patient care, they have shared a struggle to obtain recognition and autonomy through state licensure, to expand their state-granted practice prerogatives and to achieve broader reimbursement from third-party payers and managed care. Most entered into a growth spurt beginning in the early 1990s. All now provide care that not only overlaps that of physicians but that complements and supplements that care. The central question is, how does their care contribute to quality? The evidence thus far shows that non-physician clinicians throughout the range of disciplines can produce high-quality outcomes under particular circumstances. However, the strongest body of evidence is derived from care that is at the least complex end of the clinical spectrum or that is provided under the umbrella of physicians. Unfortunately, few studies have critically examined the outcomes of non-physician clinicians at the leading edge of their practice prerogatives and under conditions that are free of physician oversight. Thus, while the principle that they can deliver high quality care within the practice of medicine is unequivocally true, more research is needed to test this principle under conditions of greater clinical complexity and autonomy, and, pending the results of such research, caution must be exercised in applying this principle too broadly. PMID:15006227

  14. Distribution of Cavitations as Identified with Accelerometry during Lumbar Spinal Manipulation

    PubMed Central

    Cramer, Gregory D.; Ross, J. Kim; Raju, P.K.; Cambron, Jerrilyn A.; Dexheimer, Jennifer M.; Bora, Preetam; McKinnis, Ray; Selby, Scott; Habeck, Adam R.

    2011-01-01

    Objective This project determined the location and distribution of cavitations (audible sounds producing vibrations) in the lumbar zygapophyseal (Z) joints that were targeted by spinal manipulative therapy (SMT). Methods This randomized, controlled, clinical study assessed 40 healthy subjects (20 male, 20 female), 18–30 years of age, that were block randomized into SMT (Group 1, n=30) or side-posture positioning only (Group 2, control, n=10) groups. Nine accelerometers were placed on each patient (7 on SPs/sacral tubercles of L1–S2 and 2 placed 3 cm left and right lateral to the L4/L5 interspinous space). Accelerometer recordings were made during side-posture positioning (Groups 1 and 2) and SMT (Group 1 only). The SMT was delivered by a chiropractic physician with 19 years of practice experience and included 2 high-velocity, low-amplitude thrusts delivered in rapid succession. Comparisons using chi-square or McNemar’s test were made between number of joints cavitating from: Group 1 vs. Group 2, up-side (contact side for SMT) vs. down-side, and Z joints within the target area (L3/L4, L4L5, L5/S1) vs. outside the target area (L1/L2, L2/L3, sacroiliac). Results Fifty-six cavitations were recorded from 46 joints of 40 subjects. Eight joints cavitated more than once. Group 1 joints cavitated more than Group 2 joints (p<0.0001), up-side joints cavitated more than down-side joints (p<0.0001), and joints inside the target area cavitated more than those outside the target area (p<0.01). Conclusions Most cavitations (93.5%) occurred on the up-side of SMT subjects in segments within the target area (71.7%). As expected, SMT subjects cavitated more frequently than side-posture positioning only subjects (96.7% vs. 30%). Multiple cavitations from the same Z joints had not been previously reported. PMID:21986305

  15. Development and psychometric evaluation of scales to measure professional confidence in manual medicine: a Rasch measurement approach

    PubMed Central

    2014-01-01

    Background Health professionals in athletic training, chiropractic, osteopathy, and physiotherapy fields, require high-level knowledge and skills in their assessment and management of patients. This is important when communicating with patients and applying a range of manual procedures. Prior to embarking on professional practice, it is imperative to acquire optimal situation-specific levels of self-confidence for a beginner practitioner in these areas. In order to foster this professional self-confidence within the higher education context, it is necessary to have valid and reliable scales that can measure and track levels and how they change. This study reports on the development and psychometric analysis of two new scales, Patient Communication Confidence Scale (PCCS) and the Clinical Skills Confidence Scale (CSCS), to measure confidence in these two areas for students in manual medicine programs. The Rasch measurement model was used to guide the development of the scales and establish their psychometric properties. Methods The responses to 269 returned questionnaires over two occasions were submitted to psychometric analysis, with various aspects of the scales examined including: item thresholds; item fit; Differential Item Functioning; targeting; item locations; item dependencies; and reliability. To provide further evidence of validity, scores were correlated with two existing valid scales. Results Analyses showed that the scales provided valid and reliable measures of confidence for this sample of persons. High Person Separation Indices (0.96 for PCCS; 0.93 for SCSC) provided statistical evidence of reliability, meaning the scales are able to discriminate amongst persons with different levels of confidence. For the PCCS, item categories were operating as required, and for the CSCS only two items’ thresholds were slightly disordered. Three tests of fit revealed good fit to the model (indicating the internal consistency of both scales) and results of the correlations with two existing valid scales were consistent with expectations. Conclusions The importance of confidence cannot be overlooked in health education because students learning new information and skills, and dealing with challenging situations can be negatively impacted by a lack of confidence which can result in students disengaging from placements or leaving a program. Valid and reliable instruments are essential in tracking change in levels of confidence in specific skills over time and the examination of the degree of congruence between confidence and competence. Analysis of responses to the two confidence scales established that they are valid and reliable instruments. PMID:24899372

  16. Testing the effectiveness of an innovative information package on practitioner reported behaviour and beliefs: The UK Chiropractors, Osteopaths and Musculoskeletal Physiotherapists Low back pain ManagemENT (COMPLeMENT) trial [ISRCTN77245761

    PubMed Central

    Evans, David W; Foster, Nadine E; Underwood, Martin; Vogel, Steven; Breen, Alan C; Pincus, Tamar

    2005-01-01

    Background Low back pain (LBP) is a common and costly problem. Initiatives designed to assist practitioner and patient decisions about appropriate healthcare for LBP include printed evidence-based clinical guidelines. The three professional groups of chiropractic, osteopathy and musculoskeletal physiotherapy in the UK share common ground with their approaches to managing LBP and are amongst those targeted by LBP guidelines. Even so, many seem unaware that such guidelines exist. Furthermore, the behaviour of at least some of these practitioners differs from that recommended in these guidelines. Few randomised controlled trials evaluating printed information as an intervention to change practitioner behaviour have utilised a no-intervention control. All these trials have used a cluster design and most have methodological flaws. None specifically focus upon practitioner behaviour towards LBP patients. Studies that have investigated other strategies to change practitioner behaviour with LBP patients have produced conflicting results. Although numerous LBP guidelines have been developed worldwide, there is a paucity of data on whether their dissemination actually changes practitioner behaviour. Primarily because of its low unit cost, sending printed information to large numbers of practitioners is an attractive dissemination and implementation strategy. The effect size of such a strategy, at an individual practitioner level, is likely to be small. However, if large numbers of practitioners are targeted, this strategy might achieve meaningful changes at a population level. Methods The primary aim of this prospective, pragmatic randomised controlled trial is to test the short-term effectiveness (six-months following intervention) of a directly-posted information package on the reported clinical behaviour (primary outcome), attitudes and beliefs of UK chiropractors, osteopaths and musculoskeletal physiotherapists. We sought to randomly allocate a combined sample of 1,800 consenting practitioners to receive either the information package (intervention arm) or no information above that gained during normal practice (control arm). We collected questionnaire data at baseline and six-months post-intervention. The analysis of the primary outcome will assess between-arm differences of proportions of responses to questions on recommendations about activity, work and bed-rest, that fall within categories previously defined by an expert consensus exercise as either 'guideline-consistent' and 'guideline-inconsistent'. PMID:16033646

  17. Changes in anthropometric measurements, body composition, blood pressure, lipid profile, and testosterone in patients participating in a low-energy dietary intervention

    PubMed Central

    Balliett, Mary; Burke, Jeanmarie R.

    2013-01-01

    Objective The purpose of this study was to describe changes in anthropometric measurements, body composition, blood pressure, lipid profile, and testosterone following a low–energy-density dietary intervention plus regimented supplementation program. Methods The study design was a pre-post intervention design without a control group. Normal participants were recruited from the faculty, staff, students, and community members from a chiropractic college to participate in a 21-day weight loss program. All participants (n = 49; 36 women, 13 men; 31 ± 10.3 years of age) received freshly prepared mostly vegan meals (breakfast, lunch, and dinner) that included 1200 to 1400 daily calories (5020.8 to 5857.6 J) for the women and 1600 to 1800 (6694.4 to 7531.2 J) daily calories for the men. Nutritional supplements containing enzymes that were intended to facilitate digestion, reduce cholesterol levels, increase metabolic rate, and mediate inflammatory processes were consumed 30 minutes before each meal. The regimented supplementation program included once-daily supplementation with a green drink that contained alfalfa, wheatgrass, apple cider vinegar, and fulvic acid throughout the study period. A cleanse supplementation containing magnesium, chia, flaxseed, lemon, camu camu, cat's claw, bentonite clay, tumeric, pau d'arco, chanca piedra, stevia, zeolite clay, slippery elm, garlic, ginger, peppermint, aloe, citrus bioflavonoids, and fulvic acid was added before each meal during week 2. During week 3, the cleanse supplementation was replaced with probiotic and prebiotic supplementation. Results Multiple paired t tests detected clinically meaningful reductions in weight (? 8.7 ± 5.54 lb) (? 3.9 ± 2.5 kg), total cholesterol (? 30.0 ± 29.77 mg/dL), and low-density lipoprotein cholesterol (? 21.0 ± 25.20 mg/dL) (P < .05). There was a pre-post intervention increase in testosterone for men (111.0 ± 121.13 ng/dL, P < .05). Conclusions Weight loss and improvements in total cholesterol and low-density lipoprotein cholesterol levels occurred after a low–energy-density dietary intervention plus regimented supplementation program. PMID:23997718

  18. THE ROLE OF PRISM GLASS AND POSTURAL RESTORATION IN MANAGING A COLLEGIATE BASEBALL PLAYER WITH BILATERAL SACROILIAC JOINT DYSFUNCTION: A CASE REPORT

    PubMed Central

    Boyle, Kyndall

    2013-01-01

    Background and Purpose: Sacroiliac joint dysfunction (SIJD) is a condition affecting 15–30% of patients with low back pain seen in outpatient clinics. Currently there is no well?defined standard of care. The purpose of this case report is to discuss the multidisciplinary management between an athletic trainer and an optometrist for an athlete with bilateral SIJ dysfunction and a visual midline shift syndrome. Case Description: A 21?year?old collegiate baseball player reported to the athletic training room, presenting with low back pain of three day duration, with tenderness over both posterior superior iliac spines (PSIS) (left > right). His pain at its worse was a 7/10 on the Numeric Pain Scale (NPS). The pain increased to the point that it limited his activities of daily living (ADLs) including getting dressed, putting on his shoes, sleeping, and getting in and out of a car. Interventions: The athlete was initially treated using traditional muscle energy techniques (MET) based intervention to correct SIJD, and lumbar stabilization exercises directed by a licensed athletic trainer, as well as manipulation by a chiropractor. Three weeks of treatment did not prove to be beneficial with only a minimal (1 point on the NPRS) decrease in pain. The athlete was then referred to the head athletic trainer for consultation who prescribed orthotics, for bilateral rear?foot valgus, and Postural Restoration (PR) therapeutic exercises. After two weeks of orthotic use and PR exercises the athlete’s pain decreased one additional point on the NPRS. Due to lack of progress, an optometrist was then consulted. The neuro?optometrist prescribed 2 diopter base?down prisms to be worn two hours a day, for four weeks. After four weeks of prisms and new exercises, the athlete was asymptomatic and returned to full pain?free baseball participation without further complications. Outcomes: The Oswestry Disability Index Questionnaire (ODI) was 48% at initial (severe disability), 40% at five weeks and 0% at discharge. The Numeric Pain Scale (NPS) score went from 7/10 to 0/10. Discussion: The athlete demonstrated only minimal relief of symptoms following MET, therapeutic exercises, and chiropractic manipulation. Intervention using prism glasses and PR exercises, designed to optimize posture and correct his visual midline shift syndrome, led to complete resolution of his symptoms. Evidence Level: 3a PMID:24175150

  19. Use of localized human growth hormone and testosterone injections in addition to manual therapy and exercise for lower back pain: a case series with 12-month follow-up

    PubMed Central

    Dubick, Marc N; Ravin, Thomas H; Michel, Yvonne; Morrisette, David C

    2015-01-01

    Objective The objective of this case series was to investigate the feasibility and safety of a novel method for the management of chronic lower back pain. Injections of recombinant human growth hormone and testosterone to the painful and dysfunctional areas in individuals with chronic lower back pain were used. In addition, the participants received manual therapies and exercise addressing physical impairments such as motor control, strength, endurance, pain, and loss of movement. Pain ratings and self-rated functional outcomes were assessed. Study design This is a case series involving consecutive patients with chronic lower back pain who received the intervention of injections of recombinant human growth hormone and testosterone, and attended chiropractic and/or physical therapy. Outcomes were measured at 12 months from the time of injection. Setting A community based hospital affiliated office, and a private practice block suite. Participants A total of 60 consecutive patients attending a pain management practice for chronic lower back pain were recruited for the experimental treatment. Most participants were private pay. Interventions Participants who provided informed consent and were determined not to have radicular pain received diagnostic blocks. Those who responded favorably to the diagnostic blocks received injections of recombinant human growth hormone and testosterone in the areas treated with the blocks. Participants also received manipulation- and impairment-based exercises. Outcome measures Outcomes were assessed at 12 months through pain ratings with the Mankowski Pain Scale and the Oswestry Disability Index. Results Of the 60 patients recruited, 49 provided informed consent, and 39 completed all aspects of the study. Those patients receiving the intervention reported a significant decrease in pain ratings (P<0.01) and a significant improvement in self-rated Oswestry Disability Index scores (P<0.01). In addition, in the Oswestry Disability Index results, 41% of the patients demonstrated a 50% or greater change in their disability score. Of the subjects who withdrew from the study, one was due to the pain created by the injections and nine were for nonstudy factors. Conclusion The intervention appeared to be safe and the results provide a reasonable expectation that the intervention would be beneficial for a population of individuals with chronic nonradicular lower back pain. Due to the design of the study, causality cannot be inferred, but the results do indicate that further study of the intervention may be warranted. PMID:26203272

  20. Access to complementary medicine via general practice.

    PubMed Central

    Thomas, K J; Nicholl, J P; Fall, M

    2001-01-01

    BACKGROUND: The popularity of complementary medicine continues to be asserted by the professional associations and umbrella organisations of these therapies. Within conventional medicine there are also signs that attitudes towards some of the complementary therapies are changing. AIM: To describe the scale and scope of access to complementary therapies (acupuncture, chiropractic, homoeopathy, hypnotherapy, medical herbalism, and osteopathy) via general practice in England. DESIGN OF STUDY: A postal questionnaire sent to 1226 individual general practitioners (GPs) in a random cluster sample of GP partnerships in England. GPs received up to three reminders. SETTING: One in eight (1226) GP partnerships in England in 1995. METHOD: Postal questionnaire to assess estimates of the number of practices offering 'in-house' access to a range of complementary therapies or making National Health Service (NHS) referrals outside the practice; sources of funding for provision and variations by practice characteristics. RESULTS: A total of 964 GPs replied (78.6%). Of these, 760 provided detailed information. An estimated 39.5% (95% CI = 35%-43%) of GP partnerships in England provided access to some form of complementary therapy for their NHS patients. If all non-responding partnerships are assumed to be non-providers, the lowest possible estimate is 30.3%. An estimated 21.4% (95% CI = 19%-24%) were offering access via the provision of treatment by a member of the primary health care team, 6.1% (95% CI = 2%-10%) employed an 'independent' complementary therapist, and an estimated 24.6% of partnerships (95% CI = 21%-28%) had made NHS referrals for complementary therapies. The reported volume of provision within any individual service tended to be low. Acupuncture and homoeopathy were the most commonly available therapies. Patients made some payment for 25% of practice-based provision. Former fundholding practices were significantly more likely to offer complementary therapies than non-fundholding practices, (45% versus 36%, P = 0.02). Fundholding did not affect the range of therapies offered, and patients from former fundholding practices were no more likely to pay for treatment. CONCLUSION: Access to complementary health care for NHS patients was widespread in English general practices in 1995. This data suggests that a limited range of complementary therapies were acceptable to a large proportion of GPs. Fundholding clearly provided a mechanism for the provision of complementary therapies in primary care. Patterns of provision are likely to alter with the demise of fundholding and existing provision may significantly reduce unless the Primary Care Groups or Primary Care Trusts are prepared to support the 'levelling up' of some services. PMID:11271869

  1. Cognitive interviews guide design of a new CAM patient expectations questionnaire

    PubMed Central

    2014-01-01

    Background No consistent relationship exists between pre-treatment expectations and therapeutic benefit from various complementary and alternative medicine (CAM) therapies in clinical trials. However, many different expectancy measures have been used in those studies, with no validated questionnaires clearly focused on CAM and pain. We undertook cognitive interviews as part of a process to develop and validate such a questionnaire. Methods We reviewed questions about expectations of benefits of acupuncture, chiropractic, massage, or yoga for pain. Components of the questions – verbs, nouns, response options, terms and phrases describing back pain – were identified. Using seven different cognitive interview scripts, we conducted 39 interviews to evaluate how individuals with chronic low back pain understood these individual components in the context of expectancy questions for a therapy they had not yet received. Chosen items were those with the greatest agreement and least confusion among participants, and were closest to the meanings intended by the investigators. Results The questionnaire drafted for psychometric evaluation had 18 items covering various domains of expectancy. “Back pain” was the most consistently interpreted descriptor for this condition. The most understandable response options were 0-10 scales, a structure used throughout the questionnaire, with 0 always indicating no change, and 10 anchored with an absolute descriptor such as “complete relief”. The use of words to describe midpoints was found to be confusing. The word “expect” held different and shifting meanings for participants. Thus paired items comparing “hope” and “realistically expect” were chosen to evaluate 5 different aspects of treatment expectations (back pain; back dysfunction and global effects; impact of back pain on specific areas of life; sleep, mood, and energy; coping). “Impact of back pain” on various areas of life was found to be a consistently meaningful concept, and more global than “interference”. Conclusions Cognitive interviews identified wordings with considerable agreement among both participants and investigators. Some items widely used in clinical studies had different meanings to participants than investigators, or were confusing to participants. The final 18-item questionnaire is undergoing psychometric evaluation with goals of streamlining as well as identifying best items for use when questionnaire length is constrained. PMID:24460709

  2. Longitudinal Use of Complementary and Alternative Medicine among Older Adults with Radiographic Knee Osteoarthritis

    PubMed Central

    Yang, Shibing; Dubé, Catherine E.; Eaton, Charles B.; McAlindon, Timothy E.; Lapane, Kate L.

    2013-01-01

    Background Osteoarthritis (OA) accounts for more mobility issues in older adults than any other disease. OA is a chronic and often painful disease for which there is no cure. Cross-sectional studies have shown that older adults frequently use complementary and alternative medicine (CAM) and arthritis is the most common reason for CAM use. While previous research has profiled the sociodemographic and clinical characteristics of CAM users, few have provided information on variation in CAM use over time and most only considered use of any CAM, which was often a mixture of heterogeneous therapies. Objectives This study sought to describe the longitudinal patterns of CAM use among older adults with knee OA, and to identify correlates/predictors of different commonly-used CAM therapies. Methods The Osteoarthritis Initiative included 1,121 adults aged 65 years and above with radiographic tibiofemoral OA in one or both knees at baseline. Annual surveys captured current use of conventional therapies and 25 CAM modalities (grouped into 6 categories) for joint pain or arthritis at baseline and during the 4-year follow-up. We assessed longitudinal use of CAM modalities by summing the number of visits with participants reporting use of each modality. Correlates of CAM use under consideration included sociodemographic indicators, body mass index, overall measures of mental and physical wellbeing, and clinical indices of knee OA. Generalized estimation equations provided adjusted odds ratio estimates and 95% confidence intervals. Results Nearly one third of older adults reported using ? one CAM modality for treating OA at all assessments. With the exception of glucosamine and chondroitin (18%), few were persistent users of other CAM modalities. One in five of those using NSAIDs or glucosamine/chondroitin were using them concurrently. Adjusted models showed: 1) adults aged ?75 years were less likely to use dietary supplements than those aged between 65 and 75 years; 2) persons with more severe knee pain or stiffness reported more CAM use; 3) better knee-related physical function was correlated with more use of chiropractic/massage; 4) older adults with more comorbidities were less likely to report use of dietary supplements. Conclusion Patterns of CAM use are, to some extent, inconsistent with current guidelines for OA treatment. Evaluating the potential risks and benefits in older adults from commonly-used CAM modalities, with or without combination use of conventional analgesics, is warranted. PMID:24145044

  3. A survey of Canadian regulated complementary and alternative medicine schools about research, evidence-based health care and interprofessional training, as well as continuing education

    PubMed Central

    2013-01-01

    Background While some effort has been made to integrate complementary and alternative medicine (CAM) information in conventional biomedical training, it is unclear whether regulated Canadian CAM schools’ students are exposed to research activities and continuing education, or whether topics such as evidence-based health care and interprofessional collaboration (IPC) are covered during their training. Since these areas are valued by the biomedical training field, this may help to bridge the attitudinal and communication gaps between these different practices. The aim of this study was to describe the training offered in these areas and gather the perceptions of curriculum/program directors in regulated Canadian CAM schools. Methods A two-phase study consisting of an electronic survey and subsequent semi-structured telephone interviews was conducted with curriculum/program (C/P) directors in regulated Canadian CAM schools. Questions assessed the extent of the research, evidence-based health care, IPC training and continuing education, as well as the C/P directors’ perceptions about the training. Descriptive statistics were used to describe the schools’, curriculum’s and the C/P directors’ characteristics. Content analysis was conducted on the interview material. Results Twenty-eight C/P directors replied to the electronic survey and 11 participated in the interviews, representing chiropractic, naturopathy, acupuncture and massage therapy schools. Canadian regulated CAM schools offered research and evidence-based health care training as well as opportunities for collaboration with biomedical peers and continuing education to a various extent (58% to 91%). Although directors were generally satisfied with the training offered at their school, they expressed a desire for improvements. They felt future CAM providers should understand research findings and be able to rely on high quality research and to communicate with conventional care providers as well as to engage in continuing education. Limited length of the curriculum was one of the barriers to such improvements. Conclusions These findings seem to reinforce the directors’ interest and the importance of integrating these topics in order to ensure best CAM practices and improve communication between CAM and conventional providers. PMID:24373181

  4. Comparison of a triaxial fluxgate magnetometer and Toftness sensometer for body surface EMF measurement

    PubMed Central

    Zhang, John; Toftness, Dave; Snyder, Brian; Nosco, Dennis; Balcavage, Walter; Nindl, Gabi

    2004-01-01

    Introduction The use of magnetic fields to treat disease has intrigued mankind since the time of the ancient Greeks. More recently it has been shown that electromagnetic field (EMF) treatment aids bone healing, and repetitive transcranial magnetic stimulation (rTMS) appears to be beneficial in treating schizophrenia and depression. Since external EMFs influence internal body processes, we hypothesized that measurement of body surface EMFs might be used to detect disease states and direct the course of subsequent therapy. However, measurement of minute body surface EMFs requires use of a sensitive and well documented magnetometer. In this study we evaluated the sensitivity and frequency response of a fluxgate magnetometer with a triaxial probe for use in detecting body surface EMF and we compared the magnetometer readings with a signal from a Toftness Sensometer, operated by an experienced clinician, in the laboratory and in a clinical setting. Methods A Peavy Audio Amplifier and variable power output Telulex signal generator were used to develop 50 ?T EMFs in a three coil Merritt coil system. A calibrated magnetometer was used to set a 60 Hz 50 ?T field in the coil and an ammeter was used to measure the current required to develop the 50 ?T field. At frequencies other than 60 Hz, the field strength was maintained at 50 ?T by adjusting the Telulex signal output to keep the current constant. The field generated was monitored using a 10 turn coil connected to an oscilloscope. The oscilloscope reading indicated that the field strength was the same at all frequencies tested. To determine if there was a correspondence between the signals detected by a fluxgate magnetometer (FGM1) and the Toftness Sensometer both devices were placed in the Merritt coil and readings were recorded from the FGM1 and compared with the ability of a highly experienced Toftness operator to detect the 50 ?T field. Subsequently, in a clinical setting, FGM1 readings made by an FGM1 technician and Sensometer readings were made by 4 Toftness Sensometer operators, having various degrees of experience with this device. Each examiner obtained instrument readings from 5 different volunteers in separate chiropractic adjusting rooms. Additionally, one of the Toftness Sensometers was equipped with an integrated fluxgate magnetometer (FGM2) and this magnetometer was used to obtain a second set of EMF readings in the clinical setting. Results The triaxial fluxgate magnetometer was determined to be moderately responsive to changes in magnetic field frequency below 10 Hz. At frequencies above 10 Hz the readings corresponded to that of the ambient static geofield. The practitioner operating the Toftness Sensometer was unable to detect magnetic fields at high frequencies (above 10 Hz) even at very high EMFs. The fluxgate magnetometer was shown to be essentially a DC/static magnetic field detector and like all such devices it has a limited frequency range with some low level of sensitivity at very low field frequencies. The interexaminer reliability of four Toftness practitioners using the Sensometer on 5 patients showed low to moderate correlation. Conclusions The fluxgate magnetometer although highly sensitive to static (DC) EMFs has only limited sensitivity to EMFs in the range of 1 to 10 Hz and is very insensitive to frequencies above 10 Hz. In laboratory comparisons of the Sensometer and the fluxgate magnetometer there was an occasional correspondence between the two instruments in detecting magnetic fields within the Merritt coil but these occasions were not reproducible. In the clinical studies there was low to moderate agreement between the clinicians using the Sensometer to diagnosing spinal conditions and there was little if any agreement between the Sensometer and the fluxgate magnetometer in detecting EMFs emanating from the volunteers body surface. PMID:17549105

  5. Before-after study to determine the effectiveness of an adjustable wood frame-foam and wool mattress bed-system (The Natura Mattress System) in reducing chronic back pain in adults

    PubMed Central

    Hagino, Carol; Erfanian, Parham

    1997-01-01

    Objective and Design: The purpose of this 6-week Before-After trial was to investigate the effectiveness of the Natura Mattress System in reducing back pain by ? 1 unit on the 11-Point Pain Severity Scale (p ? 0.05), in chronic low back pain sufferers. Subject Profile: The subjects were adults recruited from within and outside the Canadian Memorial Chiropractic College (CMCC) Outpatient Clinic, with chronic low back pain (LBP) of ? 2 months duration at the time of entering the study. Sample Size: 15 subjects were targeted to complete the study. Outcome Measures: The primary outcome measure consisted of: morning severity of pain as measured by an 11-point ordinal pain scale (Numeric Rating Scale or NRS). Secondary outcome measures consisted of: (1) daily quality of sleep as measured by a 4-point ordinal scale; (2) effect on daily activity as measured by a 4-point ordinal scale; and (3) daily quantity of analgesics. These outcomes were collected via a daily diary-type of questionnaire. Statistical Analysis: Baseline to 4-week post treatment-commencement differences were analyzed for statistical significance using Repeated Measures ANOVA, at the 0.05 level of significance. In addition, all outcome measures were graphed and examined descriptively for any clinically important changes across the 6 week time-frame of the study. Methods Protocol: Eligible subjects who read and signed the written informed consent form, were given a package containing a copy of the written informed consent form, and upon completing the 2 week baseline daily diary questionnaires, were contacted by the bed manufacturer, who arranged with the subject a date and time of mutual convenience to deliver the bed (twin or queen size). The subject was then required to complete 4 more weeks of diary questionnaires. Thank-you cards were sent to each subject who completed the study. Results: The sample consisted of 6 caucasian females and 7 caucasian males, between the ages of 22 and 75 years, with an average(sd) age of 37.0 (18.44) years. Five subjects were adult students, 5 had sedentary occupations, while 3 had relatively physical occupations. Baseline low back pain (LBP) severities of the sample ranged from 2 to 8 on the 11 point pain scale (NRS), with an average(sd) level of 3.0 (1.75). Average duration of the subjects’ chronic LBP state was 5.6 years, ranging from 3 months to 30 years. Only 2 subjects were taking LBP medications at the start of the study. Conclusion: For a generally well educated, young (20-40 years of age), caucasian population with mild-moderate chronic LBP, use of the Natura Bed can be expected to result in a clinically important reduction in pain severity upon both waking and at the end of the day, of at least 1 point (on the NRS) over a 4 week period (p ? 0.05). Further research is recommended which utilizes the Randomized Clinical Trial (RCT) design to investigate the performance of the Natura Bed compared to other beds on the market, and assesses patient characteristics predicting suitability for the Natura Bed. ImagesFigure 1

  6. Review of methods used by chiropractors to determine the site for applying manipulation

    PubMed Central

    2013-01-01

    Background With the development of increasing evidence for the use of manipulation in the management of musculoskeletal conditions, there is growing interest in identifying the appropriate indications for care. Recently, attempts have been made to develop clinical prediction rules, however the validity of these clinical prediction rules remains unclear and their impact on care delivery has yet to be established. The current study was designed to evaluate the literature on the validity and reliability of the more common methods used by doctors of chiropractic to inform the choice of the site at which to apply spinal manipulation. Methods Structured searches were conducted in Medline, PubMed, CINAHL and ICL, supported by hand searches of archives, to identify studies of the diagnostic reliability and validity of common methods used to identify the site of treatment application. To be included, studies were to present original data from studies of human subjects and be designed to address the region or location of care delivery. Only English language manuscripts from peer-reviewed journals were included. The quality of evidence was ranked using QUADAS for validity and QAREL for reliability, as appropriate. Data were extracted and synthesized, and were evaluated in terms of strength of evidence and the degree to which the evidence was favourable for clinical use of the method under investigation. Results A total of 2594 titles were screened from which 201 articles met all inclusion criteria. The spectrum of manuscript quality was quite broad, as was the degree to which the evidence favoured clinical application of the diagnostic methods reviewed. The most convincing favourable evidence was for methods which confirmed or provoked pain at a specific spinal segmental level or region. There was also high quality evidence supporting the use, with limitations, of static and motion palpation, and measures of leg length inequality. Evidence of mixed quality supported the use, with limitations, of postural evaluation. The evidence was unclear on the applicability of measures of stiffness and the use of spinal x-rays. The evidence was of mixed quality, but unfavourable for the use of manual muscle testing, skin conductance, surface electromyography and skin temperature measurement. Conclusions A considerable range of methods is in use for determining where in the spine to administer spinal manipulation. The currently published evidence falls across a spectrum ranging from strongly favourable to strongly unfavourable in regard to using these methods. In general, the stronger and more favourable evidence is for those procedures which take a direct measure of the presumptive site of care– methods involving pain provocation upon palpation or localized tissue examination. Procedures which involve some indirect assessment for identifying the manipulable lesion of the spine–such as skin conductance or thermography–tend not to be supported by the available evidence. PMID:24499598

  7. [USE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE AMONG FAMILY MEDICINE PATIENTS--EXAMPLE OF THE TOWN OF ?AKOVEC].

    PubMed

    Vitale, Ksenija; Mun?ar, Roko; Sovi?, Slavica; Bergman-Markovi?, Biserka; Janev Holcer, Nataša

    2014-12-01

    The use of complementary and alternative medicine (CAM) is widespread around the world including Croatia. The number of studies that investigate both quantitative and qualitative use of CAM in Croatia is limited. The aim of this study was to investigate the use of CAM among family medicine patients in the town of ?akovec and the rate they report it to their family doctor. This was a cross-sectional study in a sample of 300 patients that visited primary health center for any reason. We used anonymous questionnaire already employed in a previous investigation (?ižmešija et al. 2008), which describes socioeconomic characteristics, modalities of CAM use, and reasons for use. We also added questions on the type of herbs used and use of over-the-counter vitamin and mineral supplements. On data analysis we used descriptive statistics, ?2-test and Fisher's exact test, while the level of statistical significance was set at p ? 0.05. The response rate was 76%. Out of the total number of patients, 82% used some modality of CAM. Women, patients with secondary school education, employed and retired persons used CAM more often. Students and pupils reported least use of CAM. The most commonly used were herbs (87%), bioenergy (29%), diet therapy (28%), chiropractics (22%), and homeopathy and acupuncture (11% each). Vitamin and mineral supplements were used by 77% of study subjects. CAM was most frequently used for respiratory, urinary and musculoskeletal problems, as well as to improve overall health condition. Of the respondents that reported CAM use, 55% believed it would help them, 43% used it because they wanted to try something new, while only 2% indicated dissatisfaction with their physician as the reason for using CAM. Statistically, there were more subjects that used CAM and did not notify their family doctor about it, which could indicate poor communication between family doctors and health care users. Our results are consistent with a previous quantitative study conducted in Croatia and with literature data on the countries with a predominant use of western medicine. Qualitative data from previous studies in Croatia could explain the cultural and socioeconomic context of CAM use. Dissatisfaction with their physician as the reason for using CAM was rarely indicated, suggesting that CAM most probably fills the gap between successful and unsuccessful treatment, and perception that evidence based medicine has its own limitations. The arguments to turn to CAM therapy could involve poor doctor to patient ratio, i.e. 1750 patients per family medicine doctor on average, and the 20% increase in the number of diseases and conditions diagnosed by family medicine units. In conclusion, these results suggest that the use of CAM is common among patients in family medicine. When taking patient history, doctors should ask about CAM use and be aware of the patient beliefs and lifestyle. When patients strongly believe in CAM methods, there is the need of making compromise in therapy, with explanation of the possible side effects and at the same time continuous follow up. There is the need of additional education of family doctors and population about good and bad effects of CAM. In Croatia, accent should be on herbalism because this modality is most widespread. PMID:26285467

  8. Respiratory and allergic diseases: from upper respiratory tract infections to asthma.

    PubMed

    Jaber, Raja

    2002-06-01

    Patients with asthma and allergic rhinitis may benefit from hydration and a diet low in sodium, omega-6 fatty acids, and transfatty acids, but high in omega-3 fatty acids (i.e., fish, almonds, walnuts, pumpkin, and flax seeds), onions, and fruits and vegetables (at least five servings a day). Physicians may need to be more cautious when prescribing antibiotics to children in their first year of life when they are born to families with a history of atopy. More research is needed to establish whether supplementation with probiotics (lactobacillus and bifidobacterium) during the first year of life or after antibiotic use decreases the risk of developing asthma and allergic rhinitis. Despite a theoretic basis for the use of vitamin C supplements in asthmatic patients, the evidence is still equivocal, and long-term studies are needed. The evidence is stronger for exercise-induced asthma, in which the use of vitamin C supplementation at a dosage of 1 to 2 g per day may be helpful. It is also possible that fish oil supplements, administered in a dosage of 1 to 1.2 g of EPA and DHA per day, also may be helpful to some patients with asthma. Long-term studies of fish oil and vitamin C are needed for more definite answers. For the patient interested in incorporating nutritional approaches, vitamin C and fish oils have a safe profile. However, aspirin-sensitive individuals should avoid fish oils, and red blood cell magnesium levels may help in making the decision whether to use additional magnesium supplements. Combination herbal formulas should be used in the treatment of asthma with medical supervision and in collaboration with an experienced herbalist or practitioner of TCM. Safe herbs, such as Boswellia and gingko, may be used singly as adjuncts to a comprehensive plan of care if the patient and practitioner have an interest in trying them while staying alert for drug-herb interactions. No data on the long-term use of these single herbs in asthma exist. For the motivated patient, mind-body interventions such as yoga, hypnosis, and biofeedback-assisted relaxation and breathing exercises are beneficial for stress reduction in general and may be helpful in further controlling asthma. Encouraging parents to learn how to massage their asthmatic children may appeal to some parents and provide benefits for parents and children alike. Acupuncture and chiropractic treatment cannot be recommended at this time, although some patients may derive benefit because of the placebo effect. For patients with allergic rhinitis, there are no good clinical research data on the use of quercetin and vitamin C. Similarly, freeze-dried stinging nettle leaves may be tried, but the applicable research evidence also is poor. Further studies are needed to assess the efficacy of these supplements and herbs. Homeopathic remedies based on extreme dilutions of the allergen may be beneficial in allergic rhinitis but require collaboration with an experienced homeopath. There are no research data on constitutional homeopathic approaches to asthma and allergic rhinitis. Patients with COPD are helped by exercise, pulmonary rehabilitation, and increased caloric protein and fat intake. Vitamin C and n-3 supplements are safe and reasonable; however, studies are needed to establish their efficacy in COPD. On the other hand, there are convincing data in favor of N-acetyl-cysteine supplementation for the patient with COPD at doses ranging between 400 and 1200 mg daily. Red blood cell magnesium levels may guide the use of magnesium replacement. The use of L-carnitine and coenzyme Q10 in patients with COPD needs further study. The addition of essential oils to the dietary regimen of patients with chronic bronchitis is worth exploring. Patients with upper respiratory tract infections can expect a shorter duration of symptoms by taking high doses of vitamin C (2 g) with zinc supplements, preferably the nasal zinc gel, at the onset of their symptoms. Adding an herb such as echinacea or Andrographis shortens the duration of the common cold. The one study on Elderberry's use for