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Sample records for chiropractic

  1. History of Chiropractic Care

    MedlinePlus

    ... Public Policies Committees American Chiropractic Foundation Origins and History of Chiropractic Care The word ‘Chiropractic’ comes from ... field was therefore the codification of the philosophy, art and science of chiropractic which was based on ...

  2. Chiropractic Handbook.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of the Professions.

    The laws, rules and regulations of the State Education Department governing chiropractic practice in New York State are provided in this handbook. Requirements and procedures are also highlighted, and the forms for obtaining a license and first registration as a chiropractor are provided. The booklet is divided into the following sections:…

  3. Chiropractic Handbook.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of the Professions.

    This reference guide contains laws, regulations, and licensing requirements and procedures governing chiropractic practice in New York State. Following a general introduction to professional regulation in New York State, licensure requirements are spelled out in detail, including general requirements, education requirements, examination…

  4. Chiropractic: a critical evaluation.

    PubMed

    Ernst, Edzard

    2008-05-01

    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

  5. American Chiropractic Association

    MedlinePlus

    ... About Chiropractic Chiropractic in the Media ACA Radio Social Media Facebook Twitter YouTube Instagram LinkedIn Advocacy Regulatory Policy Issue Briefs Medicare Veteran's Affairs Engage with ACA National ...

  6. Chiropractic audits

    PubMed Central

    Freedman, Allan M

    2000-01-01

    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.

  7. Frequently Asked Questions about Chiropractic

    MedlinePlus

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

  8. Educational Standards for Chiropractic Colleges.

    ERIC Educational Resources Information Center

    Council on Chiropractic Education, Des Moines, IA.

    The policy of accreditation for the chiropractic profession and educational standards for chiropractic colleges are presented. The following types are historical development of chiropractic accreditation; the structure and function of the Council on Chiropractic Education; and eligibility, procedures, and classifications for status as an

  9. Educational Standards for Chiropractic Colleges.

    ERIC Educational Resources Information Center

    Council on Chiropractic Education, Des Moines, IA.

    The policy of accreditation for the chiropractic profession and educational standards for chiropractic colleges are presented. The following types are historical development of chiropractic accreditation; the structure and function of the Council on Chiropractic Education; and eligibility, procedures, and classifications for status as an…

  10. A Chiropracticness Test

    PubMed Central

    Charlton, Keith H

    2005-01-01

    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. PMID:16307687

  11. Educational Standards for Chiropractic Colleges.

    ERIC Educational Resources Information Center

    Council on Chiropractic Education, Des Moines, IA.

    Contents include: background information on the historical development, purpose, structure, and function of chiropractic accreditation; accreditation policy (eligibility, procedures, classifications, commission actions, and reports); standards for chiropractic colleges (organization, administration, scholastic regulations curriculum, faculty,…

  12. Educational Standards for Chiropractic Colleges.

    ERIC Educational Resources Information Center

    Council on Chiropractic Education, Des Moines, IA.

    Contents include: background information on the historical development, purpose, structure, and function of chiropractic accreditation; accreditation policy (eligibility, procedures, classifications, commission actions, and reports); standards for chiropractic colleges (organization, administration, scholastic regulations curriculum, faculty,

  13. Chiropractic. New York State.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of the Professions.

    A reference guide to laws, rules, and regulations that govern the chiropractic practice in New York State is presented. After an overview of professional regulation in the state, licensing requirements/procedures for chiropractors are described. Provisions of Title VIII, Articles 130 and 132, of the Education Law are also covered, along with…

  14. Chiropractic. State of the Art.

    ERIC Educational Resources Information Center

    Schafer, R. C., Ed.

    The review covers: (1) the discipline (description, scientific theories and principles, its practice, contributions to the health field, and history); (2) the profession (a doctor profile, patients, students, and the American Chiropractic Association); (3) chiropractic education (colleges, career opportunities, standard basic curriculum,…

  15. Chiropractic manipulation: reasons for concern?

    PubMed

    Gouveia, Liliana Olim; Castanho, Pedro; Ferreira, Joaquim J; Guedes, Miguel Moura; Falcão, Filipa; e Melo, Teresa Pinho

    2007-12-01

    Chiropractic's popularity is rising among the general population. Moreover, few studies have been conducted to properly evaluate its safety. We report three cases of serious neurological adverse events in patients treated with chiropractic manipulation. The first case is a 41 years old woman who developed a vertebro-basilar stroke 48 h after cervical manipulation. The second case represents a 68 years old woman who presented a neuropraxic injury of both radial nerves after three sessions of spinal manipulation. The last case is a 34 years old man who developed a cervical epidural haematoma after a chiropractic treatment for neck pain. In all three cases there were criteria to consider a causality relation between the neurological adverse events and the chiropractic manipulation. The described serious adverse events promptly recommend the implementation of a risk alert system. PMID:17904731

  16. Early chiropractic education in Oregon

    PubMed Central

    Keating, Joseph C

    2002-01-01

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

  17. The Chiropractic Care of Children

    PubMed Central

    Ohm, Jeanne; Kunz, Derek

    2010-01-01

    Abstract Objective The objective of this study was to characterize the practice of pediatric chiropractic. Design The study design was a cross-sectional descriptive survey. Settings/location The settings were private practices throughout the United States, Canada, and Europe. Participants The participants were 548 chiropractors, the majority of whom are practicing in the United States, Canada, and Europe. Main outcome measures Practitioner demographics (i.e., gender, years in practice, and chiropractic alma mater), practice characteristics (i.e., patient visits per week, practice income reimbursement), and chiropractic technique were surveyed. The practitioners were also asked to indicate common indicators for pediatric presentation, their practice activities (i.e., use of herbal remedies, exercise and rehabilitation, prayer healing, etc.), and referral patterns. Results A majority of the responders were female with an average practice experience of 8 years. They attended an average of 133 patient visits per week, with 21% devoted to the care of children (<18 years of age). Practice income was derived primarily from out-of-pocket reimbursement with charges of an average of $127 and $42 for the first and subsequent visits, respectively. These visits were reimbursed to address common conditions of childhood (i.e., asthma, ear infections, etc.). Approach to patient care was spinal manipulative therapy (SMT) augmented with herbal remedies, exercises, rehabilitation, and so on. Wellness care also figured prominently as a motivator for chiropractic care. Fifty-eight percent (58%) indicated an established relationship with an osteopathic or medical physician. Eighty percent (80%) of the responders indicated referring patients to medical practitioners while only 29% indicated receiving a referral from a medical/osteopathic physician. Conclusions The chiropractic care of children is a significant aspect of the practice of chiropractic. Further research is warranted to examine the safety and effectiveness of this popular nonallopathic approach to children's health. PMID:20569028

  18. Dr. Tom Lawrence: a life in chiropractic

    PubMed Central

    Keating, Joseph C

    2005-01-01

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

  19. Chiropractic and CAM Utilization: A Descriptive Review

    PubMed Central

    Lawrence, Dana J; Meeker, William C

    2007-01-01

    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. PMID:17241465

  20. Evidence-Based Practice and Chiropractic Care.

    PubMed

    Lefebvre, Ron; Peterson, David; Haas, Mitchell

    2012-12-28

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

  1. Back problems. Chiropractic evaluation and management.

    PubMed

    Haussler, K K

    1999-04-01

    A thorough knowledge of equine spinal anatomy, biomechanics, and potential pathology is required to understand the principles and theories behind chiropractic and to apply its techniques properly. Chiropractic provides additional diagnostic and therapeutic means that may help equine practitioners to identify and treat the primary cause of lameness or poor performance. Specialized training in the evaluation and treatment of vertebral joint dysfunction and neuromusculoskeletal disorders places chiropractic in the forefront of conservative treatment of spinal-related disorders. Nevertheless, limited research is currently available on equine chiropractic and other nontraditional modalities in veterinary medicine. In 1996, the American Veterinary Medicine Association's Committee on Alternative and Complementary Therapies suggested that the research community should be encouraged to prioritize avenues of research and to allocate research funds to projects that are designed to provide further scientific evaluation of these modalities. The future of equine chiropractic in veterinary medicine is dependent on future research into the clinical effects of chiropractic techniques and the basic pathophysiology of spinal-related disorders in horses. PMID:10218250

  2. Attitudes Toward Chiropractic: A Survey of Canadian Obstetricians.

    PubMed

    Weis, Carol Ann; Stuber, Kent; Barrett, Jon; Greco, Alexandra; Kipershlak, Alexander; Glenn, Tierney; Desjardins, Ryan; Nash, Jennifer; Busse, Jason

    2016-04-01

    We assessed the attitudes of Canadian obstetricians toward chiropractic with a 38-item cross-sectional survey. Ninety-one obstetricians completed the survey, for a response rate of 14% (91 of 659). Overall, 30% of respondents held positive views toward chiropractic, 37% were neutral, and 33% reported negative views. Most (77%) reported that chiropractic care was effective for some musculoskeletal complaints, but 74% disagreed that chiropractic had a role in treatment of non-musculoskeletal conditions. Forty percent of respondents referred at least some patients for chiropractic care each year, and 56% were interested in learning more about chiropractic care. Written comments from respondents revealed concerns regarding safety of spinal manipulation and variability among chiropractors. Canadian obstetricians' attitudes toward chiropractic are diverse and referrals to chiropractic care for their patients who suffer from pregnancy-related low back pain are limited. Improved interprofessional relations may help optimize care of pregnant patients suffering from low back pain. PMID:26350243

  3. Chiropractic approach to the management of children

    PubMed Central

    2010-01-01

    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. PMID:20525200

  4. Chiropractic

    MedlinePlus

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

  5. Development of the Murdoch Chiropractic Graduate Pledge

    PubMed Central

    Simpson, J. Keith; Losco, Barrett; Young, Kenneth J.

    2010-01-01

    Purpose: This paper reviews the origins of the learned professions, the foundational concepts of professionalism, and the common elements within various healer's oaths. It then reveals the development of the Murdoch Chiropractic Graduate Pledge. Methods: A committee comprised of three Murdoch academics performed literature searches on the topic of professionalism and healer's oaths and utilized the Quaker consensus process to develop the Murdoch Chiropractic Graduate Pledge. Results: The committee in its deliberations utilized over 200 relevant papers and textbooks to formulate the Murdoch Chiropractic Graduate Pledge that was administered to the 2010 Murdoch School of Chiropractic and Sports Science graduates. The School of Chiropractic and Sports Science included professionalism as one of its strategic goals and began the process of curriculum review to align it with the goal of providing a curriculum that recognizes and emphasizes the development of professionalism. Conclusions: The reciting of a healer's oath such as the Hippocratic Oath is widely considered to be the first step in a new doctor's career. It is seen as the affirmation that a newly trained health care provider will use his or her newfound knowledge and skill exclusively for the benefit of mankind in an ethical manner. Born from the very meaning of the word profession, the tradition of recitation of a healer's oath is resurgent in health care. It is important for health care instructors to understand that the curriculum must be such that it contributes positively to the students' professional development. PMID:21048880

  6. Should the chiropractic profession embrace the doctrine of informed consent?

    PubMed

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

    2008-09-01

    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. PMID:19646372

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

    PubMed Central

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

    2005-01-01

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

  8. Lasers and their therapeutic application in chiropractic

    PubMed Central

    Fitz-Ritson, Don

    2001-01-01

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

  9. Chiropractic complaints and disciplinary cases in Canada

    PubMed Central

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

    1998-01-01

    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.

  10. Chiropractic Colleges Seek Legitimacy amid Financial Woes

    ERIC Educational Resources Information Center

    Fuller, Andrea

    2012-01-01

    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 are…

  11. Applying ‘science’ in chiropractic clinical practice

    PubMed Central

    Jamison, Jennifer R

    1990-01-01

    The chiropractic profession is increasingly expressing the sentiment that chiropractic clinical intervention should rest upon a scientific foundation. Before ‘scientific research’ can become meaningful in chiropractic clinical practice, it is necessary that field practitioners be conversant with research terminology. If chiropractic clinical practice is to achieve credibility as a scientific mode of health care and if the benefits of a ‘scientific’ practice model are to enhance patient care, then future chiropractic practitioners must be familiar with a currently accredited scientific frame of reference. A survey of final year chiropractic students at Phillip Institute of Technology found that respondents appreciation of the strength of diverse clinical research methodologies and their ranking of criteria for ascertaining a cause-effect association bears some similarity (RHO = 0.97 and 0.98 respectively, p < 0.05) to that of the ‘scientific’ clinical community.

  12. Pediatric Chiropractic Care: The Subluxation Question And Referral Risk.

    PubMed

    Homola, Samuel

    2016-02-01

    Chiropractors commonly treat children for a variety of ailments by manipulating the spine to correct a 'vertebral subluxation' or a 'vertebral subluxation complex' alleged to be a cause of disease. Such treatment might begin soon after a child is born. Both major American chiropractic associations - the International Chiropractic Association and the American Chiropractic Association - support chiropractic care for children, which includes subluxation correction as a treatment or preventive measure. I do not know of any credible evidence to support chiropractic subluxation theory. Any attempt to manipulate the immature, cartilaginous spine of a neonate or a small child to correct a putative chiropractic subluxation should be regarded as dangerous and unnecessary. Referral of a child to a chiropractor for such treatment should not be considered lest a bad outcome harms the child or leads to a charge of negligence or malpractice. PMID:26806448

  13. Nitric oxide: a challenge to chiropractic

    PubMed Central

    Morgan, Lon

    2000-01-01

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

  14. Iowa Chiropractic Students Outlook for Practitioners and Need for State-Funded Assistance.

    ERIC Educational Resources Information Center

    Greiner, Keith

    This state-mandated study examined the needs of Iowa chiropractic students and the Iowa demand for chiropractic health care in order to determine the feasibility of establishing a chiropractic forgivable loan program. The project used financial aid data and repayment rate data to evaluate the need for financial aid for chiropractic students;…

  15. Chiropractic Use by Urban and Rural Residents with Insurance Coverage

    ERIC Educational Resources Information Center

    Lind, Bonnie K.; Diehr, Paula K.; Grembowski, David E.; Lafferty, William E.

    2009-01-01

    Purpose: To describe the use of chiropractic care by urban and rural residents in Washington state with musculoskeletal diagnoses, all of whom have insurance coverage for this care. The analyses investigate whether restricting the analyses to insured individuals attenuates previously reported differences in the prevalence of chiropractic use…

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

    PubMed

    Johnson, Claire D; Green, Bart N

    2012-01-01

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

  17. National Board Scores versus Student GPA's in Chiropractic Education.

    ERIC Educational Resources Information Center

    Kalthoff, Theodore J.

    1985-01-01

    The relationship between student GPAs and scores on the National Board of Chiropractic Examiners tests was investigated in an effort to determine if the chiropractic curriculum was properly preparing students to be licensed. The study found that there was a significant correlation between GPAs and board scores. (Author/MLW)

  18. Chiropractic Use by Urban and Rural Residents with Insurance Coverage

    ERIC Educational Resources Information Center

    Lind, Bonnie K.; Diehr, Paula K.; Grembowski, David E.; Lafferty, William E.

    2009-01-01

    Purpose: To describe the use of chiropractic care by urban and rural residents in Washington state with musculoskeletal diagnoses, all of whom have insurance coverage for this care. The analyses investigate whether restricting the analyses to insured individuals attenuates previously reported differences in the prevalence of chiropractic use

  19. Chiropractic and children: Is more research enough?

    PubMed

    Leboeuf-Yde, Charlotte; Hestbæk, Lise

    2010-01-01

    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. PMID:20525193

  20. Chiropractic management of chronic idiopathic meralgia paresthetica: a case study

    PubMed Central

    Houle, Sébastien

    2012-01-01

    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. PMID:22942840

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

    PubMed Central

    Keating, Joseph C; Rehm, William S

    1993-01-01

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

  2. A History of The Journal of Chiropractic Education

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2015-06-01

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

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

    PubMed Central

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

    2015-01-01

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

  5. Oswald Hall, PhD: Chiropractic advocate; 1971 to 1998

    PubMed Central

    Brown, Douglas M

    2005-01-01

    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). PMID:17549211

  6. Legislative approaches to the regulation of the chiropractic profession

    PubMed Central

    Chapman-Smith, David A

    1996-01-01

    Traditional or complementary health care services have a growing and significant role in both developed and developing countries. In the United Kingdom there was new legislation to regulate the chiropractic and osteopathy professions in 1993 and 1994. This was supported by the British Medical Association. There is now legislation regulating chiropractic practice in many jurisdictions. In general chiropractic is regulated as a separate discipline, although chiropractic and osteopathy are jointly regulated in some Australian states and South Africa. Regulatory bodies generally have chiropractic and lay representation, and sometimes medical representation. In Canada and the United States there is an emphasis on a defined scope of practice. In the UK, Australia, New Zealand and Hong Kong there is no definition of scope of practice and an emphasis on protection of title. This paper reviews the different approaches to regulation of the chiropractic profession. Subjects discussed include the composition of regulatory boards, scope of practice including access to diagnostic services, educational requirements and protection of title.

  7. Helping address the national research and research capacity needs of Australian chiropractic: introducing the Australian Chiropractic Research Network (ACORN) project.

    PubMed

    Adams, Jon; Steel, Amie; Chang, Sungwon; Sibbritt, David

    2015-01-01

    Chiropractic is a popular health care choice in Australia and yet major gaps in our empirical understanding of this area of practice remain. Furthermore, while some research excellence exists, a largely uncoordinated approach to research activity and development has in effect led to silos of interest and a lack of strategic 'big-picture' planning essential to producing a sustainable research culture and capacity for the profession. This commentary identifies the significance of a number of key features - including a national, coordinated focus, and a rich engagement with the practitioner and patient base amongst others - arguably important to the future development of research and research capacity within Australian chiropractic. The design features and phases of the Australian Chiropractic Research Network (ACORN) project are also outlined. ACORN is one contemporary initiative specifically developed to address chiropractic's research and research capacity building needs and help grow a broad evidence-base to inform safe, effective patient care. PMID:25834727

  8. Plastination: a modern approach to chiropractic teaching

    PubMed Central

    Grondin, Gilles

    1998-01-01

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

  9. The chiropractic services market: a literature review.

    PubMed

    Stano, M

    1992-01-01

    This article surveys the economic literature on chiropractors. Chiropractors provide a substantial amount of care for those with various neuro-musculo-skeletal disorders and represent the fastest growing segment of the professional health services market. Yet the study of the profession has been neglected in the health services research literature. The goals of this article are to take stock of the existing literature and data sources. After providing background information, including recent developments in antitrust, I merge various data sources to assess the growth of expenditures for chiropractic care and the proportion of the population using this care. Other data sources and features are also described. I conclude with a discussion of the significance of further research on the profession to existing policy efforts to contain costs and improve health care delivery. PMID:10129443

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

    ERIC Educational Resources Information Center

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

    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…

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

    ERIC Educational Resources Information Center

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

    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

  12. Constructing a philosophy of chiropractic: evolving worldviews and premodern roots☆

    PubMed Central

    Senzon, Simon A.

    2011-01-01

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

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

    PubMed Central

    2011-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  15. Clinical evaluation tools: a survey of doctors of chiropractic and students at one chiropractic college

    PubMed Central

    Mansholt, Barbara A.; Vining, Robert D.

    2016-01-01

    Introduction: The reliability and validity of many evaluation tools leading to clinical decision-making for spinal manipulation are varied. We surveyed senior students and DC employees at one chiropractic college regarding 1) which analysis tools should be used and 2) factors that influence their choices. Methods: The survey queried which tools should be used on a routine patient encounter. Clinical evaluation tools included palpation, skin temperature analysis, leg length analysis, and radiographs. Results: Surveys were collected from 58 doctors of chiropractic (DCs) and 74 students. Respondents from both groups reported to most commonly use static palpation, followed by motion palpation and leg length analysis. DC respondents ranked evidence and personal experience high for rationale; student respondents frequently chose patient preference. Conclusion: DC and student respondents reported use of clinical evaluation tools consistently. However, some variations in rationale were noted. It is important for educators to provide a balanced presentation of the strengths and limitations of clinical analysis procedures to support the development of well-justified evidence-based clinical decision-making skills. PMID:27069264

  16. Essential literature for the chiropractic profession: a survey of chiropractic research leaders

    PubMed Central

    2013-01-01

    Background Evidence-based clinical practice (EBCP) is an accepted practice for informed clinical decision making in mainstream health care professions. EBCP augments clinical experience and can have far reaching effects in education, policy, reimbursement and clinical management. The proliferation of published research can be overwhelming—finding a mechanism to identify literature that is essential for practitioners and students is desirable. The purpose of this study was to survey leaders in the chiropractic profession on their opinions of essential literature for doctors of chiropractic, faculty, and students to read or reference. Methods Deployment of an IRB exempted survey occurred with 68 academic and research leaders using SurveyMonkey®. Individuals were solicited via e-mail in August of 2011; the study closed in October of 2011. Collected data were checked for citation accuracy and compiled to determine multiple responses. A secondary analysis assessed the scholarly impact and Internet accessibility of the recommended literature. Results Forty-three (43) individuals consented to participate; seventeen (17) contributed at least one article of importance. A total of 41 unique articles were reported. Of the six articles contributed more than once, one article was reported 6 times, and 5 were reported twice. Conclusions A manageable list of relevant literature was created. Shortcomings of methods were identified, and improvements for continued implementation are suggested. A wide variety of articles were reported as “essential” knowledge; annual or bi-annual surveys would be helpful for the profession. PMID:24289298

  17. Chiropractic quality assurance: standards and guidelines

    PubMed Central

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

    2001-01-01

    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.

  18. Daniel David Palmer: alchemy in the creation of chiropractic.

    PubMed

    Gaucher-Peslherbe, P L

    1995-12-01

    D.D. Palmer has been a much ignored man in the discipline he founded. The same applies to several early concepts he used to develop from a mere healer's background: D.D. Palmer invested them with an entirely different meaning. When considered, they help to understand the inner logic that allowed for chiropractic survival. There was an alchemy in the creation of chiropractic and the senior Palmer was the alchemist. He has not been recognized even within his own profession for the self-taught scholar and clinician that he was, knowledgeable about the various medical and scientific theories of his time. PMID:11613396

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

    PubMed Central

    2013-01-01

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

  20. The influence of curricular and extracurricular learning activities on students' choice of chiropractic technique

    PubMed Central

    Sikorski, David M.; KizhakkeVeettil, Anupama; Tobias, Gene S.

    2016-01-01

    Objective: Surveys for the National Board of Chiropractic Examiners indicate that diversified chiropractic technique is the most commonly used chiropractic manipulation method. The study objective was to investigate the influences of our diversified core technique curriculum, a technique survey course, and extracurricular technique activities on students' future practice technique preferences. Methods: We conducted an anonymous, voluntary survey of 1st, 2nd, and 3rd year chiropractic students at our institution. Surveys were pretested for face validity, and data were analyzed using descriptive and inferential statistics. Results: We had 164 students (78% response rate) participate in the survey. Diversified was the most preferred technique for future practice by students, and more than half who completed the chiropractic technique survey course reported changing their future practice technique choice as a result. The students surveyed agreed that the chiropractic technique curriculum and their experiences with chiropractic practitioners were the two greatest bases for their current practice technique preference, and that their participation in extracurricular technique clubs and seminars was less influential. Conclusions: Students appear to have the same practice technique preferences as practicing chiropractors. The chiropractic technique curriculum and the students' experience with chiropractic practitioners seem to have the greatest influence on their choice of chiropractic technique for future practice. Extracurricular activities, including technique clubs and seminars, although well attended, showed a lesser influence on students' practice technique preferences. PMID:26655282

  1. United States Chiropractic Practice Acts and Institute of Medicine defined primary care practice

    PubMed Central

    Duenas, Richard

    2002-01-01

    Abstract Objective This review was conducted to analyze the law for the practice of chiropractic throughout the United States, including the District of Columbia, Puerto Rico and the U.S. Virgin Islands, to determine the legal ability of the Doctor of Chiropractic in each jurisdiction to provide primary care service as described by the 1996 Institute of Medicine Definition of Primary Care. Method The practice acts for each State, the District of Columbia, Puerto Rico and the U.S. Virgin Islands were reviewed for language that would permit the chiropractic doctor to meet the 9 criteria of primary care practice described by the Institute of Medicine. Forty-four practice acts were cross referenced with the results of a scope of practice survey of State Boards of Chiropractic in 1999. Results The review of the practice acts and the survey on chiropractic scope of practice revealed a varied degree of chiropractic scope of practice with 23 of 53 of the jurisdictions limiting the ability of the chiropractic doctor to fully provide IOM defined primary care. Conclusion The varied practice act definitions for chiropractic practice throughout the United States the District of Columbia, Puerto Rico and the U.S. Virgin Islands reveal an inability of the chiropractic profession to respond to a call for a standard nationally-based primary-care policy that could be readily achieved by all chiropractic practitioners throughout the Union. This void of primary-care qualification in many State and Commonwealth practice acts will need to be addressed by the leaders of the profession if government entities and national third party organizations are to utilize chiropractic health care services to the standard of chiropractic education and clinical experience. The need for a broad range chiropractic scope of practice model practice act is suggested. PMID:19674578

  2. The self-concept of chiropractic students as science students

    PubMed Central

    Shields, Robert F.

    2005-01-01

    Abstract Purpose To determine the self-concepts of chiropractic students as science students and if any personal variable affect their self-concepts. Participants Students in their first trimester and eighth trimester at the Los Angeles College of Chiropractic during the 1993 academic year (n=158). Methods Peterson-Yaakobi Q-Sort, National Assessment of Educational Progress, two-tailed T-test, one way analysis of variance and Spearman-rho correlation. Results The majority of students have positive self- concepts as science students and although there was a difference between the 2 trimesters, it was not significant. As a group they generally had less exposure to science compared to undergraduates from a selected science program. Variables of socio-economic status, undergraduate major, and highest completed level of education did not statistically affect their self-concept. Conclusion Chiropractic students had the self-concept that enables them to subscribe to the philosophical foundations of science and better engage in basic sciences and, later, science-based clinical research. Knowledge of this self- concept can be used in the development of a more rigorous basic science curricula and clinical research programs at chiropractic colleges with the ultimate goal of providing a more firm scientifically based foundation for the profession. PMID:19674649

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

    PubMed Central

    Henry, Lucian

    2015-01-01

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

  4. 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

    von Kuster, Thomas, Jr.

    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…

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

    PubMed

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

    2007-01-01

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

  6. Chiropractic and concussion in sport: a narrative review of the literature

    PubMed Central

    Johnson, Claire D.; Green, Bart N.; Nelson, Robert C.; Moreau, Bill; Nabhan, Dustin

    2013-01-01

    Objective Concussion is a common sporting injury that may be seen by doctors of chiropractic and should be managed following current practice guidelines. The purpose of this abstract is to present a literature review on chiropractic management of concussion in sport and to discuss current guidelines. Methods A review of the literature was performed using the PubMed search engine. MeSH terms included chiropractic and concussion. Search dates were the beginning of the record through July 30, 2013. All languages and article types were included in the search. Articles found were retrieved and evaluated for the relevance of chiropractic management of concussion in sport. Results Five articles were found (1 prospective study, 1 survey, 3 literature reviews) ranging in publication years from 1993 to 2012. No articles reported a position statement, and none provided a review of current concussion management practices related to chiropractic practice. No articles reported adverse outcomes of chiropractic management of an athlete with concussion. Conclusion Research related to the chiropractic management of concussion in sport is a nascent area of investigation. Although there are few published articles, the articles in this review showed that doctors of chiropractic encounter concussed athletes at events and in clinical practice. It is essential for doctors of chiropractic to understand the importance of using standardized concussion assessment tools and current concussion guidelines. PMID:24396325

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

    PubMed

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

    2013-02-01

    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

  8. The first research agenda for the chiropractic profession in Europe

    PubMed Central

    2014-01-01

    Background Research involving chiropractors is evolving and expanding in Europe while resources are limited. Therefore, we considered it timely to initiate a research agenda for the chiropractic profession in Europe. The aim was to identify and suggest priorities for future research in order to best channel the available resources and facilitate advancement of the profession. Methods In total, 60 academics and clinicians working in a chiropractic setting, and who had attended any of the annual European Chiropractors’ Union/European Academy of Chiropractic (ECU/EAC) Researchers’ Day meetings since their inception in 2008, were invited to participate. Data collection consisted of the following phases: phase 1 identification of themes; phase 2 consensus, which employed a Delphi process and allowed us to distill the list of research priorities; and phase 3 presentation of the results during both the Researchers’ Day and a plenary session of the annual ECU Convention in May 2013. In addition, results were distributed to all ECU member countries. Results The response rate was 42% from phase 1 and 68% from phase 2. In general, participants were middle-aged, male and had been awarded a Doctor of Philosophy (PhD) as well as chiropractic degree. Approximately equal numbers of participants had obtained their chiropractic degree from the UK/Europe and North America. The majority of participants worked primarily in an academic/research environment and approximately half worked in an independent institution. In total, 58% of the participants were from the UK and Denmark, collectively representing 44% of the chiropractors working in Europe. In total, 70 research priorities were identified, of which 19 reached consensus as priorities for future research. The following three items were thought to be most important: 1) cost-effectiveness/economic evaluations, 2) identification of subgroups likely to respond to treatment, and 3) initiation and promotion of collaborative research activities. Conclusions This is the first formal and systematic attempt to develop a research agenda for the chiropractic profession in Europe. Future discussion and study is necessary to determine whether the themes identified in this survey should be broadly implemented. PMID:24512854

  9. 78 FR 48904 - United States v. Chiropractic Associates, Ltd. of South Dakota; Public Comment and Response on...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ... Antitrust Division United States v. Chiropractic Associates, Ltd. of South Dakota; Public Comment and... United States v. Chiropractic Associates, Ltd. of South Dakota., Civil Action No. 13-CV- 4030-LLP, which... DIVISION UNITED STATES OF AMERICA, Plaintiff, v. CHIROPRACTIC ASSOCIATES, LTD. OF SOUTH DAKOTA,...

  10. Morris Fishbein, M.D.: the "medical Mussolini" and chiropractic.

    PubMed

    Donahue, J H

    1996-06-01

    Morris Fishbein, M.D. is the most important non-chiropractor to influence the chiropractic profession. From his post as editor and secretary of the American Medical Association, his anti-chiropractic writings, speeches and political activities had a profound effect on the profession's development. Because he was not only the foremost medical politician of the time, but also perceived as a multi-faceted author on public health issues, his credibility was high across large sections of the population and in most social institutions. His tactics and stature undoubtedly helped keep the profession limited to caring for a small percentage of the population. Because of him, chiropractors devised survival strategies that continue to influence the profession even today. PMID:11619004

  11. Constructing a philosophy of chiropractic: evolving worldviews and modern foundation☆

    PubMed Central

    Senzon, Simon A.

    2011-01-01

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

  12. Intractable migraine headaches during pregnancy under chiropractic care.

    PubMed

    Alcantara, Joel; Cossette, Martine

    2009-11-01

    The absence of hormone fluctuations and/or the analgesic effects of increased beta-endorphins are thought to confer improvements in headache symptoms during pregnancy. However, for a number of pregnant patients, they continue to suffer or have worsening headache symptoms. The use of pharmacotherapy for palliative care is a concern for both the mother and the developing fetus and alternative/complementary care options are sought. We present a 24-year-old gravid female with chronic migraine headaches since age 12years. Previous unsuccessful care included osteopathy, physical therapy, massage and medication. Non-steroidal anti-inflammatory medication with codeine provided minor and temporary relief. Chiropractic care involving spinal manipulative therapy (SMT) and adjunctive therapies resulted in symptom improvement and independence from medication. This document provides supporting evidence on the safety and possible effectiveness of chiropractic care for patients with headaches during pregnancy. PMID:19880080

  13. Issues surrounding chiropractic fee negotiations in Saskatchewan †

    PubMed Central

    Grier, Alexander R; Grier, Katharine L

    1992-01-01

    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.

  14. Preceptor doctors' assessment of the clinical skills of chiropractic externs

    PubMed Central

    Hynes, Roger J.R.; Callender, Alana K.; Hynes, Rachelle A.; Gran, Donald F.

    2016-01-01

    Objective: This study surveyed preceptor doctors' opinions of student competence before and after a chiropractic preceptorship. Methods: The qualitative and quantitative survey asked doctors about the competence of externs in various skills and asked opened-ended questions about the strengths and weaknesses of the externs. The survey was conducted using a common Web-based platform called SurveyMonkey. Results: A total of 125 doctors responded to the survey. The doctors tended to agree that they saw a positive change in the skills of the externs over time. Externs presented to the preceptors lacking in confidence and office management skills. The preceptors reported an increase from 2.7 to 3.9 on a 5.0 Likert scale in the students' confidence in adjusting skills during the preceptorship. The preceptor doctors were split on students' preparedness in chiropractic adjusting technique, reporting it as both the strongest and the weakest presenting skill. Conclusion: Preceptor doctors perceived that their student externs were academically qualified but were weaker in the clinical application of procedures. Results from this survey suggest that the preceptor program can improve the confidence levels and practice management knowledge of chiropractic externs. PMID:26600271

  15. A brief history of historical scholarship in chiropractic

    PubMed Central

    Keating, Joseph C

    2001-01-01

    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

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

    PubMed Central

    2011-01-01

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

  17. The Fountain Head Chiropractic Hospital: the dream that almost came true

    PubMed Central

    Bakkum, Barclay W.; Nolan, Delores Bakkum

    2010-01-01

    Objective The purpose of this article is to relate information about the life of Dr William Ivens and describe the worldwide effort led by him to establish a chiropractic hospital at the Palmer School of Chiropractic. Discussion Dr William Ivens, a colorful politician and chiropractor from Winnipeg, Canada, was the driving force behind the idea of establishing a chiropractic hospital at the Palmer School of Chiropractic in Davenport, IA, during the late 1930s. With the blessings of Dr BJ Palmer, president of the Palmer School of Chiropractic, Dr Ivens led an aggressive, worldwide campaign to raise the funds necessary to establish what was to be called the Fountain Head Chiropractic Hospital. During the tumultuous years of 1937-1942, this campaign successfully raised the target sum of $50 000, thought necessary to create the hospital, but the idea never became a reality. These funds were eventually used to purchase the Clear View Sanitarium, a chiropractic psychiatric facility, in Davenport, IA, in 1952. Conclusion Dr William Ivens stands as a prime example of a relatively small, but dedicated, number of chiropractors during the mid-20th century who not only believed in, but toiled for, the idea of chiropractic care being given in an in-patient setting. PMID:22693476

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

    PubMed Central

    2012-01-01

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

  19. Core Competencies of the Certified Pediatric Doctor of Chiropractic: Results of a Delphi Consensus Process.

    PubMed

    Hewitt, Elise; Hestbaek, Lise; Pohlman, Katherine A

    2016-04-01

    An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed using a Delphi consensus process. The initial set of seed statements and substatements was modeled on competency documents used by organizations that oversee chiropractic and medical education. These statements were distributed to the Delphi panel, reaching consensus when 80% of the panelists approved each segment. The panel consisted of 23 specialists in chiropractic pediatrics (14 females) from across the broad spectrum of the chiropractic profession. Sixty-one percent of panelists had postgraduate pediatric certifications or degrees, 39% had additional graduate degrees, and 74% were faculty at a chiropractic institution and/or in a postgraduate pediatrics program. The panel were initially given 10 statements with related substatements formulated by the study's steering committee. On all 3 rounds of the Delphi process the panelists reached consensus; however, multiple rounds occurred to incorporate the valuable qualitative feedback received. PMID:26739669

  20. Racial Disparities in Use of Chiropractic Services by Medicare Beneficiaries Aged 65 to 99 in Los Angeles County, California.

    PubMed

    Whedon, James M; Kimura, Melissa N; Phillips, Reed B

    2016-04-01

    Racial and ethnic disparities in utilization of chiropractic services have been described at the state level, but little is known about such local disparities. We analyzed Medicare data for the year 2008 to evaluate by ZIP code for utilization of chiropractic services among older adults in Los Angeles County, California. We evaluated for availability and use of chiropractic services by racial/ethnic category, quantified geographic variations by coefficient of variation, and mapped utilization by selected racial/ethnic categories. Among 7502 beneficiaries who used chiropractic services, 72% were white, 12% Asian, 1% black, 1% Hispanic, and 14% other/unknown. Variation in the number of beneficiaries per ZIP code who used chiropractic services was highest among Hispanics, blacks, and Asians. We found evidence of racial disparities in use of chiropractic services at the local level in Los Angeles County. Older blacks and Hispanics in Los Angeles County may be underserved with regard to chiropractic care. PMID:26350244

  1. A longitudinal study of chiropractic use among older adults in the United States

    PubMed Central

    2010-01-01

    Background Longitudinal patterns of chiropractic use in the United States, particularly among Medicare beneficiaries, are not well documented. Using a nationally representative sample of older Medicare beneficiaries we describe the use of chiropractic over fifteen years, and classify chiropractic users by annual visit volume. We assess the characteristics that are associated with chiropractic use versus nonuse, as well as between different levels of use. Methods We analyzed data from two linked sources: the baseline (1993-1994) interview responses of 5,510 self-respondents in the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD), and their Medicare claims from 1993 to 2007. Binomial logistic regression was used to identify factors associated with chiropractic use versus nonuse, and conditional upon use, to identify factors associated with high volume relative to lower volume use. Results There were 806 users of chiropractic in the AHEAD sample yielding a full period prevalence for 1993-2007 of 14.6%. Average annual prevalence between 1993 and 2007 was 4.8% with a range from 4.1% to 5.4%. Approximately 42% of the users consumed chiropractic services only in a single calendar year while 38% used chiropractic in three or more calendar years. Chiropractic users were more likely to be women, white, overweight, have pain, have multiple comorbid conditions, better self-rated health, access to transportation, higher physician utilization levels, live in the Midwest, and live in an area with fewer physicians per capita. Among chiropractic users, 16% had at least one year in which they exceeded Medicare's "soft cap" of 12 visits per calendar year. These over-the-cap users were more likely to have arthritis and mobility limitations, but were less likely to have a high school education. Additionally, these over-the-cap individuals accounted for 58% of total chiropractic claim volume. High volume users saw chiropractors the most among all types of providers, even more than family practice and internal medicine combined. Conclusion There is substantial heterogeneity in the patterns of use of chiropractic services among older adults. In spite of the variability of use patterns, however, there are not many characteristics that distinguish high volume users from lower volume users. While high volume users accounted for a significant portion of claims, the enforcement of a hard cap on annual visits by Medicare would not significantly decrease overall claim volume. Further research to understand the factors causing high volume chiropractic utilization among older Americans is warranted to discern between patterns of "need" and patterns of "health maintenance". PMID:21176137

  2. Journal publications by Australian chiropractic academics: are they enough?

    PubMed Central

    Hoskins, Wayne; Pollard, Henry; Reggars, John; Vitiello, Andrew; Bonello, Rod

    2006-01-01

    Purpose To document the number of journal publications attributed to the academic faculty of Australian chiropractic tertiary institutions. To provide a discussion of the significance of this output and to relate this to the difficulty the profession appears to be experiencing in the uptake of evidence based healthcare outcomes and cultures. Methods The departmental websites for the three Australian chiropractic tertiary institutions were accessed and a list of academic faculty compiled. It was noted whether each academic held a chiropractic qualification or research Doctoral (not professional) degree qualification A review of the literature was conducted using the names of the academics and cross-referencing to publications listed independently in the PubMed and Index to Chiropractic Literature (ICL) databases (from inception to February 27 2006). Publications were excluded that were duplicates, corrected reprints, conference abstracts/proceedings, books, monographs, letters to the editor/comments or editorials. Using this information an annual and recent publication rate was constructed. Results For the 41 academics there was a total of 155 PubMed listed publications (mean 3.8, annual rate per academic 0.31) and 415 ICL listed publications (mean 10.1, annual rate 0.62). Over the last five years there have been 50 PubMed listed publications (mean 1.2, annual rate 0.24) and 97 ICL listed publications (mean 2.4, annual rate 0.47). Chiropractor academics (n = 31) had 29 PubMed listed publications (mean 2.5, annual rate 0.27) and 265 ICL listed publications (mean 8.5, annual rate 0.57). Academics with a doctoral degree (n = 13) had 134 PubMed listed publications (mean 10.3, annual rate 0.70) and 311 ICL listed publications (mean 23.9, annual rate 1.44). Academics without a Doctoral degree (n = 28) had 21 PubMed listed publications (mean 0.8, annual rate 0.13) and 104 ICL listed publications (mean 3.7, annual rate 0.24). Conclusion While several academics have compiled an impressive list of publications, overall there is a significant paucity of published research authored by the majority of academics, with a trend for a falling recent publication rate and not having a doctoral degree being a risk factor for poor publication productivity. It is suggested that there is an urgent necessity to facilitate the acquisition of research skills in academic staff particularly in research methods and publication skills. Only when undergraduate students are exposed to an institutional environment conducive to and fostering research will concepts of evidence based healthcare really be appreciated and implemented by the profession. PMID:16872544

  3. [Chiropractic care of infants with colic lacks evidence].

    PubMed

    Aase, Karoline; Blaakær, Jan

    2013-02-11

    Chiropractic care of infants with colic is a heavily used treatment today, but also a treatment that is much discussed because of uncertainty about the effect. The literature concerning this topic is surprisingly scarce, of poor quality and lack of convincing conclusions. With the present day data on this topic, it is impossible to say whether this kind of treatment has a significant effect. This underlines that the health visitors and other health-care workers cannot give guidance or suggestion of this form of treatment before more solid evidence-based findings have been reported. PMID:23402252

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

    PubMed Central

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

    1990-01-01

    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 clinics in 11 centres. PATIENTS--741 Patients aged 18-65 who had no contraindications to manipulation and who had not been treated within the past month. INTERVENTIONS--Treatment at the discretion of the chiropractors, who used chiropractic manipulation in most patients, or of the hospital staff, who most commonly used Maitland mobilisation or manipulation, or both. MAIN OUTCOME MEASURES--Changes in the score on the Oswestry pain disability questionnaire and in the results of tests of straight leg raising and lumbar flexion. RESULTS--Chiropractic treatment was more effective than hospital outpatient management, mainly for patients with chronic or severe back pain. A benefit of about 7% points on the Oswestry scale was seen at two years. The benefit of chiropractic treatment became more evident throughout the follow up period. Secondary outcome measures also showed that chiropractic was more beneficial. CONCLUSIONS--For patients with low back pain in whom manipulation is not contraindicated chiropractic almost certainly confers worthwhile, long term benefit in comparison with hospital outpatient management. The benefit is seen mainly in those with chronic or severe pain. Introducing chiropractic into NHS practice should be considered. PMID:2143092

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

    PubMed Central

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

    2009-01-01

    Abstract Objective By 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 guideline for hand and treatment table surface sanitizing for the chiropractic profession that is evidence-based and can easily be adopted by teaching institutions and doctors in the field. Methods A review of the chiropractic literature demonstrated that pathogenic microbes are present on treatment tables in teaching clinics at multiple facilities, yet no standardized protocols exist in the United States regarding table sanitizing and hand hygiene in chiropractic clinics or education institutions. This article reviews the scientific literature on the subject by using several search engines, databases, and specific reviews of documents pertaining to the topic including existing general guidelines. Results The literature has several existing guidelines that the authors used to develop a proposed protocol for hand and table sanitizing specific to the chiropractic profession. Recommendations were developed and are presented on hand hygiene and table sanitizing procedures that could lower the risk of infection for both clinical personnel and patients in chiropractic facilities. Conclusion This article offers a protocol for hand and table sanitizing in chiropractic clinics and education institutions. The chiropractic profession should consider adoption of these or similar measures and disseminate them to teaching clinics, institutions, and private practitioners. PMID:19646384

  6. Philosophy of chiropractic: lessons from the past — guidance for the future 1

    PubMed Central

    Donahue, Joseph

    1990-01-01

    In this paper, the argument will be made that present day “chiropractic philosophy” must be rejected as a professional obstacle. It is an unscientific relic of D.D. Palmer’s personal religious beliefs. A philosophy of chiropractic can only emerge from the application of philosophy of science to our scientific and clinical practices. This new philosophy should incorporate the general healing perspective of the ancient Coan tradition which will be described. This perspective can be made distinctively chiropractic by a synthesis with D.D. Palmer’s principle of Tone. Discussion will focus on how our philosophy can be developed to guide us into the 21st century.

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

    PubMed

    Green, Bart N; Johnson, Claire

    2010-01-01

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

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

    PubMed

    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

    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

  9. Chiropractic: from rejection to acceptance 1900-1980

    PubMed Central

    Sutherland, Donald C

    1998-01-01

    This paper presents some of the significant milestones that were reached in the long struggle from rejection to acceptance. While it does not attempt to include all of the historical events which contributed to this evolutionary process, it does identify some of the key elements in the laying of a sound foundation upon which the profession could continue to build. It is hoped that other papers will be written to add to our understanding of this important era in chiropractic’s early development. The years from 1917-1958 deal mainly with medicine’s intransigent opposition; then the tide began to turn in chiropractic’s favour. Governments appointed commissions of enquiry to bring some order into the health care field. Our profession’s brief to the Royal Commission on Health Services was described by the Minister of National Health and Welfare as “a very powerful document”. The government enquiries, in addition to identifying professional weaknesses, also made favourable recommendations which encouraged the further growth and development of chiropractic. Commenting on his work as a Royal Commissioner, Mr. Justice Gerard Lacroix said that the medical opposition to chiropractic was: “... based on bias and prejudice, ignorance and refusal to learn about chiropraxy. I thought it safer to know and understand before judging” (p. 13).8

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

    PubMed Central

    Kopansky-Giles, Deborah; Papadopoulos, Costa

    1997-01-01

    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 inventory of data and practical information on Canada’s licensed chiropractors. The data is now available for use internally by the CCA or by external audiences who may need statistical information from time to time. It is hoped that the survey which led to the establishment of the CCRD will be repeated on a periodic basis, with requisite modifications, to update the data bank and to determine longitudinal trends regarding the chiropractic profession in Canada. The CCRD can be an important source of information for decision making and planning.

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

    PubMed Central

    Young, Kenneth J.; Siordia, Lawrence

    2012-01-01

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

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

    PubMed Central

    Lehman, James J.; Suozzi, Paul J.

    2008-01-01

    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 PMID:18483589

  13. Buckeye chiropractic: turbulence in a limited branch of medicine, 1915-1975.

    PubMed

    Callender, A

    1995-12-01

    In Ohio in 1915, the Platt-Ellis Law was enacted, a compromise between medical and chiropractic forces that defined chiropractic as a "limited branch of medicine or surgery." Practitioners of chiropractic, naprapathy, spondylotherapy, mechanotherapy, magnetic healing, and other "minor" healing arts excluding osteopathy and midwifery were all examined by the State Medical Board. The two disparate definitions created six decades of turmoil for chiropractic in Ohio. The 1920's were marked by the civil disobedience employed successfully in other states, with hundreds of unlicensed chiropractors choosing jail over fines. Multiple state organizations were formed, representing "straights, mixers, straight-mixers, mixing straights, minglers" and every other possible combination. The public accepted licensed and unlicensed practitioners, and doctors included their licensing status in their advertisements. PMID:11613404

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

    PubMed Central

    Lystad, Reidar P; Pollard, Henry

    2009-01-01

    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. PMID:19421353

  15. Financial attitudes, knowledge, and habits of chiropractic students: A descriptive survey

    PubMed Central

    Lorence, Julie; Lawrence, Dana J.; Salsbury, Stacie A.; Goertz, Christine M.

    2014-01-01

    Objective: Our purpose was to describe the financial knowledge, habits and attitudes of chiropractic students. Methods: We designed a cross-sectional survey to measure basic financial knowledge, current financial habits, risk tolerance, and beliefs about future income among 250 students enrolled in business courses at one US chiropractic college. Descriptive statistical analyses were performed. Results: We received 57 questionnaires (23% response rate). Most respondents would accumulate over $125,000 in student loan debt by graduation. Financial knowledge was low (mean 77%). Most respondents (72%) scored as average financial risk takers. Chiropractic students reported recommended short-term habits such as having checking accounts (90%) and health insurance (63%) or paying monthly bills (88%) and credit cards (60%). Few saved money for unplanned expenses (39%) or long-term goals (26%), kept written budgets (32%), or had retirement accounts (19%). Conclusion: These chiropractic students demonstrated inadequate financial literacy and did not engage in many recommended financial habits. PMID:24587498

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

    PubMed Central

    Miners, Andrew L.

    2010-01-01

    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

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

    PubMed Central

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

    2014-01-01

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

  18. Integration of Chiropractic Services in Military and Veteran Health Care Facilities: A Systematic Review of the Literature.

    PubMed

    Green, Bart N; Johnson, Claire D; Daniels, Clinton J; Napuli, Jason G; Gliedt, Jordan A; Paris, David J

    2016-04-01

    This literature review examined studies that described practice, utilization, and policy of chiropractic services within military and veteran health care environments. A systematic search of Medline, CINAHL, and Index to Chiropractic Literature was performed from inception through April 2015. Thirty articles met inclusion criteria. Studies reporting utilization and policy show that chiropractic services are successfully implemented in various military and veteran health care settings and that integration varies by facility. Doctors of chiropractic that are integrated within military and veteran health care facilities manage common neurological, musculoskeletal, and other conditions; severe injuries obtained in combat; complex cases; and cases that include psychosocial factors. Chiropractors collaboratively manage patients with other providers and focus on reducing morbidity for veterans and rehabilitating military service members to full duty status. Patient satisfaction with chiropractic services is high. Preliminary findings show that chiropractic management of common conditions shows significant improvement. PMID:26677851

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

    PubMed Central

    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

    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. PMID:23966884

  20. Assessing the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after an educational intervention.

    PubMed

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

    2014-10-01

    Objective : We assessed the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after a 1-hour educational intervention. Methods : A mixed-methods approach was used with a 52-item cross-sectional paper survey and 1 focus group of third-year medical students. The views of these medical students towards chiropractic were assessed previously in their second-year of medical school. ANOVA and the Wilcoxon rank-sum test were used to assess between-group differences between the medical students' views before and after the educational intervention. The constant comparative method for analyzing qualitative data was used to identify emergent themes from the focus group transcript. Results : Of 112 third-year medical students, 58 completed the survey (51.7% response rate). The focus group consisted of 6 medical students. Self-reported understanding of chiropractic and number of attitude-positive responses were significantly higher in the group after the educational session. The average number of correct responses assessing knowledge on chiropractic also was significantly higher. Focus group themes were that medical students wanted exposure to chiropractic in clinical settings, had negative attitudes towards chiropractic formed from hidden curriculum, had concerns regarding evidence and safety of chiropractic, and thought that timing of the session on chiropractic was too late in the curriculum. Conclusions : The attitudes and knowledge of medical students towards chiropractic improved immediately after a 1-hour educational intervention. Formally educating medical students on chiropractic may help minimize hidden curriculum issues regarding chiropractic, as identified by the medical students, and facilitate collaboration between medical and chiropractic providers. PMID:25237768

  1. Assessing the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after an educational intervention*

    PubMed Central

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

    2014-01-01

    Objective We assessed the change in attitudes, knowledge, and perspectives of medical students towards chiropractic after a 1-hour educational intervention. Methods A mixed-methods approach was used with a 52-item cross-sectional paper survey and 1 focus group of third-year medical students. The views of these medical students towards chiropractic were assessed previously in their second-year of medical school. ANOVA and the Wilcoxon rank-sum test were used to assess between-group differences between the medical students' views before and after the educational intervention. The constant comparative method for analyzing qualitative data was used to identify emergent themes from the focus group transcript. Results Of 112 third-year medical students, 58 completed the survey (51.7% response rate). The focus group consisted of 6 medical students. Self-reported understanding of chiropractic and number of attitude-positive responses were significantly higher in the group after the educational session. The average number of correct responses assessing knowledge on chiropractic also was significantly higher. Focus group themes were that medical students wanted exposure to chiropractic in clinical settings, had negative attitudes towards chiropractic formed from hidden curriculum, had concerns regarding evidence and safety of chiropractic, and thought that timing of the session on chiropractic was too late in the curriculum. Conclusions The attitudes and knowledge of medical students towards chiropractic improved immediately after a 1-hour educational intervention. Formally educating medical students on chiropractic may help minimize hidden curriculum issues regarding chiropractic, as identified by the medical students, and facilitate collaboration between medical and chiropractic providers. PMID:25237768

  2. Chiropractic practice in Hong Kong: the need for amendments of health laws and provisions

    PubMed Central

    Woo, Chun-Cheung

    1995-01-01

    Chiropractic practitioners with accredited qualifications should have the right to diagnose, the right to operate diagnostic imaging machines, and the right to the title doctor and Yee San. This paper reviews chiropractic practice in Hong Kong as well as laws and provisions of the health professions namely Chiropractors Registration Ordinance, Medical Registration Ordinance, Dentists Registration Ordinance, Radiation Ordinance, and the provisions of codes of practice of Medical Laboratory Technologists and Radiographers. The need for amendments of relevant sections of health laws and provisions, which concern chiropractic rights, chiropractic practice, and clinical research of mechanical neuromusculoskeletal disorders is discussed. Patient privileges relevant to chiropractic practice are proposed. The Chinese title Yee San or Yee and the English title Doctor are generic terms. Hence, legally “Yee San” and “Doctor” should not be coined by medical practitioners and vice versa. Diagnostic imaging and laboratory procedures are essential for differential diagnosis of neuromusculoskeletal disorders, which may indicate or contraindicate the application of manipulation, and hence are essential for chiropractic practice and clinical research. Proposed amendments of the listed sections of the ordinances and provisions are also outlined.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-10-01

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

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

    PubMed Central

    2010-01-01

    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. PMID:20525197

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

    Gleberzon, Brian J.

    2001-01-01

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

  8. Patient perceptions in New Mexico about doctors of chiropractic functioning as primary care providers with limited prescriptive authority

    PubMed Central

    Lehman, James J.; Suozzi, Paul J.; Simmons, George R.; Jegtvig, Shereen K.

    2011-01-01

    Objectives The purpose of this study was to determine chiropractic patients' perceptions of chiropractors serving as primary care providers and having a limited prescriptive authority. Methods Four doctors of chiropractic in Albuquerque and Santa Fe, NM, participated in surveying their patients during the summer of 2008. The chiropractors distributed the questionnaires consecutively to chiropractic patients. Patients answered questions regarding their perceptions of their chiropractors, use of chiropractic care, and medications for pain. The participating chiropractors collected the completed patient questionnaires and mailed them to the primary investigator. Results The chiropractic providers collected 275 chiropractic patient questionnaires. The number of patient questionnaires collected by each of the 4 participating chiropractors ranged from 35 to 100. The patients primarily sought care for the management and treatment of pain (98.5%), and 57.5% considered that their chiropractors were “primary care providers.” Eighty-five percent preferred that their chiropractor be qualified to prescribe medications and provide hands-on treatment, whereas 97.5% perceived their chiropractors to be chiropractic physicians. Conclusions This small group of chiropractic patients from 4 offices in New Mexico perceived that their doctors of chiropractic were physicians and primary care providers, and 85% preferred that their chiropractor treat patients with limited prescriptive authority when appropriately trained. PMID:22027203

  9. Sports chiropractic management at the World Ice Hockey Championships

    PubMed Central

    2010-01-01

    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. PMID:21129212

  10. Constructing a philosophy of chiropractic: evolving worldviews and postmodern core☆

    PubMed Central

    Senzon, Simon A.

    2011-01-01

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

  11. Chiropractic leadership in the eradication of sexual abuse

    PubMed Central

    Kinsinger, F. Stuart; Sutton, Wendy

    2012-01-01

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

  12. Chiropractic Response to a Spontaneous Vertebral Artery Dissection

    PubMed Central

    Tarola, Gary; Phillips, Reed B.

    2015-01-01

    Objective The purpose of this case report is to describe a case in which early detection and proper follow-up of spontaneous vertebral artery dissection led to satisfactory outcomes. Clinical Features A 34-year old white woman reported to a chiropractic clinic with a constant burning pain at the right side of her neck and shoulder with a limited ability to turn her head from side to side, periods of blurred vision, and muffled hearing. Dizziness, visual and auditory disturbances, and balance difficulty abated within 1 hour of onset and were not present at the time of evaluation. A pain drawing indicated burning pain in the suboccipital area, neck, and upper shoulder on the right and a pins and needles sensation on the dorsal surface of both forearms. Turning her head from side-to-side aggravated the pain, and the application of heat brought temporary relief. The Neck Disability Index score of 44 placed the patient’s pain in the most severe category. Intervention and Outcome The patient was not treated on the initial visit but was advised of the possibility of a vertebral artery or carotid artery dissection and was recommended to the emergency department for immediate evaluation. The patient declined but later was convinced by her chiropractor to present to the emergency department. A magnetic resonance angiogram of the neck and carotid arteries was performed showing that the left vertebral artery was hypoplastic and appeared to terminate at the left posterior inferior cerebellar artery. There was an abrupt moderately long segment of narrowing involving the right vertebral artery beginning near the junction of the V1 and V2 segments. The radiologist noted a concern regarding right vertebral artery dissection. Symptoms resolved and the patient was cleared of any medications but advised that if symptoms reoccurred she was to go for emergency care immediately. Conclusion Recognition and rapid response by the chiropractic physician provided the optimum outcome for this particular patient. PMID:26778932

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    2010-01-01

    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. PMID:20525195

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

    PubMed Central

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

    2008-01-01

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

  16. The effect of chiropractic techniques on the Cobb angle in idiopathic scoliosis arising in adolescence

    PubMed Central

    Byun, Sunghak; Han, Dongwook

    2016-01-01

    [Purpose] The purpose of this study was to examine whether chiropractic techniques would reduce the curvature of idiopathic scoliosis, which commonly occurs in elementary school children. [Subjects] The subjects of this study were 5 healthy elementary students who listened to an explanation of the study methods and purpose of the study and agreed to participate in the experiment. [Methods] The Cobb angle was measured by taking an X-ray (FCT-1, Dongmun, Goyangsi, Republic of Korea) taken from the rear, using X-ray film. The method of intervention this study used was application of chiropractic techniques. Spinal correction was carried out for 30 minutes per session, which included soft tissue massage, 3 times a week for 8 weeks. [Results] It was established that the Cobb angle was noticeably decreased after 4 weeks of the intervention. Post Hoc analysis revealed that the Cobb angle noticeably decreased after 4 weeks compared with the Cobb angle before the chiropractic techniques were applied. However, no significant difference in Cobb angle was evident after the fourth week. [Conclusion] This study demonstrated that chiropractic techniques can effectively reduce the Cobb angle within as little as 4 weeks. So, we can confirm that the chiropractic techniques were effective for reducing the curvature of idiopathic scoliosis. PMID:27190435

  17. The effect of chiropractic techniques on the Cobb angle in idiopathic scoliosis arising in adolescence.

    PubMed

    Byun, Sunghak; Han, Dongwook

    2016-04-01

    [Purpose] The purpose of this study was to examine whether chiropractic techniques would reduce the curvature of idiopathic scoliosis, which commonly occurs in elementary school children. [Subjects] The subjects of this study were 5 healthy elementary students who listened to an explanation of the study methods and purpose of the study and agreed to participate in the experiment. [Methods] The Cobb angle was measured by taking an X-ray (FCT-1, Dongmun, Goyangsi, Republic of Korea) taken from the rear, using X-ray film. The method of intervention this study used was application of chiropractic techniques. Spinal correction was carried out for 30 minutes per session, which included soft tissue massage, 3 times a week for 8 weeks. [Results] It was established that the Cobb angle was noticeably decreased after 4 weeks of the intervention. Post Hoc analysis revealed that the Cobb angle noticeably decreased after 4 weeks compared with the Cobb angle before the chiropractic techniques were applied. However, no significant difference in Cobb angle was evident after the fourth week. [Conclusion] This study demonstrated that chiropractic techniques can effectively reduce the Cobb angle within as little as 4 weeks. So, we can confirm that the chiropractic techniques were effective for reducing the curvature of idiopathic scoliosis. PMID:27190435

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

    PubMed Central

    Gleberzon, Brian J.

    2011-01-01

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

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

    PubMed Central

    Angus, Katherine; Asgharifar, Sepideh; Gleberzon, Brian

    2015-01-01

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

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

    PubMed

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

    1995-01-01

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

  1. Cost-effectiveness of chiropractic care versus self-management in patients with musculoskeletal chest pain

    PubMed Central

    Sørensen, Jan; Vach, Werner; Christensen, Henrik Wulff; Høilund-Carlsen, Poul Flemming; Hartvigsen, Jan

    2016-01-01

    Aims To assess whether primary sector healthcare in the form of chiropractic care is cost-effective compared with self-management in patients with musculoskeletal chest pain, that is, a subgroup of patients with non-specific chest pain. Methods and results 115 adults aged 18–75 years with acute, non-specific chest pain of musculoskeletal origin were recruited from a cardiology department in Denmark. After ruling out acute coronary syndrome and receiving usual care, patients with musculoskeletal chest pain were randomised to 4 weeks of community-based chiropractic care (n=59) or to a single information session aimed at encouraging self-management as complementary to usual care (n=56). Data on resource use were obtained from Danish national registries and valued from a societal perspective. Patient cost and health-related quality-adjusted life years (QALYs; based on EuroQol five-dimension questionnaire (EQ-5D) and Short Form 36-item Health Survey (SF-36)) were compared in cost-effectiveness analyses over 12 months from baseline. Mean costs were €2183 lower for the group with chiropractic care, but not statistically significant (95% CI −4410.5 to 43.0). The incremental cost-effectiveness ratio suggested that chiropractic care was cost-effective with a probability of 97%, given a threshold value of €30 000 per QALY gained. In both groups, there was an increase in the health-related quality of life, and the mean increases were similar over the 12-month evaluation period. The mean differences in QALYs between the groups were negligible. Conclusions Chiropractic care was more cost-effective than self-management. Therefore, chiropractic care can be seen as a good example of a targeted primary care approach for a subgroup of patients with non-specific chest pain. Trial registration number NCT00462241. PMID:27175285

  2. The Comparative Effect of Episodes of Chiropractic and Medical Treatment on the Health of Older Adults

    PubMed Central

    Weigel, Paula A; Hockenberry, Jason; Bentler, Suzanne E.; Wolinsky, Fredric D.

    2014-01-01

    Objectives The comparative effect of chiropractic vs. medical care on health, as used in everyday practice settings by older adults, is not well understood. The purpose of this study is to examine how chiropractic compares to medical treatment in episodes of care for uncomplicated back conditions. Episode of care patterns between treatment groups are described, and effects on health outcomes among an older group of Medicare beneficiaries over a two-year period are estimated. Methods Survey data from the nationally representative Survey on Assets and Health Dynamics among the Oldest Old (AHEAD) were linked to participants' Medicare Part B claims under a restricted Data Use Agreement with the Centers for Medicare and Medicaid Services. Logistic regression was used to model the effect of chiropractic use in an episode of care relative to medical treatment on declines in function and well-being among a clinically homogenous older adult population. Two analytic approaches were used, the first assumed no selection bias and the second using propensity score analyses to adjust for selection effects in the outcome models. Results Episodes of care between treatment groups varied in duration and provider visit pattern. Among the unadjusted models there was no significant difference between chiropractic and medical episodes of care. The propensity score results indicate a significant protective effect of chiropractic against declines in activities of daily living, instrumental activities of daily living, and self-rated health (AOR 0.49, AOR 0.62, and AOR 0.59, respectively). There was no difference between treatment types on declines in lower body function or depressive symptoms. Conclusion The findings from this study suggest that chiropractic use in episodes of care for uncomplicated back conditions has protective effects against declines in activities of daily living, instrumental activities of daily living, and self-rated health for older Medicare beneficiaries over a two-year period. PMID:24636108

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

    PubMed Central

    Hobaek Siegenthaler, Mette

    2015-01-01

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

  4. Resolution of cervical radiculopathy in a woman after chiropractic manipulation

    PubMed Central

    Whalen, Wayne M.

    2008-01-01

    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. PMID:19674715

  5. Test anxiety and academic performance in chiropractic students.

    PubMed

    Zhang, Niu; Henderson, Charles N R

    2014-01-01

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

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

    PubMed Central

    Cooperstein, Robert; Lisi, Anthony; Burd, Andrew

    2014-01-01

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

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

    PubMed Central

    Brown, Douglas M.

    2001-01-01

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

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

    ERIC Educational Resources Information Center

    Duray, Stephen M.; Mekow, Craig L.

    2011-01-01

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

  9. An Investigation into the Faculty Development Practices in Chiropractic Education Programs

    ERIC Educational Resources Information Center

    Scaringe, John G.

    2010-01-01

    A descriptive case study design using a cross-sectional quantitative survey method was used to investigate the impact of faculty development programs on teaching effectiveness perceived by faculty teaching at chiropractic colleges in the United States. The availability of faculty development programs related to teaching and student learning was…

  10. Correlations Between Chiropractic National Board (Part I) Scores and Basic Science Course Grades and Related Data.

    ERIC Educational Resources Information Center

    Wolfenberger, Virginia

    1999-01-01

    A study at one institution found significant correlations between students' scores on the National Board of Chiropractic Examiners test and academic achievement data. Results indicate that it is not always course subject matter that influences the relationship between course grade and board scores, but may instead be the ability to assimilate…

  11. Texas Chiropractic College Practice Management Education: The Patient's Point of View.

    ERIC Educational Resources Information Center

    Waigandt, Alex; And Others

    A survey was conducted to determine the patient's perception of treatment received from clinicians at the Texas Chiropractic College Clinic in Pasadena, Texas. A questionnaire designed to assess various aspects of the school's clinical and dispensary services was administered to 79 patients who had completed their treatment prescriptions. The…

  12. Self-Regulation of a Chiropractic Association through Participatory Action Research

    ERIC Educational Resources Information Center

    Sheppard, Lorraine A.; Jorgensen, Anna Maria S.; Crowe, Michael J.

    2012-01-01

    Participatory action research (PAR) can be used in the health professions to redefine their roles. This study investigated a small health professional group, the members of The Chiropractic Association Singapore (TCAS), by using a PAR method; researchers and participants gained insights into the self-regulation of a health profession. A…

  13. Utilizing doctors' attitudes toward staff training to inform a chiropractic technology curriculum

    PubMed Central

    Eberhart, Catherine A.; Martel, Stacie S.

    2015-01-01

    Objective The purpose of this study is to determine attitudes of doctors of chiropractic regarding the importance of staff training in specific skill areas to inform the curriculum management process of a chiropractic technology program. Methods A survey was distributed to registrants of a chiropractic homecoming event. On a 5-point Likert scale, respondents were asked to rate the degree of importance that staff members be trained in specific skills. Descriptive statistics were derived, and a 1-way analysis of variance (ANOVA) was used to test differences between groups based on years in practice and level of staff training. Results Doctors place a high level of importance on oral communication skills and low importance on nutrition and physical examinations. Comparing groups based on years in practice revealed differences in the areas of passive physiotherapies (F = 3.61, p = .015), legal issues/regulations (F = 3.01, p = .032), occupational safety and health regulation (F = 4.27, p = .006), and marketing (F = 2.67, p = .049). Comparing groups based on level of staff training revealed differences in the areas of occupational safety and health regulations (F = 4.56, p = .005) and cardiopulmonary resuscitation (F = 4.91, p = .003). Conclusion With regard to their assistants, doctors of chiropractic tend to place high importance on office skills requiring effective communication and place less importance on clinical skills such as physical examinations and physiotherapy. PMID:24837884

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

    ERIC Educational Resources Information Center

    Duray, Stephen M.; Mekow, Craig L.

    2011-01-01

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

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

    PubMed Central

    Keating, Joseph C

    2003-01-01

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

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

    PubMed Central

    2010-01-01

    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. PMID:20546582

  17. The American Chiropractic Board of Sports Physicians Position Statement on Pre-Participation Examinations: An Expert Consensus

    PubMed Central

    Moreau, William J.; Nabhan, Dustin C.; Roecker, Christopher; Kimura, Melissa Nagare; Klein, Andrew; Guimard, Brett; Pierce, Kevin; Helma, Patrick; Nelson, Robert; Bahr, Kelly Shockley; Nelson, Laney; Williams, Perry

    2015-01-01

    Objective The purpose of this paper is to present a position statement of best practices for the provision of a safe and high-quality pre-participation examination (PPE) and to provide recommendations on education requirements for doctors of chiropractic providing the PPE. Methods In 2014, the American Chiropractic Board of Sports Physicians (ACBSP) Board of Directors identified a need to review and update the ACBSP position statements and practice guidelines in order to be current with evolving best practices. Twelve ACBSP certificants, 10 Diplomates of the ACBSP, and 2 Certified Chiropractic Sports Physicians, met in April 2015 to author a pre-participation position statement using an expert consensus process. Panel members excluded anyone with commercial conflicts of interest and included individuals with expertise in clinical sports medicine and the performance of PPEs. A literature review was performed and circulated in advance for use by the panel in addressing the topic. The position statement was written through a consensus process and accepted by the ACBSP Board of Directors in May of 2015. Results The ACBSP Position Statement on Pre-participation Examinations identifies the qualifications and best practices for doctors of chiropractic to perform a PPE. Conclusion This position statement states that doctors of chiropractic with post graduate education and current Diplomates of the ACBSP or Certified Chiropractic Sports Physicians certification have the prerequisite education and qualifying skills to perform PPEs. PMID:26778931

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

    PubMed Central

    Senzon, Simon A.

    2014-01-01

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

  19. Emphasis on various subtopics in the anatomy curriculum for chiropractic training: An international survey of chiropractors and anatomists

    PubMed Central

    Chapman, Peter D.; Meyer, Amanda; Young, Kenneth; Wibowo, Daniel; Walker, Bruce

    2015-01-01

    Objective The aim of this study was to conduct an international survey of the perceived optimal level of anatomy teaching from anatomy academics and practicing chiropractors. We hypothesized that the optimum level of anatomical understanding for chiropractic students does not differ between the anatomists teaching the students and practicing chiropractors. Methods The opinion of anatomists teaching in a chiropractic course (n = 16) was compared to practicing chiropractors (n = 589). The students' level of understanding was based on the revised Bloom's taxonomy for 16 different curriculum areas. Anatomists were recruited by contacting the accredited chiropractic courses worldwide. Snowball sampling was used for the practicing chiropractors. Independent-samples Mann-Whitney U tests were used to compare the results of anatomists and chiropractors. Results Opinions differed between anatomists and chiropractors on 9 out of the 16 questions. Where opinions differed, chiropractors recommended a higher standard of anatomical knowledge. The level suggested by chiropractors for these curriculum areas is equal to the “evaluating” level where chiropractic students can remember, understand, apply, and analyze anatomical knowledge to be able to justify a clinical decision. Conclusion Compared to anatomists working in chiropractic programs, chiropractors suggest a higher standard of anatomy be taught to undergraduates. Collaboration between chiropractors and anatomists would likely be beneficial in creating or modifying anatomy curricula for chiropractic students. PMID:25517738

  20. Attitudes toward evidence-based clinical practice among doctors of chiropractic with diplomate-level training in orthopedics

    PubMed Central

    2013-01-01

    Background Evidence-based clinical practice (EBCP) is a practice model gaining prominence within healthcare, including the chiropractic profession. The status of EBCP has been evaluated in a variety of healthcare disciplines, but little is known regarding the attitudes doctors of chiropractic (DCs) hold toward this model of healthcare. This project examines the attitudes toward EBCP within a specialty discipline of DCs. Methods We identified a survey questionnaire previously used to evaluate EBCP among non-chiropractic complementary and alternative practitioners. We adapted this questionnaire for use among DCs and pretested it in 5 chiropractic college faculty. The final version was administered to DCs with diplomate-level training in orthopedics. The survey was emailed to 299 potential participants; descriptive results were calculated. Results 144 surveys were returned, resulting in a 48% response rate. The majority of respondents perceived EBCP as an important aspect of chiropractic practice. Respondents also believed themselves to have an above average skill level in EBCP, reported that training originated from their diplomate education, and based the majority of their practice on clinical research. Conclusion Doctors of chiropractic with an orthopedic diplomate appear to have favorable attitudes toward EBCP. Further study will help understand EBCP perceptions among general field DCs. A logical next step includes validation of this questionnaire. PMID:24314309

  1. An audit of health products and services marketed on chiropractic websites in Alberta and consideration of these practices in the context of chiropractic codes of conduct and ethics

    PubMed Central

    Page, Stacey A.

    2007-01-01

    Background Chiropractic’s success as a health care profession is evidenced in part by the rising number of practitioners. Paradoxically, this success may start to cost the profession, as the number of consumers may not be increasing proportionally. Fewer patients mean less income for practitioners. Some chiropractors are responding to these pressures by marketing health products, and services Objectives To describe the extent to which Alberta chiropractors with websites sold health products and the extent to which fee discounts/service inducements were advertised. To consider these practices in the context of chiropractic codes of conduct and ethics. Methods Chiropractic websites in the province of Alberta were identified using the online Telus Business Finder and cross-referenced with the Yellow Pages print directories. The websites were searched and an inventory of the health products for sale was recorded. Fee discounts and service inducements were also recorded. Results 56 websites were identified and reviewed. Just under two-thirds of the chiropractic websites surveyed contained information on health products for sale. Orthotics were sold most often (N = 29 practices; 51.8%), followed by pillows and supports (N = 15: 26.8%), vitamins/nutritional supplements (N = 15; 26.8%) and exercise/rehabilitation products (N = 10; 17.9%). Nine practices (16.1%) offered some type of inducement to potential customers. These included discounts on treatment packages (N = 2; 3.6%), free gait/ posture analyses (N = 2; 3.6%) and free general consultations with the chiropractors (N = 3; 5.4%) Conclusions The marketing of health care products and services by chiropractors in Alberta is common. Such practices raise ethical considerations for the profession. Professional guidelines vary on the acceptability of these practices. Consumer and practitioner perspectives and practices regarding retailing need to be further examined. PMID:17657302

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

    PubMed

    Gibbons, R W

    1996-12-01

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

  3. Chiropractic Management of an 81-Year-Old Man With Parkinson Disease Signs and Symptoms

    PubMed Central

    Bova, Joesph; Sergent, Adam

    2014-01-01

    Objective The purpose of this case report is to describe the chiropractic management of a patient with Parkinson disease. Clinical features An 81-year-old male with a 12-year history of Parkinson disease sought chiropractic care. He had a stooped posture and a shuffling gait. He was not able to ambulate comfortably without the guidance of his walker. The patient had a resting tremor, most notably in his right hand. Outcome measures were documented using the Parkinson’s Disease Questionaire-39 (PDQ-39) and patient subjective reports. Intervention and outcome The patient was treated with blue-lensed glasses, vibration stimulation therapy, spinal manipulation, and eye-movement exercises. Within the first week of treatment, there was a reduction in symptoms, improvement in ambulation, and tremor. Conclusion For this particular patient, the use of alternative treatment procedures appeared to help his Parkinson disease signs and symptoms. PMID:25685120

  4. Cortex-sparing infarction in triple cervical artery dissection following chiropractic neck manipulation

    PubMed Central

    Melikyan, Gayane; Kamran, Saadat; Akhtar, Naveed; Deleu, Dirk; Miyares, Francisco Ruiz

    2015-01-01

    Background: Multivessel cervical dissection with cortical sparing is exceptional in clinical practice. Case presentation: A 55-year-old man presented with acute-onset neck pain with associated sudden onset right-sided hemiparesis and dysphasia after chiropractic manipulation for chronic neck pain. Results and Discussion: Magnetic resonance imaging revealed bilateral internal carotid artery dissection and left extracranial vertebral artery dissection with bilateral anterior cerebral artery territory infarctions and large cortical-sparing left middle cerebral artery infarction. This suggests the presence of functionally patent and interconnecting leptomeningeal anastomoses between cerebral arteries, which may provide sufficient blood flow to salvage penumbral regions when a supplying artery is occluded. Conclusion: Chiropractic cervical manipulation can result in catastrophic vascular lesions preventable if these practices are limited to highly specialized personnel under very specific situations. PMID:26835412

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

    PubMed Central

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

    2005-01-01

    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 upright posture in the presence of other postural deficits. These perspectives need to be explored in more detail. PMID:16091134

  6. Evidence-based medicine and its implications for the profession of chiropractic.

    PubMed

    Villanueva-Russell, Yvonne

    2005-02-01

    Evidence-based medicine (EBM) has grown in popularity and prominence in the world of orthodox medicine since the 1980s. The focus of this article is on the process of developing practice guidelines (one type of EBM) and its effects upon chiropractic, a profession with a "philosophy, science and art" that is constructed upon divergent epistemological and methodological tenets (namely, the idea of "vitalism"). The EBM movement is conceptualized as part of a larger political economy surrounding the health care environment that creates a new set of imperatives for orthodox medicine, and also branches of alternative medicine that are in the process of professionalization. The quantitative, positivist and empiricist assumptions of EBM dictate which approaches to treatment and which clinical procedures are legitimate and perhaps reimbursable under systems of managed care. The ramifications of practice guidelines and its effects upon the intraprofessional segments of the chiropractic profession are also discussed. PMID:15550303

  7. Evaluation of clinical practice guidelines in chiropractic care: a comparison of North American guideline reports

    PubMed Central

    Brouwers, Melissa; Charette, Manya

    2001-01-01

    Clinical practice guidelines developed by the Canadian Chiropractic Association (CCA) and the Council on Chiropractic Practice (CCP) were evaluated by three independent appraisers using the most current version of the Appraisal of Guidelines for Research and Evaluation in Europe (AGREE) Instrument. Eighteen eligible chapters within the two documents (nine from each organization) were evaluated. In general, the CCA document was rated more favourably than the CCP document. The strengths of both documents include clarity of objectives and target users and complete descriptions of methods used to formulate recommendations. Areas of improvement for both documents include the need for more detail regarding the bodies of evidence under consideration for each section of the guideline. This paper presents the complete results of the evaluation, discusses the strengths of each guideline document, and makes suggestions for areas of improvement. Imagesp153-a

  8. Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation

    PubMed Central

    Sieg, Emily P; Zalatimo, Omar; Hussain, Namath S; Glantz, Michael; Harbaugh, Robert E

    2016-01-01

    Background Case reports and case control studies have suggested an association between chiropractic neck manipulation and cervical artery dissection (CAD), but a causal relationship has not been established. We evaluated the evidence related to this topic by performing a systematic review and meta-analysis of published data on chiropractic manipulation and CAD. Methods Search terms were entered into standard search engines in a systematic fashion. The articles were reviewed by study authors, graded independently for class of evidence, and combined in a meta-analysis. The total body of evidence was evaluated according to GRADE criteria. Results Our search yielded 253 articles. We identified two class II and four class III studies. There were no discrepancies among article ratings (i.e., kappa=1). The meta-analysis revealed a small association between chiropractic care and dissection (OR 1.74, 95% CI 1.26-2.41). The quality of the body of evidence according to GRADE criteria was “very low.” Conclusions The quality of the published literature on the relationship between chiropractic manipulation and CAD is very low. Our analysis shows a small association between chiropractic neck manipulation and cervical artery dissection. This relationship may be explained by the high risk of bias and confounding in the available studies, and in particular by the known association of neck pain with CAD and with chiropractic manipulation. There is no convincing evidence to support a causal link between chiropractic manipulation and CAD. Belief in a causal link may have significant negative consequences such as numerous episodes of litigation. PMID:27014532

  9. Risk of Traumatic Injury Associated with Chiropractic Spinal Manipulation in Medicare Part B Beneficiaries Aged 66–99

    PubMed Central

    Whedon, James M; Mackenzie, Todd A; Phillips, Reed B; Lurie, Jon D

    2014-01-01

    Study Design Retrospective cohort study. Objective In older adults with a neuromusculoskeletal complaint, to evaluate risk of injury to the head, neck or trunk following an office visit for chiropractic spinal manipulation, as compared to office visit for evaluation by primary care physician. Summary of Background Data The risk of physical injury due to spinal manipulation has not been rigorously evaluated for older adults, a population particularly vulnerable to traumatic injury in general. Methods We analyzed Medicare administrative data on Medicare B beneficiaries aged 66–99 with an office visit in 2007 for a neuromusculoskeletal complaint. Using a Cox proportional hazards model, we evaluated for adjusted risk of injury within 7 days, comparing two cohorts: those treated by chiropractic spinal manipulation vs. those evaluated by a primary care physician. We used direct adjusted survival curves to estimate the cumulative probability of injury. In the chiropractic cohort only, we used logistic regression to evaluate the effect of specific chronic conditions on likelihood of injury. Results The adjusted risk of injury in the chiropractic cohort was lower as compared to the primary care cohort (hazard ratio 0.24; 95% CI 0.23–0.25). The cumulative probability of injury in the chiropractic cohort was 40 injury incidents per 100,000 subjects, as compared to 153 incidents per 100,000 subjects in the primary care cohort. Among subjects who saw a chiropractic physician, the likelihood of injury was increased in those with a chronic coagulation defect, inflammatory spondylopathy, osteoporosis, aortic aneurysm and dissection, or long-term use of anticoagulant therapy. Conclusions Among Medicare beneficiaries aged 66–99 with an office visit risk for a neuromusculoskeletal problem, risk of injury to the head, neck or trunk within 7 days was 76% lower among subjects with a chiropractic office visit as compared to those who saw a primary care physician. PMID:25494315

  10. Rehabilitation — an addition to standard chiropractic management for chronic low back pain

    PubMed Central

    Wildberg, Brad

    1996-01-01

    A case of chronic vertebrogenic low back pain of biomechanical origin characterized by intermittent radiculitis and truck muscle insufficiency is presented. Initial allopathic and chiropractic management provided only palliative relief. A three-month program of in-office rehabilitation including progressive/resistance exercise was administered in conjunction with spinal manipulation. This program proved effective in reducing the patient’s low back pain and dependency on passive care.

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

    PubMed Central

    Brown, Douglas M.

    2010-01-01

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

  12. A Collaborative Approach Between Chiropractic and Dentistry to Address Temporomandibular Dysfunction: A Case Report

    PubMed Central

    Rubis, Lisa M.; Rubis, David; Winchester, Brett

    2014-01-01

    Objective The purpose of this case report is to describe the chiropractic and dental comanagement of a patient with temporomandibular dysfunction, headaches, and myalgia. Clinical features A 38-year-old black female patient presented for chiropractic care with a chief concern of jaw pain, tinnitus, headaches, and neck and shoulder soreness of 8 months’ duration. The patient rated the pain a 6/10. The patient had a maximum mouth opening of 42 mm, graphed evidence of disk displacement, loss of translation on opening of the right temporomandibular joint viewed on the lateral radiograph, and numerous areas of point tenderness on the Kinnie-Funt Chief Complaint Visual Index. She had decreased lateral cervical flexion. Intervention and outcome Dental treatment consisted of an anterior repositioning splint. Chiropractic care consisted of Activator treatment to the pelvis and the thoracic and cervical spine. Manual manipulation of the temporomandibular joint was performed along with a soft tissue technique intraorally on the lateral pterygoid. Postisometric relaxation in the head and neck region was also done. The patient was treated 6 times over 3 weeks. At the end of treatment, the patient had a pain rating of 0/10, maximum mouth opening of 49 mm, no tender points on the follow-up Kinnie-Funt, and increased cervical range of motion. Conclusion The patient demonstrated increased mouth opening, decreased pain rating, improved Kinnie-Funt visual index, and an increased cervical lateral flexion range of motion after 3 weeks of a combination of chiropractic and dental care. PMID:24711786

  13. Chiropractic management of low back pain in a patient with a transfemoral amputation

    PubMed Central

    Illes, Jennifer D.; Maola, Chad J.

    2012-01-01

    Objective The purpose of this case report is to describe the chiropractic management of a patient with a unilateral transfemoral amputation and low back pain (LBP). Clinical Features A 20-year-old woman with right transfemoral amputation and a right upper extremity amputation due to amniotic band syndrome had approximately 40 different prosthetic lower extremities in the prior 20 years. She presented for chiropractic care for LBP (5/10 numeric pain scale) that she experienced after receiving a new right prosthetic leg. The pain increased with walking, attempts to exercise, and lying supine. Physical evaluation revealed asymmetrical leg length (long right limb); restricted left ankle dorsiflexion; restricted lumbopelvic motion; and hypertonicity of the left triceps surae muscle complex as well as the gluteus maximus, quadratus lumborum, and erector spinae bilaterally. Gait examination revealed a right Trendelenberg gait as well as a pattern of left vaulting. The working diagnosis was sacroiliac joint dysfunction, with lumbar facet syndrome secondary to a leg length inequality causing alteration in gait. Intervention and Outcome Chiropractic management included manipulative therapy to the lumbar spine and pelvis, trigger point therapy of hypertonic musculature, and strengthening of pelvic musculature. In addition, the patient's prosthetist shortened her new prosthetic device. After 18 treatments, LBP severity was resolved (0/10); and there was an overall improvement with gait biomechanics. Conclusion This case illustrates the importance of considering leg length inequality in patients with amputations as a possible cause of lower back pain, and that proper management may include adjusting the length of the prosthetic device and strengthening of the hip flexors and abductors, in addition to trigger point therapy and chiropractic manipulation. PMID:23450067

  14. Conservative chiropractic management of urinary incontinence using applied kinesiology: a retrospective case-series report

    PubMed Central

    Cuthbert, Scott C.; Rosner, Anthony L.

    2012-01-01

    Objective The purpose of this case series is to describe the chiropractic management of 21 patients with daily stress and occasional total urinary incontinence (UI). Clinical Features Twenty-one case files of patients 13 to 90 years of age with UI from a chiropractic clinic were reviewed. The patients had a 4-month to 49-year history of UI and associated muscle dysfunction and low back and/or pelvic pain. Eighteen wore an incontinence pad throughout the day and night at the time of their appointments because of unpredictable UI. Intervention and Outcome Patients were evaluated for muscle impairments in the lumbar spine, pelvis, and pelvic floor and low back and/or hip pain. Positive manual muscle test results of the pelvis, lumbar spine muscles, and pelvic floor muscles were the most common findings. Lumbosacral dysfunction was found in 13 of the cases with pain provocation tests (applied kinesiology sensorimotor challenge); in 8 cases, this sensorimotor challenge was absent. Chiropractic manipulative therapy and soft tissue treatment addressed the soft tissue and articular dysfunctions. Chiropractic manipulative therapy involved high-velocity, low-amplitude manipulation; Cox flexion distraction manipulation; and/or use of a percussion instrument for the treatment of myofascial trigger points. Urinary incontinence symptoms resolved in 10 patients, considerably improved in 7 cases, and slightly improved in 4 cases. Periodic follow-up examinations for the past 6 years, and no less than 2 years, indicate that for each participant in this case-series report, the improvements of UI remained stable. Conclusion The patients reported in this retrospective case series showed improvement in UI symptoms that persisted over time. PMID:22942842

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

    Taylor, David N.

    2011-01-01

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

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

    PubMed

    Young, Kenneth J

    2015-01-01

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

  18. Chiropractic Treatment of Lateral Epicondylitis: A Case Report Utilizing Active Release Techniques

    PubMed Central

    Gliedt, Jordan A.; Daniels, Clinton J.

    2014-01-01

    Objective The purpose of this report is to describe the chiropractic management of a case of lateral epicondylitis with active release techniques (ART). Clinical features A 48-year-old white man presented to a chiropractic clinic with a complaint of left lateral elbow pain that began 2 years previous with insidious onset. The patient reported an inability to play 18 consecutive holes of golf due to the pain. Intervention and outcome Treatment consisted of 5 sessions of ART (a soft tissue technique that is applied to muscles, fascia, tendons, ligaments, and nerves) applied to the left elbow soft tissue over a duration of 3 weeks. The patient reported an absence of pain and ability to consistently play 18 consecutive holes of golf up to 3 times per week at 4 and 8 weeks post-treatment. Conclusion This patient with lateral epicondylitis responded favorably to chiropractic treatment using the application of ART, as demonstrated by reduced pain and increased functional outcomes. PMID:25685118

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

    PubMed Central

    Schwab, Matthew J.

    2008-01-01

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

  20. Chiropractic management of a medial meniscus tear in a patient with tibiofemoral degeneration: a case report

    PubMed Central

    Jarosz, Brett S.; Ames, Rick A.

    2010-01-01

    Objective The purpose of this case report is to describe and discuss the clinical diagnosis of a medial meniscus tear in an older patient using a multimodal management approach provided by a chiropractor. Clinical Features A 60-year-old woman reported to a chiropractic clinic with left knee pain and swelling. The history and physical examination findings suggested a medial meniscus tear, which was confirmed with magnetic resonance imaging. Intervention and Outcome Treatment consisted of therapeutic ultrasound; rest, ice, compression, and elevation protocol; soft tissue therapy using effleurage and lymphatic drainage; chiropractic mechanically assisted adjusting techniques to the left knee using a handheld mechanical thrusting instrument; sports taping applied to assist facilitation of the vastus medialis obliquus; and a specific rehabilitation program aimed at strengthening this musculature. The patient's pain was assessed using a quadruple numeric pain scale. Function of the left knee was examined using McMurray, Apley, and a variation of Helfet orthopedic tests, as well as joint line tenderness. Monitoring was done at the initial consultation and at the sixth and 12th treatments. The patient reported being able to walk, swim, and ride a bicycle asymptomatically. Her pain score at the concluding visit was 16.7%, indicating low-intensity pain. Conclusion This case indicated that conservative management of a meniscus tear through a chiropractic multimodal treatment approach provided an alternative or adjunctive therapy to routine orthopedic surgery for this patient. PMID:22027113

  1. Commonwealth laws of Massachusetts v. early chiropractic pioneers, 1911-1915.

    PubMed

    Jackson, R B

    1999-06-01

    The first few chiropractors in Massachusetts practiced as they desired, unmolested by the authorities. All this changed after Joe Shelby Riley, D.C., established his New England College of Chiropractic in Boston in 1911. Printed publicity got out as to the tuition costs, length of the course and what graduates could expect to earn in a short time, when the police stepped in. They arrested first J.O. Zimmerman, D.C., of Boston, followed by Dr. Riley, a school president, then Samuel Mendelson, D.C., in Lynn, all for illegal practices. From the judical decision in Commonwealth v Zimmerman, 1915 by the Supreme Judicial Court (State Supreme Court), the high court held that the practice of chiropractic to be the illegal practice of medicine without a license, according to the Commonwealth laws of 1902. Next came the Commonwealth v New England College of Chiropractic; this case was shortly followed on appeal from the Municipal Court in Boston, to the Suffolk County Superior Court, to the Supreme Judicial Court like Zimmerman. In this case against Dr. Riley and his school, the high court affirmed the school to be illegal because Dr. Riley had failed to receive authority from the Great General Court (the Legislature) to get a bill passed authorizing the school to have the right of granting degrees. According to the Boston Herald, all this legal action was the culmination of a campaign spearheaded by the Massachusetts Medical Society. PMID:11624039

  2. Nutrition-related backgrounds and counseling practices of doctors of chiropractic.

    PubMed

    Newman, C F; Downes, N J; Tseng, R Y; McProud, L M; Newman, L K

    1989-07-01

    A questionnaire was designed and mailed to the entire membership (no. = 438) of the San Francisco Bay Area Chiropractic Society to determine their nutrition education backgrounds and counseling practices and the relationship of backgrounds and counseling practices and the relationship of backgrounds and information resources to counseling practices. Results, based on the 23% response rate, indicated that the hours of formal nutrition education in chiropractic college varied widely in the five categories of responses from zero to more than 120, with the median respondent falling in the median category (81 to 100 hours). Sixty percent of the respondents indicated that they provided nutrition information to their patients on a routine basis, and 38% provided information on request only. The major forms of nutrition information dissemination were counseling (87%) and written materials (74%). The majority of respondents reported that they diagnose osteoporosis, arthritis, and allergies and use nutrition treatments for those disorders as a part of overall therapy. Chiropractic journals and texts were the most frequently used sources of nutrition information. Awareness of the educational backgrounds of registered dietitians correlated positively with the use of dietitians as a resource for nutrition information (p less than .005). The survey results suggest a need for dietitians to become involved in the nutrition-related practices of chiropractors as sources for information and referral. PMID:2745912

  3. Sport Concussion Knowledge and Clinical Practices: A Survey of Doctors of Chiropractic With Sports Certification

    PubMed Central

    Moreau, William J.; Nabhan, Dustin C.; Walden, Taylor

    2015-01-01

    Objective The purpose of this study is to describe the knowledge base and clinical practices regarding concussion by sports-certified doctors of chiropractic. Methods A 21-item survey was distributed to the 312 attendees of the 2014 American Chiropractic Board of Sports Physicians Sports Sciences Symposium. Results were measured by frequency analysis and descriptive statistics for all surveys completed by sports-certified chiropractors. Results Seventy-six surveys were returned by sports-certified doctors of chiropractic. All (N = 76) 100% of respondents believe that the evaluation of concussion should be performed by a health care provider with training in concussion. The respondents actively assess and manage concussion in adults (96%), adolescents (95%), and children (75%). A majority (79%) of respondents believe that the Sideline Concussion Assessment Tool–3 represents a current standard of care for the sideline evaluation of the athlete who possibly has sustained a sport concussion. Most respondents agreed or strongly agreed that manual therapies may be appropriate in certain circumstances in adults (80%) and minors (80%). Conclusion This cross section of certified sports chiropractors strongly believes that the evaluation of concussion should be performed by a health care provider with specific training in concussion. A high percentage of the sports-certified chiropractors who responded assess and manage sport concussion in their practice, and many of them endorse the use of the Sideline Concussion Assessment Tool–3 as a sideline assessment tool. PMID:26778930

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

    PubMed Central

    Coulis, Christopher M.; Lisi, Anthony J.

    2013-01-01

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

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

    PubMed Central

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

    2008-01-01

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

  6. Current efforts in chiropractic quality assurance and standards of care †

    PubMed Central

    Hansen, Daniel T

    1991-01-01

    The chiropractic profession has recently begun to proactively address the problems identified by the health care industry. Prompted by rising health care costs, careful analysis revealed that the major culprit was the variance in the delivery of health care. Concerned with outside regulation, health professionals, both in the USA and Canada, are generating clinical guidelines that will serve as templates for the development of standards of care. More specifically, the chiropractic profession is identifying and establishing standards of practice. This in part is due to published data illustrating the variations in treatment frequencies between geographic locations. Acknowledging these variations will enable the identification of solutions. The solutions will be formulated from a growing knowledge base comprised of printed literature and the opinions of recognized experts through consensus panels. The result is the creation of practice standards and guidelines that will serve to answer concerns of accountability and ultimately to protect the public. The process from the creation to the implementation of the guidelines is necessarily detailed; but can be enhanced by the use of clinical algorithms. Clinical algorithms describe a step wise procedure to patient management that may impact upon patient care, health care costs and outcome measures. As chiropractic achieves greater visibility, it will be expected to perform at the same level of accountability as the other health provider groups. Each chiropractor should understand the process and its limitations, and be prepared to contribute in the development, distribution and implementation of reasonable practice guidelines.

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

    PubMed Central

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

    2011-01-01

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

  8. Curriculum reform in a public health course at a chiropractic college: are we making progress toward improving clinical relevance?

    PubMed

    Borody, Cameron; Till, Hettie

    2007-01-01

    Improving education in health promotion and prevention has been identified as a priority for all accredited professional health care training programs, an issue recently addressed by a collaboration of stakeholders in chiropractic education who developed a model course outline for public health education. Using a course evaluation questionnaire, the authors surveyed students in the public health course at the Canadian Memorial Chiropractic College (CMCC) before and after the implementation of new course content based on the model course outline. Following the new course, there were significant improvements in perceived relevance to chiropractic practice and motivation to learn the material as a foundation for clinical practice. Changes made to the content and delivery of the course based on the model course outline were well received in the short term. PMID:18483637

  9. Inflammatory response following a short-term course of chiropractic treatment in subjects with and without chronic low back pain☆

    PubMed Central

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

    2010-01-01

    Objective Inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) have not been evaluated in response to a short course of lumbar spinal manipulation. The purpose of this study is to observe the responses of inflammatory markers (IL-6 and CRP) after a series of 9 chiropractic spinal manipulations. Methods Twenty-one participants were assigned to a treatment or a control group. Only the treatment group received 9 chiropractic interventions. Pre- and postintervention measures were recorded for blood samples for detection of proinflammatory cytokines IL-6 and CRP. Results Mediators of inflammation (IL-6 and high-sensitivity CRP) were modified by the intervention received in the treatment group, and the effect size demonstrated a tendency toward the control group values. Conclusion A total of 9 chiropractic lower back manipulations caused the mediators of inflammation to present a normalization response in individuals suffering from chronic low back pain. PMID:22027032

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

    PubMed Central

    Kanga, Ismat; Steiman, Igor

    2015-01-01

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

  11. Initial integration of chiropractic services into a provincially funded inner city community health centre: a program description

    PubMed Central

    Passmore, Steven R.; Toth, Audrey; Kanovsky, Joel; Olin, Gerald

    2015-01-01

    Background: The burden of fees for chiropractic services rendered often falls on the patient and must be provided out-of-pocket regardless of their socioeconomic status and clinical need. Universal healthcare coverage reduces the financial barrier to healthcare utilization, thereby increasing the opportunity for the financially disadvantaged to have access to care. In 2011 the Canadian Province of Manitoba initiated a pilot program providing access to chiropractic care within the Mount Carmel Clinic (MCC), a non-secular, non-profit, inner city community health centre. Objective: To describe the initial integration of chiropractic services into a publically funded healthcare facility including patient demographics, referral patterns, treatment practices and clinical outcomes. Method: A retrospective database review of chiropractic consultations in 2011 (N=177) was performed. Results: The typical patient referred for chiropractic care was a non-working (86%), 47.3(SD=16.8) year old, who self-identified as Caucasian (52.2%), or Aboriginal (35.8%) and female (68.3%) with a body mass index considered obese at 30.4(SD=7.0). New patient consultations were primarily referrals from other health providers internal to the MCC (71.2%), frequently primary care physicians (76%). Baseline to discharge comparisons of numeric rating scale scores for the cervical, thoracic, lumbar, sacroiliac and extremity regions all exceeded the minimally clinically important difference for reduction in musculoskeletal pain. Improvements occurred over an average of 12.7 (SD=14.3) treatments, and pain reductions were also statistically significant at p<0.05. Conclusion: Chiropractic services are being utilized by patients, and referring providers. Clinical outcomes indicate that services rendered decrease musculoskeletal pain in an inner city population. PMID:26816049

  12. Symptomatic improvement in function and disease activity in a patient with ankylosing spondylitis utilizing a course of chiropractic therapy: a prospective case study

    PubMed Central

    Rutherford, Susan M; Nicolson, Cameron F; Crowther, Edward R

    2005-01-01

    Background There is limited outcome measure support for chiropractic manipulative therapy in the management of ankylosing spondylitis. An improvement in specific indices for both function and disease activity during chiropractic therapy for ankylosing spondylitis has not previously been reported. Objective To measure changes in function and disease activity in a patient with ankylosing spondylitis during a course of chiropractic therapy. The clinical management of ankylosing spondylitis, including chiropractic manipulative therapy and the implications of this case study are discussed. Clinical Features A 34-year-old male with a 10 year diagnosis of ankylosing spondylitis sought chiropractic treatment for spinal pain and stiffness. His advanced radiographic signs included an increased atlantodental interspace and cervical vertebral ankylosis. Intervention and outcome The Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), finger-tip-to-floor distance and chest expansion were assessed during an 18 week course of chiropractic spinal manipulation and mobilization therapy. There was a 90% improvement in the disease activity index and an 85% improvement in the functional index from the pre-treatment baseline, as measured by the BASDAI and BASFI respectively. Spinal flexibility and chest expansion also improved. Conclusion To the authors knowledge this is the first study to incorporate ankylosing spondylitis specific indices, for both disease activity and function, to objectively support the use of chiropractic manipulative therapy in the management of ankylosing spondylitis. More intensive research is suggested. PMID:17549197

  13. Effects of Expanded Coverage for Chiropractic Services on Medicare Costs in a CMS Demonstration

    PubMed Central

    Stason, William B.; Ritter, Grant A; Prottas, Jeffrey; Tompkins, Christopher; Shepard, Donald S.

    2016-01-01

    Background Moderately convincing evidence supports the benefits of chiropractic manipulations for low back pain. Its effectiveness in other applications is less well documented, and its cost-effectiveness is not known. These questions led the Centers for Medicaid and Medicare Services (CMS) to conduct a two-year demonstration of expanded Medicare coverage for chiropractic services in the treatment of beneficiaries with neuromusculoskeletal (NMS) conditions affecting the back, limbs, neck, or head. Methods The demonstration was conducted in 2005–2007 in selected counties of Illinois, Iowa, and Virginia and the entire states of Maine and New Mexico. Medicare claims were compiled for the preceding year and two demonstration years for the demonstration areas and matched comparison areas. The impact of the demonstration was analyzed through multivariate regression analysis with a difference-in-difference framework. Results Expanded coverage increased Medicare expenditures by $50 million or 28.5% in users of chiropractic services and by $114 million or 10.4% in all patients treated for NMS conditions in demonstration areas during the two-year period. Results varied widely among demonstration areas ranging from increased costs per user of $485 in Northern Illinois and Chicago counties to decreases in costs per user of $59 in New Mexico and $178 in Scott County, Iowa. Conclusion The demonstration did not assess possible decreases in costs to other insurers, out-of-pocket payments by patients, the need for and costs of pain medications, or longer term clinical benefits such as avoidance of orthopedic surgical procedures beyond the two-year period of the demonstration. It is possible that other payers or beneficiaries saved money during the demonstration while costs to Medicare were increased. PMID:26928221

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

    PubMed Central

    Wenban, Adrian B

    2006-01-01

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

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

    PubMed Central

    2011-01-01

    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. PMID:21943490

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

    PubMed

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

    2011-08-01

    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

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

    PubMed Central

    Grayson, J Paul

    2002-01-01

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

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

    PubMed Central

    2011-01-01

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

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

    PubMed Central

    Young, Kenneth J.

    2014-01-01

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

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

    PubMed Central

    Bova, Joseph; Sergent, Adam

    2014-01-01

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

  1. Primary spontaneous pneumothorax presenting to a chiropractic clinic as undifferentiated thoracic spine pain: a case report

    PubMed Central

    Larson, Ryan

    2016-01-01

    Objective: To present a case of primary spontaneous pneumothorax presenting to a chiropractic clinic as undifferentiated thoracic spine pain. Clinical Features: A tall thin 25-year-old male anxiously presented to a chiropractic clinic with six days of sudden unexplained left thorax pain. His breathing was laboured and his dry cough aggravating. After assessment a high clinical suspicion of primary spontaneous pneumothorax prevailed. Intervention and Outcome: The patient was referred to hospital for further investigation and primary spontaneous pneumothorax was confirmed on chest radiograph. He underwent immediate tube thoracostomy to drain the air from his pleural space and to re-inflate his lung. After three days the tube was removed. By two weeks the lung had returned to full size. No recurrences have occurred to date. Conclusions: Primary spontaneous pneumothorax is a medical emergency in the presence of shortness of breath. The focus of treatment is to drain air from the pleural linings and to prevent recurrences. In less severe cases, patients may believe they have thoracic spine pain and seek manual therapy care. This case highlights the important role chiropractors have as primary contact health care providers. PMID:27069268

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

    SciTech Connect

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

    1985-09-01

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

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

    PubMed Central

    Gleberzon, Brian J.

    2010-01-01

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

  4. Chiropractic outcomes managing radiculopathy in a hospital setting: a retrospective review of 162 patients

    PubMed Central

    Christensen, Kim D.; Buswell, Kirsten

    2008-01-01

    Abstract Objective The objective of this study was to gather descriptive information concerning the clinical outcomes of patients with cervical and lumbar radiculopathy treated with a nonsurgical, chiropractic treatment protocol in combination with other interventions. Methods This is a retrospective review of 162 patients with a working diagnosis of radiculopathy who met the inclusion criteria (312 consecutive patients were screened to obtain the 162 cases). Data reviewed were collected initially, during, and at the end of active treatment. The treatment protocol included chiropractic manipulation, neuromobilization, and exercise stabilization. Pain intensity was measured using the numerical pain rating scale. Results Of the 162 cases reviewed, 85.5% had resolution of their primary subjective radicular complaints. The treatment trial was 9 (mean) treatment sessions. The number of days between the first treatment date and the first symptom improvement was 4.2 days (mean). The change in numeric pain scale between initial and final score was 4.2 (median). There were 10 unresolved cases referred for epidural steroid injection, 10 unresolved cases referred for further medication management, and 3 cases referred for and underwent surgery. Conclusion The conservative management strategy we reviewed in our sample produced favorable outcomes for most of the patients with radiculopathy. The strategy appears to be safe. Randomized clinical trials are needed to separate treatment effectiveness from the natural history of radiculopathy. PMID:19646373

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

    PubMed Central

    Seaman, David R.; Palombo, Adam D.

    2014-01-01

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

  6. A proposed quality assurance program for the clinical use of surface electromyography in the chiropractic office

    PubMed Central

    Nicholson, W Reginald; Dainty, David A; Marcarian, David

    1996-01-01

    This paper presents a proposed quality assurance (QA) program for chiropractors using surface electromyography (SEMG) in their offices. The paper examines in detail the various aspects of the program including both the technical and professional components. The technical component has three sub topics: equipment, technical procedures and data processing; as does the professional component: qualification/certification, compliance/peer review and patient selection. These are also further broken down to discuss the aspects dealing with quality and also other basic components necessary to understand the effective use of SEMG in the chiropractic office. The rationale for such a program is presented first and the details of the various aspects later. The complete program is represented in a number of charts which form a blueprint for the total QA program. As this is a proposed program, the authors invite feedback and criticism so that it may be optimized.

  7. A comparison of quality and satisfaction experiences of patients attending chiropractic and physician offices in Ontario

    PubMed Central

    Crowther, Edward R.

    2014-01-01

    Introduction: Improving the quality of healthcare is a common goal of consumers, providers, payer groups, and governments. There is evidence that patient satisfaction influences the perceptions of the quality of care received. Methods: This exploratory, qualitative study described and analyzed, the similarities and differences in satisfaction and dissatisfaction experiences of patients attending physicians (social justice) and chiropractors (market justice) for healthcare services in Niagara Region, Ontario. Using inductive content analysis the satisfaction and dissatisfaction experiences were themed to develop groups, categories, and sub-categories of quality judgments of care experiences. Results: Study participants experienced both satisfying and dissatisfying critical incidents in the areas of standards of practice, professional and practice attributes, time management, and treatment outcomes. Cost was not a marked source of satisfaction or dissatisfaction. Conclusion: Patients may be more capable of generating quality judgments on the technical aspects of medical and chiropractic care, particularly treatment outcomes and standards of practice, than previously thought. PMID:24587494

  8. Barriers to Implementing a Reporting and Learning Patient Safety System: Pediatric Chiropractic Perspective.

    PubMed

    Pohlman, Katherine A; Carroll, Linda; Hartling, Lisa; Tsuyuki, Ross T; Vohra, Sunita

    2016-04-01

    A reporting and learning system is a method of monitoring the occurrence of incidents that affect patient safety. This cross-sectional survey asked pediatric chiropractors about factors that may limit their participation in such a system. The list of potential barriers for participation was developed using a systematic approach. All members of the 2 pediatric councils associated with US national chiropractic organizations were invited to complete the survey (N = 400). The cross-sectional survey was created using an online survey tool (REDCap) and sent directly to member emails addressed by the respective executive committees. Of the 400 potential respondents, 81 responded (20.3%). The most common limitations to participating were identified as time pressure (96%) and patient concerns (81%). Reporting and learning systems have been utilized to increase safety awareness in many high-risk industries. To be successful, future patient safety studies with pediatric chiropractors need to ensure these barriers are understood and addressed. PMID:26438719

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

    Spears, Lolita G.

    2005-01-01

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

  11. A nutritional program improved lipid profiles and weight in 28 chiropractic patients: a retrospective case series☆

    PubMed Central

    Powell, James P.; Leonard, Joseph S.

    2008-01-01

    Abstract Objective This study retrospectively examined the effects of a 21-day nutritional intervention program, which included fruit and vegetable consumption, energy restriction, and nutritional supplements, on serum lipid measures in 28 chiropractic patients. Methods Medical records were reviewed for 28 chiropractic patients who had completed a commercially available 21-day nutritional intervention program between April 2005 and August 2007 and for whom complete serum lipid and weight measures immediately pre- and postintervention were available. The primary outcome was change in serum lipids, and change in body weight was a secondary outcome variable. Results Significant reductions in total, low-density lipoprotein, very low-density lipoprotein, and high-density lipoprotein cholesterol, and triglycerides were observed. Serum triglycerides decreased from 116.3 ± 54.6 (mean ± SD) to 88.6 ± 40.5 mg/dL (P < .01). Total cholesterol decreased from 223.3 ± 40.7 to 176.2 ± 30.0 mg/dL (P < .0001). Low-density lipoprotein cholesterol decreased from 145.7 ± 36.8 to 110.9 ± 25.3 mg/dL (P < .0001). High-density lipoprotein cholesterol decreased from 54.3 ± 14.6 to 47.6 ± 10.5 mg/dL (P < .001). Weight for patients decreased from 191.2 ± 38.8 to 182.2 ± 36.3 lb (P < .0001). Conclusions This retrospective case series supports the hypothesis that a nutritional purification intervention program emphasizing fruit and vegetable consumption, energy restriction, and nutritional supplements reduces serum lipids and weight. PMID:19646370

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

    PubMed Central

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

    2005-01-01

    OBJECTIVE To provide an evidence-based clinical practice guideline for the chiropractic cervical treatment of adults with acute or chronic neck pain not due to whiplash. This is a considerable health concern considered to be a priority by stakeholders, and about which the scientific information was poorly organized. OPTIONS Cervical treatments: manipulation, mobilization, ischemic pressure, clinic- and home-based exercise, traction, education, low-power laser, massage, transcutaneous electrical nerve stimulation, pillows, pulsed electromagnetic therapy, and ultrasound. OUTCOMES The primary outcomes considered were improved (reduced and less intrusive) pain and improved (increased and easier) ranges of motion (ROM) of the adult cervical spine. EVIDENCE An “extraction” team recorded evidence from articles found by literature search teams using 4 separate literature searches, and rated it using a Table adapted from the Oxford Centre for Evidence-based Medicine. The searches were 1) Treatment; August, 2003, using MEDLINE, CINAHL, AMED, MANTIS, ICL, The Cochrane Library (includes CENTRAL), and EBSCO, identified 182 articles. 2) Risk management (adverse events); October, 2004, identified 230 articles and 2 texts. 3) Risk management (dissection); September, 2003, identified 79 articles. 4) Treatment update; a repeat of the treatment search for articles published between September, 2003 and November, 2004 inclusive identified 121 articles. VALUES To enable the search of the literature, the authors (Guidelines Development Committee [GDC]) regarded chiropractic treatment as including elements of “conservative” care in the search strategies, but not in the consideration of the range of chiropractic practice. Also, knowledge based only on clinical experience was considered less valid and reliable than good-caliber evidence, but where the caliber of the relevant evidence was low or it was non-existent, unpublished clinical experience was considered to be equivalent to, or better than the published evidence. REPORTED BENEFITS, HARMS AND COSTS The expected benefits from the recommendations include more rapid recovery from pain, impairment and disability (improved pain and ROM). The GDC identified evidence-based pain benefits from 10 unimodal treatments and more than 7 multimodal treatments. There were no pain benefits from magnets in necklaces, education or relaxation alone, occipital release alone, or head retraction-extension exercise combinations alone. The specificity of the studied treatments meant few studies could be generalized to more than a minority of patients. Adverse events were not addressed in most studies, but where they were, there were none or they were minor. The theoretic harm of vertebral artery dissection (VAD) was not reported, but an analysis suggested that 1 VAD may occur subsequent to 1 million cervical manipulations. Costs were not analyzed in this guideline, but it is the understanding of the GDC that recommendations limiting ineffective care and promoting a more rapid return of patients to full functional capacity will reduce patient costs, as well as increase patient safety and satisfaction. For simplicity, this version of the guideline includes primarily data synthesized across studies (evidence syntheses), whereas the technical and the interactive versions of this guideline (http://ccachiro.org/cpg) also include relevant data from individual studies (evidence extractions). RECOMMENDATIONS The GDC developed treatment, risk-management and research recommendations using the available evidence. Treatment recommendations addressing 13 treatment modalities revolved around a decision algorithm comprising diagnosis (or assessment leading to diagnosis), treatment and reassessment. Several specific variations of modalities of treatment were not recommended. For adverse events not associated with a treatment modality, but that occur in the clinical setting, there was evidence to recommend reconsideration of treatment options or referral to the appropriate health services. For adverse events associated with a treatment modality, but not a known or observable risk factor, there was evidence to recommend heightened vigilance when a relevant treatment is planned or administered. For adverse events associated with a treatment modality and predicted by an observable risk factor, there was evidence to recommend absolute contraindications, and requirements for treatment modality modification or caution to minimize harm and maximize benefit. For managing the theoretic risk of dissection, there was evidence to recommend a systematic risk-management approach. For managing the theoretic risk of stroke, there was support to recommend minimal rotation in administering any modality of upper-cervical spine treatment, and to recommend caution in treating a patient with hyperhomocysteinemia, although the evidence was especially ambiguous in both of these areas. Research recommendations addressed the poor caliber of many of the studies; the GDC concluded that the scientific base for chiropractic cervical treatment of neck pain was not of sufficient quality or scope to “cover” current chiropractic practice comprehensively, although this should not suggest other disciplines are more evidence-based. VALIDATION This guideline was authored by the 10 members of the GDC (Elizabeth Anderson-Peacock, Jean-Sébastien Blouin, Roland Bryans, Normand Danis, Andrea Furlan, Henri Marcoux, Brock Potter, Rick Ruegg, Janice Gross Stein, Eleanor White) based on the work of 3 literature search teams and an evidence extraction team, and in light of feedback from a commentator (Donald R Murphy), a 5-person review panel (Robert R Burton, Andrea Furlan, Richard Roy, Steven Silk, Roy Till), a 6-person Task Force (Grayden Bridge, H James Duncan, Wanda Lee MacPhee, Bruce Squires, Greg Stewart, Dean Wright), and 2 national profession-wide critiques of complete drafts. Two professional editors with extensive guidelines experience were contracted (Thor Eglington, Bruce P Squires). Key contributors to the guideline included individuals with specialties or expert knowledge in chiropractic, medicine, research processes, literature analysis processes, clinical practice guideline processes, protective association affairs, regulatory affairs, and the public interest. This guideline has been formally peer reviewed. PMID:17549134

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

    PubMed Central

    Solecki, Thomas J.; Hostnik, Kurt D.

    2012-01-01

    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. PMID:22942841

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

    PubMed Central

    2011-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  16. Self-regulation in a small professional group is an important step toward professionalization: the Chiropractic Association in Singapore

    PubMed Central

    Jorgensen, Anna Maria S.; Sheppard, Lorraine A.

    2010-01-01

    Objective The chiropractic profession is immersed in the process of professionalization with particular consideration of self-regulation as an avenue toward state recognition in Singapore. The purpose of this article is to discuss the emergence of chiropractic as a profession in Singapore and the Chiropractic Association (Singapore). Discussion The concept of professionalization is varied and context based, and the institutionalization of formal knowledge plays an important role in the socialization of how a profession forms a unifying identity. The difference in institutional socialization of the professions plays a role in the way a profession is perceived in the hierarchy of societal power. Continuing professional development is an essential part of professionalism and is best done within the realm of self-regulation and autonomous control of the profession itself. Conclusion The social process of professionalization can be a process of internal conflict and external battles almost from the profession's inception with university training only entering late in its development, rather than being a linear development. A sequential progress ensued as with other professions, with the seeking of legal protection and a code of ethics as the final areas reached toward becoming an acknowledged member of the health care system. PMID:22693465

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

    PubMed Central

    Murray, Kelvin J.; Azari, Michael F.

    2015-01-01

    Objective The purpose of this case report is to describe chiropractic management of an elderly man with untreated bilateral hip joint dysplasia presenting with mild acute mechanical low back pain. Clinical Features A 75-year-old man presented with an insidious-onset intermittent low back pain of 3 days’ duration. Physical examination findings supported a mechanical cause for mild acute low back pain. Plain radiography revealed dysplasia of hip joints with absence of femoral heads and necks and bilateral high dislocation. Intervention and Outcome Chiropractic management included vibration, mobilization, light drop-piece adjustments of the lower lumbar and sacroiliac joints, and recommendation of the use of heat at home. Treatments were given 3 times over the course of 1 week. The low back pain intensity over this period dropped from 5 to 0 on an 11-point numerical rating scale, and the patient was discharged. Conclusion This patient with substantial postural and gait abnormalities as a result of severe bilateral hip dysplasia associated with an unusual pattern of osteoarthritic change in the spine responded favorably to a short course of chiropractic care. PMID:26644785

  18. Self-reported attitudes, skills and use of evidence-based practice among Canadian doctors of chiropractic: a national survey

    PubMed Central

    Bussières, André E.; Terhorst, Lauren; Leach, Matthew; Stuber, Kent; Evans, Roni; Schneider, Michael J.

    2015-01-01

    Objectives: To identify Canadian chiropractors’ attitudes, skills and use of evidence based practice (EBP), as well as their level of awareness of previously published chiropractic clinical practice guidelines (CPGs). Methods: 7,200 members of the Canadian Chiropractic Association were invited by e-mail to complete an online version of the Evidence Based practice Attitude & utilisation SurvEy (EBASE); a valid and reliable measure of participant attitudes, skills and use of EBP. Results: Questionnaires were completed by 554 respondents. Most respondents (>75%) held positive attitudes toward EBP. Over half indicated a high level of self-reported skills in EBP, and over 90% expressed an interest in improving these skills. A majority of respondents (65%) reported over half of their practice was based on evidence from clinical research, and only half (52%) agreed that chiropractic CPGs significantly impacted on their practice. Conclusions: While most Canadian chiropractors held positive attitudes towards EBP, believed EBP was useful, and were interested in improving their skills in EBP, many did not use research evidence or CPGs to guide clinical decision making. Our findings should be interpreted cautiously due to the low response rate. PMID:26816412

  19. Multimodal Chiropractic Care of Pain and Disability for a Patient Diagnosed With Benign Joint Hypermobility Syndrome: A Case Report

    PubMed Central

    Strunk, Richard G.; Pfefer, Mark T.; Dube, Derrick

    2014-01-01

    Objective The purpose of this case report is to describe multimodal chiropractic care of a female patient diagnosed with benign joint hypermobility syndrome (BJHS) and a history of chronic spine pain. Clinical features A 23-year-old white female presented for chiropractic care with chronic low back pain, neck pain, and headaches. The patient was diagnosed with BJHS, including joint hypermobility of her thumbs, elbows, right knee, and lumbopelvic region. A 6-year history of low back pain and varicose veins in her posterior thighs and knees were additional significant diagnostic findings of BJHS. Interventions and outcomes The treatment consisted of spinal and extremity manipulation, Graston technique, and postisometric relaxation combined with sensory motor stimulation and scapular stabilization exercises. The patient was seen 15 times over an 18-week period. After 18 weeks of care, the Revised Oswestry Low Back Questionnaire and Headache Disability Index demonstrated clinically important improvements with her low back pain and headache; but little change was noted in her neck pain as measured by the Neck Disability Index. Conclusion This patient with BJHS who had decreased disability and spine pain improved after a course of multimodal chiropractic care. PMID:24711783

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

    Solecki, Thomas J.; Herbst, Elizabeth M.

    2011-01-01

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

  2. Retrospective analysis of laboratory testing at the chiropractic clinic of Université du Québec à Trois-Rivières (UQTR)

    PubMed Central

    Boisvert, Daniel

    2006-01-01

    This study provides data based on the clinical experience of the Université du Québec à Trois-Rivières (UQTR) chiropractic clinic justifying the use of laboratory tests in chiropractic practice. The data was gathered retrospectively over a 51 month period from January 22, 1997 to April 10, 2001. During this period, the UQTR Chiropractic Clinic opened 6571 patient files. The analysis reveals that of the 6571 patients, 1200 (18.27%) underwent laboratory processes or tests. Of these 1200 processes or tests, 676 (56.34%) showed abnormal findings. Of the 676 patients with abnormal findings, 122 (18.05%) cases were serious enough to justify a referral to a medical doctor (general practitioner or specialist) for immediate follow-up. Among these serious conditions, one was a bone neoplastic pathology and one was a case of leukemia. This study emphasizes the significant contribution of laboratory tests in chiropractic practice. Its importance rests not only with teaching purposes, but also rests with the proper assessment of clinical conditions frequently observed in chiropractic practice. Laboratory tests used in a proper context serve not only as a valuable instrument to identify primary and underlying abnormal physiological factors, but also assist the chiropractor in identifying more precisely those cases that require a medical referral. This study also demonstrates that laboratory testing of chiropractic patients is a necessary and essential clinical procedure for complete public protection. It also demonstrates that chiropractors are an essential part of the health team even when patients are under medical supervision. PMID:17549159

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Johnson, C D; Green, B N

    1996-12-01

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

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

    PubMed Central

    2012-01-01

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

  6. Chiropractic utilization in BMX athletes at the UCI World Championships: a retrospective study

    PubMed Central

    Konczak, Clark Ryan

    2010-01-01

    Objective To examine paramedical (chiropractic, physiotherapy and massage therapy) utilization among high-level BMX athletes following sport-related injury at the 2007 UCI World Championships. Methods Retrospective analysis was conducted on a dataset from international male and female BMX athletes (n = 110) who sustained injury in training and competition at the 2007 BMX World Championships. Results Fifty percent of individuals aged 8–17 presented to a chiropractor versus 32% to physiotherapists and 18% to massage therapists. There was a significant difference in paramedical practitioner choice when comparing the sample across the different locations of injury. Specifically, the proportion of individuals presenting for treatment to chiropractors (84%) was much higher than to physiotherapists/massage therapists (16%) for spine or torso complaints. Conclusion Utilization of chiropractors by BMX athletes may be higher than utilization of other paramedical professionals as suggested by this study. Chiropractors appear to be the paramedical practitioner of choice in regards to spine and torso related complaints. PMID:21120016

  7. Audit and feedback intervention: An examination of differences in chiropractic record-keeping compliance.

    PubMed

    Homb, Nicole M; Sheybani, Shayan; Derby, Dustin; Wood, Kurt

    2014-10-01

    Objective : The objective of this study was to investigate the association of a clinical documentation quality improvement program using audit-feedback with clinical compliance to indicators of quality chart documentation. Methods : This was an analysis of differences between adherence to quality indicators of chiropractic record documentation and audit-feedback intervention (feedback report only vs. feedback report with one-on-one educational consultation) at different campuses. Comparisons among groups were analyzed using analysis of variance (ANOVA), Tukey or Dunnett post hoc tests, and Cohen's d effect size estimates. Results : There was a significant increase in the mean percentile compliance in 2 of 5 compliance areas and 1 of 11 compliance objectives. Campus B demonstrated significantly higher levels of compliance relative to campus A and/or campus C in 5 of 5 compliance areas and 7 of 11 compliance objectives. Across-campus comparisons indicated that the compliance area Review (Non-Medicare) Treatment Plan [F(2,18) = 17.537, p < .001] and compliance objective Treatment Plan Goals [F(2,26) = 5.653, p < .001] exhibited the highest practical importance for clinical compliance practice. Conclusions : Feedback of performance improved compliance to indicators of quality health record documentation, especially when baseline adherence is relatively low. Required educational consultations with clinicians combined with audit-feedback were no more effective at increasing compliance to indicators of quality health record documentation than audit-feedback alone. PMID:24804561

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2008-01-01

    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. PMID:19674723

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

    PubMed

    Brown, Richard

    2012-01-01

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

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

    PubMed

    Hester, Hilary; Cunliffe, Christina; Hunnisett, Adrian

    2013-01-01

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

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

    PubMed Central

    Cox, James M.

    2012-01-01

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

  13. Chiropractic distractive decompression in treating pelvic pain and multiple system pelvic organic dysfunction.

    PubMed

    Browning, J E

    1989-08-01

    No data are available on the incidence of pelvic pain and organic dysfunction (PPOD) in patients suffering from low back pain. PPOD is not an uncommon finding in the low back pain patient. Women appear to be more frequently involved than men. The results of recent electrophysiologic investigations indicate that many patients with urological, bowel or anorectal dysfunction demonstrate evidence of denervation neuropathy in muscles innervated by the branches of the pudendal nerve. Six patients with low back pain meeting predetermined criteria, indicating the presence of PPOD as a result of suspected lower sacral nerve root compression (LSNRC) secondary to a mechanical disorder of the low back were treated with chiropractic distractive decompressive manipulation of the lumbar spine. Symptoms of PPOD, and indicators of LSNRC were assessed prior to the onset, and following the termination of treatment. It appears that selected indicators of LSNRC represent the most sensitive clinical signs of identifying the presence of PPOD which may respond to manipulative treatment, and may also provide the most sensitive measure of overall PPOD response. These findings, although preliminary suggest a possible etiology of PPOD in the low back pain patient with evidence of LSNRC. Further work in this area is encouraged. PMID:2527938

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

    Objective The purpose of this study was to describe non-Hispanic blacks that use chiropractic health care to better understand this underserved demographic. Methods E-mail and telephone calls were used to recruit doctors of chiropractic (DCs) in Texas and Louisiana to distribute anonymous surveys to their non-Hispanic black patients. Twenty doctors volunteered to participate. Each was sent 10 surveys and self-addressed envelopes to distribute. All doctors were given at least 3 months to distribute surveys to as many non-Hispanic black patients that they had. The survey contained 20 questions designed to develop a profile of non-Hispanic black patients that used chiropractic care. Descriptive statistics were used to summarize demographic and other patient attributes. Results Two-hundred surveys were distributed and 44 were completed, yielding a response rate of 22%. Non-Hispanic black patients were more likely to be female (54.5%), be older than 50 years (56.8%), be a college graduate (59.1%), be employed (61.9%), report not receiving public assistance in the past 5 years (81.4%), report a household income of $20 000 to $60 000 a year (48.8%), and born in the United States (83.7%). Participants reported that there was a DC within 30 minutes of their address (81.4%), their DC always explained things to them in an easy-to-understand manner (81.8%), their DC always showed respect for what they had to say (88.6%), and their DC always cared about them as a person (86.4%). Conclusions In the sample surveyed, non-Hispanic black patients tended to be female, be older, be college educated, be employed, and have a positive viewpoint on their interactions with their DC. PMID:26693213

  16. VARK learning preferences and mobile anatomy software application use in pre-clinical chiropractic students.

    PubMed

    Meyer, Amanda J; Stomski, Norman J; Innes, Stanley I; Armson, Anthony J

    2016-05-01

    Ubiquitous smartphone ownership and reduced face-to-face teaching time may lead to students making greater use of mobile technologies in their learning. This is the first study to report on the prevalence of mobile gross anatomy software applications (apps) usage in pre-clinical chiropractic students and to ascertain if a relationship exists between preferred learning styles as determined by the validated VARK(©) questionnaire and use of mobile anatomy apps. The majority of the students who completed the VARK questionnaire were multimodal learners with kinesthetic and visual preferences. Sixty-seven percent (73/109) of students owned one or more mobile anatomy apps which were used by 57 students. Most of these students owned one to five apps and spent less than 30 minutes per week using them. Six of the top eight mobile anatomy apps owned and recommended by the students were developed by 3D4Medical. Visual learning preferences were not associated with time spent using mobile anatomy apps (OR = 0.40, 95% CI 0.12-1.40). Similarly, kinesthetic learning preferences (OR = 1.88, 95% CI 0.18-20.2), quadmodal preferences (OR = 0.71, 95% CI 0.06-9.25), or gender (OR = 1.51, 95% CI 0.48-4.81) did not affect the time students' spent using mobile anatomy apps. Learning preferences do not appear to influence students' time spent using mobile anatomy apps. Anat Sci Educ 9: 247-254. © 2015 American Association of Anatomists. PMID:26109371

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

    PubMed Central

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

    1995-01-01

    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.

  18. 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

    Chapman, Cynthia; Bakkum, Barclay W.

    2012-01-01

    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. PMID:22942838

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

    Schwartz, Jan

    2010-01-01

    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

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

    PubMed Central

    Gleberzon, Brian; Statz, Rachel; Pym, Matthew

    2015-01-01

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

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

    PubMed Central

    Burke, Jeanmarie R.

    2014-01-01

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

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

    PubMed Central

    2011-01-01

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

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

    PubMed Central

    Gotlib, Allan C; Beingessner, Melanie

    1995-01-01

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

  5. The Role of Chiropractic Care in the Treatment of Dizziness or Balance Disorders: Analysis of National Health Interview Survey Data.

    PubMed

    Ndetan, Harrison; Hawk, Cheryl; Sekhon, Vishaldeep Ka; Chiusano, Miguel

    2016-04-01

    The purpose of this study was to explore the role of chiropractic in the treatment of dizziness or balance disorders through an analysis of data from the 2008 National Health Interview Survey. Odds ratios and 95% confidence intervals (CIs) were used to assess the likelihood that respondents with dizziness or balance problems perceived that they were helped by specified practitioners. Eleven percent of respondents reported having had a balance or dizziness problem; more than 35% were aged 65 years and older. The odds ratio for perceiving being helped by a chiropractor was 4.36 (95% CI, 1.17-16.31) for respondents aged 65 years or older; 9.5 (95% CI, 7.92-11.40) for respondents reporting head or neck trauma; and 13.78 (95% CI, 5.59-33.99) for those reporting neurological or muscular conditions as the cause of their balance or dizziness. PMID:26362851

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

    PubMed Central

    McRae, Marc P.

    2010-01-01

    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 PMID:20480012

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

    Bisiacchi, Debra W; Huber, Laura L

    2006-01-01

    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 performing them in the clinical setting. Methods A survey was developed to record musculoskeletal injuries that students reported to have sustained while practicing chiropractic adjustment set-ups and while delivering adjustments. The survey was modeled from similar instruments used in the university's clinic as well as those used in professional practice. Stratified sampling was used to obtain participants for the study. Data reported the anatomical areas of injury, adjustive technique utilized, the type of injury received, and the recovery time from sustained injuries. The survey also inquired as to the type and area of any past physical injuries as well as the mechanism(s) of injury. Results Data obtained from the study identified injuries of the shoulder, wrist, elbow, neck, low back, and mid-back. The low back was the most common injury site reported by females, and the neck was the most common site reported by males. The reported wrist injuries in both genders were 1% male complaints and 17% female complaints. A total of 13% of female respondents reported shoulder injuries, whereas less than 1% of male respondents indicated similar complaints. Conclusion The data collected from the project indicated that obtaining further information on the subject would be worthwhile, and could provide an integral step toward developing methods of behavior modification in an attempt to reduce and/or prevent the incidence of musculoskeletal injuries. PMID:16930481

  9. Chiropractic management of a 40-year-old female patient with Ménière disease

    PubMed Central

    Emary, Peter C.

    2010-01-01

    Objective The purpose of this case report is to describe the chiropractic management of a patient with Ménière disease. Clinical Features A 40-year-old woman presented with a diagnosis of Ménière disease including a 2-month history of vertigo and a 16-month history of left-sided tinnitus, low-frequency hearing loss, and aural fullness. The patient's other symptoms included left-sided neck pain, temporomandibular joint pain, and headaches. Examination revealed left-sided upper cervical joint dysfunction along with myofascial trigger points in the middle and upper trapezius muscle. Intervention and Outcome Treatment included primarily high-velocity, low-amplitude spinal manipulation to the upper cervical and thoracic spine, along with soft-tissue trigger-point therapy, and stretching exercises. Within 2 weeks of treatment, the patient's tinnitus had resolved; and all other symptoms (including vertigo) were improved. The patient's headaches, neck pain, and vertigo were subsequently resolved within 3 months of treatment. The patient experienced only 2 minor episodes of self-resolving “light-headedness” over that time. After 2½ years of follow-up, any occasional episodes of mild aural fullness and/or light-headedness are either self-resolving or relieved with cervical spinal manipulation and soft-tissue treatment. Conclusion This case report suggests that chiropractic care, including upper cervical spinal manipulation and soft-tissue therapy, may be beneficial in treating some patients with Ménière disease. PMID:21629395

  10. 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

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

    2010-01-01

    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. PMID:22693461

  11. Bladder and Bowel Symptoms Among Adults Presenting With Low Back Pain to an Academic Chiropractic Clinic: Results of a Preliminary Study

    PubMed Central

    Walden, Anna L.; Salsbury, Stacie A.; Reed, William R.; Lawrence, Dana J.

    2014-01-01

    Objective The purposes of this study were to estimate the 1-month point prevalence of bowel and bladder symptoms (BBS) among adult chiropractic patients and to evaluate associations between these symptoms and low back pain (LBP). Methods Patients 18 years or older presenting to a chiropractic college academic health clinic between March 25 and April 25, 2013, were asked to complete a symptom screening questionnaire. Descriptive statistics, binary logistic regression, Fisher exact test, and P values were calculated from the sample. Results The sample included 140 of 1300 patients who visited the clinic during the survey period (11%). Mean age was 47.5 (range 18-79) years. LBP was the primary chief complaint in 42%. The 1-month point prevalence of any bladder symptoms was 75%, while the rate for bowel symptoms was 62%; 55% reported both BBS. Binary logistic regression analyses showed no statistically significant association between a chief complaint of LBP and combined BBS (OR = 1.67, P = .164). Conclusion The prevalence of bowel and bladder symptoms in chiropractic patients was high. There was no statistically significant association between these symptoms and LBP in this group of patients seeking care for LBP. PMID:25225466

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

    PubMed Central

    2013-01-01

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

  13. Evaluating the feasibility of using online software to collect patient information in a chiropractic practice-based research network

    PubMed Central

    Kania-Richmond, Ania; Weeks, Laura; Scholten, Jeffrey; Reney, Mikaël

    2016-01-01

    Background: Practice based research networks (PBRNs) are increasingly used as a tool for evidence based practice. We developed and tested the feasibility of using software to enable online collection of patient data within a chiropractic PBRN to support clinical decision making and research in participating clinics. Purpose: To assess the feasibility of using online software to collect quality patient information. Methods: The study consisted of two phases: 1) Assessment of the quality of information provided, using a standardized form; and 2) Exploration of patients’ perspectives and experiences regarding online information provision through semi-structured interviews. Data analysis was descriptive. Results: Forty-five new patients were recruited. Thirty-six completed online forms, which were submitted by an appropriate person 100% of the time, with an error rate of less than 1%, and submitted in a timely manner 83% of the time. Twenty-one participants were interviewed. Overall, online forms were preferred given perceived security, ease of use, and enabling provision of more accurate information. Conclusions: Use of online software is feasible, provides high quality information, and is preferred by most participants. A pen-and-paper format should be available for patients with this preference and in case of technical difficulties. PMID:27069272

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

    PubMed Central

    Mizel, Dennis H

    1999-01-01

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

  15. Training and certification of doctors of chiropractic in delivering manual cervical traction forces: Results of a longitudinal observational study

    PubMed Central

    Gudavalli, Maruti Ram; Vining, Robert D.; Salsbury, Stacie A.; Goertz, Christine M.

    2014-01-01

    Objective Doctors of chiropractic (DCs) use manual cervical distraction to treat patients with neck pain. Previous research demonstrates variability in traction forces generated by different DCs. This article reports on a training protocol and monthly certification process using bioengineering technology to standardize cervical traction force delivery among clinicians. Methods This longitudinal observational study evaluated a training and certification process for DCs who provided force-based manual cervical distraction during a randomized clinical trial. The DCs completed a 7-week initial training that included instructional lectures, observation, and guided practice by a clinical expert, followed by 3 hours of weekly practice sessions delivering the technique to asymptomatic volunteers who served as simulated patients. An instrument-modified table and computer software provided the DCs with real-time audible and visual feedback on the traction forces they generated and graphical displays of the magnitude of traction forces as a function of time immediately after the delivery of the treatment. The DCs completed monthly certifications on traction force delivery throughout the trial. Descriptive accounts of certification attempts are provided. Results Two DCs achieved certification in traction force delivery over 10 consecutive months. No certification required more than 3 attempts at C5 and occiput contacts for 3 force ranges (0–20 N, 21–50 N, and 51–100 N). Conclusions This study demonstrates the feasibility of a training protocol and certification process using bioengineering technology for training DCs to deliver manual cervical distraction within specified traction force ranges over a 10-month period. PMID:25237767

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

    PubMed

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

    2015-12-01

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

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

    PubMed Central

    Chaibi, Aleksander; Šaltytė Benth, Jūratė; Tuchin, Peter J; Russell, Michael Bjørn

    2015-01-01

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

  18. Influence of year-on-year performance on final degree classification in a chiropractic master's degree program

    PubMed Central

    Dewhurst, Philip; Rix, Jacqueline; Newell, David

    2016-01-01

    Objective: We explored if any predictors of success could be identified from end-of-year grades in a chiropractic master's program and whether these grades could predict final-year grade performance and year-on-year performance. Methods: End-of-year average grades and module grades for a single cohort of students covering all academic results for years 1–4 of the 2013 graduating class were used for this analysis. Analysis consisted of within-year correlations of module grades with end-of-year average grades, linear regression models for continuous data, and logistic regression models for predicting final degree classifications. Results: In year 1, 140 students were enrolled; 85.7% of students completed the program 4 years later. End-of-year average grades for years 1–3 were correlated (Pearson r values ranging from .75 to .87), but the end-of-year grades for years 1–3 were poorly correlated with clinic internship performance. In linear regression, several modules were predictive of end-of-year average grades for each year. For year 1, logistic regression showed that the modules Physiology and Pharmacology and Investigative Imaging were predictive of year 1 performance (odds ratio [OR] = 1.15 and 0.9, respectively). In year 3, the modules Anatomy and Histopathology 3 and Problem Solving were predictors of the difference between a pass/merit or distinction final degree classification (OR = 1.06 and 1.12, respectively). Conclusion: Early academic performance is weakly correlated with final-year clinic internship performance. The modules of Anatomy and Histopathology year 3 and Problem Solving year 3 emerged more consistently than other modules as being associated with final-year classifications. PMID:26076397

  19. Chiropractic management using a brain-based model of care for a 15-year-old adolescent boy with migraine headaches and behavioral and learning difficulties: a case report

    PubMed Central

    Kuhn, Kurt W.; Cambron, Jerrilyn

    2013-01-01

    Objective The purpose of this report is to describe chiropractic management, using a brain-based model of care, of a teen who had migraine headaches and several social and learning difficulties. Clinical features A 15-year-old adolescent boy with a chronic history of migraines and more than 10 years of learning and behavioral difficulties, including attention-deficit/hyperactivity disorder, obsessive compulsive disorder, and Tourette syndrome, presented for chiropractic care. Intervention and outcome The patient received spinal manipulation and was given home physical coordination activities that were contralateral to the side of the involved basal ganglia and ipsilateral to the involved cerebellum, along with interactive metronome training. Quantitative changes were noted in neurological soft signs, tests of variables of attention Conners’ Parent Rating Scale, the California Achievement Test, grade point, and reduction of medications. The patient reported qualitative improvements in tics, attention, reading, vision, health, relationships with his peers and his family, and self-esteem. Conclusion The patient with migraine headaches and learning difficulties responded well to the course of chiropractic care. This study suggests that there may be value in a brain-based model of care in the chiropractic management of conditions that are beyond musculoskeletal in nature. PMID:24396330

  20. Perspectives of older adults on co-management of low back pain by doctors of chiropractic and family medicine physicians: a focus group study

    PubMed Central

    2013-01-01

    Background While older adults may seek care for low back pain (LBP) from both medical doctors (MDs) and doctors of chiropractic (DCs), co-management between these providers is uncommon. The purposes of this study were to describe the preferences of older adults for LBP co-management by MDs and DCs and to identify their concerns for receiving care under such a treatment model. Methods We conducted 10 focus groups with 48 older adults who received LBP care in the past year. Interviews explored participants’ care seeking experiences, co-management preferences, and perceived challenges to successful implementation of a MD-DC co-management model. We analyzed the qualitative data using thematic content analysis. Results Older adults considered LBP co-management by MDs and DCs a positive approach as the professions have complementary strengths. Participants wanted providers who worked in a co-management model to talk openly and honestly about LBP, offer clear and consistent recommendations about treatment, and provide individualized care. Facilitators of MD-DC co-management included collegial relationships between providers, arrangements between doctors to support interdisciplinary referral, computer systems that allowed exchange of health information between clinics, and practice settings where providers worked in one location. Perceived barriers to the co-management of LBP included the financial costs associated with receiving care from multiple providers concurrently, duplication of tests or imaging, scheduling and transportation problems, and potential side effects of medication and chiropractic care. A few participants expressed concern that some providers would not support a patient-preferred co-managed care model. Conclusions Older adults are interested in receiving LBP treatment co-managed by MDs and DCs. Older adults considered patient-centered communication, collegial interdisciplinary interactions between these providers, and administrative supports such as scheduling systems and health record sharing as key components for successful LBP co-management. PMID:24040970

  1. Chiropractic: An Introduction

    MedlinePlus

    ... Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. ... RB, et al. Perceived benefit of complementary and alternative medicine (CAM) for back pain: a national survey. Journal ...

  2. What Is Chiropractic?

    MedlinePlus

    ... ACA Careers Find A Doctor Benefits for Doctors Students CAs My Cart Sign In Join Navigation Practice ... Foundation Get Healthy Blog Donate Membership Join Doctors Students CAs Code of Ethics Corporate My Account Login ...

  3. Your First Chiropractic Visit

    MedlinePlus

    ... copies of previous tests (for example, MRI or X-ray reports), lab results, and a list of any medications you are taking, including over-the-counter medications, nutritional supplements, vitamins, herbs, teas, and homeopathic and/or naturo- pathic ...

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

    PubMed Central

    2011-01-01

    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. PMID:22168838

  5. The psychometric profile of chiropractic patients in Norway and England: using and comparing the generic versions of the STarT Back 5-item screening tool and the Bournemouth Questionnaire

    PubMed Central

    2013-01-01

    Background Musculoskeletal pain and low back pain (LBP) in particular is one of the more costly health challenges to society. The STarT Back Tool (SBT) has been developed in the UK with a view to identifying subgroups of LBP patients in order to guide more cost effective care decisions. The Bournemouth Questionnaire (BQ) is a validated multidimensional patient reported outcome measure (PROM) that is widely used in routine clinical practice settings. This study sets out to describe and compare SBT and BQ scores within and between populations of patients presenting for chiropractic care in Norway and Great Britain. Methods Patient demographics, BQ and the 5-item generic condition SBT data were collected from patients presenting with musculoskeletal pain to 18 Norwegian and 12 English chiropractors. Analysis of correlation between groups was achieved using a 1-way Chi2 approximation (p < 0.05). Results Eleven percent of Norwegian LBP patients (n = 214) and 24% of English LBP patients (n = 186) were “distressed by their condition” (SBT > 4). By comparison, Norwegian chiropractic patients are: somewhat younger, have lower BQ scores, are less distressed by the condition and score significantly lower on items relating to catastrophisation and depression than English patients. There was an apparent association between total BQ and SBT scores (correlation 0.59, p < .0001) and patients who scored higher than 45 (IQR 39–58) on BQ were more likely to respond “distressed by condition” (>4) on SBT. Furthermore, patients in “distressed by condition” SBT category who had marked the “low mood” question on SBT also had a high score on the “depression” question of BQ (>6 (IQR 4–8), correlation 0.54, p < .0001). Conclusion The BQ and SBT appear to identify the same subgroups in some, but not all of the measured items. It appears that unknown factors result in variations between patients seeking chiropractic care for comparable complaints in primary care in England vs Norway. Comparison of populations from Norway and UK demonstrate that extrapolating and pooling of data in relation to different populations should be done with caution, in regard to these stratification tools. PMID:24268179

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

    PubMed Central

    2010-01-01

    Background Hamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol provided in addition to the current best practice management could prevent the occurrence of and weeks missed due to hamstring and other lower-limb injuries at the semi-elite level of Australian football. Methods Sixty male subjects were assessed for eligibility with 59 meeting entry requirements and randomly allocated to an intervention (n = 29) or control group (n = 30), being matched for age and hamstring injury history. Twenty-eight intervention and 29 control group participants completed the trial. Both groups received the current best practice medical and sports science management, which acted as the control. Additionally, the intervention group received a sports chiropractic intervention. Treatment for the intervention group was individually determined and could involve manipulation/mobilization and/or soft tissue therapies to the spine and extremity. Minimum scheduling was: 1 treatment per week for 6 weeks, 1 treatment per fortnight for 3 months, 1 treatment per month for the remainder of the season (3 months). The main outcome measure was an injury surveillance with a missed match injury definition. Results After 24 matches there was no statistical significant difference between the groups for the incidence of hamstring injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051) and primary non-contact knee injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051). The difference for primary lower-limb muscle strains was significant (OR:0.097, 95%CI:0.011-0.839, p = 0.025). There was no significant difference for weeks missed due to hamstring injury (4 v14, χ2:1.12, p = 0.29) and lower-limb muscle strains (4 v 21, χ2:2.66, p = 0.10). A significant difference in weeks missed due to non-contact knee injury was noted (1 v 24, χ2:6.70, p = 0.01). Conclusions This study demonstrated a trend towards lower limb injury prevention with a significant reduction in primary lower limb muscle strains and weeks missed due to non-contact knee injuries through the addition of a sports chiropractic intervention to the current best practice management. Trial registration The study was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12608000533392). PMID:20374662

  7. Chiropractic care for back pain

    MedlinePlus

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

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

    PubMed Central

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

    2015-01-01

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

  9. Stability: from biomechanical concept to chiropractic practice

    PubMed Central

    McGill, Stuart M

    1999-01-01

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

  10. Clinical competency evaluation of Brazilian chiropractic interns

    PubMed Central

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

    2015-01-01

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

  11. Manipulative therapy (Feldenkrais, massage, chiropractic manipulation) for neck pain.

    PubMed

    Plastaras, Christopher; Schran, Seth; Kim, Natasha; Darr, Deborah; Chen, Mary Susan

    2013-07-01

    Neck pain is an extremely common symptom with many possible etiologies. A substantial number of patients are turning to complementary and alternative medicine (CAM). Low-quality evidence supports the beneficial effects of CAM. Feldenkrais, massage therapy, and spinal manipulation are discussed in detail. Complications are generally benign and self-limited, although occasional catastrophic consequences have been documented. Despite the favorable opinion many rheumatologists have of some CAM therapy, many patients are not disclosing CAM use to their medical providers. By expressing interest, asking questions, and taking a shared-decision-making approach, providers can encourage disclosure and provide valuable input. PMID:23666468

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

    PubMed Central

    Brown, Douglas M.

    2014-01-01

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

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

    PubMed

    Brown, Douglas M

    2014-03-01

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

  14. 78 FR 22901 - United States v. Chiropractic Associates, Ltd. of South Dakota Proposed Final Judgment and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ... Defendant, and venue is proper in the District of South Dakota under Section 12 of the Clayton Act, 15 U.S.C... Private Litigants Section 4 of the Clayton Act, 15 U.S.C. 15, provides that any person who has been... damage action. Under the provisions of Section 5(a) of the Clayton Act, 15 U.S.C. 16(a), the...

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

    PubMed Central

    Guagliardo, Joseph G.; Hoiriis, Kathryn T.

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  17. Chiropractic manipulation in pediatric health conditions – an updated systematic review

    PubMed Central

    Gotlib, Allan; Rupert, Ron

    2008-01-01

    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. PMID:18789139

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

    PubMed Central

    Dies, Stephen; Strapp, J Walter

    1992-01-01

    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.

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

    PubMed

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

    2015-03-01

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

  20. Short-Term Stability of Resting Pulse Rates in Chiropractic Students

    PubMed Central

    Hart, John

    2015-01-01

    Objective This study assessed the short-term stability of resting pulse rate (RPR) over an approximate 10-minute period in college students. Methods Thirty-one students were recruited as a convenience sample. The RPRs were manually measured in the seated position after 1, 3, 5, 7, and 9 minutes of seated rest. The RPRs were compared by rest time in repeated-measures analysis of variance. Results Mean RPR increased by 1.9 beats per minute (BPM) from 1 minute of pretest rest to the 3-minute measurement (P < .05) and by 1.5 BPM from 3 minutes to 5 minutes (P > .05). Among the 5-, 7-, and 9-minute pretest rested readings, a difference of less than or equal to 0.6 BPM was observed. Statistically significant differences were observed for (a) all comparisons involving the 1-minute rested measurement and (b) the 3- and 7-minute rested measurement. Overall, RPRs began to stabilize beginning with the 5-minute rested measurement. Conclusion In this sample of participants, RPR measurements could stabilize after a minimum of 5 minutes of pretest rest. PMID:26778929

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

    PubMed Central

    Hains, Guy

    2002-01-01

    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

  2. Are Patients Receiving Health Promotion Advice in the Chiropractic Teaching Clinic Setting?

    PubMed Central

    Evans, Marion Willard; Page, Gregory; Ndetan, Harrison; Martinez, Daniel; Brandon, Patricia; Daniel, Dwain; Walker, Clark

    2011-01-01

    Purpose: The aim of this study was to analyze patient-reported health issues and levels of engagement, discussion of needed lifestyle changes, and goal setting with the patient’s intern or staff doctor before and after a brief intervention to increase health-promoting activities in the clinic. Methods: Patient surveys were developed and administered to outpatients before and after a brief intervention aimed at increasing staff and intern engagement with patients on health promotion measures. Patients self-reported areas of need and levels of engagement by their doctor or intern. Data were analyzed as pre- and postintervention independent, cross-sectional samples. Frequencies and chi-square assessments were performed. Results: One hundred twenty-eight preintervention surveys and 162 postintervention surveys were collected. Back pain was the most common reason for being seen in the clinic (60% of patients) and most patients were white. More than 10% were smokers in both samples. Many patients reported poor diet, unhealthy weight, sleep issues, stress, or lack of regular physical activity, but 65% of the preintervention group and 72% of the postintervention group said a needed lifestyle change was discussed. Goals were set for 74% of the preintervention group and 84% of the postintervention group (p = .04). Information on lifestyle change was received by 52% of preintervention patients and 62% of postintervention patients and most were satisfied with this information. Goal setting was more common when a lifestyle change was discussed. Written information that was related to physical activity, for example, increased 350% (p < .0001). Conclusion: There are many opportunities for discussing needed lifestyle changes with patients. Patients self-report health behavioral issues related to physical activity, unhealthy weight, diet, stress, and sleep. More can be done in this area by this clinic, but initial assessments of impact from a brief intervention seem to have increased some levels of engagement by interns. PMID:22069338

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

    PubMed Central

    Brown, Douglas M.

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Kong, Shelley Young

    2012-01-01

    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…

  5. Ankylosing spondylitis presenting to a chiropractic office: a report of two cases

    PubMed Central

    McDermaid, Cameron; Mior, Silvano

    2000-01-01

    Ankylosing spondylitis (AS) is a seronegative spondyloarthropathy that predilects young men. It is difficult to diagnose in its early stages and challenging to manage, once detected. Two cases of patients with previously undiagnosed AS are presented. The role of the clinical history and examination, imaging, and paraclinical studies are discussed. Suggestions for management and outcome measures for patients with ankylosing spondylitis are presented. ImagesFigure 1aFigure 1bFigure 2aFigure 2bp97-ap97-bp97-cp97-dp97-e

  6. Alternative Treatments for Ankylosing Spondylitis

    MedlinePlus

    ... the National Center for Complementary and Alternative Medicine. Chiropractic Treatment Some people with spondylitis swear by regular chiropractic sessions, but doctors do not recommend this treatment ...

  7. A biopsychological approach to chronic low back pain and disability in a private chiropractic setting: a case study

    PubMed Central

    Parish, Kevin A.

    2002-01-01

    For the clinician in private practice, a patient presenting with chronic low back disability can be challenging. Physical factors as well as psychosocial factors play a role in the development of chronicity. In fact, psychosocial factors may be the most dominant factor in the development of chronic low back pain and disability. Fear-avoidance behaviour is identified as one component of the bio-psychosocial model of low back disability. The clinician must recognize that treatment outcome will be dependent on addressing both physical and psychosocial factors. This case study presents an attempt at addressing the psychosocial factors (specifically fear-avoidance behaviour) of a patient presenting with chronic low back disability with a cognitive-behavioural approach, including screening, education and graded exposure. This approach appears to have played a role in returning this patient to modified duties after a year absence from work. More empirical and clinical studies are needed to develop and define which measures and treatment protocols are the most practical and effective for a clinician in private practice to utilize.

  8. Use of post-isometric relaxation in the chiropractic management of a 55-year-old man with cervical radiculopathy

    PubMed Central

    Emary, Peter

    2012-01-01

    This case report chronicles the successful management of a 55-year-old patient diagnosed with cervical radiculopathy using spinal manipulative therapy and cervical paraspinal post-isometric relaxation stretches. PMID:22457537

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  11. Establishing force and speed training targets for lumbar spine high-velocity, low-amplitude chiropractic adjustments*

    PubMed Central

    Owens, Edward F.; Hosek, Ronald S.; Sullivan, Stephanie G.B.; Russell, Brent S.; Mullin, Linda E.; Dever, Lydia L.

    2016-01-01

    Objective: We developed an adjusting bench with a force plate supporting the lumbar portion to measure loads transmitted during lumbar manual adjustment. It will be used to provide force-feedback to enhance student learning in technique labs. The study goal is to define the learning target loads and speeds, with instructors as expert models. Methods: A total of 11 faculty members experienced in teaching Gonstead technique methods performed 81 simulated adjustments on a mannequin on the force plate. Adjustments were along 9 lumbopelvic “listings” at 3 load levels: light, normal, and heavy. We analyzed the thrusts to find preload, peak load, duration, and thrust rate. Results: Analysis of 891 thrusts showed wide variations between doctors. Peak loads ranged from 100 to 1400 N. All doctors showed clear distinctions between peak load levels, but there was overlap between high and low loads. Thrust rates were more uniform across doctors, averaging 3 N/ms. Conclusion: These faculty members delivered a range of thrusts, not unlike those seen in the literature for high velocity, low amplitude manipulation. We have established at least minimum force and speed targets for student performance, but more work must be done to create a normative adjustment to guide refinement of student learning. PMID:26600272

  12. Parent Reports of Exclusive Breastfeeding After Attending a Combined Midwifery and Chiropractic Feeding Clinic in the United Kingdom

    PubMed Central

    Beharie, Monica Christine; Taylor, Alison M.; Simmenes, Elisabeth Berg; Way, Susan

    2016-01-01

    This service evaluation investigated an interdisciplinary allied professional health care strategy to address the problem of suboptimal breastfeeding. A clinic of midwives and chiropractors was developed in a university-affiliated clinic in the United Kingdom to care for suboptimal feeding through a multidisciplinary approach. No studies have previously investigated the effect of such an approach. The aim was to assess any impact to the breastfeeding dyad and maternal satisfaction after attending the multidisciplinary clinic through a service evaluation. Eighty-five initial questionnaires were completed and 72 (85%) follow-up questionnaires were returned. On follow-up, 93% of mothers reported an improvement in feeding as well as satisfaction with the care provided. Prior to treatment, 26% of the infants were exclusively breastfed. At the follow-up survey, 86% of mothers reported exclusive breastfeeding. The relative risk ratio for exclusive breastfeeding after attending the multidisciplinary clinic was 3.6 (95% confidence interval = 2.4-5.4). PMID:26763046

  13. Unexpected Salter-Harris type II fracture of the proximal phalanx of the second toe: a chiropractic perspective

    PubMed Central

    Murdock, Mark

    2015-01-01

    Objectives: To discuss the diagnosis and management of a Salter-Harris type II fracture in a nine-year-old girl who was managed conservatively. Clinical Features: A nine-year-old girl fell while playing in bare feet in the grass. She experienced pain when she walked or moved her toe. There was minor swelling and bruising. Intervention and Outcome: Plain film radiographs revealed a Salter-Harris type II fracture of the 2nd proximal phalanx. Her toe was stabilized and she was referred to an orthopedist. Orthopedic management involved a taping procedure. After three weeks, her fracture healed and she was pain free. Summary: Chiropractors may consider radiography of post-traumatic injury sites even with equivocal examination findings despite histories suggesting seemingly innocuous mechanisms of injury. PMID:26816417

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

    PubMed Central

    2012-01-01

    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. PMID:22713168

  15. Parent Reports of Exclusive Breastfeeding After Attending a Combined Midwifery and Chiropractic Feeding Clinic in the United Kingdom: A Cross-Sectional Service Evaluation.

    PubMed

    Miller, Joyce; Beharie, Monica Christine; Taylor, Alison M; Simmenes, Elisabeth Berg; Way, Susan

    2016-04-01

    This service evaluation investigated an interdisciplinary allied professional health care strategy to address the problem of suboptimal breastfeeding. A clinic of midwives and chiropractors was developed in a university-affiliated clinic in the United Kingdom to care for suboptimal feeding through a multidisciplinary approach. No studies have previously investigated the effect of such an approach. The aim was to assess any impact to the breastfeeding dyad and maternal satisfaction after attending the multidisciplinary clinic through a service evaluation. Eighty-five initial questionnaires were completed and 72 (85%) follow-up questionnaires were returned. On follow-up, 93% of mothers reported an improvement in feeding as well as satisfaction with the care provided. Prior to treatment, 26% of the infants were exclusively breastfed. At the follow-up survey, 86% of mothers reported exclusive breastfeeding. The relative risk ratio for exclusive breastfeeding after attending the multidisciplinary clinic was 3.6 (95% confidence interval = 2.4-5.4). PMID:26763046

  16. Correlation Between Student Performances on Course Level Integrated Clinical Skills Examinations and Objective Structured Clinical Examinations in a Chiropractic College Program

    PubMed Central

    Russell, Brent S.; Hoiriis, Kathryn T.; Guagliardo, Joseph

    2012-01-01

    Purpose: This retrospective study measured correlation of student performance between 2 objective structured clinical examinations (OSCEs) and an introductory integrated clinical skills course that preceded the OSCEs. The hypothesis was that there would be a strong, positive correlation between the earlier level examinations and the upper level OSCE, high enough that earlier examinations could be viewed as predictors of upper level OSCE performance. Methods: Using student scores for 5 academic terms of upper level OSCEs for 2008–2009 (n = 208) and respective earlier scores, correlation coefficients were calculated for the upper level OSCE and Clinical Skills course, and upper and lower level OSCEs. Multiple linear regression analysis was used to evaluate how well the lower level OSCE and clinical skills scores, both as lone and combined independent variables, predicted the upper level OSCE scores. Results: There was at least a moderate correlation between both sets of scores: r = .51 (p < .001) between upper level OSCE and clinical skills course, r = .54 (p < .001) between the upper and lower level OSCEs. A combination of clinical skills and lower level OSCE scores suggested a moderate prediction of upper level OSCE scores (R2 = .38.) Conclusions: Correlations were found to be of at least a moderate level. According to linear regression analysis, a combination of the earlier scores was moderately predictive for the upper level OSCE. More research could be done to determine additional components of student performance. PMID:23362360

  17. Measuring philosophy: a philosophy index

    PubMed Central

    Biggs, Lesley; Mierau, Dale; Hay, David

    2002-01-01

    Chiropractic philosophy which has been debated since the founding of chiropractic in 1895 has taken on new vigour over the past ten years. Despite a growing body of literature examining chiropractic philosophy, the chiropractic profession continues to be divided over this issue. To date, there has been little research examining the meaning of chiropractic philosophy to rank-and-file practitioners. The purpose of this paper is to present a philosophy index, based on thirteen items, which measures Canadian chiropractors' attitudes toward chiropractic philosophy. The internal consistency alpha reliability coefficient was .7700. Trends in practice philosophy were compared between males and females, among eight geopolitical regions, between those who attended the Canadian Memorial Chiropractic College and those who attended other colleges, between those who graduated before 1983 and those who graduated after 1983, and income. The data indicate that distinct, identifable groups (empiricists, rationalists and moderates) exist within the profession, and that the profession is divided with respect to chiropractic epistemology, the role of science, chiropractic's status as an alternative form of healing and the etiology of disease. In addition, the data reveal statistically significant differences in attitudes toward philosophy across the country and college attended. The authors argue that more research needs to be done in order to understand more fully the meaning of chiropractic, its impact on practice and professional identity.

  18. The McAndrews Leadership Lecture: February 2015, by Dr Scott Haldeman. Challenges of the Past, Challenges of the Present

    PubMed Central

    Haldeman, Scott; McAndrews, George P.; Goertz, Christine; Sportelli, Louis; Hamm, Anthony W.; Johnson, Claire

    2015-01-01

    The McAndrews Leadership Lecture was developed by the American Chiropractic Association to honor the legacy of Jerome F. McAndrews, DC, and George P. McAndrews, JD, and their contributions to the chiropractic profession. This article is a transcription of the presentation made by Dr Scott Haldeman on February 28, 2015, in Washington, DC, at the National Chiropractic Leadership Conference. PMID:26770177

  19. 78 FR 18988 - Agency Information Collection Activities; Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ...-insured loans to students in schools of allopathic medicine, osteopathic medicine, dentistry, veterinary medicine, optometry, podiatric medicine, pharmacy, public health, allied health, or chiropractic,...

  20. Recent advances in lumbar mechanics with relevance to clinicians

    PubMed Central

    McGill, Stuart M

    1989-01-01

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

  1. Environment for Innovation: Exploring Associations with Individual Disposition toward Change, Organizational Conflict, Justice and Trust

    ERIC Educational Resources Information Center

    Weinert, Daniel James

    2013-01-01

    The environment in higher education and healthcare is rapidly changing. Adaptation through innovation is critical for organizations responsible for the education of healthcare providers. This study examined the climate for innovation at chiropractic colleges and health sciences universities offering a doctor of chiropractic program. The…

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

    PubMed Central

    Brown, Douglas M.

    2007-01-01

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

  3. Acute thoracic epidural hematoma following spinal manipulative therapy: case report and review of the literature.

    PubMed

    Lee, Tsung-Han; Chen, Chih-Feng; Lee, Tao-Chen; Lee, Hsiang-Lin; Lu, Cheng-Hsien

    2011-09-01

    Spinal epidural hematoma is a rare complication of chiropractic manipulation. This study reports a case of thoracic spinal epidural hematoma following spinal manipulative therapy in the absence of predisposing factors. The effectiveness and safety of chiropractic treatment in chronic spinal pain and a literature review are also presented. PMID:21397387

  4. How Much Health Promotion and Disease Prevention Is Enough?

    PubMed Central

    Terre, Lisa; Globe, Gary; Pfefer, Mark T.

    2006-01-01

    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 of the empirical literature on family violence was conducted with a focus on issues relevant to chiropractic training and professional identity. Results: Extrapolating from the research, several models for medical training and continuing education have been proposed that emphasize a multidisciplinary, developmental approach to infusing knowledge, skill building, and mentored practice experiences into professional education experiences. Conclusion: As chiropractors become more mainstream portal-of-entry providers, there is a clear need to translate the didactics of family violence into the clinical setting. Clinical education may provide students the opportunity to master basic competencies for managing challenging family violence problems. The clinical environment may be appropriate for inculcating skills commensurate with those of other primary care providers. Yet, the extent to which training priorities and approaches extrapolated from other health care disciplines should be accepted wholesale by the chiropractic profession merits further discussion, including issues around the professional identity of chiropractic, the impact of accreditation standards and practice guidelines on actual professional practice behaviors, and the possible limits and unintended consequences associated with expanding the traditional chiropractic scope of practice from a specialty to a primary care profession. PMID:18483632

  5. A jurisdictional review of the legislation governing informed consent by chiropractors across Canada

    PubMed Central

    Boucher, Pierre B.; Brousseau, Danica; Chahine, Sarah

    2016-01-01

    The objective of this jurisdictional review is to provide summary information pertaining to the regulation of chiropractors in Canadian provinces and territories on the topic of informed consent. Our review shows that two provinces have legislated for all healthcare professions: Ontario and Prince Edward Island. Two chiropractic regulatory bodies (New Brunswick and, Newfoundland and Labrador) have adopted the Canadian Chiropractic Association Code of Conduct. All chiropractic regulatory bodies of the other provinces and Yukon have adopted their own specific dispositions regarding informed consent. Chiropractors in Prince Edward Island, Saskatchewan and Québec must obtain informed consent in writing. PMID:27069269

  6. A jurisdictional review of the legislation governing informed consent by chiropractors across Canada.

    PubMed

    Boucher, Pierre B; Brousseau, Danica; Chahine, Sarah

    2016-03-01

    The objective of this jurisdictional review is to provide summary information pertaining to the regulation of chiropractors in Canadian provinces and territories on the topic of informed consent. Our review shows that two provinces have legislated for all healthcare professions: Ontario and Prince Edward Island. Two chiropractic regulatory bodies (New Brunswick and, Newfoundland and Labrador) have adopted the Canadian Chiropractic Association Code of Conduct. All chiropractic regulatory bodies of the other provinces and Yukon have adopted their own specific dispositions regarding informed consent. Chiropractors in Prince Edward Island, Saskatchewan and Québec must obtain informed consent in writing. PMID:27069269

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

    MedlinePlus

    ... from the 2012 National Health Interview Survey adult alternative medicine supplement ( 2 ). Keywords: National Health Interview Survey, U.S. ... refer to the National Center for Complementary and Alternative Medicine . Chiropractic manipulation : A technique that uses a type ...

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

    MedlinePlus

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

  9. 75 FR 16136 - Agency Information Collection Activities: Proposed Collection: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-31

    ... information technology. Proposed Project: The Health Education Assistance Loan (HEAL) Program: Physician's... Education Assistance Loan (HEAL) program provided federally-insured loans to students in schools of..., pharmacy, public health, allied health, or chiropractic, and graduate students in health administration...

  10. 49 CFR 390.103 - Eligibility requirements for medical examiner certification.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS FEDERAL MOTOR CARRIER SAFETY REGULATIONS; GENERAL National Registry of Certified Medical Examiners... nurse, doctor of chiropractic, doctor of medicine, doctor of osteopathy, physician assistant, or...

  11. 49 CFR 390.103 - Eligibility requirements for medical examiner certification.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS FEDERAL MOTOR CARRIER SAFETY REGULATIONS; GENERAL National Registry of Certified Medical Examiners... nurse, doctor of chiropractic, doctor of medicine, doctor of osteopathy, physician assistant, or...

  12. 49 CFR 390.103 - Eligibility requirements for medical examiner certification.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS FEDERAL MOTOR CARRIER SAFETY REGULATIONS; GENERAL National Registry of Certified Medical Examiners... nurse, doctor of chiropractic, doctor of medicine, doctor of osteopathy, physician assistant, or...

  13. 76 FR 51014 - National Advisory Committee on Institutional Quality and Integrity, Office of Postsecondary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ... Education. Petitions for Renewal of Recognition Accrediting Agencies 1. American Podiatric Medical Association, Council on Podiatric Medical Education. 2. The Council on Chiropractic Education, Commission on... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF...

  14. Teaching Biochemistry in a "Guided Discovery Curriculum".

    ERIC Educational Resources Information Center

    Surlekar, Sheela

    1998-01-01

    Describes the implementation of the innovative Guided Discovery Curriculum at the National College of Chiropractic. Emphasizes the relevance of biochemical principles to clinical practice through the selection of two clinical cases. (DDR)

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

    MedlinePlus

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

  16. Cancer Alternative Therapies

    MedlinePlus

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

  17. 32 CFR 935.152 - Activities for which permit is required.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Disposal Act, as amended, 42 U.S.C. 6901 et seq., and its implementing regulations (40 CFR chapter I). ... medical profession, including dentistry, surgery, osteopathy, and chiropractic. (c) The erection of...

  18. 32 CFR 935.152 - Activities for which permit is required.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Disposal Act, as amended, 42 U.S.C. 6901 et seq., and its implementing regulations (40 CFR chapter I). ... medical profession, including dentistry, surgery, osteopathy, and chiropractic. (c) The erection of...

  19. 32 CFR 935.152 - Activities for which permit is required.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Disposal Act, as amended, 42 U.S.C. 6901 et seq., and its implementing regulations (40 CFR chapter I). ... medical profession, including dentistry, surgery, osteopathy, and chiropractic. (c) The erection of...

  20. 32 CFR 935.152 - Activities for which permit is required.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Disposal Act, as amended, 42 U.S.C. 6901 et seq., and its implementing regulations (40 CFR chapter I). ... medical profession, including dentistry, surgery, osteopathy, and chiropractic. (c) The erection of...

  1. 32 CFR 935.152 - Activities for which permit is required.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Disposal Act, as amended, 42 U.S.C. 6901 et seq., and its implementing regulations (40 CFR chapter I). ... medical profession, including dentistry, surgery, osteopathy, and chiropractic. (c) The erection of...

  2. Guidelines of conduct in forensic practice.

    PubMed

    Jahn, Warren T; Cupon, Leanne N; Perle, Stephen M

    2004-01-01

    As the profession of chiropractic grows in stature within our society, the morality of each chiropractor's conduct will be increasingly examined and scrutinized by the public, the media, the government and the profession itself. Immoral conduct occurs not by just a few unscrupulous individuals, but by a host of apparently good, successful professionals who lead what appear to be exemplary private lives. Recent increasing examples of professional and corporate moral decay as reported by chiropractic state boards, in print media, etc., should spur chiropractic colleges to make determined efforts to reemphasize ethics as part of the core curriculum. Ethical judgments depend upon both the decision making process itself and the experience, intelligence and integrity of the decision maker. The College on Forensic Sciences (CFS), a subsidiary of the American Chiropractic Association's (ACA's) Council on Chiropractic Orthopedics (CCO), developed a guideline of conduct to assist forensic examiners in making decisions in their every day subspecialty practice. Guidelines provide guideposts that can be helpful in assisting forensic examiners in evaluating the circumstances they are encountering and providing possible approaches that may be taken in addressing the ethical issues involved. PMID:19674625

  3. Standards of care: what do they mean to chiropractors, and which organizations should develop them

    PubMed Central

    Biggs, Lesley; Hay, David; Mierau, Dale

    1999-01-01

    This article is a follow-up on our previous work examining Canadian chiropractors’ attitudes towards chiropractic philosophy and scope of practice and their implications for the implementation of clinical practice guidelines. In this current study, we examined Canadian chiropractors’ attitudes toward standards of care, the organizations developing them and their relationship to the philosophy index. The findings indicated that there was no agreement about the definition of standards of care among chiropractors, although there was strong support for the concept. Most chiropractors preferred that chiropractic organizations set standards of care - the strongest support was for the Canadian Chiropractic Association. Finally, we found differences among chiropractors’ attitudes toward standards of care and the organizations developing them with respect to philosophy. Empirically oriented chiropractors supported only a narrow definition of standards of care limited to issues surrounding safety and diagnosis. In addition, empirically oriented chiropractors would only support the development of standards of care by an expert panel of chiropractors. Rationalist and moderates supported the development of standards of care by a broader range of chiropractic organizations. We concluded that successful implementation of standards of care could occur if the CCA, in consultation with other chiropractic organizations, was actively committed to this initiative. Imagesp257-ap257-bp257-cp257-dp257-e

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

    PubMed Central

    Rubin, Drew

    2010-01-01

    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. PMID:21629555

  5. Commentary on a framework for multicultural education

    PubMed Central

    Hammerich, Karin F.

    2014-01-01

    Today’s changing demographics require that multicultural factors be considered in the delivery of quality patient-centred health care in chiropractic. Yet minimal training in cultural competency in chiropractic education leaves graduates ill-equipped to treat a diverse population. This commentary examines cultural competency training in current literature, demonstrates frameworks for curriculum integration, and suggests how cultural competency might be included in a chiropractic college curriculum. A database search yielded little evidence that cultural competency is integrated into curricula of chiropractic schools. Some journal articles note that promoting multicultural education and cultural sensitivity is an important goal. However, they provide no mechanisms as to how this can be achieved within training programs. Thus, although an undeniable need exists for all healthcare practitioners to develop cultural competency in the face of an increasingly diverse population, cultural competency education has not kept pace. Chiropractic schools must review their curricula to develop the cultural competencies of their graduates and a basic framework is suggested. PMID:25202156

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

    PubMed

    Keating, J C

    1998-12-01

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

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

    PubMed

    Brown, Douglas M

    2015-09-01

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

  8. Chiropractic’s unique evolution and its future status

    PubMed Central

    Wardwell, Walter I

    1996-01-01

    Chiropractic’s demise was regularly predicted but the AMA’s campaign to “contain and then eliminate” it did not succeed. Nor did chiropractic follow osteopathy toward fusion with medicine. D.D. and B.J. Palmer were charismatic outsiders who emphasized the differences between medicine and chiropractic. Chiropractic’s unique evolution and survival owed a lot to BJ’s activity in publishing books and brochures and in part, to motivating his followers to fight for separate and distinct licensure. This paper proposes that in the twenty-first century chiropractic is most likely to become well established as an independent limited medical profession like dentistry, podiatry, optometry, and psychology.

  9. Relationship between Ontario chiropractors’ attitudes toward drug prescription rights and Canadian versus non-Canadian college of graduation: results from an online survey

    PubMed Central

    Emary, Peter Charles; Stuber, Kent Jason

    2016-01-01

    Objective: To investigate differences between chiropractors’ attitudes toward drug prescription rights based on chiropractic college of graduation. Methods: A secondary data analysis of a 2015 survey of chiropractors from Ontario, Canada was performed. The questionnaire included 14 items concerning chiropractors’ knowledge and attitudes toward drug prescription including demographics. Results: 960 of 2,677 deliverable questionnaires were completed (36% response rate). The majority of respondents favoured limited prescribing rights for chiropractors regardless of college of graduation. Respondents who graduated from Canadian institutions were significantly more in favour of these privileges compared to graduates from non-Canadian schools. Over three-quarters of all respondents opposed the idea of chiropractors having full prescribing rights. No significant association was found between respondents’ philosophical orientation and school attended. Conclusion: Ontario chiropractors who graduated from Canadian chiropractic institutions were most interested in obtaining limited drug prescription rights for the profession compared to non-Canadian chiropractic institution graduates. PMID:27069262

  10. Management of Mild Traumatic Brain Injury Symptoms in a 31-Year-Old Woman Using Cervical Manipulation and Acupuncture: A Case Report

    PubMed Central

    Gergen, Danielle M.

    2015-01-01

    Objective The objective was to describe chiropractic and acupuncture care of a patient with acute mild traumatic brain injury (mTBI) symptoms. Clinical Features A 31-year-old woman had acute neck pain, headache, dizziness, nausea, tinnitus, difficulty concentrating, and fatigue following a fall. She was diagnosed at an urgent care facility with mTBI immediately following the fall. Pharmaceutical intervention had been ineffective for her symptoms. Intervention and Outcome The patient was treated with chiropractic adjustments characterized as high velocity, low amplitude thrusts directed to the cervical spine and local acupuncture points in the cervical and cranial regions. The patient received care for a total of 8 visits over 2.5 weeks with resolution of concussive symptoms. Conclusion This patient with mTBI responded favorably to a conservative treatment protocol with the combination of chiropractic and acupuncture care. PMID:26778936

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

    PubMed Central

    Brown, Douglas M.

    2015-01-01

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

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

    PubMed Central

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

    2005-01-01

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

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

    PubMed Central

    Brown, Douglas M.

    2013-01-01

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

  14. A Needling Controversy.

    PubMed

    Berlin, Joey

    2016-01-01

    Acupuncture licensing requires thousands of hours of training, but the Texas Board of Chiropractic Examiners' (TBCE's) rules allow chiropractors to perform the procedure and to do so with considerably less training. The Texas Association of Acupuncture and Oriental Medicine (TAAOM) is challenging those rules in a lawsuit, saying acupuncture is beyond the chiropractic scope of practice, and TBCE's inclusion of it constitutes a public health risk. The Texas Medical Association filed an amicus curiae brief to support TAAOM's case, citing the limitations on acupuncture practice in the Texas Occupations Code and the large disparity in required training hours between licensed acupuncturists and chiropractors who perform the technique. PMID:26928818

  15. Description and evaluation of a freshman orientation program

    PubMed Central

    Josefowitz, N; Moss, J

    1985-01-01

    A freshman orientation program was developed to assist first year students in adjusting to student life at the Canadian Memorial Chiropractic College. The orientation program consisted of an orientation package, small student led discussion groups, discussions on chiropractic education with members of the Board of Governors and the faculty, a tour of the building, an introduction to the library, a seminar on study skills and informal social gatherings. The orientation program was positively evaluated by all students. Students met colleagues with whom they later became friends, and were exposed to coping skills which proved useful in helping them adjust to student life.

  16. The Homewood influence in Canada and beyond

    PubMed Central

    Keating, Joseph C

    2006-01-01

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

  17. Nutritional intervention for cancer minimization

    PubMed Central

    Jamison, Jennifer R

    1987-01-01

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

  18. Bodywork Abstracts. 1989 Edition.

    ERIC Educational Resources Information Center

    van Why, Richard P., Comp.

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

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

    PubMed Central

    Brown, Douglas M.

    2013-01-01

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

  20. 78 FR 4439 - United States

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ..., Antitrust Division's Internet website, and, under certain circumstances, published in the Federal Register... chiropractic physicians into one group. Through OSCIPA, a chiropractor can maintain an individual practice... one or more of them, from i. continuing, maintaining, or renewing in any manner, directly...

  1. Back Pain

    MedlinePlus

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

  2. 42 CFR 60.1 - What is the HEAL program?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS HEALTH EDUCATION ASSISTANCE LOAN PROGRAM General Program Description § 60.1 What is the HEAL program? (a) The Health Education... medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The...

  3. 42 CFR 60.1 - What is the HEAL program?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS HEALTH EDUCATION ASSISTANCE LOAN PROGRAM General Program Description § 60.1 What is the HEAL program? (a) The Health Education... medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The...

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS HEALTH EDUCATION ASSISTANCE LOAN PROGRAM General Program Description § 60.1 What is the HEAL program? (a) The Health Education... medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The...

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

    ERIC Educational Resources Information Center

    Linaker, Kathleen Linda

    2012-01-01

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

  6. The Comprehensive Health Assessment.

    ERIC Educational Resources Information Center

    Eastern Iowa Community Coll. District, Davenport.

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

  7. At Life U., an Omnipresent President Pushes the Institution and Its Specialty.

    ERIC Educational Resources Information Center

    Suggs, Welch

    1999-01-01

    Describes development and expansion of Life University (Georgia) to an institution with 3,500 students offering the doctor of chiropractic degree, a master's degree in sport health science, and bachelor's degrees in 32 related areas. Notes the president's dominant role and critics' objections to high salaries for the president and his family…

  8. Improving College Faculty Instruction in the Basic and Allied Health Sciences.

    ERIC Educational Resources Information Center

    Washton, Nathan S.

    A project to improve college instruction in the basic and allied health sciences at New York Chiropractic College and the New York Institute of Technology is described. Attention was directed to: the kinds of resources colleges and professional schools provide to improve instruction; motivation of faculty to explore innovative or strategic…

  9. Mentoring in the Clinical Setting to Improve Student Decision-Making Competence

    ERIC Educational Resources Information Center

    Stick-Mueller, Misty; Boesch, Ron; Silverman, Steven; Carpenter, Scott; Illingworth, Robert; Countryman, James

    2010-01-01

    Introduction: The physician-intern relationship can be difficult to develop. A new chiropractic intern in a teaching clinic undergoes a major transition from classroom to clinical practice and must learn to turn classroom knowledge into clinical application. The ability to start formulating clinical techniques and apply them on a patient is…

  10. Community Attitudes about Economic Impacts of Colleges: A Case Study. AIR 1996 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Stout, Robert J.

    This study examined attitudes of people about benefits of the economic impacts of two local colleges (Palmer College of Chiropractic and Scott Community College) in the metropolitan Quad Cities area of Rock Island County (Illinois) and Scott County (Iowa). The study compared impacts considered important by the community with those estimated by the…

  11. Multidisciplinary Meeting (MDM) Can Provide Education and Reinforcement of Inter-Professional Development

    ERIC Educational Resources Information Center

    Zafiropoulos, George; Byfield, David

    2016-01-01

    The introduction of a multidisciplinary meeting (MDM) was analysed through a retrospective empirical study. The question of using it as a valuable tool to reinforce inter-professional development was made. The data was collected from 60 forth year Chiropractic students, who were at the end of their education and who were practicing their…

  12. Grades as Predictors of College and Career Success: The Case of a Health-Related Institution.

    ERIC Educational Resources Information Center

    Tan, David L.

    1991-01-01

    Examined relationship between grades, academic performance, and career success in case of nontraditional, health-related educational institution (Palmer College of Chiropractic). Found direct relationship between entering grade point average and subsequent college performance. Relationship between good grades in professional schools and career…

  13. Grades as Predictors of College and Career Success: The Case of a Health-Related Institution.

    ERIC Educational Resources Information Center

    Tan, David L.

    1991-01-01

    Examined relationship between grades, academic performance, and career success in case of nontraditional, health-related educational institution (Palmer College of Chiropractic). Found direct relationship between entering grade point average and subsequent college performance. Relationship between good grades in professional schools and career

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

    ERIC Educational Resources Information Center

    Linaker, Kathleen Linda

    2012-01-01

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

  15. Diet & Nutrition

    MedlinePlus

    ... Acupuncture Learn More Massage and Bodywork Learn More Marijuana (Cannabis) Learn More Chiropractic Therapy Learn More The National ... Society Store MSConnection Blog Información en Español Glossary Legal Notice/Privacy Policy Site Map Site Tour Contact ...

  16. Quality assurance: standards of care and ethical practice

    PubMed Central

    Vear, Herbert J

    1991-01-01

    In the past, standards of care in chiropractic were based upon the bias, empiricism and little if any scientific work by the author. This was due, in part, to history which fostered the belief that all that was needed was anecdotal testimony and in part to the isolation of chiropractic colleges from main stream science. Today, standards are being based upon the scientific evaluation of the clinical procedures used and formulated by consensus of experts within the profession. The chiropractic profession has the duty to create standards of practice that will advance its clinical practice, protect the patient, ensure its contribution to health care and promote research into the assessment of outcomes and effectiveness. Although such steps are being actively pursued, significant discrepancies exist between the 60 statutes regulating chiropractic practice. Absence of consensus not only in the scope of practice but also in lexicon, adds confusion within and outside the profession. In addition, the profession is facing the same difficult task as the other health care professions, the need to develop quality assurance parameters for standards of care, quality of care and outcome of care measurements. Each of the parameters must be rational, defensible and modifiable as advances in science and technology become available. It is the responsibility of each chiropractor to maintain the appropriate level of professional skills to ensure that the patient receives the best care possible.

  17. Bodywork Abstracts. 1989 Edition.

    ERIC Educational Resources Information Center

    van Why, Richard P., Comp.

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

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

    PubMed Central

    Keating, Joseph C.

    2008-01-01

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

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

    PubMed Central

    2012-01-01

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

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

    PubMed Central

    Keating, Joseph C; Haldeman, Scott

    1995-01-01

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

  1. Ian Douglass Coulter, PhD

    PubMed Central

    Brown, Douglas M

    2004-01-01

    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. PMID:17549218

  2. Diagnosis and management of "an apparent mechanical" femoral mononeuropathy: a case study.

    PubMed

    Desmarais, Ariane; Descarreaux, Martin

    2007-12-01

    This report describes an apparent case of femoral nerve mononeuropathy in a 58-year-old equestrian due to mechanical stress. A woman presented at a chiropractic office complaining of right buttock pain radiating to the right groin and knee. A treatment plan, consisting of chiropractic adjustments in addition to stretching and myofascial therapy, was initiated. The goal was to reduce pain and inflammation in the sacroiliac articulation by restoring normal biomechanical function. A rehabilitation program to alleviate tension in the musculature was initiated to reduce mechanical stresses exerted on the femoral nerve. The patient received five treatments over a period of three weeks and became asymptomatic. Even though peripheral nerve entrapment is an uncommon condition, clinicians must not overlook the possibility of a femoral mononeuropathy as it can produce a complex presentation and lead to ineffective patient management. PMID:18060007

  3. An overview of systematic reviews of complementary and alternative medicine for fibromyalgia.

    PubMed

    Terry, Rohini; Perry, Rachel; Ernst, Edzard

    2012-01-01

    Fibromyalgia (FM) is a chronic pain condition which is difficult to diagnose and to treat. Most individuals suffering from FM use a variety of complementary or alternative medicine (CAM) interventions to treat and manage their symptoms. The aim of this overview was to critically evaluate all systematic reviews of single CAM interventions for the treatment of FM. Five systematic reviews met the inclusion criteria, evaluating the effectiveness of homoeopathy, chiropractic, acupuncture, hydrotherapy and massage. The reviews found some evidence of beneficial effects arising from acupuncture, homoeopathy, hydrotherapy and massage, whilst no evidence for therapeutic effects from chiropractic interventions for the treatment of FM symptoms was found. The implications of these findings and future directions for the application of CAM in chronic pain conditions, as well as for CAM research, are discussed. PMID:21614472

  4. Innate intelligence: its origins and problems

    PubMed Central

    Morgan, Lon

    1998-01-01

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

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

    PubMed

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

    2015-09-01

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

  6. Organizational commitment of a health profession faculty: dimensions, correlates and conditions.

    PubMed

    Marchiori, Dennis M; Henkin, Alan B

    2004-06-01

    Health professions depend on their faculties to prepare new practitioners, conduct research and provide essential services. Organizational commitment is an important aspect of faculty effectiveness and job performance, and may impact on turnover, absenteeism and interpersonal trust. A survey of organizational commitment, including faculty demographics and workplace variables, was conducted. Respondents were full- and part-time chiropractic faculty working in the United States and Canada. More than 54% of the study population (n = 609) completed and returned the instrument. A large majority of the respondents were male (68.4%) and employed full-time (81.6%). Almost half (47.5%) of the respondents were assigned to the area of patient care at their institutions. This study provides an initial assessment of organizational commitment among chiropractic faculty. Tenure in higher education, gender and age were found to be the most important predictors of organizational commitment. PMID:15203850

  7. Beyond the spine: a new clinical research priority.

    PubMed

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

    2015-03-01

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

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

    PubMed Central

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

    2015-01-01

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

  9. Learning From a Lifetime of Leading Effective Change

    PubMed Central

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

    2014-01-01

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

  10. A single cohort prospective trial of the immediate effects of spinal manipulation on visual acuity

    PubMed Central

    Athaide, Michelle; Rego, Carol; Budgell, Brian

    2016-01-01

    Introduction: There is no high quality evidence on which to judge the generalizability of isolated reports of improvement in vision following manipulation. The current paucity of research results also precludes the thoughtful design of a controlled, prospective clinical study. Hence, the purpose of the current study was to test the feasibility of conducting a clinical trial of the acute effects of spinal manipulation on visual acuity. Methods: New adult patients presenting to a community based chiropractic clinic were recruited into a single cohort prospective trial to determine the immediate effects of cervical spinal manipulation on visual acuity. Results: The experimental protocol was well accepted by patients and caused minimal or no disruption of the clinic routine. By some measures, chiropractic treatment was accompanied by statistically significant improvements in visual acuity. Discussion: The results of this study indicate that it is quite feasible to conduct a prospective, community based clinical study of the acute effects of spinal manipulation on visual acuity. PMID:27069271

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

    PubMed

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

    2013-03-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  14. Osteolysis of the distal clavicle: an important consideration in chronic shoulder pain

    PubMed Central

    OBrien, Stewart A.

    1987-01-01

    Post-traumatic osteolysis of the distal clavicle must be considered as a differential diagnosis in all cases of progressive shoulder pain with insidious onset. While its mechanisms is still not fully understood, its incidence of recognition is rapidly increasing in clinical practice. Two case reports with substantially different etiology are documented. Osteolysis is a largely self-limiting disease that responds very well to chiropractic care. ImagesFigure 1Figure 2Figure 3

  15. 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)

    2009-08-01

    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?

  16. Partial lumbosacral transitional vertebrae: 2 cases of unilateral sacralization

    PubMed Central

    Muir, Jeffrey M.

    2012-01-01

    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. PMID:23204950

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

    PubMed Central

    Green, Bart N; Sims, John; Allen, Rachel

    2006-01-01

    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 had insidious severe low back pain without radiation or neurological deficit, resulting in 24 hours of hospitalization. Spinal degeneration was discovered upon imaging. Four months later, it still took up to 10 minutes for him to get out of bed and several minutes to exit the jet due to stiffness and pain. He had discontinued his regular Marine Corps fitness training due to pain avoidance. Pain severity ranged from 1.5–7.1 cm on a visual analog scale. His Roland Morris Disability Questionnaire score was 5 out of 24. The pilot's pain was managed with the coordinated efforts of the flight surgeon, physiatrist, physical therapist, and doctor of chiropractic. Following this regimen he had no pain and no functional disability; he was able to fly multiple training missions per week and exercise to Marine Corps standards. Conclusion A course of care integrating flight medicine, chiropractic, physical therapy, and physiatry appeared to alleviate pain and restore function to this F/A-18 aviator with low back pain. PMID:16820063

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

    PubMed Central

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

    2011-01-01

    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. PMID:22027211

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

    PubMed Central

    Powell, Wayne; Knaap, Simone F.C.

    2015-01-01

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

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

    PubMed Central

    2010-01-01

    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. PMID:21083911

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

    PubMed Central

    Shreeve, Michael W.

    2008-01-01

    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. PMID:18483586

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

    PubMed Central

    2013-01-01

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

  3. The great subluxation debate: a centrist's perspective

    PubMed Central

    Good, Christopher J.

    2010-01-01

    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. PMID:22693474

  4. Nutrition and muscle protein synthesis: a descriptive review

    PubMed Central

    Weinert, Dan J.

    2009-01-01

    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. PMID:19714233

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

    PubMed Central

    Avrahami, Daniel; Pajaczkowski, Jason A.

    2012-01-01

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

  6. Allowing a Possible Margin of Error When Assessing Student Skills in Spinous Process Location

    PubMed Central

    Hart, John; Neely, Cheneir

    2011-01-01

    Introduction: Spinal palpation is subject to inconsistency between examiners. When testing students on the location of vertebral spinous processes, faculty examiners may wish to allow for a margin of error that is observed between experienced practitioners. This study attempts to determine such a margin of error for selected vertebral levels that could be allowed in testing situations at Sherman Chiropractic College. This could serve as a model for other chiropractic colleges in determining their margins of error. Methods: Two faculty clinicians palpated spinous processes at four different vertebral levels (C2, T3, T9, and L2) on 18 student volunteers. Differences for each vertebral level, along with one, two, and three standard deviations, were calculated. Results: Average differences between examiners increased caudally, as follows: C2, 4.23 ± 3.77 mm; T3, 13.41 ± 10.53 mm; T9, 18.17 ± 17.62 mm; L2, 18.70 ± 16.58 mm. Discussion: In this study, faculty examiners exhibited variation in their locations of spinous processes for these vertebrae. These variations could be allowed when assessing student skills in locating these spinous processes at this chiropractic college. Conclusion: In this study, differences between examiners plus or minus one standard deviation ranged from 4.23 ± 3.77 mm for C2 to 18.70 ± 16.58 mm for L2. The concept of margin of error should be considered by faculty examiners when assessing the skill of students in locating the spinous process of various vertebral levels. PMID:22069343

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

    PubMed Central

    2012-01-01

    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. PMID:23046615

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

    PubMed Central

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

    1995-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  11. Subtle radiographic presentation of a pleural effusion secondary to a cancer of unknown primary: a case study

    PubMed Central

    Blanchette, Marc-André; Grenier, Julie-Marthe

    2014-01-01

    Carcinoma of unknown primary sites is a clinical syndrome that represents many types of cancer. The mortality rate associate to this type of cancer is elevated and a rapid medical referral is required for patients presenting this condition. Pleural effusion may be the only visible sign. We report a case of pleural effusion secondary to a cancer of unknown primary site in a 60-year-old man that sought chiropractic care for radiating low back pain. The radiographic studies revealed a pleural effusion as one of the only significant finding. This article will address the clinical presentation, radiographic studies and a discussion on the radiographic detection of pleural effusion. PMID:25202155

  12. Abdominal aortic aneurysms: case report

    PubMed Central

    Hadida, Camille; Rajwani, Moez

    1998-01-01

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

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

    PubMed Central

    Brown, Douglas M.

    2009-01-01

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

  14. Business Training and Education Needs of Chiropractors

    PubMed Central

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

    2008-01-01

    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 PMID:19043535

  15. The role of alternative medicine in rhinology.

    PubMed

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

    2012-02-01

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

  16. Complementary medicine: where is the evidence?

    PubMed

    Ernst, Edzard

    2003-08-01

    Herbal medicines have been submitted to systematic reviews more frequently than any other complementary therapy, and it is here where the most positive evidence can be found. There is not much research into potential serious risks of complementary medicine. Possible risks range from the toxicity of herbs to vertebral artery dissection or nerve damage after chiropractic manipulation. Currently the Cochrane Library contains 34 systematic reviews of complementary medicine: 20 of herbal medicines, 7 of acupuncture, 3 of homeopathy, 2 of manual therapies, and 2 of other forms. PMID:12899818

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

    PubMed Central

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

    2015-01-01

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

  18. Building Interprofessional Frameworks Through Educational Reform

    PubMed Central

    Karim, Rahim

    2011-01-01

    The North American health care sector is being reformed to enhance collaboration among health care professionals to render patient care and improve outcomes. Changing educational frameworks will play a key role in achieving this goal. It is therefore important to gain an understanding of the application of interprofessional health care education and collaborative models of education. Chiropractic and other health care faculties would need to have an effective understanding and clarification of the characteristics of interprofessional care and its foundation in education from which appropriate educational and curricular models could be developed. PMID:21677871

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

    PubMed Central

    Rathore, Sundeep

    2003-01-01

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

  20. Subluxation: dogma or science?

    PubMed Central

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

    2005-01-01

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

  1. Campuses of the LACC.

    PubMed

    Siordia, Lawrence; Keating, Joseph C

    2005-06-01

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

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

    PubMed Central

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

    2003-01-01

    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.

  3. Alternative medicines for the geriatric veterinary patient.

    PubMed

    Kidd, J Randy

    2012-07-01

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

  4. Allan C. Gotlib, DC, CM: A worthy Member of the Order of Canada.

    PubMed

    Brown, Douglas M

    2016-03-01

    On June 29, 2012, His Excellency the Right Honourable David Johnston, Governor General of Canada, announced 70 new appointments to the Order of Canada. Among them was Dr. Allan Gotlib, who was subsequently installed as a Member of the Order of Canada, in recognition of his contributions to advancing research in the chiropractic profession and its inter-professional integration. This paper attempts an objective view of his career, to substantiate the accomplishments that led to Dr. Gotlib receiving Canada's highest civilian honour. PMID:27069273

  5. PubMed Central

    Kobrossi, T.; Steiman, I.

    1990-01-01

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

  6. Alternative methods of conservative treatment of idiopathic scoliosis.

    PubMed

    Zarzycka, Maja; Rozek, Karina; Zarzycki, Michał

    2009-01-01

    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

  7. Allan C. Gotlib, DC, CM: A worthy Member of the Order of Canada

    PubMed Central

    Brown, Douglas M.

    2016-01-01

    On June 29, 2012, His Excellency the Right Honourable David Johnston, Governor General of Canada, announced 70 new appointments to the Order of Canada. Among them was Dr. Allan Gotlib, who was subsequently installed as a Member of the Order of Canada, in recognition of his contributions to advancing research in the chiropractic profession and its inter-professional integration. This paper attempts an objective view of his career, to substantiate the accomplishments that led to Dr. Gotlib receiving Canada’s highest civilian honour. PMID:27069273

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

    PubMed Central

    Kobsar, Bradley; Alcantara, Joel

    2009-01-01

    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

  9. Neurofibromatosis clinical presentations: A report of two cases

    PubMed Central

    Kitchen, Robert G; Waddell, Brad M; Willson, Robert D

    1987-01-01

    Neurofibromatosis (NFT) is an autosomal dominant disorder. Several distinctive clinical features may be discovered in the presence of the disease, including ècafé au laité spots, cutaneous neurofibromas, axillary freckling, Lisch nodules, and a positive familial history. Chiropractic management of this condition should include early recognition, appropriate supportive referral and symptomatic treatment of accompanying biomechanical dysfunctions. Early diagnosis will not only permit appropriate assessment, but will allow for vital genetic counselling. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7

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

    PubMed Central

    Lavigne, Valrie; Gleberzon, Brian J.

    2012-01-01

    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. PMID:23449233

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Hardy, Katie; Pollard, Henry

    2006-01-01

    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. PMID:17044942

  13. A 69-Year-Old Presenting With Musculoskeletal Low Back Pain: A Case of Lumbosacral Chordoma

    PubMed Central

    Williams, Shawn P.; Beckerman, Bernard; Piña Fonti, Maria Elena

    2014-01-01

    Objective The purpose of this case report is to describe the presentation of a patient with lumbosacral chordoma characterized by somatic chronic low back pain and intermittent sacral nerve impingement. Case report A 69-year-old male presenting to an emergency department (ED) with low back pain was provided analgesics and muscle relaxants then referred for a series of chiropractic treatments. Chiropractic treatment included manipulation, physical therapy, and rehabilitation. After 3 times per week for a total of 4 weeks, re-examination showed little relief of his symptoms. His pain symptoms worsened and he presented to the ED for the second time. Magnetic resonance imaging was performed and revealed a high intensity mass. Intervention and outcome The soft tissue mass identified on magnetic resonance imaging was surgically removed. Shortly after the surgery, the patient developed post-operative bleeding and was returned to surgery. During the second procedure, he developed a post-operative hemorrhage related to the development of disseminated intravascular coagulation and subsequently died during the second procedure. A malignant lumbosacral chordoma was diagnosed on pathologic examination. Conclusion This case report describes the presentation of a patient with lumbosacral chordoma presenting with musculoskeletal low back pain. Chordomas are rare with few prominent manifestations. An early diagnosis can potentially make a difference in morbidity and mortality. Due to its insidious nature, it is a difficult diagnosis and one that is often delayed. PMID:25685125

  14. PubMed Central

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

    1990-01-01

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

  15. Cerebrospinal fluid stasis and its clinical significance.

    PubMed

    Whedon, James M; Glassey, Donald

    2009-01-01

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

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

    PubMed Central

    Cuthbert, Scott; Rosner, Anthony

    2010-01-01

    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. PMID:22027037

  17. Correlation of expertise with error detection skills of force application during spinal manipulation learning*

    PubMed Central

    Loranger, Michel; Treboz, Julien; Boucher, Jean-Alexandre; Nougarou, François; Dugas, Claude; Descarreaux, Martin

    2016-01-01

    Objective: Most studies on spinal manipulation learning demonstrate the relevance of including motor learning strategies in chiropractic curricula. Two outcomes of practice are the production of movement in an efficient manner and the improved capability of learners to evaluate their own motor performance. The goals of this study were to evaluate if expertise is associated with increased spinal manipulation proficiency and if error detection skills of force application during a high-velocity low-amplitude spinal manipulation are related to expertise. Methods: Three groups of students and 1 group of expert chiropractors completed 10 thoracic spine manipulations on an instrumented device with the specific goal of reaching a maximum peak force of 300 N after a brief period of practice. After each trial, participants were asked to give an estimate of their maximal peak force. Force-time profiles were analyzed to determine the biomechanical parameters of each participant and the participant's capacity to estimate his or her own performance. Results: Significant between-group differences were found for each biomechanical parameter. No significant difference was found between groups for the error detection variables (p > .05). The lack of significant effects related to the error detection capabilities with expertise could be related to the specificity of the task and how the training process was structured. Conclusion: This study confirms that improvements in biomechanical parameters of spinal manipulation are related to expertise. Feedback based on error detection could be implemented in chiropractic curricula to improve trainee abilities in detecting motor execution errors. PMID:26270897

  18. Disabling low back Oregon Workers' Compensation claims. Part II: Time loss.

    PubMed

    Nyiendo, J

    1991-05-01

    This paper reports on time loss incurred by chiropractic (DC) and medical (MD) claimants with disabling low back work-related injuries in Oregon. Clinical categorization was accomplished using medical records and was based on reported symptomatology, objective clinical findings and functional impairment. The median time loss days for cases with comparable clinical presentation (severity) was 9.0 for DC cases and 11.5 for MD cases. Chiropractic claimants had a higher frequency of return to work with 1 wk or less of time loss. No difference was seen in time loss days for MD or DC claimants with no documented history of low back pain. However, for claimants with a history of chronic low back problems, the median time loss days for MD cases was 34.5 days, compared to 9 days for DC cases. It is suggested that chiropractors are better able to manage injured workers with a history of chronic low back problems and to return them more quickly to productive employment. PMID:1829752

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

    PubMed Central

    Konczak, Clark R

    2005-01-01

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

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

    PubMed Central

    Horseman, Ian; Morningstar, Mark W.

    2008-01-01

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

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

    PubMed

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

    2015-09-01

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

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

    PubMed Central

    Greenwood, Dean M.

    2012-01-01

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

  3. Therapeutic Management of the Hallux Rigidus

    PubMed Central

    Aggarwal, Anoop; Kumar, Suraj; Kumar, Ratnesh

    2012-01-01

    Background. Hallux rigidus is a chronic, disabling condition of foot characterized by reduced great toe extension. The manual therapy approaches are described theoretically however their practical published evidence has not been analyzed well. Objective. Aim of the present paper was to systematically review the literature available for therapeutic management of the hallux rigidus by identifying and evaluating the randomized controlled trials (RCTs) and non-RCTs. Methods. To view the hallux rigidus and its rehabilitation, a webbased published literature search of Pubmed, Ovid Medline, Science direct, Cochrane Database, PEDro database, CINAHL was conducted for last 35 years in August 2010 using 4 specific keywords “hallux rigidus, physical therapy, chiropractic, and manual therapy” typed in exactly same manner in the search column of the databases. Result. the review finds that there is acute need of the quality studies and RCTs for the manual therapy, chiropractic, or physiotherapeutic management of the hallux rigidus. Conclusion. Review conclude that conservative programs for hallux rigidus consists of comprehensive intervention program that includes great toe mobilization, toe flexor strengthening, sesamoid bones mobilization and long MTP joint. The clinician should put an emphasis on the mobilization program with proper follow up along with comparative studies for rehabilitation of hallux rigidus. PMID:22991669

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

    PubMed Central

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

    2004-01-01

    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

  5. [Low Back Pain in Pregnancy: Diagnosis, Treatment Options and Outcomes].

    PubMed

    Mühlemann, Daniel; Mühlemann, Malin B

    2015-05-20

    Low back pain in pregnancy is a common occurrence and is mainly caused by hormonal and biomechanical changes. Patients with pregnancy-induced low back pain (PILBP) frequently complain of moderate to severe and disabling pain often restricting their daily activities. In these cases, a “watch and wait” approach cannot be the best solution. On the basis of anamnesis and examination PILBP can be divided into three subgroups: pregnancy-related low back pain (PLBP), pelvic girdle pain (PGP) and the combination of PLBP and PGP. The three entities ask for different diagnostic workups and therapeutic modalities. There are many possible treatments for PLBP, however, only a few are based on sound evidence. Information and advice, exercise and training programs, acupuncture, stabilizing belts and analgesic medication can have a positive impact on pain and disability. PGP und PLBP respond well to chiropractic interventions. PMID:26098153

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

    PubMed Central

    Knutson, Gary A; Owens, Edward F

    2003-01-01

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

  7. Guillain-Barre syndrome: a case report

    PubMed Central

    Pikula, John R

    1995-01-01

    Guillain-Barre syndrome (GBS) is a complicated degenerative neurological disorder which can be acute or chronic in nature. It is an acquired condition which is characterized by progressive, symmetrical, proximal and distal tingling and weakness. Muscle stretch reflexes are decreased to absent and loss of sensation is common. Etiology remains unclear but pathophysiology includes demyelination of spinal nerve roots. Death is rare. Early diagnosis and prompt referral should occur in severe cases due to the incidence of potential ventilatory failure and cardiovascular instability in some patients. The case of a 37-year-old male presenting to a chiropractic office is described. The importance of a correct diagnosis by the chiropractor and the subsequent management is reviewed.

  8. Dietary and Lifestyle Changes in the Treatment of a 23-Year-Old Female Patient With Migraine

    PubMed Central

    Martin, Brett R.; Seaman, David R.

    2015-01-01

    Objective The purpose of this case report is to describe the chiropractic management of a patient with atypical migraine headache. Clinical Features A 23-year-old woman experienced migraines for 3 months. She had no previous history of migraines and was unresponsive to pharmaceutical and musculoskeletal therapies. The migraine headaches could not be classified according to the common categories associated with migraines. She had a change in diet due to severe gastroesophageal reflux causing her to reduce or avoid consuming foods. She also had a history of smoking and alcohol consumption. Intervention and Outcome Dietary and lifestyle changes were recommended in conjunction with the administration of a multivitamin, magnesium oxide, and Ulmus rubra. Her migraine headaches improved with the resolution of her gastroesophageal reflux symptoms. Conclusion This patient with atypical migraines and a history of poor dietary and lifestyle choices improved using nutritional changes and supplementing with a multivitamin and magnesium oxide. PMID:26778934

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

    PubMed Central

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

    2014-01-01

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

  10. Thirtieth Annual Congress on Veterinary Acupuncture: IVAS Report

    PubMed Central

    2005-01-01

    More than 155 participants from 25 countries attended the 30th Annual IVAS Congress, September 8–11, 2004 in Oostende, Belgium. The focus was on veterinary acupuncture (AP) and immunology, and the event was sponsored by the International Veterinary Acupuncture Society (IVAS). IVAS is a non-profit organization dedicated to promoting excellence in the practice of veterinary AP as an integral part of the total veterinary health care delivery system. The Society endeavors to establish uniformly high standards of veterinary AP through its educational programs and accreditation examination. IVAS seeks to integrate veterinary AP and the practice of Western veterinary science, while also noting that the science of veterinary AP does not overlook allied health systems, such as homeopathy, herbology, nutrition, chiropractic, kinesiology, etc. ().

  11. A History of Manipulative Therapy

    PubMed Central

    Pettman, Erland

    2007-01-01

    Manipulative therapy has known a parallel development throughout many parts of the world. The earliest historical reference to the practice of manipulative therapy in Europe dates back to 400 BCE. Over the centuries, manipulative interventions have fallen in and out of favor with the medical profession. Manipulative therapy also was initially the mainstay of the two leading alternative health care systems, osteopathy and chiropractic, both founded in the latter part of the 19th century in response to shortcomings in allopathic medicine. With medical and osteopathic physicians initially instrumental in introducing manipulative therapy to the profession of physical therapy, physical therapists have since then provided strong contributions to the field, thereby solidifying the profession's claim to have manipulative therapy within in its legally regulated scope of practice. PMID:19066664

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

    PubMed Central

    Knutson, Gary A.; Owens, Edward F.

    2003-01-01

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

  13. The development of medical sects.

    PubMed

    Jones, R K

    1983-12-01

    There exist a number of studies that demonstrate a parallel between secular and transcendental movements. A useful exercise is to look at the development of medicine and compare the origin and development of medical sects with sects that we would more normally associate with religious development. Thus, the struggle for a dominant ideology in medicine meant that Galenism as the New Systematists gave way to the emergence of a dominant medical orthodoxy. The dilemmas presented by new discoveries in medicine highlight this struggle for dominance. Running alongside medical sectarianism is the phenomenon of medical cults such as phrenology and mesmerism. Osteopathy, naturopathy, homeopathy, and chiropractic are significant examples of modern challenges to the monopoly of medical knowledge exhibited by sects. PMID:24306828

  14. CMCC’s persistent pursuit of university affiliation Part III: the push for union with the University of Victoria, BC, 1988 to 1992

    PubMed Central

    Brown, Douglas M

    1996-01-01

    The period between 1988 and 1992 is reviewed with respect to the Canadian Memorial Chiropractic College (CMCC) and its attempted affiliation with the University of Victoria in British Columbia. Part I, published earlier, detailed the period between 1945 and 1969 and the proposals for university affiliation with the University of Alberta and Brandon College in Manitoba. Part II focused on the period between 1969 and 1988 and discussed government inquiries, strategic planning and political intervention. In Part III of this triad, the chronology of events with respect to CMCC’s sustained, sophisticated and focused attempt at affiliation with the University of Victoria is discussed and the problems encountered with the Senate are described which lead to the eventual breakdown of any potential union.

  15. The musculoskeletal effects of diabetes mellitus.

    PubMed

    Wyatt, Lawrence H; Ferrance, Randy J

    2006-03-01

    Diabetes mellitus (DM) is a multi-system disease characterized by persistent hyperglycemia that has both acute and chronic biochemical and anatomical sequelae, with Type-2 DM representing the most common form of the disease. Neuromusculoskeletal sequelae of DM are common and the practicing chiropractor should be alert to these conditions, as some are manageable in a chiropractic office, while others are life and/or limb threatening. This paper reviews the effects of DM on the musculoskeletal system so as assist the chiropractor in making appropriate clinical decisions regarding therapy, understanding contraindications to therapy, referring patients to medical physicians when appropriate and understanding the impact that DM may have on the prognosis for their patients suffering from the myriad musculoskeletal conditions associated with this disease. PMID:17549168

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

    PubMed

    Su, Dejun; Li, Lifeng

    2011-02-01

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

  17. Effectiveness of CAM therapy: understanding the evidence.

    PubMed

    Staud, Roland

    2011-02-01

    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

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

    PubMed Central

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

    2000-01-01

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

  19. The role of manual therapies in equine pain management.

    PubMed

    Haussler, Kevin K

    2010-12-01

    Manual therapy includes a diverse array of techniques, such as touch therapies, massage, physical therapy, osteopathy, and chiropractic, that were originally developed for use in humans and have been gradually applied to horses. All forms of manual therapy have variable reported levels of effectiveness for treating musculoskeletal issues in humans, but mostly only anecdotal evidence exists in horses. This article explores the scientific literature for evidence of efficacy, safety, and common mechanisms of action of the different forms of manual therapies for potential use in managing acute or chronic pain syndromes in horses. Currently, there is limited evidence supporting the effectiveness of spinal mobilization and manipulation in reducing pain and muscle hypertonicity. Further research is needed to assess the efficacy of specific manual therapy techniques and their contribution to multimodal protocols for managing specific somatic pain conditions in horses. PMID:21056301

  20. Complementary and alternative medicine practitioners' standard of care: responsibilities to patients and parents.

    PubMed

    Gilmour, Joan; Harrison, Christine; Asadi, Leyla; Cohen, Michael H; Vohra, Sunita

    2011-11-01

    In this article we explain (1) the standard of care that health care providers must meet and (2) how these principles apply to complementary and alternative medicine practitioners. The scenario describes a 14-year-old boy who is experiencing back pain and whose chiropractor performed spinal manipulation but did not recognize or take steps to rule out serious underlying disease-in this case, testicular cancer--either initially or when the patient's condition continued to deteriorate despite treatment. We use chiropractic care for a patient with a sore back as an example, because back pain is such a common problem and chiropracty is a common treatment chosen by both adult and pediatric patients. The scenario illustrates the responsibilities that complementary and alternative medicine practitioners owe patients/parents, the potential for liability when deficient care harms patients, and the importance of ample formal pediatric training for practitioners who treat pediatric patients. PMID:22045864

  1. Chronic recurrent multifocal osteomyelitis in a 13 year old female athlete: a case report.

    PubMed

    Ferguson, Brad; Gryfe, David; Hsu, William

    2013-12-01

    Chronic recurrent mutlifocal osteomyelitis (CRMO) is an extremely rare skeletal disorder in the younger population. It presents with multifocal bony lesions that often mimic more sinister diagnoses such as infection or neoplasm. The cause of this condition remains unknown and there is limited evidence on effective treatments. In this case, a 13-year-old female athlete presented to a sports chiropractic clinic with non-traumatic onset of right ankle pain. After failed conservative management, radiographs and MRI were obtained exhibiting a bony lesion of the distal tibia resembling osteomyelitis. The patient was non-responsive to antibiotics, which lead to the diagnosis of CRMO. CRMO should be considered as a differential diagnosis for chronic bone pain with affinity for the long bones of the lower extremity in children and adolescents. The role of the primary clinician in cases of CRMO is primarily that of recognition and referral for further diagnostic investigations. PMID:24302781

  2. Perceptions of interprofessional education and practice within a complementary and alternative medicine institution.

    PubMed

    Kadar, Gena E; Vosko, Andrew; Sackett, Michael; Thompson, H Garrett Rush

    2015-01-01

    A survey of the constituents of a complementary and alternative medicine (CAM) institution was conducted to identify perceptions of interprofessional education (IPE) and practice (IPP). A 22 question survey was developed and administered to: chiropractic students, acupuncture and oriental medicine students, faculty and alumni of both professions, staff and administrators. The majority of the 321 respondents demonstrated positive perceptions of IPE and IPP, however many reported a lack of understanding of the distinct roles of select healthcare professions. The study also suggested that the campus community is not homogenous in its understanding of CAM or allopathic professions, or is it homogenous in its understanding of IPE and IPP. While the overall positive attitudes toward IPE and IPP imply a willingness to improve collaboration between these groups, the lack of understanding of profession-specific roles must be addressed to support effective implementation of IPE. PMID:25291261

  3. A primer of complementary and alternative medicine commonly used by cancer patients.

    PubMed

    Ernst, E

    2001-01-15

    Complementary and alternative medicine (CAM) is frequently used by cancer patients, and many oncologists have limited knowledge of CAM. This article provides a brief, evidence-based introduction to several CAM treatments relevant in the context of cancer. "Alternative" diets, chiropractic, coffee enemas, ozone therapy, and shark cartilage seem to have little to offer cancer patients. The evidence for or against homoeopathy and spiritual healing is at present inconclusive. Acupuncture, aromatherapy, and meditation may be useful for nausea/vomiting, for mild relaxation, and for pain/anxiety, respectively. Herbal treatments offer no reasonable prospect of a cure (mistletoe), but could be useful as palliative treatments (eg, for depression [St John's wort] or anxiety [kava]). Our knowledge regarding the potential benefit and harm of CAM is insufficient. PMID:11245510

  4. Detection of syringomyelia in a pediatric patient with mild scoliosis: a case report

    PubMed Central

    Kanga, Ismat; Wong, Jessica J.; Stern, Paula J.

    2014-01-01

    It can be challenging to detect syringomyelia in patients with scoliosis, as some cases are mildly symptomatic with little to no neurological deficits. However, a timely diagnosis of syringomyelia is needed to facilitate important treatment considerations. This case report details an 11-year-old female with mild scoliosis and a two-year history of spinal pain that had short-term symptomatic relief from chiropractic treatment. Subtle neurological signs were detected only at re-evaluation, which prompted further investigation with radiographs and subsequent magnetic resonance imaging (MRI). MRI revealed a non-expansile syrinx measuring 3 mm at its widest diameter that extended from C5 to the conus medullaris. The aim of this case is to heighten awareness of the potential diagnostic challenges in patients with syringomyelia and scoliosis. The incidence, pathogenesis, clinical presentation, and management of syringomyelia will be presented to help primary contact providers with appropriate referral and co-management of these patients. PMID:24587493

  5. Chronic recurrent multifocal osteomyelitis in a 13 year old female athlete: a case report

    PubMed Central

    Ferguson, Brad; Gryfe, David; Hsu, William

    2013-01-01

    Chronic recurrent mutlifocal osteomyelitis (CRMO) is an extremely rare skeletal disorder in the younger population. It presents with multifocal bony lesions that often mimic more sinister diagnoses such as infection or neoplasm. The cause of this condition remains unknown and there is limited evidence on effective treatments. In this case, a 13-year-old female athlete presented to a sports chiropractic clinic with non-traumatic onset of right ankle pain. After failed conservative management, radiographs and MRI were obtained exhibiting a bony lesion of the distal tibia resembling osteomyelitis. The patient was non-responsive to antibiotics, which lead to the diagnosis of CRMO. CRMO should be considered as a differential diagnosis for chronic bone pain with affinity for the long bones of the lower extremity in children and adolescents. The role of the primary clinician in cases of CRMO is primarily that of recognition and referral for further diagnostic investigations. PMID:24302781

  6. Oral squamous cell carcinoma: an atypical presentation mimicking temporomandibular joint disorder

    PubMed Central

    Jensen, Andrea; Nolet, Paul S; Diwan, Murtaza A

    2004-01-01

    A 50-year-old female presented to a chiropractic clinic with left jaw pain consistent with temporomandibular joint disorder. Examination revealed a large ulcerated mass on the posterolateral margin of the tongue which was later diagnosed as squamous cell carcinoma. Squamous cell carcinoma is the most common of the oral cancers. These cancers are often detected late making treatment more complicated and reducing the chance of survival. In the early stages squamous cell carcinoma can be asymptomatic. Symptoms can be similar to that of temporomandibular joint disorder making examination of the patient’s mouth important to rule out oral cancers. Oral cancers should be considered when patients present to a chiropractor with pain in the area of the temporomandibular joint. Risk factors such as chronic tobacco and alcohol use should raise concern in these patients. Suspicious lesions should be referred immediately for further investigation. PMID:17549104

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

    PubMed Central

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

    2013-01-01

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

  8. Results of an International Survey of Practice Patterns for Establishing Prognosis in Neck Pain: The ICON Project

    PubMed Central

    Walton, David M; MacDermid, Joy C; Santaguida, P. Lina; Gross, Anita; Carlesso, Lisa

    2013-01-01

    Results of an international survey of health care providers for neck pain are reported. The survey specifically collected self-reported practice patterns for establishing a prognosis in neck pain. Over 440 responses from 27 countries were collected. Descriptive results indicate that respondents assigned large prognostic impact to factors including mechanism of injury and psychological or behavioral constructs. Range of motion, age and sex were routinely collected despite relatively moderate impact on prognosis. A comparison between chiropractic and manual/physical therapy groups showed differences in practice patterns that were unlikely to affect prognostic accuracy. The results suggest a gap exists between current best-evidence and actual practice when the goal is to establish a prognosis in neck pain. PMID:24115968

  9. Complementary and alternative medicine use by psychiatric inpatients.

    PubMed

    Elkins, Gary; Rajab, M Hasan; Marcus, Joel

    2005-02-01

    82 psychiatric inpatients hospitalized for acute care were interviewed about their use of complementary and alternative medicine (CAM) modalities. The clinical diagnoses of respondents included Depressive Disorder (61%), Substance Abuse (26%), Schizophrenia (9%), and Anxiety Disorders (5%). Analysis indicated that 63% used at least one CAM modality within the previous 12 mo. The most frequently used modality was herbal therapies (44%), followed by mind-body therapies such as relaxation or mental imagery, hypnosis, meditation, biofeedback (30%), and spiritual healing by another (30%). Physical modalities such as massage, chiropractic treatment, acupuncture, and yoga were used by 21% of respondents. CAM therapies were used for a variety of reasons ranging from treatment of anxiety and depression to weight loss. However, most respondents indicated they did not discuss such use with their psychiatrist or psychotherapist. PMID:15825920

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

    PubMed Central

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

    2001-01-01

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

  11. Cervical artery dissection: emerging risk factors.

    PubMed

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

    2010-01-01

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

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

    PubMed

    Grace, Sandra

    2015-01-01

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

  13. The musculoskeletal effects of diabetes mellitus

    PubMed Central

    Wyatt, Lawrence H; Ferrance, Randy J

    2006-01-01

    Diabetes mellitus (DM) is a multi-system disease characterized by persistent hyperglycemia that has both acute and chronic biochemical and anatomical sequelae, with Type-2 DM representing the most common form of the disease. Neuromusculoskeletal sequelae of DM are common and the practicing chiropractor should be alert to these conditions, as some are manageable in a chiropractic office, while others are life and/or limb threatening. This paper reviews the effects of DM on the musculoskeletal system so as assist the chiropractor in making appropriate clinical decisions regarding therapy, understanding contraindications to therapy, referring patients to medical physicians when appropriate and understanding the impact that DM may have on the prognosis for their patients suffering from the myriad musculoskeletal conditions associated with this disease. PMID:17549168

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

    PubMed Central

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

    2011-01-01

    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. PMID:22014906

  15. The Tampa Scale of Kinesiophobia and neck pain, disability and range of motion: a narrative review of the literature

    PubMed Central

    Hudes, Karen

    2011-01-01

    Background: The Tampa Scale of Kinesiophobia (TSK) that was developed in 1990 is a 17 item scale originally developed to measure the fear of movement related to chronic lower back pain. Objective: To review the literature regarding TSK and neck pain, perceived disability and range of motion of the cervical spine. Methods: Medline, MANTIS, Index to Chiropractic Literature and CINAHL were searched. Results: A total of 16 related articles were found and divided into four categories: TSK and Neck Pain; TSK, Neck Pain and Disability; TSK, Neck Pain, Disability and Strength; and TSK, Neck Pain and Surface Electromyography. Conclusion: The fear avoidance model can be applied to neck pain sufferers and there is value from a psychometric perspective in using the TSK to assess kinesiophobia. Future research should investigate if, and to what extent, other measureable factors commonly associated with neck pain, such as decreased range of motion, correlate with kinesiophobia. PMID:21886284

  16. Benign intracranial hypertension

    PubMed Central

    Crowther, Edward R

    1993-01-01

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

  17. Effect of Atlas Vertebrae Realignment in Subjects with Migraine: An Observational Pilot Study

    PubMed Central

    Woodfield, H. Charles; Hasick, D. Gordon; Becker, Werner J.; Rose, Marianne S.; Scott, James N.

    2015-01-01

    Introduction. In a migraine case study, headache symptoms significantly decreased with an accompanying increase in intracranial compliance index following atlas vertebrae realignment. This observational pilot study followed eleven neurologist diagnosed migraine subjects to determine if the case findings were repeatable at baseline, week four, and week eight, following a National Upper Cervical Chiropractic Association intervention. Secondary outcomes consisted of migraine-specific quality of life measures. Methods. After examination by a neurologist, volunteers signed consent forms and completed baseline migraine-specific outcomes. Presence of atlas misalignment allowed study inclusion, permitting baseline MRI data collection. Chiropractic care continued for eight weeks. Postintervention reimaging occurred at week four and week eight concomitant with migraine-specific outcomes measurement. Results. Five of eleven subjects exhibited an increase in the primary outcome, intracranial compliance; however, mean overall change showed no statistical significance. End of study mean changes in migraine-specific outcome assessments, the secondary outcome, revealed clinically significant improvement in symptoms with a decrease in headache days. Discussion. The lack of robust increase in compliance may be understood by the logarithmic and dynamic nature of intracranial hemodynamic and hydrodynamic flow, allowing individual components comprising compliance to change while overall it did not. Study results suggest that the atlas realignment intervention may be associated with a reduction in migraine frequency and marked improvement in quality of life yielding significant reduction in headache-related disability as observed in this cohort. Future study with controls is necessary, however, to confirm these findings. Clinicaltrials.gov registration number is NCT01980927. PMID:26783523

  18. Using the STarT Back Tool: Does timing of stratification matter?

    PubMed

    Newell, D; Field, J; Pollard, D

    2015-08-01

    It is likely that individuals with nonspecific LBP (nsLBP) constitute a heterogenic group and targeting treatment appropriately to those most likely to respond is of major relevance. The STarT Back Tool (SBT) has been developed to stratify patients into risk groups to aid management choices. However, there is controversy over its generalisability and uncertainty as to the timing of use. This study investigated whether SBT categorisation early in a course of treatment would prove more prognostic than categorising patients at baseline. Seven hundred and forty nine patients over the age of 16 were recruited at 11 chiropractic clinics within the UK. The SBT was used to categorise these patients at presentation and 2 days following initial treatment with patient characteristics and condition specific markers also collected at baseline. The primary outcome was the Patient Global Impression of Change (PGIC) collected at 14, 30 and 90 days following the initial visit. In this population undergoing chiropractic care, patients had similar outcomes irrespective of their STarT back risk ranking. Multivariate prognostic models included only the post initial visit SBT as an independent predictor of favourable outcome for the medium risk group but only at 30 days. Follow up improvement was dominated by previous improvement in 30 and 90-day models. Over one third of patients swapped SBT risk groups in the 2 day period between initial stratification and post initial visit although there was little difference in eventual improvement at follow-up. Understanding the impact of timing of SBT stratification is indicated. PMID:25175750

  19. Multiple Venous Thromboses Presenting as Mechanical Low Back Pain in an 18-Year-Old Woman

    PubMed Central

    Marchand, Andrée-Anne; Boucher, Jean-Alexandre; O’Shaughnessy, Julie

    2015-01-01

    Objective The purpose of this case report is to describe a patient who presented with acute musculoskeletal symptoms but was later diagnosed with multiple deep vein thrombosis (DVT). Clinical Features An 18-year-old female presented to a chiropractic clinic with left lumbosacral pain with referral into the posterior left thigh. A provisional diagnosis was made of acute myofascial syndrome of the left piriformis and gluteus medius muscles. The patient received 3 chiropractic treatments over 1 week resulting in 80% improvement in pain intensity. Two days later, a sudden onset of severe abdominal pain caused the patient to seek urgent medical attention. A diagnostic ultrasound of the abdomen and pelvis were performed and interpreted as normal. Following this, the patient reported increased pain in her left leg. Evaluation revealed edema of the left calf and decreased left lower limb sensation. A venous Doppler ultrasound was ordered. Intervention and Outcomes Doppler ultrasound revealed reduction of the venous flow in the femoral vein area. An additional ultrasonography evaluation revealed an extensive DVTs affecting the left femoral vein and iliac axis extending towards the vena cava. Upon follow-up with a hematologist, the potential diagnosis of May-Thurner syndrome was considered based on the absence of blood dyscrasias and sustained anatomical changes found in the left common iliac vein at its junction with the right common iliac artery. A week following discharge, she presented with chest pain and was diagnosed with venous thromboembolism. The patient was successfully treated with anticoagulation therapy and insertion of a vena cava filter. Conclusion Although DVTs are common in the general population, presence in low-risk individuals may be overlooked. In the presence of subtle initial clinical signs such as those described in this case report, clinicians should keep a high index of suspicion for a DVT. Rapid identification of such clinical signs in association with a lack of objective examination findings warrants further evaluation due to potentially negative outcomes. PMID:26257592

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

    PubMed Central

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

    2009-01-01

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

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

    PubMed Central

    Zhang, Niu; Rabatsky, Ali

    2015-01-01

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

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

    PubMed Central

    Robb, Andrew J.; Howitt, Scott

    2011-01-01

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

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

    PubMed Central

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

    2010-01-01

    Abstract Objective This study investigated the demographic, behavioral, and health correlates of the most frequently used types of complementary and alternative medicine (CAM) therapy and the use of prayer for health among midlife women. We also examined the extent to which women used CAM for treatment of health conditions, including menopausal symptoms, and for general health and well-being. Methods Data from the 2002 National Health Interview Survey (NHIS), a cross-sectional, household survey representative of the U.S. civilian adult population, were used. Midlife women aged 4059 years (n?=?5849) were analyzed. Bivariate prevalence estimates were obtained, and binomial logistic regression models were estimated; all analyses were weighted. Results Overall, 46% of midlife women used any type of CAM in the past 12 months, and 54% reported using prayer for health reasons. The top five specific CAM therapies used were herbs and natural products; relaxation techniques; chiropractic care; yoga, tai chi, or qi gong; and massage. Multivariate results demonstrated different patterns of association between demographic, health, and behavioral characteristics and specific CAM therapies. A higher percentage of women used chiropractic care for an existing health condition than those using relaxation techniques, and few women used CAM specifically for menopausal symptoms. Conclusions CAM and prayer are frequently used by midlife women, and herbs and natural supplements are the mostly frequently used. The findings underscore the importance, particularly in the clinical setting, of asking women about their use of individual CAM therapies. Such clinical assessment is also important because of the potential for interactions of CAM therapies with prescribed therapies. PMID:20088655

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

    PubMed Central

    2003-01-01

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

  5. CLINICIAN PROFICIENCY IN DELIVERING MANUAL TREATMENT FOR NECK PAIN WITHIN SPECIFIED FORCE RANGES

    PubMed Central

    Gudavalli, Maruti Ram; Vining, Robert D.; Salsbury, Stacie A.; Corber, Lance; Long, Cynthia R.; Patwardhan, Avinash G.; Goertz, Christine M.

    2015-01-01

    Background Context Neck pain is a common musculoskeletal complaint responsive to manual therapies. Doctors of chiropractic commonly use manual cervical distraction, a mobilization procedure, to treat neck pain patients. However, it is unknown if clinicians can consistently apply standardized cervical traction forces, a critical step toward identifying an optimal therapeutic dose. Purpose The purpose of this study was to assess clinicians’ proficiency in delivering manually applied traction forces within specified ranges to neck pain patients. Study Design/Setting Observational study nested within a randomized clinical trial. Sample Two research clinicians provided study interventions to 48 participants with neck pain. Outcome Measures Clinician proficiency in delivering cervical traction forces within three specified ranges (low force <20 newtons (N); medium force 21–50N; and high force 51–100N). Methods This study was funded by a grant from the National Center for Complementary and Alternative Medicine, National Institutes of Health (Grant # 1 U19AT004663-01), and conducted in a facility funded by National Center for Research Resources, National Institutes of Health (Grant # C06 RR15433-01), and approved by an Institutional Review Board for the protection of human subjects. Senior author receives approximately $400–600 travel reimbursements per year for giving research presentations at certification seminars. The table manufacturer (Haven Innovations) sold the treatment table at a discounted price ($5000 discount) for research purposes. Participants were randomly allocated to three force-based treatment groups. Participants received five manual cervical distraction treatments over two weeks while lying prone on a treatment table instrumented with force sensors. Two clinicians delivered manual traction forces by treatment group. Clinicians treated participants first without real-time visual feedback displaying traction force and then with visual feedback. Peak traction force data were extracted and descriptively analyzed. None of the authors have any conflict of interest relative to this study. Results Clinicians delivered manual cervical distraction treatments within the prescribed traction force ranges 75% of the time without visual feedback and 97% of the time with visual feedback. Conclusions This study demonstrates that doctors of chiropractic can successfully deliver prescribed traction forces while treating neck pain patients enabling the capability to conduct force-based dose-response clinical studies. This trial was registered with ClinicalTrials.gov NCT01765751 PMID:25452013

  6. Complementary and alternative medicine use among Chinese and white Canadians.

    PubMed

    Quan, Hude; Lai, Daniel; Johnson, Delaine; Verhoef, Marja; Musto, Richard

    2008-11-01

    ABSTRACTOBJECTIVEThis study aimed to describe the level of complementary and alternative medicine (CAM) use and the factors associated with CAM use among Chinese and white Canadians.DESIGNA cross-sectional telephone survey conducted in English, Cantonese, and Mandarin.SETTINGCalgary, Alta.PARTICIPANTSChinese and white residents of Calgary aged 18 or older.MAIN OUTCOME MEASURESRates of use of 11 CAM therapies, particularly herbal therapy, massage, chiropractic care, and acupuncture; reasons for use of CAM therapies.RESULTSSixty percent of 835 Chinese respondents (95% confidence interval [CI] 56.5% to 63.2%) and 59% of 802 white respondents (95% CI 55.1% to 62.0%) had used CAM in the past year. Chinese respondents were more likely to use herbal therapy than white respondents were (48.7% vs 33.7%, P < .001), less likely to use massage (17.1% vs 30.4%, P < .001) and chiropractic care (8.4% vs 21.2%, P < .001), but equally likely to use acupuncture (8.3% vs 7.9%, P = .173). The common factor associated with herbal therapy, acupuncture, or massage use among Chinese and white respondents was receiving a CAM recommendation from a family member or friend. Factors unique to either Chinese or white CAM users varied by therapy. For example, herbal therapy use for Chinese respondents was associated with the presence of chronic disease (adjusted odds ratio [AOR] 2.15, 95% CI 1.09 to 4.24 for having 3 diseases compared with those without chronic disease), beliefs about the effectiveness of herbal therapy (AOR 1.56, 95% CI 1.12 to 2.17), and trust in herbal therapy practitioners (AOR 1.72, 95% CI 1.24 to 2.37). Herbal therapy use for white respondents was associated with the beliefs that herbal treatment had fewer side effects than prescription drugs (AOR 1.81, 95% CI 1.31 to 2.50) and that herbalists took a holistic approach (AOR 2.07, 95% CI 1.49 to 2.87).CONCLUSIONWhile the percentage of CAM use was similar in both groups, Chinese Canadians mainly used herbal therapy and white Canadians used a range of CAM therapies. Factors associated with CAM use varied with ethnicity and type of CAM therapy. Presence of chronic disease, however, was an important factor for Chinese Canadians. That finding suggests that Chinese Canadians use CAM for the treatment of chronic disease, while white Canadians use such therapies for disease treatment and health maintenance. PMID:19005129

  7. Diagnostic and treatment methods used by chiropractors: A random sample survey of Canada’s English-speaking provinces

    PubMed Central

    Puhl, Aaron A.; Reinhart, Christine J; Injeyan, H. Stephen

    2015-01-01

    Objective: It is important to understand how chiropractors practice beyond their formal education. The objective of this analysis was to assess the diagnostic and treatment methods used by chiropractors in English-speaking Canadian provinces. Methods: A questionnaire was created that examined practice patterns amongst chiropractors. This was sent by mail to 749 chiropractors, randomly selected and stratified proportionally across the nine English-speaking Canadian provinces. Participation was voluntary and anonymous. Data were entered into an Excel spreadsheet, and descriptive statistics were calculated. Results: The response rate was 68.0%. Almost all (95.1%) of respondents reported performing differential diagnosis procedures with their new patients; most commonly orthopaedic testing, palpation, history taking, range of motion testing and neurological examination. Palpation and painful joint findings were the most commonly used methods to determine the appropriate joint to apply manipulation. The most common treatment methods were manual joint manipulation/mobilization, stretching and exercise, posture/ergonomic advice and soft-tissue therapies. Conclusions: Differential diagnosis is a standard part of the assessment of new chiropractic patients in English-speaking Canadian provinces and the most common methods used to determine the site to apply manipulation are consistent with current scientific literature. Patients are treated with a combination of manual and/or manipulative interventions directed towards the joints and/or soft-tissues, as well as exercise instruction and postural/ergonomic advice. PMID:26500362

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

    PubMed Central

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

    2015-01-01

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

  9. Active functional restoration and work hardening program returns patient with 2½-year-old elbow fracture-dislocation to work after 6 months: a case report

    PubMed Central

    Teperman, Lorne J

    2002-01-01

    The rehabilitation of elbow fracture and dislocation is not generally considered a mainstream chiropractic concern. The clinician who is able to successfully manage the elbow articulation will rely upon his/her knowledge of functional anatomy, pathobiomechanics, history and examination principles, when selecting the appropriate treatment available. A case is presented of an individual that sustained a radial head fracture and dislocation following a motor vehicle accident. Subsequent to receiving 1½ years of physiotherapy for post-surgical complications (decreased range of motion, pain, stiffness and tingling to the 4th and 5th fingers), the patient was referred to a multidisciplinary clinic for a Work Hardening/Conditioning Program. This article discusses the need for active functional restoration vs. passive therapy, work hardening regimens and outcome measures. After 6 months of rehabilitation and 3 years following his motor vehicle accident, the patient has successfully returned to his previous work environment. A summary of the sequential steps in providing appropriate management has been provided.

  10. Development and psychometric evaluation of an information literacy self-efficacy survey and an information literacy knowledge test*

    PubMed Central

    Tepe, Rodger; Tepe, Chabha

    2015-01-01

    Objective To develop and psychometrically evaluate an information literacy (IL) self-efficacy survey and an IL knowledge test. Methods In this test–retest reliability study, a 25-item IL self-efficacy survey and a 50-item IL knowledge test were developed and administered to a convenience sample of 53 chiropractic students. Item analyses were performed on all questions. Results The IL self-efficacy survey demonstrated good reliability (test–retest correlation = 0.81) and good/very good internal consistency (mean κ = .56 and Cronbach's α = .92). A total of 25 questions with the best item analysis characteristics were chosen from the 50-item IL knowledge test, resulting in a 25-item IL knowledge test that demonstrated good reliability (test–retest correlation = 0.87), very good internal consistency (mean κ = .69, KR20 = 0.85), and good item discrimination (mean point-biserial = 0.48). Conclusions This study resulted in the development of three instruments: a 25-item IL self-efficacy survey, a 50-item IL knowledge test, and a 25-item IL knowledge test. The information literacy self-efficacy survey and the 25-item version of the information literacy knowledge test have shown preliminary evidence of adequate reliability and validity to justify continuing study with these instruments. PMID:25517736

  11. Mimicking turf-toe: myofasopathy of the first dorsal interosseous muscle treated with ART®

    PubMed Central

    Pajaczkowski, Jason A

    2003-01-01

    Objective: To present the diagnostic features and response to treatment of an unreported clinical entity, first dorsal interosseous myofasopathy mimicking turf-toe. Clinical features: The salient features include an insidious onset of pain in the first MTP joint which compromises forceful propulsion in the absence of ecchymosis and joint effusion. Range of motion may be restricted in both instances, however muscular palpation and resisted manual muscle testing will reproduce the patient's complaints and isolate the first dorsal interosseous muscle as the culprit versus the fibrous plantar plate and joint capsule. Intervention and outcome: Treatment involves eliminating inflammation, reducing muscular hypertonicity, and restricting the offending activity. Active Release Technique® was utilized to remove adhesions and promote the restoration of normal tissue texture with excellent results. No other soft tissue treatment methods were implemented. Alternatively, other soft tissue techniques or modalities aimed at reducing inflammation and pain (i.e. ice, IFC, gentle stretching, etc. ...) may be useful. Conclusion: Although the etiology and epidemiology of first dorsal interosseous myofasopathy mimicking turf-toe has yet to be elucidated the clinical implications regarding misdiagnosis and treatment are extremely important to allopathic and chiropractic practitioners alike.

  12. Computer-aided pattern analysis of temperature differentials.

    PubMed

    Stewart, M S; Riffle, D W; Boone, W R

    1989-10-01

    Chiropractic analysis often incorporates the evaluation of heat distribution patterns observed in skin temperature profiles. Historically, temperature recordings of the spine have been made with a heat detection instrument using a thermocouple design. The advent of refinements in infrared technology, however, have greatly enhanced temperature detection in terms of accuracy and reliability. The present research reflects the development of computer software designed to express the data obtained with a dual channel heat sensing instrument. Two phases are involved: a) digital information, received from the sensing instrument, is standardized, stored for future analysis, and retrieved for comparisons with other graphs; b) stored data is graphically displayed, statistically analyzed, and otherwise compared. The data is displayed for visual observation as a) temperature data received from either channel of the sensing instrument or b) relative temperature differences between data from both channels of the sending instrument. For statistical evaluation, corresponding readings (comparisons between graphs) are plotted against one another and analyzed by a moving Pearson Product Moment correlation and moving t-test. This evaluation is graphically represented with a numeric display of pertinent statistical values. Current work indicates that a 10 point moving correlation and t-test will yield accurate comparisons between graphs. PMID:2607225

  13. Complementary and Alternative Medicine Treatment Options for Otitis Media: A Systematic Review.

    PubMed

    Marom, Tal; Marchisio, Paola; Tamir, Sharon Ovnat; Torretta, Sara; Gavriel, Haim; Esposito, Susanna

    2016-02-01

    Otitis media (OM) has numerous presentations in children. Together with conventional medical therapies aimed to prevent and/or treat OM, a rising number of complementary and alternative medicine (CAM) treatment options can be offered. Since OM is common in children, parents may ask healthcare professionals about possible CAM therapies. Many physicians feel that their knowledge is limited regarding these therapies, and that they desire some information. Therefore, we conducted a literature review of CAM therapies for OM, taking into account that many of these treatments, their validity and efficacy and have not been scientifically demonstrated.We performed a search in MEDLINE (accessed via PubMed) using the following terms: "CAM" in conjunction with "OM" and "children. Retrieved publications regarding treatment of OM in children which included these terms included randomized controlled trials, prospective/retrospective studies, and case studies.The following CAM options for OM treatment in children were considered: acupuncture, homeopathy, herbal medicine/phytotherapy, osteopathy, chiropractic, xylitol, ear candling, vitamin D supplement, and systemic and topical probiotics. We reviewed each treatment and described the level of scientific evidence of the relevant publications.The therapeutic approaches commonly associated with CAM are usually conservative, and do not include drugs or surgery. Currently, CAM is not considered by physicians a potential treatment of OM, as there is limited supporting evidence. Further studies are warranted in order to evaluate the potential value of CAM therapies for OM. PMID:26871802

  14. Human Direct Actions May Alter Animal Welfare, a Study on Horses (Equus caballus)

    PubMed Central

    Lesimple, Clmence; Fureix, Carole; Menguy, Herv; Hausberger, Martine

    2010-01-01

    Background Back pain is the cause of bad welfare in humans and animals. Although vertebral problems are regularly reported on riding horses, these problems are not always identified nor noticed enough to prevent these horses to be used for work. Methodology/Principal Findings Nineteen horses from two riding centres were submitted to chiropractic examinations performed by an experienced chiropractor and both horses' and riders' postures were observed during a riding lesson. The results show that 74% of horses were severely affected by vertebral problems, while only 26% were mildly or not affected. The degree of vertebral problems identified at rest was statistically correlated with horses' attitudes at work (neck height and curve), and horses' attitudes at work were clearly correlated with riders' positions. Clear differences appeared between schools concerning both riders' and horses' postures, and the analysis of the teachers' speech content and duration highlighted differences in the attention devoted to the riders' position. Conclusion/Significance These findings are to our knowledge the first to underline the impact of riding on horses' back problems and the importance of teaching proper balance to beginner riders in order to increase animals' welfare. PMID:20442766

  15. A research synthesis of therapeutic interventions for whiplash-associated disorder (WAD): part 3 - interventions for subacute WAD.

    PubMed

    Teasell, Robert W; McClure, J Andrew; Walton, David; Pretty, Jason; Salter, Katherine; Meyer, Matthew; Sequeira, Keith; Death, Barry

    2010-01-01

    Whiplash-associated disorder (WAD) represents a significant public health problem, resulting in substantial social and economic costs throughout the industrialized world. While many treatments have been advocated for patients with WAD, scientific evidence supporting their effectiveness is often lacking. A systematic review was conducted to evaluate the strength of evidence associated with various WAD therapies. Multiple databases (including Web of Science, EMBASE and PubMed) were searched to identify all studies published from January 1980 through March 2009 that evaluated the effectiveness of any clearly defined treatment for acute (less than two weeks), subacute (two to 12 weeks) or chronic (longer than 12 weeks) WAD. The present article, the third in a five-part series, evaluates the evidence for interventions initiated during the subacute phase of WAD. Thirteen studies that met the inclusion criteria were identified, six of which were randomized controlled trials with 'good' overall methodology (median Physiotherapy Evidence Database score of 6). Although some evidence was identified to support the use of interdisciplinary interventions and chiropractic manipulation, the evidence was not strong for any of the evaluated treatments. There is a clear need for further research to evaluate interventions aimed at treating patients with subacute WAD because there are currently no interventions satisfactorily supported by the research literature. PMID:21038009

  16. Infantile Colic: Recognition and Treatment.

    PubMed

    Johnson, Jeremy D; Cocker, Katherine; Chang, Elisabeth

    2015-10-01

    Infantile colic is a benign process in which an infant has paroxysms of inconsolable crying for more than three hours per day, more than three days per week, for longer than three weeks. It affects approximately 10% to 40% of infants worldwide and peaks at around six weeks of age, with symptoms resolving by three to six months of age. The incidence is equal between sexes, and there is no correlation with type of feeding (breast vs. bottle), gestational age, or socioeconomic status. The cause of infantile colic is not known; proposed causes include alterations in fecal microflora, intolerance to cow's milk protein or lactose, gastrointestinal immaturity or inflammation, increased serotonin secretion, poor feeding technique, and maternal smoking or nicotine replacement therapy. Colic is a diagnosis of exclusion after a detailed history and physical examination have ruled out concerning causes. Parental support and reassurance are key components of the management of colic. Simethicone and proton pump inhibitors are ineffective for the treatment of colic, and dicyclomine is contraindicated. Treatment options for breastfed infants include the probiotic Lactobacillus reuteri (strain DSM 17938) and reducing maternal dietary allergen intake. Switching to a hydrolyzed formula is an option for formula-fed infants. Evidence does not support chiropractic or osteopathic manipulation, infant massage, swaddling, acupuncture, or herbal supplements. PMID:26447441

  17. Acromial apophysitis in a 13-year-old adolescent boy: a common condition in an uncommon location

    PubMed Central

    Quinlan, Erin; Bogar, William C.

    2012-01-01

    Objective Traction apophysitis is a common condition in physically active and skeletally immature adolescents. This case study describes the clinical presentation and plain film imaging of traction apophysitis of the acromion process of the scapula. Clinical Features A physically active 13-year-old adolescent boy presented to a chiropractic physician with an acute onset of moderate shoulder pain. Plain film radiographs of the shoulder were performed that revealed fragmentation, sclerosis, and irregularity of the left acromial apophysis. Intervention and Outcome The patient was treated with conservative therapy for 10 weeks, with complete resolution of symptoms. Follow-up radiographs 9 weeks later revealed no radiographic change in the appearance of the apophysis; however, clinical symptoms were absent. The apophyseal growth cartilage is the most vulnerable site in the muscle-tendon unit in the skeletally immature patient and is more susceptible to very small avulsion fractures. Repetitive microtrauma following chronic overuse at a tendon insertion site in a skeletally immature patient may result in traction apophysitis. Conclusions Acromial apophysitis should be included in the differential diagnosis when presented with a young active patient with shoulder pain. Early treatment with restriction of activities is important in the prevention of permanent injury to the acromial cartilaginous growth plate. This case demonstrates that a prompt diagnosis can be made with a careful history, physical examination, and conventional imaging. PMID:23204953

  18. Deep Brain Stimulation Significantly Decreases Disability from Low Back Pain in Patients with Advanced Parkinson's Disease

    PubMed Central

    Smith, Heather; Gee, Lucy; Kumar, Vignessh; Ramirez-Zamora, Adolfo; Durphy, Jennifer; Hanspal, Era; Barba, Anne; Molho, Eric; Shin, Damian; Pilitsis, Julie G.

    2015-01-01

    Background Up to 60% of Parkinson's patients suffer from low back pain (LBP) during the course of their disease. How LBP affects daily functional status and how to manage this aspect of PD has not been adequately explored. Methods We examined sixteen patients undergoing bilateral subthalamic nucleus deep brain stimulation (STN DBS) who met inclusion criteria for moderate disability from LBP, as classified by the Oswestry Low Back Pain Disability Index (OLBPD). Results Thirteen of 16 patients had attempted additional treatments for LBP including medical management, massage, chiropractic, epidural steroid injections and/or surgery and with minimal relief. Following DBS, there was a significant improvement in OLBPD at both the 6-month and 1-year time points (p < 0.02, p < 0.005 respectively). A mean improvement of 31.7% on OLBPD score was noted. Visual Analogue Scale (VAS) similarly decreased significantly at 1 year (p = 0.015). There was no correlation between OLBPD score and other measures including UPDRS, age, and other non-motor symptoms. Conclusion Given the prevalent yet undertreated disability associated with LBP in PD, these results are novel in that they show STN DBS has a significant positive effect on disability associated with LBP. PMID:25895600

  19. The state of systemic threat surveillance in some Australian health organisations.

    PubMed

    Canyon, Deon V

    Crises are preceded by the emission of a series of early warning signals. If detected, these act like triggers for organisational action in anticipation of a known or unknown threat. It is vitally important to detect these signals to enable proactive, preventative actions that limit the impact of ensuing damage. The extent of threat surveillance (signal detection) in health organisations is an unknown, so a cross-sectional survey was conducted to assess the degree to which signal detection mechanisms are used. The focus of signal detection mechanisms and their degree of organisational integration was also assessed, as were organisational attitudes to whistle-blowers. Participants were executives in hospitals, medical centres, aged care homes, pharmacies, dental clinics and physiotherapy, chiropractic and podiatry practices. The results show that health organisations have inadequate signal detection mechanisms focusing on a limited selection of threats. Organisations often fail to integrate and disperse their mechanisms and focus almost entirely on internal signals. A majority of the surveyed organisations failed to reward bearers of bad news. In conclusion, the health organisations surveyed lacked systematic and systemic threat surveillance processes and mechanisms that are essential if they are to become better prepared for crises. PMID:23315245

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

    PubMed Central

    Zhang, Niu; Henderson, Charles N.R.

    2015-01-01

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

  1. Chronic pelvic pain.

    PubMed

    Herbert, Bettina

    2010-01-01

    Though there are myriad etiologies of CPP, common therapeutic targets include inflammation, somatic dysfunction, and psychological disturbances. Inflammation may be addressed not only with dietary changes including nutritional and botanical supplements but also with mind-body therapies. Somatic dysfunction may respond to manipulative therapies provided by osteopaths, naturopaths, chiropractors, and some physical therapists. Therapists may also offer visceral, craniosacral, myofascial, and other whole-body therapies, as can highly trained massage therapists and bodyworkers. Mental health care may be key in many cases. Integrative medicine heralds the return to a sense of the human being's intrinsic capacity for healing, incorporating the vitalism of many of the therapies' origins (traditional Chinese medicine, indigenous medicine, ayurveda, osteopathy, chiropractic, etc) with the gains made by a more reductionistic tradition. Given the complexity and wide variation of etiologies and symptoms of CPP, using an integrative approach may offer expanded therapeutic solutions. We must expand our capacity to listen to each patient-with ears, eyes, mind, heart, and hands. Each treatment plan may then be tailored to the unique history and perspective that lie within the individual. Doing so requires the essential elements of time, skill, and love. PMID:20085175

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

    PubMed Central

    Joachim, George C.

    2014-01-01

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

  3. Use of a modified journal club and letters to editors to teach critical appraisal skills.

    PubMed

    Green, Bart N; Johnson, Claire D

    2007-01-01

    The objective of this study was to report the use of a journal club and letter to the editor writing project to teach critical appraisal skills to health sciences students. Data were collected from 22 consecutive classes (n = 907 students) between 1997 and 2003. The program took place in an 11-week evidence-based practice course in the second year of a chiropractic curriculum. After didactic preparation, students participated in several journal club exercises to appraise papers representing specific research designs. Students then critically appraised a recent article of their choice and wrote a critical appraisal essay in the form of a letter to the editor. The project was evaluated through a review of student assessment, an anonymous survey instrument, and the number of letters submitted and published. Assessments of student performance were consistently high, yielding an average score of 23.7 out of 25 possible points on an objective scale. Responses from 277 students completing a survey on their perceptions of the project were positive, indicating that the goals of the project were being met. Over the 7-year period, approximately 450 letters were written, 12 were submitted for publication, and 10 were published. The results of this study suggest that the use of a journal club and letter-to-the-editor writing project may provide a means by which health care students can gain skills in critical appraisal. Further investigation into these methods should be undertaken. PMID:17425191

  4. R + C Factors and Sacro Occipital Technique Orthopedic Blocking: a pilot study using pre and post VAS assessment

    PubMed Central

    Blum, Charles L.

    2015-01-01

    Introduction: The concept of a systematic or predictive relationship between distant vertebral levels distinct from accumulative functional compensatory mechanisms, such as in scoliosis, has been perpetuated within chiropractic technique systems based on clinical observation and experience. This study seeks to investigate this relationship between the cervical and lumbar vertebrae. Methods: Patients (experimental group n=26 and control group n=12) were selected from the patient base of one office, and were limited to patients that had sensitivity at specific cervical reflex points. Using a pre and post outcome measurement and sacro occipital technique R + C protocols, the related lumbar vertebra was adjusted in the direction indicated by the cervical vertebral sensitivity. Results: Statistical analysis revealed there was a statistically significant difference between pre- and post-VAS measurements and found that the notable difference in mean change in VAS scores were statistically significantly different between the experimental and control groups (p < .001). Conclusion: The findings of this study suggest that further research into cervical and lumbar vertebra interrelationships, and the efficacy of orthopedic block treatment, may be warranted. Further studies are needed to confirm whether a causal relationship exists between lumbar manipulation and decreased cervical spine sensitivity. PMID:26136605

  5. Relative efficacy for radiation reducing methods in scoliotic patients

    SciTech Connect

    Aikenhead, J.; Triano, J.; Baker, J. )

    1989-08-01

    Radiation dosages to sensitive organs in full spine radiography have in recent years been a concern of physicians as well as the general public. The spine is the prime target for exposure in scoliosis radiography, though the exposure usually necessitates irradiation of several radio-sensitive organs. In recent studies, various protection techniques have been used including various lead and aluminum filtration systems, altered patient positioning and varied tube-film distances. The purpose of this study was to evaluate the efficiency for radiation dosage reduction of three filtration systems used frequently in the chiropractic profession. The systems tested were the Nolan Multiple X-ray Filters, the Clear-Pb system and the Sportelli Wedge system. These systems were tested in seven configurations varying breast shielding, distance and patient positioning. All systems tested demonstrated significant radiation reductions to organs, especially breast tissue. The Clear-Pb system appeared to be the most effective for all organs except the breast, and the Sportelli Wedge system demonstrated the greatest reduction to breast tissue.

  6. [History of conservative spinal therapy].

    PubMed

    Kladny, B

    2015-12-01

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

  7. Inter-examiner reliability of the interpretation of paraspinal thermographic pattern analysis

    PubMed Central

    Mansholt, Barbara A.; Vining, Robert D.; Long, Cynthia R.; Goertz, Christine M.

    2015-01-01

    Introduction: A few spinal manipulation techniques use paraspinal surface thermography as an examination tool that informs clinical-decision making; however, inter-examiner reliability of this interpretation has not been reported. The purpose of this study was to report inter-examiner reliability for classifying cervical paraspinal thermographic findings. Methods: Seventeen doctors of chiropractic self-reporting a minimum of 2 years of experience using thermography classified thermographic scans into categories (full pattern, partial +, partial, partial −, and adaptation). Kappa statistics (k) were calculated to determine inter-examiner reliability. Results: Overall inter-examiner reliability was fair (k=0.43). There was good agreement for identifying full pattern (k=0.73) and fair agreement for adaptation (k=0.55). Poor agreement was noted in partial categories (k=0.05–0.22). Conclusion: Inter-examiner reliability demonstrated fair to good agreement for identifying comparable (full pattern) and disparate (adaptation) thermographic findings; agreement was poor for those with moderate similarity (partial). Further research is needed to determine whether thermographic findings should be used in clinical decision-making for spinal manipulation. PMID:26136608

  8. Use of complementary and alternative medicine in epilepsy.

    PubMed

    Ricotti, Valeria; Delanty, Norman

    2006-07-01

    Complementary and alternative medicine (CAM) has become much in vogue, and CAM practitioners have increased in tandem with this. The trend of using CAM for treating epilepsy does not differ from that in other medical conditions, with nearly one half of patients using CAM. In this article we review the major complementary and alternative medicines used for treatment of epilepsy. They include mind-body medicines such as reiki and yoga; biologic-based medicine such as herbal remedies, dietary supplements, and homeopathy; and manipulative-based medicine such as chiropractic. In the available literature, there is a sense of the merit of these therapies in epilepsy, but there is a paucity of research in these areas. Individualized therapies such as homeopathy and reiki cannot be compared with medicines in a conventional pharmaceutical model. Hence, many studies are inconclusive. In a science of double-blind, randomized controlled trials, appropriate designs and outcome measurements need to be tailored to CAM. This article explains the principles of the major CAM therapies in epilepsy, and discusses peer-reviewed literature where available. More effort needs to be put into future trials, with the assistance of qualified CAM professionals to ensure conformation to their therapeutic principles. PMID:16822357

  9. Complementary and Alternative Medicine Treatment Options for Otitis Media

    PubMed Central

    Marom, Tal; Marchisio, Paola; Tamir, Sharon Ovnat; Torretta, Sara; Gavriel, Haim; Esposito, Susanna

    2016-01-01

    Abstract Otitis media (OM) has numerous presentations in children. Together with conventional medical therapies aimed to prevent and/or treat OM, a rising number of complementary and alternative medicine (CAM) treatment options can be offered. Since OM is common in children, parents may ask healthcare professionals about possible CAM therapies. Many physicians feel that their knowledge is limited regarding these therapies, and that they desire some information. Therefore, we conducted a literature review of CAM therapies for OM, taking into account that many of these treatments, their validity and efficacy and have not been scientifically demonstrated. We performed a search in MEDLINE (accessed via PubMed) using the following terms: “CAM” in conjunction with “OM” and “children. Retrieved publications regarding treatment of OM in children which included these terms included randomized controlled trials, prospective/retrospective studies, and case studies. The following CAM options for OM treatment in children were considered: acupuncture, homeopathy, herbal medicine/phytotherapy, osteopathy, chiropractic, xylitol, ear candling, vitamin D supplement, and systemic and topical probiotics. We reviewed each treatment and described the level of scientific evidence of the relevant publications. The therapeutic approaches commonly associated with CAM are usually conservative, and do not include drugs or surgery. Currently, CAM is not considered by physicians a potential treatment of OM, as there is limited supporting evidence. Further studies are warranted in order to evaluate the potential value of CAM therapies for OM. PMID:26871802

  10. Management of neck pain in Royal Australian Air Force fast jet aircrew.

    PubMed

    Netto, Kevin; Hampson, Gregory; Oppermann, Brett; Carstairs, Greg; Aisbett, Brad

    2011-01-01

    To examine the type and effectiveness of various strategies used by Royal Australian Air Force (RAAF) fast jet (FJ) aircrew in self-referral and management of flight-related neck pain, a 6-section, 18-question survey tool was distributed to 86 eligible RAAF aircrew. Selective results from the sections evaluating aircrew demographics, incidence of flight-related neck pain, and the self-referral strategies of aircrew to manage these injuries are presented here. Eighty-two RAAF FJ aircrew responded to the survey. Ninety-five percent of the respondents experienced flight-related neck pain. The most commonly sought treatment modalities were on-base medical and physiotherapy services. Many respondents reported that currently provided on-base treatment and ancillary services such as chiropractic therapy are the most effective in alleviating symptoms. Further investigation into the effectiveness and safety of these ancillary therapies needs to be performed to allow appropriate consideration of their place in the management of neck pain in FJ aircrew. PMID:21305970

  11. Interprofessional Competencies in Integrative Primary Healthcare

    PubMed Central

    Brooks, Audrey J.; Maizes, Victoria; Goldblatt, Elizabeth; Klatt, Maryanna; Koithan, Mary S.; Kreitzer, Mary Jo; Lee, Jeannie K.; Lopez, Ana Marie; McClafferty, Hilary; Rhode, Robert; Sandvold, Irene; Saper, Robert; Taren, Douglas; Wells, Eden; Lebensohn, Patricia

    2015-01-01

    In October 2014, the National Center for Integrative Primary Healthcare (NCIPH) was launched as a collaboration between the University of Arizona Center for Integrative Medicine and the Academic Consortium for Integrative Health and Medicine and supported by a grant from the Health Resources and Services Administration. A primary goal of the NCIPH is to develop a core set of integrative healthcare (IH) competencies and educational programs that will span the interprofessional primary care training and practice spectra and ultimately become a required part of primary care education. This article reports on the first phase of the NCIPH effort, which focused on the development of a shared set of competencies in IH for primary care disciplines. The process of development, refinement, and adoption of 10 “meta-competencies” through a collaborative process involving a diverse interprofessional team is described. Team members represent nursing, the primary care medicine professions, pharmacy, public health, acupuncture, naturopathy, chiropractic, nutrition, and behavioral medicine. Examples of the discipline-specific sub-competencies being developed within each of the participating professions are provided, along with initial results of an assessment of potential barriers and facilitators of adoption within each discipline. The competencies presented here will form the basis of a 45-hour online curriculum produced by the NCIPH for use in primary care training programs that will be piloted in a wide range of programs in early 2016 and then revised for wider use over the following year. PMID:26421232

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

    PubMed

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

    2015-01-01

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

  13. Infectious diseases physicians' attitudes and practices related to complementary and integrative medicine: results of a national survey.

    PubMed

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

    2013-01-01

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

  14. Orthotics Compared to Conventional Therapy and Other Non-Surgical Treatments for Plantar Fasciitis

    PubMed Central

    Lewis, Rebecca D.; Wright, Paul; McCarthy, Laine H.

    2016-01-01

    Clinical Question In adults with acute plantar fasciitis whose symptoms have not been relieved with the conventional regimen of NSAIDS, stretching and lifestyle modification, do the addition of orthotics (prefabricated or custom fitted) reduce pain and improve function compared with other non-surgical treatments (manipulative chiropractic, physical therapy and/or heel steroid injections)? Answer Yes. Studies have shown that orthotics, both prefabricated and custom fitted, reduce pain and improve function in adults with acute plantar fasciitis with few risks or side effects. Used alone or in addition to conventional therapy (NSAIDs, stretching, lifestyle modification), orthotics are effective and well tolerated by patients for short-term pain relief and improved function. Prefabricated orthotics are less costly and provide similar relief to more expensive custom orthotics. Level of Evidence of the Answer A Search Terms Plantar fasciitis, heel pain, treatment, orthotics, Limits Adult, human, English, Review, Randomized-Control Trials, Systematic Reviews, adults age 18 or more, publication dates 2004 to present. Date Search was Conducted January 16, 2014; updated January 20, 2015 Inclusion Criteria Recent published systematic reviews, randomized controlled, meta-analyses; adults with confirmed acute or recent diagnosis of plantar fasciitis. Exclusion Criteria Studies older than 10 years, children, adolescents less than 18 years of age, chronic or recalcitrant plantar fasciitis. PMID:26855444

  15. Subtle clinical signs of a meningioma in an adult: a case report

    PubMed Central

    2014-01-01

    Background Meningiomas are the most common brain tumor in the adult population. This case report describes the epidemiology, the clinical presentation as well as the current treatment options for this condition. Case presentation A 49 year-old man attended a chiropractic clinic with non-specific chronic low back pain. Upon the history taking and the systems review, he reported a loss of both smell and taste for which investigations conducted by two different otolaryngologists did not yield a specific diagnosis. The patient was referred to a neurologist who ordered a computer tomography scan that eventually revealed a compression brain tumor. Brain tumors can produce a large variety of clinical presentations, such as upper motor neuron lesion symptoms, altered consciousness or vital functions which are easy to identify. However, subtle signs, such as those presented in this case, can be neglected. Conclusion Clinicians should be aware of uncommon clinical presentations including cranial nerve or neurological dysfunction and refer their patient to a specialist when detected. PMID:24490991

  16. Sacroiliac Joint Pain and Its Treatment.

    PubMed

    Rashbaum, Ralph F; Ohnmeiss, Donna D; Lindley, Emily M; Kitchel, Scott H; Patel, Vikas V

    2016-03-01

    The sacroiliac joint (SIJ) as a source of symptoms has been controversial; however, as knowledge about the joint increased, its role as a pain generator in patients complaining of symptoms that are often attributed to spinal pathology has become better appreciated. The literature reports that the SIJ is the pain origin in as many as 30% of patients presenting with low back pain. Clinically, the SIJ can be challenging to evaluate; however, assessing pain location, patient posture/movement, and provocative manual testing are useful in making the presumptive diagnosis of SIJ disruption. The most definitive evaluation is image-guided injection of anesthetic solutions into the joint which is diagnostic if there is at least 75% symptom relief acutely. Treatment begins with nonoperative intervention including physical therapy and/or chiropractic care. If these fail, the next option is generally radiofrequency denervation (rhizotomy) of the joint. If this does not provide adequate relief, surgical intervention, in the form of minimally invasive SIJ fusion may be considered. The literature increasingly supports favorable results of SIJ fusion in appropriately selected patients. The purpose of this review is to provide an overview of the current literature on the SIJ, with focus on its surgical treatment. PMID:26889985

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

    PubMed Central

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

    2014-01-01

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

  18. Classification of complementary and alternative medical practices: Family physicians' ratings of effectiveness.

    PubMed

    Fries, Christopher J

    2008-11-01

    ABSTRACTOBJECTIVETo develop a classification of complementary and alternative medicine (CAM) practices widely available in Canada based on physicians' effectiveness ratings of the therapies.DESIGNA self-administered postal questionnaire asking family physicians to rate their "belief in the degree of therapeutic effectiveness" of 15 CAM therapies.SETTINGProvince of Alberta.PARTICIPANTSA total of 875 family physicians.MAIN OUTCOME MEASURESDescriptive statistics of physicians' awareness of and effectiveness ratings for each of the therapies; factor analysis was applied to the ratings of the 15 therapies in order to explore whether or not the data support the proposed classification of CAM practices into categories of accepted and rejected.RESULTSPhysicians believed that acupuncture, massage therapy, chiropractic care, relaxation therapy, biofeedback, and spiritual or religious healing were effective when used in conjunction with biomedicine to treat chronic or psychosomatic indications. Physicians attributed little effectiveness to homeopathy or naturopathy, Feldenkrais or Alexander technique, Rolfing, herbal medicine, traditional Chinese medicine, and reflexology. The factor analysis revealed an underlying dimensionality to physicians' effectiveness ratings of the CAM therapies that supports the classification of these practices as either accepted or rejected.CONCLUSIONThis study provides Canadian family physicians with information concerning which CAM therapies are generally accepted by their peers as effective and which are not. PMID:19005130

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Morningstar, Mark W.; Strauchman, Megan N.

    2010-01-01

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

  1. Knowledge and Attitudes towards Complementary and Alternative Medicine among Senior Medical Students in King Abdulaziz University, Saudi Arabia.

    PubMed

    Alzahrani, Sami H; Bashawri, Jamil; Salawati, Emad M; Bakarman, Marwan A

    2016-01-01

    Objectives. This study assessed the knowledge and attitudes regarding complementary and alternative medicine (CAM) in medical students in Saudi Arabia. Furthermore, it evaluated their views on the incorporation of CAM in their medical syllabus. Methods. The study was conducted by selecting a cross-sectional sample of senior medical students in the Faculty of Medicine. A validated and reliable self-administered questionnaire was used to explore the knowledge, attitude, and benefits of CAM. It was distributed to a sample of 273 students. Results. The study included 242 students, making the response rate 88.6%. Only two-thirds of students (62.4%) were aware of acupuncture principles and only 17.4% recognized that chiropractic is associated with pain management. The knowledge of common herbs such as St. John's Wort, Echinacea, and Ginkgo biloba was limited among the students. Older students had a positive CAM attitude compared to younger students (p = 0.027). Conclusion. Students attitudes toward CAM learning were encouraging regardless of their limited knowledge on the subject. A high percentage of students agreed that CAM in combination with conventional therapy is beneficial in treating unusual cases, but the choice of CAM should be based on evidence. Furthermore, medical students are still reluctant to have CAM practitioners in their referral network. PMID:27066102

  2. Septic arthritis of the hip: a case report

    PubMed Central

    Kim, Peter S Y; Mierau, Dale; Loback, Dwight

    1993-01-01

    A 61-year-old female presented to a chiropractic clinic complaining of right hip pain of three days duration. Examination revealed a stiff and painful hip. An AP pelvis radiograph taken on that day did not reveal radiographic signs of hip infection. A diagnosis of hip sprain was recorded. The patient was treated conservatively for 7 weeks with rest, NSAIDS and electrotherapy. Her condition failed to improve with this treatment and deteriorated further. The patient was then referred for an orthopaedic consultation. Results from a technetium-99m-labelled methylene diphosphonate ([99mTc]MDP) bone scan and a gallium-67 (67Ga) bone scan suggested a diagnosis of hip joint infection. Subsequent, radiographs of the right hip revealed marked destruction of the right femoral head and acetabulum. Staphylococcus aureus was isolated following aspiration of the painful hip confirming a diagnosis of septic arthritis. The patient went on to operative treatment and is awaiting a total hip replacement. Septic arthritis of the hip can be easily overlooked, initially, as a possible cause of hip pain. The differential diagnosis of a stiff and painful hip must include septic arthritis. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6

  3. Interprofessional Competencies in Integrative Primary Healthcare.

    PubMed

    Kligler, Benjamin; Brooks, Audrey J; Maizes, Victoria; Goldblatt, Elizabeth; Klatt, Maryanna; Koithan, Mary S; Kreitzer, Mary Jo; Lee, Jeannie K; Lopez, Ana Marie; McClafferty, Hilary; Rhode, Robert; Sandvold, Irene; Saper, Robert; Taren, Douglas; Wells, Eden; Lebensohn, Patricia

    2015-09-01

    In October 2014, the National Center for Integrative Primary Healthcare (NCIPH) was launched as a collaboration between the University of Arizona Center for Integrative Medicine and the Academic Consortium for Integrative Health and Medicine and supported by a grant from the Health Resources and Services Administration. A primary goal of the NCIPH is to develop a core set of integrative healthcare (IH) competencies and educational programs that will span the interprofessional primary care training and practice spectra and ultimately become a required part of primary care education. This article reports on the first phase of the NCIPH effort, which focused on the development of a shared set of competencies in IH for primary care disciplines. The process of development, refinement, and adoption of 10 "meta-competencies" through a collaborative process involving a diverse interprofessional team is described. Team members represent nursing, the primary care medicine professions, pharmacy, public health, acupuncture, naturopathy, chiropractic, nutrition, and behavioral medicine. Examples of the discipline-specific sub-competencies being developed within each of the participating professions are provided, along with initial results of an assessment of potential barriers and facilitators of adoption within each discipline. The competencies presented here will form the basis of a 45-hour online curriculum produced by the NCIPH for use in primary care training programs that will be piloted in a wide range of programs in early 2016 and then revised for wider use over the following year. PMID:26421232

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

    PubMed Central

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

    2015-01-01

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

  5. Pathological burst fracture in the cervical spine with negative red flags: a case report

    PubMed Central

    Cox, Jocelyn; DeGraauw, Chris; Klein, Erik

    2016-01-01

    Objective: To report on a case of a pathological burst fracture in the cervical spine where typical core red flag tests failed to identify a significant lesion, and to remind chiropractors to be vigilant in the recognition of subtle signs and symptoms of disease processes. Clinical Features: A 61-year-old man presented to a chiropractic clinic with neck pain that began earlier that morning. After a physical exam that was relatively unremarkable, imaging identified a burst fracture in the cervical spine. Intervention & Outcomes: The patient was sent by ambulance to the hospital where he was diagnosed with multiple myeloma. No medical intervention was performed on the fracture. Summary: The patient’s initial physical examination was largely unremarkable, with an absence of clinical red flags. The screening tools were non-diagnostic. Pain with traction and the sudden onset of symptoms prompted further investigation with plain film imaging of the cervical spine. This identified a pathological burst fracture in the C4 vertebrae. PMID:27069270

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

    PubMed Central

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

    2013-01-01

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

  7. Herpes zoster in a 6-month-old infant with 13-year follow-up: a retrospective case report

    PubMed Central

    Aikenhead, Kristine J.; Johnson, Theodore L.

    2011-01-01

    Objective The purpose of this report is to present a case of herpes zoster in a 6-month-old infant, conservatively managed without oral antivirals, and its 13-year follow-up, demonstrating no sequelae or recurrences. Clinical Features A 6-month-old white female infant presented with a vesicular rash of the right lower extremity to a chiropractic office. The rash consisted of grouped vesicles on erythematous plaques, the characteristic herpetiform lesion, distributed in the S1 dermatome of the right lower extremity only. The infant's history was significant for exposure to chicken pox at age 1 week through siblings. Consequently, only one vesicle developed, representing subclinical chicken pox. The clinical diagnosis of herpes zoster was made. Intervention and Outcome The infant was treated conservatively at home. Treatment consisted of aluminum acetate (Burow) solution compresses 3 times each day, followed by a loose dressing. The lesions crusted in 1 week and completely resolved in 2 weeks. Follow-up, consisting of 13 years of observation, demonstrated no evidence of sequelae, such as postherpetic neuralgia, or recurrence. Conclusion Herpes zoster is uncommon in infants; however, it may occur. The presentation of the rash is characteristic; but otherwise, the condition differs from that in adults in that it is mild and not associated with postherpetic neuralgia. In uncomplicated cases, conservative treatment measures support the quick resolution with no sequelae. PMID:22654690

  8. Complementary and Alternative Medicine: A Survey of Its Use in Pediatric Oncology

    PubMed Central

    Valji, Rafiaa; Adams, Denise; Dagenais, Simon; Baydala, Lola; King, W. James

    2013-01-01

    Background. The use of complementary and alternative medicine (CAM) is high among children and youths with chronic illnesses, including cancer. The objective of this study was to assess prevalence and patterns of CAM use among pediatric oncology outpatients in two academic clinics in Canada. Procedure. A survey was developed to ask patients (or their parents/guardians) presenting to oncology clinics at the Stollery Children's Hospital in Edmonton and the Children's Hospital of Eastern Ontario (CHEO) in Ottawa about current or previous use of CAM products and practices. Results. Of the 137 families approached, 129 completed the survey. Overall CAM use was 60.5% and was not significantly different between the two hospitals. The most commonly reported reason for not using CAM was lack of knowledge about it. The most common CAM products ever used were multivitamins (86.5%), vitamin C (43.2%), cold remedies (28.4%), teething remedies (27.5%), and calcium (23.0%). The most common CAM practices ever used were faith healing (51.0%), massage (46.8%), chiropractic (27.7%), and relaxation (25.5%). Many patients (40.8%) used CAM products at the same time as prescription drugs. Conclusion. CAM use was high among patients at two academic pediatric oncology clinics. Although most respondents felt that their CAM use was helpful, many were not discussing it with their physicians. PMID:24307910

  9. Rehabilitation and treatment of a recreational golfer with hip osteoarthritis: a case report

    PubMed Central

    Howell, Emily R.

    2012-01-01

    Objective: This case study reviews the conservative chiropractic treatment of hip osteoarthritis (OA) and the prescription of a rehabilitation program for a recreational golfer. Clinical features: A 49-year-old registered nurse/ college instructor presented with a five year history of left hip OA and pain, recent right hip pain and occasional low back stiffness. Once her symptoms improved, a golf-specific functional rehabilitation program was prescribed in preparation for the upcoming golf season. Intervention and Outcome: The initial treatment included ultrasound, soft tissue and myofascial therapy, mobilizations, acupuncture and home advice. Rehabilitative exercises included core and scapular stability exercises, general conditioning, golf specific stretches, functional swinging, proprioceptive and strengthening exercises, and referral to a swing coach. The positive outcomes included increased ranges of motion, decreased pain, as well as improvements in golf driving distance and endurance. Summary: Conservative management and golf-specific rehabilitation prescription appears to be beneficial for hip OA and recreational golf performance in this case. PMID:22997470

  10. Alternative medicine and general practitioners. Opinions and behaviour.

    PubMed Central

    Verhoef, M. J.; Sutherland, L. R.

    1995-01-01

    OBJECTIVE: To describe general practitioners' opinions and behaviour regarding alternative medicine. DESIGN: Cross-sectional survey of a random sample of Ontario and Alberta general practitioners. SETTING: General practices in Ontario and Alberta. PARTICIPANTS: A questionnaire was mailed to 400 general practitioners. Of the 384 eligible physicians, 200 completed the questionnaire. MAIN OUTCOME MEASURES: Reported beliefs and practices concerning alternative medicine. RESULTS: Acupuncture, chiropractic, and hypnosis were considered most useful and reflexology, naturopathy, and homeopathy least useful. Results showed 56% of general practitioners believed that alternative medicine has ideas and methods from which conventional medicine could benefit, 54% referred to alternative practitioners, and 16% practised some form of alternative medicine. Province of practice, place of graduation, training in alternative approaches, number of alternative approaches perceived useful, and attitude toward alternative medicine were clearly related to referring to alternative practitioners. Sex, age, type of practice, training in alternative medicine, referring to alternative practitioners, number of alternative approaches perceived useful, and attitude toward alternative medicine were related to practicing alternative medicine. CONCLUSION: Although acceptance and integration of alternative medicine extend only to certain approaches, alternative medicine cannot be discounted in general practice. A study encompassing all Canadian provinces could help in planning medical education and developing policies to guide physician behaviour. PMID:7780312

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  13. Alternative medicine as a carve-out in managed care.

    PubMed

    Montoya, I D

    1998-01-01

    A major philosophical shift continues to occur in how health care is delivered in the United States. Traditional western medicine continues to develop new technologies that require new delivery systems, however, other factors are affecting this shift as well. Alternative medicine is one of these factors and is rapidly gaining attention. Alternative medicine is comprised of homeopathy, chiropractic, naturopathy, and cultural beliefs and practices such as those of the Native Americans or the Mexican Folk healers. Several managed care plans are now including alternative medicine as part of their product lines. Employers are moving from a passive role to an aggressive one in the selection of health care services available to their work force. This is in response to the changing demographics of the United States and the increased sensitivity to diversity in the work-place. Managed care companies have a marketing opportunity to increase their share of the market by looking at alternative medicine as a new product line designed to attract new subscribers. As with behavioral medicine, alternative medicine does not fit into the systems developed for delivering medical-surgical services. It, however, does not fit the systems developed for behavioral medicine either and appears to be a carve-out onto itself. PMID:10345892

  14. [Alternative methods instead of external cephalic version in the event of breech presentation. Review of the literature].

    PubMed

    Boog, G

    2004-04-01

    Fetal breech presentation at term is more and more treated by a planned cesarean section. Considering the increased maternal morbidity and mortality in relation to abdominal delivery versus vaginal birth, natural and innocuous methods have been proposed for the promotion of a spontaneous fetal cephalic version during the last two Months of pregnancy. In order to stimulate fetal motility many techniques have been described, either advising postural methods (passive bridge, Indian version, knee-chest position) or using acupuncture (stimulation of the fifth toe and auricular points). Other techniques like chiropractic manipulations or hypnosis have also been tried. Unfortunately, most publications are retrospective and methodologically inaccurate, but it seems that their results may be favorably compared with that of the external cephalic version, a much more complex procedure, which is potentially dangerous and certainly time consuming and expensive. The only randomized controlled trial with a proven efficacy concerns moxibustion (burning herbs to stimulate the acupoint BL 67 or Zhiyin, located beside the outer corner of the fifth toenail). PMID:15052174

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  17. Complementary, Alternative, and Mainstream Service use Among Families with Young Children with Multiple Disabilities: Family Costs to Access Choices.

    PubMed

    Bourke-Taylor, Helen; Cotter, Claire; Stephan, Rebecca

    2014-11-01

    ABSTRACT Families raising a young child with multiple disabilities are charged with significant responsibilities such as learning about their child's condition and navigating mainstream and alternative services. Aim: Describe service choices, costs, out of pocket expenses, and the impact on families. Methods: Survey design using a custom questionnaire was used to collect extensive retrospective and current data. Purposive sampling (N = 29) occurred from one early intervention facility specialized in servicing children with cerebral palsy (CP) and, or multiple disabilities in Australia. Descriptive statistics were used for analysis of data. Results: Twenty-three (79%) families reported caring for a child with CP. Twenty-three families reported using at least one complementary/alternative intervention. Out-of-pocket amounts were reported including: chiropractic services (10 families); naturopathy (9 families); point percussion therapy (7 families), and Chinese medicine (6 families). Expenses resulted in families reporting forgoing clothing items, family entertainment, recreation/hobbies for parents (55%); family holidays (59%); time for parents alone (66%); and health services for parents (38%). Conclusions: Families of young children with multiple disabilities select a wide range of services for their child, with consequential out of pocket expenses. Early intervention professionals can be an important resource for families as they evaluate their choices and select interventions for their child. PMID:25365470

  18. Supraclavicular glomus tumor, 20 year history of undiagnosed shoulder pain: a case report.

    PubMed

    Ghaly, R F; Ring, A M

    1999-11-01

    A long-standing case of severe dysesthesia due to a supraclavicular glomus tumor is presented. Chronic pain caused by a subcutaneous glomus (non-chemodectoma) tumor is rare and usually misdiagnosed. The supraclavicular location, presentation, and coincidence of trauma history are unique in this case. A 62-year-old male complained of 20 years of intractable right shoulder and supraclavicular region pain, which started 6 months after a fall. The pain was unrelieved by repeated and extensive physical therapy, chiropractic manipulation, local steroid injections, and two shoulder operations. The cause of the condition remained undiagnosed and obscure. Local surgical exploration revealed a subcutaneous grayish mass with pathologically proven glomus tumor. Immediate alleviation of the pain and tenderness followed complete resection of the mass. The patient remained free of pain at a 2-year follow-up. Subcutaneous glomus (non-chemodectoma) tumors can occur in unusual sites, and should be considered in chronic regional pain syndromes. Immediate cure is generally achieved by local resection. Pertinent literature is reviewed. PMID:10534611

  19. Bilateral Idiopathic Osteonecrosis of the Femoral Head: A Case Report With an Emphasis on Differential Diagnosis, Imaging, and Treatment

    PubMed Central

    Battaglia, Patrick J.; Gliedt, Jordan; McDaniel, Courtney; Kettner, Norman

    2014-01-01

    Objective The purpose of this case report is to describe a patient with bilateral idiopathic osteonecrosis of the femoral head (ONFH), provide a discussion of differential diagnosis for anterior hip pain, imaging, and treatment recommendations for ONFH. Clinical features A 34-year-old man was initially treated by a chiropractic physician for low back pain. At the end of a three week trial of care, the patient’s low back pain resolved. However, he reported a new complaint of mild left anterior hip stiffness. After re-examination, a homecare exercise program was prescribed. The patient returned 1 month later with substantial left anterior hip pain and walked with a noticeable limp. Radiography of the left hip demonstrated advanced ONFH. Magnetic resonance imaging of both hips demonstrated the extent of involvement of the left hip while incidentally revealing ONFH on the right. Intervention and Outcome A total hip arthroplasty was performed on the left hip and the right hip is being monitored without intervention. Conclusion Osteonecrosis of the femoral head is a challenging clinical problem with non-specific and wide-ranging signs and symptoms requiring clinicians to engage a cautious and comprehensive differential diagnosis. Prompt recognition ensures that appropriate treatment can be initiated in a timely manner and optimal patient outcomes achieved. PMID:25225469

  20. Andrew Taylor Still and the birth of osteopathy (Baldwin, Kansas, USA, 1855).

    PubMed

    Hamonet, Claude

    2003-02-01

    Osteopathy has gained ground in recent years and has been seeking recognition in France. Physicians often lack the information needed to answer patients who have derived from the media, advertisements, and other patients what they believe is a clear idea of osteopathy and its twin sister chiropractic. My academic activities led me to the heart of the United States, to Kansas, where settlers and Indians once stood face to face and where wagon trains left daily for the Western territories. There, in Baldwin, Andrew Taylor Still "discovered" osteopathy. I conducted an in-depth study of the birth of osteopathy and of the ideological and cultural influences that shaped this doctrine. The circumstances that surrounded the development of osteopathy deserve to be widely known because they explain how contemporary osteopaths work. Indeed, although the terms are different, the ideology that underlies osteopathy seems unchanged. The history of osteopathy emphasizes the importance of logical thinking in medicine, of the principle of pathophysiological foundation, of diagnostic hypotheses, and of careful treatment selection complying with the rules of deontology and ethics. Osteopathy is without doubt a product of society and perhaps also of vogue. It cannot leave physicians indifferent. PMID:12639626