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1

Chiropractic: a critical evaluation.  

PubMed

Chiropractic was defined by D.D. Palmer as "a science of healing without drugs." About 60,000 chiropractors currently practice in North America, and, worldwide, billions are spent each year for their services. This article attempts to critically evaluate chiropractic. The specific topics include the history of chiropractic; the internal conflicts within the profession; the concepts of chiropractic, particularly those of subluxation and spinal manipulation; chiropractic practice and research; and the efficacy, safety, and cost of chiropractic. A narrative review of selected articles from the published chiropractic literature was performed. For the assessment of efficacy, safety, and cost, the evaluation relied on previously published systematic reviews. Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today. Currently, there are two types of chiropractors: those religiously adhering to the gospel of its founding fathers and those open to change. The core concepts of chiropractic, subluxation and spinal manipulation, are not based on sound science. Back and neck pain are the domains of chiropractic but many chiropractors treat conditions other than musculoskeletal problems. With the possible exception of back pain, chiropractic spinal manipulation has not been shown to be effective for any medical condition. Manipulation is associated with frequent mild adverse effects and with serious complications of unknown incidence. Its cost-effectiveness has not been demonstrated beyond reasonable doubt. The concepts of chiropractic are not based on solid science and its therapeutic value has not been demonstrated beyond reasonable doubt. PMID:18280103

Ernst, Edzard

2008-02-14

2

What Is Chiropractic?  

MedlinePLUS

... headaches. Doctors of Chiropractic – often referred to as chiropractors or chiropractic physicians – practice a drug-free, hands- ... care that includes patient examination, diagnosis and treatment. Chiropractors have broad diagnostic skills and are also trained ...

3

Chiropractic audits  

PubMed Central

This paper reviews the process which deals with audits of chiropractic billings. It includes the statutory right to review accounts, the factors which lead to a possible audit, the review process itself as well as the possible outcome of a review. Generally, the number of audits performed on professional practices is minimal in relation to the number of practitioners who submit billings for services. Audits are a matter of public necessity involving accountability to the patient and, if government billings are involved, to the public in general. It is incumbent upon the doctor to ensure that proper protocols exist within his or her office to ensure that an audit is nothing more than opening one’s office for an inspection which should satisfy all of the concerned parties as to legitimacy of the practitioner’s entitlement for reimbursement for services rendered.

Freedman, Allan M

2000-01-01

4

A Chiropracticness Test  

PubMed Central

Background There is little homogeneity of opinion in the chiropractic profession about its essence and identity. Matters compromising the establishment of a coherent identity include the issue of vertebral subluxation, philosophy, mercantilism, poverty of qualifications in some chiropractic college faculty, and lack of intellectual productivity in some chiropractic college faculty. Discussion The Chiropractic profession has mislabeled rhetoric, supposition and cant as philosophy, whilst showing sparse evidence for the existence of more than a few chiropractors writing in philosophy as a discipline. There is no evidence for "Chiropractic Philosophy". I propose, however, that a better use of the discipline of philosophy can be of great use to the Chiropractic profession. Various thinkers throughout the ages have written about deduction, induction and falsificationism as methods to discover more reliably the nature of things in the world about us. Each method has strengths and frailties, but some of the latter are insurmountable for our purposes. Summary Using a contrivance of that method which seems most suited, sui generis, for the purpose, I propose a Chiropracticness Test as a tool to assist the search for essence and identity in Chiropractic.

Charlton, Keith H

2005-01-01

5

Ambulatory Chiropractic Practice in Connecticut.  

National Technical Information Service (NTIS)

Background data were obtained in a study to characterize the number and type of patients using chiropractic services in Connecticut, and financial aspects of chiropractic care were investigated. Of 15,500 chiropractors actively engaged in practice in the ...

1975-01-01

6

Department of Defense Chiropractic Internships  

PubMed Central

Objective: Department of Defense (DoD) chiropractic internships first began in July of 2001. At the time of this study, 30 New York Chiropractic College student interns had completed part of their clinical education within chiropractic clinics at either the National Naval Medical Center or Naval Hospital Camp Lejeune. The purpose of this study was to evaluate and compare the careers of DoD chiropractic internship participants with comparable nonparticipants in terms of demographics, professional activities, income, and satisfaction. Methods: Survey research was employed to gather data from DoD chiropractic internship participants and comparable nonparticipants. Statistical analysis was carried out to determine significant differences with a nominal significance level set as.05. Results: There were no statistically significant differences in demographics, professional activities, income, or career satisfaction between the 21 DoD chiropractic internship participants (70% response rate) and 35 internship nonparticipants (35% response rate). Conclusions: This study utilized practice parameters as a form of feedback for a comparative analysis of DoD chiropractic internship participants and nonparticipants and found no significant differences between these groups. Limitations of the study may have influenced the results. Opportunities for chiropractic students to train within these settings remains limited and should be further explored, as should additional research into this component of chiropractic clinical education.

Dunn, Andrew S.

2006-01-01

7

The Journal of Chiropractic Medicine: an update on selected specialties in the chiropractic profession?  

PubMed Central

This article presents a brief description of the specialty chiropractic groups that are affiliated with the Journal of Chiropractic Medicine: American Academy of Chiropractic Physicians (AACP), The American Chiropractic Board of Sports Physicians (ACBSP), The College on Forensic Sciences (CFS), and The International Academy of Chiropractic Neurology (IACN), and the Council on Diagnostic Imaging (CDI).

Johnson, Claire

2012-01-01

8

Stroke following Chiropractic Manipulation  

Microsoft Academic Search

We present 3 cases of stroke due to arterial dissection following chiropractic manipulation: (1) a 31-year-old woman with left vertebral dissection developed a large cerebellar infarct, (2) a 64-year-old man developed a left parietal infarct due to left carotid dissection and (3) a 51-year-old man developed right Horner’s syndrome, fluctuating dysarthria, left facial droop, and left arm weakness due to

Joseph S. Jeret; Mark Bluth

2002-01-01

9

Find a Doctor of Chiropractic  

MedlinePLUS

... Kinesiology Bioenergetics CAT Scan (CT Scan) Cervical / Lumbar Traction Chiropractic Adjustment Corporate Health Cox Flexion-Distraction Craniosacral ... Technique Grostic Technique Interferential Electro-Therapy (IFT) Intersegmental Traction /Roller Table Kinesio Tape/ Taping Laser Therapy Logan ...

10

Early chiropractic education in Oregon  

PubMed Central

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

Keating, Joseph C

2002-01-01

11

Chiropractic utilization in Taekwondo athletes  

PubMed Central

The purpose of the present study was to examine chiropractic utilization following a sport-related injury among National Team members and other high level Taekwondo athletes. Methods Retrospective surveys were conducted among Canadian male and female Taekwondo athletes (Group A, n = 60) competing in a national tournament and National Taekwondo team athletes (Group B, n = 16) at a training camp. Results A response rate of 46.7% (Group A) and 100% (Group B) was achieved. Twenty five percent (n = 4) of Group A athletes reported never seen a doctor of chiropractic (DC) regarding their injuries. Over 12% (n = 2) reported visiting a DC often, while just over 6% (n = 1) reported that they usually visited the DC following an injury. When injured, over 36% (n = 7) of the National Team members visit their family physician, over 15% (n = 3) visit a chiropractor or physiotherapist and the remaining athletes (n = 6) equally visit osteopaths, massage therapists, or athletic therapist following an injury. Conclusion There is a lack of information surrounding chiropractic utilization in the majority of sports and minimal research published regarding the health care utilization of Taekwondo athletes. Chiropractors, and particularly those with extensive athlete contact, should endeavour to further utilization studies.

Kazemi, Mohsen; Shearer, Heather

2008-01-01

12

Is chiropractic care primary health care?  

PubMed Central

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).

Coulter, ID

1992-01-01

13

Chiropractic and CAM Utilization: A Descriptive Review  

PubMed Central

Objective To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions Data Sources A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. Data Selection A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Data Synthesis Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. Results Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Conclusion Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

Lawrence, Dana J; Meeker, William C

2007-01-01

14

How consumers view chiropractic advertising.  

PubMed

Chiropractic, as a medical profession, is finally receiving acceptance from the American Medical Association (AMA) and other medical groups. However, what do consumers think about chiropractors and how do they respond to the advertising efforts of chiropractors? This paper presents the findings of a survey concerning consumers' opinions of advertising by chiropractors. Although the opinions of the respondents were mixed, an analysis of the results of the survey suggests important implications for chiropractors and other medical practitioners who wish to use advertising media in marketing their services. PMID:10156605

Moser, H R; Johns, H E; Kittrell, L M

1995-01-01

15

Evidence-Based Practice and Chiropractic Care  

PubMed Central

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.

LeFebvre, Ron; Peterson, David; Haas, Mitchell

2013-01-01

16

Cerebrospinal fluid leak secondary to chiropractic manipulation  

PubMed Central

Background: There is a paucity of quality data on the incidence of adverse outcomes of chiropractic manipulation. Spontaneous intracranial hypotension (SIH) subsequent to cervical spinal manipulation has been documented. However, no imaging correlates have previously been presented demonstrating a clear causal relationship to manipulation with follow-up and correlating with clinical symptomatology. Case Description: We present a case of subacute cervical cerebrospinal fluid (CSF) leak resulting from chiropractic manipulation of the cervical spine. The patient is a 29-year-old female who received manipulation one week prior to developing symptoms of severe orthostatic headache, nausea, and vomiting. Magnetic resonance imaging (MRI) revealed a new C5-C6 ventral CSF collection. Symptomatic onset corresponded with the recent cervical chiropractic adjustment. We present serial imaging correlating with her symptomatology and review the pertinent literature on complications of chiropractic manipulation. Conclusion: Our case of ventral CSF leak with symptoms of intracranial hypotension demonstrated spontaneous symptomatic resolution without permanent neurological sequelae.

Kusnezov, Nicholas A.; Velani, Shamsha A.; Lu, Daniel C.

2013-01-01

17

Inappropriate Medicare Payments for Chiropractic Services.  

National Technical Information Service (NTIS)

As required by the Social Security Act, Medicare pays only for medically necessary chiropractic services, which are limited to active/corrective manual manipulations of the spine to correct subluxations. Chiropractors must use the acute treatment (AT) mod...

D. R. Levinson

2009-01-01

18

Chiropractic maintenance treatment, a useful preventative approach?  

PubMed

Most chiropractors advise patients to have regular maintenance treatments with spinal manipulation, even in the absence of any symptoms or diseases. This article evaluates the evidence for or against this approach. No compelling evidence was found to indicate that chiropractic maintenance therapy effectively prevents symptoms or diseases. As spinal manipulation has repeatedly been associated with considerable harm, the risk benefit balance of chiropractic maintenance care is not demonstrably positive. Therefore there are no good reasons to recommend it. PMID:19465044

Ernst, E

2009-05-22

19

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

PubMed Central

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.

Senzon, Simon A.

2011-01-01

20

Chiropractic treatment of coccygodynia via instrumental adjusting procedures using activator methods chiropractic technique  

Microsoft Academic Search

Objective: To discuss a case of coccygodynia that responded favorably to conservative chiropractic adjusting procedures with the Activator Methods Chiropractic Technique (AMCT) and the Activator II Adjusting Instrument (AAI II). Clinical Features: A 29-year-old woman had unremitting coccygeal pain of 3 weeks' duration. The problem began after she had moved heavy boxes while at work. The pain was characterized by

Bradley S. Polkinghorn; Christopher J. Colloca

1999-01-01

21

Chiropractic approach to the management of children  

PubMed Central

Background Chiropractic (Greek: done by hand) is a health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques, including joint adjustment and/or manipulation, with a particular focus on joint subluxation (World Health Organization 2005) or mechanical lesion and restoring function. The chiropractor's role in wellness care, prevention and treatment of injury or illness is based on education in anatomy and physiology, nutrition, exercise and healthy lifestyle counseling as well as referral to other health practitioners. Depending on education, geographic location, scope of practice, as well as consumer preference, chiropractors may assume the role of primary care for families who are pursuing a more natural and holistic approach to health care for their families. Objective To present a perspective on current management of the paediatric patient by members of the chiropractic profession and to make recommendations as to how the profession can safely and effectively manage the paediatric patient. Discussion The chiropractic profession holds the responsibility of ethical and safe practice and requires the cultivation and mastery of both an academic foundation and clinical expertise that distinguishes chiropractic from other disciplines. Research into the effectiveness of chiropractic care for paediatric patients has lagged behind that of adult care, but this is being addressed through educational programs where research is now being incorporated into academic tracks to attain advanced chiropractic degrees. Conclusion Studies in the United States show that over the last several decades, chiropractors are the most common complementary and alternative medicine providers visited by children and adolescents. Chiropractors continue to seek integration with other healthcare providers to provide the most appropriate care for their paediatric patients. In the interest of what is best for the paediatric population in the future, collaborative efforts for research into the effectiveness and safety of chiropractic care as an alternative healthcare approach for children should be negotiated and are welcomed.

2010-01-01

22

Chiropractic  

MedlinePLUS

... to heal itself. They may also use other treatments including Heat and ice Electrical stimulation Relaxation techniques Dietary supplements Many people visit chiropractors for treatment of low back pain. NIH: National Center for ...

23

Should the chiropractic profession embrace the doctrine of informed consent?  

PubMed Central

Abstract This commentary provides a narrative review of the literature focusing on the use of a health care informed consent process in the United States. This article reviews the current positions of the World Medical Association, American Medical Association, American Chiropractic Association, Wisconsin and New Jersey State Courts, US Federal Government Office of Health Policy and Clinical Outcomes, and 1 college of chiropractic regarding the doctrine of informed consent. The authors recommend that the chiropractic profession embrace the doctrine of informed consent and promulgate it as a standard of care. The implementation of this doctrine by chiropractic physicians promotes and improves the safety of chiropractic interventions.

Lehman, James J.; Conwell, Timothy D.; Sherman, Paul R.

2008-01-01

24

Chiropractic as spine care: a model for the profession  

PubMed Central

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.

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

2005-01-01

25

Complications of chiropractic treatment for back pain.  

PubMed

Back pain often causes patients great despair, and they expect the primary care physician or orthopedic surgeon to provide a quick, simple solution. Rest and analgesia are the most commonly prescribed treatments, and muscle relaxants, heat, traction, and physiotherapy are also used. If these treatments do not help, the patient may search for relief through faith healing, acupuncture, chiropractic treatment, or other nonconventional forms of treatment. Although chiropractic treatment is a popular alternative, its long-term effect is questionable and the medical literature contains numerous reports of patients whose condition worsened as a result of it. Physicians should be aware of the dangers of chiropractic treatment, particularly in patients with severe spondylitic changes, osteoporosis, fractures, tumors, ankylosing spondylitis, infections, or signs of nerve root pressure. PMID:2966932

Shvartzman, P; Abelson, A

1988-05-15

26

Lasers and their therapeutic application in chiropractic  

PubMed Central

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

Fitz-Ritson, Don

2001-01-01

27

Chiropractic Colleges Seek Legitimacy amid Financial Woes  

ERIC Educational Resources Information Center

|Many of the nation's chiropractic colleges, like other small colleges that rely heavily on tuition, are struggling to stay in business. At the same time that they are working to improve their stature in higher education and broadening their missions to increase their appeal, a number of the colleges are seeing enrollments plummet--and revenues…

Fuller, Andrea

2012-01-01

28

Chiropractic and CAM Utilization: A Descriptive Review  

Microsoft Academic Search

OBJECTIVE: To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions DATA SOURCES: A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations.

Dana J Lawrence; William C Meeker

2007-01-01

29

Chiropractic complaints and disciplinary cases in Canada  

PubMed Central

This paper retrospectively reviews various complaints and disciplinary cases that have appeared before chiropractic provincial regulatory boards throughout Canada, and have resulted in a significant outcome. This information was compiled by the Disciplinary Records Committee of the Canadian Federation of Chiropractic Regulatory Boards. Annually, the committee recorded the following; jurisdiction, year of disciplinary decision, nature of charge/allegation, specific mitigating factors, findings/outcome, penalties imposed, costs related to proceedings, who costs were attributed to, formal or informal proceeding(s). A total of 99 complaints are reviewed. In addition to demographic analysis of the data, a series of descriptive cases are included. This information is provided for the purpose of examining any parallels that might exist when chiropractic regulatory boards evaluate cases so they might arrive at conclusions in a fair and reasonable manner. Consistency in the application of rules and sanctions is a desirable objective of all chiropractic regulatory boards. While this paper is disseminated for informative purposes, ultimately each provincial regulatory board must exhibit good judgement with respect to case-specific issues.

Toth, E Audrey; Lawson, Douglas M; Nykoliation, Jim W

1998-01-01

30

Chiropractic and Stroke: What Are Our Responsibilities?  

Microsoft Academic Search

Over past few decades there have been looming critiques of chiropractors possibly causing strokes due to cervical manipulation and\\/or adjusting. As physicians we have had profound concerns a therapeutic intervention we could render may have iatrogenic implications for a patient. Recent research has illustrated that chiropractic cervical treatment has not been implicated in causing strokes. Apparently any relationship is more

Charles L. Blum

31

Pregnancy and chiropractic: a narrative review of the literature  

PubMed Central

Abstract Objective The purpose of this article is to review the literature on the topic of chiropractic care during pregnancy. Methods A PubMed search was performed using the terms pregnancy and chiropractic. Sources were cross-referenced to obtain further articles and research information after reviewing the articles obtained through the search. Results Thirty-three references were used for this review. The current literature reports favorable results on the use of chiropractic care throughout pregnancy. Conclusions Chiropractic evaluation and treatment during pregnancy may be considered a safe and effective means of treating common musculoskeletal symptoms that affect pregnant patients. The scarcity of published literature warrants further research.

Borggren, Cara L.

2007-01-01

32

The journal 'chiropractic & osteopathy' changes its title to 'chiropractic & manual therapies'. a new name, a new era  

PubMed Central

Chiropractic & Osteopathy changes its title to Chiropractic & Manual Therapies in January 2011. This change reflects the expanding base of submissions from clinical scientists interested in the discipline of manual therapy. It is also in accord with the findings of a review of the journal content and a joint venture between the original parent organisation the Chiropractic and Osteopathic College of Australasia and a new partner the European Academy of Chiropractic, which is a subsidiary body of the European Chiropractors' Union. The title change should encourage submissions from all professionals interested in manual therapy including chiropractors, osteopaths, physiotherapists, medical doctors and scientists interested in this field.

2011-01-01

33

Issues surrounding chiropractic fee negotiations in Saskatchewan †  

PubMed Central

Chiropractic fee negotiations in Saskatchewan utilize the Chiropractic Compensation Review Committee with recourse to the Chiropractic Consultation Committee. Health care professionals who practise on a fee for service basis provide the government with a budgetary problem. Although the fees are set, the health care provider can determine his own income by deciding how many visit services he/she wishes to provide. In the fiscal years 1981-82 to 1990-91, chiropractors earned $699.00 per year more than one would expect given the increases in fee schedules. Each chiropractor earned $2,329.00 per year more than was necessary to make up for losses due to inflation. The allegation that unnecessary treatments were performed on patients is countered by analysis of the services per discrete patient values by mode of practice. The increased earnings of chiropractors was accomplished by treating an increasing percentage of the population who sought health care. Comparative information was obtained from the four western provinces.

Grier, Alexander R; Grier, Katharine L

1992-01-01

34

The Health Information Brochure: A Useful Tool for Chiropractic Practice?  

Microsoft Academic Search

Background: It has been suggested that clinicians should be looking at new ways to enhance their patients' self-care. Patient education is one strategy that primary providers may use. Objective: This study investigates the format in which patients would like to pursue their health education within the chiropractic clinic. Methods: An exploratory study of chiropractic patients was undertaken to investigate patients'

Jennifer R. Jamison

2001-01-01

35

Rating specific chiropractic technique procedures for common low back conditions  

Microsoft Academic Search

Objective: To rate specific chiropractic technique procedures used in the treatment of common low back conditions.Design and Methods: A panel of chiropractors rated specific chiropractic technique procedures for their effectiveness in the treatment of common low back conditions, based on the quality of supporting evidence after systematic literature reviews and expert clinical opinion. Statements related to the rating process and

Meridel I. Gatterman; Robert Cooperstein; Charles Lantz; Stephen M. Perle; Michael J. Schneider

2001-01-01

36

Status of Activator Methods Chiropractic Technique, Theory, and Practice  

Microsoft Academic Search

Objective: To provide an historical overview, description, synthesis, and critique of the Activator Adjusting Instrument (AAI) and Activator Methods Chiropractic Technique of clinical assessment. Methods: Online resources were searched including Index to Chiropractic Literature, EBSCO Online, MANTIS, CHIROLARS, CINAHL, eJournals, Ovid, MDConsult, Lane Catalog, SU Catalog, and Pubmed. Relevant peer-reviewed studies, commentaries, and reviews were selected. Studies fell into 2

Arlan W. Fuhr; J. Michael Menke

2005-01-01

37

A brief history of historical scholarship in chiropractic  

Microsoft Academic Search

This paper provides a cursory overview of attempts to discover, preserve and disseminate the history of the chiropractic profession, up to and including the organization of the Association for the History of Chiropractic (AHC). A surprisingly wide range of materials have been available for many decades, but sustained efforts at historical scholarship are more recent (past quarter century). The quality

Joseph C Keating

38

Diversity in the Chiropractic Profession: Preparing for 2050  

PubMed Central

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.

Johnson, Claire D.; Green, Bart N.

2012-01-01

39

Beyond the "Jim Crow" experience: blacks in chiropractic education.  

PubMed

Although the first chiropractic adjustment was given by D.D. Palmer to a black man in 1895, within two decades attendance at the Palmer School of Chiropractic was forbidden to blacks. Not until mid-century were blacks allowed entrance into the oldest and largest chiropractic college in the United states. Denied entry at the Palmer School, most blacks who entered chirporactic studied in "Jim Crow" schools run by white practitioners in the North. This paper explores the social, historicl and economic factors influencing the exclusion of blacks from medical education, and concludes that chirpractic education is at the stage medical education was twenty-five years ago in its attempts to recruit black students. The author recommends that the Association of Chiropractic Colleges establish a task force on minoritiy recruitment to expand the educational opportunities in chiropractic for blacks and other minorities. PMID:11613378

Wiese, G

1994-06-01

40

Chiropractic Health Care: A National Study of Cost of Education, Service Utilization, Number of Practicing Doctors of Chiropractic and Other Key Policy Issues. Volume II: Appendix.  

National Technical Information Service (NTIS)

The report presents the most comprehensive information ever gathered and analyzed regarding chiropractic health care in the United States. The project is the first federally sponsored study of chiropractic to look at a broad range of issues of concern to ...

T. von Kuster

1980-01-01

41

Chiropractic Health Care: A National Study of Cost of Education, Service Utilization, Number of Practicing Doctors of Chiropractic, and Other Key Policy Issues. Volume 1.  

National Technical Information Service (NTIS)

This report presents the most comprehensive information ever gathered and analyzed regarding chiropractic health care in the United States. The project is the first federally sponsored study of chiropractic to look at a broad range of issues of concern to...

T. von Kuster

1980-01-01

42

Chiropractic and children: Is more research enough?  

PubMed Central

Many health science research and review articles end with the words: "More research is needed". However, when it comes to research, it is not as much a question of quantity as of quality. There are a number of important prerequisites before research should be initiated. The three pillars, relevance, quality and ethics should be respected but for a project to be meaningful, it must also be based on plausible rationale. In evidence-based (informed) practice, one takes into account not only research-based evidence but also clinical expertise and the patients' perspectives. In this paper, we briefly discuss how this should be handled in clinical practice is briefly discussed, using the concept of "traffic lights" (red, yellow, green). We explain how the combination of evidence and plausibility can be used to reach a decision as to whether a treatment or diagnostic procedure is suitable, possible, or unsuitable. In this thematic series of Chiropractic & Osteopathy a number of reviews are presented, in which the research status of pediatric chiropractic is scrutinized and found wanting. Two important aspects were studied in these reviews: the effect of treatment and safety issues. Two types of problems were identified: the lack of research in general and the lack of research using the appropriate study designs and methodology in particular. Therefore, we discuss the meager research noted in the areas of chiropractic care in children and the clinical consequences this should have. The prerequisites for "more research" are scrutinized and an example given of suitable research programs. Finally, the important issue of implementation of research findings is covered, emphasizing the responsibility of all stakeholders involved at both the undergraduate and the postgraduate level, within professional associations, and on an individual level.

2010-01-01

43

Chiropractic's current state: impacts for the future.  

PubMed

The chiropractic profession is currently facing a shift in practice and health care environments. This editorial reflects on the current state of the profession and suggests that the profession should move from the thinking and practice styles of the past that primarily attempted to prove patient care and practice to a more productive approach that strives to improve patient care and practice. The following primary areas that require attention are discussed: (1) evidence-based and best practices-oriented research priorities; (2) constructive engagement of the greater health care system; and (3) successful ethical business models. PMID:17224347

Mootz, Robert D

2007-01-01

44

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

Federal Register 2010, 2011, 2012, 2013

...Division United States v. Chiropractic Associates, Ltd. of South Dakota; Public Comment...Judgment in United States v. Chiropractic Associates, Ltd. of South Dakota., Civil Action...AMERICA, Plaintiff, v. CHIROPRACTIC ASSOCIATES, LTD. OF SOUTH DAKOTA,...

2013-08-12

45

The role of chiropractic care in older adults  

PubMed Central

There are a rising number of older adults; in the US alone nearly 20% of the population will be 65 or older by 2030. Chiropractic is one of the most frequently utilized types of complementary and alternative care by older adults, used by an estimated 5% of older adults in the U.S. annually. Chiropractic care involves many different types of interventions, including preventive strategies. This commentary by experts in the field of geriatrics, discusses the evidence for the use of spinal manipulative therapy, acupuncture, nutritional counseling and fall prevention strategies as delivered by doctors of chiropractic. Given the utilization of chiropractic services by the older adult, it is imperative that providers be familiar with the evidence for and the prudent use of different management strategies for older adults.

2012-01-01

46

Chiropractic in the United States: Training, Practice, and Research.  

National Technical Information Service (NTIS)

This research report was developed under grant No. HS 07915 by the Center for Health Studies, Group Health Cooperative of Puget Sound (Seattle, Washington). In view of the growing popularity of chiropractic care, it is important that health care providers...

D. C. Cherkin R. B. Phillips R. D. Mootz

1997-01-01

47

Chiropractic management of chronic idiopathic meralgia paresthetica: a case study  

PubMed Central

Objectives This report describes the case of a patient with chronic idiopathic meralgia paresthetica associated with bilateral sacroiliac joint dysfunction who was managed with chiropractic care. Clinical Features A 35-year-old white woman presented to a private chiropractic clinic with a complaint of numbness in the right anterolateral thigh region. Neurological assessment revealed a diminution of sensibility and discrimination on the right lateral femoral cutaneous nerve territory. Pain was rated as 8.5 on a numeric pain scale of 0 to 10. Musculoskeletal examination of the pelvic region disclosed bilateral sacroiliac joint dysfunction. Intervention and Outcomes Chiropractic management included pelvic mobilizations, myofascial therapy, transverse friction massage, and stretching exercises. After 3 visits (2 weeks later), result of neurological evaluation was normal, with no residual numbness over the lateral thigh. Conclusion In the present case, chiropractic management with standard and applied kinesiology techniques resulted in recovery of meralgia paresthetica symptoms for this patient.

Houle, Sebastien

2012-01-01

48

Chiropractic management of breast-feeding difficulties: a case report  

PubMed Central

Objective The purpose of this study is to discuss a chiropractic case of management and resolution of breast-feeding difficulties. Clinical Features The case involves an 8-day-old baby unable to breast-feed since 4 days old. Initial examination revealed cervical, cranial, and sacral restrictions. She was diagnosed with craniocervical syndrome by a doctor of chiropractic. Intervention and Outcome Following history and examination, the infant received gentle chiropractic manipulation based on clinical findings. Immediate improvement and complete resolution of the nursing problems were observed after 3 treatments over 14 days. Conclusion The results of this case suggest that neuromusculoskeletal dysfunction may influence the ability of an infant to suckle successfully and that intervention via chiropractic adjustments may result in improving the infant's ability to suckle efficiently.

Holleman, Annique C.; Nee, John; Knaap, Simone F.C.

2011-01-01

49

A History of The Journal of Chiropractic Education  

PubMed Central

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.

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

2011-01-01

50

Oswald Hall, PhD: Chiropractic advocate; 1971 to 1998  

PubMed Central

Oswald Hall is one of the “outsiders” who has profoundly impacted Canadian chiropractic and by extension, its various constituencies. The purpose of this paper is to document how Dr. Hall used the depth and breadth of knowledge and experience assimilated in his career, to interact with the chiropractic profession and the Canadian Memorial Chiropractic College (CMCC). Dr. Hall’s main achievement for chiropractic was to quietly, firmly, yet politely, open doors for the acceptance by and of chiropractic and CMCC into the arena of graduate level professional education. He did this in three ways: Dr. Hall’s first step took place in 1973, when as Chair of the Task Force on Chiropractic for the OCH, he assisted the committee to make positive recommendations regarding our education and practice. Dr. Hall’s second step was his contribution to the sociological study culminating in the book, “Chiropractors: Do They Help.” His third, and most complex initiative began in 1982 when he joined the CMCC Board. His stamina and affability were tested during his sixteen year tenure on the University Affiliation Committee as the College endured protracted, failed attempts to unite with the University of Victoria, BC (1988–1992) and York University, Toronto, ON (1995–2001).

Brown, Douglas M

2005-01-01

51

Health Hazard Evaluation Report: HETA 2000-0363-2834, Pappas Chiropractic Center, Piscataway, New Jersey.  

National Technical Information Service (NTIS)

On July 14, 2000, the National Institute for Occupational Safety and Health (NIOSH) received a request from the owner of Pappas Chiropractic Center to conduct a health hazard evaluation (HHE) to evaluate possible exposure to mercury (Hg) at his chiropract...

K. K. Gwin

2001-01-01

52

Chiropractic hospitals in America: A case study of the Bakkum Hospital (1936-1950)  

Microsoft Academic Search

Objective: The purpose of this article is to relate the story of the Bakkum Chiropractic Clinic and Hospital and offer evidence regarding the lost days of chiropractic hospitalization and inpatient care. Discussion: The number of chiropractic facilities offering inpatient care peaked in the period between World Wars I and II. Little information is available about the vast majority of these

Barclay W. Bakkum; Bart N. Green

2001-01-01

53

The Nature of Morality and Its Implications for Chiropractic Educators in Ethics  

Microsoft Academic Search

It is well known that chiropractic colleges teach ethics and professional responsibility to chiropractic students. Casual observation shows faculty members and college administrators share frustration over the anxiety and hours of work devoted to students that violate these expectations. Although it is clear that chiropractic students are taught to behave in an ethical manner, on what moral ground is this

Keith A. Wells

54

An investigation into the demographics and motivations of students studying for a chiropractic degree  

PubMed Central

Objective This research aimed to investigate motivations for studying chiropractic, and to determine what students look for in a course/college and potential barriers to studying chiropractic. Methods The study design was a cross-sectional survey. Following IRB/Ethical approval, a paper-based questionnaire was distributed to students at McTimoney College of Chiropractic. Demographic data were compared to another chiropractic college in the United Kingdom. Results The questionnaire response rate was 70.8% (n = 121). Motivating factors for studying chiropractic included a desire to help others (54.5%, n = 66), with 44.6% (n = 54) attracted by chiropractic's holistic, drugless approach to health. Previous help from chiropractic influenced 55.4% (n = 67) and 22.3% (n = 27) felt chiropractic had “changed their life.” Just over half of the respondents (55.4%, n = 67) viewed the ability to work while studying as extremely important and 73.6% (n = 89) said they could not have studied chiropractic without this. Conclusion Previous help from chiropractic care was a common motivation for studying chiropractic. The ability to work while studying was seen as vital by many students and, without it, the vast majority felt they could not have studied chiropractic.

Yalden, Philip; Cunliffe, Christina; Hunnisett, Adrian

2013-01-01

55

How can chiropractic become a respected mainstream profession? The example of podiatry  

Microsoft Academic Search

BACKGROUND: The chiropractic profession has succeeded to remain in existence for over 110 years despite the fact that many other professions which had their start at around the same time as chiropractic have disappeared. Despite chiropractic's longevity, the profession has not succeeded in establishing cultural authority and respect within mainstream society, and its market share is dwindling. In the meantime,

Donald R Murphy; Michael J Schneider; David R Seaman; Stephen M Perle; Craig F Nelson

2008-01-01

56

Chiropractic: a profession at the crossroads of mainstream and alternative medicine  

Microsoft Academic Search

Chiropractic is a large and well-established health care profession in the United States. In this overview, we briefly examine the development of chiropractic from humble and contentious beginnings to its current state at the crossroads of alternative and mainstream medicine. Chiropractic has taken on many of the attributes of an established profession, improving its educational and licensing systems and substantially

William C. Meeker; Scott Haldeman

2002-01-01

57

The Effects of Chiropractic Treatment on Students With Learning and Behavioral Impairments Due to Neurological Dysfunction.  

ERIC Educational Resources Information Center

The effects of chiropractic treatment on children with learning and behavioral problems was investigated with 24 elementary and secondary level students, 12 receiving regular chiropractic treatment and 12 receiving medication. Results indicated that chiropractic treatment was more effective for the wide range symptoms common in the neurological…

Walton, E. V.; Brzozowski, Walter T.

58

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

PubMed Central

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.

2011-01-01

59

Cognitive processes in learning chiropractic skills: The role of imagery  

PubMed Central

The role of imagery in learning a chiropractic adjustment was examined. Thirty students from C.M.C.C. were randomly divided into two groups and exposed to two different types of imagery. The first group mentally rehearsed performing the adjustment, and the second group imagined the spine and the positive outcome of the adjustment. Subjects’ ability to perform the adjustment was assessed before and after exposure to the imagery. The performance of the group who imagined the spine improved significantly more than the group who mentally rehearsed the adjustment. In addition, students were questioned on the types of imagery they spontaneously use in learning new chiropractic techniques. Implications for chiropractic education are discussed.

Josefowitz, N.; Stermac, L.; Grice, A.; Fligg, B.; Moss, J.; Szaraz, Z.

1986-01-01

60

Chiropractic quality assurance: standards and guidelines  

PubMed Central

Chiropractic quality assurance involves development of both clinical guidelines and standards. Confusion generated by poor differentiation of guidelines from standards contributes to mistrust of the guideline development process. Guidelines are considered to be recommendations that allow for flexibility and individual patient differences. Standards are more binding and require a high level of supporting evidence. While guidelines serve as educational tools to improve the quality of practice, standards that outline minimum competency are used more as administrative tools on which to base policy. Barriers to development of clinical guidelines and standards include fear that they will create prescriptive “cookbook” practice, and the distrust that guidelines are developed primarily for cost containment. Clinicians also criticize guidelines developed by academics that don't relate to practice, and those based on evidence that lacks clinical relevance. Conflicting guidelines perceived to be based on strong bias or conflict of interest are also suspect. To reduce barriers to acceptance and implementation, guidelines should be inclusive, patient-centered, and based on a variety of evidence and clinical experience.

Gatterman, Meridel I; Dobson, Thomas P; LeFevbre, Ron

2001-01-01

61

Medicolegal corner: Quadriplegia following chiropractic manipulation.  

PubMed

A 45 year old male with multiple comorbidities presented to his internist with a 2 week history of right sided neck pain and tenderness, accompanied by tingling in the hand. The internists' neurological examination was normal, except for decreased range of motion of the right arm. He referred the patient to a chiropractor; he performed plain X rays which revealed mild spasm, but never ordered a magnetic resonance imaging study. The chiropractor manipulated the patient's neck on two successive days. By the morning of the third visit, the patient reported extreme pain and difficulty walking. Without performing a new neurological examination or obtaining an MR scan, the chiropractor again manipulated the patient's neck. He immediately became quadriplegic. Despite undergoing an emergency C5 C6 anterior cervical diskectomy/fusion to address a massive disc found on the MR scan (CT was negative), the patient remained quadriplegic (e.g., C4 sensory, C6 motor levels). A major point of negligence in this case was the failure of both the referring internist and chiropractor to order an MR of the cervical spine prior to the chiropractic manipulation. The internist claimed that there was no known report of permanent quadriplegia resulting from neck manipulation in any medical journal, article or book, or in any literature of any kind or on the internet and that the risk of this injury must be vanishingly small given the large numbers of manipulations performed annually. The total amount of the verdict was $14,596,000.00 the internist's liability was 5% ($759,181.65). PMID:23878767

Epstein, Nancy E; Forte Esq, Carol L

2013-05-28

62

Medicolegal corner: Quadriplegia following chiropractic manipulation  

PubMed Central

A 45 year old male with multiple comorbidities presented to his internist with a 2 week history of right sided neck pain and tenderness, accompanied by tingling in the hand. The internists’ neurological examination was normal, except for decreased range of motion of the right arm. He referred the patient to a chiropractor; he performed plain X rays which revealed mild spasm, but never ordered a magnetic resonance imaging study. The chiropractor manipulated the patient's neck on two successive days. By the morning of the third visit, the patient reported extreme pain and difficulty walking. Without performing a new neurological examination or obtaining an MR scan, the chiropractor again manipulated the patient's neck. He immediately became quadriplegic. Despite undergoing an emergency C5 C6 anterior cervical diskectomy/fusion to address a massive disc found on the MR scan (CT was negative), the patient remained quadriplegic (e.g., C4 sensory, C6 motor levels). A major point of negligence in this case was the failure of both the referring internist and chiropractor to order an MR of the cervical spine prior to the chiropractic manipulation. The internist claimed that there was no known report of permanent quadriplegia resulting from neck manipulation in any medical journal, article or book, or in any literature of any kind or on the internet and that the risk of this injury must be vanishingly small given the large numbers of manipulations performed annually. The total amount of the verdict was $14,596,000.00 the internist's liability was 5% ($759,181.65).

Epstein, Nancy E.; Forte Esq, Carol L.

2013-01-01

63

THE EFFECT OF CHIROPRACTIC MANIPULATION ON SALIVARY CORTISOL LEVELS  

Microsoft Academic Search

Background: The stress response in humans is a healthy response and is necessary for life. The effects of chiropractic manipulation (CM), if any, on stress are ill-defined. Cortisol has been used as an accurate measure of the stress response system in humans. Salivary cortisol is a noninvasive technique to accurately quantify biologically active cortisol. Objective: To determine whether basal salivary

Tara L. Whelan; J. Donald Dishman; Jean Burke; Seymour Levine; Veronica Sciotti

64

The effect of chiropractic manipulation on salivary cortisol levels  

Microsoft Academic Search

Background: The stress response in humans is a healthy response and is necessary for life. The effects of chiropractic manipulation (CM), if any, on stress are ill-defined. Cortisol has been used as an accurate measure of the stress response system in humans. Salivary cortisol is a noninvasive technique to accurately quantify biologically active cortisol. Objective: To determine whether basal salivary

Tara L. Whelan; J. Donald Dishman; Jean Burke; Seymour Levine; Veronica Sciotti

2002-01-01

65

Sports chiropractic management at the World Ice Hockey Championships  

Microsoft Academic Search

BACKGROUND: Ice hockey is an international sport. Injuries occur in a full body fashion, to a number of tissues, commonly through body contact. There is a lack of literature documenting the scope of sports chiropractic practice. Thus, it was the aim to document the type, scope and severity of conditions presenting to, and the treatment provided by, the New Zealand

Chris Julian; Wayne Hoskins; Andrew L Vitiello

2010-01-01

66

Chiropractic Health Care: A National Study of Cost of Education, Service Utilization, Number of Practicing Doctors of Chiropractic, and Other Key Policy Issues. Volumes I-II.  

ERIC Educational Resources Information Center

|Results from the first federally sponsored study of the chiropractic health care profession are presented, and a broad range of facts and issues of concern to policy-makers, the profession, and the public are described. The two-year project included three national surveys of: service providers (doctors of chiropractic in practice more than two…

von Kuster, Thomas, Jr.

67

Comparison of Nutrition Knowledge, Perceptions and Dietary Practices of Chiropractic Student Doctors at Three Points in their Chiropractic Training  

Microsoft Academic Search

Knowledge of and attitudes toward nutrition and dietary practices of chiropractic student doctors were evaluated at three points in their training. Students in trimester 1 (TR 1, n = 55), trimester 7 (TR 7, n = 13), and trimester 10 who were graduating (TR 10, n = 20) participated in the study. Subjects provided information on background and demographics and

S. L. Bohanan; K. S. Kubena; W. A. McIntosh

1995-01-01

68

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

PubMed Central

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.

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

2007-01-01

69

Overview of clinical application of chiropractic therapy in the past ten years  

Microsoft Academic Search

Chiropractic therapy is a common massage method of simplicity, convenience, efficacy and low cost. In the past years, chiropractic\\u000a therapy is increasingly used to treat many diseases in relation to internal medicine, gynecology, pediatrics, medical prevention,\\u000a healtheare and cosmetology, etc. This paper collects 21 articles concerning chiropractic therapy in the past 10 years, and\\u000a then sums up the clinical application

Zhou Er-chun

2004-01-01

70

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

Microsoft Academic Search

Background  Chiropractic in Australia has seen many changes over the past 30 years. Some of these changes have advanced the professional\\u000a status of chiropractic, improved undergraduate training and paved the way for a research culture. Unfortunately, other changes\\u000a or lack of changes, have hindered the growth, public utilisation and professional standing of chiropractic in Australia. This\\u000a article explores what influences have

John W Reggars

2011-01-01

71

Creating European guidelines for Chiropractic Incident Reporting and Learning Systems (CIRLS): relevance and structure  

Microsoft Academic Search

Background  In 2009, the heads of the Executive Council of the European Chiropractors' Union (ECU) and the European Academy of Chiropractic\\u000a (EAC) involved in the European Committee for Standardization (CEN) process for the chiropractic profession, set out to establish\\u000a European guidelines for the reporting of adverse reactions to chiropractic treatment. There were a number of reasons for this:\\u000a first, to improve

Martin Wangler; Ricardo Fujikawa; Lise Hestbæk; Tom Michielsen; Timothy J Raven; Haymo W Thiel; Beatrice Zaugg

2011-01-01

72

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

PubMed

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

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

2007-09-19

73

Low back pain of mechanical origin: randomised comparison of chiropractic and hospital outpatient treatment  

Microsoft Academic Search

OBJECTIVE--To compare chiropractic and hospital outpatient treatment for managing low back pain of mechanical origin. DESIGN--Randomised controlled trial. Allocation to chiropractic or hospital management by minimisation to establish groups for analysis of results according to initial referral clinic, length of current episode, history, and severity of back pain. Patients were followed up for up two years. SETTING--Chiropractic and hospital outpatient

T W Meade; S Dyer; W Browne; J Townsend; A O Frank

1990-01-01

74

The effect of chiropractic care on jet lag of finnish junior elite athletes  

Microsoft Academic Search

Objective: To determine the effect of chiro-practic care on jet lag in Finnish junior elite athletes.Subjects: Fifteen Finnish junior elite athletes.Methods: Through use of a table of random numbers, each athlete was assigned by sex to one of 3 groups: chiropractic adjustment,sham adjustment, or control. As needed,the chiropractic adjustment group athletes (n = 5) were adjusted on a daily basis

William F. Straub; Michael P. Spino; Medhat M. Alattar; Bruce Pfleger; John W. Downes; Marco A. Belizaire; Olli J. Heinonen; Tommi Vasankari

2001-01-01

75

Well-being outcomes of chiropractic intervention for lower back pain: a systematic review.  

PubMed

The usefulness of chiropractic for treatment of low back pain is a contentious issue. Chiropractors advocate holism and general well-being as a key principle on which they base their clinical practice, yet the quality of life, lifestyle, health and economic impacts of chiropractic intervention for back pain in adults have rarely been investigated. This article provides an overview of chiropractic principles and practices, together with the results of a systematic review of peer-reviewed publications between 2000 and 2010 retrieved from MEDLINE, CINAHL, EMBASE, AMED and Cochrane Database of Systematic Reviews. This review sought to determine the benefits of chiropractic treatment and care to well-being, and to what extent chiropractic treatment and care improve quality of life. Of 1,165 articles, 12 articles were retained, representing six studies (four randomised controlled trial, two observational) of varying quality. There was a high degree of inconsistency and lack of standardisation in measurement instruments and outcome measures. Three studies reported reduced use of other/extra treatments as a positive outcome; two studies reported a positive effect of chiropractic intervention on pain, and two studies reported a positive effect on disability. The six studies reviewed concentrated on the impact of chiropractic care on physical health and disability, rather than the wider holistic view which was the focus of this study. It is difficult, therefore, to defend any conclusion about the impact of chiropractic intervention on the quality of life, lifestyle, health and economic impact on chiropractic patients presenting with back pain. PMID:23149906

Parkinson, Lynne; Sibbritt, David; Bolton, Philip; van Rotterdam, Joan; Villadsen, Inger

2012-11-14

76

Radiograph utilization and demographics in a chiropractic college teaching clinic  

PubMed Central

Objective The purpose of this study is to present radiograph utilization at a chiropractic college teaching clinic, the associated patient demographics, and the utilization rates by body region. Methods Data for outpatient services over a 3-year period were extracted from a college clinic administrative software program. Radiographic data were matched with patient demographic information providing the age, sex, and financial class for all patients. Results The overall radiograph utilization rate was 8%, with the highest frequency occurring in the spine in the order of lumbar, cervical, and then thoracic regions. Spinal radiographs made up 66% of the total radiographs taken. The utilization rate increased as the age of the patients increased. The average patient age was 46, and 48% were female. Conclusion The radiograph utilization rate at this teaching clinic was lower than previous studies. This study provides new information regarding overall and regional radiography rates and associated patient demographics from an American chiropractic college.

Lew, Makani; Snow, Gregory J.

2012-01-01

77

The Effects of Chiropractic Care on Individuals Suffering from Learning Disabilities and Dyslexia: A Review of the Literature  

Microsoft Academic Search

Objective: To present current mainstream and alternative theo- ries about learning disabilities, with a special emphasis on dys- lexia, as well as to systematically review the chiropractic and related literature about the effects of chiropractic care in people suffering from learning disabilities and dyslexia, and to com- pare chiropractic causal theories to accepted medical models. Methods: Computerized and hand searching

Yannick Pauli

2007-01-01

78

Chiropractic claims in the English-speaking world  

Microsoft Academic Search

Background Some chiropractors and their associations claim that chiropractic is effective for conditions that lack sound supporting evidence or scientific rationale. This study therefore sought to determine the frequency of World Wide Web claims of chiropractors and their associations to treat, asthma, headache\\/migraine, infant colic, colic, ear infection\\/earache\\/otitis media, neck pain, whiplash (not supported by sound evidence), and lower back

Edzard Ernst; Andrew Gilbey

2010-01-01

79

Chiropractic management of pediatric plantar fasciitis: a case report  

PubMed Central

Objective The purpose of this report is to present the case of a 10-year-old football player with bilateral plantar fasciitis who improved with a multimodal conservative approach using chiropractic treatment. Clinical Features The patient presented with bilateral plantar heel pain at the origin of the plantar fascia with a duration of 3 weeks. Intervention and Outcome Treatment was provided for 6 visits over a 6-week period. Chiropractic care consisted of manipulative therapy, soft tissue therapy, and home rehabilitation exercises. The soft tissue technique (Graston Technique) was performed to the origin of the plantar fascia and the triceps surae bilaterally. High-velocity, low-amplitude manipulation was applied to the restricted ankle mortise joint. After 6 treatments, the patient reported resolution of foot pain bilaterally and improvements in activities of daily livings. Three months later, the patient reported no further complications and the absence of pain. Conclusion This patient with bilateral plantar fasciitis improved after a course of a multimodal treatment approach using chiropractic manipulation and soft tissue therapy in addition to exercise and stretching therapies.

Daniels, Clinton J.; Morrell, Adam P.

2012-01-01

80

Trigeminal neuralgia and chiropractic care: a case report  

PubMed Central

The following case describes a 68 year-old woman with a 7½ year history of worsening head and neck pain diagnosed as trigeminal neuralgia following surgical resection of a brain tumor. After years of unsuccessful management with medication and physical therapies, a therapeutic trial of chiropractic was carried out. Chiropractic care included ultrasound, manual therapies (manipulation and mobilization), soft tissue therapies, and home stretching exercises. After an initial treatment period followed by 18 months of supportive care the patient reported satisfactory improvement. It became evident that there were at least three sources of her symptoms: mechanical and/or degenerative neck pain, temporomandibular joint syndrome, and trigeminal neuralgia. While never completely pain-free, the patient continued to report that her pains reduced to minimal at times. At the most recent follow-up, the pain had not returned to pre-treatment intractable levels. This case study demonstrates the importance of diagnosing and treating multiple sources of pain and the positive role chiropractic care can have in the management of patients with these clinical conditions. The potential for convergence of sensory input from the upper three cervical segments and the trigeminal nerve via the trigeminocervical nucleus is discussed.

Rodine, Robert J; Aker, Peter

2010-01-01

81

A brief history of historical scholarship in chiropractic  

PubMed Central

This paper provides a cursory overview of attempts to discover, preserve and disseminate the history of the chiropractic profession, up to and including the organization of the Association for the History of Chiropractic (AHC). A surprisingly wide range of materials have been available for many decades, but sustained efforts at historical scholarship are more recent (past quarter century). The quality of these works has been uneven, but has improved with the emergence of chiropractic scholarly periodicals and interest from non-chiropractor investigators. Affiliates of the American-based AHC are located in Australia and Canada; organized historical scholarship in other regions of the world has yet to develop. Several substantial archival resources for historical investigations are available, and merit greater scrutiny and support within the profession. ImagesFigure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10Figure 11Figure 12Figure 13Figure 14Figure 15Figure 16Figure 17Figure 18Figure 19Figure 20Figure 21Figure 22Figure 23Figure 24Figure 25p136-ap136-bp136-cp136-dp136-e

Keating, Joseph C

2001-01-01

82

Chiropractic diagnosis and management of non-musculoskeletal conditions in children and adolescents  

Microsoft Academic Search

BACKGROUND: A great deal has been published in the chiropractic literature regarding the response, or lack thereof, of various common pediatric conditions to chiropractic care. The majority of that literature is of low scientific value (that is, case reports or case series). The purpose of this review is to summarize the literature from the point of view of clinicians, rather

Randy J Ferrance; Joyce Miller

2010-01-01

83

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

Microsoft Academic Search

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

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

2007-01-01

84

Maintenance care: Health promotion services administered to US chiropractic patients aged 65 and older, part II  

Microsoft Academic Search

Objective: Health promotion and prevetion services provided by the chiropractic profession historically have been referred to as maintenance care (MC). The primary objective of this investigation was to obtain information regarding multiple health issues of patients age 65 years and over who have had a long-term regimen of chiropractic health promotion and preventive care. The study also sought to explore

Ronald L Rupert; Donna Manello; Ruth Sandefur

2000-01-01

85

Towards a 21st Century Paradigm of Chiropractic: Stage 1, Redesigning Clinical Learning  

PubMed Central

Objective: To describe a formal process designed to determine the nature and extent of change that may enhance the depth of student learning in the pre-professional, clinical chiropractic environment. Methods: Project teams in the Royal Melbourne Institute of Technology (RMIT) School of Health Sciences and the Division of Chiropractic explored questions of clinical assessment in several health care disciplines of the School and the issue of implementing change in a manner that would be embraced by the clinicians who supervise student-learning in the clinical environment. The teams applied to RMIT for grant funding within the Learning and Teaching Investment Fund to support two proposed studies. Results: Both research proposals were fully funded and are in process. Discussion: The genesis of this work is the discovery that the predominant management plan in the chiropractic teaching clinics is based on diagnostic reductionism. It is felt this is counter-productive to the holistic dimensions of chiropractic practice taught in the classroom and non-supportive of chiropractic's paradigm shift towards wellness. A need is seen to improve processes around student assessment in the contemporary work-integrated learning that is a prime element of learning within the clinical disciplines of the School of Health Sciences, including chiropractic. Conclusion: Any improvements in the manner of clinical assessment within the chiropractic discipline will need to be accompanied by improvement in the training and development of the clinicians responsible for managing the provision of quality patient care by Registered Chiropractic Students

Ebrall, Phillip; Draper, Barry; Repka, Adrian

2008-01-01

86

Improvement in a 3½-year-old Autistic Child Following Chiropractic Intervention to Reduce Vertebral Subluxation  

Microsoft Academic Search

Objective: To describe, discuss and track the subjective and objective changes of a 3½ year old autistic girl following chiropractic adjustments over a 10 week period. Clinical Features: A 3½ year old female child with reduced social interaction and language skills and learning difficulties presented for chiropractic care. The child had been diagnosed with autism 1 year earlier. Interventions and

Nick Hoffmann; David Russell

87

The centralization phenomenon in chiropractic spinal manipulation of discogenic low back pain and sciatica  

Microsoft Academic Search

Objective: To describe 3 cases of discogenic low back pain and leg pain in which the centralization phenomenon was used in determining chiropractic treatment and prognosis. Clinical Features: Three men with low back pain and sciatica, positive straight leg raise, mild neurologic deficits, and evidence of discogenic disease requested chiropractic treatment. Two of the patients exhibited centralization of pain on

Anthony J. Lisi

2001-01-01

88

Chiropractic Management of Cow's Milk Protein Intolerance in Infants With Sleep Dysfunction Syndrome: A Therapeutic Trial  

Microsoft Academic Search

ObjectiveIn addition to the more usual cutaneous, gastrointestinal, and respiratory problems, infants with cow's milk intolerance (CMI) may present with a disturbed sleep pattern. Frustrated mothers may turn to their doctor of chiropractic for assistance. This pilot study shows how a therapeutic trial may offer a realistic, noninvasive approach to the chiropractic management of infants with this clinical problem.

Jennifer R. Jamison; Neil J. Davies

2006-01-01

89

Self-reported recognition of undiagnosed life threatening conditions in chiropractic practice: a random survey  

PubMed Central

Background The purpose of this study was to identify the type and frequency of previously undiagnosed life threatening conditions (LTC), based on self-reports of chiropractic physicians, which were first recognized by the chiropractic physician. Additionally this information may have a preliminary role in determining whether chiropractic education provides the knowledge necessary to recognize these events. Methods The study design was a postal, cross-sectional, epidemiological self-administered survey. Two thousand Doctors of Chiropractic in the US were randomly selected from a list of 57878. The survey asked respondents to state the number of cases from the list where they were the first physician to recognize the condition over the course of their practice careers. Space was provided for unlisted conditions. Results The response rate was 29.9%. Respondents represented 11442?years in practice and included 3861 patients with a reported undiagnosed LTC. The most commonly presenting conditions were in rank order: carcinoma, abdominal aneurysm, deep vein thrombosis, stroke, myocardial infarction, subdural hematoma and a large group of other diagnoses. The occurrence of a previously undiagnosed LTC can be expected to present to the chiropractic physician every 2.5?years based on the responding doctors reports. Conclusion Based on this survey chiropractic physicians report encountering undiagnosed LTC’s in the normal course of practice. The findings of this study are of importance to the chiropractic profession and chiropractic education. Increased awareness and emphasis on recognition of LTC is a critical part of the education process and practice life.

2012-01-01

90

Vertigo as Manifestation of Vertebral Artery Dissection after Chiropractic Neck Manipulations  

Microsoft Academic Search

We recently observed a case of vertebral artery (VA) dissection following chiropractic neck manipulations. The first manifestation was unusual; in the form of vertigo. Therefore, the patient was referred to the otoneurologist. A VA dissection should be suspected in a case of vertigo following chiropractic neck manipulations, and vestibular tests should be done carefully, avoiding Rose’s positions. In our case,

Dominique Vibert; Josette Rohr-Le Floch; Gèrard Gauthier

1993-01-01

91

Assessment and risk reduction of infectious pathogens on chiropractic treatment tables  

Microsoft Academic Search

BACKGROUND: To investigate the presence of pathogenic microbes on chiropractic treatment tables in one outpatient teaching clinic. Additional aims were to test inexpensive disinfectants on tables that may kill microbes and suggest infection control measures for chiropractic offices, clinics and classrooms. The aim of the study was to assess the presence of pathogenic microbes on treatment tables in one outpatient

Marion Willard Evans; Jennell Breshears; Alan Campbell; Chris Husbands; Ronald Rupert

2007-01-01

92

The life and contribution of Dr. Ronald Gitelman: a pioneer of modern chiropractic science  

PubMed Central

Objective: The life and contribution to chiropractic science of Dr. Ronald Gitelman is reviewed. Methods: Sources for this article included review of the notes prepared by Dr. Joseph Keating in his “biography” of the Canadian Memorial Chiropractic College (CMCC); review of the important articles published by Dr. Gitelman; review of the important projects undertaken by him along with various colleagues; notes from reminiscences obtained from many of these colleagues and discussions with his family. Discussion: Dr. Gitelman’s academic career spanned from 1963 to the late 1980’s. During that time, he made foundational contributions to the development of chiropractic science including: developing the Archives (1974), the first collection of scientific articles supporting chiropractic science (which was subsequently published as the Chiropractic Archives Research Collection (CRAC)); delivering one of the few chiropractic papers at the seminal NINCDS conference (1975) and, developing the collaboration between CMCC and Dr. Kirkaldy-Willis at the University of Saskatoon (1976). He practiced in Toronto from 1961 to 2007. Summary: Dr. Gitelman was a pioneer in the development of chiropractic science. He died on October 7, 2012.

Vernon, Howard

2013-01-01

93

A framework for chiropractic training in clinical preventive services.  

PubMed

The 2010 Patient Protection and Affordable Care Act provides incentives for both patients and providers to engage in evidence-based clinical preventive services recommended by the United States Preventive Services Task Force (USPSTF). Depending upon the application of the new health care act, Doctors of Chiropractic (DC) may be considered to be covered providers of many of these services. It is therefore essential that DCs' training prepare them to competently deliver them. The aim of this commentary is to describe a framework for training in clinical preventive services, based largely on the USPSTF recommendations, which could be readily integrated into existing DC educational programs. PMID:23962353

Hawk, Cheryl; Evans, Marion Willard

2013-08-20

94

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

PubMed Central

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.

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

2007-01-01

95

Chiropractic management of a patient with low back pain and Castellvi type II lumbosacral transitional vertebrae  

PubMed Central

Objective The purpose of this study is to report the chiropractic management of a patient with low back pain and Castellvi type II lumbosacral transitional vertebrae (LSTV). Clinical Features A patient with previously undiagnosed LSTV presented with moderate low back pain. Interventions and Outcome Manual therapy, soft tissue therapy, and exercise/stretching were included in the initial treatment plan. Following a short course of treatment, the presenting symptoms resolved; however, they returned after 3 symptom-free months. At that time, radiographs were ordered and the LSTV were identified. Following another course of chiropractic care, the patient's symptoms resolved. Conclusions Chiropractic management resulted in resolution of symptoms for this patient with LSTV.

Muir, Jeffrey M.

2012-01-01

96

Trends in the use and cost of chiropractic spinal manipulation under Medicare Part B.  

PubMed

BACKGROUND CONTEXT: Concern about improper payments to chiropractic physicians prompted the US Department of Health and Human Services to describe chiropractic services as a "significant vulnerability" for Medicare, but little is known about trends in the use and cost of chiropractic spinal manipulation provided under Medicare. PURPOSE: To quantify the volume and cost of chiropractic spinal manipulation services for older adults under Medicare Part B and identify longitudinal trends. STUDY DESIGN/SETTING: Serial cross-sectional design for retrospective analysis of administrative data. PATIENT SAMPLE: Annualized nationally representative samples of 5.0 to 5.4 million beneficiaries. OUTCOME MEASURES: Chiropractic users, allowed services, allowed charges, and payments. METHODS: Descriptive statistics were generated by analysis of Medicare administrative data on chiropractic spinal manipulation provided in the United States from 2002 to 2008. A 20% nationally representative sample of allowed Medicare Part B fee-for-service claims was merged, based on beneficiary identifier, with patient demographic data. The data sample was restricted to adults aged 65 to 99 years, and duplicate claims were excluded. Annualized estimates of outcome measures were extrapolated, per beneficiary and per user rates were estimated, and volumes were stratified by current procedural terminology code. RESULTS: The number of Medicare beneficiaries who used chiropractic spinal manipulation grew 13% from 2002 to 2004, remained flat through 2007, and then declined 5% through 2008. An estimated 1.7 million beneficiaries (6.9%) used 18.6 million allowed chiropractic services in 2008. In inflation-adjusted dollars, allowed charges per user increased 4% through 2005 and then declined by 17% through 2008; payments per user increased by 5% from 2002 to 2005 and then declined by 18% through 2008. Expenditures for chiropractic in 2008 totaled an estimated $420 million. Longitudinal trends in allowed claims for spinal manipulation varied by procedure: the relative frequency of treatment of one to two spinal regions declined from 43% to 29% of services, treatment of three to four regions increased from 48% to 62% of services, and treatment of five regions remained flat at 9% of services. CONCLUSIONS: Chiropractic claims account for less than 1/10th of 1% of overall Medicare expenditures. Allowed services, allowed charges, and fee-for-service payments for chiropractic spinal manipulation under Medicare Part B generally increased from 2002, peaked in 2005 and 2006, and then declined through 2008. Per user spending for chiropractic spinal manipulation also declined by 18% from 2006 to 2008, in contrast to 10% growth in total spending per beneficiary and 16% growth in overall Medicare spending. PMID:23773429

Whedon, James M; Song, Yunjie; Davis, Matthew A

2013-06-14

97

Chiropractic care and public health: answering difficult questions about safety, care through the lifespan, and community action.  

PubMed

The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues through the lifespan, and effective participation in community health issues. The questions that are addressed include: Is spinal manipulative therapy for neck and low-back pain a public health problem? What is the role of chiropractic care in prevention or reduction of musculoskeletal injuries in children? What ways can doctors of chiropractic stay updated on evidence-based information about vaccines and immunization throughout the lifespan? Can smoking cessation be a prevention strategy for back pain? Does chiropractic have relevance within the VA Health Care System for chronic pain and comorbid disorders? How can chiropractic use cognitive behavioral therapy to address chronic low back pain as a public health problem? What opportunities exist for doctors of chiropractic to more effectively serve the aging population? What is the role of ethics and the contribution of the chiropractic profession to public health? What public health roles can chiropractic interns perform for underserved communities in a collaborative environment? Can the chiropractic profession contribute to community health? What opportunities do doctors of chiropractic have to be involved in health care reform in the areas of prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change? PMID:23069244

Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre; Hestbaek, Lise; Injeyan, H Stephen; Puhl, Aaron; Green, Bart; Napuli, Jason G; Dunn, Andrew S; Dougherty, Paul; Killinger, Lisa Zaynab; Page, Stacey A; Stites, John S; Ramcharan, Michael; Leach, Robert A; Byrd, Lori D; Redwood, Daniel; Kopansky-Giles, Deborah R

2012-09-01

98

Health Promotion Practices in Two Chiropractic Teaching Clinics  

PubMed Central

Purpose: To retrospectively review patient files in two teaching clinics in the United States and to assess the documented attempts to deliver health promotion messages when a chart indicated a need for health promotion or a red-flag condition that could be helped with positive behavioral changes. Methods: Approximately 100 patient files were randomly selected from each of two separate chiropractic teaching clinics, for patients seen after January 2007. Files were assessed for pertinent family history of diseases, personal medical history, and red-flag conditions of patients that would warrant intervention with health promotion. Results: Health promotion advice on at least one occasion was noted in 108 (53.7%) patient charts. Only 7 of 98 overweight or obese patients and none of those with family history of obesity were advised on weight management. Among 23 hypertensive patients, only 5 were advised and 17 of the 97 patients with risk of cardiovascular disease were advised. Conclusion: Chiropractic teaching clinics should assess what they are doing to help Americans reach their health goals. There is an opportunity to shape future practitioners so they include primary prevention as a part of what they do if the profession cares to move in that direction. Future research should look at mechanisms of delivery for health promotion, including better tracking of patients who need it and how staff doctors are trained to deliver oversight to interns in the area of primary prevention.

Ndetan, Harrison; Evans, Marion Willard; Lo, Kaming; Walters, David; Ramcharan, Michael; Brandon, Patricia; Evans, Cathy; Rupert, Ronald

2010-01-01

99

Knowledge of accurate blood pressure measurement procedures in chiropractic students  

PubMed Central

Objective Blood pressure measurement is a basic clinical procedure. However, studies have shown that many errors are made when health care providers acquire blood pressure readings. Our study assessed knowledge of blood pressure measurement procedures in chiropractic students. Methods This was an observational, descriptive study. A questionnaire based on one created by the American Heart Association was given to 1st, 2nd, 3rd, and final year students (n = 186). A one way ANOVA was used to analyze the data. Results Of the students 80% were confident that their knowledge of this clinical skill was adequate or better. However, the overall score on the knowledge test of blood pressure–taking skills was 52% (range, 24%–88%). The only significant difference in the mean scores was between the 1st and 2nd year students compared to the 3rd and 4th year students (p < .005). Of the 16 questions given, the following mean scores were: 1st year 10.45, 2nd year 9.75, 3rd year 7.93, and 4th year 8.33. Of the 16 areas tested, 10 were of major concern (test item score <70%), showing the need for frequent retraining of chiropractic students. Conclusion Consistent with studies in other health care disciplines, our research found the knowledge of blood pressure skills to be deficient in our sample. There is a need for subsequent training in our teaching program.

Crosley, Angela M.; Rose, James R. La

2013-01-01

100

Laboratory Pre-Participation Screening Examination in a Chiropractic College  

PubMed Central

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.

Funk, Matthew F.; Cantito, Albert A.

2011-01-01

101

Health Manpower in Oklahoma. Chiropractic: A Statistical Investigation of Practice Patterns and Service Characteristics in Oklahoma.  

National Technical Information Service (NTIS)

The characteristics of the chirpractic physician (D.C.) in Oklahoma are described statistically. A questionnaire was mailed to all 262 active, full-time chiropractic physicians; 163 (62 percent) returned the questionnaires. The questionnaire contained que...

W. W. Edmundson

1976-01-01

102

Founding Integrative Medicine Centers of Excellence: One Strategy for Chiropractic Medicine to Build Higher Cultural Authority  

PubMed Central

Chiropractic physicians are seeking a higher level of cultural authority within their communities and the United States health care system. This commentary suggests an innovative strategy that might expedite the attainment of professional authority while improving the training of chiropractic students and faculty. The authors propose the founding of integrative medicine centers of excellence by colleges of chiropractic that will employ clinical faculties comprised of allopathic, chiropractic, osteopathic, and naturopathic physicians. Initially, the health care facilities should offer primary care through an integrative medicine model. It is anticipated that these centers of excellence will require both government and private funding in order to develop research programs, provide high-quality patient care, and improve the medical training for students with residents programs

Lehman, James J.; Suozzi, Paul J.

2008-01-01

103

Functional neuroimaging: a brief overview and feasibility for use in chiropractic research  

PubMed Central

There is a need to further our understanding of the neurophysiological effects of chiropractic spinal manipulation on brain activity as it pertains to both musculoskeletal and non-musculoskeletal complaints. This paper aims to provide a basic overview of the most commonly utilised techniques in the neurosciences for functional imaging the brain (positron emission tomography, single-photon emission computerised tomography, functional magnetic resonance imaging, electroencephalography, and magnetoencephalography), and discuss their applicability in future chiropractic research. Functional neuroimaging modalities are used in a wide range of different research and clinical settings, and are powerful tools in the investigation of neuronal activity in the human brain. There are many potential applications for functional neuroimaging in future chiropractic research, but there are some feasibility issues, mainly pertaining to access and funding. We strongly encourage the use of functional neuroimaging in future investigations of the effects of chiropractic spinal manipulation on brain function.

Lystad, Reidar P; Pollard, Henry

2009-01-01

104

Chiropractic treatment and the enhancement of sport performance: a narrative literature review.  

PubMed

A literature search and narrative review was carried out with the intent of determining the current level of knowledge regarding the chiropractic treatment of athletes for the purpose of sport performance enhancement. Of the fifty-nine relevant articles retrieved, only 7 articles of variable quality were obtained which specifically investigated/discussed chiropractic treatment and its involvement in sport performance enhancement. The role of the chiropractor in sport, unsubstantiated claims of performance enhancement, theories of how chiropractic treatment may influence sport performance, and the available evidence for the benefit of chiropractic treatment on sport performance are reviewed and discussed. Areas and directions for future studies are postulated. At this time there is insufficient evidence to convincingly support the notion that treatment provided by chiropractors can directly improve sport performance. PMID:21120012

Miners, Andrew L

2010-12-01

105

Research Highlights: Changing Views of Chiropractic ... and a National Reappraisal of Nontraditional Health Care.  

National Technical Information Service (NTIS)

For half a century, the American Medical Association waged war against chiropractic, an intervention that relies on spinal adjustments to treat health problems. Chiropractors were regarded as the modern-day equivalent of snake-oil salesmen. Today, chiropr...

2001-01-01

106

Chiropractic care of interstitial cystitis/painful bladder syndrome associated with pelvic lumbar spine dysfunction: a case series  

PubMed Central

Objective The purpose of this case series is to describe findings for patients with bladder pain syndrome (BPS) or interstitial cystitis (IC) who responded positively under chiropractic care. Clinical Features Eight cases were selected retrospectively reviewed from 2 independent chiropractic clinics in Scotland. Cases were selected if patients reported bladder dysfunction problems and responded positively to chiropractic care. The cases in this report describe the range of patients affected by this condition. Each patient was treated using chiropractic methods that were specific to the individual case. Intervention and Outcomes The patients selected for this case series showed positive response to chiropractic care over various lengths of time and numbers of treatments. Some of the chiropractic patients who had chronic spinal conditions had reoccurrence of bladder symptoms during an exacerbation of mechanical spinal problems. Conclusion This case series highlights that bladder and urinary problems may be associated with spinal dysfunction for some patients.

Cashley, Mark A.P.; Cashley, Marie A.

2012-01-01

107

Clinical considerations in the chiropractic management of the patient with Marfan syndrome  

Microsoft Academic Search

Objective: To describe the chiropractic management of a patient with whiplash-associated disorder and a covert, concomitant dissecting aneurysm of the thoracic aorta caused by Marfan syndrome or a related variant. Clinical Features: A 25-year-old man was referred by his family physician for chiropractic assessment and treatment of neck injuries received in a motor vehicle accident. After history, physical examination, and

Jeffrey R. Tuling; Edward T. Crowther; Phyllis McCord

2000-01-01

108

A proposed protocol for hand and table sanitizing in chiropractic clinics and education institutions  

Microsoft Academic Search

ObjectiveBy nature, chiropractic is a hands-on profession using manipulation applied to the joints with direct skin-to-skin contacts. Chiropractic tables are designed with a face piece to accommodate the prone patient's head in a neutral position and hand rests to allow for relaxed shoulders and upper spine so treatment is facilitated. The purpose of this article is to present a proposed

Marion Willard Evans Jr.; Michael Ramcharan; Rod Floyd; Gary Globe; Harrison Ndetan; Ronald Williams; Ronald Ivie

2009-01-01

109

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

PubMed Central

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.

2012-01-01

110

Multiple views to address diversity issues: an initial dialog to advance the chiropractic profession  

PubMed Central

The purpose of this article is to provide expert viewpoints on the topic of diversity in the chiropractic profession, including cultural competency, diversity in the profession, educational and clinical practice strategies for addressing diversity, and workforce issues. Over the next decades, changing demographics in North America will alter how the chiropractic profession functions on many levels. As the population increases in diversity, we will need to prepare our workforce to meet the needs of future patients and society.

Johnson, Claire; Killinger, Lisa Zaynab; Christensen, Mark G.; Hyland, John K.; Mrozek, John P.; Zuker, R. Fred; Kizhakkeveettil, Anupama; Perle, Stephen M.; Oyelowo, Tolu

2012-01-01

111

Canadian Chiropractic Resources Databank (CCRD): a profile of Canadian chiropractors  

PubMed Central

Objective: To establish a data bank which will serve as a comprehensive inventory of data and document practical information on Canada’s licensed chiropractors and to produce a summary report of this information. Design: A national census mail survey. Setting: Canada. The survey administration timeline during which information was collected was the period of August 1995 to July 1996. Participants: All chiropractors licensed to practice chiropractic in Canada, excluding chiropractors practising in the Yukon and Northwest Territories. A total of 4,246 questionnaires were mailed, of which 121 were ineligible. There were 2,905 valid responses (response rate 70.4%). Main outcome measures: Background information (demographics), professional activity, educational, training and affiliations, practice characteristics, finances and income. Results: Background information: 82.8% of all respondents were male. On January 1, 1997, the mean age of all respondents was 41.9 years. 88.6% of all respondents were born in Canada and 74.8% graduated from the Canadian Memorial Chiropractic College. The mean number of years in practice by all respondents was 13.7 years. 17.5% of all respondents had more than one practice location. Professional activity: A total of 96.2% of the respondents were active chiropractors (a chiropractor in active practice was one whose level of activity was self-described as full-time, part-time or semi-retired and who was in practice at least 10 hours per week). 85% reported being in full-time practice, 8.7% in part-time practice and 2.5% reported being semi-retired. Full-time chiropractors reported working on average 41.3 hours per week, 49.1 weeks per year and receiving 158.6 total patient visits per week. Active chiropractors reported spending on average 75.1% of their work time on direct patient care. 39.6% of active chiropractors reported that their practice had decreased over the last three years (in terms of number of patient visits). Education, training and affiliations: 42.1% of all respondents had obtained a baccalaureate degree prior to attending chiropractic college. 3.7% of all respondents held a CCA recognized specialty certification. 15.5% of all respondents held a certification or were registered to practice naturopathy, homeopathy, acupuncture, massage therapy or other related discipline. Practice Characteristics: 69.1% of active chiropractors reported being in sole proprietorship, and 85.3% reported working in a private chiropractic office. On an aggregate basis, active chiropractors reported using diversified techniques on 77.3% of their patients. Chiropractors in active practice reported treating on average 86.3% of their patients for primary conditions of a neuromusculoskeletal nature. Active chiropractors reported that their current patients were their greatest source of patient referrals, accounting for on average 58.5% of all their patients. Finances and Income: In provinces with public insurance for chiropractic services (Ontario, Manitoba, Saskatchewan, Alberta, British Columbia) active chiropractors reported deriving on average 39.7% of their practice income from the provincial plan, 44.7% directly from the patient, 9.6% from a third party payer and 6.1% from workers’ compensation boards. 56.2% of active chiropractors reported a gross annual practice income of less than $150,000 whereas 14.1% reported earning $250,000 or more. 49.5% of active chiropractors reported a net annual practice income of less than $60,000 whereas 21.4% reported earning $100,000 or more. In aggregate, active chiropractors reported that 37.3% of their patients exhausted their public insurance coverage for chiropractic care (in provinces where public insurance is available), and of those patients 35.3% discontinued care. Conclusions: This report is a first attempt to document a statistical portrait of Canada’s chiropractors. The report has been prepared by using data derived from the Canadian Chiropractic Resource Databank (CCRD), a data bank (housed at the CCA) which now holds a comprehensive inv

Kopansky-Giles, Deborah; Papadopoulos, Costa

1997-01-01

112

Chiropractic diagnosis and management of non-musculoskeletal conditions in children and adolescents  

PubMed Central

Background A great deal has been published in the chiropractic literature regarding the response, or lack thereof, of various common pediatric conditions to chiropractic care. The majority of that literature is of low scientific value (that is, case reports or case series). The purpose of this review is to summarize the literature from the point of view of clinicians, rather than researchers, and to discuss some additional detail of the conditions themselves. Methods Databases searched were PubMed, Mantis, Index to Chiropractic Literature, and CINAHL. Keywords were chiropractic paired with colic, crying infant, nocturnal enuresis, asthma, otitis media and attention deficit hyperactivity disorder. Results Most of the published literature centers around case reports or series. The more scientifically rigorous studies show conflicting results for colic and the crying infant, and there is little data to suggest improvement of otitis media, asthma, nocturnal enuresis or attention deficit hyperactivity disorder. Discussion The efficacy of chiropractic care in the treatment of non-musculoskeletal disorders has yet to be definitely proven or disproven, with the burden of proof still resting upon the chiropractic profession.

2010-01-01

113

Background, expectations and beliefs of a chiropractic student population: a cross-sectional survey.  

PubMed

Purpose: Research encompassing the characteristics of chiropractic students is limited. The purpose of our study was to evaluate a current chiropractic student population enrolled at a chiropractic college concerning demographics, expectations, and beliefs. Methods: A 44-item survey was administered to volunteer participants. Direct verbal interaction in a classroom setting to potential participants was the recruitment strategy used. Data were collected and stored on a safe network. Percentages for all responses were calculated and means were recorded where appropriate. Results: A total of 664 students participated of 877 potential eligible candidates (75%). The respondents tended to be 21-25 years of age, Caucasian, and male. Most respondents expected to work in a private practice immediately following graduation and anticipated an annual income of at least $100,000 eventually. Respondents preferred the retaining of the term, "subluxation," and identified the importance of new and emerging scientific data. Additionally, respondents held the viewpoint that some non-musculoskeletal diseases can be treated effectively with spinal manipulation as a primary treatment. Conclusions: The majority of chiropractic students in our study were represented by specific demographic characteristics, and a strong favoritism toward the expectations of working in a private practice setting and earning at least $100,000 per year at some point in their career. Distinct beliefs are shared between chiropractic students and practicing chiropractors in North America, and certain aspects of students in our study are comparable to chiropractic students in similar studies. PMID:23362362

Gliedt, Jordan A; Briggs, Shaun; Williams, Joshua S M; Smith, Derek P; Blampied, Joseph

2012-01-01

114

Sports chiropractic management at the World Ice Hockey Championships  

PubMed Central

Background Ice hockey is an international sport. Injuries occur in a full body fashion, to a number of tissues, commonly through body contact. There is a lack of literature documenting the scope of sports chiropractic practice. Thus, it was the aim to document the type, scope and severity of conditions presenting to, and the treatment provided by, the New Zealand team chiropractor acting as a primary health provider for the duration of the 2007 World Ice Hockey Championships. Methods All conditions presenting were recorded. Diagnosis was recorded along with clinical parameters of injury: injury type, severity, mechanism and whether referral or advanced imaging was required. All treatment provided was continuously recorded, including information on the number of treatments required and the reason, duration, type and location of treatment. Results Players presented for diagnosis of injury 50 times. Muscle (34%), joint (24%) and tendon injuries (18%) were most common. Players presented with a new injury 76% of the time. Most injuries had been present for less than one week (84%), with 53% occurring through a contact mechanism. Injuries were common at training and match locations. Only two injuries required the player to stop playing or training, both of which were referred for advanced imaging. During the study, 134 treatment consultations were rendered to 45 player injuries. Eighty per-cent of injuries were managed with four or less treatments. Three quarters of treatment was provided at training locations with treatment duration predominantly being between 11-15 minutes (71%) and 16-20 minutes (27%). Most treatment delivered was passive in nature (71%) although combination active and passive care was provided (27%). Treatment typically involved joint (81%) and soft tissue based therapies (81%) and was delivered in a full body manner. Conclusions This study documented the injury profile of ice hockey at an international level of competition. It documented the conditions presenting to a chiropractor for diagnosis and the treatment provided. Treatment was consistent with that recommended for chiropractic management of athletic injuries. This documentation of sports chiropractic scope of practice fills a void in the literature and assists in determining a role for sports chiropractors as primary health providers or in multidisciplinary sports management teams.

2010-01-01

115

A Report of the 2009 World Games Injury Surveillance of Individuals Who Voluntarily Used the International Federation of Sports Chiropractic Delegation  

Microsoft Academic Search

ObjectiveThe purpose of this study was to describe the frequency and nature of injuries treated by the International Federation of Sports Chiropractic (FICS) chiropractic health care delegation at the 2009 World Games in Kaohsiung, Taiwan.

Debra D. Nook; Brian C. Nook

2011-01-01

116

Manikin-Based Clinical Simulation in Chiropractic Education  

PubMed Central

Objective: The purpose of this pilot investigation was to describe the development and implementation of simulation exercises and investigate the feasibility, satisfaction, and relative effectiveness of a manikin-based simulation program in chiropractic undergraduate education. Methods: This investigation consisted of (1) a qualitative review of other simulation environments and evaluation of related simulation literature to develop the educational processes to be used, (2) implementation of simulation scenarios for 95 student interns and their 11 supervising clinicians, and (3) implementation of simulation scenarios in a random sample of 35 1st-year and 24 2nd-year chiropractic students. Assessment of success was based on results from satisfaction and usability questionnaires and perceived achievement of learning outcomes. Anxiety scores were measured for all participants via a visual analog scale. The level of successful integration of 2nd-year basic science material was assessed using a t test comparing test results between students who participated in the pilot and those who did not. Results: Implementation methods were developed on the basis of qualitative investigation. Simulation program feedback from all participants indicated high levels of satisfaction, usability, and perceived achievement of learning outcomes. Anxiety levels among interns differed according to role chosen (F = 8.07, p =.00). Mean difference in course examination scores of students who participated in simulations versus those who did not was 3.25% favoring students who participated (t = 1.28, p =.10). Conclusions: High levels of student satisfaction and perceived achievement of learning outcomes were consistently achieved. A trend to successful integration of basic science knowledge provides reason for cautious optimism. More research is recommended.

McGregor, Marion; Giuliano, Dominic

2012-01-01

117

How Much Health Promotion and Disease Prevention Is Enough? Should Chiropractic Colleges Focus on Efficacy Training in Screening for Family Violence?  

Microsoft Academic Search

Introduction: Although family violence has been identified as a major public health issue, it has received little attention in the chiropractic literature. Accordingly, this article provides a conceptual overview on family violence, discusses the role of chiropractors in its detection, and raises several issues germane to chiropractic education that deserve further attention in future chiropractic publications. Methods: A selective review

Lisa Terre; Gary Globe; Mark T. Pfefer

118

A patient-centered paradigm: a model for chiropractic education and research.  

PubMed

Within the chiropractic profession there is concern over both the appropriate paradigm for educating the student and the appropriate research model for investigating health care and promotion. The purpose of this study was to identify, interpret, and describe a paradigm for chiropractic education and research. Chiropractic first principles and existing health care paradigms were identified and integrated with the characteristics of chiropractic practice described in sociological studies of the chiropractic profession. A patient-centered paradigm emerged, incorporating the principles of vitalism, holism, humanism, conservatism, naturalism, and rationalism. Characteristics of a patient-centered paradigm that were identified were then subjected to an eight-member consensus panel with representatives drawn from chiropractic education, research, and sociology. The characteristics of a patient-centered paradigm agreed upon include self-healing, recognition of the patient as a unified whole, respect for the patient's values, beliefs, and dignity, involvement of the patient as a partner in health promotion, and a natural and conservative approach to evidence based care. Patient-centered research must reach beyond the randomized controlled trial, involving designs where clinicians apply their own patient-centered therapy in a "real world" assessment. A pluralism of methods, including both qualitative and quantitative studies, needs to be designed and implemented. Patient-centered research is a process that is pragmatic, realistic, and grounded in the day-to-day experiences of both patients and chiropractors. A patient-centered paradigm offers a useful model to critically study what benefits patients and to prepare chiropractic students to practice in the patient's interest. PMID:9395632

Gatterman, M I

1995-01-01

119

Chiropractic care for paediatric and adolescent Attention-Deficit/Hyperactivity Disorder: A systematic review  

PubMed Central

Background Psychostimulants are first line of therapy for paediatric and adolescent AD/HD. The evidence suggests that up to 30% of those prescribed stimulant medications do not show clinically significant outcomes. In addition, many children and adolescents experience side-effects from these medications. As a result, parents are seeking alternate interventions for their children. Complementary and alternative medicine therapies for behavioural disorders such as AD/HD are increasing with as many as 68% of parents having sought help from alternative practitioners, including chiropractors. Objective The review seeks to answer the question of whether chiropractic care can reduce symptoms of inattention, impulsivity and hyperactivity for paediatric and adolescent AD/HD. Methods Electronic databases (Cochrane CENTRAL register of Controlled Trials, Cochrane Database of Systematic reviews, MEDLINE, PsycINFO, CINAHL, Scopus, ISI Web of Science, Index to Chiropractic Literature) were searched from inception until July 2009 for English language studies for chiropractic care and AD/HD. Inclusion and exclusion criteria were applied to select studies. All randomised controlled trials were evaluated using the Jadad score and a checklist developed from the CONSORT (Consolidated Standards of Reporting Trials) guidelines. Results The search yielded 58 citations of which 22 were intervention studies. Of these, only three studies were identified for paediatric and adolescent AD/HD cohorts. The methodological quality was poor and none of the studies qualified using inclusion criteria. Conclusions To date there is insufficient evidence to evaluate the efficacy of chiropractic care for paediatric and adolescent AD/HD. The claim that chiropractic care improves paediatric and adolescent AD/HD, is only supported by low levels of scientific evidence. In the interest of paediatric and adolescent health, if chiropractic care for AD/HD is to continue, more rigorous scientific research needs to be undertaken to examine the efficacy and effectiveness of chiropractic treatment. Adequately-sized RCTs using clinically relevant outcomes and standardised measures to examine the effectiveness of chiropractic care verses no-treatment/placebo control or standard care (pharmacological and psychosocial care) are needed to determine whether chiropractic care is an effective alternative intervention for paediatric and adolescent AD/HD.

2010-01-01

120

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

PubMed Central

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

Keating, Joseph C

2003-01-01

121

Chiropractic practice in military and veterans health care: The state of the literature  

PubMed Central

Objective To summarize scholarly literature that describes practice, utilization, and/or policy of chiropractic services within international active duty and/or veteran health care environments. Data Sources PubMed, the Cumulative Index to Nursing and Allied Health Literature, and the Index to Chiropractic Literature were searched from their starting dates through June 2009. Review Methods All authors independently reviewed each of the articles to verify that each met the inclusion criteria. Citations of included papers and other pertinent findings were logged in a summary table. Results Thirteen articles were included in this study. Integration of chiropractic care into military or veteran health care systems has been described in 3 systems: the United States Department of Defense, the United States Department of Veterans Affairs, and the Canadian Forces. Conclusion Chiropractic services seem to be included successfully within military and veteran health care facilities. However, there is a great need for additional written evaluation of the processes, policies, practices, and effectiveness of chiropractic services in these environments.

Green, Bart N.; Johnson, Claire D.; Lisi, Anthony J.; Tucker, John

2009-01-01

122

A narrative review of the published chiropractic literature regarding older patients from 2001-2010  

PubMed Central

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.

Gleberzon, Brian J.

2011-01-01

123

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

PubMed Central

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.

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

2012-01-01

124

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

PubMed

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

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

2013-09-01

125

A case of central retinal artery occlusion after chiropractic manipulation of the neck.  

PubMed

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

Jang, Young-Jun; Chun, Jun-Woo; Lee, Seung-Woo; Kim, Ho-Chang

2012-03-22

126

Outcomes of usual chiropractic, harm & efficacy, the ouch study: study protocol for a randomized controlled trial  

PubMed Central

Background Previous studies have demonstrated that adverse events occur during chiropractic treatment. However, because of these studies design we do not know the frequency and extent of these events when compared to sham treatment. The principal aims of this study are to establish the frequency and severity of adverse effects from short term usual chiropractic treatment of the spine when compared to a sham treatment group. The secondary aim of this study is to establish the efficacy of usual short term chiropractic care for spinal pain when compared to a sham intervention. Methods One hundred and eighty participants will be randomly allocated to either usual chiropractic care or a sham intervention group. To be considered for inclusion the participants must have experienced non-specific spinal pain for at least one week. The study will be conducted at the clinics of registered chiropractors in Western Australia. Participants in each group will receive two treatments at intervals no less than one week. For the usual chiropractic care group, the selection of therapeutic techniques will be left to the chiropractors' discretion. For the sham intervention group, de-tuned ultrasound and de-tuned activator treatment will be applied by the chiropractors to the regions where spinal pain is experienced. Adverse events will be assessed two days after each appointment using a questionnaire developed for this study. The efficacy of short term chiropractic care for spinal pain will be examined at two week follow-up by assessing pain, physical function, minimum acceptable outcome, and satisfaction with care, with the use of the following outcome measures: Numerical Rating Scale, Functional Rating Index, Neck Disability Index, Minimum Acceptable Outcome Questionnaire, Oswestry Disability Index, and a global measure of treatment satisfaction. The statistician, outcome assessor, and participants will be blinded to treatment allocation. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000542998

2011-01-01

127

Resolution of cervical radiculopathy in a woman after chiropractic manipulation  

PubMed Central

Abstract Objective To describe a case regarding a woman with 2-level cervical disk herniation with radicular symptoms conservatively treated with chiropractic care including high-velocity, low-amplitude (HVLA) manipulation with complete resolution of her symptoms. Clinical Features A 40-year-old woman developed right finger paresthesia and neck pain. Results of electrodiagnostics were normal, but clinical examination revealed subtle findings of cervical radiculopathy. A subsequent magnetic resonance imaging revealed a large right posterolateral disk protrusion and spur impinging on the right hemicord with moderate to severe central canal and right neuroforaminal stenosis at C5-6 and C6-7. She was treated with HVLA manipulation to the cervical spine, as well as soft tissue techniques, traction, nonsteroidal anti-inflammatory drugs, and exercise. Intervention and Outcome Her clinical findings and symptoms resolved within 90 days of initiating care and did not return in 1 year. There were no untoward effects, including transient ones. Conclusion This case describes the clinical presentation and course of a patient with multilevel large herniated disks and associated radiculopathy who was treated with HVLA manipulation and other conservative approaches and appeared to have good outcomes.

Whalen, Wayne M.

2008-01-01

128

Chiropractic in the yellow pages: a content analysis study.  

PubMed

This paper presents a content analysis of advertisements by chiropractors in the yellow pages. Information was gathered from 13 cities in the United States for the years 1985 and 1986. Results were categorized by size, number and content of the ads. Estimated expenditures for each city were calculated and a total cost for advertising for the entire chiropractic profession was estimated. Of the 5456 chiropractors listed in the yellow pages in this study, 14.7% bought additional space in the regular listing section, and 11.6% purchased large display advertisements. The remaining 73.7% listed only their name and telephone number. Of those who bought additional space, 10.8% advertised techniques, 11.6% symptoms, 14.7% injuries, 3% professional affiliations and 4% advertised free services. The average annual expenditure for the chiropractor was $2474.00. Future research needs to address the attitudes of the profession and patients toward advertising, and the cost-effectiveness of advertising. The value of the distribution of resources for advertising by chiropractors is questioned. PMID:3049889

Hurwitz, E L; Phillips, R B

1988-08-01

129

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

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.

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

2005-01-01

130

Evidence-Based Health Care in Medical and Chiropractic Education A Literature Review  

Microsoft Academic Search

Objective: The purpose of this article is to review educational and patient outcomes of teaching and utilizing evidence-based health care (EBHC) in medical and chiropractic education, and to discuss future directions for research. Methodology: Literature search identified 190 EBHC studies and 21 of these were reviewed and categorized into the following areas: educational and patient outcomes after EBHC medical training,

Charles E. Fernandez; Paul M. Delaney

2004-01-01

131

Chiropractic management of a patient with symptoms of attention-deficit/hyperactivity disorder  

PubMed Central

Objective The purpose of this study is to report a case of a child with attention-deficit/hyperactivity disorder (ADHD) who was treated with chiropractic care. Clinical Features Parents of a 5-year-old boy with diagnosed ADHD brought him for chiropractic care to address his subjective signs (acting out, ability to follow instructions, and poor home and school performance), which also included waking at night due to asthmatic symptoms and low self-esteem. Palpation revealed hypertonicity and trigger points in the paraspinal muscles at the thoracolumbar region with local pain. A preliminary diagnosis included cervical and thoracolumbar facet joint irritation with concurrent muscle hypertonicity. Intervention and Outcomes Treatment including spinal manipulative therapy, soft tissue therapy, and stretching was provided. Treatment began on a thrice-weekly basis and declined to twice weekly over the course of approximately 12 weeks. After 1 year of treatment, subjective improvements were noted in episodes of acting out, ability to follow instructions, and general home and school performance. Conclusions The patient improved over 1 year in which he received chiropractic care, including manual treatments such as spinal manipulative therapy and soft tissue therapies. This suggests that there may be a role for doctors of chiropractic in the management of patients with ADHD.

Muir, Jeffrey M.

2012-01-01

132

Chiropractic care amongst people with multiple sclerosis: A survey of MS therapy centres in the UK  

Microsoft Academic Search

Summary Objective: Many of the musculoskeletal symptoms associated with multiple sclerosis (MS) can be managed with physical therapy. Chiropractors are well placed to deliver this, but the extent of their involvement in the team management of multiple sclerosis in the UK is unknown. The present study investigates the level of awareness and use of chiropractic by people with MS in

Elizabeth A. Carson; Gabrielle Swait; Ian P. Johnson; Christina Cunliffe

2009-01-01

133

Chiropractic technique procedures for specific low back conditions: Characterizing the literature  

Microsoft Academic Search

Background: Many original clinical trials and several review papers have come to the conclusion that manipulation is safe and effective for the treatment of low back pain. However, it is necessary to determine which specific types of manipulation and nonmanipulative types of chiropractic adjustive care are most effective for particular types of low back pain across both tissue-specific and functional

Robert Cooperstein; Stephen M. Perle; Meridel I. Gatterman; Charles Lantz; Michael J. Schneider

2001-01-01

134

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

PubMed Central

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

Brown, Douglas M.

2001-01-01

135

Chiropractic Versus Medical Care Low-Back Pain. Abstract, Executive Summary and Final Report.  

National Technical Information Service (NTIS)

Despite the public-health importance of low-back pain, little is known about the relative effectiveness of treatment strategies in managed care. The primary objectives of the study were to compare the effectiveness of medical and chiropractic care for low...

H. Morganstern

2001-01-01

136

Evaluation of chiropractic management of pediatric patients with low back pain: A prospective cohort study  

Microsoft Academic Search

Background: Recent epidemiologic studies have estimated that the lifetime prevalence of low back pain (LBP) in children is approximately 50%, with almost 15% of children experiencing frequent or continual pain. A literature search revealed no published studies addressing conservative treatment of childhood LBP. Objective: To describe chiropractic management of LBP in patients between the ages of 4 and 18 years,

Jill A. Hayden; Silvano A. Mior; Marja J. Verhoef

2003-01-01

137

An Empirical Analysis of Consumers' Attitudes Toward Chiropractic Services Advertising: A Comparative Cross-Sectional Study  

Microsoft Academic Search

Current consumer attitudes toward chiropractic advertising were studied and compared to those expressed 17 years ago. This study was designed to determine (a) consumers' attitudes toward advertising by chiropractors; and (b) whether age, occupation, race, income, education, number of children in household, marital status, or sex of consumers accounted for any significant difference in attitudes toward chiropractors who advertise. Replicating

H. Ronald Moser; Gordon L. Freeman Jr

2010-01-01

138

Acupuncture, chiropractic and osteopathy use in Australia: a national population survey  

Microsoft Academic Search

BACKGROUND: There have been no published national studies on the use in Australia of the manipulative therapies, acupuncture, chiropractic or osteopathy, or on matters including the purposes for which these therapies are used, treatment outcomes and the socio-demographic characteristics of users. METHODS: This study on the three manipulative therapies was a component of a broader investigation on the use of

Charlie CL Xue; Anthony L Zhang; Vivian Lin; Ray Myers; Barbara Polus; David F Story

2008-01-01

139

Materializing complementary and alternative medicine: aromatherapy, chiropractic, and Chinese herbal medicine in the UK  

Microsoft Academic Search

The paper explores the materiality of complementary and alternative medicine (CAM), with particular reference to aromatherapy, Chinese herbal medicine, and chiropractic, as presented in the journals of UK-based practitioner associations. The paper begins by arguing for a poststructuralist approach to materiality. It then considers how certain materials play a signature (or emblematic) role in the definition and practice of various

Marcus A. Doel; Jeremy Segrott

2004-01-01

140

A Model Framework for Patient Safety Training in Chiropractic: A Literature Synthesis  

Microsoft Academic Search

ObjectiveThe objective of this review is to develop an evidence-focused and work-based model framework for patient safety training, that is, reporting and learning from adverse events in chiropractic care. This article will not debate specific issues of adverse events from spinal manipulation. The main focus is on education for patient safety.

Beatrice Zaugg; Martin Wangler

2009-01-01

141

Slipped capital femoral epiphysis (SCFE) detected in a chiropractic office: a case report  

Microsoft Academic Search

Objective: To report on a case of slipped capital femoral epiphysis (SCFE), which is a somewhat rare condition but one that can present in a chiropractic clinic, particularly one with a musculoskeletal scope of practice. Case: This is a single case report of a 16-year-old adolescent male patient who presented with an 18-month history of hip pain. Radiographs originally ordered

Peter Emary

2009-01-01

142

Practice patterns of doctors of chiropractic with a pediatric diplomate: a cross-sectional survey  

PubMed Central

Background Complementary and alternative medicine (CAM) is growing in popularity, especially within the pediatric population. Research on CAM practitioners and their specialties, such as pediatrics, is lacking. Within the chiropractic profession, pediatrics is one of the most recently established post-graduate specialty programs. This paper describes the demographic and practice characteristics of doctors of chiropractic with a pediatric diplomate. Methods 218 chiropractors with a pediatric diplomate were invited to complete our survey using either web-based or mailed paper survey methods. Practitioner demographics, practice characteristics, treatment procedures, referral patterns, and patient characteristics were queried with a survey created with the online survey tool, SurveyMonkey©®. Results A total of 135 chiropractors responded (62.2% response rate); they were predominantly female (74%) and white (93%). Techniques most commonly used were Diversified, Activator ®, and Thompson with the addition of cranial and extremity manipulation to their chiropractic treatments. Adjunctive therapies commonly provided to patients included recommendations for activities of daily living, corrective or therapeutic exercise, ice pack\\cryotherapy, and nutritional counseling. Thirty eight percent of respondents' patients were private pay and 23% had private insurance that was not managed care. Pediatrics represented 31% of the survey respondents' patients. Chiropractors also reported 63% of their work time devoted to direct patient care. Health conditions reportedly treated within the pediatric population included back or neck pain, asthma, birth trauma, colic, constipation, ear infection, head or chest cold, and upper respiratory infections. Referrals made to or from these chiropractors were uncommon. Conclusions This mixed mode survey identified similarities and differences between doctors of chiropractic with a pediatric diplomate to other surveys of doctors of chiropractic, CAM professionals, and pediatric healthcare providers. The pediatric diplomate certificate was established in 1993 and provides didactic education over a 2 to 3 year span. The results of this study can be used for historical information as this specialty continues to grow.

2010-01-01

143

The Nordic maintenance care program – case management of chiropractic patients with low back pain: A survey of Swedish chiropractors  

Microsoft Academic Search

BACKGROUND: Chiropractic treatment for low back pain (LBP) can often be divided into two phases: Initial treatment of the problem to attempt to remove pain and bring it back into its pre-clinical or maximum improvement status, and \\

Iben Axén; Annika Rosenbaum; Andreas Eklund; Laszlo Halasz; Kristian Jørgensen; Peter W Lövgren; Fredrik Lange; Charlotte Leboeuf-Yde

2008-01-01

144

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

PubMed Central

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.

2013-01-01

145

Modification of a local smoking ordinance: a case-report of chiropractic health advocacy  

PubMed Central

Abstract Background Health Promotion may involve assessing the community and assisting in the formation of coalitions that empower a community to reduce health risks. Objective To describe an intervention lead by a doctor of chiropractic to reduce exposure to environmental tobacco smoke in one rural southeast Alabama town. Discussion A coalition influenced the city council to modify an existing ordinance governing smoking in public places. As a secondary goal, the coalition hoped to use the local media to significantly increase public awareness of the dangers of ETS through positive press coverage of their efforts and general media advocacy. City councilmen and the local media were involved in the coalition to use a political process to change the ordinance. Ten months after initiating the project, the existing ordinance was modified. Conclusion Doctors of chiropractic involved as health advocates were able to change the local ordinance pertaining to indoor smoking.

Evans, Marion W.

2006-01-01

146

Reflex control of the spine and posture: a review of the literature from a chiropractic perspective  

PubMed Central

Objective This review details the anatomy and interactions of the postural and somatosensory reflexes. We attempt to identify the important role the nervous system plays in maintaining reflex control of the spine and posture. We also review, illustrate, and discuss how the human vertebral column develops, functions, and adapts to Earth's gravity in an upright position. We identify functional characteristics of the postural reflexes by reporting previous observations of subjects during periods of microgravity or weightlessness. Background Historically, chiropractic has centered around the concept that the nervous system controls and regulates all other bodily systems; and that disruption to normal nervous system function can contribute to a wide variety of common ailments. Surprisingly, the chiropractic literature has paid relatively little attention to the importance of neurological regulation of static upright human posture. With so much information available on how posture may affect health and function, we felt it important to review the neuroanatomical structures and pathways responsible for maintaining the spine and posture. Maintenance of static upright posture is regulated by the nervous system through the various postural reflexes. Hence, from a chiropractic standpoint, it is clinically beneficial to understand how the individual postural reflexes work, as it may explain some of the clinical presentations seen in chiropractic practice. Method We performed a manual search for available relevant textbooks, and a computer search of the MEDLINE, MANTIS, and Index to Chiropractic Literature databases from 1970 to present, using the following key words and phrases: "posture," "ocular," "vestibular," "cervical facet joint," "afferent," "vestibulocollic," "cervicocollic," "postural reflexes," "spaceflight," "microgravity," "weightlessness," "gravity," "posture," and "postural." Studies were selected if they specifically tested any or all of the postural reflexes either in Earth's gravity or in microgravitational environments. Studies testing the function of each postural component, as well as those discussing postural reflex interactions, were also included in this review. Discussion It is quite apparent from the indexed literature we searched that posture is largely maintained by reflexive, involuntary control. While reflexive components for postural control are found in skin and joint receptors, somatic graviceptors, and baroreceptors throughout the body, much of the reflexive postural control mechanisms are housed, or occur, within the head and neck region primarily. We suggest that the postural reflexes may function in a hierarchical fashion. This hierarchy may well be based on the gravity-dependent or gravity-independent nature of each postural reflex. Some or all of these postural reflexes may contribute to the development of a postural body scheme, a conceptual internal representation of the external environment under normal gravity. This model may be the framework through which the postural reflexes anticipate and adapt to new gravitational environments. Conclusion Visual and vestibular input, as well as joint and soft tissue mechanoreceptors, are major players in the regulation of static upright posture. Each of these input sources detects and responds to specific types of postural stimulus and perturbations, and each region has specific pathways by which it communicates with other postural reflexes, as well as higher central nervous system structures. This review of the postural reflex structures and mechanisms adds to the growing body of posture rehabilitation literature relating specifically to chiropractic treatment. Chiropractic interest in these reflexes may enhance the ability of chiropractic physicians to treat and correct global spine and posture disorders. With the knowledge and understanding of these postural reflexes, chiropractors can evaluate spinal configurations not only from a segmental perspective, but can also determine how spinal dysfunction may be the ultimate consequence of maintaining an u

Morningstar, Mark W; Pettibon, Burl R; Schlappi, Heidi; Schlappi, Mark; Ireland, Trevor V

2005-01-01

147

The chiropractic market segment: a viable market opportunity for M.D.'s?  

PubMed

Physicians have traditionally paid closer attention to the competition from other medical practitioners, but have ignored competition arising from "alternative therapies" such as hypnosis, acupuncture, or chiropractic. The purpose of this article is to survey the market segment served by one such unconventional practitioner, i.e., chiropractors, with the intention of determining its likelihood as a viable market to be pursued by M.D.'s. PMID:10116304

Hanna, N; Kizilbash, A H; Wagle, J

1991-01-01

148

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

PubMed Central

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.

Brown, Douglas M.

2010-01-01

149

Assessing the evidence for the use of chiropractic manipulation in paediatric health conditions: A systematic review  

PubMed Central

OBJECTIVE To review the biomedical literature up to and including 2003, and determine the extent of the evidence related to the therapeutic application of chiropractic manipulation for paediatric health conditions. No critical appraisal of the evidence is undertaken. DATA SOURCES The indexed manual therapy sector including medical, chiropractic, physiotherapy, naturopathic and osteopathic literature was searched. This included PubMed; the Manual, Alternative, and Natural Therapy Index System; the Cumulative Index to Nursing and Allied Health Literature; the Index to Chiropractic Literature; the Paediatric Economic Database Evaluation Project; the Cochrane Library; the Canadian Coordinating Office for Health Technology Assessment database; and the Agency for Healthcare Research and Quality database. Other resources included research conference and symposium proceedings, and the references of identified studies. RESULT The search identified 1731 articles, of which 166 met the eligibility criteria. Two reviewers determined by consensus each citation’s appropriate level on the strength of evidence scale. There was one systematic review, nine randomized controlled trials, one observational study, 141 descriptive case studies and 14 conference abstracts. SUMMARY Health claims made by practitioners regarding the application of chiropractic manipulation as a health care intervention for paediatric health conditions are, for the most part, supported by low levels of scientific evidence. Chiropractors, in particular, employ manipulation for the treatment of a wide variety of paediatric health conditions. The evidence rests primarily with clinical experience, descriptive case studies and a few randomized controlled trials. There is a need for more rigorous scientific inquiry to examine the value of manipulative therapy in the treatment of paediatric conditions. To advance the health interests of paediatric patients, health care decisions made on the basis of expert opinion or clinical experience must integrate the best research evidence available from high-quality, scientific studies.

Gotlib, Allan; Rupert, Ron

2005-01-01

150

Statutory determinants and curriculum development in chiropractic colleges in the absence of university affiliation  

PubMed Central

Statutory and administrative rules continue to influence curriculum in chiropractic colleges. Pressure is frequently exerted by jurisdictions to add classes or hours, or conversely to delete subject matter and procedures not included in the scope of practice acts. Lack of government funding and university affiliation perpetuates the diversity of curriculum content which must satisfy licensing boards driven by the varied scope of practice of statutes rather than following research supported standards of care.

Gatterman, Meridel I; Vear, Herbert J

1992-01-01

151

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

PubMed Central

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.

Taylor, David N.

2011-01-01

152

Chiropractic management of a 5-year-old boy with urinary and bowel incontinence  

PubMed Central

Objective The purpose of this article is to describe chiropractic management of a 5-year-old boy with urinary and bowel incontinence. Clinical Features A 5-year-old boy presented with the primary symptoms of a complete lack of bowel and bladder control with prior surgical correction for lumbar meningocele, spinal lipoma, and tethered spinal cord. Examination revealed spinal and pelvic dysfunction. Intervention and Outcome Chiropractic treatment methods included using the Activator adjusting instrument and shortwave diathermy to the lumbar spine and sacrum. A total of 5 treatments were initially provided over a period of 4 weeks. After the initial treatment period, he was able to maintain satisfactory control of his bladder and bowel, day and night, for a period of approximately 6 months. A second course of treatments was initiated approximately 6 months later because of a recurrence of bladder and bowel incontinence. Four additional treatments were provided over a period of 4 weeks. This second course of treatment reestablished satisfactory control of bladder and bowel function. Conclusion For this patient, chiropractic care was successful in establishing satisfactory bladder and bowel control.

Kamrath, Keith R.

2010-01-01

153

International web survey of chiropractic students about evidence-based practice: a pilot study  

PubMed Central

Background Positive attitude toward evidence-based practice (EBP) principles in healthcare education may be one of the first steps for motivating a healthcare professional student to later apply EBP principles in clinical decision-making. The objectives for this project were to pilot an international web-based survey of chiropractic students and to describe student attitudes, behaviors, and knowledge about EBP principles. Methods We used SurveyMonkey™ to develop our survey based on an existing questionnaire used to measure basic knowledge, skills and beliefs about EBP among allied healthcare professionals and CAM practitioners. We invited 26 chiropractic educational institutions teaching in English and accredited by official organizations to participate. Academic officials and registrars at participating institutions forwarded an invitation email and two reminders to students between July and September 2010. The invitation contained a link to the 38-item web-based questionnaire. Descriptive statistics were performed for analysis. Results Fourteen institutions from Australia, Canada, US, Denmark and New Zealand participated. Among an estimated 7,142 student recipients of invitation letters, 674 participated in the survey for an estimated response rate of 9.4%. Most respondents reported having access to medical/healthcare literature through the internet, but only 11% read literature every week and 21% did not read literature at all. Respondents generally agreed that the use of research evidence in chiropractic was important. Although 76% of respondents found it easy to understand research evidence and 81% had some level of confidence assessing the general worth of research articles, 71% felt they needed more training in EBP to be able to apply evidence in chiropractic care. Respondents without previous training in research methods had lower confidence in assessing published papers. While more than 60% marked the correct answer for two knowledge items, the mean number of correct answers to the five knowledge questions was 1.3 (SD 0.9). Conclusions Although it is feasible to conduct an international web survey of chiropractic students, significant stakeholder participation is important to improve response rates. Students had relatively positive attitudes toward EBP. However, participants felt they needed more training in EBP and based on the knowledge questions they may need further training about basic research concepts.

2011-01-01

154

Embedding chiropractic in Indigenous Health Care Organisations: applying the normalisation process model  

PubMed Central

Background Improving the health of Indigenous Australians remains a major challenge. A chiropractic service was established to evaluate this treatment option for musculoskeletal illness in rural Indigenous communities, based on the philosophy of keeping the community involved in all the phases of development, implementation, and evaluation. The development and integration of this service has experienced many difficulties with referrals, funding and building sustainability. Evaluation of the program was a key aspect of its implementation, requiring an appropriate process to identify specific problems and formulate solutions to improve the service. Methods We used the normalisation process model (May 2006) to order the data collected in consultation meetings and to inform our strategy and actions. The normalisation process model provided us with a structure for organising consultation meeting data and helped prioritise tasks. Our data was analysed as it applied to each dimension of the model, noting aspects that the model did not encompass. During this process we reworded the dimensions into more everyday terminology. The final analysis focused on to what extent the model helped us to prioritise and systematise our tasks and plans. Results We used the model to consider ways to promote the chiropractic service, to enhance relationships and interactions between clinicians and procedures within the health service, and to avoid disruption of the existing service. We identified ways in which chiropractors can become trusted team members who have acceptable and recognised knowledge and skills. We also developed strategies that should result in chiropractic practitioners finding a place within a complex occupational web, by being seen as similar to well-known occupations such as physiotherapy. Interestingly, one dimension identified by our data, which we have labelled ‘emancipatory’, was absent from the model. Conclusions The normalisation process model has resulted in a number of new insights and questions. We have now established thriving weekly chiropractic clinics staffed by a team of volunteer chiropractors. We identified an ‘emancipatory’ dimension that requires further study. We provide a worked example of using this model to establish, integrate and evaluate a chiropractic service in an Indigenous Australian community.

2012-01-01

155

Creating European guidelines for Chiropractic Incident Reporting and Learning Systems (CIRLS): relevance and structure  

PubMed Central

Background In 2009, the heads of the Executive Council of the European Chiropractors' Union (ECU) and the European Academy of Chiropractic (EAC) involved in the European Committee for Standardization (CEN) process for the chiropractic profession, set out to establish European guidelines for the reporting of adverse reactions to chiropractic treatment. There were a number of reasons for this: first, to improve the overall quality of patient care by aiming to reduce the application of potentially harmful interventions and to facilitate the treatment of patients within the context of achieving maximum benefit with a minimum risk of harm; second, to inform the training objectives for the Graduate Education and Continuing Professional Development programmes of all 19 ECU member nations, regarding knowledge and skills to be acquired for maximising patient safety; and third, to develop a guideline on patient safety incident reporting as it is likely to be part of future CEN standards for ECU member nations. Objective To introduce patient safety incident reporting within the context of chiropractic practice in Europe and to help individual countries and their national professional associations to develop or improve reporting and learning systems. Discussion Providing health care of any kind, including the provision of chiropractic treatment, can be a complex and, at times, a risky activity. Safety in healthcare cannot be guaranteed, it can only be improved. One of the most important aspects of any learning and reporting system lies in the appropriate use of the data and information it gathers. Reporting should not just be seen as a vehicle for obtaining information on patient safety issues, but also be utilised as a tool to facilitate learning, advance quality improvement and to ultimately minimise the rate of the occurrence of errors linked to patient care. Conclusions Before a reporting and learning system can be established it has to be clear what the objectives of the system are, what resources will be required and whether the implementing organisation has the capacity to operate the system to its full advantage. Responding to adverse event reports requires the availability of experts to analyse the incidents and to provide feedback in a timely fashion. A comprehensive strategy for national implementation must be in place including, but not limited to, presentations at national meetings, the provision of written information to all practitioners and the running of workshops, so that all stakeholders fully understand the purposes of adverse event reporting. Unless this is achieved, any system runs the risk of failure, or at the very least, limited usefulness.

2011-01-01

156

Comparing the Satisfaction of Low Back Pain Patients Randomized to Receive Medical or Chiropractic Care: Results From the UCLA Low-Back Pain Study  

PubMed Central

Objectives. This study examined the difference in satisfaction between patients assigned to chiropractic vs medical care for treatment of low back pain in a managed care organization. Methods. Satisfaction scores (on a 10–50 scale) after 4 weeks of follow-up were compared among 672 patients randomized to receive medical or chiropractic care. Results. The mean satisfaction score for chiropractic patients was greater than the score for medical patients (crude difference = 5.5; 95% confidence interval = 4.5, 6.5). Self-care advice and explanation of treatment predicted satisfaction and reduced the estimated difference between chiropractic and medical patients’ satisfaction. Conclusions. Communication of advice and information to patients with low back pain increases their satisfaction with providers and accounts for much of the difference between chiropractic and medical patients’ satisfaction.

Hertzman-Miller, Ruth P.; Morgenstern, Hal; Hurwitz, Eric L.; Yu, Fei; Adams, Alan H.; Harber, Philip; Kominski, Gerald F.

2002-01-01

157

Perception of Educational Environment Among Undergraduate Students in a Chiropractic Training Institution  

PubMed Central

Purpose: The impact of the educational environment in student learning is well documented. However, there is a scarcity in the literature exploring the educational environment in chiropractic training institutions. This study aimed to identify the perceived educational environment in a chiropractic training institution and the possible perceptual differences among different demographic groups. Methods: The perceived educational environment was surveyed using Dundee Ready Education Environment (DREEM), which is a validated, self-administered, and Likert-type inventory. DREEM items focus on subdomains related to learning, teachers, self-confidence, academic atmosphere, and social environment. The results were analyzed and interpreted in relation to standard norms of DREEM and demographic variables. Results: The survey was completed by 124 chiropractic undergraduate students (response rate 83%). Statistically, the inventory items showed high correlation and the subdomains showed a close relationship. Overall the DREEM score was very high: 156.1/200 (78%). The subdomain scores were also at very high levels. However, the scoring of four items by students was consistently poor: lack of a support system for stressed students, 1.8 (SD 1.1); authoritarian teachers, 1.8 (SD 1.2); inadequate school time-tabling, 2.0 (SD 1.1); and overemphasis on factual learning, 2.0 (SD 1.0). There were no statistically significant differences in DREEM scores between gender, age, minority, and ethnicity groups. Conclusions: In general, students perceived that a sound educational environment is fostered by the institution and its educational program for all students despite their demographic variations. However, certain specific elements of the educational process may need to be addressed to improve the educational experience.

Palmgren, Per J.; Chandratilake, Madawa

2011-01-01

158

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

PubMed Central

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.

Grayson, J Paul

2002-01-01

159

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

PubMed

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

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

2013-06-01

160

Complementary and alternative treatment for neck pain: chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais.  

PubMed

Of the multitude of treatment options for the management of neck pain, no obvious single treatment modality has been shown to be most efficacious. As such, the clinician should consider alternative treatment modalities if a modality is engaging, available, financially feasible, potentially efficacious, and is low risk for the patient. As evidence-based medicine for neck pain develops, the clinician is faced with the challenge of which treatments to encourage patients to pursue. Treatment modalities explored in this article, including chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais, represent reasonable complementary and alternative medicine methods for patients with neck pain. PMID:21824591

Plastaras, Christopher T; Schran, Seth; Kim, Natasha; Sorosky, Susan; Darr, Deborah; Chen, Mary Susan; Lansky, Rebecca

2011-08-01

161

Case management of chiropractic patients with cervical brachialgia: A survey of French chiropractors  

PubMed Central

Background Not much is known about the French chiropractic profession on, for example, level of consensus on clinical issues. Objectives The first objective was to investigate if French chiropractors' management choices appeared reasonable for various neck problem scenarios. The second objective was to investigate if there was agreement between chiropractors on the patient management. The third objective was to see to which degree and at what stages chiropractors would consider to interact with other health-care practitioners, such as physiotherapists, general practitioners and specialists. Method A questionnaire was sent to a randomly selected sample of all French chiropractors known to the national chiropractic college. It consisted of an invitation to participate in the study, a brief case description, and drawings of five stages of how a case of neck pain gradually evolves into a brachialgia to end up with a compromised spinal cord. Each stage offered five management choices. Participants were asked at what stages patients would be treated solely by the chiropractor and when patients would be referred out for second opinion or other care without chiropractic treatment, plus an open ended option, resulting in a "five-by-six" table. The percentages of respondents choosing the different management strategies were identified for the different scenarios and the 95% confidence intervals were calculated. There was a pre hoc agreement on when chiropractic care would or would not be suitable. Consensus was arbitrarily defined as "moderate" when 50- 69% of respondents agreed on the same management choice and as "excellent" when 70% or more provided the same answer. It was expected that inter professional contacts would be rare. Results The response rate was 53% out of 254 potential participants. The first two uncomplicated cases would generally have been treated by the chiropractors. As the patient worsened, the responses tended towards external assistance and for the most severe case, the majority of respondents would have referred the patient out. There was excellent consensus for the two extreme cases (the most benign and the most severe), moderate consensus for the cases next to these two and least agreement relating to the "middle" case. Inter-professional collaboration was contemplated mainly for the severe case. Conclusion The French chiropractors who participated in this study seem to have a similar approach to patients with neck pain that gradually develops into a brachialgia and worsens. However, it is not known if the large group of non-participants in the study would agree with this treatment strategy.

2011-01-01

162

A feasibility study of chiropractic spinal manipulation versus sham spinal manipulation for chronic otitis media with effusion in children  

Microsoft Academic Search

Background: Pediatric otitis media with effusion is a common and costly condition. Although chiropractors have anecdotally claimed success in treating otitis media, there is little research to support their claims. Objective: A pilot study was undertaken for the purpose of assessing the feasibility of conducting a full-scale randomized clinical trial investigating the efficacy of chiropractic spinal manipulative therapy (SMT) for

Charles E. Sawyer; Roni L. Evans; Patrick D. Boline; Richard Branson; Anne Spicer

1999-01-01

163

Physical injury assessment of male versus female chiropractic students when learning and performing various adjustive techniques: a preliminary investigative study  

Microsoft Academic Search

BACKGROUND: Reports of musculoskeletal injuries that some chiropractic students experienced while in the role of adjustor became increasingly evident and developed into the basis of this study. The main objective of this study was to survey a select student population and identify, by gender, the specific types of musculoskeletal injuries they experienced when learning adjustive techniques in the classroom, and

Debra W Bisiacchi; Laura L Huber

2006-01-01

164

The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: The emperor's new suit?  

Microsoft Academic Search

Five to ten percent of chiropractic patients are children and adolescents. Most of these consult because of spinal pain, or other musculoskeletal complaints. These musculoskeletal disorders in early life not only affect the quality of children's lives, but also seem to have an impact on adult musculoskeletal health. Thus, this is an important part of the chiropractors' scope of practice,

Lise Hestbaek; Mette Jensen Stochkendahl

2010-01-01

165

Chiropractic management of frozen shoulder syndrome using a novel technique: a retrospective case series of 50 patients  

PubMed Central

Objective The purpose of this case series is to describe the treatment and outcomes of a series of patients presenting with frozen shoulder syndrome who received a novel chiropractic approach (OTZ Tension Adjustment). Methods The files of 50 consecutive patients who presented to a private chiropractic practice with frozen shoulder syndrome were reviewed retrospectively. Two primary outcomes were extracted from the files for initial examination and at final evaluation: (1) the 11-point numeric pain rating scale and (2) the percentage change in shoulder abduction. Each patient received a series of chiropractic manipulative procedures that focused on the cervical and thoracic spine. Results Of the case files reviewed, 20 were male and 30 were female; and all were between the ages of 40 and 70 years. The median number of days under care was 28 days (range, 11 to 51 days). The median change in Numeric Pain Rating Scale score was ? 7 (range, 0 to ? 10). Of the 50 cases, 16 resolved completely (100% improvement), 25 showed 75% to 90% improvement, 8 showed 50% to 75% improvement, and 1 showed 0% to 50% improvement. Conclusion Most patients with frozen shoulder syndrome in this case series appeared to improve with the chiropractic treatment.

Murphy, Francis X.; Hall, Michael W.; D'Amico, Louis; Jensen, Anne M.

2012-01-01

166

Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature  

Microsoft Academic Search

Single-vessel cervical arterial dissections typically occur in young adults and are a common cause of cerebral ischemia and stroke. Although the pathogenesis of multivessel dissection is unclear, it is thought to be a consequence of underlying collagen vascular disease. We present a 34-year-old previously healthy man who developed bilateral internal carotid and vertebral artery dissection following chiropractic manipulation.

R. N. Nadgir; L. A. Loevner; T. Ahmed; G. Moonis; J. Chalela; K. Slawek; S. Imbesi

2003-01-01

167

Hand Hygiene and Treatment Table Sanitizing in Chiropractic Teaching Institutions: Results of an Education Intervention to Increase Compliance  

Microsoft Academic Search

ObjectiveThe purpose of this study was to test an educational intervention designed to increase hand and treatment table sanitizing on 3 chiropractic college campuses using a theory-based intervention. The second purpose is to see if an increase in observed hand hygiene would be noted as a result of the intervention.

Marion W. Evans Jr.; Michael Ramcharan; Harrison Ndetan; Rod Floyd; Gary Globe; Mark Pfefer; James Brantingham

2009-01-01

168

Use of Radiographic Imaging Protocols by Canadian Memorial Chiropractic College Interns  

PubMed Central

Objectives: The purpose of this study was to determine if 4th-year interns plan to x-ray their patients, once they are in private practice, in accordance with the principles taught throughout their radiology program and with the evidence-based imaging guidelines outlined in the literature. Methods: Questionnaires were provided to all 4th-year interns. Each questionnaire consisted of 10 case scenarios representing possible chiropractic patients. Each intern was asked if he or she would radiograph the patient and, if so, which views would be taken. A “gold standard” was established by two chiropractic radiologists using evidence-based guidelines. Intern answers were compared with the gold standard using percent agreement. Results: Sixty-eight interns completed the questionnaire. Agreement between the interns and the gold standards for the question of whether or not they would take x-rays ranged from 63.2% to 100%. The percent agreement for the correct radiographic views chosen ranged from 32.6% to 48.4%. Conclusion: Interns are generally aware of and plan to apply the radiographic guidelines for determining whether or not radiographs are indicated, as outlined in the current literature. However, interns are inconsistent in choosing the correct views.

Butt, Amy; Clarfield-Henry, Jordanna; Bui, Loan; Butler, Kim; Peterson, Cynthia

2007-01-01

169

Clinical presentation of a patient with thoracic myelopathy at a chiropractic clinic  

PubMed Central

Introduction The purpose of this case report is to describe the clinical presentation, examination findings, and management decisions of a patient with thoracic myelopathy who presented to a chiropractic clinic. Case Report/Methods After receiving a diagnosis of a diffuse arthritic condition and kidney stones based on lumbar radiograph interpretation at a local urgent care facility, a 45-year-old woman presented to an outpatient chiropractic clinic with primary complaints of generalized low back pain, bilateral lower extremity paresthesias, and difficulty walking. An abnormal neurological examination result led to an initial working diagnosis of myelopathy of unknown cause. The patient was referred for a neurological consult. Results Computed tomography revealed severe multilevel degenerative spondylosis with diffuse ligamentous calcification, facet joint hypertrophy, and disk protrusion at T9-10 resulting in midthoracic cord compression. The patient underwent multilevel spinal decompressive surgery. Following surgical intervention, the patient reported symptom improvement. Conclusion It is important to include a neurologic examination on all patients presenting with musculoskeletal complaints, regardless of prior medical attention. The ability to recognize myelopathy and localize the lesion to a specific spinal region by clinical examination may help prioritize diagnostic imaging decisions as well as facilitate diagnosis and treatment.

Gay, Charles W.; Bishop, Mark D.; Beres, Jacqueline L.

2012-01-01

170

The effects of chiropractic care on a patient with chronic constipation  

PubMed Central

Objective and rationale: To report the effect of weekly chiropractic adjustments on a patient with reported chronic constipation. Design architecture: case report. Outcome measures: The outcome measures assessed were a reduction in the diagnostic criteria of constipation, the patient's overall sense of well being rated on a Global Well-Being Scale and the frequency of low back pain. Method: The patient completed all required intake forms according to the H.K. Lee Outpatient clinic protocol at CMCC, and a questionnaire regarding bowel habits. A senior intern performed a complete history and spinal examination and the patient was treated for two months. Throughout the two months the patient completed the bowel habit questionnaire at each visit and at a follow up appointment one month later. Results: Results support a decline in constipation according to the requisite criteria, resolution of low back pain, and a Global Well-Being scale score of over 9/10. Conclusion: It appears that chiropractic treatment may have a role in the improvement of chronic constipation.

Redly, Monika

2001-01-01

171

Clinical decision-making to facilitate appropriate patient management in chiropractic practice: 'the 3-questions model'  

PubMed Central

Background A definitive diagnosis in chiropractic clinical practice is frequently elusive, yet decisions around management are still necessary. Often, a clinical impression is made after the exclusion of serious illness or injury, and care provided within the context of diagnostic uncertainty. Rather than focussing on labelling the condition, the clinician may choose to develop a defendable management plan since the response to treatment often clarifies the diagnosis. Discussion This paper explores the concept and elements of defensive problem-solving practice, with a view to developing a model of agile, pragmatic decision-making amenable to real-world application. A theoretical framework that reflects the elements of this approach will be offered in order to validate the potential of a so called '3-Questions Model'; Summary Clinical decision-making is considered to be a key characteristic of any modern healthcare practitioner. It is, thus, prudent for chiropractors to re-visit the concept of defensible practice with a view to facilitate capable clinical decision-making and competent patient examination skills. In turn, the perception of competence and trustworthiness of chiropractors within the wider healthcare community helps integration of chiropractic services into broader healthcare settings.

2012-01-01

172

Prevalence of nonmusculoskeletal versus musculoskeletal cases in a chiropractic student clinic  

PubMed Central

Objective We sought to identify the percentage of nonmusculoskeletal and musculoskeletal conditions treated by interns in the National University of Health Sciences (NUHS) Student Clinic compared to chiropractic and allopathic health care professionals. Methods The information gathered was taken from the charts of patients treated in the fall trimester, dated September 12, 2011 through December 9, 2011. The data collected included ICD-9 codes for the conditions treated, the number of patient visits, age, and gender, and was evaluated using Microsoft Excel. Results Over half of the 113 eligible patients were women with a mean patient age of 28 years, an average of three treated diagnoses, and a mean of seven treatments. Those treated only for musculoskeletal conditions totaled 52% of the patients; 48% of the patients were treated for nonmusculoskeletal conditions, or musculoskeletal plus nonmusculoskeletal conditions. Conclusion The NUHS Student Clinic interns are treating a greater percentage of nonmusculoskeletal conditions and a lesser percentage of musculoskeletal conditions than practicing chiropractic physicians. The student interns also treat a lesser percentage of nonmusculoskeletal and a greater percentage of musculoskeletal conditions than allopathic practitioners. This comparison would suggest that NUHS is nearing its institutional goal of training its student interns as primary care practitioners.

Hodges, Bruce R.; Cambron, Jerrilyn A.; Klein, Rachel M.; Madigan, Dana M.

2013-01-01

173

Inter- and intraexaminer reliability of the Blair protractoview method: examination of a chiropractic radiographic technique  

PubMed Central

Objective The purpose of this study was to evaluate the inter- and intraexaminer reliability of the Blair protractoview radiographic method. Methods This retrospective study evaluated 25 participants attending a Blair technique seminar. Participants included chiropractic students and doctors of chiropractic with more than 11 years of experience. Participants evaluated 100 Blair protractoview radiographs (oblique nasium). A ? analysis was used to determine the inter- and intraexaminer reliability because of the nominal categorical value of the variables. For the interexaminer reliability, a ? score was given for each examiner combination. The scores were then averaged to give the total interexaminer reliability. Results The overall interexaminer reliability showed substantial reliability at 0.62. Within-group ? values were as follows: no certification = 0.61, proficiency = 0.66, primary level = 0.61, and advanced level = 0.74. The overall intraexaminer reliability showed outstanding reliability at 0.81. Within-group ? values were as follows: no certification = 0.76, proficiency = 0.84, primary level = 0.82, and advanced level = 0.92. All ? values had a P value < .001. Conclusion The participants in this study showed good inter- and intraexaminer reliability using the Blair protractoview radiographic method.

Hubbard, Todd A.; Vowles, Brett M.; Forest, Tom

2010-01-01

174

Prevalence of nonmusculoskeletal versus musculoskeletal cases in a chiropractic student clinic.  

PubMed

Objective : We sought to identify the percentage of nonmusculoskeletal and musculoskeletal conditions treated by interns in the National University of Health Sciences (NUHS) Student Clinic compared to chiropractic and allopathic health care professionals. Methods : The information gathered was taken from the charts of patients treated in the fall trimester, dated September 12, 2011 through December 9, 2011. The data collected included ICD-9 codes for the conditions treated, the number of patient visits, age, and gender, and was evaluated using Microsoft Excel. Results : Over half of the 113 eligible patients were women with a mean patient age of 28 years, an average of three treated diagnoses, and a mean of seven treatments. Those treated only for musculoskeletal conditions totaled 52% of the patients; 48% of the patients were treated for nonmusculoskeletal conditions, or musculoskeletal plus nonmusculoskeletal conditions. Conclusion : The NUHS Student Clinic interns are treating a greater percentage of nonmusculoskeletal conditions and a lesser percentage of musculoskeletal conditions than practicing chiropractic physicians. The student interns also treat a lesser percentage of nonmusculoskeletal and a greater percentage of musculoskeletal conditions than allopathic practitioners. This comparison would suggest that NUHS is nearing its institutional goal of training its student interns as primary care practitioners. PMID:24087902

Hodges, Bruce R; Cambron, Jerrilyn A; Klein, Rachel M; Madigan, Dana M

2013-01-01

175

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

PubMed Central

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.

Gleberzon, Brian J.

2010-01-01

176

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

Microsoft Academic Search

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

Eric L Hurwitz; Lu-May Chiang

2006-01-01

177

The reliability and potential value of a specific ?centre of pressure locator? in chiropractic practice  

PubMed Central

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.

De Camillis, David; Carr, Robin

2000-01-01

178

Feasibility of using a standardized patient encounter for training chiropractic students in tobacco cessation counseling  

PubMed Central

Objective Although tobacco cessation training is included in many health profession programs, it is not yet routinely incorporated into chiropractic education. The purpose of this study was to assess the feasibility of incorporating a problem-based learning tobacco cessation activity into a lecture course for chiropractic students. Methods Seventy-two students were assigned to participate in two 1-hour lectures on health promotion counseling and tobacco cessation followed by an experiential student-driven lab session using standardized patients at various stages of dependency and willingness to quit. The intervention was based on the transtheoretic model and the “5 A's” of counseling (ask, advise, assess, assist, arrange). Outcomes were assessed via (1) questionnaires completed by the standardized patients regarding the students' use of the 5A's, and (2) questionnaires completed by the students using a 5-point Likert scale of “strongly disagree” to “strongly agree” on the acceptability of this method of learning. Descriptive statistics were computed. Results Sixty-eight students (94%) completed the activity, spending a median of 2.5 minutes with patients. Over 90% addressed 4 of the 5A's: 99% asked patients if they were smokers; 97% advised them to quit; 90% assessed if they were willing to quit; and 99% offered assistance in quitting. Only 79% arranged a follow-up visit. Overall, students expressed a positive response to the experience; 81% said it increased their confidence in being able to advise patients, and 77% felt it would be valuable for use in their future practice. Conclusion This active learning exercise appeared to be a feasible way to introduce tobacco counseling into the curriculum.

Hawk, Cheryl; Kaeser, Martha A.; Beavers, David V.

2013-01-01

179

Feasibility of using a standardized patient encounter for training chiropractic students in tobacco cessation counseling.  

PubMed

Objective : Although tobacco cessation training is included in many health profession programs, it is not yet routinely incorporated into chiropractic education. The purpose of this study was to assess the feasibility of incorporating a problem-based learning tobacco cessation activity into a lecture course for chiropractic students. Methods : Seventy-two students were assigned to participate in two 1-hour lectures on health promotion counseling and tobacco cessation followed by an experiential student-driven lab session using standardized patients at various stages of dependency and willingness to quit. The intervention was based on the transtheoretic model and the "5 A's" of counseling (ask, advise, assess, assist, arrange). Outcomes were assessed via (1) questionnaires completed by the standardized patients regarding the students' use of the 5A's, and (2) questionnaires completed by the students using a 5-point Likert scale of "strongly disagree" to "strongly agree" on the acceptability of this method of learning. Descriptive statistics were computed. Results : Sixty-eight students (94%) completed the activity, spending a median of 2.5 minutes with patients. Over 90% addressed 4 of the 5A's: 99% asked patients if they were smokers; 97% advised them to quit; 90% assessed if they were willing to quit; and 99% offered assistance in quitting. Only 79% arranged a follow-up visit. Overall, students expressed a positive response to the experience; 81% said it increased their confidence in being able to advise patients, and 77% felt it would be valuable for use in their future practice. Conclusion : This active learning exercise appeared to be a feasible way to introduce tobacco counseling into the curriculum. PMID:23957322

Hawk, Cheryl; Kaeser, Martha A; Beavers, David V

2013-06-27

180

Chiropractic management of a patient with postoperative lateral retinacular release using a multimodal approach: a case report  

PubMed Central

Objective The purpose of this case report is to describe a chiropractic rehabilitation program for a patient with postsurgical lateral retinaculum release. Clinical Features A 26-year-old male ice hockey goalie presented 1 month after having lateral retinaculum release surgery for his left knee with residual mild discomfort and edema in his left knee. Intervention and Outcome The patient was treated using a multimodal approach of both passive and active chiropractic care focusing on the restoration of full range of motion, increased proprioception, balance, strength, and endurance to return the patient to competitive ice hockey. Conclusion This case study demonstrated that, after 14 weeks of care, the patient was able to return to ice hockey training with no residual symptoms.

Solecki, Thomas J.; Hostnik, Kurt D.

2012-01-01

181

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

PubMed Central

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

2011-01-01

182

Effectiveness of an evidence-based chiropractic continuing education workshop on participant knowledge of evidence-based health care  

Microsoft Academic Search

BACKGROUND: Chiropractors must continue to learn, develop themselves professionally throughout their careers, and become self-directed and lifelong learners. Using an evidence-based approach increases the probability of optimal patient outcomes. But most chiropractors lack knowledge and interest in evidence-based approaches. The purpose of this study was to develop and measure the effectiveness of evidence-based training for chiropractic practitioners in a continuing

Ronald J Feise; Jaroslaw P Grod; Anne Taylor-Vaisey

2006-01-01

183

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

PubMed Central

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.

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

2013-01-01

184

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

PubMed Central

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.

Gleberzon, Brain J

2002-01-01

185

The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: The emperor's new suit?  

PubMed

Five to ten percent of chiropractic patients are children and adolescents. Most of these consult because of spinal pain, or other musculoskeletal complaints. These musculoskeletal disorders in early life not only affect the quality of children's lives, but also seem to have an impact on adult musculoskeletal health. Thus, this is an important part of the chiropractors' scope of practice, and the objective of this review is to assess the evidence base for manual treatment of musculoskeletal disorders in children and adolescents.Randomized, quasi-randomized and non-randomized clinical studies were included if they investigated the effect of manual therapy on musculoskeletal disorders in children and/or adolescents. The MEDLINE and MANTIS databases were searched, and studies published in English, Danish, Swedish or Norwegian were included.Only three studies were identified that in some way attempted to look at the effectiveness of manual therapy for children or adolescents with spinal problems, and none of these was a randomized controlled clinical trial. As for the rest of the musculoskeletal system, only one study of temporomandibular disorder was identified.With this review, we have detected a paradox within the chiropractic profession: Although the major reason for pediatric patients to attend a chiropractor is spinal pain, no adequate studies have been performed in this area. It is time for the chiropractic profession to take responsibility and systematically investigate the efficiency of joint manipulation of problems relating to the developing musculoskeletal system. PMID:20525199

Hestbaek, Lise; Stochkendahl, Mette Jensen

2010-06-02

186

Chiropractic Adjustment  

MedlinePLUS

... care is an outgrowth of belief in these concepts: Your body has a natural ability to heal ... conditions of use policy (Updated July 13, 2013) LEGAL CONDITIONS AND TERMS OF USE APPLICABLE TO ALL ...

187

English language proficiency and the accommodations for language non-concordance amongst patients utilizing chiropractic college teaching clinics  

PubMed Central

Background The number of households in the United States that are not proficient in the English language is growing and presenting a challenge to the health care system. Over nineteen percent of the US population speak a language other than English in the home. This increase in language discordance generates a greater need to find and implement accommodations in the clinical setting to insure accurate and efficient diagnosis and treatment as well as provide for patient safety. Aim: The purpose of this study is to determine the percentage of patients accessing the chiropractic college teaching clinics who are not proficient in the English language and to what extent the colleges provide accommodations for that language disparity. Methods The clinic directors and deans of the Association of Chiropractic Colleges were surveyed via an on-line survey engine. The survey queried the percentage of the patient population that is not English language proficient, the accommodations the college currently has in place, if the college has a language specific consent to treat document and if the college has a written policy concerning patients without English proficiency. Results Fifty percent of the contacted chiropractic colleges responded to the survey. In the respondent college clinics 16.5% of the patient population is not proficient in English, with over 75% speaking Spanish. All but one of the respondents provide some level of accommodation for the language non-concordance. Forty five percent of the responding colleges employ a language specific consent to treat form. The implementation of accommodations and the use of a language specific consent to treat form is more prevalent at colleges with a higher percentage of non-English speaking patients. Conclusions The percentage of patients with limited English proficiency accessing services at the teaching clinics of the chiropractic colleges mirrors the numbers in the general population. There is a wide disparity in the accommodations that the individual colleges make to address this language discordance. There is a need to further develop accurate and meaningful accommodations to address language disparity in the chiropractic teaching clinics.

2013-01-01

188

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

PubMed Central

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

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

2005-01-01

189

The prevalence of posticus ponticus: retrospective analysis of radiographs from a chiropractic health center  

PubMed Central

Objective The potential clinical significance of posticus ponticus is controversial because the majority of patients with this finding are asymptomatic. This study sought to estimate the prevalence of posticus ponticus in a chiropractic college clinic patient population. Methods From the archived records in the College Health Center, 304 lateral cervical spine radiographs were randomly selected and assessed by 2 independent examiners for the presence of posticus ponticus in any of its forms. The number of radiographs showing posticus ponticus, as well as analysis of agreement between examiners, was obtained. Results There were 60 radiographs where the examiners disagreed as to the presence or absence of posticus ponticus. These 60 were not counted for prevalence of posticus ponticus but were included in the ? analysis. Among the remaining 246 radiographs, 112 (46%) showed some type of posticus ponticus, whereas 132 (54%) did not show any posticus ponticus finding. Examiners A and B showed a ? score agreement of 0.72, and examiners C and D showed a ? score agreement of 0.51. Discussion The ? scores for both sets of examiners show acceptable agreement. Within this population, the finding of 45.9% prevalence of some type of posticus ponticus was determined. Compared with other studies, the prevalence of posticus ponticus was found to range between 9% and 72%. Conclusion Within this sample, 45.9% of radiographs showed some type of posticus ponticus.

Kuhta, Patricia; Hart, John; Greene-Orndorff, Laura; McDowell-Reizer, Beth; Rush, Perry

2010-01-01

190

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

PubMed

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

Johnson, C D; Green, B N

1996-12-01

191

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

PubMed

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

Foreman, Stephen M; Stahl, Michael J; Schultz, Gary D

2013-07-08

192

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

PubMed

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

Hester, Hilary; Cunliffe, Christina; Hunnisett, Adrian

2013-06-27

193

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

PubMed Central

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.

2012-01-01

194

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

PubMed Central

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.

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

2013-01-01

195

A Retrospective Analysis of the Cultural Competence of Chiropractic Students in a Public Health Course  

PubMed Central

Purpose: Diverse communities require chiropractors to be culturally competent to serve diverse populations. The purpose of this analysis is to describe the effect on knowledge and confidence to serve diverse populations following 6 hours of cultural competency training. Methods: Using a quasi-experimental one-group design, a paired t-test using a 40-item questionnaire to assess knowledge and a 15-item questionnaire to rate confidence was used for the stated purpose. Results: A total of 45 students completed the 40-item questionnaire and 48 students completed the 15-item questionnaire. Analyses showed significant increases from pre-to post-training (? score = 21.34%; p < 0.001) in knowledge to serve diverse populations; but in confidence no significant change was found (? score = 0.24; p = 0.26). However, when accounting for sex differences, female students showed a significant increase in confidence with 7 of the 15 items at p < 0.05, while male students did not achieve signifi-cant changes in any of these items. Conclusions: The knowledge of chiropractic students increased significantly following a course in cultural competence. Their confidence to serve diverse populations, however, did not change significantly. Further examination of the data revealed that baseline measures on confidence may be relatively high. Further study is required to determine the covariates of successful training in cultural competency.

Khauv, Kim B.; Alcantara, Joel

2012-01-01

196

Chiropractic Care for a Patient with Spasmodic Dysphonia Associated with Cervical Spine Trauma  

PubMed Central

Abstract Objective To discuss the diagnosis and response to treatment of spasmodic dysphonia in a 25-year-old female vocalist following an auto accident. Clinical Features The voice disorder and neck pain appeared after the traumatic incident. Examination of the cervical spine revealed moderate pain, muscle spasm and restricted joint motion at C-1 and C-5 on the left side. Cervical range of motion was reduced on left rotation. Bilateral manual muscle testing of the trapezius and sternocleidomastoid muscles, which share innervation with the laryngeal muscles by way of the spinal accessory nerve, were weak on the left side. Pre and post accident voice range profiles (phonetograms) that measure singing voice quality were examined. The pre- and post-accident phonetograms revealed significant reduction in voice intensity and fundamental frequency as measured in decibels and hertz. Intervention and Outcome Low-force chiropractic spinal manipulative therapy to C-1 and C-5 was employed. Following a course of care, the patient's singing voice returned to normal, as well as a resolution of her musculo- skeletal complaints. Conclusion It appears that in certain cases, the singing voice can be adversely affected if neck or head trauma is severe enough. This case proposes that trauma with irritation to the cervical spine nerve roots as they communicate with the spinal accessory, and in turn the laryngeal nerves, may be contributory in some functional voice disorders or muscle tension dysphonia.

Waddell, Roger K.

2005-01-01

197

Public health advocacy and chiropractic: a guide to helping your community reach its health objectives  

PubMed Central

Abstract Objective Doctors of chiropractic (DCs) provide health educational and promotion efforts in the communities they serve by counseling patients at the individual level. This article outlines a method and model in which DCs can effectively serve as public health advocates within their community. Discussion The social ecological model of health education and health promotion serves as an excellent template for taking into account every antecedent to disease within a community and how to prevent it through health promotion. A step-by-step guide to getting the DC involved in the community can be centered on this model, with the DC serving as a health advocate for his or her community. Resources are provided to assist in this process. Conclusion The DC can and should engage his or her community in areas that are conducive to health through involvement and advocacy roles where these are suitable. A community's health can be enhanced with greater health care provider involvement, and DCs need to consider themselves a part of this process.

Evans, Marion W.; Williams, Ronald D.; Perko, Michael

2008-01-01

198

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

PubMed

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

Brown, Richard

2012-12-06

199

Slipped capital femoral epiphysis (SCFE) detected in a chiropractic office: a case report  

PubMed Central

Objective To report on a case of slipped capital femoral epiphysis (SCFE), which is a somewhat rare condition but one that can present in a chiropractic clinic, particularly one with a musculoskeletal scope of practice. Case This is a single case report of a 16-year-old adolescent male patient who presented with an 18-month history of hip pain. Radiographs originally ordered by the patient’s family physician were read by the medical radiologist as “unremarkable.” The family physician diagnosed the patient with tendonitis. Treatment After reviewing the radiographs and examining the patient, the chiropractor suspected a SCFE that was confirmed with a repeat radiographic examination. The patient was referred back to his family physician with a diagnosis of SCFE and recommendation for orthopedic surgical consultation. The patient was subsequently treated successfully with surgical reduction by in situ pinning. Conclusion The prognosis for the SCFE patient when diagnosed early and managed appropriately is good. The consequences of a delay in the diagnosis of SCFE are an increased risk of further slippage and deformity, increased complications such as avascular necrosis and chondrolysis and increased likelihood of degenerative osteoarthritis of the involved hip later in life. The diagnosis and appropriate management of SCFE is where the chiropractor has an important role to play in the management of this condition.

Emary, Peter

2009-01-01

200

Chiropractic care of a pediatric patient with symptoms associated with gastroesophageal reflux disease, fuss-cry-irritability with sleep disorder syndrome and irritable infant syndrome of musculoskeletal origin  

PubMed Central

The mother of a 3-month old girl presented her daughter for chiropractic care with a medical diagnosis of gastroesophageal reflux disease. Her complaints included frequently interrupted sleep, excessive intestinal gas, frequent vomiting, excessive crying, difficulty breastfeeding, plagiocephaly and torticollis. Previous medical care consisted of Prilosec prescription medication. Notable improvement in the patient’s symptoms was observed within four visits and total resolution of symptoms within three months of care. This case study suggests that patients with complaints associated with both musculoskeletal and non-musculoskeletal origin may benefit from chiropractic care.

Alcantara, Joel; Anderson, Renata

2008-01-01

201

Upper extremity deep vein thrombosis presenting to a chiropractic clinic: a description of 2 cases  

PubMed Central

Objective The purpose of this case series is to describe the presentation of 2 patients who presented to a chiropractic teaching clinic with Paget-Schroetter syndrome (PSS) and to discuss the potential role for conservative therapy in the management of symptoms. Clinical Features Two patients presented with a vascular and muscular findings suggesting activity-related upper extremity deep vein thrombosis. One patient presented with recent onset of symptoms (pain in the neck with a “pinched nerve sensation” in the left upper trapezius); and the other presented with chronic, low-grade neck pain of 1 year's duration. Intervention and Outcome The initial treatment approach for the patient with acute symptoms included soft tissue therapy. During the second appointment, he was immediately referred for medical evaluation and management because of worsening symptoms. He was diagnosed with thrombus in the left brachial vein, started immediately on a thrombolytic agent, and referred to a thrombosis clinic. Treatment for the second patient with chronic symptoms included soft tissue therapy, spinal manipulative therapy, and active care. Two months after 3 treatments, she reported improved symptoms. She remains under supportive care and has reported continued relief of her symptoms. Conclusion Although a rare condition, PSS has the potential to result in significant morbidity and potentially fatal complications; thus, it is critical that practitioners recognize the signs and symptoms to facilitate appropriate and timely referrals. Clinicians should be aware of the presentation and proposed pathogenesis of PSS, and consider this diagnosis in patients with unilateral upper limb and/or neck pain.

Stainsby, Brynne E.; Muir, Bradley J.; Miners, Andrew L.

2012-01-01

202

Chiropractic rehabilitation of spinal pain patients: principles, practices and outcome data  

PubMed Central

Objective: To review basic principles and practices of chiropractic rehabilitation for spine pain patients and to present data on outcomes of an active care program. Design: Pre-post statistical comparisons of patient outcomes in a 6-week program of active care. Setting: Rehabilitation clinic. Participants: A convenience sample of seventy-three work-injured spine-pain patients from January 1993 to September 1994 who completed a 6-week intervention program. Forty eight (48) males with an average age of 41 years, and 25 females with an average age of 39 years were included. Outcome measures: VAS for pain severity; Oswestry and Neck Disability Indices; self-ratings for improvement; an outcomes satisfaction index. Results: The average duration of complaint was 48 days. Mean pre-post changes in pain scores (6.7 to 3.4) and disability scores (27.3 to 17.1) were highly significant (p < .0001). Eight-one percent (81%) of subjects were discharged as fit to return to at least modified work. The average level of self-rated improvement was 68%. The average level of satisfaction with outcome was 39/50. The highest correlations were found between disability status, self-rated improvement and outcomes satisfaction (.57-.81) Conclusion: An active care program has been shown to produce high levels of clinical improvement and patient satisfaction in a sample of moderate-to-severely disabled spine-pain patients. While this study has limitations, investigations such as this are essential to improve the quality of care provided to work-injured spine-pain patients.

Vernon, Howard T; Piccininni, Joseph; Kopansky-Giles, Deborah; Hagino, Carol; Fuligni, Shirley

1995-01-01

203

Resolution of Low Back and Radicular Pain in a 40-year-old Male United States Navy Petty Officer after Collaborative Medical and Chiropractic Care.  

National Technical Information Service (NTIS)

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 Fe...

G. R. Lillie

2009-01-01

204

Chiropractic management of a US Army veteran with low back pain and piriformis syndrome complicated by an anatomical anomaly of the piriformis muscle: a case study  

PubMed Central

Objective The purpose of this article is to present the case of a patient with an anatomical anomaly of the piriformis muscle who had a piriformis syndrome and was managed with chiropractic care. Case Report A 32-year-old male patient presented to a chiropractic clinic with a chief complaint of low back pain that radiated into his right buttock, right posterior thigh, and right posterior calf. The complaint began 5 years prior as a result of injuries during Airborne School in the US Army resulting in a 60% disability rating from the Veterans Administration. Magnetic resonance imaging demonstrated a mildly decreased intradiscal T2 signal with shallow central subligamentous disk displacement and low-grade facet arthropathy at L5/S1, a hypolordotic lumbar curvature, and accessory superior bundles of the right piriformis muscle without morphologic magnetic resonance imaging evidence of piriformis syndrome. Intervention and Outcome Chiropractic treatment included lumbar and sacral spinal manipulation with soft tissue massage to associated musculature and home exercise recommendations. Variations from routine care included proprioceptive neuromuscular facilitation stretches, electric muscle stimulation, acupressure point stimulation, Sacro Occipital Technique pelvic blocking, CranioSacral therapy, and an ergonomic evaluation. Conclusion A patient with a piriformis anomaly with symptoms of low back pain and piriformis syndrome responded positively to conservative chiropractic care, although the underlying cause of the piriformis syndrome remained.

Chapman, Cynthia; Bakkum, Barclay W.

2012-01-01

205

Expectations of chiropractic treatment: What are the expectations of new patients consulting a chiropractor, and do chiropractors and patients have similar expectations?  

Microsoft Academic Search

Background: There are conflicting views about whether expectation plays a role in patient satisfaction. No studies regarding the importance of patient expectations have been done in the chiropractic field. Objective: To investigate the expectations of new patients consulting a chiropractor and to evaluate differences and similarities in expectations between chiropractors and patients. Design: A questionnaire survey. Study participants: Thirty chiropractors

Håkan Sigrell

2002-01-01

206

Preliminary study into the components of the fear-avoidance model of LBP: change after an initial chiropractic visit and influence on outcome  

Microsoft Academic Search

BACKGROUND: In the last decade the sub grouping of low back pain (LBP) patients according to their likely response to treatment has been identified as a research priority. As with other patient groups, researchers have found few if any factors from the case history or physical examination that are helpful in predicting the outcome of chiropractic care. However, in the

Jonathan R Field; Dave Newell; Peter W McCarthy

2010-01-01

207

Predictive factors for 1-year outcome of low-back and neck pain in patients treated in primary care: comparison between the treatment strategies chiropractic and physiotherapy  

Microsoft Academic Search

The inability to predict outcome in patients with low back\\/neck pain leads to inappropriate or unnecessary treatment. The aims of the study were to identify prognostic factors for disability at 1-year follow-up in patients with back pain visiting primary care, and to compare the effect of these in two treatment strategies – chiropractic and physiotherapy. Data were taken from a

Elisabeth I Skargren; Birgitta E. Öberg

1998-01-01

208

Faculty perception of and resistance to online education in the fields of acupuncture, chiropractic, and massage therapy.  

PubMed

This paper reports findings of a research study undertaken to determine the attitudes and perceptions of acupuncture, chiropractic, and massage therapy faculty with regard to online learning within their respective disciplines, and to determine how they might be persuaded to teach online. The study surveyed faculty teaching at schools in these three fields and followed up with additional interviews. The study results indicate that, in general, acupuncture, chiropractic, and massage therapy faculty lack awareness of the capabilities of online education and the elements of good online learning. There is also a perception that what they teach cannot be taught online because of its kinesthetic requirements. The faculty hold this perception in spite of the success of medical science and related health care fields in the online environment, and they do not seem to separate the kinesthetic from the didactic. The present study indicates that faculty opinions about online instruction in this alternative type of education range from being willing to look at the potential of online education to outright dismissing it. PMID:21589712

Schwartz, Jan

2010-09-28

209

Faculty Perception of and Resistance to Online Education in the Fields of Acupuncture, Chiropractic, and Massage Therapy  

PubMed Central

This paper reports findings of a research study undertaken to determine the attitudes and perceptions of acupuncture, chiropractic, and massage therapy faculty with regard to online learning within their respective disciplines, and to determine how they might be persuaded to teach online. The study surveyed faculty teaching at schools in these three fields and followed up with additional interviews. The study results indicate that, in general, acupuncture, chiropractic, and massage therapy faculty lack awareness of the capabilities of online education and the elements of good online learning. There is also a perception that what they teach cannot be taught online because of its kinesthetic requirements. The faculty hold this perception in spite of the success of medical science and related health care fields in the online environment, and they do not seem to separate the kinesthetic from the didactic. The present study indicates that faculty opinions about online instruction in this alternative type of education range from being willing to look at the potential of online education to outright dismissing it.

Schwartz, Jan

2010-01-01

210

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

PubMed Central

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

2011-01-01

211

Knowledge and application of correct car seat head restraint usage among chiropractic college interns: a cross-sectional study  

PubMed Central

Summary of background data Cervical spine injuries sustained in rear-end crashes cost at least $7 billion in insurance claims annually in the United States alone. When positioned correctly, head restraint systems have been proven effective in reducing the risk of whiplash associated disorders. Chiropractors should be knowledgeable about the correct use of head restraint systems to educate their patients and thereby prevent or minimize such injuries. Objectives The primary objective of this study was to determine the prevalence of correct positioning of car seat head restraints among the interns at our institution. The secondary objective was to determine the same chiropractic interns’ knowledge of the correct positioning of car seat head restraints. It was hypothesized that 100 percent of interns would have their head restraint correctly positioned within an acceptable range and that all interns would possess the knowledge to instruct patients in the correct positioning of head restraints. Study Design Cross-sectional study of a convenient sample of 30 chiropractic interns from one institution. Methods Interns driving into the parking lot of our health center were asked to volunteer to have measurements taken and to complete a survey. Vertical and horizontal positions of the head restraint were measured using a beam compass. A survey was administered to determine knowledge of correct head restraint position. The results were recorded, entered into a spreadsheet, and analyzed. Results 13.3 percent of subjects knew the recommended vertical distance and only 20 percent of subjects knew the recommended horizontal distance. Chi Square analyses substantiated that the majority of subjects were unaware of guidelines set forth by the National Highway Traffic Safety Administration (NHTSA) for the correct positioning of the head restraint (?2vertical = 16.13, ?2horizontal = 10.80, p <.05). Only 6.7 percent of the subjects positioned their head restraint at the vertical distance of 6 cm or less (p <.05). However, 60 percent of the subjects positioned their head restraint at the recommended horizontal distance of 7 cm or less, but this was no different than could be expected by chance alone (p >.05). Interestingly, the 13.3 percent of the subjects who were aware of the vertical plane recommendations did not correctly position their own head restraint in the vertical plane. Similarly, only half of the subjects who were aware of the horizontal plane recommendations correctly positioned their head restraint in the horizontal plane. The data suggest that chance alone could account for the correct positioning of the head restraint in our subjects. Conclusions The results of this cross-sectional study raise concerns about chiropractic intern knowledge and application of correct head restraint positioning. The importance of chiropractors informing patients of the correct head restraint position should be emphasized in chiropractic education to help minimize or prevent injury in patients involved in motor vehicle collisions.

Taylor, John AM; Burke, Jeanmarie; Gavencak, John; Panwar, Pervinder

2005-01-01

212

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

PubMed Central

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.

Gotlib, Allan C; Beingessner, Melanie

1995-01-01

213

Correlation of Preadmission Organic Chemistry Courses and Academic Performance in Biochemistry at a Midwest Chiropractic Doctoral Program*  

PubMed Central

Purpose: Organic chemistry has been shown to correlate with academic success in the preclinical years of medicine, dentistry, and graduate physiology. The purpose of this study is to examine the relationship between undergraduate organic chemistry grades and first-semester biochemistry grades at a Midwest chiropractic doctoral program. Methods: Students enrolled in a first-semester biochemistry course who had completed the prerequisite courses in organic chemistry offered at this same institution were entered into the study. The total grade for each of the three courses was calculated using the midterm and final exam raw scores with a weighting of 50% each. Analysis consisted of obtaining correlation coefficients between the total grades of organic 1 with biochemistry and organic 2 with biochemistry. Using the biochemistry total grade, the students were divided into quartiles and course grades for both organic chemistry 1 and 2 were calculated. Results: For the 109 students in the study, the correlation coefficient between the biochemistry and organic chemistry 1 and biochemistry and organic chemistry 2 courses was r = 0.744 and r = 0.725, respectively. The difference in organic chemistry grades between those in the first and fourth quartiles was 63.2% and 86.9% for organic chemistry 1 (p < .001) and 60.9% and 79.4% for organic chemistry 2 (p < .001). Conclusion: This study shows that organic chemistry can be used as an indicator of future academic success in a chiropractic biochemistry course. Knowledge of such a relationship could prove useful to identify students who may potentially run into academic difficulty with first-year biochemistry

McRae, Marc P.

2010-01-01

214

Trends in Articles Published Over the Past 20 Years in The Journal of Chiropractic Education: Country of Origin, Academic Affiliation, and Data Versus Nondata Studies  

PubMed Central

Purpose: To review trends in articles published during the first 20 years of The Journal of Chiropractic Education (JCE), which is the primary periodical that publishes chiropractic educational research. This study focused on article type, country of origin, contributions by institutions, use of references, and use of structured abstracts. Methods: All volumes of the JCE were retrieved (1987–2006). Only full articles were included in this study; abstracts from proceedings and ephemera were excluded from this analysis. Articles that presented no data (eg, commentary, narrative descriptions) were classified as nondata articles. Articles that reported data (eg, experimental studies, survey research, etc) were classified as data articles. Each article was reviewed by hand for the type of study (data vs nondata), geographic region of origin, college of origin, use of references, and the presence of a structured or unstructured abstract. Results: After applying the inclusion and exclusion criteria, 153 papers were assessed. Published articles came from 5 countries and represented 23 chiropractic colleges. A majority (80.2%) of papers were from the United States. Of all articles, 101 articles (66%) were nondata in nature. Consistent use of references and structured abstracts increased over time. Conclusion: During its first 20 years, the JCE has published more nondata than data studies and the number of data papers published per year has remained constant. The journal has reached a consistent level of quality in its publication of manuscripts containing structured abstracts and references, and articles have been authored primarily by US authors. It is recommended that more efforts and resources are dedicated to data-driven studies and that greater geographic diversity is obtained to better represent the worldwide distribution of the chiropractic profession's educational institutions

Johnson, Claire D.; Green, Bart N.

2008-01-01

215

Enhancing the 3rd-Year Intern Clinical Experience Procedures and Protocols for Supervised On-Site Chiropractic Care at Athletic Events  

Microsoft Academic Search

The clinical education of the chiropractic intern can be enhanced by participation in an off-site treatment experience. A well planned and coordinated effort results in a win-win-win experience for the intern, the profession, and the patient\\/athlete. The supervised off-campus treatment of athletes at running road races and track meets has proven to be an excellent learning opportunity for interns, allowing

J. Russell Ebbets

216

Upper Cervical Chiropractic Care For A Nine-Year-Old Male With Tourette Syndrome, Attention Deficit Hyperactivity Disorder, Depression, Asthma, Insomnia, and Headaches: A Case Report  

Microsoft Academic Search

Objective: To review the effectiveness of chiropractic care using an upper cervical technique in the case of a nine-year- old male who presented with Tourette Syndrome (TS), Atten- tion Deficit Hyperactivity Disorder (ADHD), depression, asthma, insomnia, and headaches. Clinical Features: This nine-year-old boy suffered from asthma and upper respiratory infections since infancy; head- aches since age 6; TS, ADHD, depression

Erin L. Elster

2003-01-01

217

Future chiropractic physicians: toward a synthesis of select concepts in the behavioral sciences in health care and the society-culture-personality model for the 21st century  

PubMed Central

Objective The purpose of this article is to offer aspects of a conceptual model that can be applied as an organizational instrument for aiding preclinical and clinical chiropractic students to develop a thorough understanding of their roles among the next generation of health care providers for the 21st century. Discussion It is necessary for chiropractic physicians to comprehend the basis of the society-culture-personality model as an organizational device in the health care institution. The structure of the family and the socialization process as conceptual components of the model may allow an enriched understanding of their interrelationships and thereby could expand and provide quality care for patients as a whole. Conclusion The society-culture-personality model has the potential for synthesizing the features of the socialization process and the family in relation to the institution of health care. This model is particularly appropriate for the needs of the next generation of health care professionals (chiropractic physicians, physicians, dentists, nurses, and osteopathic physicians) who may not have had the chance to be exposed entirely to the behavioral sciences in health care.

Fredericks, Marcel; Kondellas, Bill; Ross, Michael W.V.; Hang, Lam; Fredericks, Janet

2010-01-01

218

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

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.

2013-01-01

219

Preliminary study into the components of the fear-avoidance model of LBP: change after an initial chiropractic visit and influence on outcome  

PubMed Central

Background In the last decade the sub grouping of low back pain (LBP) patients according to their likely response to treatment has been identified as a research priority. As with other patient groups, researchers have found few if any factors from the case history or physical examination that are helpful in predicting the outcome of chiropractic care. However, in the wider LBP population psychosocial factors have been identified that are significantly prognostic. This study investigated changes in the components of the LBP fear-avoidance beliefs model in patients pre- and post- their initial visit with a chiropractor to determine if there was a relationship with outcomes at 1 month. Methods Seventy one new patients with lower back pain as their primary complaint presenting for chiropractic care to one of five clinics (nine chiropractors) completed questionnaires before their initial visit (pre-visit) and again just before their second appointment (post-visit). One month after the initial consultation, patient global impression of change (PGIC) scores were collected. Pre visit and post visit psychological domain scores were analysed for any association with outcomes at 1 month. Results Group mean scores for Fear Avoidance Beliefs (FAB), catastrophisation and self-efficacy were all improved significantly within a few days of a patient's initial chiropractic consultation. Pre-visit catastrophisation as well as post-visit scores for catastrophisation, back beliefs (inevitability) and self-efficacy were weakly correlated with patient's global impression of change (PGIC) at 1 month. However when the four assessed psychological variables were dichotomised about pre-visit group medians those individuals with 2 or more high variables post-visit had a substantially increased risk (OR 36.4 (95% CI 6.2-213.0) of poor recovery at 1 month. Seven percent of patients with 1 or fewer adverse psychological variables described poor benefit compared to 73% of those with 2 or more. Conclusions The results presented suggest that catastrophisation, FAB and low self-efficacy could be potential barriers to early improvement during chiropractic care. In most patients presenting with higher psychological scores these were reduced within a few days of an initial chiropractic visit. Those patients who exhibited higher adverse psychology post-initial visit appear to have an increased risk of poor outcome at 1 month.

2010-01-01

220

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

PubMed Central

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.

2011-01-01

221

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  

Microsoft Academic Search

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

Wayne Hoskins; Henry Pollard

2010-01-01

222

Perceived effects of the delisting of chiropractic services from the Ontario Health Insurance Plan on practice activities: a survey of chiropractors in Toronto, Ontario  

PubMed Central

The purpose of this study was to survey a random sample of Toronto chiropractors and gather their perceptions of the effects that the delisting of chiropractic services from OHIP had on their practices profiles. Methods: A survey was mailed to 199 chiropractors who were asked to disclose demographic information, if they were in practice at the time when OHIP coverage was in effect, the perceived effect OHIP delisting had on their patient volumes, income, the profession’s credibility and if they would be in favor of having OHIP reinstated. Results: Among the 123 respondents in practice during OHIP coverage (n = 92), 48.9% indicated they perceived their practice income and 36.6% perceived their patient volume was negatively affected; 57.5% reported both had subsequently recovered. Almost 50% perceived OHIP delisting negatively affected the profession’s credibility and 46.1% of respondents were in favor of it being reinstated for chiropractic services; this percentage was much higher among chiropractors who were not in practice during the time of OHIP coverage. Conclusion: Most chiropractors reported that patient volumes and incomes have returned to pre-delisting levels and few chiropractors who were in practice during OHIP coverage expressed interest in having it reinstated.

Longo, Matthew; Grabowski, Michael; Gleberzon, Brian; Chappus, Jesse; Jakym, Crystal

2011-01-01

223

Aneurysmal bone cyst in a 21-year-old woman presenting with chronic low back pain in a chiropractic office: a case report.  

PubMed

Abstract Objective: To emphasize the importance of early detection, recognition, appropriate investigation, accurate diagnosis, proper referral, and treatment of an aneurysmal bone cyst (ABC) presenting as chronic low back pain (LBP) in a chiropractic office. Clinical features: A 21-year-old female student presented to the chiropractic office with a 2-year history of severe and progressive LBP. The patient described the LBP as an aching type of pain that was more pronounced during activity and exercises. She also reported weight loss and increased fatigue. Intervention and outcome: A detailed clinical, physical, and imaging evaluation was performed. A well-defined, expansile, and lytic bone lesion with the appearance of a possible ABC was detected; it involved the left inferior half and posterolateral aspect of the vertebral body of L3. Results: Treatment consisted of an L3 hemivertebrectomy resection en bloc and a vertebral fusion from L2 to L4 with tricortical iliac crest graft. After surgery and recovery, LBP was relieved and the bone lesion did not recur. Conclusion: Although uncommon, ABC is an important lesion that can affect the spine. Healthcare providers must be aware that the cause of LBP may extend beyond musculoskeletal dysfunction. It is important to identify an ABC and refer the patient for appropriate evaluation and care. PMID:23438037

Tasca, Luana; Reinke, Tari

2013-02-25

224

Chiropractic management using Cox cervical flexion-distraction technique for a disk herniation with left foraminal narrowing in a 64-year-old man  

PubMed Central

Objective The purpose of this case report is to describe chiropractic management of a patient with a C6/C7 left posteromedial disk herniation with foraminal narrowing and concomitant neurological compromise in the form of left upper extremity radiating pain and hypoesthesia/anesthesia using Cox flexion-distraction technique. Clinical Features A 64-year-old man presented to a chiropractic clinic with complaints of neck/left shoulder pain and hypoesthesia/anesthesia into the palmar side of his left hand. Magnetic resonance images of the cervical spine revealed a left posteromedial C6/C7 disk herniation along with foraminal narrowing. In addition, there were other levels of degeneration, most noted at the C3/C4 spinal level, which also had significant left-sided foraminal narrowing. Intervention and Outcome Treatment included Cox flexion-distraction protocols aimed to reduce nerve root compression along with supportive physiological therapeutic interventions to aid with pain reduction and functional improvement. The patient was treated a total of 10 times over a course of 4 weeks. The patient reported being pain-free and fully functional 8 months following the conclusion of care. Conclusion This case study demonstrated the use of Cox flexion-distraction for treatment of a patient with a cervical disk herniation, foraminal narrowing, and associated radiating pain and radiculopathy in the left upper extremity.

Manison, Allen M.

2011-01-01

225

Delineating inflammatory and mechanical sub-types of low back pain: a pilot survey of fifty low back pain patients in a chiropractic setting  

PubMed Central

Background An instrument known as the Mechanical and Inflammatory Low Back Pain (MAIL) Scale was drafted using the results of a previous expert opinion study. A pilot survey was conducted to test the feasibility of a larger study designed to determine the MAIL Scale's ability to distinguish two potential subgroups of low back pain: inflammatory and mechanical. Methods Patients with a primary complaint of low back pain (LBP) presenting to chiropractic clinics in Perth, Western Australia were asked to fill out the MAIL Scale questionnaire. The instrument's ability to separate patients into inflammatory and mechanical subgroups of LBP was examined using the mean score of each notional subgroup as an arbitrary cut-off point. Results Data were collected from 50 patients. The MAIL Scale did not appear to separate cases of LBP into the two notionally distinct groups of inflammatory (n = 6) or mechanical (n = 5). A larger "mixed symptom" group (n = 39) was revealed. Conclusions In this pilot study the MAIL Scale was unable to clearly discriminate between what is thought to be mechanical and inflammatory LBP in 50 cases seen in a chiropractic setting. However, the small sample size means any conclusions must be viewed with caution. Further research within a larger study population may be warranted and feasible.

2011-01-01

226

Feasibility of the STarT back screening tool in chiropractic clinics: a cross-sectional study of patients with low back pain  

PubMed Central

The STarT back screening tool (SBT) allocates low back pain (LBP) patients into three risk groups and is intended to assist clinicians in their decisions about choice of treatment. The tool consists of domains from larger questionnaires that previously have been shown to be predictive of non-recovery from LBP. This study was performed to describe the distribution of depression, fear avoidance and catastrophising in relation to the SBT risk groups. A total of 475 primary care patients were included from 19 chiropractic clinics. They completed the SBT, the Major Depression Inventory (MDI), the Fear Avoidance Beliefs Questionnaire (FABQ), and the Coping Strategies Questionnaire. Associations between the continuous scores of the psychological questionnaires and the SBT were tested by means of linear regression, and the diagnostic performance of the SBT in relation to the other questionnaires was described in terms of sensitivity, specificity and likelihood ratios. In this cohort 59% were in the SBT low risk, 29% in the medium risk and 11% in high risk group. The SBT risk groups were positively associated with all of the psychological questionnaires. The SBT high risk group had positive likelihood ratios for having a risk profile on the psychological scales ranging from 3.8 (95% CI 2.3 - 6.3) for the MDI to 7.6 (95% CI 4.9 - 11.7) for the FABQ. The SBT questionnaire was feasible to use in chiropractic practice and risk groups were related to the presence of well-established psychological prognostic factors. If the tool proves to predict prognosis in future studies, it would be a relevant alternative in clinical practice to other more comprehensive questionnaires.

2011-01-01

227

Chiropractic: An Introduction  

MedlinePLUS

... the National Library of Medicine (NLM), PubMed® contains publication information and (in most cases) ... to help people learn about clinical trials, why they matter, and how to participate. The site ...

228

Your First Chiropractic Visit  

MedlinePLUS

... will adapt the treatment plan to meet your specific needs. Other treatments, including therapeutic ultrasound, electrical muscle stimulation, ice and heat, traction, soft-tissue massage, and rehabilitative exercises, may ...

229

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...(9/11/13) A Message from the ACA ... health care needs. Insurance Resources ACA offers members a ...

230

Intentions of Chiropractic Interns Regarding use of Health Promotion in Practice: Applying Theory of Reasoned Action to Identify Attitudes, Beliefs, and Influencing Factors  

PubMed Central

Purpose: The theory of reasoned action is a health behavioral theory that has been used to predict personal health behaviors and intentions as well as those of providers delivering health care. The purpose of this study was to determine interns' future practices regarding the use of health promotion using this model to develop survey questions and to determine attitudes and perceived influences on their prospective behaviors in general, toward the use of health promotion once in practice. Methods: Across the course of one year, all graduating interns at a chiropractic college were queried with a 20 question survey designed using the theory of reasoned action. Frequencies and inferential statistics were performed including prediction modeling using logistic regression. Results: A majority (>85%) of interns indicated they would use health promotion in practice. Differences were noted based on perceived skill levels, perception of educational emphasis, various normative beliefs, and gender. Conclusion: Most interns will use some form of health promotion in practice. Normative influences including those seen as key influencers are as powerful a predictor as perceived education or skill levels on future practice of health promotion.

Evans, Marion W.; Ndetan, Harrison; Williams, Ronald D.

2009-01-01

231

Prevalence of pain-free weeks in chiropractic subjects with low back pain - a longitudinal study using data gathered with text messages  

PubMed Central

Introduction The use of automated text messages has made it possible to identify different courses of low back pain (LBP), and it has been observed that pain often fluctuates and that absolute recovery is rather rare. The purpose of this study was to describe the prevalence of pain-free weeks and pain-free periods in subjects with non-specific LBP treated by chiropractors, and to compare subjects from two different countries in these aspects. Methods Data were obtained from two practice-based multicentre prospective outcome studies, one Danish and one Swedish, involving subjects being treated by chiropractors for non-specific LBP. Over 18 weeks, subjects answered a weekly automated text message question on the number of days in the past week that they had experienced bothersome LBP, i.e. a number between 0 and 7. The number of weeks in a row without any LBP at all ("zero weeks") as well as the maximum number of zero weeks in a row was determined for each individual. Comparisons were made between the two study samples. Estimates are presented as percentages with 95% confidence intervals. Results In the Danish and the Swedish populations respectively, 93/110 (85%) and 233/262 (89%) of the subjects were eligible for analysis. In both groups, zero weeks were rather rare and were most commonly (in 40% of the zero weeks) reported as a single isolated week. The prevalence of pain free periods, i.e. reporting a maximum of 0, 1 or 2, or 3-6 zero weeks in a row, were similar in the two populations (20-31%). Smaller percentages were reported for ? 7 zero weeks in a row. There were no significant differences between the two study groups. Conclusion It was uncommon that chiropractic subjects treated for non-specific LBP experienced an entire week without any LBP at all over 18 weeks. When this occurred, it was most commonly reported for brief periods only. Hence, recovery in the sense that patients become absolutely pain free is rare, even in a primary care population.

2011-01-01

232

Individualized chiropractic and integrative care for low back pain: the design of a randomized clinical trial using a mixed-methods approach  

PubMed Central

Background Low back pain (LBP) is a prevalent and costly condition in the United States. Evidence suggests there is no one treatment which is best for all patients, but instead several viable treatment options. Additionally, multidisciplinary management of LBP may be more effective than monodisciplinary care. An integrative model that includes both complementary and alternative medicine (CAM) and conventional therapies, while also incorporating patient choice, has yet to be tested for chronic LBP. The primary aim of this study is to determine the relative clinical effectiveness of 1) monodisciplinary chiropractic care and 2) multidisciplinary integrative care in 200 adults with non-acute LBP, in both the short-term (after 12 weeks) and long-term (after 52 weeks). The primary outcome measure is patient-rated back pain. Secondary aims compare the treatment approaches in terms of frequency of symptoms, low back disability, fear avoidance, self-efficacy, general health status, improvement, satisfaction, work loss, medication use, lumbar dynamic motion, and torso muscle endurance. Patients' and providers' perceptions of treatment will be described using qualitative methods, and cost-effectiveness and cost utility will be assessed. Methods and Design This paper describes the design of a randomized clinical trial (RCT), with cost-effectiveness and qualitative studies conducted alongside the RCT. Two hundred participants ages 18 and older are being recruited and randomized to one of two 12-week treatment interventions. Patient-rated outcome measures are collected via self-report questionnaires at baseline, and at 4, 12, 26, and 52 weeks post-randomization. Objective outcome measures are assessed at baseline and 12 weeks by examiners blinded to treatment assignment. Health care cost data is collected by self-report questionnaires and treatment records during the intervention phase and by monthly phone interviews thereafter. Qualitative interviews, using a semi-structured format, are conducted with patients at the end of the 12-week treatment period and also with providers at the end of the trial. Discussion This mixed-methods randomized clinical trial assesses clinical effectiveness, cost-effectiveness, and patients' and providers' perceptions of care, in treating non-acute LBP through evidence-based individualized care delivered by monodisciplinary or multidisciplinary care teams. Trial registration ClinicalTrials.gov NCT00567333

2010-01-01

233

Frequency of use of diagnostic and manual therapeutic procedures of the spine taught at the Canadian Memorial Chiropractic College: A preliminary survey of Ontario chiropractors. Part 1 - practice characteristics and demographic profiles  

PubMed Central

Background: Students learn a plethora of physical examination and manual therapy procedures over the course of their chiropractic education. However, it is uncertain to what extent they continue to use these procedures in practice after graduation. Objective: The purpose of this study was to determine which diagnostic and therapeutic procedures of the spine are most commonly utilized by chiropractors practicing in Ontario. In Part 1 of this study (presented here), the demographics and practice patterns of the respondents are presented. Part 2 of this study will present the results of the utilization rates of diagnostic and therapeutic procedures used by respondents. Methods: The study consisted of a paper-based survey that was sent to 500 pseudo-randomly selected Ontario chiropractors who responded confidentially. Survey questions inquired into demographic and practice style characteristics. Results: There were 108 respondents to the survey, giving a response rate of 22.4%. Many chiropractors self-identified themselves with more than one practice style characteristic such as 72.4% of the self-described pain-based chiropractors who also described themselves as evidence-based, compared with 51.9% of subluxation-based chiropractors who also described themselves as evidence-based. Diversified technique was the most commonly employed technique used by 90.7% of respondents, followed by trigger point therapy indicated by 57.4% of respondents. Conclusions: Despite a low response rate, respondents reported practice characteristics in this study that were similar to practice characteristics previously published, particularly in terms of professional demographics and techniques employed. While Diversified was the most commonly used technique, respondents reported higher levels of use of proprietary soft tissue techniques systems and upper cervical techniques than have been previously reported.

Gleberzon, Brian; Stuber, Kent

2013-01-01

234

Stability: from biomechanical concept to chiropractic practice  

PubMed Central

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

McGill, Stuart M

1999-01-01

235

Vertebral and carotid artery dissection following chiropractic cervical manipulation  

Microsoft Academic Search

A 50-year-old woman presented a sudden left occipital headache and a posterior circulation stroke after cervical manipulation\\u000a for neck pain. Magnetic resonance imaging documented a left intracranial vertebral artery occlusive dissection associated\\u000a with an ipsilateral internal carotid artery dissection with vessel stenosis in its prepetrous tract. This is the first reported\\u000a case showing an associate vertebral and carotid artery dissection

Giuliano Parenti; Giovanni Orlandi; Mariacristina Bianchi; Maria Renna; Antonio Martini; Luigi Murri

1999-01-01

236

Maintenance care in chiropractic – what do we know?  

Microsoft Academic Search

BACKGROUND: Back problems are often recurring or chronic. It is therefore not surprising that chiropractors wish to prevent their return or reduce their impact. This is often attempted with a long-term treatment strategy, commonly called maintenance care. However, some aspects of maintenance care are considered controversial. It is therefore relevant to investigate the scientific evidence forming the basis for its

Charlotte Leboeuf-Yde; Lise Hestbæk

2008-01-01

237

Chiropractic manipulation in pediatric health conditions - an updated systematic review  

PubMed Central

Objective Our purpose was to review the biomedical literature from January 2004 to June 2007 inclusive to determine the extent of new evidence related to the therapeutic application of manipulation for pediatric health conditions. This updates a previous systematic review published in 2005. No critical appraisal of the evidence is undertaken. Data Sources We searched both the indexed and non-indexed biomedical manual therapy literature. This included PubMed, MANTIS, CINAHL, ICL, as well as reference tracking. Other resources included the Cochrane Library, CCOHTA, PEDro, WHO ICTRP, AMED, EMBASE and AHRQ databases, as well as research conferences and symposium proceedings. Results The search identified 1275 citations of which 57 discrete citations met the eligibility criteria determined by three reviewers who then determined by consensus, each citation's appropriate level on the strength of evidence scale. The new evidence from the relevant time period was 1 systematic review, 1 RCT, 2 observational studies, 36 descriptive case studies and 17 conference abstracts. When this additional evidence is combined with the previous systematic review undertaken up to 2003, there are now in total, 2 systematic reviews, 10 RCT's, 3 observational studies, 177 descriptive studies, and 31 conference abstracts defining this body of knowledge. Summary There has been no substantive shift in this body of knowledge during the past 3 1/2 years. The health claims made by chiropractors with respect to the application of manipulation as a health care intervention for pediatric health conditions continue to be supported by only low levels of scientific evidence. Chiropractors continue to treat a wide variety of pediatric health conditions. The evidence rests primarily with clinical experience, descriptive case studies and very few observational and experimental studies. The health interests of pediatric patients would be advanced if more rigorous scientific inquiry was undertaken to examine the value of manipulative therapy in the treatment of pediatric conditions.

Gotlib, Allan; Rupert, Ron

2008-01-01

238

Chiropractic management of shoulder pain and dysfunction of myofascial origin using ischemic compression techniques  

PubMed Central

Shoulder pain and dysfunction is a chief complaint commonly presenting to a chiropractor's office. The purpose of this article is to review the most common etiologies of shoulder pain, focusing on those conditions of a myofascial origin. In addition to a review of the literature, the author draws upon his own clinical experience to describe a method to diagnose and manage, patients with shoulder pain of myofascial origin using ischemic compression techniques. This hands-on therapeutic approach conveys several benefits including: positive therapeutic outcomes; a favorable safety profile and; it is minimally strenuous on the doctor and well tolerated by the patient. ImagesFigure 7

Hains, Guy

2002-01-01

239

Basic Science Research Related to Chiropractic Spinal Adjusting: The State of the Art and Recommendations Revisited  

Microsoft Academic Search

ObjectiveThe objectives of this white paper are to review and summarize the basic science literature relevant to spinal fixation (subluxation) and spinal adjusting procedures and to make specific recommendations for future research.

Gregory Cramer; Brian Budgell; Charles Henderson; Partap Khalsa; Joel Pickar

2006-01-01

240

Chiropractic management of patients post-disc arthroplasty: eight case reports  

Microsoft Academic Search

BACKGROUND: When conservative therapies for low back pain (LBP) are not effective, elective surgery may be proposed to these patients. Over the last 20 years, a new technology, disc replacement, has become increasingly popular because it is believed to maintain or restore the integrity of spinal movement and minimize the side-effects compared to fusion. Although disc replacement may relieve a

Julie O'Shaughnessy; Marc Drolet; Jean-François Roy; Martin Descarreaux

2010-01-01

241

PRIZE-WINNING PAPERS FROM THE WORLD FEDERATION OF CHIROPRACTIC 6 TH BIENNIAL CONGRESS  

Microsoft Academic Search

Background: The physiologic mechanism by which spinal manipulation may reduce pain and muscular spasm is not fully un- derstood. One such mechanistic theory pro- posed is that spinal manipulation may inter- vene in the cycle of pain and spasm by affecting the resting excitability of the motoneuron pool in the spinal cord. Previous data from our laboratory indicate that spinal

J. Donald Dishman; Kevin A. Ball; Jeanmarie Burke

2002-01-01

242

Chiropractic rehabilitation of a patient with S1 radiculopathy associated with a large lumbar disk herniation  

Microsoft Academic Search

Objective: To describe the nonsurgical treatment of acute S1 radiculopathy from a large (12 × 12 × 13 mm) L5-S1 disk herniation. Clinical Features: A 31-year-old man presented with severe lower back pain and pain, paresthesia, and plantar flexion weakness of the left leg. His symptoms began 5 days before the initial visit and progressed despite nonsteroidal anti-inflammatory drugs and

Craig E. Morris

1999-01-01

243

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

Federal Register 2010, 2011, 2012, 2013

...of a regularly scheduled medical educational seminar offering continuing medical education credit; (2...education, training, malpractice and adverse clinical occurrences...of a regularly scheduled medical educational seminar...

2013-04-17

244

The Emotional Impact of Being Recently Diagnosed with Dyslexia from the Perspective of Chiropractic Students  

ERIC Educational Resources Information Center

|Increased awareness and improved tests have contributed to the identification of rising numbers of dyslexic students entering higher education in the United Kingdom. Nearly half of these students are not diagnosed until they start their HE courses. Studies of experiences of dyslexic students diagnosed as children exist; however, there is little…

Kong, Shelley Young

2012-01-01

245

The role of chiropractic in primary care: Findings of four community studies  

Microsoft Academic Search

Objective: To assess, through qualitative studies of 4 medically underserved communities, the receptivity of chiropractors, other health care providers, and consumers to the idea of chiropractors' assuming a focal role in primary care. Method: Visits by a team of 2 researchers to 4 medically underserved communities: (1) rural towns in eastern Oregon; (2) rural towns in Iowa; (3) underserved areas

Michele Teitelbaum

2000-01-01

246

Barriers to expanding primary care roles for chiropractors: The role of chiropractic as primary care gatekeeper  

Microsoft Academic Search

Objective: To examine the feasibility of broader and more frequent primary care roles for chiropractors. Data Collection: Literature review and analysis of existing databases. Six types of barriers were examined, including legal, financial, professional, accessibility or geographic location, consumer preference, and self-imposed barriers. Results: Although research into the barriers of an expanded primary care role for chiropractors is inconclusive, several

Gary Gaumer; Annette Koren; Eric Gemmen

2002-01-01

247

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

PubMed Central

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.

Guagliardo, Joseph G.; Hoiriis, Kathryn T.

2013-01-01

248

How far can complementary and alternative medicine go? The case of chiropractic and homeopathy  

Microsoft Academic Search

This paper examines the efforts of two complementary and alternative occupations, chiropractors and homeopaths, to move from the margins to the mainstream in health care in the province of Ontario. We use a variety of theoretical perspectives to understand how health occupations professionalize: the trait functionalist framework, social closure, the system of professions, and the concept of countervailing powers. The

Merrijoy Kelner; Beverly Wellman; Sandy Welsh; Heather Boon

2006-01-01

249

The Emotional Impact of Being Recently Diagnosed with Dyslexia from the Perspective of Chiropractic Students  

ERIC Educational Resources Information Center

Increased awareness and improved tests have contributed to the identification of rising numbers of dyslexic students entering higher education in the United Kingdom. Nearly half of these students are not diagnosed until they start their HE courses. Studies of experiences of dyslexic students diagnosed as children exist; however, there is little…

Kong, Shelley Young

2012-01-01

250

Reflex control of the spine and posture: a review of the literature from a chiropractic perspective  

Microsoft Academic Search

OBJECTIVE: This review details the anatomy and interactions of the postural and somatosensory reflexes. We attempt to identify the important role the nervous system plays in maintaining reflex control of the spine and posture. We also review, illustrate, and discuss how the human vertebral column develops, functions, and adapts to Earth's gravity in an upright position. We identify functional characteristics

Mark W Morningstar; Burl R Pettibon; Heidi Schlappi; Mark Schlappi; Trevor V Ireland

2005-01-01

251

Chiropractic treatment of patients in motor vehicle accidents: a statistical analysis †  

PubMed Central

Motor vehicle accidents (MVA) are a major cause of spinal injuries treated by chiropractors. In this study the files of one chiropractor were reviewed retrospectively to generate a data base on the MVA cases (n = 149). The effect of age, sex, vehicle damage, symptoms and concurrent physiotherapy on the dependent variables of number of treatments, improvement and requirement for ongoing treatment was computed using an analysis of variance. Overall the average number of treatments given was 14.2. Patients who complained of headache or low back pain required more treatments than average. Improvement level was lowered by delay in seeking treatment, the presence of uncomplicated nausea and advancing age. Ongoing treatment to relieve persistent pain was required in 40.2 percent of the cases. None of the factors studied had a significant effect on this variable. The results of this study are comparable to those reported in the medical literature.

Dies, Stephen; Strapp, J Walter

1992-01-01

252

Life University  

NSDL National Science Digital Library

Life University offers professional degrees in chiropractic, and undergraduate and graduate degrees in health related fields. Information is provided about the college, the chiropractic profession and research.

1997-01-01

253

Spinal manipulation for low-back pain: a treatment package agreed by the UK chiropractic, osteopathy and physiotherapy professional associations  

Microsoft Academic Search

Trials of manipulative treatment have been compromised by, amongst other things, different definitions of the therapeutic procedures involved. This paper describes a spinal manipulation package agreed by the UK professional bodies that represent chiropractors, osteopaths and physiotherapists. It was devised for use in the UK Back pain Exercise And Manipulation (UK BEAM) trial—a national study of physical treatments in primary

E. Harvey; A. K. Burton; J. K. Moffett; A. Breen

2003-01-01

254

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

PubMed Central

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.

Lothe, Lise R.; Bolton, Jennifer E.

2013-01-01

255

Chiropractic and exercise for seniors with low back pain or neck pain: the design of two randomized clinical trials  

PubMed Central

Background Low back pain (LBP) and neck pain (NP) are common conditions in old age, leading to impaired functional ability and decreased independence. Manual and exercise therapies are common and effective therapies for the general LBP and NP populations. However, these treatments have not been adequately researched in older LBP and NP sufferers. The primary aim of these studies is to assess the relative clinical effectiveness of 1) manual treatment plus home exercise, 2) supervised rehabilitative exercise plus home exercise, and 3) home exercise alone, in terms of patient-rated pain, for senior LBP and NP patients. Secondary aims are to compare the three treatment approaches in regards to patient-rated disability, general health status, satisfaction, improvement and medication use, as well as objective outcomes of spinal motion, trunk strength and endurance, and functional ability. Cost-effectiveness and cost-utility will also be assessed. Finally, using qualitative methods, older LBP and NP patient's perceptions of treatment will be explored and described. Methods/Design This paper describes the design of two multi-methods clinical studies focusing on elderly patients with non-acute LBP and NP. Each study includes a randomized clinical trial (RCT), a cost-effectiveness study alongside the RCT, and a qualitative study. Four hundred and eighty participants (240 per study), ages 65 and older, will be recruited and randomized to one of three, 12-week treatment programs. Patient-rated outcome measures are collected via self-report questionnaires at baseline and at 4, 12, 26, and 52 weeks post-randomization. Objective outcomes are assessed by examiners masked to treatment assignment at baseline and 12 weeks. Health care cost data is collected through standardized clinician forms, monthly phone interviews, and self-report questionnaires throughout the study. Qualitative interviews using a semi-structured format are conducted at the end of the 12 week treatment period. Discussion To our knowledge, these are the first randomized clinical trials to comprehensively address clinical effectiveness, cost-effectiveness, and patients' perceptions of commonly used treatments for elderly LBP and NP sufferers. Trial Registration NCT00269321 and NCT00269308

Maiers, Michele J; Hartvigsen, Jan; Schulz, Craig; Schulz, Karen; Evans, Roni L; Bronfort, Gert

2007-01-01

256

Chiropractic and exercise for seniors with low back pain or neck pain: the design of two randomized clinical trials  

Microsoft Academic Search

BACKGROUND: Low back pain (LBP) and neck pain (NP) are common conditions in old age, leading to impaired functional ability and decreased independence. Manual and exercise therapies are common and effective therapies for the general LBP and NP populations. However, these treatments have not been adequately researched in older LBP and NP sufferers. The primary aim of these studies is

Michele J Maiers; Jan Hartvigsen; Craig Schulz; Karen Schulz; Roni L Evans; Gert Bronfort

2007-01-01

257

A RANDOMIZED CONTROLLED TRIAL OF THE EFFECTS OF INSTRUMENT-APPLIED CHIROPRACTIC MANIPULATIVE THERAPY ON MYOFASCIAL TRIGGER POINTS  

Microsoft Academic Search

Introduction: Myofascial trigger points (MTrPs) are characterized as discrete, focal, hypersensitive spots in a taut band of muscle that are painful to palpation and reproduce the patient's local and referred pain symptoms. (Borg-Stein & Simons, 2002) Other features may include \\

Rodger Tepe; John Zhang

258

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

Code of Federal Regulations, 2010 CFR

...Graduate or equivalent degree in Public Health Doctor of Chiropractic or equivalent degree Doctoral degree of Clinical Psychology...Council on Education for Public Health. (I) Council on Chiropractic Education. (J) Accrediting Commission on Education...

2010-10-01

259

42 CFR 410.21 - Limitations on services of a chiropractor.  

Code of Federal Regulations, 2010 CFR

...symptomatology and diagnosis, hygiene and sanitation, chemistry, histology, pathology, and principles and practice of chiropractic...symptomatology and diagnosis, hygiene and sanitation, chemistry, histology, pathology, principles and practice of chiropractic,...

2009-10-01

260

42 CFR 410.21 - Limitations on services of a chiropractor.  

Code of Federal Regulations, 2010 CFR

...symptomatology and diagnosis, hygiene and sanitation, chemistry, histology, pathology, and principles and practice of chiropractic...symptomatology and diagnosis, hygiene and sanitation, chemistry, histology, pathology, principles and practice of chiropractic,...

2010-10-01

261

Defense Health Care: DOD Chiropractor Wage Rates.  

National Technical Information Service (NTIS)

In 2000, Congress mandated that the Department of Defense (DOD) develop a plan to provide chiropractic care as a permanent part of the Defense Health Program. Prior to the establishment of DOD's chiropractic program, Congress directed DOD to conduct demon...

2013-01-01

262

The knowledge of our knowledge?  

PubMed Central

This classic article was published in the first volume and issue of Philosophical Constructs for the Chiropractic Profession. In this paper, Dr. McAndrews reviews the use of the term “philosophy” in chiropractic and urges the chiropractic profession to consider the use and misuse of this term. Reprinted with permission from McAndrews JF. The Knowledge of Our Knowledge. Philosophical Constructs for the Chiropractic Profession. 1991;1:14-17.

McAndrews, Jerome F.

2012-01-01

263

Data quality assurance: an analysis of patient non-response  

Microsoft Academic Search

Purpose – Patient satisfaction is paramount to maintaining high clinical quality assurance. This study seeks to compare response rates, response bias, and the completeness of data between paper and electronic collection modes of a chiropractic patient satisfaction survey. Design\\/methodology\\/approach – A convenience sample of 206 patients presenting to a chiropractic college clinic were surveyed concerning satisfaction with their chiropractic care.

Dustin C. Derby; Andrea Haan; Kurt Wood

2011-01-01

264

Prevention and Health Promotion by Chiropractors  

Microsoft Academic Search

Chiropractic care includes a variety of minimally invasive approaches, with both treatment and prevention as essential elements of clinical practice. Although chiropractic adjustment (manipulation) is the signature therapy and best-known identifier of the profession, the practice of chiropractic involves more than manual therapeutics. In general, chiropractors seek to bring a holistic worldview to the doctor—patient encounter, seeking not only to

Daniel Redwood; Gary Globe

2008-01-01

265

Delineating inflammatory and mechanical sub-types of low back pain: a pilot survey of fifty low back pain patients in a chiropractic setting  

Microsoft Academic Search

Background  An instrument known as the Mechanical and Inflammatory Low Back Pain (MAIL) Scale was drafted using the results of a previous\\u000a expert opinion study. A pilot survey was conducted to test the feasibility of a larger study designed to determine the MAIL\\u000a Scale's ability to distinguish two potential subgroups of low back pain: inflammatory and mechanical.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Patients with a primary

Janine S Riksman; Owen D Williamson; Bruce F Walker

2011-01-01

266

Tracing the evolution of chiropractic students' confidence in clinical and patient communication skills during a clinical internship: a multi-methods study  

PubMed Central

Background Anecdotal evidence points to variations in individual students’ evolving confidence in clinical and patient communication skills during a clinical internship. A better understanding of the specific aspects of internships that contribute to increasing or decreasing confidence is needed to best support students during the clinical component of their study. Methods A multi-method approach, combining two large-scale surveys with 269 students and three in-depth individual interviews with a sub-sample of 29 students, was used to investigate the evolution of change in student confidence during a 10-month long internship. Change in levels of confidence in patient communication and clinical skills was measured and relationship to demographic factors were explored. The interviews elicited students’ accounts and reflections on what affected the evolution of their confidence during the internship. Results At the start of their internship, students were more confident in their patient communication skills than their clinical skills but prior experience was significantly related to confidence in both. Initial confidence in patient communication skills was also related to age and prior qualification but not gender whilst confidence in clinical skills was related to gender but not age or prior qualification. These influences were maintained over time. Overall, students’ levels of confidence in patient communication and clinical skills confidence increased significantly over the duration of the internship with evidence that change over time in these two aspects were inter-related. To explore how specific aspects of the internship contributed to changing levels of confidence, two extreme sub-groups of interviewees were identified, those with the least increase and those with the highest increase in professional confidence over time. A number of key factors affecting the development of confidence were identified, including among others, interactions with clinicians and patients, personal agency and maturing as a student clinician. Conclusion This study provides insight into the factors perceived by students as affecting the development of professional confidence during internships. One particularly promising area for educational intervention may be the promotion of a pro-active approach to professional learning.

2012-01-01

267

Individualized chiropractic and integrative care for low back pain: the design of a randomized clinical trial using a mixed-methods approach  

Microsoft Academic Search

BACKGROUND: Low back pain (LBP) is a prevalent and costly condition in the United States. Evidence suggests there is no one treatment which is best for all patients, but instead several viable treatment options. Additionally, multidisciplinary management of LBP may be more effective than monodisciplinary care. An integrative model that includes both complementary and alternative medicine (CAM) and conventional therapies,

Kristine K Westrom; Michele J Maiers; Roni L Evans; Gert Bronfort

2010-01-01

268

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

PubMed

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

Rush, Perry O; Boone, William R

2009-01-01

269

32 CFR 732.15 - Unauthorized care.  

Code of Federal Regulations, 2010 CFR

...authorized by this part: (a) Chiropractic services. (b) Vasectomies. (c) Tubal ligations. (d) Breast augmentations or reductions. (e) Psychiatric care, beyond the initial evaluation. (f) Court ordered care....

2010-07-01

270

32 CFR 732.15 - Unauthorized care.  

Code of Federal Regulations, 2010 CFR

...authorized by this part: (a) Chiropractic services. (b) Vasectomies. (c) Tubal ligations. (d) Breast augmentations or reductions. (e) Psychiatric care, beyond the initial evaluation. (f) Court ordered care....

2009-07-01

271

Alternative Therapies for Fibromyalgia  

MedlinePLUS

... Articles Español Acupuncture Advocacy Alternative Therapies Animals Chiropractic Depression Diagnosis Disability Doctor-Patient Relationship Exercise Fibrofog Finances Goal Setting Hands-on Therapies Holidays ...

272

Fibromyalgia and Holidays/Vacations  

MedlinePLUS

... Articles Español Acupuncture Advocacy Alternative Therapies Animals Chiropractic Depression Diagnosis Disability Doctor-Patient Relationship Exercise Fibrofog Finances Goal Setting Hands-on Therapies Holidays ...

273

Exercise and Fibromyalgia  

MedlinePLUS

... Articles Español Acupuncture Advocacy Alternative Therapies Animals Chiropractic Depression Diagnosis Disability Doctor-Patient Relationship Exercise Fibrofog Finances Goal Setting Hands-on Therapies Holidays ...

274

Juvenile Fibromyalgia  

MedlinePLUS

... Articles Español Acupuncture Advocacy Alternative Therapies Animals Chiropractic Depression Diagnosis Disability Doctor-Patient Relationship Exercise Fibrofog Finances Goal Setting Hands-on Therapies Holidays ...

275

Men with Fibromyalgia  

MedlinePLUS

... Articles Español Acupuncture Advocacy Alternative Therapies Animals Chiropractic Depression Diagnosis Disability Doctor-Patient Relationship Exercise Fibrofog Finances Goal Setting Hands-on Therapies Holidays ...

276

Fibromyalgia and Pregnancy  

MedlinePLUS

... Articles Español Acupuncture Advocacy Alternative Therapies Animals Chiropractic Depression Diagnosis Disability Doctor-Patient Relationship Exercise Fibrofog Finances Goal Setting Hands-on Therapies Holidays ...

277

Primary osteoporosis revisited  

PubMed Central

Osteoporosis is a prevalent problem in industrialized society. It is suggested that attempts to limit the development of this condition should constitute a routine health promotion and disease prevention measure in chiropractic clinical care. This paper reviews contemporary trends in the minimization and control of osteopenia as a means of preventing clinically detectable osteoporosis. Modes of intervention accessible to chiropractic clinicians are emphasised.

Jamison, Jennifer R.

1987-01-01

278

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

PubMed Central

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.

Brown, Douglas M.

2007-01-01

279

How to select a chiropractor for the management of athletic conditions  

Microsoft Academic Search

BACKGROUND: Chiropractors are an integral part of the management of musculoskeletal injuries. A considerable communication gap between the chiropractic and medical professions exists. Subsequently referring allopathic practitioners lack confidence in picking a chiropractic practitioner with appropriate management strategies to adequately resolve sporting injuries. Subsequently, the question is often raised: \\

Wayne Hoskins; Henry Pollard; Peter Garbutt

2009-01-01

280

EFFECTS OF A MANUALLY ASSISTED MECHANICAL FORCE ON CUTANEOUS TEMPERATURE  

Microsoft Academic Search

Objective: Digitized infrared segmental thermometry (DIST) is a tool used for measuring cutaneous temperature (CT). This project ascertains the effect of a manually assisted mechanical force producing a chiropractic adjustment in the lumbar spine after the Activator Methods Chiropractic Technique on CT during 2 different time recording periods (TRPs). Methods: Sixty-six healthy subjects (36 women and 30 men) without acute

Richard A. Roy; Jean P. Boucher; Alain S. Comtois

281

Effects of a Manually Assisted Mechanical Force on Cutaneous Temperature  

Microsoft Academic Search

ObjectiveDigitized infrared segmental thermometry (DIST) is a tool used for measuring cutaneous temperature (CT). This project ascertains the effect of a manually assisted mechanical force producing a chiropractic adjustment in the lumbar spine after the Activator Methods Chiropractic Technique on CT during 2 different time recording periods (TRPs).

Richard A. Roy; Jean P. Boucher; Alain S. Comtois

2008-01-01

282

The Bournemouth Questionnaire: A short-form comprehensive outcome measure. I. Psychometric properties in back pain patients  

Microsoft Academic Search

Objective: Develop and test a short-form comprehensive outcome measure for back pain. Design: Prospective longitudinal study of 3 consecutive cohorts of back pain patients. Setting: Anglo-European College of Chiropractic outpatient clinic and several field chiropractic practices. Method: Domains judged important in the back pain model and responsive to clinical change were identified from the literature. Items were scored on an

Jennifer E. Bolton; Alan C. Breen

1999-01-01

283

Recruitment and accrual of women in a randomized controlled trial of spinal manipulation  

Microsoft Academic Search

Objective: To report on recruitment efforts and accrual rates for a nonmusculoskeletal chiropractic clinical trial. Design: Information regarding the method of recruitment was collected for each individual who responded to an advertisement and completed an interviewer-administered telephone screening. Setting: A suburban chiropractic teaching clinic with recruitment efforts extending throughout the larger metropolitan area. Patients: A total of 2312 women were

Jerrilyn A. Cambron

2001-01-01

284

Chiropractors and Vaccination: A Historical Perspective  

Microsoft Academic Search

Although there is overwhelming evidence to show that vaccination is a highly effective method of controlling infectious diseases, a vocal element of the chiropractic profession maintains a strongly antivaccina- tion bias. Reasons for this are examined. The basis seems to lie in early chiropractic philosophy, which, eschewing both the germ theory of infectious disease and vaccina- tion, considered disease the

James B. Campbell; Jason W. Busse; H. Stephen Injeyan

285

A Population-Based Case-Series of Ontario Patients Who Develop a Vertebrobasilar Artery Stroke After Seeing a Chiropractor  

Microsoft Academic Search

PurposeThe current evidence suggests that association between chiropractic care and vertebrobasilar artery (VBA) stroke is not causal. Rather, recent epidemiological studies suggest that it is coincidental and reflects the natural history of the disorder. Because neck pain and headaches are symptoms that commonly precede the onset of a VBA stroke, these patients might seek chiropractic care while their stroke is

Stephanie Choi; Eleanor Boyle; Pierre Côté; J. David Cassidy

2011-01-01

286

Chiropractors in Finland – a demographic survey  

Microsoft Academic Search

BACKGROUND: The Finnish chiropractic profession is young and not fully accepted by Finnish healthcare authorities. The demographic profile and style of practice has not been described to date. However, as the profession seems to be under rapid development, it would be of interest to stakeholders, both chiropractic and political, to obtain a baseline description of this profession with a view

Stefan Malmqvist; Charlotte Leboeuf-Yde

2008-01-01

287

chiropractors as folk devils: published and unpublished news coverage of a moral panic  

Microsoft Academic Search

This research provides empirical support for an existing processual model, documenting the social context, development, and growth of a moral panic surrounding stroke risk from chiropractic neck manipulation. This case highlights the importance of both published and unpublished news stories regarding the nature of claims that evolve over time and in specific stages of a moral panic. Chiropractic's status as

Yvonne Villanueva-Russell

2009-01-01

288

The use and role of sport chiropractors in the National Football League: A short report  

Microsoft Academic Search

Objective: To analyze chiropractic utilization on National Football League (NFL) medical teams and the role played by chiropractors. Design: Postal survey of head athletic trainers of the 36 teams. Survey questions were developed from responses to a questionnaire submitted to a pilot group of 30 sport chiropractors and a panel of 20 postdoctoral faculty of the sport chiropractic program of

John L. Stump; Daniel Redwood

2002-01-01

289

Towards Embracing a Complex Systems Model  

Microsoft Academic Search

The chiropractic academy should recognize the multivariable nature of the human experience. We should recognize the current scientific understanding of the interconnections between the mind, body and society. However, we should not embrace the biopsychosocial model. The biopsychosocial model, as currently applied, does not best encompass the needs of the chiropractic academy. It fails to fully meet our needs in

Margaret Smith

290

The Bournemouth Questionnaire: A short-form comprehensive outcome measure. II. Psychometric properties in neck pain patients  

Microsoft Academic Search

Objective: To modify an existing outcome measure (Bournemouth Questionnaire [BQ]) for use in patients with nonspecific neck pain and test its psychometric properties. Design: Prospective longitudinal study in which the questionnaire was administered on 3 occasions (pretreatment, retest, and posttreatment). Setting: Anglo-European College of Chiropractic outpatient clinic and 8 field chiropractic practices. Method: Seven core items relating to the biopsychosocial

Jennifer E. Bolton; B. Kim Humphreys

2002-01-01

291

Theory of small vertebral motions: an analytical model compared to data  

Microsoft Academic Search

Object. Develop an analytical theory describing the dynamics of small impulses applied to vertebrae, such as in chiropractic adjustments or spinal manipulative therapy.Design. Data were compared with damped harmonic oscillator models of vertebrae.Background. Evidence accumulates that chiropractic adjustments are effective in addressing a variety of health problems. However, the biomechanics characterizing spinal manipulation is largely unknown. Recently, relative separations of

Alan B. Solinger

2000-01-01

292

Effects of side-posture positioning and side-posture adjusting on the lumbar zygapophysial joints as evaluated by magnetic resonance imaging: A before and after study with randomization  

Microsoft Academic Search

Objective: To test the a priori hypothesis that one of the positive mechanisms of action of chiropractic side-posture manipulation (adjusting) of the lumbar spine is to separate, or gap, the zygapophysial (Z) joints. Design: Before and after study with randomization. Setting: Chiropractic college clinic and magnetic resonance imaging (MRI) facility. Participants: Sixteen healthy student volunteers (8 men and 8 women)

Gregory D. Cramer; Nathaniel R. Tuck; J. Todd Knudsen; Scott D. Fonda; Jason S. Schliesser; Jaeson T. Fournier; Pritesh Patel

2000-01-01

293

Triad of spinal pain, spinal joint dysfunction, and extremity pain in 4 pediatric cases of "Wii-itis": a 21st century pediatric condition  

PubMed Central

Objective This article describes 4 pediatric cases of overuse injuries related to playing Nintendo Wii (Nintendo, Redmond, WA). A brief discussion is also presented regarding other 21st century problems found in the literature, such as problems associated with playing the Nintendo DS portable electronic device, text messaging, and Blackberry (Research in Motion, Waterloo, Ontario) thumb. Clinical Features Four pediatric patients, ranging from 3 to 9 years old, who had injuries causally related to what has been described in the literature as “Wii-itis” (spinal pain, spinal joint dysfunction [chiropractic subluxation], and related extremity pain), presented to a chiropractic clinic. Intervention and Outcomes Each of the 4 pediatric cases was evaluated and managed using chiropractic techniques. All patients successfully had their complaints resolve with 1 chiropractic visit. Conclusion Children in the new era of portable electronic devices are presenting to chiropractic offices with a set of symptoms directly related to overuse or repetitive strain from prolonged play on these systems.

Rubin, Drew

2010-01-01

294

 

PubMed Central

Ethical concerns about informed consent encompass the legal functions of protection of patients through self-determination, but also considers other ways of respecting patients through seeking their benefit and their autonomy. The influence of traditional medicine on patient expectations, and use of consent forms often renders consent a difficult issue in the relative safety and non-invasiveness of chiropractic practice. The ethical concern with consent, however, focuses attention on patient participation in health care decisions. Chiropractic relationships are often quite conclusive to this sharing of health care decisions after education. Exceptions to informed consent are not typically relevant to chiropractic patients who are conscious, competent and not in need of emergency treatment. It is therefore important that patients are aware of non-chiropractic alternatives and very rare risks of a serious nature. Rather than an impediment, ethical concerns about consent encourage a relationship of education and shared responsibility which encourages chiropractic patients to accept responsibility for their health.

Burgess, Michael M

1990-01-01

295

Functional Outcome (Disability) Study of Patients Treated for Low Back Pain Under the Chiropractor Health Care Demonstration Project at Naval Hospital, Jacksonville.  

National Technical Information Service (NTIS)

The purpose of this Graduate Management Project is to provide a methodology to evaluate the outcome effectiveness of chiropractic treatment rendered to patients with lower back pain under the CHCDP. Using an Oswestry pain questionnaire, patient perception...

R. L. Sellers

1996-01-01

296

32 CFR 935.152 - Activities for which permit is required.  

Code of Federal Regulations, 2013 CFR

...sold for human consumption (except for personal or family use). (b) The practice of any medical profession, including dentistry, surgery, osteopathy, and chiropractic. (c) The erection of any structure or sign, including a major alteration...

2013-07-01

297

Insurance Resources for Patients  

MedlinePLUS

... in ensuring the health and safety of their employees. The ACA has developed resources to assist patients ... with management to determine who makes decisions regarding employee benefits. Resources to Educate Others about Chiropractic ACA ...

298

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

Code of Federal Regulations, 2012 CFR

...completely owned by one 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....

2012-10-01

299

16 CFR 255.4 - Endorsements by organizations.  

Code of Federal Regulations, 2010 CFR

...d) regarding the liability of endorsers.] Example: A mattress seller advertises that its product is endorsed by a chiropractic association. Because the association would be regarded as expert with respect to judging mattresses, its endorsement...

2010-01-01

300

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

Code of Federal Regulations, 2010 CFR

...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 the exclusion....

2009-10-01

301

Curriculum Vitae: Jean Rexford  

Center for Biologics Evaluation and Research (CBER)

Text Version... Commissioner, Permanent Commission on the Status of Women Consumers Union, Safe Patient Project CT Chiropractic Examining Board ... More results from www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials

302

Reactive Attachment Disorder: A Preventable Mental Health Disease  

Microsoft Academic Search

ObjectiveTo discuss attachment disorders; most specifically, Reactive Attachment Disorder, its etiology, background causes, symptoms, and its prevention with the intervention of allopathic, chiropractic, naturopathic, and osteopathic physicians.

James J. Lehman; Shereen K. Jegtvig

2004-01-01

303

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

Code of Federal Regulations, 2010 CFR

...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...

2009-10-01

304

42 CFR 60.5 - Who is an eligible student borrower?  

Code of Federal Regulations, 2010 CFR

...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...

2010-10-01

305

42 CFR 60.1 - What is the HEAL program?  

Code of Federal Regulations, 2010 CFR

...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...

2009-10-01

306

42 CFR 60.10 - How much can be borrowed?  

Code of Federal Regulations, 2010 CFR

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

2009-10-01

307

42 CFR 60.10 - How much can be borrowed?  

Code of Federal Regulations, 2010 CFR

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

2010-10-01

308

Nebraska Health Manpower Reports: Chiropractors 1978.  

National Technical Information Service (NTIS)

This statistical report of Nebraska Chiropractic Manpower was compiled from questionnaires mailed to all Chiropractors licensed by the State of Nebraska as of September 1, 1978. Such surveys and reports are produced annually for thirteen health profession...

1978-01-01

309

Chiropractor Handbook.  

National Technical Information Service (NTIS)

A chiropractor handbook is presented as supporting documentation for an evaluation of the Medicaid Management Information System of the Nebraska Department of Public Welfare (SHR-0001031). Chiropractic services are briefly examined, and discussions of the...

1975-01-01

310

Occupational hazards at the work place  

PubMed Central

Industrial accidents and injuries are prevalent amongst the industrialised world. Accident related research has long attempted to find common denominators among the human and environmental antecedents of occupational hazards. Chemical substances can adversely effect one or several of the body systems, with resulting symptoms which may not fit in a specific disease pattern. While occupational health physicians will be familiar with hazards of particular industries, general physicians or chiropractic clinicians may easily overlook industrial poisoning as a cause of symptoms because of its relative rarity. Even though awareness of chiropractic and use of chiropractic care has been increasing, there are still millions of Canadians who know little or nothing about chiropractic and are not part of its utilization profile.

Dhami, MSI; Vernon, H

1985-01-01

311

Symptom Management  

MedlinePLUS

... relieve damaging stresses. Apitherapy The therapeutic use of bee venom to help alleviate pain and various conditions. ... massage, and acupressure are then added for treatments. Bee Sting Therapy See Apitherapy Chiropractic - A technique of ...

312

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 ...

313

Interexaminer reliability of the palpation of trigger points in the trunk and lower limb muscles  

Microsoft Academic Search

Objectives: To determine the interexaminer reliability of palpation of three characteristics of trigger points (taut band, local twitch response, and referred pain) in patients with subacute low back pain, to determine whether training in palpation would improve reliability, and whether there was a difference between the physiatric and chiropractic physicians.Design: Reliability study.Setting: Whittier Health Campus. Los Angeles College of Chiropractic.Participants:

Chang-Yu J. Hsieh; Chang-Zern Hong; Alan H. Adams; Katherine J. Platt; Clark D. Danielson; Fred K. Hoehler; Jerome S. Tobis

2000-01-01

314

Thomas Henry Storey, D.O., D.C. 1843 to 1923.  

PubMed

Who was Thomas Henry Storey? Dedicated healer or charlatan? A danger to his patients or hero to the profession? He graduated from the Palmer School and Infirmary of Chiropractic in 1901. One of the largest chiropractic colleges, the Los Angeles College of Chiropractic, would be founded by one of his patients in 1910 and incorporated in 1911. He led the founder of chiropractic on his first expedition to Los Angeles. Thomas' seventy-nine year life span took him from Canada through the north central United States to the West Coast from Washington to California and south into Mexico. He was, at various times, a taxidermist, a farmer and, in later years, a rancher. He studied and practiced many types of healing and even operated a chiropractice school for a time. He invented the most ubiquitous of all chiropractic equipment, the bifid table. Whether he desired it or not, Thomas was often thrust into the spotlight, usually under less than admirable circumstances. Even in death, the remnants of his life remained a complicated morass that took sixteen years to resolve in the courts. It is hoped this article will shine some light on a colorful chiropractic pioneer who has been shrouded in a veil of mystery. PMID:11624129

Smith, B A

1999-12-01

315

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

PubMed Central

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.

Keating, Joseph C.

2008-01-01

316

Referrals to chiropractors and osteopaths: a survey of general practitioners in rural and regional New South Wales, Australia  

PubMed Central

Background Chiropractic and osteopathy form a significant part of the healthcare setting in rural and regional Australia, with national registration of practitioners, public subsidies for services and high utilisation by the Australian public. However, despite their significant role in rural and regional Australia, there has been little exploration of the interface between chiropractic and osteopathy and conventional primary health care practitioners in this area. The study aim was to examine the referral practices and factors that underlie referral to chiropractors and osteopaths by rural and regional Australian general practitioners (GPs), by drawing on a sample of GPs in rural and regional New South Wales. Methods A 27-item questionnaire was sent to all 1486 GPs currently practising in rural and regional Divisions of General Practice in New South Wales, Australia. Results A total of 585 GPs responded to the questionnaire, with 49 questionnaires returned as “no longer at this address” (response rate: 40.7%). The majority of GPs (64.1%) referred to a chiropractor or osteopath at least a few times per year while 21.7% stated that they would not refer to a chiropractor or osteopath under any circumstances. Patients asking the GP about CAM (OR=3.59; CI: 1.12, 11.55), GP’s use of CAM practitioners as a major source of information (OR=4.39; 95% CI: 2.04, 9.41), lack of other treatment options (OR=2.41; 95% CI: 1.18, 5.12), access to a wide variety of medical specialists (OR=12.5; 95% CI: 2.4, 50.0), GP’s belief in the efficacy of chiropractic and osteopathy services (OR=3.39; 95% CI: 2.19, 5.25) and experiencing positive results from patients using these services previously (OR=1.67; CI: 1.02, 2.75) were all independently predictive of increased referral to chiropractic and osteopathy services amongst the rural GPs. Conclusions There is a significant interface between chiropractic and osteopathy and Australian rural and regional general practice in New South Wales. Although there is generally high support for chiropractic and osteopathy among Australian GPs, this was not absolute and the heterogeneity of responses suggests that there remain tensions between the professions. The significant interface between chiropractic and osteopathy may be due in part to the inclusion of these professions in the publicly subsidised national healthcare delivery scheme. The significant impact of chiropractic and osteopathy and general practice in rural and regional Australian healthcare delivery should serve as an impetus for increased research into chiropractic and osteopathy practice, policy and regulation in these areas.

2013-01-01

317

Interprofessional Collaboration and Turf Wars How Prevalent Are Hidden Attitudes?*  

PubMed Central

Purpose: Interprofessional collaboration in health care is believed to enhance patient outcomes. However, where professions have overlapping scopes of practice (eg, chiropractors and physical therapists), "turf wars" can hinder effective collaboration. Deep-rooted beliefs, identified as implicit attitudes, provide a potential explanation. Even with positive explicit attitudes toward a social group, negative stereotypes may be influential. Previous studies on interprofessional attitudes have mostly used qualitative research methodologies. This study used quantitative methods to evaluate explicit and implicit attitudes of physical therapy students toward chiropractic. Methods: A paper-and-pencil instrument was developed and administered to 49 individuals (students and faculty) associated with a Canadian University master's entry-level physical therapy program after approval by the Research Ethics Board. The instrument evaluated explicit and implicit attitudes toward the chiropractic profession. Implicit attitudes were determined by comparing response times of chiropractic paired with positive versus negative descriptors. Results: Mean time to complete a word association task was significantly longer (t = 4.75, p =.00) when chiropractic was associated with positive rather than negative words. Explicit and implicit attitudes were not correlated (r = 0.13, p =.38). Conclusions: While little explicit bias existed, individuals associated with a master's entry-level physical therapy program appeared to have a significant negative implicit bias toward chiropractic

Chung, Chadwick L. R.; Manga, Jasmin; McGregor, Marion; Michailidis, Christos; Stavros, Demetrios; Woodhouse, Linda J.

2012-01-01

318

Training the Evidence-Based Practitioner  

PubMed Central

An important goal of chiropractic clinical education should be to teach specific evidence-based practice (EBP) skills to chiropractic students, interns, and doctors. Using a nominal group process, the authors produced a document similar to the Council of Chiropractic Education standards for clinical competencies that can be used to drive an EBP curriculum. Standard texts and journal articles were consulted to create the standards for this program and each standard and corresponding learning objective was discussed in detail and was then graded by the committee in terms of importance and the level of competency that should be attained. Six standards and 31 learning objectives were generated with the learning objectives being further divided into lists of specific competencies. It is the hope of these authors that by sharing this document it can serve as a comprehensive and detailed seed document for other institutions.

LeFebvre, Ronald P.; Peterson, David H.; Haas, Mitchell; Gillette, Richard G.; Novak, Charles W.; Tapper, Janet; Muench, John P.

2011-01-01

319

Historical overview and update on subluxation theories?  

PubMed Central

Objective This article presents a personal view of the historical evolution of theories of subluxation in the chiropractic profession. Discussion Two major themes emerge from this review: those related to the mechanical behavior of the spine and those related to the neurologic implications of these mechanical issues. Chiropractic subluxation theory is one of the few health-related theories whereby these mechanical and neurologic theories have been unified into a comprehensive theory of disorder of spinal function. For this disorder, doctors of chiropractic have used the term subluxation. These theories, and their unification in the “subluxation concept,” have undergone evolution in the profession's history. Conclusion The “subluxation concept” currently faces challenges, which are briefly reviewed in this article. The only way forward is to strengthen our efforts to investigate the “subluxation concept” with high-quality scientific studies including animal models and human clinical studies.

Vernon, Howard

2010-01-01

320

Adhesive capsulitis: a case report  

PubMed Central

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

Kazemi, Mohsen

2000-01-01

321

An unusual presentation and outcome of complex regional pain syndrome: a case report  

PubMed Central

A 44 year-old woman presented to a chiropractic clinic with swelling and point tenderness over the right metacarpals and right shoulder and elbow pain of insidious onset. Examination revealed right wrist and hand swelling, diminished grip strength, and reduced wrist and cervical ranges of motion. A bone scan, radiographs, and clinical examination led to the diagnosis of complex regional pain syndrome (CRPS). Following chiropractic care, the patient had improved grip strength, functional abilities, and pain reduction. The primary characteristics of CRPS include motor, trophic and sensory changes, usually in a peripheral limb following some form of trauma. Due to the varied symptom presentation, it may be unclear which conservative therapies will be most beneficial in the treatment of CRPS. A multidisciplinary approach to treatment should be pursued with these patients. More investigation of therapies such as chiropractic care as it relates to the pathophysiology of CRPS is needed.

Shearer, Heather M; Trim, Astrid

2006-01-01

322

Historical perspective. Joseph Janse.  

PubMed

The purpose of this presentation is to acknowledge the pioneering work of a key historical figure who contributed to the available knowledge in anatomy and biomechanics, developed political and social infrastructure to promote the maturation and standardization of chiropractic education, and influenced a paradigmatic shift away from a monocausal belief in the origin of disease. Literature search and archives retrieval were used. Janse was a man with personal intellectual integrity and whose personal commitment was driven by a family experience. Evidence shows that Janse took bold initiatives to influence the chiropractic profession and give it the opportunity to develop as a legitimate healthcare discipline. Janse was a visionary clinical scientist and educator whose 38-year tenure as president of a chiropractic college enabled him to influence the course and development of his profession. PMID:8553126

Phillips, R; Triano, J J

1995-11-01

323

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

PubMed Central

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.

Cooperstein, Robert

2010-01-01

324

Wallenberg's syndrome following neck manipulation.  

PubMed

We describe 4 patients ages 28 to 41 with lateral medullary infarction (Wallenberg's syndrome) following chiropractic neck manipulation. In 3 patients, angiography documented dissection of the extracranial 3rd segment of the vertebral artery near the atlantoaxial joint. The onset of neurologic symptoms following manipulation varied from immediate to 4 days. All had good recovery with minor residual deficits. Although the association between chiropractic neck manipulation and vertebral-basilar artery distribution infarction is well known, we emphasize its occurrence in young healthy individuals without commonly regarded predisposing factors. PMID:2181339

Frumkin, L R; Baloh, R W

1990-04-01

325

The Relationship Between the Spine, Cranium and TMJ  

Microsoft Academic Search

relationships between the TMJ, cervical 1 and lumbar spine 2 , as well as a relationship between the sacroiliac joint and TMJ 3 . In each case the spine had a primary role in treatment. Chiropractic literature has also discussed how cranial therapy or craniopathy is incumbent upon the balancing of spine and pelvis. 4,5 The dura mater is a

Charles L. Blum

326

Danger and safety in medicines  

Microsoft Academic Search

Convictions about established medical safety and the danger of alternative remedies and practitioners are discussed in this article. While most alternative medicines continue to be denounced as unscientific and unsafe, government reviews have concluded that chiropractic and osteopathy and (more recently) acupuncture should be registered occupations and that qualifying courses of tertiary education should be instituted in Australia. This paradoxical

Arthur ONeill

1994-01-01

327

Impact of massage therapy in the treatment of linked pathologies: Scoliosis, costovertebral dysfunction, and thoracic outlet syndrome  

Microsoft Academic Search

Summary Objectives: To investigate the efficacy of massage therapy in the concurrent treatment of three related, but discrete, disorders: scoliosis, costovertebral dysfunction, and thoracic outlet syndrome. Methods: A 34-year-old female subject reported steadily increasing pain in the right shoulder over the previous 8 months. Chiropractic diagnosis and assessment by the author's clinical supervisor had identified these three conditions. Massage therapy

Michael Hamm

2006-01-01

328

Effectiveness of spinal manipulative therapy in the treatment of mechanical thoracic spine pain: A pilot randomized clinical trial  

Microsoft Academic Search

Background: To date, no substantiated studies have been performed to investigate the efficacy of spinal manipulative therapy on thoracic spinal syndromes. Objective: To investigate the effectiveness of spinal manipulative therapy in the treatment of mechanical thoracic spine pain. Study Design: A single-blind, randomized, comparative, controlled pilot study. Setting: Technikon Natal Chiropractic Clinic in Durban, South Africa. Participants: Thirty subjects selected

Linda Schiller

2001-01-01

329

Review of Manual Therapy Techniques in Equine Practice  

Microsoft Academic Search

The realm of manual therapy includes diverse techniques such as chiropractic, osteopathy, physical therapy, massage therapy, and touch therapies, which have been developed for use in human beings and the techniques transferred to horses. All forms of manual therapy have reported levels of effectiveness for treating musculoskeletal issues in human beings, but mostly only anecdotally evidence exists in horses. The

Kevin K. Haussler

2009-01-01

330

The Comprehensive Health Assessment.  

ERIC Educational Resources Information Center

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…

Eastern Iowa Community Coll. District, Davenport.

331

Xiphodynia: A diagnostic conundrum  

PubMed Central

This paper presents 3 case reports of xiphodynia that presented to a chiropractic clinic. The paper examines aspects of xiphodynia including relevant anatomy of the xiphoid, as well as the incidence, aetiology, symptoms, diagnosis, and treatment. A brief overview of the mechanism of referred pain is presented.

Simpson, J Keith; Hawken, Erin

2007-01-01

332

A pilot randomized clinical trial on the relative effect of instrumental (MFMA) versus manual (HVLA) manipulation in the treatment of cervical spine dysfunction  

Microsoft Academic Search

Objective: To determine the relative effect of instrument-delivered thrust cervical manipulations in comparison with traditional manual-delivered thrust cervical manipulations in the treatment of cervical spine dysfunction. Design: Prospective, randomized, comparative clinical trial. Setting: Outpatient chiropractic clinic, Technikon Natal, South Africa. Patients: Thirty patients diagnosed with neck pain and restricted cervical spine range of motion without complicating pathosis for at least

Timothy G. Wood; Christopher J. Colloca; Rob Matthews

2001-01-01

333

Relationship between techniques taught and practice behavior: Education and clinical correlation  

Microsoft Academic Search

Objective: This study was undertaken to determine the relationship between the time spent teaching various manual procedures in each of two different chiropractic colleges and the actual practice of those procedures in the graduate clinical environment of the doctors involved. Methods: A simple questionnaire instrument was constructed to assess the frequency of use of 9 different manual evaluation treatment procedures.

Angela Leone

1999-01-01

334

Appropriateness of Spinal Manipulation for Low-Back Pain: Indications and Ratings by a Multidisciplinary Expert Panel.  

National Technical Information Service (NTIS)

The report presents results from one part of the RAND Appropriateness of Spinal Manipulation for Low-Back-Pain Study. The study is designed to ascertain the clinical criteria for the appropriate use of spinal manipulation for low-back pain from chiropract...

P. G. Shekelle A. H. Adams M. R. Chassin E. L. Hurwitz R. E. Park

1993-01-01

335

Appropriateness of Spinal Manipulation for Low-Back Pain: Project Overview and Literature Review.  

National Technical Information Service (NTIS)

The report presents results from one part of the RAND Appropriateness of Spinal Manipulation for Low-Back-Pain Study. The study is designed to ascertain the clinical criteria for the appropriate use of spinal manipulation for low-back pain from chiropract...

P. G. Shekelle A. H. Adams M. R. Chassin E. L. Hurwitz R. B. Phillips

1993-01-01

336

Amount of health care and self-care following a randomized clinical trial comparing flexion-distraction with exercise program for chronic low back pain  

PubMed Central

Background Previous clinical trials have assessed the percentage of participants who utilized further health care after a period of conservative care for low back pain, however no chiropractic clinical trial has determined the total amount of care during this time and any differences based on assigned treatment group. The objective of this clinical trial follow-up was to assess if there was a difference in the total number of office visits for low back pain over one year after a four week clinical trial of either a form of physical therapy (Exercise Program) or a form of chiropractic care (Flexion Distraction) for chronic low back pain. Methods In this randomized clinical trial follow up study, 195 participants were followed for one year after a four-week period of either a form of chiropractic care (FD) or a form of physical therapy (EP). Weekly structured telephone interview questions regarded visitation of various health care practitioners and the practice of self-care for low back pain. Results Participants in the physical therapy group demonstrated on average significantly more visits to any health care provider and to a general practitioner during the year after trial care (p < 0.05). No group differences were noted in the number of visits to a chiropractor or physical therapist. Self-care was initiated by nearly every participant in both groups. Conclusion During a one-year follow-up, participants previously randomized to physical therapy attended significantly more health care visits than those participants who received chiropractic care.

Cambron, Jerrilyn A; Gudavalli, M Ram; McGregor, Marion; Jedlicka, James; Keenum, Michael; Ghanayem, Alexander J; Patwardhan, Avinash G; Furner, Sylvia E

2006-01-01

337

Post-surgical care of a professional ballet dancer following calcaneal exostectomy and debridement with re-attachment of the left Achilles tendon  

Microsoft Academic Search

The extraordinary physical demands placed upon ballet dancers are only now being appreciated as comparable to that of other highly competitive athletic pursuits. The professional ballet dancer presents with an array of injuries associated with their physically vigorous performance requirements. In keeping with evidence- based practice, we describe the chiropractic care of a professional ballet dancer following surgical calcaneal exostectomy

Bradley Kobsar; Joel Alcantara

2009-01-01

338

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

PubMed

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

Brown, Douglas M

2013-09-01

339

Library denies \\  

Microsoft Academic Search

A librarian from the Multnomah County Library, in reaction to cries of censorship for not putting a book on the shelves, writes this letter to the editor in order to dispel this accusation. The librarian states that books selected for the collection must be reputable and not simply advertisements with false claims and quotes. The librarian stated that a chiropractic

Bernard Van Horne

1958-01-01

340

Effects of Gender and Age on Students' Performance in Adjustive Technique Classes  

Microsoft Academic Search

Physical manipulation in the form of spinal adjustments is the primary form of treatment offered by chiropractors. Entry requirements and teaching methods outlined by the Anglo-European College of Chiropractic (AECC) have to ensure that students are selected and trained in a way that will allow them to eventually leave the college as a group of competently skilled practitioners. If significant

Anne Rampacher; Cynthia Peterson

341

`We Have all theBases Covered'Constructions of Professional Boundaries in Sport Medicine  

Microsoft Academic Search

Three professions that figure prominently in sport medicine in Canada are athletic therapy, physiotherapy and chiropractic. These professions are characterized by blurred occupational boundaries, arising from overlap in the content of practice and differences within the professions in the skills of individual practitioners. Accordingly, they face challenges in establishing jurisdiction over professional practice. This article examines the claims made by

Nancy Theberge

2009-01-01

342

Effects of spinal manipulative therapy on autonomic activity and the cardiovascular system: A case study using the electrocardiogram and arterial tonometry  

Microsoft Academic Search

Objective: To determine if there is alteration in the autonomic nervous and cardiovascular systems after chiropractic manipulative therapy (CMT). A novel approach was used to quantitatively probe for changes in the activity of the autonomic nervous system, in blood pressure, and in pressure pulse transmission time. This approach uses the electrocardiogram and arterial tonometry equipment. Design: This case study involves

M. Darcy Driscoll; Marty J. Hall

2000-01-01

343

Bodywork Abstracts. 1989 Edition.  

ERIC Educational Resources Information Center

|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…

van Why, Richard P., Comp.

344

Referral patterns and attitudes of Primary Care Physicians towards chiropractors  

Microsoft Academic Search

BACKGROUND: Despite the increasing usage and popularity of chiropractic care, there has been limited research conducted to examine the professional relationships between conventional trained primary care physicians (PCPs) and chiropractors (DCs). The objectives of our study were to contrast the intra-professional referral patterns among PCPs with referral patterns to DCs, and to identify predictors of PCP referral to DCs. METHODS:

Barry R Greene; Monica Smith; Veerasathpurush Allareddy; Mitchell Haas

2006-01-01

345

A survey of practice patterns and the health promotion and prevention attitudes of US chiropractors, maintenance care: Part I  

Microsoft Academic Search

Objective: To investigate the primary care, health promotion activities associated with what has historically been called “maintenance care” (MC) as used in the practice of chiropractic in the United States. This includes issues such as investigating the purpose of MC, what conditions and patient populations it best serves, how frequently it is required, what therapeutic interventions constitute MC, how often

Ronald L Rupert

2000-01-01

346

Survey of US Chiropractor Attitudes and Behaviors about Subluxation  

Microsoft Academic Search

Objectives: This paper provides new information that describes chiropractors' professional identity relative to their concept of subluxation in chiropractic practice and education. Methods: We performed a pragmatic, descriptive, cross-sectional survey of state- board licensed chiropractors in the US during 2002-03 to assess their attitudes and behaviors about their use of \\

Monica Smith; Lynn A. Carber

2008-01-01

347

Chiropractors' use of X-rays  

Microsoft Academic Search

Computerized literature searches were used raphy studies were permitted in 100%, 98%, 96%, (Medline and Embase, 1966-1997) to access stud- 36% and 56% of the boards, respectively. ies of the use of X-rays within the chiropractic A survey of all members of The Netherlands profession. The bibliographies of all studies and Chiropractors' Association showed that 80% of reviews located were

E ERNST

348

Phenomenology: a resource pack for chiropractors  

Microsoft Academic Search

Chiropractic is being challenged to produce research to back up its claims of therapeutic effect. This paper presents an argument for using a qualitative approach for some of this research, namely the research methodology of phenomenology.The aim of the paper is to provide the basis for the chiropractor to embark on a research project using a phenomenological methodology. It should

Peter J Miller

2004-01-01

349

Canadian Chiropractors' Perception of Educational Preparation to Counsel Patients on Immunization  

Microsoft Academic Search

ObjectiveThis study describes the prevalence and correlates of perceptions of Canadian doctors of chiropractic regarding the adequacy of their undergraduate (UG) and postgraduate (PG) educational preparation to counsel patients about immunization\\/vaccination and explores their preferences for continuing education (CE) in this area.

H. Stephen Injeyan; Margaret L. Russell; Marja J. Verhoef; Donatus Mutasingwa

2006-01-01

350

Communication between general practitioners and chiropractors  

Microsoft Academic Search

Objective: Good communication between health care professionals has proved to be important in ensuring high standards of care. Patients have shown an increased use of complementary medicine (eg, chiropractic) in addition to conventional medicine. However, this does not automatically guarantee good cooperation and communication between complementary practitioners and conventional practitioners. The objective of this study was to assess the nature

William J. Brussee; Willem J. J. Assendelft; Alan C. Breen

2001-01-01

351

The Nordic Subpopulation Research Programme: prediction of treatment outcome in patients with low back pain treated by chiropractors - does the psychological profile matter?  

Microsoft Academic Search

BACKGROUND: It is clinically important to be able to select patients suitable for treatment and to be able to predict with some certainty the outcome for patients treated for low back pain (LBP). It is not known to what degree outcome among chiropractic patients is affected by psychological factors. OBJECTIVES: To investigate if some demographic, psychological, and clinical variables can

Charlotte Leboeuf-Yde; Annika Rosenbaum; Iben Axén; Peter W Lövgren; Kristian Jørgensen; Laszlo Halasz; Andreas Eklund; Niels Wedderkopp

2009-01-01

352

An online survey of chiropractors' opinions of continuing education  

Microsoft Academic Search

BACKGROUND: Continuing Education (CE) for chiropractors is mandatory for licensure in most North American jurisdictions. Numerous chiropractic colleges have begun collaborating with universities to offer master's degree programs. Distance education master's degree programs may be desirable to allow full-time practicing doctors to further their post-graduate education. The present survey sought to answer three questions. First, what is the level of

Kent J Stuber; Jaroslaw P Grod; Dean L Smith; Paul Powers

2005-01-01

353

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  

Microsoft Academic Search

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

David W Evans; Nadine E Foster; Martin Underwood; Steven Vogel; Alan C Breen; Tamar Pincus

2005-01-01

354

Use of conventional and alternative treatment strategies for a case of low back pain in a F\\/A-18 aviator  

Microsoft Academic Search

BACKGROUND: Low back pain can diminish jet pilot concentration and function during flight and be severe enough to ground pilots or cause decreased flying time. The objective of this case report is to present an example of the integration of chiropractic care with conventional treatments for the management of low back pain in a F\\/A-18 aviator. CASE PRESENTATION: The patient

Bart N Green; John Sims; Rachel Allen

2006-01-01

355

A Review of the Incorporation of Complementary and Alternative Medicine by Mainstream Physicians  

Microsoft Academic Search

of the surveyed physicians believed in the efficacy of acu- puncture (51%), chiropractic (53%), and massage (48%), while fewer believed in the value of homeopathy (26%) and herbal approaches (13%). Conclusions: This review suggests that large numbers of physicians are either referring to or practicing some of the more prominent and well-known forms of CAM and that many physicians believe

John A. Astin; Ariane Marie; Kenneth R. Pelletier; Erik Hansen; William L. Haskell

1998-01-01

356

Complementary and alternative medical therapies for chronic low back pain: What treatments are patients willing to try?  

Microsoft Academic Search

BACKGROUND: Although back pain is the most common reason patients use complementary and alternative medical (CAM) therapies, little is known about the willingness of primary care back pain patients to try these therapies. As part of an effort to refine recruitment strategies for clinical trials, we sought to determine if back pain patients are willing to try acupuncture, chiropractic, massage,

Karen J Sherman; Daniel C Cherkin; Maureen T Connelly; Janet Erro; Jacqueline B Savetsky; Roger B Davis; David M Eisenberg

2004-01-01

357

Interactive Atlas of Histology A Tool for Self-Directed Learning, Practice, and Self-Assessment  

Microsoft Academic Search

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

Emile Z. Goubran; Sivarama P. Vinjamury

358

In response to "The Knowledge of Our Knowledge": a reflection on McAndrews' view of epistemology.  

PubMed

This commentary considers one of the articles published in the first volume of this journal and reflects on the status of research and knowledge at that time. The chiropractic profession has witnessed advancement in the use of the scientific method in the past several decades, and scholarly journals have helped support this substantial growth. PMID:23966889

Winterstein, James

2012-07-12

359

The clinical aspects of the acute facet syndrome: results from a structured discussion among European chiropractors  

Microsoft Academic Search

BACKGROUND: The term 'acute facet syndrome' is widely used and accepted amongst chiropractors, but poorly described in the literature, as most of the present literature relates to chronic facet joint pain. Therefore, research into the degree of consensus on the subject amongst a large group of chiropractic practitioners was seen to be a useful contribution. METHODS: During the annual congress

Lise Hestbaek; Alice Kongsted; Tue Secher Jensen; Charlotte Leboeuf-Yde

2009-01-01

360

Public demand and the integration of complementary and alternative medicine in the US health care system  

Microsoft Academic Search

Public use of complementary and alternative medicine (CAM) grew 25% between 1990 and 1997 and had a number of implications for chiropractic and the US health care system. Recent surveys describe the issues surrounding definitions of CAM; patterns of CAM use and its costs; attitudes of the public, health care providers and business entities; increasing scientific research; and changes in

William C Meeker

2000-01-01

361

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

PubMed Central

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.

1973-01-01

362

A replication of the study 'Adverse effects of spinal manipulation: a systematic review'  

PubMed Central

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.

2012-01-01

363

Management of chest pain: exploring the views and experiences of chiropractors and medical practitioners in a focus group interview  

PubMed Central

Background We report on a multidisciplinary focus group project related to the appropriate care of chiropractic patients who present with chest pain. The prevalence and clinical management, both diagnosis and treatment, of musculoskeletal chest pain in ambulatory medical settings, was explored as the second dimension of the focus group project reported here. Methods This project collected observational data from a multidisciplinary focus group composed of both chiropractic and medical professionals. The goals of the focus group were to explore the attitudes and experiences of medical and chiropractic clinicians regarding their patients with chest pain who receive care from both medical and chiropractic providers, to identify important clinical or research questions that may inform the development of 'best practices' for coordinating or managing care of chest pain patients between medical and chiropractic providers, to identify important clinical or research questions regarding the diagnosis and treatment of chest pain of musculoskeletal origin, to explore various methods that might be used to answer those questions, and to discuss the feasibility of conducting or coordinating a multidisciplinary research effort along this line of inquiry. The convenience-sample of five focus group participants included two chiropractors, two medical cardiologists, and one dual-degreed chiropractor/medical physician. The focus group was audiotaped and transcripts were prepared of the focus group interaction. Content analysis of the focus group transcripts were performed to identify key themes and concepts, using categories of narratives. Results Six key themes emerged from the analysis of the focus group interaction, including issues surrounding (1) Diagnosis; (2) Treatment and prognosis; (3) Chest pain as a chronic, multifactorial, or comorbid condition; (4) Inter-professional coordination of care; (5) Best practices and standardization of care; and (6) Training and education. Conclusion This study carries implications for chiropractic clinical training relative to enhancing diagnostic competencies in chest pain, as well as the need to ascertain and improve those skills, competencies, and standards for referrals and sharing of clinical information that may improve cross-disciplinary coordination of care for chest pain patients.

Smith, Monica; Lawrence, Dana J; Rowell, Robert M

2005-01-01

364

Attitudes of non-practicing chiropractors: a pilot survey concerning factors related to attrition  

PubMed Central

Background Research into attitudes about chiropractors who are no longer engaged in active clinical practice is non-existent. Yet non-practicing chiropractors (NPCs) represent a valid sub-group worthy of study. Aim The purpose of this research was to assess attrition attitudes of NPCs about the chiropractic profession and develop a scale to assess such attitudes. Methods A 48 item survey was developed using the PsychData software. This survey included 35 Likert-style items assessing various aspects of the profession namely financial, educational, psychosocial and political. An internet discussion site where NPCs may be members was accessed for recruitment purposes. Results A total of 70 valid responses were received for analysis. A majority of respondents were male with 66% being in non-practice status for 3 to 5 years and less with 43% indicating that they had graduated since the year 2000. Most respondents were employed either in other healthcare professions and non-chiropractic education. A majority of NPCs believed that business ethics in chiropractic were questionable and that overhead expense and student loans were factors in practice success. A majority of NPCs were in associate practice at one time with many believing that associates were encouraged to prolong the care of patients and that associate salaries were not fair. Most NPCs surveyed believed that chiropractic was not a good career choice and would not recommend someone to become a chiropractor. From this survey, a 12 item scale was developed called the "chiropractor attrition attitude scale" for future research. Reliability analysis of this novel scale demonstrated a coefficient alpha of 0.90. Conclusion The low response rate indicates that findings cannot be generalized to the NPC population. This study nonetheless demonstrates that NPCs attrition attitudes can be assessed. The lack of a central database of NPCs is a challenge to future research. Appropriate investigation of attrition within the chiropractic profession would be helpful in the analysis of attitudes regarding both chiropractic education and practice. Further research is needed in this area.

2010-01-01

365

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

PubMed Central

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.

Scalena, Adam

2006-01-01

366

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

PubMed

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

Scalena, Adam

2006-09-01

367

Fluoridation referendum in La Crosse, Wisconsin: contributing factors to success.  

PubMed Central

Residents of La Crosse, Wisconsin approved a public referendum in favor of water fluoridation on April 5, 1988. The vote, 57 percent supportive, culminated a two-year community effort. Three public referenda had been defeated in the past. Contributing to the success of this recent campaign were: broad-based community support led by a 34-member Citizens for Better Dental Health in La Crosse Committee; American Dental Association/Wisconsin Division of Health/US Public Health Service consultation and support; knowledgeable and supportive press coverage; the timing of the ballot to coincide with the Wisconsin Presidential Primary; and local chiropractic support to offset chiropractic anti-fluoridation leadership. La Crosse, population 50,000, was the largest fluoride-deficient community in a nine-state upper Midwest area.

Jones, R B; Mormann, D N; Durtsche, T B

1989-01-01

368

Report to the profession  

PubMed Central

The Canadian Chiropractic Examining Board (CCEB) is now in its fortieth year of providing quality measurement and evaluation services to the chiropractic profession in Canada. Dr. James Langford and his wife Lorraine are to be acknowledged for their significant contribution in the early days of the organization. The CCEB now provides both written knowledge and clinical skills examinations. External consultants are utilized on both examinations to ensure that the examinations are of high quality and to provide guidance to the CCEB and its Board of Governors. The CCEB is committed to expert consulting, research and publication, and external accreditation. The following is a description of the current measurement and evaluation practices, future advancements to the examinations, changes in the corporate structure and governance model, and sustainability of the examination processes. Imagesp201-ap203-ap203-bp203-cp203-dp203-ep203-fp203-g

Lawson, Douglas M

2002-01-01

369

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

PubMed Central

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.

Nykoliation, Jim; Mierau, Dale

1999-01-01

370

Effective management of low back pain: it's time to accept the evidence  

PubMed Central

Low back pain is a ubiquitous and economically costly problem. Unfortunately, the clinical management of low back pain is not yet well understood. Chiropractic management of back pain, long the black sheep of back care, has undergone a transition and is now a more respected and understood alternative to conservative medical care, itself under increased scrutiny due to unsatisfactory outcomes and unacceptable iatrogenic side effects. The substantial amount of clinical and related research on the effectiveness of manipulation for low back pain is summarized here from a larger study, divided into randomized control trials, case-control trials, meta-analyses and descriptive studies. The chiropractic management of low back pain is found to be a more effective way of dealing with this medical, social and economic problem. It is suggested that greater utilization of chiropractors be encouraged such that the “right people are doing the right things at the right time”.

Manga, Pran; Angus, Douglas E; Swan, William R

1993-01-01

371

Multiple Myeloma presenting as sacroiliac joint pain: a case report  

PubMed Central

Multiple Myeloma (MM) is the most common primary cancer of bone in adults. The clinical presentation of MM is varied and depends on the sites and extent of involvement. Most importantly for chiropractors, the leading clinical symptoms of MM are related to bone neoplasm and may mimic pain of musculoskeletal origin. The following is the case of a 56 year old male chiropractic patient presenting with a 6 month history of sacroiliac joint pain previously diagnosed and managed unsuccessfully as a hematoma by multiple providers. Physical examination, imaging, and laboratory investigations confirmed a diagnosis of MM. The case report describes relevant pathophysiology, clinical presentation, imaging, and management for MM, while illustrating key issues in patient management as they relate to chiropractic practice and the recognition of pathology in the context of musculoskeletal pain.

Southerst, Danielle; Dufton, John; Stern, Paula

2012-01-01

372

Innate intelligence: its origins and problems  

PubMed Central

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.

Morgan, Lon

1998-01-01

373

Ian Douglass Coulter, PhD  

PubMed Central

This paper focuses on Dr. Ian Coulter’s accomplishments from the time he became Executive Vice-President of CMCC in 1981, until he ended his presidency with a year’s administrative leave in 1990. Annual planning initiatives, pedagogy, scholarship, conflicts, and the quest for university affiliation are discussed as well as his legacy to the College and the chiropractic profession. The term “adventurous” was first attributed to Coulter by Oswald Hall, PhD, Professor Emeritus, University of Toronto who had worked closely with Coulter in a major investigation of the chiropractic profession from 1976 to 1979. Throughout this article the author tries to capture the spirit of daring, innovation and intellect that permeated Coulter’s presidency, enthralling his advocates and confounding his detractors.

Brown, Douglas M

2004-01-01

374

News and Views: Where at a supermassive black hole do gamma-rays come from? Keep libel laws out of science  

NASA Astrophysics Data System (ADS)

Radio observations of galaxy M87 at the time of a massive gamma-ray flare have established that the gamma-ray emission arises close to the central black hole, in the inner jet. Writer Simon Singh is being sued for libel by the British Chiropractic Association because he wrote a newspaper article about the evidence for the effectiveness of spinal manipulation as a treatment for childhood illnesses. Why should scientists care about this action, asks Sue Bowler?

2009-08-01

375

Mechanical force spinal manipulation increases trunk muscle strength assessed by electromyography: A comparative clinical trial  

Microsoft Academic Search

Objective: The objective of this study was to determine whether mechanical force, manually-assisted (MFMA) spinal manipulative therapy (SMT) affects paraspinal muscle strength as assessed through use of surface electromyography (sEMG). Design: Prospective clinical trial comparing sEMG output in 1 active treatment group and 2 control groups. Setting: Outpatient chiropractic clinic, Phoenix, AZ. Subjects: Forty subjects with low back pain (LBP)

Tony S. Keller; Christopher J. Colloca

2000-01-01

376

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

PubMed Central

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.

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

2013-01-01

377

A Structural Approach to Post-Surgical Laminectomy: A Case Study  

Microsoft Academic Search

Objective: Case report of a patient, having persistent low back and leg pain following a L4-L5 surgical laminectomy, who underwent Clinical Biomechanics of Posture? (CBP?) protocol designed to correct postural distortions. Clinical features: A thirty-five year-old male suffered from low back\\/leg pain following a work injury despite having a lumbar spine laminectomy 6 months prior to chiropractic care. Radiographic analysis

Paul A. Oakley; Robert H. Berry; Deed E. Harrison

378

Legal issues in alternative health care.  

PubMed

This article reviews the use of alternative and complementary health care practices by orthodox medical practitioners. Many alternative modalities such as chiropractic, acupuncture, naturopathic, and homeopathic treatments are available, and modern patients who are increasingly "consumer-oriented" and educated may inquire about these treatments. The article examines issues of informed consent, standards, procedures, and liability as they relate to a medical practice that opts to provide alternative treatments. PMID:12122846

Freedman, Allan

2002-05-01

379

Practice characteristics of chiropractors in The Netherlands  

Microsoft Academic Search

The last published survey of practice characteristics in The Netherlands was undertaken over 10 years ago. Since then, there has been a near threefold increase in the number of registered chiropractors in The Netherlands. A postal survey of all 161 SCN-registered chiropractors in The Netherlands was undertaken to re-evaluate and update the knowledge-base regarding chiropractic practice in this part of

Natalie Imbos; Jennifer Langworthy; Francis Wilson; Gerritje Regelink

2005-01-01

380

Provision of Nutrition Counseling, Referrals to Registered Dietitians, and Sources of Nutrition Information Among Practicing Chiropractors in the United States  

Microsoft Academic Search

Objective To investigate US chiropractors’ provision of nutrition counseling and referrals to registered dietitians and sources of nutrition information. Chiropractors’ perceptions of the minimum educational requirement for registered dietitians and nutrition training received in chiropractic school were also examined.Design A descriptive study was conducted by use of a nationwide, mailed survey.Subjects\\/setting Surveys were sent to 1,590 practicing chiropractors in the

BRENT H WALKER; MILDRED K MATTFELDT-BEMAN; TERRY J TOMAZIC; MARJORIE A SAWICKI

2000-01-01

381

Intra-professional and inter-professional referral patterns of chiropractors  

Microsoft Academic Search

BACKGROUND: With the increasing popularity of chiropractic care in the United States, inter-professional relationships between conventional trained physicians (MDs and DOs) and chiropractors (DCs) will have an expanding impact on patient care. The objectives of this study are to describe the intra-professional referral patterns amongst DCs, describe the inter-professional referral patterns between DCs and conventional trained medical primary care physicians

Monica Smith; Barry R Greene; Mitchell Haas; Veerasathpurush Allareddy

2006-01-01

382

Investigating the Use of Written and Performance-Based Testing to Summarize Competence on the Case Management Component of the NBCE Part IV–National Practical Examination  

Microsoft Academic Search

Background: Large-scale performance-based examinations are logistically complex and costly to run. Scores based solely on performance-based stations require extended testing time to achieve acceptable generalizability. Purpose: Combining scores from performance-based formats and written formats may improve test generalizability. Methods: Data from 718 test-takers on the standardized patient-based portion of the National Board of Chiropractic Examiners Part IV examination were analyzed

Paul D. Townsend; Mark G. Christensen; Clarence D. Kreiter; James R. zumBrunnen

2010-01-01

383

Complementary and Alternative Medicine: What's It All About?  

Microsoft Academic Search

A number of health-related interventions—from widespread therapies such as acupuncture, herbal medicine, homeopathy and yoga, to less well-known modalities such as Feldenkrais, iridology, reflexology and reiki—have increasingly come under the general heading of complementary and alternative medicine (CAM). A few, such as biofeedback, chiropractic and physical therapy, are considered conventional by some, alternative by others. Several national surveys estimate that

Bruce Barrett

2001-01-01

384

A randomized clinical trial and subgroup analysis to compare flexion–distraction with active exercise for chronic low back pain  

Microsoft Academic Search

Many clinical trials on chiropractic management of low back pain have neglected to include specific forms of care. This study compared two well-defined treatment protocols. The objective was to compare the outcome of flexion–distraction (FD) procedures performed by chiropractors with an active trunk exercise protocol (ATEP) performed by physical therapists. A randomized clinical trial study design was used. Subjects, 18 years

Maruti Ram Gudavalli; Jerrilyn A. Cambron; Marion McGregor; James Jedlicka; Michael Keenum; Alexander J. Ghanayem; Avinash G. Patwardhan

2006-01-01

385

Nutrition and muscle protein synthesis: a descriptive review  

PubMed Central

Background Doctors of Chiropractic frequently give therapeutic exercise and nutritional advice to patients. Skeletal muscle’s role in health and disease is underappreciated. Creating synergy between protein consumption and exercise promotes protein synthesis and may impact patient outcomes. Objective To review the literature describing protein metabolism and exercise as it relates to the practice of chiropractic health care. Method The PubMed and Web of Science databases were searched using the key terms protein metabolism, protein synthesis, exercise, whey, soy, and resistance training in various combinations. Limits excluded the use of papers that were not based on human subjects, included infants or disease, or were published before 1988. Thirty papers were ultimately included for analysis. Discussion The amount, type and timing of protein consumption all play critical roles in promoting protein synthesis. The intracellular mechanism behind protein synthesis has many interrelated, interesting components. Conclusion An adaptation to exercise (protein synthesis) can be enhanced by controlling the type of protein, the amount of protein consumed and the timing of protein consumption. Doctors of Chiropractic may impact patient outcomes by using empirical evidence about protein consumption and exercise to maximize protein synthesis.

Weinert, Dan J.

2009-01-01

386

Cervical artery dissection--clinical features, risk factors, therapy and outcome in 126 patients.  

PubMed

The highly variable clinical course of cervical artery dissections still poses a major challenge to the treating physician. This study was conducted (1) to describe the differences in clinical and angiographic presentation of patients with carotid and vertebral artery dissections (CAD, VAD), (2) to define the circumstances that are related to bilateral arterial dissections, and (3) to determine factors that predict a poor outcome. Retrospectively and by standardised interview, we studied 126 patients with cervical artery dissections. Preceding traumata, vascular risk factors, presenting local and ischemic symptoms, and patient-outcome were evaluated. Patients with CAD presented more often with a partial Horner's syndrome and had a higher prevalence of fibromuscular dysplasia than patients with VAD. Patients with VAD complained more often of neck pain, more frequently reported a preceding chiropractic manipulation and had a higher incidence of bilateral dissections than patients with CAD. Bilateral VAD was significantly related to a preceding chiropractic manipulation. Multivariate analysis showed that the variables stroke and arterial occlusion were the only independent factors associated with a poor outcome. This study emphasises the potential dangers of chiropractic manipulation of the cervical spine. Probably owing to the systematic use of forceful neck-rotation to both sides, this treatment was significantly associated with bilateral VAD. Patients with dissection-related cervical artery occlusion had a significantly increased risk of suffering a disabling stroke. PMID:14586598

Dziewas, Rainer; Konrad, Carsten; Dräger, Bianca; Evers, Stefan; Besselmann, Michael; Lüdemann, Peter; Kuhlenbäumer, Gregor; Stögbauer, Florian; Ringelstein, E Bernd

2003-10-01

387

Partial lumbosacral transitional vertebrae: 2 cases of unilateral sacralization  

PubMed Central

Objective Lumbosacral transitional vertebrae (LSTV) are relatively common skeletal anomalies with a debated role in low back pain. There are few documented cases of conservative care being used to address LSTV-associated symptomatology. The current report discusses chiropractic management of 2 patients with unilateral sacralization. Clinical Features Two patients with LSTV involving unilateral sacralization of L5, a Castellvi type IIIa variant, presented with back pain to a chiropractic clinic. Each case presented with symptomatology similar to piriformis syndrome. Intervention and Outcome Manual therapy, including spinal manipulation soft tissue therapies and exercise/stretching, was used to address the presenting symptoms. Approximately 2 weeks after initial treatment, the first patient subjectively reported a 70% improvement in symptoms, with lumbar extension increased to full in active range of motion at the lumbar spine but with continued tenderness and hypertonicity at the left piriformis and gluteus medius. After 4 weeks of treatment, the second patient reported improvement in pain and perceived mobility, although prolonged standing remained an aggravating factor. Although both showed improvement, neither case resulted in complete resolution of symptoms. Conclusion The presenting cases demonstrated partial resolution of symptoms after chiropractic management. It is proposed that sacralization is a possible cause of back pain in these cases.

Muir, Jeffrey M.

2012-01-01

388

Intermittent low back pain referred from a uterine adenomyosis: a case report  

PubMed Central

Objective The purpose of this case study is to describe the clinical course and treatment of a female patient with intermittent low back pain (LBP) that was associated with a uterine adenomyosis. Clinical Features A 45-year-old woman presented for chiropractic care with intermittent LBP of 4 years' duration. History revealed concurrent dysmenorrhea, menorrhagia, and a uterine leiomyoma (fibroid). Physical and radiological examination findings were unremarkable, and the LBP was not reproducible. Intervention and Outcome Activator Methods chiropractic adjustments/manipulations were given twice per week for 4 months with moderate results. The frequency and duration of low back and pelvic pains were reduced; however, the severity remained constant. A further gynecological opinion was sought, a transvaginal ultrasound was performed, and the patient's diagnosis was changed from leiomyoma to adenomyosis. Conclusion In this case report, a woman presented with a 4-year history of intermittent LBP, which was sometimes associated with menstruation. Despite being diagnosed with uterine adenomyosis, she received some relief from chiropractic care.

Jensen, Anne M.; Bewketu, Brutawit; Sanford, Douglas

2011-01-01

389

The great subluxation debate: a centrist's perspective  

PubMed Central

Objective This commentary describes the debate and some of the associated issues involving the subluxation construct. Discussion The long-standing debate regarding the chiropractic subluxation has created substantial controversy within the profession. Currently, this phenomenon can be compared with a country with a 2-party system that has a large silent majority sitting between the 2 factions. It is argued that the position held by those in the middle (the centrists) may be the most rational view when considering all of the available evidence. It is also suggested that the subluxation construct is similar to the Santa Claus construct in that both have a factual basis as well as social utility. Ultimately, the centrists must become proactive if they want to protect the profession and further advance the evidence in regard to the subluxation. They must not only engage in the debate, but fund the research that will investigate various aspects of the subluxation and then help disseminate this evidence to fellow doctors of chiropractic, other practitioners, health care policy makers, and society at large. Conclusion The role of subluxation in chiropractic practice, the progression of this debate, and the future of the profession will be directly determined by the role that centrists choose to play.

Good, Christopher J.

2010-01-01

390

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

PubMed

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

Digiorgi, Dennis

2013-05-14

391

Interprofessional education through shadowing experiences in multi-disciplinary clinical settings  

PubMed Central

The World Health Organization has recently added Interprofessional Education (IPE) to its global health agenda recognizing it as a necessary component of all health professionals' education. We suggest mandatory interprofessional shadowing experiences as a mechanism to be used by chiropractic institutions to address this agenda. IPE initiatives of other professions (pharmacy and medicine) are described along with chiropractic. This relative comparison of professions local to our jurisdiction in Ontario, Canada is made so that the chiropractic profession may take note that they are behind other health care providers in implementing IPE. Interprofessional shadowing experiences would likely take place in a multi-disciplinary clinical setting. We offer an example of how two separate professions within a Family Health Team (FHT) can work together in such a setting to enhance both student learning and patient care. For adult learners, using interprofessional shadowing experiences with learner-derived and active objectives across diverse health professional groups may help to improve the educational experience. Mandatory interprofessional shadowing experiences for chiropractors during their training can enhance future collaborative practice and provide success in reaching a goal common to each profession - improved patient care.

2010-01-01

392

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

PubMed Central

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.

2013-01-01

393

Beyond the Didactic Classroom: Educational Models to Encourage Active Student Involvement in Learning  

PubMed Central

In a chiropractic college that utilizes a hybrid curriculum model composed of adult-based learning strategies along with traditional lecture-based course delivery, a literature search for educational delivery methods that would integrate the affective domain and the cognitive domain of learning provided some insights into the use of problem-based learning (PBL), experiential learning theory (ELT), and the emerging use of appreciative inquiry (AI) to enhance the learning experience. The purpose of this literature review is to provide a brief overview of key components of PBL, ELT, and AI in educational methodology and to discuss how these might be used within the chiropractic curriculum to supplement traditional didactic lecture courses. A growing body of literature describes the use of PBL and ELT in educational settings across many disciplines, both at the undergraduate and graduate levels. The use of appreciative inquiry as an instructional methodology presents a new area for exploration and study in the academic environment. Educational research in the chiropractic classroom incorporating ELT and appreciative inquiry might provide some valuable insights for future curriculum development.

Shreeve, Michael W.

2008-01-01

394

Could chiropractors screen for adverse drug events in the community? Survey of US chiropractors  

PubMed Central

Background The "Put Prevention into Practice" campaign of the US Public Health Service (USPHS) was launched with the dissemination of the Clinician's Handbook of Preventive Services that recommended standards of clinical care for various prevention activities, including preventive clinical strategies to reduce the risk of adverse drug events. We explored whether nonprescribing clinicians such as chiropractors may contribute to advancing drug safety initiatives by identifying potential adverse drug events in their chiropractic patients, and by bringing suspected adverse drug events to the attention of the prescribing clinicians. Methods Mail survey of US chiropractors about their detection of potential adverse drug events in their chiropractic patients. Results Over half of responding chiropractors (62%) reported having identified a suspected adverse drug event occurring in one of their chiropractic patients. The severity of suspected drug-related events detected ranged from mild to severe. Conclusions Chiropractors or other nonprescribing clinicians may be in a position to detect potential adverse drug events in the community. These detection and reporting mechanisms should be standardized and policies related to clinical case management of suspected adverse drug events occurring in their patients should be developed.

2010-01-01

395

The treatment experience of patients with low back pain during pregnancy and their chiropractors: a qualitative study  

PubMed Central

Background Chiropractors regularly treat pregnant patients for low back pain during their pregnancy. An increasing amount of literature on this topic supports this form of treatment; however the experience of the pregnant patient with low back pain and their chiropractor has not yet been explored. The objective of this study is to explore the experience of chiropractic treatment for pregnant women with low back pain, and their chiropractors. Methods This qualitative study employed semi-structured interviews of pregnant patients in their second or third trimester, with low back pain during their pregnancy, and their treating chiropractors in separate interviews. Participants consisted of 11 patients and 12 chiropractors. The interviews consisted of 10 open-ended questions for patients, and eight open-ended questions for chiropractors, asking about their treatment experience or impressions of treating pregnant patients with LBP, respectively. All interviews were audio-recorded, transcribed verbatim, and reviewed independently by the investigators to develop codes, super-codes and themes. Thematic saturation was reached after the eleventh chiropractor and ninth patient interviews. All interviews were analyzed using the qualitative analysis software N-Vivo 9. Results Five themes emerged out of the chiropractor and patient interviews. The themes consisted of Treatment and Effectiveness; Chiropractor-Patient Communication; Pregnant Patient Presentation and the Chiropractic Approach to Pregnancy Care; Safety Considerations; and Self-Care. Conclusions Chiropractors approach pregnant patients with low back pain from a patient-centered standpoint, and the pregnant patients interviewed in this study who sought chiropractic care appeared to find this approach helpful for managing their back pain symptoms.

2012-01-01

396

Recruitment and Enrollment for the Simultaneous Conduct of 2 Randomized Controlled Trials for Patients with Subacute and Chronic Low Back Pain at a CAM Research Center  

PubMed Central

Abstract Objective To describe recruitment and enrollment experiences of 2 low back pain (LBP) randomized controlled trials (RCTs). Design Descriptive report. Setting Chiropractic research center in the midwest United States that is not a fee-for-service clinic. Participants Both trials enrolled participants with subacute or chronic LBP without neurologic signs who had not received spinal manipulative care during the previous month. For study 1 we screened 1940 potential participants to enroll 192 participants (89 women and 103 men), mean age 40.0 ± 9.4 years (range, 21–54 years). For study 2 we screened 1849 potential participants to enroll 240 participants (105 women and 135 men) at least 55 years old (mean, 63.1 ± 6.7 years). Interventions Study 1 randomly assigned participants to 2 weeks of 2 different chiropractic techniques or a wait list control group. Study 2 randomly assigned participants to 6 weeks of 2 different chiropractic techniques or medical care consisting of 3 provider visits for medications. Outcome measures Recruitment source costs and yield, and baseline characteristics of enrolled versus nonparticipants were recorded. Results We conducted 3789 telephone screens for both trials to enroll 432 (11%) participants, at a cost in excess of $156,000 for recruitment efforts. The cost per call for all callers averaged $41, ranging from $4 to $300 based on recruitment method; for enrolled participants, the cost per call was $361, ranging from $33 to $750. Direct mail efforts accounted for 62% of all callers, 57% for enrolled participants, and had the second lowest cost per call for recruitment efforts. Conclusions It is important that complementary and alternative medicine (CAM) research can be successfully conducted at CAM institutions. However, the costs associated with recruitment efforts for studies conducted at CAM institutions may be higher than expected and many self-identified participants are users of the CAM therapy. Therefore, strategies for efficient recruitment methods and targeting nonusers of CAM therapies should be developed early for CAM trials.

Long, Cynthia R.; Haan, Andrea G.; Spencer, Lori Byrd; Meeker, William C.

2008-01-01

397

How to select a chiropractor for the management of athletic conditions  

PubMed Central

Background Chiropractors are an integral part of the management of musculoskeletal injuries. A considerable communication gap between the chiropractic and medical professions exists. Subsequently referring allopathic practitioners lack confidence in picking a chiropractic practitioner with appropriate management strategies to adequately resolve sporting injuries. Subsequently, the question is often raised: "how do you find a good chiropractor?". Discussion Best practice guidelines are increasingly suggesting that musculoskeletal injuries should be managed with multimodal active and passive care strategies. Broadly speaking chiropractors may be subdivided into "modern multimodal" or "classical" (unimodal) in nature. The modern multimodal practitioner is better suited to managing sporting injuries by incorporating passive and active care management strategies to address three important phases of care in the continuum of injury from the acute inflammation/pain phase to the chronic/rehabilitation phase to the injury prevention phase. In contrast, the unimodal, manipulation only and typically spine only approach of the classical practitioner seems less suited to the challenges of the injured athlete. Identifying what part of the philosophical management spectrum a chiropractor falls is important as it is clearly not easily evident in most published material such as Yellow Pages advertisements. Summary Identifying a chiropractic practitioner who uses multimodal treatment of adequate duration, who incorporates active and passive components of therapy including exercise prescription whilst using medical terminology and diagnosis without mandatory x-rays or predetermined treatment schedules or prepaid contracts of care will likely result in selection of a chiropractor with the approach and philosophy suited to appropriately managing athletic conditions. Sporting organizations and associations should consider using similar criteria as a minimum standard to allow participation in health care team selections.

Hoskins, Wayne; Pollard, Henry; Garbutt, Peter

2009-01-01

398

A review of the literature pertaining to the efficacy, safety, educational requirements, uses and usage of mechanical adjusting devices  

PubMed Central

Over the past decade, mechanical adjusting devices (MADs) were a major source of debate within the Chiropractors’ Association of Saskatchewan (CAS). Since Saskatchewan was the only jurisdiction in North America to prohibit the use of MADs, the CAS established a committee in 2001 to review the literature on MADs. The committee evaluated the literature on the efficacy, safety, and uses of moving stylus instruments within chiropractic practice, and the educational requirements for chiropractic practice. Following the rating criteria for the evaluation of evidence, as outlined in the Clinical Guidelines for Chiropractic Practice in Canada (1994), the committee reviewed 55 articles – all of which pertained to the Activator. Of the 55 articles, 13 were eliminated from the final study. Of the 42 remaining articles, 6 were rated as class 1 evidence; 11 were rated as class 2 evidence and 25 were rated as class 3 evidence. In this article – the first in a series of two – the background and the methods utilized by the MAD committee’s activities are described, as well as the results for the review of the literature on efficacy. Of the 21 articles related to efficacy, five were identified as Class 1 evidence; 4 were identified as Class 2 evidence; and 12 were identified as Class 3. Overall, the committee reached consensus that the MAD procedures using the Activator were as effective as manual (HVLA) procedures in producing clinical benefit and biological change. A minority report was also written, arguing that there was not enough evidence to support or refute the efficacy of MADs.

Taylor, Shane H; Arnold, Nicole D; Biggs, Lesley; Colloca, Christopher J; Mierau, Dale R; Symons, Bruce P; Triano, John J

2004-01-01

399

A review of the literature pertaining to the efficacy, safety, educational requirements, uses and usage of mechanical adjusting devices: Part 1 of 2.  

PubMed

Over the past decade, mechanical adjusting devices (MADs) were a major source of debate within the Chiropractors' Association of Saskatchewan (CAS). Since Saskatchewan was the only jurisdiction in North America to prohibit the use of MADs, the CAS established a committee in 2001 to review the literature on MADs. The committee evaluated the literature on the efficacy, safety, and uses of moving stylus instruments within chiropractic practice, and the educational requirements for chiropractic practice. Following the rating criteria for the evaluation of evidence, as outlined in the Clinical Guidelines for Chiropractic Practice in Canada (1994), the committee reviewed 55 articles - all of which pertained to the Activator. Of the 55 articles, 13 were eliminated from the final study. Of the 42 remaining articles, 6 were rated as class 1 evidence; 11 were rated as class 2 evidence and 25 were rated as class 3 evidence. In this article - the first in a series of two - the background and the methods utilized by the MAD committee's activities are described, as well as the results for the review of the literature on efficacy. Of the 21 articles related to efficacy, five were identified as Class 1 evidence; 4 were identified as Class 2 evidence; and 12 were identified as Class 3. Overall, the committee reached consensus that the MAD procedures using the Activator were as effective as manual (HVLA) procedures in producing clinical benefit and biological change. A minority report was also written, arguing that there was not enough evidence to support or refute the efficacy of MADs. PMID:17549220

Taylor, Shane H; Arnold, Nicole D; Biggs, Lesley; Colloca, Christopher J; Mierau, Dale R; Symons, Bruce P; Triano, John J

2004-03-01

400

Alternative methods of conservative treatment of idiopathic scoliosis.  

PubMed

Scoliosis is a deformity of the spine known since Hippocrates times. The value of certain methods of conservative treatment remains controversial. Some of them have only a psychological value both for the physician and his or her caregivers. Based on current literature and the Scoliosis Research Society Report of Alternative Methods of Treatment of Idiopathic Scoliosis, we describe the effectiveness of various alternative methods, such as exercise, Dobosiewicz technique, Karski method, SEAS 02, acupuncture, Alexander technique, aromatherapy, ayurveda, ASCO treatment, biofeedback, chiropractic, Yoga, Feldenkrais method, Pilates method, massage therapy, rolfing, magnet therapy, surface electrical stimulation, PNF, Copes system, and bracing. PMID:19920282

Zarzycka, Maja; Rozek, Karina; Zarzycki, Micha?

401

Post-surgical care of a professional ballet dancer following calcaneal exostectomy and debridement with re-attachment of the left Achilles tendon  

PubMed Central

The extraordinary physical demands placed upon ballet dancers are only now being appreciated as comparable to that of other highly competitive athletic pursuits. The professional ballet dancer presents with an array of injuries associated with their physically vigorous performance requirements. In keeping with evidence-based practice, we describe the chiropractic care of a professional ballet dancer following surgical calcaneal exostectomy and debridement with re-attachment of the left Achilles tendon. The care provided involves an array of modalities from exercise and rehabilitation to spinal manipulative therapy.

Kobsar, Bradley; Alcantara, Joel

2009-01-01

402

Business Training and Education Needs of Chiropractors  

PubMed Central

Objective: This report is an examination of the perceived need for business skills among chiropractors. Methods: An online survey was completed by 64 chiropractors. They assessed the need for business skills and current levels of business skills. Using this information, gaps in business skills are identified. Results: The need for business skills is broad, encompassing all major business functions. Existing business skills are well below needed levels. Conclusion: The chiropractic profession needs significantly greater business and practice management skills. The existing gap between needed business skills and existing skills suggests that current training and education programs are not providing adequate business skills training

Henson, Steve W; Pressley, Milton; Korfmann, Scott

2008-01-01

403

The role of alternative medicine in rhinology.  

PubMed

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

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

2012-02-01

404

Spinal palpatory diagnostic procedures utilized by practitioners of spinal manipulation: annotated bibliography of content validity and reliability studies  

PubMed Central

The diagnosis of spinal neuro-musculoskeletal dysfunction is a pre-requisite for application of spinal manual therapy. Different disciplines rely on palpatory procedures to establish this diagnosis and design treatment plans. Over the past 30 years, the osteopathic, chiropractic, physical therapy and allopathic professions have investigated the validity and reliability of spinal palpatory procedures. We explored the literature from all four disciplines looking for scientific papers studying the content validity and reliability of spinal palpatory procedures. Thirteen databases were searched for relevant papers between January 1966 and October 2001. An annotated bibliography of these articles is presented and organized by the type of test used.

Seffinger, Michael; Adams, Alan; Najm, Wadie; Dickerson, Vivian; Mishra, Shiraz I; Reinsch, Sibylle; Murphy, Linda

2003-01-01

405

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

PubMed Central

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

Rathore, Sundeep

2003-01-01

406

[Organizational and methodological approaches to the medical rehabilitation of the wounded from the consequences of combat trauma in the upper limb in rehabilitation center].  

PubMed

This article discusses the possibility of optimizing the organizational and methodological approaches to the medical rehabilitation of the wounded from the consequences of combat trauma of the upper extremities in rehabilitation center. Clearly the implementation of organizational measures and technologies optimized medical rehabilitation, restoration of function provided the injured extremity: total of 152 (64%) injuries, partial in 26 (11%) injuries, as well as the stability of long-term results. Optimization using the traditional methods of treatment (biomehanoterapiya, chiropractic, massage, acupuncture, integrated technology) has increased the effectiveness of medical rehabilitation at 35%. PMID:23156106

Beliakin, S A; Burlak, A M

2012-09-01

407

Post-surgical care of a professional ballet dancer following calcaneal exostectomy and debridement with re-attachment of the left Achilles tendon.  

PubMed

The extraordinary physical demands placed upon ballet dancers are only now being appreciated as comparable to that of other highly competitive athletic pursuits. The professional ballet dancer presents with an array of injuries associated with their physically vigorous performance requirements. In keeping with evidence-based practice, we describe the chiropractic care of a professional ballet dancer following surgical calcaneal exostectomy and debridement with re-attachment of the left Achilles tendon. The care provided involves an array of modalities from exercise and rehabilitation to spinal manipulative therapy. PMID:19421349

Kobsar, Bradley; Alcantara, Joel

2009-03-01

408

Growth Restart/Recovery Lines involving the vertebral body: a rare, incidental finding and diagnostic challenge in two patients  

PubMed Central

Objective To present the phenomenon of growth restart lines and create awareness of the possible differential diagnoses. Clinical Features Two case reports outlining the presentation of growth restart lines found in the vertebrae of trampolinists. Emphasis in each case is placed on correlating the patient history with radiographic findings. Intervention and Outcome In both cases a conservative chiropractic treatment plan was initiated once the differential diagnoses could be ruled out. Conclusion Although the range of etiologies of growth restart lines is extensive, these case reports illustrate the importance of a comprehensive case history when presented with the radiographic finding of growth restart lines.

Sajko, Sandy; Stuber, Kent; Wessely, Michelle

2011-01-01

409

Subluxation: dogma or science?  

PubMed Central

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.

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

2005-01-01

410

Vertebral artery dissections afterchiropractic neck manipulationin Germany over three years  

Microsoft Academic Search

Vertebral artery dissection\\u000a (VAD) has been observed\\u000a in association with chirotherapy of\\u000a the neck. However, most publications\\u000a describe only single case reports\\u000a or a small number of cases.\\u000a We analyzed data from neurological\\u000a departments at university hospitals\\u000a in Germany over a three year\\u000a period of time of subjects with vertebral\\u000a artery dissections associated\\u000a with chiropractic neck manipulation.\\u000a We conducted a

U. Reuter; M. Hämling; I. Kavuk; K. M. Einhäupl; E. Schielke

2006-01-01

411

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

PubMed

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

Brown, Douglas M

2009-08-01

412

 

PubMed Central

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

Kobrossi, T.; Steiman, I.

1990-01-01

413

Alternative medicines for the geriatric veterinary patient.  

PubMed

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

Kidd, J Randy

2012-07-01

414

Is health services research the Holy Grail of complementary and alternative medicine research?  

PubMed

In a 2006 article in Alternative Therapies in Health and Medicine, Herman et al argued cogently that adopting a health services research (HSR) paradigm would help resolve some of the issues that the complementary and alternative medicine (CAM) community and those researching CAM face with randomized controlled trials. Although the article makes a strong case for HSR and CAM, it fails to discuss some of the work in HSR that is uniquely relevant to CAM or to provide a critique of the view one gets from HSR about CAM. There is within the studies of chiropractic a sufficient body of HSR, which can help to assess what the contribution of HSR has been in the past and also what its limitations are today. It provides a cautionary tale for CAM. This article looks at HSR in relationship to evidence-based practice and will discuss the limitations and dangers of the view of CAM from the perspective of HSR using chiropractic studies as an exemplar. PMID:18616068

Coulter, Ian D; Khorsan, Raheleh

415

The organisation of the stress response, and its relevance to chiropractors: a commentary  

PubMed Central

The stress response is a natural reaction by the body, against potentially harmful stimuli to enhance the chance for survival. Persistent activation of the stress response can cause changes to homeostatic mechanisms. The study of stress neurophysiology, in the evaluation of the manifestation of disease in the body, suggests that these chronic changes have detrimental effects on sub cortical structures. Furthermore, there is much scientific support for the notion that chronic activation of supraspinal systems will lead to maladaptation of homeostatic mechanisms, causing the impairment of processes within the body, and ultimately leading to visceral disorders. The chiropractic profession for many years has alluded to chronic change of neurophysiological pathways as a potential explanation of visceral disorders, but the profession has typically described these in terms of somatovisceral or viscerosomatic reflex activity. Change in supraspinal neurophysiological efferent activity is increasingly being used to explain "stress" related disease. The chiropractic profession should consider investigating such stress responses by conducting spinal manipulative therapy trials that evaluate supraspinal effects of manipulation. Such research may help elucidate key mechanisms associated with the change of visceral disorders noted by some chiropractors following manipulative therapy.

Hardy, Katie; Pollard, Henry

2006-01-01

416

A multi-modal treatment approach for the shoulder: A 4 patient case series  

PubMed Central

Background This paper describes the clinical management of four cases of shoulder impingement syndrome using a conservative multimodal treatment approach. Clinical Features Four patients presented to a chiropractic clinic with chronic shoulder pain, tenderness in the shoulder region and a limited range of motion with pain and catching. After physical and orthopaedic examination a clinical diagnosis of shoulder impingement syndrome was reached. The four patients were admitted to a multi-modal treatment protocol including soft tissue therapy (ischaemic pressure and cross-friction massage), 7 minutes of phonophoresis (driving of medication into tissue with ultrasound) with 1% cortisone cream, diversified spinal and peripheral joint manipulation and rotator cuff and shoulder girdle muscle exercises. The outcome measures for the study were subjective/objective visual analogue pain scales (VAS), range of motion (goniometer) and return to normal daily, work and sporting activities. All four subjects at the end of the treatment protocol were symptom free with all outcome measures being normal. At 1 month follow up all patients continued to be symptom free with full range of motion and complete return to normal daily activities. Conclusion This case series demonstrates the potential benefit of a multimodal chiropractic protocol in resolving symptoms associated with a suspected clinical diagnosis of shoulder impingement syndrome.

Pribicevic, Mario; Pollard, Henry

2005-01-01

417

Manipulation under anesthesia for patients with failed back surgery: retrospective report of 3 cases with 1-year follow-up  

PubMed Central

Objective This report describes the treatment of 3 patients with previous spinal fusion surgery who had subsequently regressed to their previous levels of pain and disability. Clinical Features Three patients with chronic intractable pain presented to a private integrative medicine clinic for manipulation under anesthesia (MUA) evaluation. All 3 patients had previously had lumbar spine fusion surgery for intervertebral disk herniation. All surgeries were performed at least 2 years before clinical presentation. Patients had plateaued with other conservative pain management strategies before seeking MUA treatment. Intervention and Outcomes The patients were evaluated for MUA. The patients received a serial MUA over 3 consecutive days by trained chiropractic and osteopathic physicians. Outcome assessments used for each patient included a quadruple numerical pain rating scale and functional rating index. Patients completed a course of post-MUA physiotherapy and rehabilitation lasting 8 weeks immediately after the serial MUA. Clinical improvements were observed in all 3 outcome assessments after the MUA, the post-MUA therapy, and were essentially maintained 1 year after conclusion of treatment. Conclusion Three patients with failed back surgery were treated conservatively using MUA by trained chiropractic and osteopathic physicians followed by 8 weeks of post-MUA therapy. Pain and disability outcomes all improved immediately following treatment.

Morningstar, Mark W.; Strauchman, Megan N.

2012-01-01

418

Conducting practice-based projects among chiropractors: a manual  

PubMed Central

Introduction Practice-based research is a challenge as clinicians are busy with their patients and any participation in research activities will be secondary to the needs of the patients and the clinic. As a result, it is difficult to obtain high compliance among clinicians. A method to enhance compliance in multicentre practice-based research has been developed and refined for use in the chiropractic setting and possibly also by other researchers in different settings. Method This manual provides a stringent step-by-step approach for conducting clinic-based research. It describes the competencies and requirements of an effective working group, how to recruit participating clinicians and how to empower, encourage and support these clinicians to obtain good compliance. Discussion The main advantage of the method is the high compliance of participating clinicians compared to many other clinical studies. Difficulties with the method are described and suggestions for solutions are presented. Conclusions This manual is a description of a method that may be of use for clinical researchers in the chiropractic setting.

2013-01-01

419

Abdominal and back pain in a 65-year-old patient with metastatic prostate cancer  

PubMed Central

Objective Prostate cancer remains the second leading cause of cancer-related deaths, and African American men are affected with this disease disproportionately in terms of incidence and mortality. The purpose of this article is to present a case report that illustrates the importance of a careful evaluation, including a comprehensive historical review and appropriate physical and laboratory assessment, of a patient with back pain and seemingly unrelated symptoms. Clinical Features A 65-year-old African American man presented to a chiropractic clinic after experiencing lower back pain for 1 month. The digital rectal examination was unremarkable, but the serum prostate-specific antigen was markedly elevated. A suspicion of metastatic prostate cancer resulted in subsequent referral, further diagnostic evaluation, and palliation. Intervention and Outcome The patient was referred for medical evaluation and palliation of his condition. Spinal decompression surgery of the thoracic spine was initiated, resulting in weakness and paresthesia in the lower limbs bilaterally. The patient died because of the complications associated with the medical interventions and the disease about 12 months after the referral. Conclusion Chiropractic physicians should maintain a high degree of suspicion for catastrophic causes of back-related complaints, such as metastatic prostate cancer. The Prostate Cancer Prevention Trial Risk Calculator, a research validated instrument, should be used in the assessment of prostate cancer risk. Performance of the digital rectal examination and of the prostate-specific antigen determination remains integral in the clinical assessment of the health status in aging men, with or without back pain.

Johnson, Theodore L.

2010-01-01

420

Effect of Implementing Instructional Videos in a Physical Examination Course  

PubMed Central

Objective: This study examined the effect of implementing instructional video in ophthalmic physical examination teaching on chiropractic students' laboratory physical examination skills and written test results. Methods: Instructional video clips of ophthalmic physical examination, consisting of both standard procedures and common mistakes, were created and used for laboratory teaching. The video clips were also available for student review after class. Students' laboratory skills and written test results were analyzed and compared using one-way analysis of variance (ANOVA) and post hoc multiple comparison tests among three study cohorts: the comparison cohort who did not utilize the instructional videos as a tool, the standard video cohort who viewed only the standard procedure of video clips, and the mistake-referenced video cohort who viewed video clips containing both standard procedure and common mistakes. Results: One-way ANOVA suggested a significant difference of lab results among the three cohorts. Post hoc multiple comparisons further revealed that the mean scores of both video cohorts were significantly higher than that of the comparison cohort (p < .001). There was, however, no significant difference of the mean scores between the two video cohorts (p > .05). However, the percentage of students having a perfect score was the highest in the mistake-referenced video cohort. There was no significant difference of written test scores among all three cohorts (p > .05). Conclusion: The instructional video of the standard procedure improves chiropractic students' ophthalmic physical examination skills, which may be further enhanced by implementing a mistake-referenced instructional video

Zhang, Niu; Chawla, Sudeep

2012-01-01

421

Ultrasound as a treatment of mammary blocked duct among 25 postpartum lactating women: a retrospective case series  

PubMed Central

Objective The purpose of this case series is to report the outcomes of 25 postpartum women who were experiencing difficulties with breastfeeding and were treated using therapeutic ultrasound. Methods Case files of postpartum women who presented to a chiropractic clinic between 2005 and 2011 with difficulties with breastfeeding due to blocked ducts were identified. Results Twenty-five cases were retrospectively identified of women who presented with a breast lump that was consistent with a blocked duct. Eight women experienced recurrent blocked ducts (5 had multiple episodes while nursing the same child; 3 women experienced episodes with more than 1 child). Patients had been treated with therapeutic ultrasound, receiving between 1 and 7 treatments (average, 3.3) to experience improvement in their presenting symptoms. A majority of the patients reported improvements in breastfeeding and symptoms after treatment. No adverse reactions were identified in the patient records. Conclusion For women reported in this case series, chiropractic management including ultrasound therapy was a beneficial treatment for women presenting with blocked ducts and difficulties breastfeeding.

Lavigne, Valerie; Gleberzon, Brian J.

2012-01-01

422

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

PubMed Central

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.

Horseman, Ian; Morningstar, Mark W.

2008-01-01

423

CEREBROSPINAL FLUID STASIS AND ITS CLINICAL SIGNIFICANCE  

PubMed Central

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.

Whedon, James M.; Glassey, Donald

2010-01-01

424

Applied kinesiology methods for a 10-year-old child with headaches, neck pain, asthma, and reading disabilities  

PubMed Central

Objective The purpose of this case report is to describe the chiropractic care of a 10-year-old boy who presented with developmental delay syndromes, asthma, and chronic neck and head pain and to present an overview of his muscular imbalances during manual muscle testing evaluation that guided the interventions offered to this child. Clinical Features The child was a poor reader, suffered eye strain while reading, had poor memory for classroom material, and was unable to move easily from one line of text to another during reading. He was using 4 medications for the asthma but was still symptomatic during exercise. Intervention and Outcome Chiropractic care, using applied kinesiology, guided evaluation, and treatment. Following spinal and cranial treatment, the patient showed improvement in his reading ability, head and neck pain, and respiratory distress. His ability to read improved (in 3 weeks, after 5 treatments), performing at his own grade level. He has remained symptom free for 2 years. Conclusion The care provided to this patient seemed to help resolve his chronic musculoskeletal dysfunction and pain and improve his academic performance.

Cuthbert, Scott; Rosner, Anthony

2010-01-01

425

Combination of acupuncture and spinal manipulative therapy: management of a 32-year-old patient with chronic tension-type headache and migraine  

PubMed Central

Objective The purpose of this case study is to describe the treatment using acupuncture and spinal manipulation for a patient with a chronic tension-type headache and episodic migraines. Clinical Features A 32-year-old woman presented with headaches of 5 months' duration. She had a history of episodic migraine that began in her teens and had been controlled with medication. She had stopped taking the prescription medications because of gastrointestinal symptoms. A neurologist diagnosed her with mixed headaches, some migrainous and some tension type. Her headaches were chronic, were daily, and fit the International Classification of Headache Disorders criteria of a chronic tension-type headache superimposed with migraine. Intervention and Outcome After 5 treatments over a 2-week period (the first using acupuncture only, the next 3 using acupuncture and chiropractic spinal manipulative therapy), her headaches resolved. The patient had no recurrences of headaches in her 1-year follow-up. Conclusion The combination of acupuncture with chiropractic spinal manipulative therapy was a reasonable alternative in treating this patient's chronic tension-type headaches superimposed with migraine.

Ohlsen, Bahia A.

2012-01-01

426

Pregnancy-related symphysis pubis dysfunction management and postpartum rehabilitation: two case reports  

PubMed Central

Objective Two case reports review the chiropractic treatment and rehabilitation management of Symphysis Pubis Dysfunction (SPD). Clinical features Patient 1: a 35-year-old female presented at 30 weeks pregnant with severe left sided Symphysis Pubis Dysfunction and low back pain. Patient 2: a 33-year-old female also 30 weeks pregnant, presented with right sided Symphysis Pubis Dysfunction and sacroiliac pain. Intervention and Outcome Treatment included soft tissue therapy, pregnancy support belt, side-lying mobilizations, pelvic blocks and instrument-assisted pubic symphysis adjustments. Home advice included: ice, staying active, moving as a unit, stretching, use of a pillow between the knees while sleeping, regular breaks from sitting and pelvic floor (Kegel) exercises. Both patients reported some relief with treatment and home care. Post-partum, rehabilitation exercises were prescribed to restore muscular endurance, control and pelvic stability. On long-term follow-up patient 1 reported no pubic symphysis pain, but some low back pain secondary to a subsequent knee injury. Patient 2 reported being mostly pain free with a rare re-exacerbation of pubic symphysis pain. Summary Conservative chiropractic management appears to reduce pain and improve mobility and function for SPD. Post partum rehabilitation of the associated lumbo-pelvic musculature with specific stabilization exercises is recommended to reduce pain, improve long term outcomes and prevent chronicity.

Howell, Emily R.

2012-01-01

427

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

PubMed Central

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

Ramelli, Frank D.

2003-01-01

428

The Nordic Maintenance Care Program: when do chiropractors recommend secondary and tertiary preventive care for low back pain?  

PubMed Central

Background Among chiropractors the use of long-term treatment is common, often referred to as "maintenance care". Although no generally accepted definition exists, the term has a self-explanatory meaning to chiropractic clinicians. In public health terms, maintenance care can be considered as both secondary and tertiary preventive care. The objective of this study was to explore what factors chiropractors consider before recommending maintenance care to patients with low back pain (LBP). Method Structured focus group discussions with Swedish chiropractors were used to discuss pre-defined cases. A questionnaire was then designed on the basis of the information obtained. In the questionnaire, respondents were asked to grade the importance of several factors when considering recommending maintenance care to a patient. The grading was done on a straight line ranging from "Very important" to "Not at all important". All members of the Swedish Chiropractors' Association (SCA) were invited to participate in the discussions and in the questionnaire survey. Results Thirty-six (22%) of SCA members participated in the group discussions and 129 (77%) returned the questionnaires. Ninety-eight percent of the questionnaire respondents claimed to believe that chiropractic care can prevent future relapses of back pain. According to the group discussions tertiary preventive care would be considered appropriate when a patient improves by 75% or more. According to the results of the questionnaire survey, two factors were considered as "very important" by more than 70% of the respondents in recommending secondary preventive care, namely frequency past year and frequency past 10 years of the low back pain problem. Eight other factors were considered "very important" by 50–69% of the respondents, namely duration (over the past year and of the present attack), treatment (effect and durability), lifestyle, work conditions, and psychosocial factors (including attitude). Conclusion The vast majority of our respondents believe that chiropractic treatment can prevent relapses of back pain. When recommending secondary preventive care, past frequency of the problem is considered. For tertiary preventive care, the patient needs to improve considerably before a recommendation of maintenance care is made.

Axen, Iben; Jensen, Irene B; Eklund, Andreas; Halasz, Laszlo; J?rgensen, Kristian; Lange, Fredrik; Lovgren, Peter W; Rosenbaum, Annika; Leboeuf-Yde, Charlotte

2009-01-01

429

Survey based investigation into general practitioner referral patterns for spinal manipulative therapy.  

PubMed

BACKGROUND: In the UK Physiotherapy, Chiropractic and Osteopathy are all statutory regulated professions. Though guidelines have supported the use of Spinal Manipulative Therapy (SMT) for low back pain (LBP), General Practitioners (GP) referral patterns to the 3 registered professions that perform SMT are generally unknown. METHOD: A short questionnaire was designed and piloted. Demographic information, patient referral to SMT and the GPs own personal utilisation of SMT were obtained. 385 GP's were contacted representing approximately 20% of the GP's in Wales Autumn 2007. RESULTS AND DISCUSSION: 182 (50.8%) completed questionnaires were returned.Profile characteristics: 2/3 of respondents were male, 79% were 40 years old or older (statistically reflective of the total population of GPs in Wales at that time) and 62% had 20 years or less in practise. Personal use of SMT by GP's: 48 respondents had sought SMT treatment and a further 56% of those that had not previously sought SMT indicated that they would consider doing so. Patient referral to SMT by GP's: 131 respondents (72%) had referred patients to SMT and of those who had not a further 13% would consider referring. The general referral pattern and utilisation pattern was Physiotherapy: Osteopathy: Chiropractic. 21% who had never referred patients neither had, nor would consider it for themselves. A small subgroup appeared to manage personal choice differently from patient referral: 5 individuals who had not referred patients either had or would consider it for themselves and 23 of the group that would refer patients neither had nor would seek it for themselves. CONCLUSIONS: This limited investigation indicates that GP's do practise consistently with guidelines on back pain and utilise SMT as a care option. Although the main option for referral was physiotherapy, slightly over 40% of respondents who expressed a preference would refer to either osteopathy or chiropractic, or both in preference to physiotherapy. There was a small proportion that did not and would not refer patients for SMT regardless of personal use of SMT; these suggested use of acupuncture. Further investigation is needed to determine the alternatives to SMT offered to patients and the decision-making criteria for patient referral to subtypes of SMT practitioner. PMID:23718217

Kier, Annabel; George, Matthew; McCarthy, Peter W

2013-05-29

430

Survey based investigation into general practitioner referral patterns for spinal manipulative therapy  

PubMed Central

Background In the UK Physiotherapy, Chiropractic and Osteopathy are all statutory regulated professions. Though guidelines have supported the use of Spinal Manipulative Therapy (SMT) for low back pain (LBP), General Practitioners (GP) referral patterns to the 3 registered professions that perform SMT are generally unknown. Method A short questionnaire was designed and piloted. Demographic information, patient referral to SMT and the GPs own personal utilisation of SMT were obtained. 385 GP’s were contacted representing approximately 20% of the GP’s in Wales Autumn 2007. Results and discussion 182 (50.8%) completed questionnaires were returned. Profile characteristics: 2/3 of respondents were male, 79% were 40 years old or older (statistically reflective of the total population of GPs in Wales at that time) and 62% had 20 years or less in practise. Personal use of SMT by GP’s: 48 respondents had sought SMT treatment and a further 56% of those that had not previously sought SMT indicated that they would consider doing so. Patient referral to SMT by GP’s: 131 respondents (72%) had referred patients to SMT and of those who had not a further 13% would consider referring. The general referral pattern and utilisation pattern was Physiotherapy: Osteopathy: Chiropractic. 21% who had never referred patients neither had, nor would consider it for themselves. A small subgroup appeared to manage personal choice differently from patient referral: 5 individuals who had not referred patients either had or would consider it for themselves and 23 of the group that would refer patients neither had nor would seek it for themselves. Conclusions This limited investigation indicates that GP’s do practise consistently with guidelines on back pain and utilise SMT as a care option. Although the main option for referral was physiotherapy, slightly over 40% of respondents who expressed a preference would refer to either osteopathy or chiropractic, or both in preference to physiotherapy. There was a small proportion that did not and would not refer patients for SMT regardless of personal use of SMT; these suggested use of acupuncture. Further investigation is needed to determine the alternatives to SMT offered to patients and the decision-making criteria for patient referral to subtypes of SMT practitioner.

2013-01-01

431

A review of the literature pertaining to the efficacy, safety, educational requirements, uses and usage of mechanical adjusting devices  

PubMed Central

Over the past decade, mechanical adjusting devices (MADs) were a major source of debate within the Chiropractors’ Association of Saskatchewan (CAS). Since Saskatchewan was the only jurisdiction in North America to prohibit the use of MADs, the CAS established a committee in 2001 to review the literature on MADs. The committee evaluated the literature on the efficacy, safety, and uses of moving stylus instruments within chiropractic practice, and the educational requirements for chiropractic practice. Following the rating criteria for the evaluation of evidence, as outlined in the Clinical Guidelines for Chiropractic Practice in Canada (1994), the committee reviewed 55 articles – all of which pertained to the Activator. Of the 55 articles, 13 were eliminated from the final study. Of the 42 remaining articles, 6 were rated as class 1 evidence; 11 were rated as class 2 evidence and 25 were rated as class 3 evidence. In this article – the second in a series of two – we review the results of uses and usage, safety and educational requirements. Of the 30 articles designated under the category of usage, 3 were rated as Class 1 evidence; 9 studies were classified as Class 2 evidence and 18 were rated as Class 3 evidence. Overall the committee reached consensus that in clinical practice, there is broad application of these procedures. A minority report was written arguing that the reviewer was unable to reach a conclusion about the use of the Activator Instrument other than it is used as a clinical and research tool. Of the 16 studies that dealt either explicitly or implicitly with safety, 4 were Class 1 evidence; 3 were Class 2 evidence and 9 were Class 3 evidence. Overall the committee reached consensus that the evidence supports that the Activator instrument is safe and has no more relative risk than do manual HVLA procedures. A minority report was written arguing that there is no evidence either to support or refute the view that MAD is safe. Of the 5 studies that dealt with educational requirements, all were Class 3 evidence. Overall the committee reached consensus that there was no evidence in the literature with respect to educational requirements to form any conclusions. A minority report was written offering opinion that there is evidence with respect to educational requirements.

Taylor, Shane H; Arnold, Nicole D; Biggs, Lesley; Colloca, Christopher J; Mierau, Dale R; Symons, Bruce P; Triano, John J

2004-01-01

432

A review of the literature pertaining to the efficacy, safety, educational requirements, uses and usage of mechanical adjusting devices: Part 2 of 2.  

PubMed

Over the past decade, mechanical adjusting devices (MADs) were a major source of debate within the Chiropractors' Association of Saskatchewan (CAS). Since Saskatchewan was the only jurisdiction in North America to prohibit the use of MADs, the CAS established a committee in 2001 to review the literature on MADs. The committee evaluated the literature on the efficacy, safety, and uses of moving stylus instruments within chiropractic practice, and the educational requirements for chiropractic practice. Following the rating criteria for the evaluation of evidence, as outlined in the Clinical Guidelines for Chiropractic Practice in Canada (1994), the committee reviewed 55 articles - all of which pertained to the Activator. Of the 55 articles, 13 were eliminated from the final study. Of the 42 remaining articles, 6 were rated as class 1 evidence; 11 were rated as class 2 evidence and 25 were rated as class 3 evidence. In this article - the second in a series of two - we review the results of uses and usage, safety and educational requirements. Of the 30 articles designated under the category of usage, 3 were rated as Class 1 evidence; 9 studies were classified as Class 2 evidence and 18 were rated as Class 3 evidence. Overall the committee reached consensus that in clinical practice, there is broad application of these procedures. A minority report was written arguing that the reviewer was unable to reach a conclusion about the use of the Activator Instrument other than it is used as a clinical and research tool. Of the 16 studies that dealt either explicitly or implicitly with safety, 4 were Class 1 evidence; 3 were Class 2 evidence and 9 were Class 3 evidence. Overall the committee reached consensus that the evidence supports that the Activator instrument is safe and has no more relative risk than do manual HVLA procedures. A minority report was written arguing that there is no evidence either to support or refute the view that MAD is safe. Of the 5 studies that dealt with educational requirements, all were Class 3 evidence. Overall the committee reached consensus that there was no evidence in the literature with respect to educational requirements to form any conclusions. A minority report was written offering opinion that there is evidence with respect to educational requirements. PMID:17549227

Taylor, Shane H; Arnold, Nicole D; Biggs, Lesley; Colloca, Christopher J; Mierau, Dale R; Symons, Bruce P; Triano, John J

2004-06-01

433

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

PubMed Central

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.

2010-01-01

434

A case of pseudo-angina pectoris from a pectoralis minor trigger point caused by cross-country skiing  

PubMed Central

Objective The aim of this article is to illustrate the pectoralis minor muscle as a possible pain source in patients with anterior chest pain, especially those who are known to be beginner cross-country skiers. Clinical Features A 58-year-old man presented with anterior chest pain and normal cardiac examination findings. Upon history taking and physical examination, the chest pain was determined to be caused by active trigger points in the pectoralis minor muscle. Intervention and Outcome The patient was treated with Graston Technique and cross-country skiing technique advice. The subject's symptoms improved significantly after 2 treatments and completely resolved after 4 treatments. Conclusion This case demonstrates the importance of differential diagnosis and mechanism of injury in regard to chest pain and that chiropractic management can be successful when addressing patients with chest wall pain of musculoskeletal origin.

Lawson, Gordon E.; Hung, Laurie Y.; Ko, Gordon D.; Laframboise, Michelle A.

2011-01-01

435

Effectiveness of CAM therapy: understanding the evidence.  

PubMed

By definition, complementary and alternative medicine (CAM) attempts to diagnose and treat illnesses in unconventional ways. CAM has been classified as: (1) alternative medical systems (eg, traditional Chinese medicine [including acupuncture], naturopathic medicine, ayurvedic medicine, and homeopathy); (2) biologic-based therapies (eg, herbal, special dietary, and individual biologic treatments); (3) energy therapies (eg, Reiki, therapeutic touch, magnet therapy, Qi Gong, and intercessory prayer); (4) manipulative and body-based systems (eg, chiropractic, osteopathy, and massage); and (5) mind-body interventions (eg, meditation, biofeedback, hypnotherapy, and the relaxation response). This review focuses on how to assess the effectiveness of CAM therapies for chronic musculoskeletal pains, emphasizing the role of specific and nonspecific analgesic mechanisms, including placebo. PMID:21220082

Staud, Roland

2010-12-03

436

Advancing Integration Through Evidence Informed Practice: Northwestern Health Sciences University's Integrated Educational Model  

PubMed Central

A consistent theme running through the healthcare debate is the need for new care models that include collaborative, team-based care. There is also growing recognition that interprofessional education is critical to achieving collaborative, patient-centered care. Not unlike conventional, biomedical professions, CAM (complementary and alternative medicine) professions have also educated students in silos with little interaction between various disciplines. Northwestern Health Sciences University, under their NIH NCCAM-funded R-25 grant, is breaking new ground in requiring that their students in chiropractic, massage, and OAM complete a common course in evidence informed practice. A previous Explore column described the core competencies that the students are required to achieve. This column focuses on the practicalities and challenges of offering a course to students enrolled in three different degree programs. Perhaps it will stimulate readers to consider how we might achieve interprofessional education that brings together all health professional students, biomedical and CAM.

Taylor, Barry; Delagran, Louise; Baldwin, Lori; Hanson, Linda; Leininger, Brent; Vihstadt, Corrie; Evans, Roni; Jo Kreitzer, Mary; Sierpina, Victor

2012-01-01

437

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

PubMed Central

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

Knutson, Gary A; Owens, Edward F

2003-01-01

438

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

PubMed Central

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.

Knutson, Gary A.; Owens, Edward F.

2003-01-01

439

Manual therapy and ear pain: a report of four cases  

PubMed Central

Purpose: To report and discuss four cases of ear pain which were treated successfully with manual therapy. Methods: Report of four cases. Results: Four patients with ear pain were referred for chiropractic consult. They were all treated with a combination of manual therapy and exercise with resolution of their ear symptoms. Conclusions: The mechanism of idiopathic ear pain that may be amenable to manual therapy is not fully known. Further research is needed to investigate the etiology of this disorder and to determine whether manual therapy and exercise are viable options in some patients with idiopathic ear pain. In the meantime, it may be advantageous for otolaryngologists to seek input from physicians skilled in assessment and treatment of the musculoskeletal system in cases ear pain for which an otolarygologic etiology cannot be found.

Murphy, Donald R.; Gay, Charles W.

2011-01-01

440

Rhabdomyolysis: a case study exploring the possible side effect of lipid lowering medication by a HIV positive patient taking a protease inhibitor  

PubMed Central

This case study explores the incidence of rhabdomyolysis in a HIV positive patient that was taking a lipid lowering drug and a protease inhibitor concurrently while under chiropractic treatment for generalized muscular soreness. Dyslipidemia is a very common problem both in the general and HIV population, with many patients being prescribed lipid lowering drugs. While extremely rare, adverse effects of lipid lowering drugs have been documented to include myopathy such as rhabdomyolysis. It is imperative that chiropractors are aware of the possible adverse side effect of lipid lowering drug therapy in their patients complaining of musculoskeletal pain. It is even more important that chiropractors treating the HIV population are aware of the potential interactions between these medications and protease inhibitors to cause myopathy.

De Carvalho, Diana; Citro, Mark; Tibbles, Anthony

2008-01-01

441

Parkinson's disease without tremor masquerading as mechanical back pain; a case report  

PubMed Central

The clinical features of a 67-year-old female suffering recurrent low back pain (LBP) who developed Parkinson’s disease (PD) are presented. PD is a progressive, age-specific neuro-degenerative disorder characterized by a combination of bradykinesia (slowness of movement), rest tremor (initially unilaterally and usually of the hands), rigidity or stiffness of the arms, legs or neck, and/or postural instability. Other non-motor and cognitive symptoms may accompany these features. Tremor, at rest, is usually the earliest and most prominent cardinal symptom of PD, but is absent in approximately 30% of patients. Considering mechanical back pain commonly presents with slowed movement and gait disturbance due to pain avoidance behavior, and considering Canada’s population is aging and living longer will inevitably cause the number of Parkinson’s patients to increase, it is important for chiropractic doctors to maintain an awareness of the condition to facilitate its early referral, diagnosis and management.

Burton, Robert R.