... structural alignment and improve your body's physical function. Low back pain, neck pain and headache are the most common ... treated. Chiropractic adjustment can be effective in treating low back pain, although much of the research done shows only ...
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:…
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…
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.
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…
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,…
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…
Lawrence, D J
There has been increasing acceptance and development of manual methods in providing for the needs of patients with musculoskeletal dysfunction. Several professions have helped fuel this growth, including the chiropractic profession. To date, there has been only a small amount of collaboration between chiropractors and physical therapists. This paper provides a base foundation for one small part of general chiropractic practice, i.e. procedures used for manipulating the foot. Information is provided about the specific diagnostic procedures used by the chiropractic profession in assessing the joints and soft tissues of the foot, followed by descriptions of a number of chiropractic manipulative techniques drawn from the form of chiropractic in widest usage, Diversified technique. For each technique, information is provided on indications for use, patient position, therapist position, hand placements and procedure. In addition, a short discussion on the genesis of Diversified technique is provided.
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,…
Keating, Joseph C
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
Kinsinger, Stuart; Puhl, Aaron Anthony; Reinhart, Christine J.
Background: The intensive training associated with health care education has been suggested to have unintended negative consequences on students’ mental or emotional health that may interfere with the development of qualities deemed essential for proficient health care professionals. This longitudinal study examined the prevalence and severity of depressive symptoms among students at a chiropractic educational institution. Methods: Chiropractic students at all levels of training were surveyed at Canadian Memorial Chiropractic College during the academic years of 2000/2001, 2001/2002, and 2002/2003. The measurement tool employed was the Beck Depression Inventory, 2nd edition (BDI-II). Previously established BDI-II cutoff scores were used to assess the severity of reported depression symptoms, and these were compared by sex and year of training. Results: The survey was completed by 1303 students (70%) over the 3 years of the study. The prevalence of depressive symptoms was nearly 25%, with 13.7% of respondents indicating a rating of mild depression, 7.1% indicating moderate depressive symptoms, and 2.8% indicating severe symptoms. Significant differences were found between years of training, with 2nd-year students having the highest prevalence of depressive symptoms, and sex, with females having a higher rate of symptoms. Conclusions: Chiropractic students surveyed at Canadian Memorial Chiropractic College had high rates of depression similar to those measured in other health care profession students. Chiropractic educational institutions should be aware of this situation and are encouraged to emphasize students’ awareness of their own personal health and well-being and their access to appropriate care, in addition to the same concerns for their future patients. PMID:22069339
Ohm, Jeanne; Kunz, Derek
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
The vast majority of those with back pain respond extremely well to chiropractic spinal manipulation. There are several hundred procedures available to a well trained chiropractor, including high velocity manipulation, mobilisation, soft tissue techniques and pressure point therapy, which may be used to eliminate the need for manipulation under anaesthesia or surgery.
Keating, Joseph C
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
Dr. Mildred Genoa Allison-Cleveland, affectionately known as "Dr. Millie," was an important part of life at Cleveland Chiropractic College for over thirty years, serving first as a clerical assistant, then instructor, administrative assistant, and trusted right hand of her husband, Dr. Carl Cleveland, Jr. Yet Mildred Cleveland, like many other women who have helped the profession grow and survive over the years, has never been the subject of an article in print. In this paper, the author will strive to outline Dr. Mildred Cleveland's accomplishments, as well as to give the reader as clear a picture as possible of the woman who was the wife of one chiropractic pioneer and mother of another.
Lawrence, Dana J; Meeker, William C
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
In October 2016, the World Federation of Chiropractic and Association of Chiropractic Colleges Education Conference was held in Montreal, Canada. This summary provides the titles of the contributed presentations. The full set of abstracts for this meeting are published online at www.journalchiroed.com as an exclusively electronic publication that is part of volume 30, issue 2 (October 2016) of the Journal of Chiropractic Education. PMID:27749117
Haussler, K K
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.
Weis, Carol Ann; Stuber, Kent; Barrett, Jon; Greco, Alexandra; Kipershlak, Alexander; Glenn, Tierney; Desjardins, Ryan; Nash, Jennifer; Busse, Jason
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.
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
Phillips, R B; Butler, R
This survey of the members of the Dade County Chiropractic Society of Miami, Florida was initiated with the encouragement and under the supervision of the Dade County Health Systems Agency (HSA). The purpose of the survey was to obtain information relative to the inclusion of chiropractic into future health planning to be conducted by the HSA. The survey was divided into a "Physicians Survey" obtaining information on location, office hours, gross income, total patient visits and type of practice of the doctor, and a "Patient Survey" obtaining information on age, sex, ethnic origin, residence, and payment source of the patients. Clinical information on initial complaints, diagnoses, treatment, referrals, and amount of care was also obtained. It was found that chiropractors work an average of 31.7 hours per week with a gross annual income of $74,750.00 (1979). The male-female distribution of patients was equal and the average patient age was 43.4 years. Anglocaucasian category comprised 80.2% of the patient sample. Nearly 50% of all chiropractic patients pay for services rendered out of their own pocket. Of the primary diagnosis, 81.3% related to the spine. The study concludes that the practice of chiropractic in Dade County is very similar to the practice of chiropractic in general.
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
O'Neill, A; Willis, E
Musculoskeletal disorders remain a common disability suffered by Australians, but the question of who should treat them remains a contentious issue as the first centenary of the original chiropractic adjustment approaches. This paper, part of a longitudinal study of the role of chiropractic in the Australian health system, analyses this ongoing debate. Recent events are analysed here in this commentary on the politics of health care in this field. These include meta-analysis to evaluate the effectiveness of spinal manipulation for the treatment of lower back pain, recent legal action in the United States, and the recent epistle against Australian chiropractors published by the Australian Medical Association.
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…
Heiner, Jason D
Spinal epidural hematoma is a rare but potentially devastating complication of spinal manipulation therapy. This is a case report of a healthy pregnant female who presented to the emergency department with a cervical epidural hematoma resulting from chiropractic spinal manipulation therapy that responded to conservative treatment rather than the more common route of surgical management.
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.
Jamison, Jennifer R
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.
Borggren, Cara L.
Abstract Objective The purpose of this article is to review the literature on the topic of chiropractic care during pregnancy. Methods A PubMed search was performed using the terms pregnancy and chiropractic. Sources were cross-referenced to obtain further articles and research information after reviewing the articles obtained through the search. Results Thirty-three references were used for this review. The current literature reports favorable results on the use of chiropractic care throughout pregnancy. Conclusions Chiropractic evaluation and treatment during pregnancy may be considered a safe and effective means of treating common musculoskeletal symptoms that affect pregnant patients. The scarcity of published literature warrants further research. PMID:19674697
The chiropractic cliché “Chiropractic Adds Life to Years and Years to Life” was examined for validity. It was assumed that chiropractors themselves would be the best informed about the health benefits of chiropractic care. Chiropractors would therefore be most likely to receive some level of chiropractic care, and do so on a long-term basis. If chiropractic care significantly improves general health then chiropractors themselves should demonstrate longer life spans than the general population. Two separate data sources were used to examine chiropractic mortality rates. One source used obituary notices from past issues of Dynamic Chiropractic from 1990 to mid-2003. The second source used biographies from Who Was Who in Chiropractic – A Necrology covering a ten year period from 1969–1979. The two sources yielded a mean age at death for chiropractors of 73.4 and 74.2 years respectively. The mean ages at death of chiropractors is below the national average of 76.9 years and is below their medical doctor counterparts of 81.5. This review of mortality date found no evidence to support the claim that chiropractic care “Adds Years to Life.” PMID:17549121
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.
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;…
Kalthoff, Theodore J.
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)
Johnson, Claire D; Green, Bart N
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.
Lind, Bonnie K.; Diehr, Paula K.; Grembowski, David E.; Lafferty, William E.
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…
There are 1080 chiropractors in the UK today, and almost one-third of these are McTimoney chiropractors. This article outlines the development of McTimoney Chiropractic, which is a particular branch of the chiropractic profession in the UK, taught at the McTimoney Chiropractic College in Abingdon, near Oxford. The McTimoney method is distinguished by its gentle, whole body approach. It aims to correct the alignment of the bones of the spine and other joints of the body, to restore nerve function, to alleviate pain, and to promote natural health. The technique is suitable for the very young as well as the old and frail. In this paper, several nurses-turned-chiropractor offer their personal views. Reference is also made to the McTimoney-Corley technique, which is a similar chiropractic method taught at the Oxford School of Chiropractic, UK.
Budgell, Brian S; Kwong, Alice; Millar, Neil
This study investigates how the language of chiropractic has changed over time. A collection of material, published up until approximately 1950 and consisting of textbooks, monographs and lecture notes from Canadian Memorial Chiropractic College, was analyzed to identify commonly occurring words and phrases. The results were compared to a corpus of recent articles from the Journal of the Canadian Chiropractic Association. This permitted the identification of words which were over-represented in the historical literature and therefore likely have become somewhat archaic or represent themes which are of less import in the modern chiropractic literature. Words which were over-represented in the historical literature often referred to anatomical, pathological and biomechanical concepts. Conversely, words which were comparatively over-represented in the modern chiropractic literature often referred to concepts of professionalism, the clinical interaction and evidence-based care. A detailed analysis is presented of trends in the use of the conceptually important terms subluxation and adjustment.
Ernst, Edzard; Posadzki, Paul
To promote an independent and critical evaluation of 11 randomised clinical trials (RCTs) of chiropractic funded by the National Centre for Complementary and Alternative Medicine (NCCAM). Electronic searches were conducted to identify all relevant RCTs. Key data were extracted and the risk of bias of each study was determined. Ten RCTs were included, mostly related to chiropractic spinal manipulation for musculoskeletal problems. Their quality was frequently questionable. Several RCTs failed to report adverse effects and the majority was not described in sufficient detail to allow replication. The criticism repeatedly aimed at NCCAM seems justified, as far as their RCTs of chiropractic is concerned. It seems questionable whether such research is worthwhile.
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
There are a rising number of older adults; in the US alone nearly 20% of the population will be 65 or older by 2030. Chiropractic is one of the most frequently utilized types of complementary and alternative care by older adults, used by an estimated 5% of older adults in the U.S. annually. Chiropractic care involves many different types of interventions, including preventive strategies. This commentary by experts in the field of geriatrics, discusses the evidence for the use of spinal manipulative therapy, acupuncture, nutritional counseling and fall prevention strategies as delivered by doctors of chiropractic. Given the utilization of chiropractic services by the older adult, it is imperative that providers be familiar with the evidence for and the prudent use of different management strategies for older adults. PMID:22348431
Sawyer, C; Haas, M; Nelson, C; Elkington, W
In the current climate of accountability, health care financing reform and the demand on all health professions for evidence, there is an urgent need to expand clinical research activity within the profession. Those randomized clinical trials that have been reported in the literature have focused primarily on low back and headache pain. Only recently have studies been initiated to investigate the effectiveness of chiropractic interventions for conditions other than back pain. The ability of chiropractic colleges to develop research infrastructures and productive clinical research programs depends on removing or minimizing a number of impediments. A shortage of chiropractic clinicians who have the experience and training to conduct clinical research is compounded by a dependency on tuition revenue, limited external funding and a lack of institutional emphasis on research. The profession generally, and chiropractic colleges specifically, must address the impediments that limit the growth of research capacity. We present several recommendations and the action steps required to achieve specific outcomes.
Chapman-Smith, D A
Traditional and complementary health care services have a growing and significant role in both developed and developing countries. In the United Kingdom the British Medical Association (BMA) has identified five complementary approaches to health care that should now be regarded as "discrete clinical disciplines" because they have "established foundations of training and have the potential for greatest use alongside orthodox medical care". These are acupuncture, chiropractic, herbalism, homeopathy and osteopathy. The BMA recommended that there should be legislation to regulate these disciplines and the Chiropractors' Act enacted in the U.K in 1994. The chiropractic profession was founded in the United States in 1895, and the practice of chiropractic has been regulated in the United States and Canada since the 1920s, in Australia since the late 1940s, in New Zealand and South Africa since the 1960s, and more recently in Asia, Europe, Latin America and elsewhere. Figure 1 lists the countries which currently recognize and regulate the chiropractic profession. Many countries, such as Japan with approximately 10,000 chiropractors with different levels of education, and Trinidad & Tobago with 5 chiropractors who are graduates of accredited chiropractic colleges in North America, are considering legislation. Croatia, with 3 chiropractors, is preparing legislation. Cyprus, with 6 chiropractors, has legislation. Even in countries such as these, where the profession is small, there are compelling public interest arguments for regulation. This is especially true in the 1990s. One reason is the growing incentive for lay healers and others without formal training to use the title "chiropractor" as chiropractic practice gains increasing acceptance. The majority of chiropractic practice involves patients with non- specific or mechanical back and neck pain. The chiropractic approach to management, which includes spinal adjustment or manipulation, other physical treatments, postural
Woodfield, H. Charles; York, Craig; Rochester, Roderic P.; Bales, Scott; Beebe, Mychal; Salminen, Bryan; Scholten, Jeffrey N.
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
Keating, Joseph C; Rehm, William S
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 5
Yalden, Philip; Cunliffe, Christina; Hunnisett, Adrian
Objective This research aimed to investigate motivations for studying chiropractic, and to determine what students look for in a course/college and potential barriers to studying chiropractic. Methods The study design was a cross-sectional survey. Following IRB/Ethical approval, a paper-based questionnaire was distributed to students at McTimoney College of Chiropractic. Demographic data were compared to another chiropractic college in the United Kingdom. Results The questionnaire response rate was 70.8% (n = 121). Motivating factors for studying chiropractic included a desire to help others (54.5%, n = 66), with 44.6% (n = 54) attracted by chiropractic's holistic, drugless approach to health. Previous help from chiropractic influenced 55.4% (n = 67) and 22.3% (n = 27) felt chiropractic had “changed their life.” Just over half of the respondents (55.4%, n = 67) viewed the ability to work while studying as extremely important and 73.6% (n = 89) said they could not have studied chiropractic without this. Conclusion Previous help from chiropractic care was a common motivation for studying chiropractic. The ability to work while studying was seen as vital by many students and, without it, the vast majority felt they could not have studied chiropractic. PMID:23957323
Yalden, Philip; Cunliffe, Christina; Hunnisett, Adrian
Objective : This research aimed to investigate motivations for studying chiropractic, and to determine what students look for in a course/college and potential barriers to studying chiropractic. Methods : The study design was a cross-sectional survey. Following IRB/Ethical approval, a paper-based questionnaire was distributed to students at McTimoney College of Chiropractic. Demographic data were compared to another chiropractic college in the United Kingdom. Results : The questionnaire response rate was 70.8% (n = 121). Motivating factors for studying chiropractic included a desire to help others (54.5%, n = 66), with 44.6% (n = 54) attracted by chiropractic's holistic, drugless approach to health. Previous help from chiropractic influenced 55.4% (n = 67) and 22.3% (n = 27) felt chiropractic had "changed their life." Just over half of the respondents (55.4%, n = 67) viewed the ability to work while studying as extremely important and 73.6% (n = 89) said they could not have studied chiropractic without this. Conclusion : Previous help from chiropractic care was a common motivation for studying chiropractic. The ability to work while studying was seen as vital by many students and, without it, the vast majority felt they could not have studied chiropractic.
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…
Senzon, Simon A.
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
Chiropractic is one of the most controversial and poorly defined healthcare professions with recognition and licensure in the United States. Chiropractic was started by D. D. Palmer, a magnetic healer who formulated the vertebral subluxation theory. The profession was developed by his son, B. J. Palmer. Although the definition of chiropractic as a method of correcting vertebral subluxations to restore and maintain health is questionable, spinal manipulation is of value in the treatment of some types of back pain. The chiropractic profession is still based on the vertebral subluxation theory, and has the confusing image of a back specialty capable of treating a broad scope of health problems. Despite opposition to use of spinal manipulation as a method of treating a broad scope of health problems (as opposed to the generally accepted use of manipulation in the treatment of back pain), chiropractors seek support as primary care providers in alternative medicine. It is essential to understand the theories, philosophies, and methods of chiropractic for an objective evaluation.
The practice of chiropractic was for many years regulated by "The Quack Act" in Norway, and the numbers of chiropractors decreased year by year. They are now authorized health care practitioners with academic training; most Norwegian students attending courses in chiropractic or clinical biomechanics go to European universities. An international council ensures reciprocity and a quality assured academic programme in all recognized colleges of chiropractic. Recent research have broadened our understanding of the biomechanical interrelationship between the nervous system, the musculature and the skeletal articulations. In the early 1990s, several studies documented favourable effect of chiropractic treatment of low back disorders. These studies are now substantiated by new studies, especially concerning cost-effectiveness. Several reports also give evidence that chiropractic manipulation is beneficial especially in combination with light exercise. There are conflicting results concerning the efficacy of varying types of exercise programmes. Patients may benefit from increased cooperation between medical doctors and chiropractors. Most acute low back syndromes should be assessed by the chiropractor in order to prevent chronic illness.
Gorrell, Lindsay; Beirman, Robyn L.; Vemulpad, Subramanyam R.
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
Newton-Leo, Linda; King-Isaacs, Debra; Lichti, Janice
This study was a preliminary investigation into the knowledge of and current attitudes towards the chiropractic profession by medical practitioners with varying years of clinical experience. A questionnaire was designed and mailed to seventy general practitioners in Downsview, Ontario who agreed to participate in the study. Twenty-six were returned for a response rate of 37%. The data were analyzed and responses from doctors with differing years of practice experience were compared using the chi square statistic. When comparing attitudes towards the chiropractic profession between medical practitioners with greater and less than 15 years of clinical experience a statistically significant difference was found (p = 0.0005). However, no significant differences were observed in terms of their interaction with or knowledge of the chiropractic profession. Further, 88% of respondents reported that they had referred a patient to a chiropractor. The limitations of the study and suggestions for improvement are discussed.
Gatterman, Meridel I; Dobson, Thomas P; LeFevbre, Ron
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.
McGregor, Marion; Wiles, Michael R.; Grice, Adrian S.
The necessity for an animal model in chiropractic research is considered and a short review of previous experimentation of manipulation on animals is presented. The guinea pig is proposed as a suitable animal model, and research into its suitability is presented. Analysis includes the animal’s physical characteristics, the choice of anesthetic and parametric and roentgenographic evaluation. A device for supporting the anesthetized animal during standard and motion roentgenographic examination is described. We conclude that this animal model fulfills the requirements necessary for successful investigation in chiropractic research, and the need for such investigation is emphasized. ImagesFigure 1Figure 2
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
Sikorski, David M.; KizhakkeVeettil, Anupama; Tobias, Gene S.
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
Green, Bart N.; Johnson, Claire D.
Objective: This paper presents the origins and development of the organized chiropractic orthopedics movement in the United States from 1954–1973. Methods: Hand searches of early periodicals were performed and information was organized chronologically to create a timeline. Context for the timeline was provided by extracting pertinent information from audio recordings of interviews. Relevant background information was located using the cumulative index of the journal Chiropractic History and searching the MANTIS database. Historical Features: After World War I, The advent of third party reimbursement for health care created a new environment for health care practitioners. For doctors of chiropractic, this event provided the impetus to begin the postgraduate chiropractic orthopedics program over 50 years ago. In 1954, Alvin A. Hancock, DC and F. Maynard Lipe, DC successfully launched an active orthopedics movement after several earlier attempts failed during the 1940s and early 1950s. The movement generated from the desire to train and certify chiropractors to manage personal injury and workers’ compensation low back injuries. In addition to developing interdisciplinary educational programs, the chiropractic orthopedics group was responsible for producing a research agenda, some of the profession’s early orthopedic-focused research, and for starting the National Council on Chiropractic Orthopedics of the National Chiropractic Association, which later became the American Chiropractic Association Council on Orthopedics. These organizations produced thousands of specialists in chiropractic orthopedics, later known as Diplomates of the American Board of Chiropractic Orthopedists. Conclusion: Several orthopedics interest groups were formed and credentialing processes were created to qualify doctors as recognized chiropractic orthopedics specialists. The popularity of this movement resulted in the inclusion of orthopedics into core chiropractic college curricula and
Epstein, Nancy E; Forte Esq, Carol L
A 45 year old male with multiple comorbidities presented to his internist with a 2 week history of right sided neck pain and tenderness, accompanied by tingling in the hand. The internists' neurological examination was normal, except for decreased range of motion of the right arm. He referred the patient to a chiropractor; he performed plain X rays which revealed mild spasm, but never ordered a magnetic resonance imaging study. The chiropractor manipulated the patient's neck on two successive days. By the morning of the third visit, the patient reported extreme pain and difficulty walking. Without performing a new neurological examination or obtaining an MR scan, the chiropractor again manipulated the patient's neck. He immediately became quadriplegic. Despite undergoing an emergency C5 C6 anterior cervical diskectomy/fusion to address a massive disc found on the MR scan (CT was negative), the patient remained quadriplegic (e.g., C4 sensory, C6 motor levels). A major point of negligence in this case was the failure of both the referring internist and chiropractor to order an MR of the cervical spine prior to the chiropractic manipulation. The internist claimed that there was no known report of permanent quadriplegia resulting from neck manipulation in any medical journal, article or book, or in any literature of any kind or on the internet and that the risk of this injury must be vanishingly small given the large numbers of manipulations performed annually. The total amount of the verdict was $14,596,000.00 the internist's liability was 5% ($759,181.65).
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.
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
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…
Pollard, Henry; Hoskins, Wayne; McHardy, Andrew; Bonello, Rod; Garbutt, Peter; Swain, Mike; Dragasevic, George; Pribicevic, Mario; Vitiello, Andrew
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
Johnson, Claire D.; Green, Bart N.; Nelson, Robert C.; Moreau, Bill; Nabhan, Dustin
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
Parkinson, Lynne; Sibbritt, David; Bolton, Philip; van Rotterdam, Joan; Villadsen, Inger
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.
Background In Sweden, chiropractic is not included in mainstream health care. In Norway chiropractic is a recognized health care profession. The aim of this study was to explore the perceptions of chiropractic among Swedish and Norwegian General Practitioners (GPs). Methods Eight hundred surveys in each country were distributed randomly by post to Swedish and Norwegian GPs offices. The survey contained two main sections: Experiences and opinions about chiropractic and referral patterns. The data were then described and compared between the countries. Results In Sweden the response rate was 44.8% and in Norway 45.3%. More than half of the Swedish GPs participating in this study stated that they had poor knowledge about chiropractic, while just a tenth of Norwegian GPs stated the same. Nearly all Norwegian GPs had some experience of chiropractic treatment whilst a fairly large number of the Swedish GPs said that they had no experience at all of chiropractic. It was twice as common for GPs in Norway to refer patients to a chiropractor as compared to Sweden. However, Swedish and Norwegian GPs agreed that chiropractors were competent to treat musculo-skeletal conditions with an adequate education to be part of mainstream medicine. Conclusions Swedish and Norwegian GPs agree that chiropractors are competent to treat musculoskeletal conditions. However, there are many differences in GPs perceptions of chiropractic between the two countries and the overall picture indicates that chiropractic is more accepted and recognised as a health care profession in Norway. PMID:24128386
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
Alcantara, Joel; Cossette, Martine
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.
In this paper the discourse over identity and cultural authority within the profession of chiropractic in the United States has been analyzed using critical discourse analysis. As the profession struggles to construct one singular image, versions of self must be internally debated and also shaped in consideration of larger, external forces. The dilemma of remaining tied to a marginal professional status must be balanced against considerations of integration. Written texts from chiropractic journals and newspapers are analyzed in a multidimensional approach that considers the rhetorical devices and thematic issues of identity construction; the representation of various voices within the discourse (both heard and unheard); and the extent to which external pressures affect the projection of cultural authority for the profession. A heterogeneous discourse characterized by conflict was found, with discrepancies between everyday chiropractors in actual practice versus academic chiropractors and leaders particularly over the idea, practice and significance of science for the profession.
Donahue, J H
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.
Senzon, Simon A.
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
... Dakota resident who consumes chiropractic care. A. Summary of Comment The commenter argues that the... SOUTH DAKOTA (CASD), its owners or members. I am a consumer of chiropractic care and have been for... Antitrust Division United States v. Chiropractic Associates, Ltd. of South Dakota; Public Comment...
The clinical course of low back pain (LBP) during chiropractic treatment has not previously been reported on the basis of a prospective survey. The prospective survey is based on patient questionnaires filled in before treatment was started, as well as 1, 3, 6 and 12 months later. Clinical examination was performed at entry and also 1 month later. Two hundred ninety-eight patients with acute or chronic LBP from ten different chiropractic clinics were selected sequentially for this study. At the time of first contact between these patients and the clinics, the current episode of LBP had lasted less than 1 wk in 30% of the patients and for more than 4 wk in 51%. Sixty-five percent had radiating pain into the lower extremity, and 38% were unable to work. Fifty-three percent of the patients had consulted a medical doctor or had received other types of treatment due to the current episode. Nineteen percent were referred by a medical doctor to the chiropractor. After each period of registration, approximately 75% of the patients reported being free of symptoms or feeling much better. The present study was designed to be compared to a similar investigation carried out in a general medical practice. A clear indication of a more favorable outcome was found in those patients receiving chiropractic treatment when compared to those receiving medical treatment, especially concerning such factors as ability to work, bedrest and use of medication. Only a randomized controlled clinical trial is suited for a direct comparison of the effect and cost of chiropractic and medical treatment of LBP.
Keating, Joseph C
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
Gleberzon, Brian J.
In a previous article, the author discussed current trends in utilization rates of chiropractic “Name Techniques” in Canada, and provided recommendations for their inclusion into the curriculum at the Canadian Memorial Chiropractic College. In this article, a review of the literature on “Name Techniques” was conducted, with interpretation and synthesis by the author. One hundred and eleven articles were found. These were: technique discussions (N = 39), case studies (N = 25), case series (N = 5), experimental studies (N = 25) and clinical trials (N = 17). The literature suggested that prone leg length testing and some x-ray mensurations may have acceptable inter and intra-rater reliability. In addition, there are several case studies that reported significant clinical benefits by patients receiving Activator, Alexander, and Upper Cervical treatments. Patients also reported improvements in quality of life while under either Upper Cervical or Network Spinal Analysis care. This information may help develop professional practice guidelines, and it may have implications for chiropractic research and education. Imagesp99-a
Goertz, Christine; Lyons, Stacie Salsbury; Andresen, Andrew; Hondras, Maria; Jones, Mark; Killinger, Lisa Zaynab; Long, Cynthia; Lyons, Kevin; Mulhausen, Paul; Vining, Robert
Integrative medicine (IM) is a subset of interprofessional health care that seeks to join the knowledge and practices of various allopathic and complementary and alternative medicine disciplines in an attempt to offer cost-effective and clinically significant healthcare options for persons with acute or chronic illnesses. Although touted as a means for improving health outcomes and patient satisfaction while possibly lowering costs, further scientific evidence regarding the utility of IM approaches to health services delivery is needed. Collaborative Care for Older Adults (COCOA) is a chiropractic demonstration project that brings together an interdisciplinary team of researchers and clinicians from the Palmer Center for Chiropractic Research, Genesis Quad Cities Family Practice Residency, The University of Iowa, and Thomas Jefferson University to study the impact of a model of interprofessional education on geriatric health care. The Health Resources and Services Administration funded COCOA in 2009 to further develop and assess a patient-centered care model for the treatment of low back pain in older adults that uses a team-based approach between medical doctors and doctors of chiropractic.
Rodine, Robert J; Aker, Peter
The following case describes a 68 year-old woman with a 7½ year history of worsening head and neck pain diagnosed as trigeminal neuralgia following surgical resection of a brain tumor. After years of unsuccessful management with medication and physical therapies, a therapeutic trial of chiropractic was carried out. Chiropractic care included ultrasound, manual therapies (manipulation and mobilization), soft tissue therapies, and home stretching exercises. After an initial treatment period followed by 18 months of supportive care the patient reported satisfactory improvement. It became evident that there were at least three sources of her symptoms: mechanical and/or degenerative neck pain, temporomandibular joint syndrome, and trigeminal neuralgia. While never completely pain-free, the patient continued to report that her pains reduced to minimal at times. At the most recent follow-up, the pain had not returned to pre-treatment intractable levels. This case study demonstrates the importance of diagnosing and treating multiple sources of pain and the positive role chiropractic care can have in the management of patients with these clinical conditions. The potential for convergence of sensory input from the upper three cervical segments and the trigeminal nerve via the trigeminocervical nucleus is discussed. PMID:20808617
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
Maler, Marilyn M
The scope of this article will be an introduction to veterinary chiropractic and its use in treating pediatric exotic patients. After discussing the general principles of human and veterinary chiropractic, the special considerations of adjusting exotic pediatric patients will be explored.
Bowden, Briana S.; Ball, Lisa
Objective: The purpose of this study was to assess nurse practitioner (NP) and physician assistant (PA) students' views of chiropractic. As the role of these providers progresses in primary care settings, providers' views and knowledge of chiropractic will impact interprofessional collaboration and patient outcomes. Understanding how NP and PA students perceive chiropractic may be beneficial in building integrative health care systems. Methods: This descriptive quantitative pilot study utilized a 56-item survey to examine attitudes, knowledge, and perspectives of NP and PA students in their 2nd year of graduate studies. Frequencies and binomial and multinomial logistic regression models were used to examine responses to survey totals. Results: Ninety-two (97%) students completed the survey. There were conflicting results as to whether participants viewed chiropractic as mainstream or alternative. The majority of participants indicated lack of awareness regarding current scientific evidence for chiropractic and indicated a positive interest in learning more about the profession. Students who reported prior experience with chiropractic had higher attitude-positive responses compared to those without experience. Participants were found to have substantial knowledge deficits in relation to chiropractic treatments and scope of practice. Conclusion: The results of this study emphasize the need for increased integrative initiatives and chiropractic exposure in NP and PA education to enhance future interprofessional collaboration in health care. PMID:26771903
Seaman, David R.; Soltys, Jonathan R.
Objective The purpose of this commentary is to discuss potential 5 factors within straight chiropractic philosophy and practice that may prevent Medicare compliance. Discussion The national Medicare Benefit Policy Manual and the Florida Local Coverage Determination were reviewed to identify documentation and conceptual issues regarding chiropractic practice. Five Medicare positions were contrasted with tenets of straight chiropractic philosophy. Based on Medicare’s documentation requirements, Medicare defines subluxation and chiropractic practice from the perspective of treating spinal pain and related functional disability. In contrast, traditional straight chiropractic philosophy is not based on the treatment of spinal pain and disability or other symptomatic presentations. In this context, 5 potential areas of conflict are discussed. Conclusion The Medicare version of chiropractic practice is not consistent with traditional straight chiropractic philosophy, which may play a role in preventing Medicare compliance. The chiropractic profession may need to consider the fashion in which “philosophy” as it relates to technique and practice is presented to students and doctors to facilitate compliance with the documentation requirements of Medicare. PMID:25067928
Davis, Matthew A.; Yakusheva, Olga; Gottlieb, Daniel J.; Bynum, Julie P.W.
Background Whether availability of chiropractic care affects use of primary care physician (PCP) services is unknown. Methods We performed a cross-sectional study of 17.7 million older adults who were enrolled in Medicare from 2010 to 2011. We examined the relationship between regional supply of chiropractic care and PCP services using Spearman correlation. Generalized linear models were used to examine the association between regional supply of chiropractic care and number of annual visits to PCPs for back and/or neck pain. Results We found a positive association between regional supply of chiropractic care and PCP services (rs = 0.52; P <.001). An inverse association between supply of chiropractic care and the number of annual visits to PCPs for back and/or neck pain was apparent. The number of PCP visits for back and/or neck pain was 8% lower (rate ratio, 0.92; 95% confidence interval, 0.91–0.92) in the quintile with the highest supply of chiropractic care compared to the lowest quintile. We estimate chiropractic care is associated with a reduction of 0.37 million visits to PCPs nationally, at a cost of $83.5 million. Conclusions Greater availability of chiropractic care in some areas may be offsetting PCP services for back and/or neck pain among older adults. (J Am Board Fam Med 2015;28:000–000.) PMID:26152439
Parkinson, Jodi; Lau, Jennifer; Kalirah, Sandeep; Gleberzon, Brian J.
Objective: The objective of this study was to determine the attitudes of clinical faculty during the 2009–2010 academic year at the Canadian Memorial Chiropractic College towards the treatment of various non-musculoskeletal disorders. Methods: A confidential survey was distributed to the clinical faculty via email. It consisted of several questions polling the demographic of the respondent such as years in clinical practice, and a list of 29 non-musculoskeletal conditions. Clinicians were asked to indicate their opinions on each condition on rating scale ranging from strongly agree to strongly disagree. Results: Twenty of 22 clinicians responded. The conditions garnering the greatest positive ratings include: asthma, constipation, chronic pelvic pain, dysmenorrhea, infantile colic, and vertigo. The options regarding vertigo and asthma, while demonstrating an overall positive attitude towards the benefits of chiropractic care, were stratified amongst clinicians with varying years in clinical practice. Conclusion: This study suggests clinicians at this college are moderately open towards the chiropractic treatment of some non-musculoskeletal disorders. PMID:21629463
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
De Finney, John; Lawson, Gordon; Gryfe, David; Gillis-Lawson, Susan; Crawford, John P.
In 1978 the Canadian Chiropractic Association recognized the need to establish an organization that would prepare chiropractors to treat athletic injuries and promote these services to sports organizations. Dr. Adrian Grice approached three chiropractors to establish such an organization. The Canadian Chiropractic Sports Academy (CCSA) was established in 1978. This was the start of the chiropractic sports movement which has seen chiropractors playing prominent roles as team doctors to professional and amateur teams and athletes and in the delivery of care at major national and international competitions. This paper will show the work done by the original founders of the CCSA which has helped to pave the way to the present level of acceptance of chiropractic sports injury management and performance enhancement and as the progenitor of the Royal College of Chiropractic Sports Sciences Canada. PMID:28065996
De Finney, John; Lawson, Gordon; Gryfe, David; Gillis-Lawson, Susan; Crawford, John P
In 1978 the Canadian Chiropractic Association recognized the need to establish an organization that would prepare chiropractors to treat athletic injuries and promote these services to sports organizations. Dr. Adrian Grice approached three chiropractors to establish such an organization. The Canadian Chiropractic Sports Academy (CCSA) was established in 1978. This was the start of the chiropractic sports movement which has seen chiropractors playing prominent roles as team doctors to professional and amateur teams and athletes and in the delivery of care at major national and international competitions. This paper will show the work done by the original founders of the CCSA which has helped to pave the way to the present level of acceptance of chiropractic sports injury management and performance enhancement and as the progenitor of the Royal College of Chiropractic Sports Sciences Canada.
Boysen, James C.; Salsbury, Stacie A.; Derby, Dustin; Lawrence, Dana J.
Objective: One objective of chiropractic education is to cultivate clinical confidence in novice practitioners. The purpose of this qualitative study was to describe how participation in a short-term international service learning experience changed perceptions of clinical confidence in senior chiropractic students. Methods: Seventeen senior chiropractic students participated in 4 moderated focus group sessions within 4 months after a clinical educational opportunity held in international settings. Participants answered standard questions on how this educational experience may have changed their clinical confidence. Two investigators performed qualitative thematic analysis of the verbatim transcripts to identify core concepts and supporting themes. Results: The core concept was transformation from an unsure student to a confident doctor. The service learning experience allowed students to deliver chiropractic treatment to patients in a real-world setting, engage in frequent repetitions of technical skills, perform clinical decision-making and care coordination, and communicate with patients and other health professionals. Students described increased clinical confidence in 9 competency areas organized within 3 domains: (1) chiropractic competencies including observation, palpation, and manipulation; (2) clinical competencies including problem solving, clinic flow, and decision-making; and (3) communication competencies, including patient communication, interprofessional communication, and doctor–patient relationship. Students recommended that future service learning programs include debriefing sessions similar to the experience offered by these focus groups to enhance student learning. Conclusion: Senior chiropractic students who participated in an international service learning program gained confidence and valuable practical experience in integrating their chiropractic, clinical, and communication skills for their future practices. PMID:27258817
Kazemi, Mohsen; Pichini, Alessandro; Scappaticci, Steven; Savic, Mitchell
Objectives: To investigate the degree of knowledge chiropractic fourth year interns and post-graduate chiropractic residents have in regard to concussion diagnosis and management. Methods: A survey modified from a study conducted by Boggild and Tator (2012), was administered to fourth year chiropractic interns and post-graduate residents via SurveyMonkey.com. Results: Chiropractic fourth year interns and postgraduate chiropractic specialty college residents scored 5.2 and 5.25 out of 9 respectively, which compares well with Bogglid and Tator’s reports on medical students and residents. Several knowledge gaps were identified in the sample population. Conclusion: The results from this survey show that the concussion knowledge among Canadian fourth year chiropractic interns and specialty college residents compares favorably with the knowledge of fourth year medical students and residents in diagnosing and managing concussions. Chiropractors appear to possess the skills and knowledge to diagnose and manage concussion equal to their medical counterparts. However, knowledge gaps regarding concussion diagnosis and management were found among chiropractic students and residents. PMID:28065987
Tardive dyskinesia (TD) is an umbrella term typically used to describe a movement disorder associated with the use of neuroleptic (anti-psychotic) medication. It is characterized by abnormal, repetitive and involuntary movements. The movements may be around the mouth and face (orofacial dyskinesia) and less frequently, in the trunk and limbs (trunk and limb dyskinesia). TD occurs in over 20% of those using neuroleptic medication continually for longer than three months. A case report is presented of a patient affected by TD who suffered mechanical musculoskeletal pain secondary to its effects, and was managed by chiropractic care. PMID:17549198
Green, Bart N; Johnson, Claire
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.
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.
Livdans-Forret, Anna B.; Harvey, Phyllis J.; Larkin-Thier, Susan M.
Introduction To make chiropractors more aware of menorrhagia and how they can serve a role in their patient’s care and education since women make up 60% of the population seeking chiropractic care. Method A review of the biomedical literature on menorrhagia was conducted. Items that were retrieved were synthesized and interpreted in order to give the best information to practicing chiropractors. Discussion Most of the information available relative to menorrhagia is medically oriented. Other treatment options can include: chiropractic, various types of herbs, and nutritional supplements. Conclusion Knowledge of medical treatment, nutritional supplements, along with chiropractic treatment options may be beneficial to doctors in their practice. PMID:18060009
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
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?
Crosley, Angela M.; Rose, James R. La
Objective Blood pressure measurement is a basic clinical procedure. However, studies have shown that many errors are made when health care providers acquire blood pressure readings. Our study assessed knowledge of blood pressure measurement procedures in chiropractic students. Methods This was an observational, descriptive study. A questionnaire based on one created by the American Heart Association was given to 1st, 2nd, 3rd, and final year students (n = 186). A one way ANOVA was used to analyze the data. Results Of the students 80% were confident that their knowledge of this clinical skill was adequate or better. However, the overall score on the knowledge test of blood pressure–taking skills was 52% (range, 24%–88%). The only significant difference in the mean scores was between the 1st and 2nd year students compared to the 3rd and 4th year students (p < .005). Of the 16 questions given, the following mean scores were: 1st year 10.45, 2nd year 9.75, 3rd year 7.93, and 4th year 8.33. Of the 16 areas tested, 10 were of major concern (test item score <70%), showing the need for frequent retraining of chiropractic students. Conclusion Consistent with studies in other health care disciplines, our research found the knowledge of blood pressure skills to be deficient in our sample. There is a need for subsequent training in our teaching program. PMID:23957320
Sherrier, William; Brennan, Teresa; Rabatsky, Ali
Objective: The purpose of this study was to measure chiropractic student attitudes toward team-based learning (TBL) to determine if they are similar to those of medical students and to help clarify existing evidence regarding student perceptions of TBL. Method: Two consecutive cohorts of chiropractic students enrolled in a course that used weekly TBL activities completed an adaptation of the value of teams survey at the end of the term. Chi square analysis was used to assess for differences in scores between the beginning and end of the term. Results: The students did value the TBL process (χ2 = 75.21, p < .001). Students had a neutral opinion regarding TBL at the start of the term (χ2 = 30.41, p < .001), but their opinion of TBL improved by the end of the term (χ2 = 51.66, p < .001). Conclusion: These results were similar to those found in medical education studies. Students tended to value TBL, but they were more receptive to it over time. PMID:27439766
Sutherland, Donald C
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
Kopansky-Giles, Deborah; Papadopoulos, Costa
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
Pavia, Steven; Fischer, Rebecca; Roy, Richard
Objective The purpose of this study is to describe chiropractic treatment of 14 patients who presented with signs and symptoms of temporomandibular joint dysfunction (TMD). Methods This is a retrospective case series of 14 patients, including 13 adults and 1 child. The majority of these patients were undergoing chiropractic care for spine-related conditions when they presented with additional TMD signs and symptoms. They were evaluated and treated with Activator Methods International published protocols relative to the temporomandibular joint before the addition of treatment to the suprahyoid muscles. Results All pre- and postadjustment assessments were recorded using a numeric pain scale. The resulting average showed a reduction in the patients’ pain scores from the initial visit of 8.3 ± 1.6 to the last visit at 1.4 ± 1.1 with an 80.9% ± 15.4% improvement. The average number of visits was 13.6 ± 8.2. Conclusion All patients selected for this case series showed a reduction of temporomandibular dysfunction symptoms. PMID:26793040
Young, Kenneth J.; Siordia, Lawrence
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
Crawford, John P; Gotlib, Allan C; Injeyan, H Stephen
Current provincial legislation in various jurisdictions across Canada, serves to impede the utilization of the diagnostic laboratory by doctors of chiropractic. Chiropractic students both in Canada and the United States, are required to successfully complete an intensive course of study in the area of laboratory diagnosis, as a necessary aspect of the undergraduate educational curriculum. Unfortunately, Canadian graduate doctors of chiropractic and their patients, are not currently afforded the privilege of direct referral to a community diagnostic laboratory. Rather, chiropractors must enlist the assistance of other health care providers, namely medical doctors, to acquire various laboratory testing procedures. The premise of this paper is intended to demonstrate the necessity of revising such laws, in order to address the needs of those health care consumers who seek the services of the rapidly growing profession of chiropractic. Two clinical cases are presented as illustrative examples.
Blum, Charles L.
Abstract Asthma is a multifactorial dysfunction of the respiratory system. Nutritional, environmental, genetic, and emotional factors all play animportant part in the etiology of this condition. One form of chiropractic, Sacro Occipital Technique (SOT), offers some conservative alternatives to the treatment of asthma. SOT expands the chiropractic armamentarium of techniques available, allowing methods putatively affecting the viscera, vertebra, post and preganglionic reflexes, as well as cranial and sacral influences on the primary respiratory mechanism. Though more research is needed to evaluate the efficacy of chiropractic care of asthma, the conservative nature of chiropractic care with its minimal side effects, warrants patient and a health practitioner's consideration prior to embarking on any course of treatment that might have serious side effects. PMID:19674555
Lorence, Julie; Lawrence, Dana J.; Salsbury, Stacie A.; Goertz, Christine M.
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
Blum, Charles L
Asthma is a multifactorial dysfunction of the respiratory system. Nutritional, environmental, genetic, and emotional factors all play animportant part in the etiology of this condition. One form of chiropractic, Sacro Occipital Technique (SOT), offers some conservative alternatives to the treatment of asthma. SOT expands the chiropractic armamentarium of techniques available, allowing methods putatively affecting the viscera, vertebra, post and preganglionic reflexes, as well as cranial and sacral influences on the primary respiratory mechanism. Though more research is needed to evaluate the efficacy of chiropractic care of asthma, the conservative nature of chiropractic care with its minimal side effects, warrants patient and a health practitioner's consideration prior to embarking on any course of treatment that might have serious side effects.
Keatin, J C
Today's National Chiropractic Mutual Insurance Company (NCMIC) evolved from the legal protective services offered initially by the Universal Chiropractors' Association, and subsequently, by the National Chiropractic Association (NCA). At first these services focused on the criminal defence of chiropractors charged with unlicensed practice. However, as an increasing number of jurisdictions enacted chiropractic statutes, the NCA's legal program became ever more involved in civil litigation: suits for malpractice and negligence. Steering the NCA throughout its tumultuous voyage was its longtime secretary-treasurer, Loran M. Rogers, D.C. When the NCA spun off its legal services division in 1946, forming the National Chiropractic Insurance Company (predecessor of the NCMIC), Rogers continued his work as executive secretary-treasurer of the malpractice insurer.
Miners, Andrew L
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.
Miners, Andrew L.
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
Lystad, Reidar P; Pollard, Henry
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
Green, Bart N; Johnson, Claire D; Daniels, Clinton J; Napuli, Jason G; Gliedt, Jordan A; Paris, David J
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.
Cashley, Mark A.P.; Cashley, Marie A.
Objective The purpose of this case series is to describe findings for patients with bladder pain syndrome (BPS) or interstitial cystitis (IC) who responded positively under chiropractic care. Clinical Features Eight cases were selected retrospectively reviewed from 2 independent chiropractic clinics in Scotland. Cases were selected if patients reported bladder dysfunction problems and responded positively to chiropractic care. The cases in this report describe the range of patients affected by this condition. Each patient was treated using chiropractic methods that were specific to the individual case. Intervention and Outcomes The patients selected for this case series showed positive response to chiropractic care over various lengths of time and numbers of treatments. Some of the chiropractic patients who had chronic spinal conditions had reoccurrence of bladder symptoms during an exacerbation of mechanical spinal problems. Conclusion This case series highlights that bladder and urinary problems may be associated with spinal dysfunction for some patients. PMID:23843758
Meeker, William C.; Watkins, R.W.; Kranz, Karl C.; Munsterman, Scott D.; Johnson, Claire
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
Wilson, Paria Majd; Greiner, Mary V; Duma, Elena M
We report on a 21-day-old infant with healing posterior rib fractures that were noted after a chiropractic visit for colic. Chiropractors are the third largest group of health care professionals in the United States, and colic is the leading complaint for pediatric chiropractic care. Rib fractures, specifically when posterior, are traditionally considered to be secondary to nonaccidental trauma. Thorough investigation is necessary to rule out bone fragility and genetic disorders, but patient history is key when evaluating unexplained fractures.
A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE) immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author's knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature.
A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE) immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature. PMID:23254252
Wong, Jessica J; Di Loreto, Luciano; Kara, Alim; Yu, Kavan; Mattia, Alicia; Soave, David; Weyman, Karen; Kopansky-Giles, Deborah
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.
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
Gleberzon, Brian J.
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.
Salehi, Alireza; Hashemi, Neda; Imanieh, Mohammad Hadi; Saber, Mahboobeh
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
Kinsinger, F. Stuart; Sutton, Wendy
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
Senzon, Simon A.
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
Tarola, Gary; Phillips, Reed B.
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
Kenya, Amilliah W.; Hart, John F.; Vuyiya, Charles K.
Objective: This study compared National Board of Chiropractic Examiners part I test scores between students who did and did not serve as tutors on the subject matter. Methods: Students who had a prior grade point average of 3.45 or above on a 4.0 scale just before taking part I of the board exams were eligible to participate. A 2-sample t-test was used to ascertain the difference in the mean scores on part I between the tutor group (n = 28) and nontutor (n = 29) group. Results: Scores were higher in all subjects for the tutor group compared to the nontutor group and the differences were statistically significant (p < .01) with large effect sizes. Conclusion: The tutors in this study performed better on part I of the board examination compared to nontutors, suggesting that tutoring results in an academic benefit for tutors themselves. PMID:26998665
Istvan, Joseph; Haas, Mitchell
Introduction: There is a sizeable and growing body of empirical literature on the effects of physician advice to quit smoking. Because of the association between tobacco use and the health problems that may provoke referral to chiropractic care, doctors of chiropractic (DCs) may be able to give patients personalized proximal health feedback that may motivate them to quit. However, DCs have not been utilized in this role. The primary aim of this study was to design and refine a brief office-based tobacco intervention for use within chiropractic settings. Methods: This study was conducted in 20 private chiropractic practices in 2 phases: (a) intervention development, in which we created and focus tested practitioner and patient materials, and (b) feasibility, in which we evaluated the impact of the intervention on 210 tobacco-using chiropractic patients. Results: Analyses were conducted on 156 patients who exclusively smoked cigarettes. Using an intent-to-treat approach, assuming all nonresponders to be smokers, 13 (8.3%) reported 7-day abstinence at 6 weeks, 22 (14.1%) at the 6-month follow-up, and 35 (22.4%) at the 12-month assessment. Eleven participants (7.1%) reported prolonged abstinence at the 6-month follow-up, and 15 (9.6%) reported prolonged abstinence at 12 months. Conclusions: To our knowledge, this is the first study to refine a brief office-based treatment for tobacco dependence for use in chiropractic settings. The results of this study were promising and will lead to a randomized clinical trial. If found to be effective, this model could be disseminated to chiropractic practitioners throughout the United States. PMID:20097840
de Luca, Katie; Tuchin, Peter; Bonello, Rod
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
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
Whillier, Stephney; Lystad, Reidar P.; Abi-Arrage, David; McPhie, Christopher; Johnston, Samara; Williams, Christopher; Rice, Mark
Objective The aims of our study were to measure the learning style preferences of chiropractic students and to assess whether they differ across the 5 years of chiropractic study. Methods A total of 407 (41.4% females) full-degree, undergraduate, and postgraduate students enrolled in an Australian chiropractic program agreed to participate in a cross-sectional survey comprised of basic demographic information and the Visual, Aural, Read/Write, Kinesthetic (VARK) questionnaire, which identifies learning preferences on four different subscales: visual, aural, reading/writing, and kinesthetic. Multivariate analysis of variance and the χ2 test were used to check for differences in continuous (VARK scores) and categorical (VARK category preference) outcome variables. Results The majority of chiropractic students (56.0%) were found to be multimodal learners. Compared to the other learning styles preferences, kinesthetic learning was preferred by a significantly greater proportion of students (65.4%, p < .001) and received a significantly greater mean VARK score (5.66 ± 2.47, p < .001). Conclusions To the best of our knowledge, this is the first time chiropractic students have been shown to be largely multimodal learners with a preference for kinesthetic learning. While this knowledge may be beneficial in the structuring of future curricula, more thorough research must be conducted to show any beneficial relationship between learning style preferences and teaching methods. PMID:24350945
Cohen, Fred L.
Background Despite widespread utilization of chiropractic treatment for various ailments, there is a paucity of documentation regarding intracerebral hemorrhage related to chiropractic trauma. Stroke has been reported from cervical manipulation, although with a suggested low incidence. Activator treatment, an instrument that produces a high-velocity, low-amplitude impact to the spine, is considered especially safe. There are no prior reports of intracerebral hemorrhage resulting from a chiropractic activator treatment. Case Description A 75-year-old woman was admitted to the hospital with a history of headaches, visual difficulties on the right, and speech disturbance of relatively acute onset. CT scan showed a brain hemorrhage in an unusual location. Extensive evaluation was undertaken because this was thought to be a spontaneous event. No cause was found on imaging. Subsequent history revealed a chiropractic activator treatment applied directly to the junction of the back of her head and the upper cervical spine immediately prior to the onset of symptoms. Her clinical course is described. Conclusions This appears to be the first report linking traumatic intracerebral hemorrhage with a chiropractic activator treatment. The use of this modality in an elderly population, with widespread utilization of anticoagulants and platelet inhibitors, is of potential concern. PMID:27999766
Gleberzon, Brian J.
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
Byun, Sunghak; Han, Dongwook
[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.
Hecimovich, Mark D.; Volet, Simone E.
Purpose: One important objective of chiropractic education is to foster student professional confidence and competence in patient communication and clinical skills. Therefore, the aim of this article is to review the extant literature on this topic, stressing the significance of building students' confidence for effective practice and the need for more research in this area. Methods: The authors reviewed MEDLINE and ERIC from 1980 through 2008 using several key words pertinent to confidence and health care. Three distinct, but interrelated, bodies of literature were assessed, including professional confidence in health care research, the nature and development of confidence in educational psychology research, and fostering professional confidence in chiropractic education. Results: It was apparent through the review that chiropractic education has developed educational methods and opportunities that may help develop and build student confidence in patient communication and clinical skills. However, there has not been sufficient research to provide empirical evidence of the impact. Conclusion: Fostering chiropractic students' development of confidence in what they say and do is of paramount importance not only to them as new practitioners but more importantly to the patient. There is no doubt that a better understanding of how confidence can be developed and consolidated during tertiary study should be a major goal of chiropractic education PMID:19826543
Byun, Sunghak; Han, Dongwook
[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
Montgomery, Michele; Huang, Sujuan; Cox, Cheryl L.; Leisenring, Wendy M.; Oeffinger, Kevin C.; Hudson, Melissa M.; Ginsberg, Jill; Armstrong, Gregory T.; Robison, Leslie L.; Ness, Kirsten K.
Introduction The use of rehabilitation services to address musculoskeletal, neurological and cardiovascular late effects among childhood cancer survivors could improve physical function and health-related quality-of-life (HRQL). We describe physical therapy (PT) and chiropractic utilization among childhood cancer survivors and their association with HRQL. Methods The sample included 5+ year survivors from the Childhood Cancer Survivor Study (N=9,289). Questions addressing use of PT or chiropractic services and HRQL (Medical Outcomes Survey Short Form (SF-36)) were evaluated. Multivariable regression models compared PT and/or chiropractic utilization between survivors and siblings, and by diagnosis, treatment and demographic characteristics; associations between chronic disease, PT/chiropractic use, and HRQL were similarly evaluated. Results Survivors were not more likely to use PT (OR 1.0; 95% CI 0.8-1.2) or chiropractic (OR 0.8; 95% CI 0.7-1.0) services than siblings. More survivors reported using chiropractic (12.4%) than PT (9.2%) services. Older age and having health insurance were associated with utilization of either PT or chiropractic services. Grade 3-4 chronic conditions and a CNS tumor or sarcoma history were associated with PT but not with chiropractic service utilization. Survivors with musculoskeletal (OR 1.8; 95% CI 1.1-2.9), neurological (OR 3.4; 95% CI 1.6-6.9), or cardiovascular (OR 3.3; 95% CI 1.6-6.9) chronic conditions who used PT/chiropractic services were more likely to report poor physical health than survivors who did not use services. Conclusions The reported prevalence of PT/chiropractic among survivors is consistent with that reported by siblings. Severity of late effects is associated with service use and with reporting poor physical health. Implications for Cancer Survivors Long-term childhood cancer survivors do not appear to utilize rehabilitation services to optimize physical function and support increased HRQL. PMID:20922492
Burnout is a psychological syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment that has been found to exist in a significant number of healthcare and helping professionals. It imposes a significant societal burden by shortened practitioner lifespan, decreased efficiency, negative health outcomes and poorer levels of patient care. Theoretical models suggest that it appears to be the result of a complex interaction between job resources and job demands. It may be reasonable to conclude that Chiropractic professionals experience similar vocational demands and thus experience significant levels of occupational stress and subsequent burnout. However the data on burnout within the chiropractic profession is limited. It is possible that this results in significant negative outcomes on chiropractors and their patients. Therefore, the objective of this paper is to demonstrate the need to explore burnout in chiropractic practice and offer a research protocol for a potential study. PMID:22369737
Angus, Katherine; Asgharifar, Sepideh; Gleberzon, Brian
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
Wates, Rebecca J.; Woodruff, Ike; Pfefer, Mark T.
Introduction: Patient-reported outcome measures are frequently used to monitor patient progress during chiropractic care, yet student interns utilizing such assessments are unfamiliar with what magnitude of change (MCID) is considered beneficial to the patient. Objective: This work seeks to determine chiropractic intern knowledge of MCID. Methods: A five-item survey was administered to 104 chiropractic student interns. Results: Nearly one-third of the interns correctly defined the MCID acronym, and approximately one-third of the interns knew at least one MCID value for the outcome assessments in the EHR. Surprisingly, 20% of the interns reported knowledge of at least one MCID value, but answered incorrectly pertaining to the MCID acronym. Conclusion: Student interns value patient perception, but have limited knowledge of MCID values. Addressing this gap will improve their understanding of patient progress and inform their treatment decisions both in the outpatient clinic and in their practices following graduation. PMID:27713580
Sørensen, Jan; Vach, Werner; Christensen, Henrik Wulff; Høilund-Carlsen, Poul Flemming; Hartvigsen, Jan
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
Macanuel, Kim; Deconinck, Amy; Sloma, Katie; LeDoux, Monique; Gleberzon, Brian J
Introduction The purpose of this study was to characterize the type, nature and frequency of injuries sustained by chiropractic students during their undergraduate training. Methods Chiropractic students in their second, third and fourth year of study at a chiropractic college were asked to complete a questionnaire that chronicled and described the occurrence of any side effects they may have sustained at the hands of their peers during technique class. Students were also asked to record their anthropomorphic characteristic. Results Of 450 questionnaires distributed, 292 were completed and returned to the authors. Of the 292 respondents, 127 reported to have experienced an injury, although the total number of injuries was 161. The most common site of injury was the lumbopelvic region. Students reported that it was during their second year of study that they experienced the highest number of injuries. Symptoms occurred the same day as the event in 85% of cases. The most common characteristic of symptoms reported was pain, followed by local stiffness, headache, dizziness, fatigue, diffuse stiffness and cramps. Two thirds of students described the extent of their injuries from ‘light’ to ‘a fair bit’. Three quarters of injuries resolved within the first 72 hours of the event. No treatment was sought by 89 (55%) of the respondents. More than half of students reported that their activities of daily living were either ‘not’ or ‘somewhat’ affected. There were three reports of long-term complaints. No statistically significant differences were found between the group of students reporting to be injured compared to those students not injured with respect to their age, gender, weight or height. Conclusion Chiropractic students experience side effects during their undergraduate training that are very similar to those experienced by patients under clinical care. PMID:17549151
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…
Scaringe, John G.
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…
Morningstar, Mark W.
Objectives The purpose of this study was to retrospectively report the results of patients who completed an exercise-based chiropractic program and its potential to alter the natural progression of adult scoliosis at 24 months after the clinic portion of treatment was concluded. Methods A retrospective chart review was conducted at 2 spine clinics in Michigan, USA. Each clinic uses the same chiropractic rehabilitation program to treat patients with adult scoliosis. Multidimensional patient outcomes included radiographic, respiratory, disability, and pain parameters. Outcomes were measured at baseline, at end of active treatment, and at long-term follow-up. Results A total of 28 patients fit the inclusion criteria for the study. The average beginning primary Cobb angle was 44° ± 6°. Patients received the same chiropractic rehabilitation program for approximately 6 months. At the end of active treatment, improvements were recorded in Cobb angle, pain scores, spirometry, and disability rating. All radiographic findings were maintained at 24-month follow-up. Conclusion This report is among the first to demonstrate sustained radiographic, self-rated, and physiologic benefits after treatment ceased. After completion of a multimodal chiropractic rehabilitation treatment, a retrospective cohort of 28 adult scoliosis patients reported improvements in pain, Cobb angle, and disability immediately following the conclusion of treatment and 24 months later. PMID:22014907
Cooperstein, Robert; Lisi, Anthony; Burd, Andrew
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
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…
Sheppard, Lorraine A.; Jorgensen, Anna Maria S.; Crowe, Michael J.
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…
Duray, Stephen M.; Mekow, Craig L.
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…
Meyer, Amanda J.; Stomski, Norman J.; Innes, Stanley I.; Armson, Anthony J.
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…
Hurwitz, E L; Coulter, I D; Adams, A H; Genovese, B J; Shekelle, P G
OBJECTIVES: The purpose of this paper is to describe the demographic and clinical characteristics of chiropractic patients and to document chiropractic visit rates in 6 sites in the United States and Canada. METHODS: Random samples of chiropractors from 5 US sites and 1 Canadian site were selected. A record abstraction system was developed to obtain demographic and clinical data from office charts. RESULTS: Of the 185 eligible chiropractors sampled, 131 (71%) participated. Sixty-eight percent of the selected charts showed that care was sought for low back pain, while 32% recorded care for other reasons. Spinal manipulative therapy was recorded in 83% of all charts. There was a greater than 2-fold difference in the median number of visits related to low back pain per episode of care across sites. The chiropractic visit rates in the US sites and Ontario are estimated to be 101.2 and 140.9 visits per 100 person-years, respectively. CONCLUSIONS: The chiropractic use rate in these sites is twice that of estimates made 15 years ago. The great majority of patients receive care for musculoskeletal conditions of the back and neck. The number of visits per episode varies appreciably by site. PMID:9585743
Wilson, David; Steel, Timothy; Sutton, Ian
We describe a woman with intracranial hypotension provoked by a combination of calcified disc protrusion and chiropractic manipulation who required surgical intervention for definitive treatment. Intracranial hypotension is a rare but increasingly well recognized cause of orthostatic headache that arises due to spinal cerebrospinal fluid leakage from meningeal diverticula or dural perforations.
Russell, David G.; Kimura, Melissa N.; Cowie, Harriet R.; de Groot, Caroline M.M.; McMinn, Elise A.P.; Sherson, Matthew W.
Objective The purpose of this case series is to report on symptomatic and quality of life (QoL) changes in 7 older adult chiropractic patients who were receiving care using Activator Methods Chiropractic Technique (AMCT). Clinical Features Seven patients were selected from 2 chiropractic offices in Auckland, New Zealand. Patients were included if they were older adults receiving AMCT care and for whom at least 2 QoL assessments had been performed. The patients, aged 69-80 years, primarily received care for a variety of musculoskeletal complaints. Intervention and Outcomes The patients reported improvements in their presenting complaints as well as a number of nonmusculoskeletal symptoms. Each patient demonstrated clinical improvements in their RAND 36-Item Short Form Health Survey (SF-36) results. The average improvement in QoL measured using a SF-36 questionnaire was 8.0 points in the physical component and 4.1 points in the mental component. Four cases had a second progress evaluation using the SF-36 and showed an overall improvement of 5.2 in the physical and 9.8 in the mental components from baseline. Conclusion This case series describes an improvement in QoL, as measured by the SF-36 instrument, as well as subjectively reported improvements in both musculoskeletal and nonmusculoskeletal symptoms in 7 older adults receiving chiropractic care. PMID:27069434
Keating, Joseph C
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
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
Stevens, Gerald; Campeanu, Michael; Sorrento, Andrew T.; Ryu, Jiwoon; Burke, Jeanmarie
Objective The purpose of this study was to describe the demographics, presenting complaints, and health history of new patients seeking treatment at a free chiropractic clinic within a university health center. Methods A retrospective analysis of patient files from 2008 to 2009 was performed for a free student chiropractic clinic in the Buffalo, NY, area. Demographics, presenting complaints, and health history of new patients seeking treatment were recorded. Results There were 343 new chiropractic patient files. Most patients were between the ages of 18 and 30 years (n = 304, 88%) with an almost equal distribution of men (n = 163, 48%) and women (n = 180, 52%). The patients were mostly single (n = 300, 87%). Patients self-reported that their case histories excluded a current medical diagnosis (n = 261, 76%), previous history of disease (n = 216, 63%), allergies (n = 240, 70%), previous surgical procedures (n = 279, 81%), and medication use (n = 250, 73%). The frequencies of spinal complaints were as follows: lumbar spine, n = 176 (51%); cervical spine, n = 78 (23%); and thoracic spine, n = 44 (13%). Maintenance care, headaches, and spine-related upper and lower extremities complaints accounted for the other 13% of patients treated. Half were chronic (n = 172, 50%), and a third were acute (n=108, 31%). Patients averaged 6 chiropractic visits, with 88% having 11 visits or less. Conclusion This study found that new patients seeking care at a free student chiropractic clinic within a university health center in the Buffalo area mainly consisted of young single adults, with chronic lumbar spine complaints with few comorbidities. PMID:27069428
Johnson, Claire; Green, Bart
This editorial presents a brief description of the Association of Chiropractic Colleges Educational Conference and Research Agenda Conference, the components of the conference, and long range goals of the peer-review committee.
Instebø, Eigil; Lystad, Reidar P
Objective The purpose of this case report is to describe the chiropractic management of an 8-year-old girl with nonorganic, primary nocturnal enuresis. Clinical Features An 8-year-old female patient presented to a chiropractic clinic with persistent nighttime bedwetting. The patient experienced enuresis, on average, 7 nights per week. The patient presented with no other comorbidities or complaints, such as low back or pelvic pain. Intervention and Outcomes Chiropractic treatment included high-velocity, low-amplitude manipulation of the left sacroiliac joint over 3 visits. Follow-up at 3 months revealed only 3 subsequent episodes of nocturnal enuresis. Conclusion This patient reported the resolution of nonorganic, primary nocturnal enuresis after receiving a series of side-posture chiropractic manipulations of the left sacroiliac joint. PMID:27069432
Blanchette, Marc-André; Stochkendahl, Mette Jensen; Borges Da Silva, Roxane; Boruff, Jill; Harrison, Pamela; Bussières, André
Background Context Low back pain (LBP) is one of the leading causes of disability worldwide and among the most common reasons for seeking primary sector care. Chiropractors, physical therapists and general practitioners are among those providers that treat LBP patients, but there is only limited evidence regarding the effectiveness and economic evaluation of care offered by these provider groups. Purpose To estimate the clinical effectiveness and to systematically review the literature of full economic evaluation of chiropractic care compared to other commonly used care approaches among adult patients with non-specific LBP. Study Design Systematic reviews of interventions and economic evaluations. Methods A comprehensive search strategy was conducted to identify 1) pragmatic randomized controlled trials (RCTs) and/or 2) full economic evaluations of chiropractic care for low back pain compared to standard care delivered by other healthcare providers. Studies published between 1990 and 4th June 2015 were considered. Primary outcomes included pain, functional status and global improvement. Study selection, critical quality appraisal and data extraction were conducted by two independent reviewers. Data from RCTs with low risk of bias were included in a meta-analysis to determine effect estimates. Cost estimates of full economic evaluations were converted to 2015 USD and results summarized using Slavin’s qualitative best-evidence synthesis. Results Six RCTs and three full economic evaluations were scientifically admissible. Five RCTs with low risk of bias compared chiropractic care to exercise therapy (n = 1), physical therapy (n = 3) and medical care (n = 1). Overall, we found similar effects for chiropractic care and the other types of care and no reports of serious adverse events. Three low to high quality full economic evaluations studies (one cost-effectiveness, one cost-minimization and one cost-benefit) compared chiropractic to medical care. Given the divergent
protocol changes. The amendments were routed through all 5 IRBs (RAND, Palmer, NHP, NMCSD, and WRNMMC) prior to site implementation. Samueli ...Chiropractic care on reaction and response times. CONTACT INFORMATION: Ian Coulter, PhD ACT Principal Investigator RAND Corp Samueli Chair in...Chiropractic Research Ph: (563)885-5150 Email: email@example.com Joan Walter, JD, PA ACT Co-Investigator Samueli Institute/VP, Military
Chapman, Peter D.; Meyer, Amanda; Young, Kenneth; Wibowo, Daniel; Walker, Bruce
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
Senzon, Simon A.
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
Page, Stacey A.
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
Morningstar, Mark W; Pettibon, Burl R; Schlappi, Heidi; Schlappi, Mark; Ireland, Trevor V
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
Larson, Ryan S.
Objective The purpose of this report is to describe 2 patients with coronary artery disease presenting with musculoskeletal symptoms to a chiropractic clinic. Clinical Features A 48-year-old male new patient had thoracic spine pain aggravated by physical exertion. A 61-year-old man under routine care for low back pain experienced a secondary complaint of acute chest pain during a reevaluation. Intervention and Outcome In both cases, the patients were strongly encouraged to consult their medical physician and were subsequently diagnosed with coronary artery disease. Following their diagnoses, each patient underwent surgical angioplasty procedures with stenting. Conclusion Patients may present for chiropractic care with what appears to be musculoskeletal chest pain when the pain may be generating from coronary artery disease necessitating medical and possibly emergency care. PMID:27069435
Cofano, Gregory P.; Anderson, Benjamin C.; Stumpff, Eric R.
Objective The purpose of this case report is to describe chiropractic care of an adolescent with acute low back pain and incidental finding of spina bifida occulta managed with high-velocity low-amplitude manipulation. Clinical Features A 10-year-old boy was referred for chiropractic care by his pediatrician for the management of low back pain after a fall 3 days prior. Examination and medical records revealed the patient also had spina bifida occulta at the level of L5. Intervention and Outcome High-velocity low-amplitude treatment for lower back pain showed resolution of patient's pain after 6 visits. No adverse effects were reported. Conclusion An adolescent patient with lower back pain and incidental finding of spina bifida occulta improved with a course of care that included with high-velocity low-amplitude manipulation therapy. PMID:25435841
Gatterman, Meridel I; Vear, Herbert J
Statutory and administrative rules continue to influence curriculum in chiropractic colleges. Pressure is frequently exerted by jurisdictions to add classes or hours, or conversely to delete subject matter and procedures not included in the scope of practice acts. Lack of government funding and university affiliation perpetuates the diversity of curriculum content which must satisfy licensing boards driven by the varied scope of practice of statutes rather than following research supported standards of care.
Brown, Douglas M.
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
Cuthbert, Scott C.; Rosner, Anthony L.
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
Rubis, Lisa M.; Rubis, David; Winchester, Brett
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
Brown, Douglas M
This paper undertook to review the history of the Canadian Chiropractic Examining Board (CCEB) during the period from 1954 up to 1985. The issues of onset, purpose, and structure are outlined and an attempt to determine its effectiveness and examination validity are recounted. The contributions made by James and Lorraine Langford to the process and history are discussed and acknowledged. Imagesp245-ap247-ap251-a
Illes, Jennifer D.; Maola, Chad J.
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
Illes, Jennifer D.; Johnson, Theodore L.
Objective The purpose of this case report is to describe chiropractic management of a patient with arm and hand numbness and who was suspected to have ulnar nerve compression. Clinical Features A 41-year-old woman presented with hand weakness and numbness along the medial aspect of her right forearm and the 3 most medial fingers. The onset of symptoms presented suddenly, 3 weeks prior, when she woke up in the morning and assumed she had “slept wrong.” The patient’s posture showed protracted shoulders and moderate forward head carriage. Orthopedic assessment revealed symptomatic right elevated arm stress test, grip strength asymmetry, and a Tinel sign at the right cubital tunnel. Intervention and Outcome The patient was treated using chiropractic care, which consisted of manipulative therapy, myofascial therapy, and elastic therapeutic taping. Active home care included performing postural exercises and education about workstation ergonomics. She demonstrated immediate subjective improvement of her numbness and weakness after the first treatment. Over a series of 11 treatments, her symptoms resolved completely; and she was able to perform work tasks without dysfunction. Conclusion Chiropractic treatment consisting of manipulation, soft tissue mobilizations, exercise, and education of workstation ergonomics appeared to reduce the symptoms of ulnar nerve compression symptoms for this patient. PMID:24294148
Shaw, Kathy; Rabatsky, Ali; Dishman, Veronica; Meseke, Christopher
Objective : This study investigated the effect of completion of course prerequisites, undergraduate grade point average (GPA), undergraduate degree, and study habits on the performance of students in the biochemistry course at Palmer College of Chiropractic Florida. Methods : Students self-reported information regarding academic preparation at the beginning of the semester using a questionnaire. Final exam grade and final course grade were noted and used as measures of performance. Multivariate analysis of variance was used to determine if number of prerequisites completed, undergraduate GPA, undergraduate degree, hours spent studying in undergraduate study, and hours spent studying in the first quarter of the chiropractic program were associated significantly with the biochemistry final exam grade or the final grade for the biochemistry course. Results : The number of prerequisites completed, undergraduate degree, hours spent studying in undergraduate study, and hours spent studying in the first quarter of the chiropractic program did not significantly affect the biochemistry final exam grade or the final grade for the biochemistry course, but undergraduate GPA did. Subsequent univariate analysis and Tukey's post hoc comparisons revealed that students with an undergraduate GPA in the 3.5 to 3.99 range earned significantly higher final course grades than students with an undergraduate GPA in the 2.5 to 2.99 range. Conclusion : No single variable was determined to be a factor that determines student success in biochemistry. The interrelationship between the factors examined warrants further investigation to understand fully how to predict the success of a student in the biochemistry course.
Hansen, Daniel T
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.
Miller, E B; Redmond, P
There is a philosophical basis for the integration of treatment using music therapy and chiropractic. Perception is intimately linked to the nervous system. A relationship between spinal integrity and consciousness does exist. We can see that as spinal distortions diminish and awareness increases, there is a natural attraction toward the higher or more loving state of consciousness. Rhythms of healing and suffering are a key concept in combining music therapy with chiropractic manipulation. Donald Epstein's conceptualization of the rhythmic stages of consciousness corresponding to prescribed physiological patterns serves as a starting point for the use of rhythm in the healing process. Using interactive music, the music therapist can help facilitate a change in the patient's physical or emotional state. This occurs when the practitioner establishes an initial connection or musical validation of the patient's emotional state and assists the healing process by improvising supportive music while suggesting possibilities for resolution. We believe that the power of music can be used as a significant tool in chiropractic work to aid individuals in their healing process.
Kizhakkeveettil, Anupama; Vosko, Andrew M.; Brash, Marissa; PH, Dr; Philips, Michael A.
Objective High levels of stress and fatigue are associated with decreased academic success, well-being, and quality of life. The objective of this research was to quantify levels of perceived stress and fatigue among chiropractic students to identify sources of and student coping mechanisms for perceived stress and fatigue and to identify the relationship between students' perceived stress and fatigue. Methods A survey comprised of the Perceived Stress Scale, the Undergraduate Sources of Stress Survey, and the Piper Fatigue Scale was administered to chiropractic students in their 2nd, 5th, and 8th trimesters of doctoral study. Data were analyzed by descriptive statistics, 1-way analysis of variance, and linear correlation tests. Results Students reported having moderate to high levels of stress and fatigue, with higher levels of stress and fatigue seen in women than in men. A nonsignificant difference among stress scores and a significant difference among fatigue scores were observed based on program term. Levels of stress predicted levels of fatigue, and stress was strongly correlated with psychological health, relationships with family members, mood, and need for learning accommodations. Fatigue was strongly correlated with psychological health, academic demands, and conflicts between studies and other activities. Conclusion There are differences in the reporting of perceived stress and fatigue levels in this chiropractic student population based on gender. The correlation between fatigue and stress also suggests that measures that may alleviate one may likely affect the other. PMID:27552030
Young, Kenneth J
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.
Moreau, William J.; Nabhan, Dustin C.; Walden, Taylor
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
Gliedt, Jordan A.; Daniels, Clinton J.
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
Minicozzi, Salvatore J.; Russell, Brent S.; Ray, Kathryn J.; Struebing, Alessandria Y.; Owens, Edward F.
Objective The aim of this study was to look for differences between patients with an increased pain response as compared with those with a decreased pain response. Methods Data were collected from consecutive new patients with lumbar or lumbopelvic pain in a chiropractic clinic. A pelvic tilt exercise was included in the initial examination, and pain response was noted. Analysis was made of pain and disability severity, as well as symptom location, chronicity, and other characteristics, before and after a course of chiropractic care. Results Patients with an increased pain response to pelvic tilt (n = 12) had higher levels of pain and disability at baseline than patients without (n = 34). There were no between-group differences in other aspects of their complaints; in age, sex, or body mass; or in the types of care they received (eg, manipulation, stretching, exercise instruction). On the average, both groups of patients showed improvement with chiropractic care, and there was no detectable difference in improvement between groups. Conclusions This study found that patients experiencing pain in response to a pelvic tilt maneuver may have a poorer precare status than patients with a decreased pain response. PMID:27069429
Howitt, Scott; Ethridge, Eric; Nelson, Eric; Gotuaco, Mike; Demello, Louis
Background: Health care practitioner’s physical activity (PA) habits are associated with their likelihood to recommend PA to their patients. The intent of this project is to better understand the Canadian Memorial Chiropractic College (CMCC) students’ perceptions and practices of PA and exercise prescription as this may predict exercise counselling they will provide to future patients. Methods: A 27-item survey was distributed to Canadian Memorial Chiropractic College (CMCC) students (N = 744). The survey determined the proportion of CMCC students that meet the (2012) Canadian Physical Activity Guidelines. Additionally the survey recorded students’ perceptions of PA counselling during patient visits and their own example of maintaining a healthy lifestyle. Results: The response rate for the survey was 46% (N = 343). By using average estimates, it was determined that 72% of the respondents meet the (2012) Canadian Physical Activity Guidelines. 86% of the respondents perceived PA counselling to be usually or always relevant during patient interactions, and approximately 73% believed that exercise counselling is highly relevant to chiropractic practice. Furthermore, at least 88% percent believed that chiropractors must adhere to a healthy lifestyle in order to effectively model a healthy lifestyle to their patients. Conclusions: A high proportion of CMCC students meet PA guidelines, and perceive PA counselling to be highly relevant and important to patient encounters. PMID:28065988
Win, Ni Ni; Nadarajah, Vishna Devi V; Win, Daw Khin
Purpose: Problem-based learning (PBL) is usually conducted in small-group learning sessions with approximately eight students per facilitator. In this study, we implemented a modified version of PBL involving collaborative groups in an undergraduate chiropractic program and assessed its pedagogical effectiveness. Methods: This study was conducted at the International Medical University, Kuala Lumpur, Malaysia, and involved the 2012 chiropractic student cohort. Six PBL cases were provided to chiropractic students, consisting of three PBL cases for which learning resources were provided and another three PBL cases for which learning resources were not provided. Group discussions were not continuously supervised, since only one facilitator was present. The students’ perceptions of PBL in collaborative groups were assessed with a questionnaire that was divided into three domains: motivation, cognitive skills, and perceived pressure to work. Results: Thirty of the 31 students (97%) participated in the study. PBL in collaborative groups was significantly associated with positive responses regarding students’ motivation, cognitive skills, and perceived pressure to work (P<0.05). The students felt that PBL with learning resources increased motivation and cognitive skills (P<0.001). Conclusion: The new PBL implementation described in this study does not require additional instructors or any additional funding. When implemented in a classroom setting, it has pedagogical benefits equivalent to those of small-group sessions. Our findings also suggest that students rely significantly on available learning resources. PMID:25961676
Injeyan, H Stephen; Gotlib, Allan C; Crawford, John P
Access to the clinical laboratory by chiropractors is an important issue in the context of the role of the chiropractor as a primary health care provider and the public’s right to optimal health care in the most efficient and cost-effective manner possible. In its efforts to gain the right to do so in Canada, the profession will have to identify and be able to justify the use of tests that would enhance the ability of its constituents to participate in the delivery of health care more effectively. In this article we have presented a set of tests which was originally developed as part of a presentation on laboratory services restructuring to the Ontario Ministry of Health by a joint committee of the College of Chiropractors of Ontario, the Ontario Chiropractic Association, and the Canadian Memorial Chiropractic College in 1996. A rationale for the use of each test in the context of chiropractic practice is presented. It is argued that the list of tests could be more, or less extensive than presented, but that it is necessary for the profession to engage in constructive debate and identify its needs more precisely in the interest of more effectively fulfilling its mandate as a primary health care profession.
McCall, Angela R.; Harvey, Richard D.
Objective The purpose of this study was to examine predictors for success on Parts I and II of the National Board of Chiropractic Examiners (NBCE) written examinations. Methods Two validity studies were conducted to examine the criterion validity of Logan College assessments for Part I and II NBCE scores. Both studies consisted of a longitudinal design to examine the validity of entrance grade point average (GPA), in-program chiropractic course content GPA, and an institutional practice exam on Parts I and II of the NBCE. Results Analyses revealed that Part I GPA and practice exam scores combined accounted for 72% of the variance within Part I NBCE scores. Furthermore, every subtest of the Part I NBCE could be reliably predicted by course performance. In the 2nd study, Part I GPA, Part I NBCE score, and Part II GPA accounted for 75% of the variance within Part II NBCE scores. Conclusions Internal training and educational assessments (eg, course grades and practice exams) proved to be strong determinants of NBCE performance above and beyond initial levels of preparedness, thus validating the impact of the chiropractic curriculum on NBCE test achievement. PMID:24611459
Schwab, Matthew J.
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
Jackson, R B
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.
Bronston, Leo J.; Austin-McClellan, Lauren E.; Lisi, Anthony J.; Donovan, Kevin C.; Engle, Walter W.
Objective The purpose of this study is to examine the self-report of experiences, attitudes, and perceived educational needs of American Chiropractic Association members regarding practice in integrated health care settings. Methods This was a descriptive observational study of the American Chiropractic Association members. Participants completed an electronic survey reporting their current participation and interest in chiropractic integrated practice. Results The survey was completed in 2011 by 1142 respondents, for a response rate of 11.8%. The majority of respondents (82.9%) did not currently practice in an integrated setting, whereas 17.1% did. Those practicing in various integrated medical settings reported delivering a range of diagnostic, therapeutic, and case management services. Participation in administrative and scholarly activities was less common. Respondents not practicing in integrated settings reported being interested in delivering a very similar array of clinical services. Doctors of chiropractic practicing in hospital or outpatient medical facilities reported frequent engagement in interprofessional collaboration. Both nonintegrated and integrated respondents reported very similar educational interests on a range of clinical topics. Conclusion The findings of this survey provide insight into the experiences, participation, and interests in integrated clinical practice for members of the American Chiropractic Association. PMID:26793034
Fredericks, Marcel; Kondellas, Bill; Hang, Lam; Fredericks, Janet; Ross, Michael WV
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
Kanga, Ismat; Steiman, Igor
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
Passmore, Steven R.; Toth, Audrey; Kanovsky, Joel; Olin, Gerald
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
Shaw, Kathy; Rabatsky, Ali; Dishman, Veronica; Meseke, Christopher
Objective This study investigated the effect of completion of course prerequisites, undergraduate grade point average (GPA), undergraduate degree, and study habits on the performance of students in the biochemistry course at Palmer College of Chiropractic Florida. Methods Students self-reported information regarding academic preparation at the beginning of the semester using a questionnaire. Final exam grade and final course grade were noted and used as measures of performance. Multivariate analysis of variance was used to determine if number of prerequisites completed, undergraduate GPA, undergraduate degree, hours spent studying in undergraduate study, and hours spent studying in the first quarter of the chiropractic program were associated significantly with the biochemistry final exam grade or the final grade for the biochemistry course. Results The number of prerequisites completed, undergraduate degree, hours spent studying in undergraduate study, and hours spent studying in the first quarter of the chiropractic program did not significantly affect the biochemistry final exam grade or the final grade for the biochemistry course, but undergraduate GPA did. Subsequent univariate analysis and Tukey's post hoc comparisons revealed that students with an undergraduate GPA in the 3.5 to 3.99 range earned significantly higher final course grades than students with an undergraduate GPA in the 2.5 to 2.99 range. Conclusion No single variable was determined to be a factor that determines student success in biochemistry. The interrelationship between the factors examined warrants further investigation to understand fully how to predict the success of a student in the biochemistry course. PMID:24295362
Stason, William B.; Ritter, Grant A; Prottas, Jeffrey; Tompkins, Christopher; Shepard, Donald S.
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
Rutherford, Susan M; Nicolson, Cameron F; Crowther, Edward R
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
Wenban, Adrian B
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
Lemire, Joe; Budgell, Brian
It appears that a great many chiropractors and chiropractic institutions are involved in health care initiatives in developing countries. Developing nations present extraordinary opportunities to do good, but also carry risks, for practitioners and organizations, which may not be obvious prior to actual local engagement. This paper describes the guiding principles under which one international collaboration has evolved in rural Tanzania, a so-called ‘low resource’ setting where the majority of families subsist in extreme poverty. Several challenges to effective care are also identified. PMID:27385832
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
Mootz, R D; Hansen, D T; Souza, T A; Triano, J J; Wiese, B C
Care for low back pain remains a clinical enigma. Its high prevalence and cost to the system warrants attention for improvement. Although, no major recent clinical breakthroughs for resolving back pain have emerged, reducing unnecessary tests, eliminating useless or harmful practices, preventing care dependence, and enhancing coping skills can be useful goals for improving patient outcomes. Quality Improvement (QI) approaches can serve as bridge between clinical intuition and large scale science. Three chiropractic delivery settings including two teaching clinics and one large multidisciplinary spine care center incorporated QI approaches as part of an initiative to improve low back pain care. All clinics were able to implement sustainable process and outcomes improvements.
Plastaras, Christopher T; Schran, Seth; Kim, Natasha; Sorosky, Susan; Darr, Deborah; Chen, Mary Susan; Lansky, Rebecca
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.
Vernon, Howard; McDermaid, Cameron
Tension-type headache (TTH) is a highly prevalent condition experienced annually by 30-70% of the population. As a chief complaint, it occupies 5-8% of chiropractors’ caseloads, but is probably more prevalent in multiple complaint cases. While numerous clinical descriptions exist in the literature of the management of TTH by chiropractors, and while there is a small body of clinical trials of the treatment of non-migrainous headache by spinal manipulation, there is no systematic survey of the approaches to its treatment by chiropractors. The goals of this study were to determine the test-retest reliability of a questionnaire designed to identify the most commonly used treatments for TTH and to report on any consistent findings as a potential profile of typical practice approach. The respondents consisted of a group of Canadian chiropractic clinical specialists. Respondents were asked to complete a survey which consisted of a comprehensive list of chiropractic treatment procedures including standard manual manipulations and mobilisations, soft tissue therapies, modalities, exercises, behavioral therapies, acupuncture, nutrition and four “systems” techniques. The respondents were asked to rate their frequency of use of these procedures on a 4-point scale ranging from “always” to “never”. The surveys were completed twice within a two day interval. The response rate was 18/25 (72%). Eighty-seven percent (87%) of the items were rated identically on both surveys. All but one of the items achieved a statistically significant reliability coefficient. The highest rated items were “upper cervical manipulations”, “upper cervical soft tissue therapy” and “neck stretching exercises”. The items which received the lowest endorsement were: chiropractic procedures to the dorso-lumbo-pelvic spine, most therapy modalities and the “systems” techniques which were included in the survey. Years in practice appeared to have very little effect on the use of
Grayson, J Paul
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
Lemire, Joe; Budgell, Brian
It appears that a great many chiropractors and chiropractic institutions are involved in health care initiatives in developing countries. Developing nations present extraordinary opportunities to do good, but also carry risks, for practitioners and organizations, which may not be obvious prior to actual local engagement. This paper describes the guiding principles under which one international collaboration has evolved in rural Tanzania, a so-called 'low resource' setting where the majority of families subsist in extreme poverty. Several challenges to effective care are also identified.
Brown, Douglas M.
This historical paper documents the unbroken legacy of the West family of chiropractors which has flourished in Canada for over 100 years. Part I, unearthed the origins, development and careers of Archibald West, the founder of this dynasty, his son Samuel and grandson Stephen. Part II, delves into the life of Archie’s brother Samson, and Samson’s chiropractic progeny: grandsons David and Neil, and great granddaughter Megan. Then it goes back to look at Stephen West’s nephew, R. Ian Buchanan and ends with a descendant of another branch of the family tree, James L. West. PMID:21629465
IA ; † Physical Medicine and Integrative Care Services, Fort Bliss, TX ; ‡ Samueli Institute, Alexandria, VA ; § Palmer College of Chiropractic...drug(s). Samueli Institute grant funds were received to support this work. Some of this work was conducted in a facility constructed with support
Young, Kenneth J.
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
Kenya, Amilliah W.M.; Kenya, Hope M.; Hart, John
Objective This study investigates the association between pre-National Board assessments and National Board Part 1 scores (NBCE) at a chiropractic college. Methods A convenience sample of 24 students enrolled in the doctor of chiropractic degree program was recruited for the study. These were 6th and 7th quarter students who had registered to take NBCE in March 2011. Each student's class scores were computed and average numeric means score derived. Subject clusters that make up testable subject categories in NBCE also were computed to obtain a single numeric mean score. Pretests were administered in all areas tested in NBCE. Results were compared to the student's scores in NBCE using correlation and multiple linear regression for 14 predictors and one response variable (NBCE). Results Among the 14 correlations for 19 students (due to missing data when running the correlation matrix), six were moderate-to-strong and statistically significant. Two predictors qualified for multiple linear regression (where n = 22): mean anatomy and mean chemistry, both of which revealed similar regression coefficients. Conclusion Mean anatomy and mean chemistry scores were shown to be the best predictors of NBCE Part 1 results in this sample. PMID:23519085
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
Seaman, David R.; Palombo, Adam D.
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
Duray, Stephen M; Mekow, Craig L
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 gross anatomy laboratory? A survey instrument was developed and pretested. IRB approval was obtained. The administrators charged with overseeing the policies and practices for the gross anatomy laboratory at each of the 16 chiropractic colleges in the USA were identified and contacted. An email containing a link to the Web based survey was sent to each, using SurveyMonkey. The survey response rate was 100%. A majority of colleges (69%) have a written policy regarding pregnancy and the gross laboratory. Of these, 36% allow pregnant students to take the laboratory if a waiver is signed, 18% do not allow them to take the laboratory, 18% allow them to take it without a waiver, and 27% have other policies. In cases where students do not take the gross laboratory while pregnant, 64% of colleges require them to take the laboratory after completion of their pregnancy, 27% require them to complete an alternative (dry) laboratory, and 9% have other policies. Considerable diversity exists in the way colleges address this issue. It is at present unknown whether pregnant students or their fetuses are at any risk from laboratory chemicals. Risk assessment research is needed before consistent policies can be developed.
Lisi, Anthony J
Low back pain is a common complaint in pregnancy, with a reported prevalence of 57% to 69% and incidence of 61%. Although such pain can result in significant disability, it has been shown that as few as 32% of women report symptoms to their prenatal provider, and only 25% of providers recommend treatment. Chiropractors sometimes manage low back pain in pregnant women; however, scarce data exist regarding such treatment. This retrospective case series was undertaken to describe the results of a group of pregnant women with low back pain who underwent chiropractic treatment including spinal manipulation. Seventeen cases met all inclusion criteria. The overall group average Numerical Rating Scale pain score decreased from 5.9 (range 2-10) at initial presentation to 1.5 (range 0-5) at termination of care. Sixteen of 17 (94.1%) cases demonstrated clinically important improvement. The average time to initial clinically important pain relief was 4.5 (range 0-13) days after initial presentation, and the average number of visits undergone up to that point was 1.8 (range 1-5). No adverse effects were reported in any of the 17 cases. The results suggest that chiropractic treatment was safe in these cases and support the hypothesis that it may be effective for reducing pain intensity.
Buehler, M.T.; Hrejsa, A.F.
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.
Gleberzon, Brian J.
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
Morries, Larry; Yochum, Terry; Barry, Michael; Slizeski, John; Freuden, Donald; Danielson, Clark
Abstract Objective To determine if there is a greater yield of pathological findings identified on MRI scans of patients referred by chiropractors as compared to those referred by allopathic providers. Methods MRI reports authored by medical radiologists from two independent MRI centers in the Denver metropolitan area were analyzed retrospectively for pathological data related to the spinal regions studied. A pathological report data sheet was used to record pathological findings in 22 different categories. A total of 150 reports from each provider group were reviewed. Results Of the 22 pathological conditions studied, a statistically significant difference between doctor of chiropractic and medical doctor referrers was identified in 4 categories: central spinal canal stenosis, lateral stenosis, facet arthrosis, and negative report. The most common primary diagnoses given for MRI referral were low back pain/sciatica, neck pain, and extremity pain. Seventy-four percent of the reports evaluated were performed on patients referred with a diagnosis of pain. In 3 of the 22 categories (14%), the medical doctors had a statistically higher pathological yield than the chiropractors. However, in 4 of the 22 categories (18%), the chiropractors had a statistically higher pathological yield. In 18 of the 22 categories (82%), there was no statistical difference between the two provider groups. Conclusion The data presented in this study suggests chiropractic and medical providers are compeer at ordering MRI for suspected pathological findings. PMID:19674677
Alexander, Michelle; Marten, Mathew; Stewart, Ella; Serafin, Stanley; Štrkalj, Goran
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.
Morningstar, Mark W.; Dovorany, Brian; Stitzel, Clayton J.; Siddiqui, Aatif
The aim of this study was to evaluate the radiographic outcomes obtained in a sample of patients treated with a chiropractic scoliosis-specific exercise program for patients with adolescent idiopathic scoliosis. Patients were treated and subsequently followed through skeletal maturity, and their results were reported in accordance with the SOSORT Consensus Guidelines. A total of 60 patient charts were consecutively selected when they met inclusion criteria. Cobb angle measurements and Risser staging were collected on all images. Using SOSORT criteria, 51.7% of patients achieved curve correction and 38.3% achieved stabilization. In the curve correction group, average total correction was 12.75°. A small number of sampled patients’ curves progressed, with a 13% failure rate based upon patients who dropped out before skeletal maturity combined with those who had progressed at skeletal maturity. Future studies are needed to corroborate these observations. PMID:28243430
Nicholson, W Reginald; Dainty, David A; Marcarian, David
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.
Morningstar, Mark W; Dovorany, Brian; Stitzel, Clayton J; Siddiqui, Aatif
The aim of this study was to evaluate the radiographic outcomes obtained in a sample of patients treated with a chiropractic scoliosis-specific exercise program for patients with adolescent idiopathic scoliosis. Patients were treated and subsequently followed through skeletal maturity, and their results were reported in accordance with the SOSORT Consensus Guidelines. A total of 60 patient charts were consecutively selected when they met inclusion criteria. Cobb angle measurements and Risser staging were collected on all images. Using SOSORT criteria, 51.7% of patients achieved curve correction and 38.3% achieved stabilization. In the curve correction group, average total correction was 12.75°. A small number of sampled patients' curves progressed, with a 13% failure rate based upon patients who dropped out before skeletal maturity combined with those who had progressed at skeletal maturity. Future studies are needed to corroborate these observations.
Ong, Chi-Keong; Doll, Helen; Bodeker, Gerard; Stewart-Brown, Sarah
Questionnaires covering health and the use of complementary, alternative and conventional health services were mailed to a random sample of 14 868 adults aged 18-64 years living in four counties of England in 1997. The present study examined the use of osteopathy/chiropractic among the 15% (n = 1377) of respondents reporting back pain. Osteopaths/chiropractors were seen by 13.4% (n = 184) of respondents with back pain during the past 3 months compared with 9.8% (n = 135) who consulted physiotherapists. The presence of back pain and non-manual social class were the strongest predictors of consultation with both types of practitioner. Women, older respondents, non-smokers and those who exercised for 30 minutes at least once a week were more likely to use osteopathy/chiropractic. The only other significant predictor of physiotherapy use was desire for more physical exercise. While those reporting back pain had Short-Form 36 (SF-36) scores suggesting very significant levels ofdisability, respondents with back pain who consulted osteopaths/chiropractors reported better health in all dimensions of the SF-36 than those using physiotherapy services. Although they reported worse pain scores than people not consulting any practitioners, their mental health, physical functioning, energy and health perception were better. It is impossible to disentangle cause and effect in this cross-sectional study, but the data suggest that people who can afford to pay are more likely to choose osteopath/chiropractor treatments than physiotherapy. The possibility that osteopath/chiropractor treatment has a generalised positive effect on health, allowing people with back pain to function better than those not receiving such treatment, warrants further investigation.
Marcon, Alessandro R; Klostermann, Philip
Background Spinal manipulation therapy (SMT) is a popular though controversial practice. The debates surrounding efficacy and risk of SMT are only partially evident in popular discourse. Objective This study aims to investigate the presence of critiques and debates surrounding efficacy and risk of SMT on the social media platform Twitter. The study examines whether there is presence of debate and whether critical information is being widely disseminated. Methods An initial corpus of 31,339 tweets was compiled through Twitter’s Search Application Programming Interface using the query terms “chiropractic,” “chiropractor,” and “spinal manipulation therapy.” Tweets were collected for the month of December 2015. Post removal of tweets made by bots and spam, the corpus totaled 20,695 tweets, of which a sample (n=1267) was analyzed for skeptical or critical tweets. Additional criteria were also assessed. Results There were 34 tweets explicitly containing skepticism or critique of SMT, representing 2.68% of the sample (n=1267). As such, there is a presence of 2.68% of tweets in the total corpus, 95% CI 0-6.58% displaying explicitly skeptical or critical perspectives of SMT. In addition, there are numerous tweets highlighting the health benefits of SMT for health issues such as attention deficit hyperactivity disorder (ADHD), immune system, and blood pressure that receive scant critical attention. The presence of tweets in the corpus highlighting the risks of “stroke” and “vertebral artery dissection” is also minute (0.1%). Conclusions In the abundance of tweets substantiating and promoting chiropractic and SMT as sound health practices and valuable business endeavors, the debates surrounding the efficacy and risks of SMT on Twitter are almost completely absent. Although there are some critical voices of SMT proving to be influential, issues persist regarding how widely this information is being disseminated. PMID:27637456
Hawk, Cheryl; Kaeser, Martha A; Beavers, David V
Objective : Although tobacco cessation training is included in many health profession programs, it is not yet routinely incorporated into chiropractic education. The purpose of this study was to assess the feasibility of incorporating a problem-based learning tobacco cessation activity into a lecture course for chiropractic students. Methods : Seventy-two students were assigned to participate in two 1-hour lectures on health promotion counseling and tobacco cessation followed by an experiential student-driven lab session using standardized patients at various stages of dependency and willingness to quit. The intervention was based on the transtheoretic model and the "5 A's" of counseling (ask, advise, assess, assist, arrange). Outcomes were assessed via (1) questionnaires completed by the standardized patients regarding the students' use of the 5A's, and (2) questionnaires completed by the students using a 5-point Likert scale of "strongly disagree" to "strongly agree" on the acceptability of this method of learning. Descriptive statistics were computed. Results : Sixty-eight students (94%) completed the activity, spending a median of 2.5 minutes with patients. Over 90% addressed 4 of the 5A's: 99% asked patients if they were smokers; 97% advised them to quit; 90% assessed if they were willing to quit; and 99% offered assistance in quitting. Only 79% arranged a follow-up visit. Overall, students expressed a positive response to the experience; 81% said it increased their confidence in being able to advise patients, and 77% felt it would be valuable for use in their future practice. Conclusion : This active learning exercise appeared to be a feasible way to introduce tobacco counseling into the curriculum.
Anderson-Peacock, Elizabeth; Blouin, Jean-Sébastien; Bryans, Roland; Danis, Normand; Furlan, Andrea; Marcoux, Henri; Potter, Brock; Ruegg, Rick; Gross Stein, Janice; White, Eleanor
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
Solecki, Thomas J.; Hostnik, Kurt D.
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
System; Wayne B. Jonas, M.D. of Samueli Institute; Anthony J. Lisi, DC of Veterans Health Administration; Dennis Marchiori, DC, Ph.D. of Palmer...received official signatures from: WRNMMC, Samueli Institute, Palmer College of Chiropractic and RAND Corporation and San Diego Commanding Admiral, who...review. Once an IT Impact Statement is obtained from WRNMMC the amendment will be sent for legal review. Samueli Institute is in the process of
Johnson, DC of VAGLA Healthcare System; Wayne B. Jonas, M.D. of Samueli Institute; Anthony J. Lisi, DC of Veterans Health Annual Report, W81XWH-11-2...concerns are minimal. After the first of the year, COL Helwig and Dr. Mona Bingham ( Samueli Institute) will begin working on the necessary documentation to...RAND’s marketing department, Samueli Institute’s marketing department, Palmer Center for Chiropractic Research employees and chiropractors working in
Rose, Kevin A.; Babajanian, Jesika
Objective: The objective structured practical examination (OSPE) is a case-based assessment that can be used to assess the clinical reasoning ability of students. The reliability of using an OSPE for this purpose has not been reported in the literature. The objective of this study was to determine the interrater reliability of the OSPE in measuring the clinical reasoning ability of chiropractic students. Methods: Two examiners tested each student simultaneously when enough were available as a check for interrater reliability. The scores for students over 4 exam administrations were compiled, and we calculated an intraclass correlation coefficient (ICC) using 1-way random single measures. Results: Paired scores were available for 133 students. The ICC was .685, showing a fair-to-good level of agreement for faculty in assessing the clinical reasoning ability of chiropractic students using an OSPE. Conclusion: The OSPE can be a valuable tool for testing clinical reasoning abilities because it can simulate the decision-making process that needs to be implemented in clinical practice. Faculty members at our chiropractic college were able to achieve an acceptable level of reliability in measuring the clinical reasoning abilities of students using an OSPE. Other health professional programs may consider using this tool for assessing the clinical reasoning skills of their students. PMID:27115474
Bussières, André E.; Terhorst, Lauren; Leach, Matthew; Stuber, Kent; Evans, Roni; Schneider, Michael J.
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
Wittman, Rebekah A.; Vallone, Sharon A.
Abstract Objective The purpose of this paper is to present a case of a child with Prader-Willi syndrome and the observed improvement in the degree of scoliosis, immune function, and behavior documented during the course of her treatment. Clinical Features A 7-year-old girl presented to Kentuckiana Children's Center with a 15° lumbar levoscoliosis and diagnosis of Prader-Willi syndrome. Intervention and Outcome The treatment plan consisted of chiropractic adjustments, craniosacral therapy, movement therapy, and nutritional therapy. Over the course of treatment, her muscle strength, tone, and motor activity increased. She improved in coordination of gait and balance. Over the course of 3 years, her scoliosis decreased to 4° to 5°. Improvements in immune function and a reduction in anxiety type behaviors were documented by the parents and doctor of chiropractic over the course of 5 years. Conclusions This case report describes the improvements and progression of one female child with Prader-Willi syndrome under chiropractic and multidisciplinary care. PMID:19948310
Jorgensen, Anna Maria S.; Sheppard, Lorraine A.
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
Murray, Kelvin J.; Azari, Michael F.
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
Francio, Vinicius T.; Boesch, Ron; Tunning, Michael
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
Hestbaek, Lise; Stochkendahl, Mette Jensen
Five to ten percent of chiropractic patients are children and adolescents. Most of these consult because of spinal pain, or other musculoskeletal complaints. These musculoskeletal disorders in early life not only affect the quality of children's lives, but also seem to have an impact on adult musculoskeletal health. Thus, this is an important part of the chiropractors' scope of practice, and the objective of this review is to assess the evidence base for manual treatment of musculoskeletal disorders in children and adolescents.Randomized, quasi-randomized and non-randomized clinical studies were included if they investigated the effect of manual therapy on musculoskeletal disorders in children and/or adolescents. The MEDLINE and MANTIS databases were searched, and studies published in English, Danish, Swedish or Norwegian were included.Only three studies were identified that in some way attempted to look at the effectiveness of manual therapy for children or adolescents with spinal problems, and none of these was a randomized controlled clinical trial. As for the rest of the musculoskeletal system, only one study of temporomandibular disorder was identified.With this review, we have detected a paradox within the chiropractic profession: Although the major reason for pediatric patients to attend a chiropractor is spinal pain, no adequate studies have been performed in this area. It is time for the chiropractic profession to take responsibility and systematically investigate the efficiency of joint manipulation of problems relating to the developing musculoskeletal system.
Gleberzon, Brain J
In a previous article, the author reported on the recommendations gathered from student projects between 1996 and 1999 investigating their preferences for including certain chiropractic Name technique systems into the curriculum at the Canadian Memorial Chiropractic College (CMCC). These results were found to be congruent with the professional treatment technique used by Canadian chiropractors. This article reports on the data obtained during the 2000 and 2001 academic years, comparing these results to those previously gathered. In addition, because of the implementation of a new curriculum during this time period, there was unique opportunity to observe whether or not student perceptions differed between those students in the `old' curricular program, and those students in the `new' curricular program. The results gathered indicate that students in both curricular programs show an interest in learning Thompson Terminal Point, Activator Methods, Gonstead, and Active Release Therapy techniques in the core curriculum, as an elective, or during continuing educational programs provided by the college. Students continue to show less interest in learning CranioSacral Therapy, SacroOccipital Technique, Logan Basic, Applied Kinesiology and Chiropractic BioPhysics. Over time, student interest has moved away from Palmer HIO and other upper cervical techniques, and students show a declining interest in being offered instruction in either Network Spinal Analysis or Torque Release Techniques. Since these findings reflect the practice activities of Canadian chiropractors they may have implications not only towards pedagogical decision-making processes at CMCC, but they may also influence professional standards of care.
Background The number of households in the United States that are not proficient in the English language is growing and presenting a challenge to the health care system. Over nineteen percent of the US population speak a language other than English in the home. This increase in language discordance generates a greater need to find and implement accommodations in the clinical setting to insure accurate and efficient diagnosis and treatment as well as provide for patient safety. Aim: The purpose of this study is to determine the percentage of patients accessing the chiropractic college teaching clinics who are not proficient in the English language and to what extent the colleges provide accommodations for that language disparity. Methods The clinic directors and deans of the Association of Chiropractic Colleges were surveyed via an on-line survey engine. The survey queried the percentage of the patient population that is not English language proficient, the accommodations the college currently has in place, if the college has a language specific consent to treat document and if the college has a written policy concerning patients without English proficiency. Results Fifty percent of the contacted chiropractic colleges responded to the survey. In the respondent college clinics 16.5% of the patient population is not proficient in English, with over 75% speaking Spanish. All but one of the respondents provide some level of accommodation for the language non-concordance. Forty five percent of the responding colleges employ a language specific consent to treat form. The implementation of accommodations and the use of a language specific consent to treat form is more prevalent at colleges with a higher percentage of non-English speaking patients. Conclusions The percentage of patients with limited English proficiency accessing services at the teaching clinics of the chiropractic colleges mirrors the numbers in the general population. There is a wide disparity in the
Violato, Claudio; Marini, Anthony; Lawson, Douglas; McEwen, Murray
Data derived from the administration of the Canadian Chiropractic Examining Board (CCEB) examinations for a nine year period, 1987-1995, were used to evaluate the reliability and validity of the subject tests: anatomy, chemistry, chiropractic practice, diagnosis and symptomatology, microbiology and public health, neurology, pathology, physiology, and x-ray interpretation and physics. Nearly two-thousand candidates from more than eighteen chiropractic colleges have written the CCEB exams over this nine year period. The results indicate that the exams have adequate alpha reliabilities (.69 to .80) and theoretically appropriate statistical properties and item characteristics. There is also substantial evidence of content validity. Results from stepwise multiple regression and factor analyses provided evidence for the criterion-related and construct validity of the exams. The implication of these results for the continued refinement and development of the CCEB exams, together with suggestions for on-going research of their reliability and validity, are discussed.
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
Homb, Nicole M; Sheybani, Shayan; Derby, Dustin; Wood, Kurt
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.
Palmgren, Per J.; Sundberg, Tobias; Laksov, Klara Bolander
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
Hester, Hilary; Cunliffe, Christina; Hunnisett, Adrian
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.
Chiropractic care of a pediatric patient with symptoms associated with gastroesophageal reflux disease, fuss-cry-irritability with sleep disorder syndrome and irritable infant syndrome of musculoskeletal origin
Alcantara, Joel; Anderson, Renata
The mother of a 3-month old girl presented her daughter for chiropractic care with a medical diagnosis of gastroesophageal reflux disease. Her complaints included frequently interrupted sleep, excessive intestinal gas, frequent vomiting, excessive crying, difficulty breastfeeding, plagiocephaly and torticollis. Previous medical care consisted of Prilosec prescription medication. Notable improvement in the patient’s symptoms was observed within four visits and total resolution of symptoms within three months of care. This case study suggests that patients with complaints associated with both musculoskeletal and non-musculoskeletal origin may benefit from chiropractic care. PMID:19066699
Ward, John; Humphries, Kelley; Coats, Jesse; Whitfield, Paige
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
Meyer, Amanda J; Stomski, Norman J; Innes, Stanley I; Armson, Anthony J
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.
Assendelft, W J; Bouter, L M; Kessels, A G
This article discusses the methodology of a recently published British randomized clinical trial comparing chiropractic and physiotherapy as treatments for low back pain. The authors base their main conclusions on a difference shown by the Oswestry pain questionnaire 2 yr after randomization, when data of only 26% of the patients were available. This might have led to an overestimation, because it appears that the difference in Oswestry scores is much larger for patients included early in the study. It may also be doubted whether the magnitude of the effect reported really indicates a clinically significant difference between the interventions. In addition to allocated intervention, the groups also differ in duration of treatment, number of sessions, level of experience of the therapist, and health care setting. The results are difficult to extrapolate, because only a small portion of the eligible patients participated, and chiropractic seems to be clearly superior only in the subgroup originally presenting to a chiropractic clinic. We conclude that it is premature to draw conclusions about the long-term effectiveness of chiropractic based on the results of this study alone.
Chapman, Cynthia; Bakkum, Barclay W.
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
Lee, Alexander D; Szabo, Kaitlyn; McDowell, Kirstie; Granger, Sydney
Introduction: A Canadian sports chiropractic research agenda has yet to be defined. The Delphi method can be utilized to achieve this purpose; however, the sample of experts who participate can influence the results. To better inform sample selection for future research agenda development, we set out to determine if differences in opinions about research priorities exist between chiropractors who have their sports specialty designation and those who do not. Methods: Fifteen sports clinical practice chiropractors who have their sports fellowship designation and fifteen without, were interviewed with a set of standardized questions about sports chiropractic research priorities. A centering resonance analysis and cluster analysis were conducted on the interview responses. Results: The two practitioner groups differed in their opinions about the type of research that they would like to see conducted, the research that would impact their clinical practice the most, and where they believed research was lacking. However, both groups were similar in their opinions about research collaborations. Conclusion: Sports clinical practice chiropractors, with their sports specialty designation and those without, differed in their opinions about sports chiropractic research priorities; however, they had similar opinions about research collaborations. These results suggest that it may be important to sample from both practitioner groups in future studies aimed at developing research agendas for chiropractic research in sport. PMID:28065995
Cracknell, Jesse; Lawson, Douglas M.; Taylor, John A.
Introduction: It is important to create a body of evidence surrounding the reliability of certain diagnostic criteria. While the reliability of the Cobb measurement is well established with various licensed health care professionals, this study aims to determine the inter- and intra-observer reliability of the Cobb Measurement among chiropractic interns. Methods: Fourteen chiropractic interns analyzed 10 pre-selected digital spinal radiographs on a Picture Archiving and Communication System (PACS) in two separate rounds of observation. The participants indicated their choice of end vertebra and Cobb Measurement in each round of observation. Agreement on vertebral levels selected was estimated using percentage agreement. Intra-observer reliability was estimated using the Pearson r correlation coefficient, and inter-observer correlation was estimated using the Inter-Class Coefficient (ICC). Results: The range of percentage agreement on vertebral level selection was 0.36 – 0.79. The Pearson r correlation coefficient for round 1 and round 2 was 0.79. The ICC (3,1) was 0.79 (round 1), and 0.70 (round 2). Conclusion: Less than optimal agreement on end vertebrae selection was found between observers. Intra- and inter-observer reliability of the Cobb Measurement was ‘excellent’ (round 1) and ‘good’ (round 2). PMID:26500360
Dane, Dawn E.; Dane, Andrew B.; Crowther, Edward R.
Objective: This study explored how chiropractic interns applied evidenced-based concepts, the sources of evidence they used, and how useful they perceived these sources to be in clinical decision making. Methods: A questionnaire containing 13 items in a Likert 5-point scale was administered to 28 chiropractic interns to gather information on the evidence types they commonly accessed and their perceived usefulness of these sources in clinical decision making. The interns were in the 8th semester of the training program. Results: There was a 93% (n = 26) response rate. Clinical guidelines were rated as the most helpful resource in clinical decision making (81%), followed by lecture materials (77%), journals (54%), databases (50%), and textbooks (35%). Students recognized scientific evidence as the most important aspect in clinical decision making. They found their personal experience and the views of their clinician to be equally important and patient preference the least. Conclusion: Interns routinely employed high-quality levels of evidence in clinical decision making. They also considered their early, limited clinical experience as important as that of their clinical supervisor in decision making. This finding should be investigated further. PMID:27389528
Cox, J M; Shreiner, S
A chiropractic multicenter observational pilot study to compile statistics on the examination procedures, diagnosis, types of treatments rendered, results of treatment, number of days of care, and number of treatments required to arrive at a 50% and a maximum clinical improvement was collected on 576 patients with low back and/or leg pain. The purpose was to determine the congenital and developmental changes in patients with low back and/or leg pain, the combinations of such anomalies, the accuracy of orthodox diagnostic tests in assessing low back pain, ergonomic factors affecting onset and, ultimately, the specific difficulty factors encountered in treating the various conditions seen in the average chiropractor's office. For all conditions treated, the average number of days to attain maximum improvement was 43 and the number of visits 19. It was concluded that this study provided useful data for assessment of routine chiropractic office based diagnosis and treatment of related conditions; however, further controlled studies are necessary for validation of specific parameters.
Burke, Jeanmarie R.
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
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
Gotlib, Allan C; Beingessner, Melanie
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.
De Camillis, David; Carr, Robin
This study assessed the reliability and potential value of a specific Centre of Pressure Locator (COPL) for the initial diagnosis of spinal mal-alignments and for the measurement of change in weight distribution resulting from clinical intervention. Basic validation of the equipment with standard weights showed it to be very precise, reliable and accurate at noting changes in the position of the centre of pressure. Control subjects were used to develop interim norms for COP position and sway. R-L COP position among both controls and patients was found to be too variable to be a useful tool for diagnosis or for the measurement of the effects of intervention. However, the equipment shows promise for the measurement of A-P and R-L postural sway; potentially important variables to consider within chiropractic practice.
Ndetan, Harrison; Hawk, Cheryl; Sekhon, Vishaldeep Ka; Chiusano, Miguel
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.
Huang, Meng; Barber, Sean M; Moisi, Marc; Powell, Suzanne; Rivera, Andreana; Rose, James
Spinal epidural hematoma (SEH) occurring after chiropractic spinal manipulation therapy (CSMT) is a rare clinical phenomenon. Our case is unique because the patient had an undiagnosed cervical spinal arteriovenous malformation (AVM) discovered on pathological analysis of the evacuated hematoma. Although the spinal manipulation likely contributed to the rupture of the AVM, there was no radiographic evidence of the use of excessive force, which was seen in another reported case. As such, patients with a known AVM who have not undergone surgical intervention should be cautioned against symptomatic treatment with CSMT, even if performed properly. Regardless of etiology, SEH is a surgical emergency and its favorable neurological recovery correlates inversely with time to surgical evacuation. PMID:26430581
Roberts, Jan A.; Wolfe, Tristy M.
Objective The purpose of this article is to report the response of chiropractic care of a geriatric veteran with degenerative disk disease and diffuse idiopathic skeletal hyperostosis. Clinical Features A 74-year-old man presented with low back pain (LBP) and loss of feeling in his lower extremities for 3 months. The LBP was of insidious onset with a 10/10 pain rating on the numeric pain scale (NPS) and history of degenerative disk disease and diffuse idiopathic skeletal hypertrophy. Oswestry questionnaire was 44% and health status questionnaire was 52%, which were below average for his age. The patient presented with antalgia and severe difficulty with ambulation and thus used a walker. Intervention and Outcome Chiropractic care included Activator Methods protocol. Two weeks into treatment, he reported no back pain; and after 4 treatments, he was able to walk with a cane instead of a walker. The NPS decreased from a 10/10 to a 0/10, and his Revised Oswestry score decreased from 44/100 to 13.3/100. His Health Status Questionnaire score increased 25 points to 77/100, bringing him from below average for his age to above average for his age. Follow-up with the patient at approximately 1 year and 9 months showed an Oswestry score of 10/100 and a Health Status Questionnaire score of 67/100, still above average for his age. Conclusion The findings in this case study showed that Activator-assisted spinal manipulative therapy had positive subjective and objective results for LBP and ambulation in a geriatric veteran with degenerative disk disease and diffuse idiopathic skeletal hyperostosis. PMID:23843763
Innes, Stanley I.
Objective The aim of this study was to explore the relationship between chiropractic students' coping styles and levels of resilience with their physical injuries, perceived levels of stress, and well-being. Methods A questionnaire was distributed to the entire student body of the chiropractic program at Murdoch University, and gathered demographic variables and responses to the Connor-Davidson Resilience Scale, Perceived Levels of Stress Scale, Everyday Feelings Questionnaire, and Coping Inventory for Stressful Situations. Linear regression analysis was used to calculate for significant relationships. Results Of 244 students, 194 (81%) completed the surveys. Being female and not having recovered from an injury within 12 months was significantly associated with lower levels of well-being and higher levels of stress. Being female, possessing an increased use of an emotional-based coping style, and having lower levels of well-being were associated with higher levels of stress (R2 = 0.65, F(6,164) = 50.47, p < .001). Lower levels of well-being were associated with being female, higher perceived levels of stress, lower levels of resilience, and an increased use emotional coping styles (R2 = 0.64, F[6,164] = 49.5, p < .001). Conclusion It is possible to identify chiropractic students at the university who are at risk of experiencing low levels of well-being and high levels of stress. These students may benefit from interventions aimed at enhancing their coping style choices and increasing their resilience levels. Future studies are recommended to see if these findings are consistent across chiropractic programs nationally and internationally. PMID:27459674
Sergent, Adam W.; Cofano, Gregory P.
Objective The purpose of this case study is to describe the chiropractic care of a patient with headaches and dizziness. Clinical Features A 34-year-old woman with a history of headaches, dizziness, photophobia, and temporary loss of vision aggravated by postural positions while bending forward sought conservative care for her symptoms. She reported a prior diagnosis of Arnold-Chiari malformation (ACM) type 1 by magnetic resonance imaging in 2005 that revealed descending cerebellar tonsils measured at 5 mm with an impression of ACM type 1. A new magnetic resonance image taken in 2013 indicated the cerebellar tonsils measured at 3 mm and did not project through the plane of the foramen magnum. The diagnosis of ACM type 1 was no longer applicable; however, the signs and symptoms of ACM type 1 persisted. Intervention and Outcome She was treated using cervical chiropractic manipulation using diversified technique. The dizziness and headache were resolved after 3 visits. At her 3-month follow-up, she continued to be symptom-free. Conclusion A patient with headaches and dizziness and a previous diagnosis of ACM type 1 responded positively to chiropractic care. PMID:25225468
Degree of Vertical Integration Between the Undergraduate Program and Clinical Internship With Respect to Cervical and Cranial Diagnostic and Therapeutic Procedures Taught at the Canadian Memorial Chiropractic College
Leppington, Charmody; Gleberzon, Brian; Fortunato, Lisa; Doucet, Nicolea; Vandervalk, Kyle
Objective: The purpose of this study was to determine if diagnostic and therapeutic procedures for the cervical and cranial spine taught to students during the undergraduate program at Canadian Memorial Chiropractic College are required to be used during their internship by their supervising clinicians and, if so, to what extent these procedures are used. Methods: Course manuals and course syllabi from the Applied Chiropractic and Clinical Diagnosis faculty of the undergraduate chiropractic program for the academic year 2009–2010 were consulted and a list of all diagnostic and therapeutic procedures for the cranial and cervical spine was compiled. This survey asked clinicians to indicate if they themselves used or if they required the students they were supervising to use each procedure listed and, if so, to what extent each procedure was used. Demographic information of each clinician was also obtained. Results: In general, most diagnostic procedures of the head and neck were seldom used, with the exception of postural observation and palpation. By contrast, most cervical orthopaedic tests were often used, with the exception of tests for vertigo. Most therapeutic procedures were used frequently with the exception of prone cervical and “muscle” adjustments. Conclusion: There was a low degree of vertical integration for cranial procedures as compared to a much higher degree of vertical integration for cervical procedures between the undergraduate and clinical internship programs taught. Vertical integration is an important element of curricular planning and these results may be helpful to aid educators to more appropriately allocate classroom instruction PMID:22778531
Walden, Anna L.; Salsbury, Stacie A.; Reed, William R.; Lawrence, Dana J.
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
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
Background Observational studies have previously shown that adverse events following manipulation to the neck and/or back are relatively common, although these reactions tend to be mild in intensity and self-limiting. However, no prospective study has examined the incidence of adverse reactions following spinal adjustments using upper cervical techniques, and the impact of this care on clinical outcomes. Methods Consecutive new patients from the offices of 83 chiropractors were recruited for this practice-based study. Clinical outcome measures included 1) Neck pain disability index (100-point scale), 2) Oswestry back pain index (100-point scale), 3) 11-point numerical rating scale (NRS) for neck, headache, midback, and low back pain, 4) treatment satisfaction, and 5) Symptomatic Reactions (SR). Data were collected at baseline, and after approximately 2 weeks of care. A patient reaching sub-clinical status for pain and disability was defined as a follow-up score <3 NRS and <10%, respectively. A SR is defined as a new complaint not present at baseline or a worsening of the presenting complaint by >30% based on an 11-point numeric rating scale occurring <24 hours after any upper cervical procedure. Results A total of 1,090 patients completed the study having 4,920 (4.5 per patient) office visits requiring 2,653 (2.4 per patient) upper cervical adjustments over 17 days. Three hundred thirty- eight (31.0%) patients had SRs meeting the accepted definition. Intense SR (NRS ≥8) occurred in 56 patients (5.1%). Outcome assessments were significantly improved for neck pain and disability, headache, mid-back pain, as well as lower back pain and disability (p <0.001) following care with a high level (mean = 9.1/10) of patient satisfaction. The 83 chiropractors administered >5 million career upper cervical adjustments without a reported incidence of serious adverse event. Conclusions Upper cervical chiropractic care may have a fairly common occurrence of mild intensity SRs
Grand, Stephen; Morehouse-Grand, Kenice; Carter, Shane
Objective: This pilot study explored the attitudes, beliefs, and intentions of a group of chiropractic interns concerning health promotion, wellness, and preventive services before and after a series of brief educational interventions. Methods: Interns completed a survey before (n = 37) and after (n = 22) the interventions. The survey included 12 Likert scale questions about attitudes and intentions toward wellness and health promotion models. The interventions consisted of classroom lectures, clinical training, and online information pertaining to health promotion and wellness. Results: The interns initially favored wellness models, perceived a need for them, and felt partially prepared to administer them, with mean Likert scores 4 or greater on a 1 to 5 scale. Afterward, the average scores were higher and the interns reported some benefit from this short course of training. Conclusion: The initial survey demonstrated that interns had some understanding of wellness, health promotion, and preventive services, and favored utilization of these services. The follow-up survey suggested that a short educational intervention could have a positive impact on these attitudes and future utilization of wellness procedures in their practices. PMID:27314433
Kania-Richmond, Ania; Weeks, Laura; Scholten, Jeffrey; Reney, Mikaël
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
Roberts, Jan A.; Wolfe, Tristy M.
Objective The purpose of this report is to describe the response of a geriatric patient with low back pain and a history of leukemia, multiple compression fractures, osteoporosis, and degenerative joint disease using Activator chiropractic technique. Case Report An 83-year-old man who is the primary caretaker for his disabled wife had low back pain after lifting her into a truck. The patient had a history of leukemia, multiple compression fractures, osteoporosis, and degenerative joint disease. His Revised Oswestry Low Back Pain Disability Questionnaire was 26%, with a 10/10 pain rating at its worst on the Numeric Pain Scale. The patient presented with a left head tilt, right high shoulder, and right high ilium with anterior translation and flexion of the torso and spasm and tenderness from the lower thoracic spine to lumbar spine. Intervention and Outcome The patient was cared for using Activator Methods protocol. After 8 treatments, the patient was stable and remained stable for 4 months without spasm or tenderness in his spine. His Revised Oswestry score dropped to 6%, with a 4/10 Numeric Pain Scale pain rating when at its worst; and the patient reported being able to take care of his wife. Conclusion The findings of this case suggest that Activator-assisted spinal manipulative therapy had a positive effect on low back pain and function in an elderly patient with a complex clinical history. PMID:22942837
Mizel, Dennis H
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.
Eirikstoft, Heidi; Kongsted, Alice
Sub-grouping of low back pain (LBP) is believed to improve prediction of prognosis and treatment effects. The objectives of this study were: (1) to examine whether chiropractic patients could be sub-grouped according to an existing pathoanatomically-based classification system, (2) to describe patient characteristics within each subgroup, and (3) to determine the proportion of patients in whom clinicians considered the classification to be unchanged after approximately 10 days. A cohort of 923 LBP patients was included during their first consultation. Patients completed an extensive questionnaire and were examined according to a standardised protocol. Based on the clinical examination, patients were classified into diagnostic subgroups. After approximately 10 days, chiropractors reported whether they considered the subgroup had changed. The most frequent subgroups were reducible and partly reducible disc syndromes followed by facet joint pain, dysfunction and sacroiliac (SI)-joint pain. Classification was inconclusive in 5% of the patients. Differences in pain, activity limitation, and psychological factors were small across subgroups. Within 10 days, 82% were reported to belong to the same subgroup as at the first visit. In conclusion, LBP patients could be classified according to a standardised protocol, and chiropractors considered most patient classifications to be unchanged within 10 days. Differences in patient characteristics between subgroups were very small, and the clinical relevance of the classification system should be investigated by testing its value as a prognostic factor or a treatment effect modifier. It is recommended that this classification system be combined with psychological and social factors if it is to be useful.
Dewhurst, Philip; Rix, Jacqueline; Newell, David
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
Chaibi, Aleksander; Šaltytė Benth, Jūratė; Tuchin, Peter J; Russell, Michael Bjørn
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
McMurtry, Angus; Wilson, Kumanan; Clarkin, Chantalle; Walji, Rishma; Kilian, Brendan C; Kilian, Carney C; Lohfeld, Lynne; Alolabi, Bashar; Hagino, Carol; Busse, Jason W
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
Roberts, Jan; Wolfe, Tristy
Abstract Objective The purpose of this case report is to describe the response to chiropractic care of a pediatric patient with complaints of neck pain; headaches; and hand, leg, and foot pain after head trauma and the reports of changes in the patient's history of chronic fatigue, vomiting, and coughing. Clinical Features A 6-year–old girl was pushed into a playground slide, hitting her head and resulting in acute complaints of her “neck and brain hurting” and hand, foot, and occasional leg pain. In addition, the patient had a several-year history of unexplained fatigue, vomiting, and coughing spells. She had a neck pain disability index of 17.8%; left lateral and rotational head tilt; cervical antalgic lean; loss of cervical range of motion; anterior cervical translation; and spasm, tenderness, trigger points, and edema along the cervical and thoracic spine. Intervention and Outcome The patient was cared for using Activator Methods protocol. After the fifth treatment, all the patient's symptoms dissipated, with a complete return to normal activity and spinal stability after 9 treatments. At 19 weeks, her spine continued to be asymptomatic; and her neck disability index was 0%. Conclusion This case demonstrated that the Activator Method of chiropractic care had a beneficial effect for this pediatric patient. PMID:19703669
Todd, Angela J.; Carroll, Matthew T.; Russell, David G.; Mitchell, Eleanor K.L
Objective To compare chiropractic students' perceptions of preparedness for practice before and after a clinical placement in Rarotonga and to report demographics from these experiences. Methods The students completed deidentified pre- and postplacement surveys assessing pediatric practice preparedness. Students tallied the patient numbers, age, and chiropractic techniques used per visit for each day of clinic placement. On completion of the program, participating students (27/34, or 79% of the student cohort) did a postplacement survey on their perception of practice preparedness. Data were analyzed with the Spearman rho correlation, the Mann-Whitney U test, and regression analysis. Results There was an increase in perceived preparedness for pediatric practice, ranging from 24.1% of the student cohort at the start of the study to 82.1% following clinical placement in Rarotonga. The change in student preparedness to practice with children was positively correlated with the total number of children managed (rs = .05, p = .01) and the number of children managed who were under 10 years of age (rs = .60, p = .001). Multiple regression analysis demonstrated a medium positive effect for postprogram preparedness (F [4, 20] = 3.567, p = .024). Conclusion Clinical outreach to Rarotonga provided a broad case mix of patients and a change in student perceptions of preparedness to practice with children, which was positively affected by the total number of children managed and the number of children managed who were under 10 years of age. PMID:27967212
Bakkum, Barclay W.; Chapman, Cynthia
Objective: We investigated the self-reported barriers to publication for authors of abstracts presented at the most recent chiropractic scientific meetings for which publication rates are known, that is the 2006 to 2008 Association of Chiropractic Colleges Educational Conference and Research Agenda Conference (ACC/RAC) meetings. Methods A 4-question electronic survey was sent via email to 1 of the listed authors for each abstract not published as a full paper within 4 years of the 2006 to 2008 ACC/RAC meetings. Each author was asked to complete the survey for only 1 abstract. Taking into account authors who appeared on more than 1 abstract, a link to the electronic survey was emailed to 111 potential participants. Results Of 111 participants, 67 completed a survey for a return rate of 60%. Over 80% (55/67) of the respondents were chiropractors who were faculty members at educational institutions. Of the subjects, 30% (20/67) indicated that the meeting abstract had either been published after 2012 or still was in the publishing process. For those who had not submitted a manuscript for publication, the most frequently cited barriers to publishing were pursuit of publishing as a low priority followed by a lack of time to prepare a manuscript. Conclusion The main barriers to publishing in this sample were that publishing had a low priority compared to other possible uses of the abstract author's time and a perceived lack of time to pursue the publication process. PMID:27967211
Weeks, William B; Leininger, Brent; Whedon, James M; Lurie, Jon D; Tosteson, Tor D; Swenson, Rand; O’Malley, Alistair J; Goertz, Christine M
Objective The purpose of this study was to determine whether use of chiropractic manipulative treatment (CMT) was associated with lower healthcare costs among multiply-comorbid Medicare beneficiaries with an episode of chronic low back pain (cLBP). Methods We conducted an observational, retrospective study of 2006–2012 Medicare fee-for-service reimbursements for 72,326 multiply-comorbid patients aged 66 and older with cLBP episodes and 1 of 4 treatment exposures: chiropractic manipulative treatment (CMT) alone, CMT followed or preceded by conventional medical care, or conventional medical care alone. We used propensity score weighting to address selection bias. Results After propensity score weighting, total and per-episode day Part A, Part B, and Part D Medicare reimbursements during the cLBP treatment episode were lowest for patients who used CMT alone; these patients had higher rates of healthcare use for low back pain but lower rates of back surgery in the year following the treatment episode. Expenditures were greatest for patients receiving medical care alone; order was irrelevant when both CMT and medical treatment were provided. Patients who used only CMT had the lowest annual growth rates in almost all Medicare expenditure categories. While patients who used only CMT had the lowest Part A and Part B expenditures per episode day, we found no indication of lower psychiatric or pain medication expenditures associated with CMT. Conclusions This study found that older multiply-comorbid patients who used only CMT during their cLBP episodes had lower overall costs of care, shorter episodes, and lower cost of care per episode day than patients in the other treatment groups. Further, costs of care for the episode and per episode day were lower for patients who used a combination of CMT and conventional medical care than for patients who did not use any CMT. These findings support initial CMT use in the treatment of, and possibly broader chiropractic management of
Background Low back pain in pregnancy is common and research evidence on the response to chiropractic treatment is limited. The purposes of this study are 1) to report outcomes in pregnant patients receiving chiropractic treatment; 2) to compare outcomes from subgroups; 3) to assess predictors of outcome. Methods Pregnant patients with low back or pelvic pain, no contraindications to manipulative therapy and no manual therapy in the prior 3 months were recruited. Baseline numerical rating scale (NRS) and Oswestry questionnaire data were collected. Duration of complaint, number of previous LBP episodes, LBP during a previous pregnancy, and category of pain location were recorded. The patient’s global impression of change (PGIC) (primary outcome), NRS, and Oswestry data (secondary outcomes) were collected at 1 week, 1 and 3 months after the first treatment. At 6 months and 1 year the PGIC and NRS scores were collected. PGIC responses of ‘better’ or ‘much better’ were categorized as ‘improved’. The proportion of patients ‘improved’ at each time point was calculated. Chi-squared test compared subgroups with ‘improvement’. Baseline and follow-up NRS and Oswestry scores were compared using the paired t-test. The unpaired t-test compared NRS and Oswestry scores in patients with and without a history of LBP and with and without LBP during a previous pregnancy. Anova compared baseline and follow-up NRS and Oswestry scores by pain location category and category of number of previous LBP episodes. Logistic regression analysis also was also performed. Results 52% of 115 recruited patients ‘improved’ at 1 week, 70% at 1 month, 85% at 3 months, 90% at 6 months and 88% at 1 year. There were significant reductions in NRS and Oswestry scores (p < 0.0005). Category of previous LBP episodes number at one year (p = 0.02) was related to ,improvement’ when analyzed alone, but was not strongly predictive in logistic regression. Patients with
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
Kongsted, Alice; Johannesen, Else; Leboeuf-Yde, Charlotte
The STarT back screening tool (SBT) allocates low back pain (LBP) patients into three risk groups and is intended to assist clinicians in their decisions about choice of treatment. The tool consists of domains from larger questionnaires that previously have been shown to be predictive of non-recovery from LBP. This study was performed to describe the distribution of depression, fear avoidance and catastrophising in relation to the SBT risk groups. A total of 475 primary care patients were included from 19 chiropractic clinics. They completed the SBT, the Major Depression Inventory (MDI), the Fear Avoidance Beliefs Questionnaire (FABQ), and the Coping Strategies Questionnaire. Associations between the continuous scores of the psychological questionnaires and the SBT were tested by means of linear regression, and the diagnostic performance of the SBT in relation to the other questionnaires was described in terms of sensitivity, specificity and likelihood ratios.In this cohort 59% were in the SBT low risk, 29% in the medium risk and 11% in high risk group. The SBT risk groups were positively associated with all of the psychological questionnaires. The SBT high risk group had positive likelihood ratios for having a risk profile on the psychological scales ranging from 3.8 (95% CI 2.3 - 6.3) for the MDI to 7.6 (95% CI 4.9 - 11.7) for the FABQ. The SBT questionnaire was feasible to use in chiropractic practice and risk groups were related to the presence of well-established psychological prognostic factors. If the tool proves to predict prognosis in future studies, it would be a relevant alternative in clinical practice to other more comprehensive questionnaires.
... Did pain/condition immediately follow an injury or accident? • Is anything improves or worsens the pain? • What ... tests (for example, MRI or X-ray reports), lab results, and a list of any medications you ...
Dryburgh, D R
A review of the literature relating to possible clinical implications of ascorbic acid (AA) supplementation was conducted. Factors requiring a higher AA intake include smoking, alcohol ingestion, stress, diabetes mellitus, pregnancy, and certain drugs, including oral contraceptives, some antibiotics, acetylsalicylate and anti-inflammatory medications. AA has been found to significantly increase wound healing, reduce the inflammatory response, lessen respiratory distress, enhance immune function and serve to benefit many common conditions including osteoarthritis. It is concluded that vitamin C supplementation could be utilized for many conditions seen by chiropractors.
Mattox, Ross; Smith, Linda W.; Kettner, Norman W.
Objective The purpose of this case report is to describe a patient who presented to a chiropractic physician for evaluation and treatment of neck pain and headache. Clinical features A 45-year-old otherwise healthy female presented for evaluation and treatment of neck pain and headache. Within minutes, non-specific musculoskeletal symptoms progressed to neurological deficits, including limb ataxia and cognitive disturbances. Suspicion was raised for cerebrovascular ischemia and emergent referral was initiated. Intervention and outcome Paramedics were immediately summoned and the patient was transported to a local hospital with a working diagnosis of acute cerebrovascular ischemia. Multiplanar computed tomographic and magnetic resonance imaging with contrast revealed vertebral artery dissection of the V2 segment in the right vertebral artery. Anticoagulation therapy was administered and the patient was discharged without complications after 5 days in the hospital. Conclusion This case highlights the potential for patients with vertebral artery dissection to present with nonspecific musculoskeletal complaints. Neurological symptoms may not manifest initially, but their sudden onset indicates the possibility of an ischemic cerebrovascular event. We suggest that early recognition and emergent referral for this patient avoided potential exacerbation of an evolving pre-existing condition and resulted in timely anticoagulation treatment. PMID:25685116
Degree of Vertical Integration Between the Undergraduate Program and Clinical Internship with Respect to Lumbopelvic Diagnostic and Therapeutic Procedures Taught at the Canadian Memorial Chiropractic College
Vermet, Shannon; McGinnis, Karen; Boodham, Melissa; Gleberzon, Brian J.
Purpose: The objective of this study was to determine to what extent the diagnostic and therapeutic procedures taught in the undergraduate program used for patients with lumbopelvic conditions are expected to be utilized by students during their clinical internship program at Canadian Memorial Chiropractic College or are being used by the clinical faculty. Methods: A confidential survey was distributed to clinical faculty at the college. It consisted of a list of diagnostic and therapeutic procedures used for lumbopelvic conditions taught at that college. Clinicians were asked to indicate the frequency with which they performed or they required students to perform each item. Results: Seventeen of 23 clinicians responded. The following procedures were most likely required to be performed by clinicians: posture; ranges of motion; lower limb sensory, motor, and reflex testing; and core orthopedic tests. The following were less likely to be required to be performed: Waddell testing, Schober's test, Gillet tests, and abdominal palpation. Students were expected to perform (or clinicians performed) most of the mobilization (in particular, iliocostal, iliotransverse, and iliofemoral) and spinal manipulative therapies (in particular, the procedures referred to as the lumbar roll, lumbar pull/hook, and upper sacroiliac) taught at the college. Conclusion: This study suggests that there was considerable, but not complete, vertical integration between the undergraduate and clinical education program at this college. PMID:20480014
Sheladia, V L; Johnston, D A
From a total pool of 1189 male and female patients with accident- (AC) and nonaccident- (NA) caused low back pain, 465 cases with completed therapy were studied for effectiveness of various chiropractic treatments. For those who completed therapy, the age distribution and incidence of this disorder were also studied. At the completion of the therapy, the response was evaluated as very good (pain-free, cured), better (very small degree of discomfort), relief (some reduction in pain) or no response to the treatment. The females with NA responded better than AC cases (p less than .001). However, male NA cases showed an increase in "no relief," but it was not significant (p = 0.052). The response of male AC cases was better than that of female AC cases (p less than 0.001). The cervical, thoracic, lumbar and ilium adjustment levels in female and male NA did not show any differences in response (p = 0.15, female; p = 0.46, male). The incidence of NA back pain disorders in both male and female was higher as compared to AC-caused back problems (p less than 0.001). The lower back pain problems did not show any age-specific association in either sex. Manipulative approaches in addition to nonmanipulative methods are superior to nonmanipulative measures alone, and females responded better to nonmanipulative care than did males.
Murdoch, Blake; Carr, Stuart; Caulfield, Timothy
Objective To identify the frequency and qualitative characteristics of marketing claims made by Canadian chiropractors, naturopaths, homeopaths and acupuncturists relating to the diagnosis and treatment of allergy and asthma. Design Cross-sectional study. Setting Canada. Data set 392 chiropractic, naturopathic, homeopathic and acupuncture clinic websites located in 10 of the largest metropolitan areas in Canada, as identified using 400 Google search results. Duplicates were not excluded from data analysis. Main outcome measures Mention of allergy, sensitivity or asthma, claim of ability to diagnose allergy, sensitivity or asthma, claim of ability to treat allergy, sensitivity or asthma, and claim of allergy, sensitivity or asthma treatment efficacy. Tests and treatments promoted were noted as qualitative examples. Results Naturopath clinic websites have the highest rates of advertising at least one of diagnosis, treatment or efficacy for allergy or sensitivity (85%) and asthma (64%), followed by acupuncturists (68% and 53%, respectively), homeopaths (60% and 54%) and chiropractors (33% and 38%). Search results from Vancouver, British Columbia were most likely to advertise at least one of diagnosis, treatment or efficacy for allergy or sensitivity (72.5%) and asthma (62.5%), and results from London, Ontario were least likely (50% and 40%, respectively). Of the interventions advertised, few are scientifically supported; the majority lack evidence of efficacy, and some are potentially harmful. Conclusions The majority of alternative healthcare clinics studied advertised interventions for allergy and asthma. Many offerings are unproven. A policy response may be warranted in order to safeguard the public interest. PMID:27986744
Weeks, William B; Tosteson, Tor D; Whedon, James M; Leininger, Brent; Lurie, Jon D; Swenson, Rand; Goertz, Christine M; O’Malley, Alistair J
Objective Patients who use complementary and integrative health services like chiropractic manipulative treatment (CMT) often have different characteristics than patients who do not, and these differences can confound attempts to compare outcomes across treatment groups, particularly in observational studies when selection bias may occur. The purposes of this study were to provide an overview on how propensity scoring methods can be used address selection bias by balancing treatment groups on key variables and to use Medicare data to compare different methods for doing so. Methods We described 2 propensity score methods (matching and weighting). Then we used Medicare data from 2006-2012 on older, multiply comorbid patients who had a chronic low back pain episode to demonstrate the impact of applying methods on the balance of demographics of patients between 2 treatment groups (those who received only CMT and those who received no CMT during their episodes). Results Before application of propensity score methods, patients who used only CMT had different characteristics from those who did not. Propensity score matching diminished observed differences across the treatment groups at the expense of reduced sample size. However, propensity score weighting achieved balance in patient characteristics between the groups and allowed us to keep the entire sample. Conclusions While propensity score matching and weighting have similar effects in terms of balancing covariates, weighting has the advantage of maintaining sample size, preserving external validity, and generalizing more naturally to comparisons of 3 or more treatment groups. Researchers should carefully consider which propensity score method to use, as using different methods can generate different results. PMID:26547763
Background Low back pain (LBP) is a prevalent and costly condition in the United States. Evidence suggests there is no one treatment which is best for all patients, but instead several viable treatment options. Additionally, multidisciplinary management of LBP may be more effective than monodisciplinary care. An integrative model that includes both complementary and alternative medicine (CAM) and conventional therapies, while also incorporating patient choice, has yet to be tested for chronic LBP. The primary aim of this study is to determine the relative clinical effectiveness of 1) monodisciplinary chiropractic care and 2) multidisciplinary integrative care in 200 adults with non-acute LBP, in both the short-term (after 12 weeks) and long-term (after 52 weeks). The primary outcome measure is patient-rated back pain. Secondary aims compare the treatment approaches in terms of frequency of symptoms, low back disability, fear avoidance, self-efficacy, general health status, improvement, satisfaction, work loss, medication use, lumbar dynamic motion, and torso muscle endurance. Patients' and providers' perceptions of treatment will be described using qualitative methods, and cost-effectiveness and cost utility will be assessed. Methods and Design This paper describes the design of a randomized clinical trial (RCT), with cost-effectiveness and qualitative studies conducted alongside the RCT. Two hundred participants ages 18 and older are being recruited and randomized to one of two 12-week treatment interventions. Patient-rated outcome measures are collected via self-report questionnaires at baseline, and at 4, 12, 26, and 52 weeks post-randomization. Objective outcome measures are assessed at baseline and 12 weeks by examiners blinded to treatment assignment. Health care cost data is collected by self-report questionnaires and treatment records during the intervention phase and by monthly phone interviews thereafter. Qualitative interviews, using a semi
... 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. ...
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
Busse, Jason W; Ebrahim, Shanil; Heels-Ansdell, Diane; Wang, Li; Couban, Rachel; Walter, Stephen D
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
McGill, Stuart M
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
Facchinato, Ana Paula A.; Benedicto, Camila C.; Mora, Aline G.; Cabral, Dayane M.C.; Fagundes, Djalma J.
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
Rep. Filner, Bob [D-CA-51
05/25/2010 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
French, Simon; Werth, Peter; Walker, Bruce
Case study. A man aged 42 years, who works as a police officer, presented with severe lower back pain, which he had experienced for 24 hours after spending the previous day helping his brother to move house. He had difficulty ambulating and most movements aggravated the pain. There were no lower limb symptoms and no red flags present on history or examination. He was otherwise well and was not taking any regular medications.
Brown, Douglas M.
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
Dufton, John A.; Giantomaso, Tony
Cervical spondylotic radiculopathy (CSR) is one of the potential sources of radiculopathy, particularly in patients aged 40 to 60 years. The hallmark sign of cervical-brachial pain presents in the majority of the cases, however a definitive clinical diagnosis is often difficult in the absence of reliable and valid diagnostic tests. Two cases of presumed CSR illustrate the usefulness of applying a comprehensive mechanical assessment that guides the patient's rehabilitation regardless of the traditional anatomical diagnosis. A brief overview of the epidemiology, clinical presentation, and management of CSR is also presented.
Kong, Shelley Young
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…
Brown, Douglas M.
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
Gotlib, Allan; Rupert, Ron
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
Durant, Claire L; Verhoef, Marja J; Conway, Phil J; Sauve, Reg S
OBJECTIVES: To explore how and when chiropractors are involved in the care of patients younger than 18 years of age, and to examine chiropractors’ beliefs about treating paediatric patients. DESIGN: A cross-sectional survey of a random sample of 140 chiropractors practising in Alberta. Data were collected by means of a mailed questionnaire, which elicited practice information and chiropractors’ beliefs, and included closed-and open-ended questions related to six vignettes of paediatric health problems. RESULTS: Fifty-seven per cent of chiropractors responded to the questionnaire. All chiropractors indicated that they treat patients younger than 18 years of age. Nine per cent of respondents do not treat patients younger than age two years, and 4% do not treat patients from ages six to 11 years. On average, 13% of chiropractors’ total patient load over the month preceding the completion of the questionnaires consisted of patients younger than the age of 18 years. With increasing age, patients are more likely to present with musculoskeletal problems (23% of patients younger than age two years, 84% of those aged 14 to 17 years). Chiropractors reported that they provided musculoskeletal treatment regardless of the cause of the problem. A high percentage of chiropractors refer to physicians and reported that they would like to provide concomitant care with physicians. CONCLUSION: The present study has shown that chiropractors do treat children and that their opinions about this practice vary by specific condition. In addition, substantial percentages of chiropractors indicated that they would like to work with physicians in treating patients with nonmusculoskeletal conditions. PMID:20107550
Dishman, R W
Intervertebral dysfunction refers to a biomechanical fault which is abnormal in both its dynamic and static components. A subluxation may be considered as being fixated and also slightly malpositioned in one or more axes of rotation. Subluxation may be considered as one component of a complex or syndrome of intervertebral dyskinesia, dysarthrosis or dysfunction. The biochemical and histological components explain some of the pain mechanisms, tissue changes and residual effects of acute and chronic intervertebral fixation and the need for repeated spinal manipulations and prolonged care. Interexaminer reliability studies indicate that a standard method of motion palpation is quite feasible and accurate. X-ray evidence of dyskinesia shows promise as a means of documenting subluxation fixations.
... these negotiations, CASD, acting on behalf of its members, made proposals and counterproposals on price... negotiation of contracts on behalf of its members is not ancillary to any procompetitive purpose of CASD or... CASD would coordinate their negotiations with payers to enable the collective negotiation of...
Guagliardo, Joseph G; Hoiriis, Kathryn T
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.
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
Guagliardo, Joseph G.; Hoiriis, Kathryn T.
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
Kaeser, Martha A.; Hawk, Cheryl; Anderson, Michelle
Objective The purpose of this study was to compare demographics and chief complaints of the new patient population at our institution's fee-for-service clinics to the patient population of practicing chiropractors in the United States. We also compared the prevalence of obesity and hypertension to reference standards for the adult population. Methods Patient data were obtained from the electronic health records. All records identified as new patients during October 2013 were included. Variables of interest were clinic site, patient demographics, blood pressure, body mass index (BMI), chief complaint, and ICD-9 codes. Descriptive statistics were computed and compared to reference standards from previous reports. Results During October 2013, there were 224 new patients that entered the clinics. The average patient was a 31- to 50-year-old white male. Our clinic patients differed from those seen by US chiropractors in the distribution of all demographic variables. For adult patients, 31.4% were overweight, 29% were obese, and 8% stage 1 or 2 hypertension. Conclusion New patients in the fee-for-service teaching clinics appear to be dissimilar to those of US practicing chiropractors in several important demographics, characteristics, and types of complaints. The new patients had lower levels of overweight, obesity, and hypertension compared to US reference standards. PMID:25162982
Kanga, Ismat; Taylor, John A.; Jacobs, Craig; Outerbridge, Geoff
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
Owens, Edward F.; Hosek, Ronald S.; Sullivan, Stephanie G.B.; Russell, Brent S.; Mullin, Linda E.; Dever, Lydia L.
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
McMurtry, Angus; Wilson, Kumanan; Clarkin, Chantalle; Walji, Rishma; Kilian, Brendan C.; Kilian, Carney C.; Lohfeld, Lynne; Alolabi, Bashar; Hagino, Carol; Busse, Jason W.
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…
Hamm, Anthony W.; Burkhart, Lori A.
Objective This article describes the origins and rationale for the McAndrews Leadership Lecture and explains why the American Chiropractic Association honors George and Jerome McAndrews. Discussion George and Jerome McAndrews’ backgrounds demonstrate their leadership contributions to the chiropractic profession. Jerome McAndrews, a chiropractor, held substantial leadership roles in the chiropractic profession. George McAndrews, a lawyer, administered a permanent injunction forbidding the American Medical Association’s restraint of trade toward the chiropractic profession. Conclusion The American Chiropractic Association has established the McAndrews Leadership Lecture to honor their contributions to the chiropractic profession. PMID:26770176
Green, Bart N.
This editorial discusses the indexing systems that include the Journal of Chiropractic Education, reflects on the increased international participation in chiropractic education scholarly meetings and peer review, and acknowledges the editorial board and peer reviewers for the journal. PMID:27557431
Members of the Retired Reserve Who Are Not Yet Age 60 ........... 13 Chiropractic Health Care for Members on Active Duty...Personnel Policy Issues Congressional Research Service 14 Chiropractic Health Care for Members on Active Duty Background: Chiropractic is a health care ...Section 702 of the Floyd D. Spence National Defense Authorization Act for Fiscal Year 2001 (P.L. 106-398) established the Chiropractic Care Program
chiropractic care (9.1%), and massage (9.6%) were also popular and reported as effective treatments in response to symptoms. Obtaining more...acupressure, chiropractic care, and massage were all listed as treatments that provided varying levels of relief. Based on the comments it seems that some...acupuncture, chiropractic care, and massage treatment was reported around 9%. Eisenberg and colleagues (1998) found similar levels of chiropractic
Sen. Harkin, Tom [D-IA
03/07/2013 Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent. (consideration: CR S1274; text as passed Senate: CR S1273) (All Actions) Tracker: This bill has the status Passed SenateHere are the steps for Status of Legislation:
Miller, Joyce; Beharie, Monica Christine; Taylor, Alison M; Simmenes, Elisabeth Berg; Way, Susan
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).
the low back, radiating into the right “hip” ( sacroiliac joint ), buttock, and leg and numbness in the lateral right foot. An examination was performed...2006;12(7):659-68. 12. Chou R, Qaseem A, Snow V, Casey D, Cross JH, Shekelle P, et al. Diagnosis and treatment of low back pain: a joint clinical
Biggs, Lesley; Mierau, Dale; Hay, David
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.
Haldeman, Scott; McAndrews, George P.; Goertz, Christine; Sportelli, Louis; Hamm, Anthony W.; Johnson, Claire
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
... AND INSULAR REGULATIONS WAKE ISLAND CODE Registration and Island Permits § 935.152 Activities for... medical profession, including dentistry, surgery, osteopathy, and chiropractic. (c) The erection of...
... Rehabilitation Program, Chiropractic Care, Audiology and Speech Pathology, Veterans Benefits, and Prosthetic and.... Long, Designated Federal Officer, Veterans Health Administration, Patient Care Services,...
... of conducting the practice of medicine, osteopathy dentistry, podiatry, optometry, or chiropractic, or is owned by other health care professionals as authorized by State law. (c) Applicability of...
... of conducting the practice of medicine, osteopathy dentistry, podiatry, optometry, or chiropractic, or is owned by other health care professionals as authorized by State law. (c) Applicability of...
... of conducting the practice of medicine, osteopathy dentistry, podiatry, optometry, or chiropractic, or is owned by other health care professionals as authorized by State law. (c) Applicability of...
... chiropractic, and graduate students in health administration or clinical psychology through September 30, 1998... time needed to review instructions; to develop, acquire, install and utilize technology and systems...
... the fields of medicine, osteopathic medicine, dentistry, veterinary medicine, optometry, podiatric medicine, pharmacy, public health, chiropractic, health administration and clinical psychology. The...
Millennium Cohort survey instrument to assess CAM use. Although these questions were not intended to encompass the full spectrum of CAM possibilities...response: acupuncture, biofeedback, chiropractic care, energy healing, folk remedies, herbal therapy, high dose/ megavitamin therapy, homeopathy, hypnosis ...National Center for CAM (24). Acupuncture, biofeedback, chiropractic care, energy healing, folk medicine, hypnosis , and massage were grouped together as
are led by lay people. Table I Healing Matrix Orthodox Marginal Alternative Physical Surgery Chiropractic Rolfing Cranial-sacral Manipulation...and. finally chiropractic therapy (9) . Commercial weight loss programs and self-help groups were also used by the respondents. Symptoms for which...mainstream of conventional medicine. These unconventional or alternative therapies include treatments by chiropractors, acupuncturists, herbal therapists , and
Weinert, Daniel James
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…
... Antitrust Division United States v. Oklahoma State Chiropractic Independent Physicians Association and Larry..., Stipulation, and Competitive Impact Statement have been filed with the United States District Court for the Northern District of Oklahoma in United States of America v. Oklahoma State Chiropractic...
Brown, Douglas M.
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
Hammerich, Karin F
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.
Burgess, Michael M
Ethical concerns about informed consent encompass the legal functions of protection of patients through self-determination, but also considers other ways of respecting patients through seeking their benefit and their autonomy. The influence of traditional medicine on patient expectations, and use of consent forms often renders consent a difficult issue in the relative safety and non-invasiveness of chiropractic practice. The ethical concern with consent, however, focuses attention on patient participation in health care decisions. Chiropractic relationships are often quite conclusive to this sharing of health care decisions after education. Exceptions to informed consent are not typically relevant to chiropractic patients who are conscious, competent and not in need of emergency treatment. It is therefore important that patients are aware of non-chiropractic alternatives and very rare risks of a serious nature. Rather than an impediment, ethical concerns about consent encourage a relationship of education and shared responsibility which encourages chiropractic patients to accept responsibility for their health.
Keating, Joseph C
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).
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 ...
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)
... acupuncture, chiropractic care, massage or other manual therapies, yoga, herbal and nutritional therapies, or others. This information helps the health care provider understand the nature of the pain or the potential benefits of treatment. The goals of the comprehensive pain ...
... pain. Treatments include: Physical therapy Chiropractic care Acupuncture Yoga Massage Cognitive-behavioral therapy Progressive muscle relaxation Check if your health insurance pays for any of these treatments. Surgery ...
... recommended for use in children — some have dangerous side effects or may interfere with conventional treatments. By Mayo Clinic Staff Alternative ear infection treatments abound on the internet and in books and magazines. They include chiropractic adjustments, homeopathy, herbal ...
... Photo: iStock Herbal supplements, meditation, chiropractic manipulation, and acupuncture are types of complementary and alternative medicine (CAM) ... effective. For example, NCCAM studies have shown that: Acupuncture can provide pain relief and improve function for ...
thyroid disease, diabetes mellitus, pregnancy , and obesity (Gerr et al., 2002; Bergqvist et al., 1995; Solomon, Katz, Bohn, Mogun, & Avorn, 1999...Local steroid injections Antidepressants for pain/sleep Chiropractic treatment Survery Other (specify
The Texas Medical Association triumphed when a Travis County district court sided with medicine in a lawsuit against the Texas Board of Chiropractic Examiners over its granting chiropractors the authority to perform certain diagnostic tests.
... Special Section CAM Quiz on Complementary and Alternative Medicine Past Issues / Winter 2009 Table of Contents For ... low back pain. True False Complementary and alternative medicine (CAM) includes: Meditation Chiropractic Use of natural products, ...
Dhami, MSI; Vernon, H
Industrial accidents and injuries are prevalent amongst the industrialised world. Accident related research has long attempted to find common denominators among the human and environmental antecedents of occupational hazards. Chemical substances can adversely effect one or several of the body systems, with resulting symptoms which may not fit in a specific disease pattern. While occupational health physicians will be familiar with hazards of particular industries, general physicians or chiropractic clinicians may easily overlook industrial poisoning as a cause of symptoms because of its relative rarity. Even though awareness of chiropractic and use of chiropractic care has been increasing, there are still millions of Canadians who know little or nothing about chiropractic and are not part of its utilization profile.
... Psy.D. (d) Counseling Psychology: Ph.D. (e) Social Work: Masters level only. (f) Chemical Dependency..., nursing, public health nursing, dentistry, psychiatry, osteopathy, optometry, pharmacy, psychology, public health, social work, marriage and family therapy, chiropractic medicine, environmental health...
... such as medication, injections, chiropractic care and/or physical therapy. Typically, you will have had an MRI that ... has gone through nonoperative treatments (such as active physical therapy, medication, injections, activity modification and/or spinal manipulation). ...
... of CAM are herbal products, chiropractic , acupuncture , and hypnosis . If you have an autoimmune disease, you might ... help you to feel your best. Meditation, self-hypnosis, and guided imagery, are simple relaxation techniques that ...
Yochum, T R
A brief historical review of the discovery of X-ray by Wilhelm Konrad Roentgen on November 9, 1895, is presented. This synopsis discusses the evolution of X-ray imaging from the primitive Crookes x-ray tube to the state-of-the-art high-frequency generators. Technological advancements from fluoroscopy to plain films, nuclear medicine, computed tomography and magnetic resonance imaging, along with changes in X-ray film and intensifying screens, are also provided. A concise overview of chiropractic radiology and the introduction of X-ray into the chiropractic curriculum, first at Palmer College and then at other colleges is presented. Historical recognition of the development of the American Chiropractic Board of Radiology (ACBR), its founding fathers and its certification program for training chiropractic radiologists is reviewed. General comments pointing to computerized digital imaging as the filmless imaging of the future are offered.
pregnancy . In addition, the law rescinded mandatory cov- erage of children between 18 to 21, giving states the option to provide coverage to children...therapy Occupational therapy Speech therapy Chiropractic services (manual manipulation of the spine to correct subluxation) Dental services that...not covered by Medicare, 1990a Acupuncture0 Chiropractic services Christian Science practitioners Cosmetic surgery0 Custodial care Dental care0
CHAMPUS to revise health-care rules. Army Times; Mar. 26, 1990; 50(33): p. 9. CHAMPUS- - CHIROPRACTIC TREATMENT Chiropractic coverage tested. Army Times...FORCES--PANAMA--AMERICAN INVASION, 1989-1990 Women’s action investigated. Army Times; Feb. 5, 1990; 50(26): p. 10. WOMEN IN THE ARMED FORCES-- PREGNANCY ... Pregnancy a growing problem in early outs. Army Times; Sept. 3, 1990; 51(4): p. 10. WOMEN IN THE ARMED FORCES--RECRUITING, ENLISTMENT, ETC. No special
treatment approaches, they primarily perform adjustments to the spine or other parts of the body with the goal of correcting alignment problems and...supporting the body’s natural ability to heal itself. Research to expand the scientific understanding of chiropractic treatment is ongoing. Section 702...at designated military treatment facilities. A service member’s primary care manager determines if chiropractic care is appropriate. Family members
The purpose of this Graduate Management Project is to provide a methodology to evaluate the outcome effectiveness of chiropractic treatment rendered...pain was gauged before and after treatment was provided. Data analysis from 40 sample patients provided strong evidence to support this project’s...research hypothesis in that patient functional disability scores will improve over time as a result of chiropractic treatment for low back pain.
focuses on the relationship between the body’s structure—mainly the spine—and its functioning. Although practitioners may use a variety of treatment ...the body’s natural ability to heal itself. Research to expand the scientific understanding of chiropractic treatment is ongoing. Section 702 of the...at designated military treatment facilities. A service member’s primary care manager determines if chiropractic care is appropriate. Family members
Hammerich, Karin F.
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
Houle, Sébastien; Descarreaux, Martin
Abstract Objective This article describes the chiropractic clinical management and therapeutic benefits accruing to a patient with temporomandibular joint (TMJ) disorder and spinal muscular atrophy type III. Clinical Features A 35-year-old white man presented at the university chiropractic outpatient clinic with a complaint of masseter muscle pain and mouth-opening restriction. Temporomandibular joint range of motion evaluation revealed restricted opening (11 mm interincisival), and pain was rated by the patient at an intensity of 5 on a pain scale of 0 to 10. Intervention and Outcome Chiropractic care was provided and included TMJ mobilization, myofascial therapy, trigger point therapy, and light spinal mobilizations of the upper cervical vertebrae. Final evaluation of TMJ range of motion showed active opening of 12 mm with absence of pain and muscle tenderness of the jaw. Conclusion This case suggests that a patient with musculoskeletal disorders related to underlying neurodegenerative pathologies may benefit from chiropractic management adapted to their condition. In the present case, chiropractic treatment of the TMJ represented a viable, low-cost approach with limited adverse effects compared with surgery. PMID:19948309
Biggs, Lesley; Hay, David; Mierau, Dale
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
Keating, J C
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.
Brown, Douglas M
"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."
Brown, Douglas M.
“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
Oliver, Mia; MacDonald, Joanna; Rajwani, Moez
Chiropractic care is a common treatment sought by patients with headaches. As some patients may not benefit from this care, chiropractors must be aware of alternative management options. Botox has more recently become a common treatment for headaches. A case of a 45-year-old female with chronic headaches and neck pain is presented. After lengthy trials of chiropractic manipulation, trigger point therapy, and acupuncture, the patient was treated with Botox-A. She experienced pain relief following the initial treatment that lasted up to 3–4 months and has since undergone subsequent trials of Botox with the same results. No side effects were experienced. As more health care practitioners are recommending Botox, the need for a better understanding of the evidence and criteria for referral for Botox treatment is required. As such, chiropractors should consider this alternative approach to managing headaches when chiropractic management is unsuccessful. PMID:17549187
Oakley, Paul A.; Harrison, Donald D.; Harrison, Deed E.; Haas, Jason W.
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
Several primary studies have shown that an anatomical short leg predicts anterior rotation of the ipsilateral ilium, whereas anatomical long leg predicts posterior rotation of the ilium on the long leg side. At the same time, in chiropractic and other manual therapy professions, it is widely believed that the leg check finding of a short leg is associated with posterior ilium rotation, and a long leg with anterior ilium rotation. The purpose of this commentary is to explore the consequences of this paradox for the manual therapy professions, insofar as leg checking procedures are commonly used to derive appropriate vectors for chiropractic manipulation/adjustive procedures. PMID:22027038
Keating, Joseph C
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
Brown, Douglas M.
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
Oswald, Christopher; Higgins, Ceara C.; Assimakopoulos, Demetry
Abstract Question Many of my pregnant patients have muscle and joint aches, and are reluctant to use analgesics. What is known about chiropractic care during pregnancy? Answer As pregnant women move into their second and third trimesters, their centres of mass shift anteriorly, causing an increase in lumbar lordosis, which causes low back and pelvic girdle pain. Increasing recent evidence attests to the effectiveness and safety of treating this pain using manual therapy. Massage therapy and chiropractic care, including spinal manipulation, are highly safe and effective evidence-based options for pregnant women suffering from mechanical low back and pelvic pain. PMID:23946024
Brown, Douglas M.
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
Tan, David L.
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…
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…
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…
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…
the Naval Health Research Center (protocol NHRC.2000.0007). Data Sources In addition to our longitudinal survey instrument , other data sources...megavitamin therapy, homeopathic remedies, hypnosis , massage therapy, relaxation, and spiritual healing. For the purposes of these analyses...acupuncture, biofeedback, chiropractic care, energy healing, folk medicine, hypnosis , and massage therapy were grouped together as practitioner-assisted
Gleberzon, Brian J.
Chiropractic pedagogy is recognizing the importance of community-based education. This article describes the manner in which a series of community-based presentations were developed, specifically targeting the elderly. With support from both the Ontario Ministry of Health and the Ontario Chiropractic Association, presentations were developed that primarily addressed the three areas of greatest concern to older persons: osteoporosis, osteoarthritis and injury prevention. The primary objectives of the presentations were to dispel any myths that older persons may have had about osteoporosis and osteoarthritis, and to suggest ways to safety-proof their homes. Additional topics discussed were exercise, nutrition and the role of chiropractic in geriatric health care. Twenty-five presentations were conducted at twelve different community centers. Presentations were conducted by chiropractic interns. The results of pre and post-surveys suggest that the primary objectives of the program were successfully met. ImagesFigure 1Figure 2p25-ap25-bp25-cp25-dp25-e
Zafiropoulos, George; Byfield, David
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…
regarding optometry) health care for rural areas) re- search on health professions issues) chiropractic demonstration projects and residency training...Extension service* Extension activities* Animal and Plant Health Inspection Service FY 1995 Appropriations Authorized: $ 1,730,000,000 Unauthorized FY...Reconciliation Act of 1990 * Grants to states to improve their child care licensing and registration requirements and procedures FY 1994 Appropriations Authorized
Child Care Human Services Receptionist Chiropractic Assistant Illustrator Recording Specialist Civil Engineering Technician Import/Export Specialist...Engraver Office Machine Reao Air Conditioning/Heating/Ventilation Environmental Health Ophthalmic Dispensing and Optical Animal Trainer Equine Studies...Building Maintenance Technician Home Health Care Aide Private Security/Investigations/ Business Administration Horsemanship Specialist Corrections
1). In addition, dental, durable medical equipment, chiropractic services, hearing aids, home health, hospice care, mental health, physical therapy...penalized parents for what they see as a non-discretionary expense. Sarah Kelly, a Vallejo physical therapist and mother of 2-year- old twins summed it up
... 32 National Defense 5 2013-07-01 2013-07-01 false Unauthorized care. 732.15 Section 732.15... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.15 Unauthorized care. The following are not authorized by this part: (a) Chiropractic services. (b) Vasectomies. (c) Tubal ligations....
... 32 National Defense 5 2012-07-01 2012-07-01 false Unauthorized care. 732.15 Section 732.15... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.15 Unauthorized care. The following are not authorized by this part: (a) Chiropractic services. (b) Vasectomies. (c) Tubal ligations....
... 32 National Defense 5 2010-07-01 2010-07-01 false Unauthorized care. 732.15 Section 732.15... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.15 Unauthorized care. The following are not authorized by this part: (a) Chiropractic services. (b) Vasectomies. (c) Tubal ligations....
... RELATING TO HEALTH CARE ACCESS ISSUER USE OF PREMIUM REVENUE: REPORTING AND REBATE REQUIREMENTS Disclosure... utilization management. For example, if an issuer contracts with a behavioral health, chiropractic network, or... Protection and Affordable Care Act, 42 U.S.C. 18061, 18062, 18063. (5) Other adjustments to incurred...
... RELATING TO HEALTH CARE ACCESS ISSUER USE OF PREMIUM REVENUE: REPORTING AND REBATE REQUIREMENTS Disclosure... utilization management. For example, if an issuer contracts with a behavioral health, chiropractic network, or... Affordable Care Act, 42 U.S.C. 18061, 18062, 18063. (5) Other adjustments to incurred claims: (i)...
Stick-Mueller, Misty; Boesch, Ron; Silverman, Steven; Carpenter, Scott; Illingworth, Robert; Countryman, James
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…
... 32 National Defense 5 2011-07-01 2011-07-01 false Unauthorized care. 732.15 Section 732.15... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.15 Unauthorized care. The following are not authorized by this part: (a) Chiropractic services. (b) Vasectomies. (c) Tubal ligations....
... 32 National Defense 5 2014-07-01 2014-07-01 false Unauthorized care. 732.15 Section 732.15... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.15 Unauthorized care. The following are not authorized by this part: (a) Chiropractic services. (b) Vasectomies. (c) Tubal ligations....
... RELATING TO HEALTH CARE ACCESS ISSUER USE OF PREMIUM REVENUE: REPORTING AND REBATE REQUIREMENTS Disclosure... utilization management. For example, if an issuer contracts with a behavioral health, chiropractic network, or... health care quality, to reflect the experience of the issuer with respect to the employer as a...
... RELATING TO HEALTH CARE ACCESS ISSUER USE OF PREMIUM REVENUE: REPORTING AND REBATE REQUIREMENTS Disclosure..., chiropractic network, or high technology radiology vendor, or a pharmacy benefit manager, and the vendor... affiliate's incurred claims and activities to improve health care quality, to reflect the experience of...
chiropractic services is limited to charges for physical examina- tions, related laboratory tests, and X-rays to diagnose a subluxation of the spine; and...FRTCONSULTED 16HSPTETVRHASME GIFNEEGNC A IjURY (ACCIDENT ORYUFOR THIS CONDITION OR SIMILAR SYMPTOMS’ CHECK HEREE PREGNANCY (LMP) YES P40 N DATE PATIENT ABLE
... Chiropractic program). 3. Commission on English Language Program Accreditation. (Current Scope: The accreditation of postsecondary, non-degree-granting English language programs and institutions in the United..., Nebraska, New Mexico, North Dakota, Ohio, Oklahoma, South Dakota, West Virginia, Wisconsin, Wyoming, and...
...: Ph.D. and Psy.D. (d) Counseling Psychology: Ph.D. (e) Social Work: Masters level only. (f) Chemical..., public health nursing, dentistry, psychiatry, osteopathy, optometry, pharmacy, psychology, public health, social work, marriage and family therapy, chiropractic medicine, environmental health and engineering,...
Chang, Caitlin A; Lin, Tony; Fung, Kevin; Sharma, Manas; Fraser, J Alexander
Eagle syndrome occurs when an elongated styloid process causes otolaryngological or neurological symptoms or signs. We report a patient who had an isolated asymptomatic Horner syndrome that resulted from a pinned internal carotid artery being dynamically injured by an elongated styloid process during chiropractic neck manipulation. There was no evidence of arterial dissection.
Linaker, Kathleen Linda
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…
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…
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…
This commentary considers one of the articles published in the first volume of this journal and reflects on the status of research and knowledge at that time. The chiropractic profession has witnessed advancement in the use of the scientific method in the past several decades, and scholarly journals have helped support this substantial growth.
Physical Therapy, Optometry , Audiology, Tele-Dermatology and Eyes, Nose & Throat (ENT); (3) Dental Care, i.e., General Dentistry, Oral Surgery...Physical Therapy, Chiropractic, Optometry , Audiology, Public Health and Eyes, Nose & Throat (ENT); (3) Dental Care, including General Dentistry
Where We Stand—CMA Position Papers: • Abortion • Acupuncture • Chiropractic • Confidentiality • Cost of Care • Drug Abuse • Environmental Health • Health Education for the Public • Health in the United States • Health Quackery • Health Maintenance Organizations and Prepaid Health Plans • Health Manpower • National Health Insurance • Physician's Assistants • Physician Unions • Professional Standards Review Organizations • Quality Medical Care
To serve the interests of members and to function in the public interest, the California Medical Association must set policies and take positions on current issues affecting the health care of Californians. These policies then guide the activities of the Association in fulfilling its leadership role and its responsibility to the public. Delegates, elected by the membership of CMA's component medical societies, meet annually to deliberate and determine the policies and courses of action for the Association. Between meetings of these Delegates, the CMA Councilors, elected by their district membership, implement the directives of the Delegates and set interim policies. By this democratic process, the membership governs the CMA. Association members must be informed if they are to participate effectively in the affairs of their medical organizations. To disseminate better understanding of CMA's activities, position papers on current issues have been developed. They are based on House of Delegates resolutions and Council actions. Entitled “Where We Stand on Medical and Health Issues,” these papers represent the current policy positions of CMA. Each paper is annotated to give the reference source of the policy actions. As with any organization, CMA policies are subject to timely revision. When policies are amended or new policies are adopted, new papers will be developed. PMID:4148533
Keating, Joseph C.
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
Vernon, L F
The practice of chiropractic has been regulated in the State of Delaware since 1937. Since that time, the battle lines in the state between medicine and chiropractic have been drawn. This war has existed on both the political and clinical fronts, and although it has always been believed by the chiropractic profession that once the "scientific evidence" of the benefit of chiropractic was proven, the war would end. This has not occurred to the extent believed. Even with its 1980 victory over the AMA, chiropractic has still been unable to achieve full acceptance as a clinical discipline among other professions. Many hospitals in this country have opened their doors to DCs. This by and large, has solely been for economic reasons and not as a recognition of the clinical benefit of manipulation. There is, however, a growing population of primary care physicians and researchers suggesting the benefit of manipulation for low back pain as well as suggesting that increased cooperation between MDs and DCs could be of extreme benefit to the patient population at large. This group continues to be in the minority. However, with increased knowledge of the benefits of spinal manipulation and the scientific evidence that now exists to support its efficacy, it is now believed that this interprofessional referral pattern will increase. In addition, many managed care programs now require primary care physicians to determine the necessity for referral to a chiropractor, thus causing a need for the primary physician to have some knowledge of spinal manipulation. This paper is presented to inform the physician community of Delaware of some of the evidence pointing to the efficacy of spinal manipulation as a treatment for low back pain.
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
Keating, Joseph C; Haldeman, Scott
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
Lawson, Douglas M
The Canadian Chiropractic Examining Board (CCEB) is now in its fortieth year of providing quality measurement and evaluation services to the chiropractic profession in Canada. Dr. James Langford and his wife Lorraine are to be acknowledged for their significant contribution in the early days of the organization. The CCEB now provides both written knowledge and clinical skills examinations. External consultants are utilized on both examinations to ensure that the examinations are of high quality and to provide guidance to the CCEB and its Board of Governors. The CCEB is committed to expert consulting, research and publication, and external accreditation. The following is a description of the current measurement and evaluation practices, future advancements to the examinations, changes in the corporate structure and governance model, and sustainability of the examination processes. Imagesp201-ap203-ap203-bp203-cp203-dp203-ep203-fp203-g
Brown, Douglas M
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
Gudavalli, Maruti Ram; Cox, James M
A form of chiropractic procedure known as Cox flexion-distraction is used by chiropractors to treat low back pain. Patient lies face down on a specially designed table having a stationery thoracic support and a moveable caudal support for the legs. The Doctor of Chiropractic (DC) holds a manual contact applying forces over the posterior lumbar spine and press down on the moving leg support to create traction effects in the lumbar spine. This paper reports on the development of real-time feedback on the applied forces during the application of the flexion-distraction procedure. In this pilot study we measured the forces applied by experienced DCs as well as novice DCs in using this procedure. After a brief training with real-time feedback novice DCs have improved on the magnitude of the applied forces. This real-time feedback technology is promising to do systematic studies in training DCs during the application of this procedure.
Passmore, Steven R; Murphy, Bernadette; Lee, Timothy D
Somatosensory evoked potentionals (SEPs) can be used to elucidate differences in cortical activity associated with a spinal manipulation (SM) intervention. The purpose of this narrative review is to overview the origin and application of SEPs, a neurophysiological technique to investigate neuroplasticity. Summaries of: 1) parameters for SEP generation and waveform recording; 2) SEP peak nomenclature, interpretation and generators; 3) peaks pertaining to tactile information processing (relevant to both chiropractic and other manual therapies); 4) utilization and application of SEPs; 5) SEPs concurrent with an experimental task and at baseline/control/pretest; 6) SEPs pain studies; and 7) SEPs design (pre/post) and neural reorganization/neuroplasticity; and 8) SEPs and future chiropractic research are all reviewed. Understanding what SEPs are, and their application allows chiropractors, educators, and other manual therapists interested in SM to understand the context, and importance of research findings from SM studies that involve SEPs.
Seidman, Michael B.; Vining, Robert D.; Salsbury, Stacie A.
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
Desmarais, Ariane; Descarreaux, Martin
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.
In the early 1920s, the Manitoba medical profession reached a pinnacle in its opposition to alternative medicine, waging an aggressive four-year campaign against chiropractic and osteopathy to “protect” the public from the dangers of alternative forms of healing and prevent “irregulars” from establishing their practices. It was during these same years that the Manitoba medical profession was able to successfully overcome many internal problems of consensus and external problems of legitimacy. Examining the years leading up to, during, and following the campaign, this paper demonstrates how the Manitoba medical profession’s militant reaction to osteopathy and chiropractic during these years helped strengthen and differentiate orthodox practitioners as a group, thus reinforcing their authority within the public realm. PMID:17549158
Chiropractors in Australia face some challenges that are unique in their history. The value of their primary treatment modality is now widely recognised. The process of professionalisation of this occupation is well advanced. Yet the integration of chiropractic services within the mainstream Australian health care system remains problematic. It is contended in this paper that chiropractors' integration will be facilitated by two genuine and strategic moves by the medically minded segment of, or the entire, profession. One is to abandon metaphysical notions as part of the 'philosophy of chiropractic' and the other is to pursue limited prescription rights allowing chiropractors to play fully the role of the primary contact practitioners of neuromusculoskeletal medicine. This development is deemed to be beneficial and appropriate for the profession as well as the patients served by this profession.
Dadone, Liza I; Haussler, Kevin K; Brown, Greg; Marsden, Melanie; Gaynor, James; Johnston, Matthew S; Garelle, Della
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.
Morgan, Lon G
A segment of chiropractic has historically opposed the practice of immunization. This opposition has been based on historical and philosophical precedent, but with little support from the scientific literature. Pertussis immunization has successfully controlled a disease with a prior history of high childhood morbidity. An evaluation of the literature fails to find supporting evidence that whole-cell pertussis vaccine causes SIDS, asthma, or encephalopathy. Countries who discontinued pertussis immunization experienced a return of the disease, and in every case pertussis immunization has been reinstated. The recent successful clinical trials and subsequent approval of an acellular pertussis vaccine should reduce the local reactions and discomfort sometimes experienced with the whole-cell product. In view of the considerable scientific evidence for the desirability and efficacy of pertussis immunization, chiropractic should encourage patient participation in this worthwhile public health service.
Athaide, Michelle; Rego, Carol; Budgell, Brian
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
Welk, Aaron B.; Werdehausen, Destiny N.; Kettner, Norman W.
Objective A retrospective case report of a 24-year-old man with recurrent lumbar disk herniation and epidural fibrosis is presented. Recurrent lumbar disk herniation and epidural fibrosis are common complications following lumbar diskectomy. Clinical Features A 24-year-old patient had a history of lumbar diskectomy and new onset of low back pain and radiculopathy. Magnetic resonance imaging revealed recurrent herniation at L5/S1, left nerve root displacement, and epidural fibrosis. Intervention and Outcomes The patient received a course of chiropractic care including lumbar spinal manipulation and rehabilitation exercises with documented subjective and objective functional and symptomatic improvement. Conclusion This case report describes chiropractic management including spinal manipulative therapy and rehabilitation exercises and subsequent objective and subjective functional and symptomatic improvement. PMID:23843756
Kim, Peter S Y; Hsu, William
Recent papers, including a review conducted by van Tulder et al., have suggested that there is paucity of information as to the efficacy of acupuncture treatment. However, there has been a significant increase in the use of acupuncture therapy for treatment of various ailments, including lower back pain. Chiropractors, along with other health care professionals, are using acupuncture as an adjunct to their main therapeutic intervention as demonstrated by a recent survey by the Canadian Chiropractic Protective Association (CCPA). However, like many other interventions, including NSAIDs and spinal manipulations, signs of side effects should be monitored when acupuncture treatments are considered. Recent papers have noted such complications as pneumothorax and hepatitis following acupuncture treatments. A case is presented in which a patient, who received previous acupuncture treatments, presented to a chiropractic clinic complaining of low back and leg pain. Early recognition of potential complications after acupuncture treatment may minimize significant impairments and disability.
Passmore, Steven R.; Murphy, Bernadette; Lee, Timothy D.
Somatosensory evoked potentionals (SEPs) can be used to elucidate differences in cortical activity associated with a spinal manipulation (SM) intervention. The purpose of this narrative review is to overview the origin and application of SEPs, a neurophysiological technique to investigate neuroplasticity. Summaries of: 1) parameters for SEP generation and waveform recording; 2) SEP peak nomenclature, interpretation and generators; 3) peaks pertaining to tactile information processing (relevant to both chiropractic and other manual therapies); 4) utilization and application of SEPs; 5) SEPs concurrent with an experimental task and at baseline/control/pretest; 6) SEPs pain studies; and 7) SEPs design (pre/post) and neural reorganization/neuroplasticity; and 8) SEPs and future chiropractic research are all reviewed. Understanding what SEPs are, and their application allows chiropractors, educators, and other manual therapists interested in SM to understand the context, and importance of research findings from SM studies that involve SEPs. PMID:24932021
Johnson, Claire; Clum, Gerard; Lassiter, Wright L.; Phillips, Reed; Sportelli, Louis; Hunter, James C.
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
treatment categories were (a) chiropractic, (b) lifestyle and diet, (c) exercise/movement, and (d) relaxation. Herbs were used as the third most popular...Most users found the treatments beneficial, with seven of the 78 herb users reporting adverse effects. Four of the six users reporting adverse events... herbs demonstrates a general belief of and willingness to use treatments other than those offered by conventional medicine. Many respondents
Liang, Raymond CR
Calcium and vitamin D deficiencies are associated with abnormal muscular functions including non-specific pain and weakness. A diet survey of a patient complaining of back pain showed a low calcium intake. Clinically patients may have low utilization of dietary calcium. In addition to the normal chiropractic treatments, the patient was given calcium and vitamin D supplements. These supplements greatly improved the recovery of the patient. The nutritional status of calcium and vitamin D in the general Canadian population is discussed.
AMED: The Allied and Complementary Medicine Database is a resource from the Health Care Information Service of the British Library. AMED offers access to complementary and alternative medicine topics, such as acupuncture, chiropractic, herbalism, homeopathy, hospice care, hypnosis, palliative care, physiotherapy, podiatry, and rehabilitation. This column features a sample search to demonstrate the type of information available within AMED. AMED is available through the EBSCOhost and OVID platforms.
Brown, Douglas M
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.
A Comparison of the Audit and Accreditation Tools Used By The Health Care Financing Administration, The Texas Department of Insurance, and The National Committee on Quality Assurance: The Cost of Multi-Agency Oversight on Medicare+Choice Plans in Texas
coverage ( Cassidy & Gold, 2000). Fewer HMOs are offering a M+C plan with no additional premium. In 1999, 62 percent of the M+C markets had plans that...from 1999 to 2000 nationwide ( Cassidy & Gold, 2000). While premiums are increasing, the availability of key benefits for Medicare members is on the...chiropractic benefits in 2000, compared to 19 percent in 1999 ( Cassidy & Gold, 2000) In Texas, two HMOs either added monthly premiums or increased service
if the actual physical or emotional disability is a result both of industrial injury (or stresses) and pre-existing and nonindustrial conditions...retrospective reviews, and negotiated rates; (3) new or marginal clinical entities, such as chiropractic , should be carefully monitored; (4) a single state...responsibilities should be considered part of a new system that will help both the doctor and the patient in their pursuit of rapid healing. To minimize physical
healthcare for certain non-active duty reservists and extended chiropractic care to active duty members placing yet additional pressures on defense health...coalition of lobbyists and elected representatives to implement reforms. The recent passage of the Patient Protection and Affordable Care Act (PPACA... Care Act (PPACA), Capitation, Health Savings Accounts (HAS), AHLTA, VistA, TRICARE, Military Healthcare System (MHS). 16. SECURITY CLASSIFICATION
providers, subject to regulations. Certain types of care , such as most dentistry and chiropractic services, are excluded. In addition to Tricare...COVERED 00-00-2009 to 00-00-2009 4. TITLE AND SUBTITLE Military Medical Care : Questions and Answers 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...deliver health care during wartime. The military health system also provides health care services through either Department of Defense (DOD) medical
providers, subject to regulations. Certain types of care , such as most dentistry and chiropractic services, are excluded. In addition to Tricare Standard...Order Code RL33537 Military Medical Care : Questions and Answers Updated August 4, 2008 Richard A. Best Jr. Specialist in National Defense Foreign...control number. 1. REPORT DATE 04 AUG 2008 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Military Medical Care : Questions and
care for rural areas; Health professions research issues; Chiropractic demonstration projects; Emergency medicine residency training FY 1995...8217 medical care and construction and leases of medical facilities authorized in the Veterans’ Health Care Eligibility Reform Act of 1996, as well as most of...1998 APPROPRIATIONS: $ 1,043,000,000 "* Emergency shelter; Supportive/transitional; Safe Haven; Section 8 SROs; Shelter plus care FY 1994 APPROPRIATIONS
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?
and a tracking of these measures over time both as a means to document and understand the normal recovery process and response to treatment and to...N, Macdonald R, Rutks I, Sayer NA, Dobscha SK and Wilt TJ. Prevalence, assessment, and treatment of mild traumatic brain injury and posttraumatic...potentially modifiable factors. 0078 Chiropractic Sacro Occipital Technique (SOT) and Cranial Treatment Model for Traumatic Brain Injury Along with
Xue, Charlie C.L.
Abstract Background Sixty percent (60%) to 80% of patients who visit chiropractic, osteopathic, or Chinese medicine practitioners are seeking pain relief. Objectives This article aimed to identify the amount, quality, and type of complementary and alternative medicine (CAM) pain research in Australia by systematically and critically reviewing the literature. Methods PubMed, Scopus, Australasian Medical Index, and Cochrane library were searched from their inception to July 2009. Australian and New Zealand Clinical Trial Registration and National Health and Medical Research Council databases were searched for human studies yet to be completed. Predefined search terms and selection criteria were used for data identification. Results Of 204 studies selected, 54% were on chiropractic, 27% on Chinese medicine, 15% about multitherapy, and 4% on osteopathy. Chronic spinal pain was the most studied condition, with visceral pain being the least studied. Half of the articles in Chinese medicine or multitherapy were systematic reviews or randomized control trials. In comparison, only 5% of chiropractic and none of osteopathy studies were in these categories. Government funding was rare, and most studies were self-funded or internally funded. All chiropractic, osteopathic, and Chinese herbal medicine studies were conducted by the researchers of the professions. In contrast, half of the acupuncture studies and all t'ai chi studies were conducted by medical doctors or physiotherapists. Multidisciplinary collaboration was uncommon. Conclusions The quantity and the quality of CAM pain research in Australia are inconsistent with the high utilization of the relevant CAM therapies by Australians. A substantial increase in government funding is required. Collaborative research examining the multimodality or multidisciplinary approach is needed. PMID:22891634
Yuen, Tammy; Wells, Kayla; Benoit, Samantha; Yohanathan, Sahila; Capelletti, Lauren; Stuber, Kent
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
Shreeve, Michael W
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.
Jensen, Anne M.; Bewketu, Brutawit; Sanford, Douglas
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
Stobert, Julia R.; Emary, Peter C.; Taylor, John A.
Objective The purpose of this case report is to describe a patient with femoroacetabular impingement (FAI) who was initially misdiagnosed and treated for a hip flexor strain. Clinical Features A 36-year-old male patient presented with insidious onset of progressive anterior right hip and groin pain of 7 years' duration. He was diagnosed with a right-sided hip flexor muscle strain and was discharged from care 1 month later. The patient then returned to the office 8 years later for treatment of unrelated lower back pain. This time, the doctor of chiropractic learned that the patient was misdiagnosed years before. The patient's past radiographs in fact revealed FAI, including severe hip joint osteoarthritis on the right and mild osteoarthritis on the left. As a result, the patient had undergone right hip joint replacement surgery. Recent radiographs also revealed FAI in the contralateral hip. Intervention and Outcome After investigating for FAI, the doctor of chiropractic was able to identify through symptomatology, history, physical examination, and radiographs the presence of FAI in the patient's left hip. An “active surveillance” approach is being taken. Conclusion This case illustrates the importance of an increasing awareness of FAI, as doctors of chiropractic are frequently the primary contact for patients with this condition. PMID:26793042
Shreeve, Michael W.
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
Stainsby, Brynne E.; Clarke, Michelle C.S.; Egonia, Jade R.
Objective: The purpose of this study was to evaluate the effectiveness of different reported methods used to teach spinal manipulative therapy to chiropractic students. Methods: For this best-evidence literature synthesis, 5 electronic databases were searched from 1900 to 2015. Eligible studies were critically appraised using the criteria of the Scottish Intercollegiate Guidelines Network. Scientifically admissible studies were synthesized following best-evidence synthesis principles. Results: Twenty articles were critically appraised, including 9 randomized clinical trials, 9 cohort studies, and 2 systematic reviews/meta-analyses. Eleven articles were accepted as scientifically admissible. The type of teaching method aids included a Thrust in Motion cervical manikin, instrumented cardiopulmonary reanimation manikin, padded contact with a load cell, instrumented treatment table with force sensor/transducer, and Dynadjust instrument. Conclusions: Several different methods exist in the literature for teaching spinal manipulative therapy techniques; however, future research in this developing area of chiropractic education is proposed. It is suggested that various teaching methods be included in the regular curricula of chiropractic colleges to aid in developing manipulation skills, efficiency, and knowledge of performance. PMID:26998630
Powell, Wayne; Knaap, Simone F.C.
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
Cox, Jocelyn; Davidian, Christine; Mior, Silvano
Introduction: Spinal pain in the paediatric population is a significant health issue, with an increasing prevalence as they age. Paediatric patients attend for chiropractor care for spinal pain, yet, there is a paucity of quality evidence to guide the practitioner with respect to appropriate care planning. Methods: A retrospective chart review was used to describe chiropractic management of paediatric neck pain. Two researchers abstracted data from 50 clinical files that met inclusion criteria from a general practice chiropractic office in the Greater Toronto Area, Canada. Data were entered into SPSS 15 and descriptively analyzed. Results: Fifty paediatric neck pain patient files were analysed. Patients’ age ranged between 6 and 18 years (mean 13 years). Most (98%) were diagnosed with Grade I–II mechanical neck pain. Treatment frequency averaged 5 visits over 19 days; with spinal manipulative therapy used in 96% of patients. Significant improvement was recorded in 96% of the files. No adverse events were documented. Conclusion: Paediatric mechanical neck pain appears to be successfully managed by chiropractic care. Spinal manipulative therapy appears to benefit paediatric mechanical neck pain resulting from day-today activities with no reported serious adverse events. Results can be used to inform clinical trials assessing effectiveness of manual therapy in managing paediatric mechanical neck pain. PMID:27713576
Cofano, Gregory; Meyers, Meredith; Sergent, Adam; LaCourt, Shawn
Objective The purpose of this case report is to describe chiropractic management and referral of a patient with rib pain who was subsequently diagnosed with renal cell carcinoma. Clinical Features A 65-year-old woman presented with radiating rib pain to a chiropractic clinic. She was treated with a 2-week course of conservative care. On follow-up evaluation, she reported a deep ache over her lower ribs, wrapping around to her abdomen. Palpation under the anterior rib cage reproduced her pain, and she also had a positive Murphy Sign. She was referred for an abdominal ultrasonography. Intervention and Outcome Ultrasonography showed a 12-cm solid vascular mass of the right kidney. Further imaging studies using computerized tomography and magnetic resonance imaging confirmed the ultrasonography findings. She was referred to a cancer center for staging of the cancer and subsequent surgical treatment. The involved tissue, as well as the kidney and part of the inferior vena cava, was removed, and the pathology report determined that the mass was clear cell carcinoma. Conclusion This case describes an unusual presentation of a patient with rib pain that had previously undiagnosed renal cancer. Referral by her doctor of chiropractic resulted in detection of the tumor and treatment. PMID:27069436
Sherman, Karen J; Cherkin, Daniel C; Connelly, Maureen T; Erro, Janet; Savetsky, Jacqueline B; Davis, Roger B; Eisenberg, David M
Background Although back pain is the most common reason patients use complementary and alternative medical (CAM) therapies, little is known about the willingness of primary care back pain patients to try these therapies. As part of an effort to refine recruitment strategies for clinical trials, we sought to determine if back pain patients are willing to try acupuncture, chiropractic, massage, meditation, and t'ai chi and to learn about their knowledge of, experience with, and perceptions about each of these therapies. Methods We identified English-speaking patients with diagnoses consistent with chronic low back pain using automated visit data from one health care organization in Boston and another in Seattle. We were able to confirm the eligibility status (i.e., current low back pain that had lasted at least 3 months) of 70% of the patients with such diagnoses and all eligible respondents were interviewed. Results Except for chiropractic, knowledge about these therapies was low. Chiropractic and massage had been used by the largest fractions of respondents (54% and 38%, respectively), mostly for back pain (45% and 24%, respectively). Among prior users of specific CAM therapies for back pain, massage was rated most helpful. Users of chiropractic reported treatment-related "significant discomfort, pain or harm" more often (23%) than users of other therapies (5–16%). Respondents expected massage would be most helpful (median of 7 on a 0 to 10 scale) and meditation least helpful (median of 3) in relieving their current pain. Most respondents indicated they would be "very likely" to try acupuncture, massage, or chiropractic for their back pain if they did not have to pay out of pocket and their physician thought it was a reasonable treatment option. Conclusions Most patients with chronic back pain in our sample were interested in trying therapeutic options that lie outside the conventional medical spectrum. This highlights the need for additional studies evaluating
Romano, Michele; Negrini, Stefano
Background The treatment of adolescent idiopathic scoliosis is contingent upon many variables. Simple observation is enough for less serious curvatures, but for very serious cases surgical intervention could be proposed. Between these there is a wide range of different treatments. Manual therapy is commonly used: the aim of this paper is to verify the data existing in the literature on the efficacy of this approach. Methods A systematic review of the scientific literature published internationally has been performed. We have included in the term manual therapy all the manipulative and generally passive techniques performed by an external operator. In a more specific meaning, osteopathic, chiropractic and massage techniques have been considered as manipulative therapeutic methods. We performed our systematic research in Medline, Embase, Cinhal, Cochrane Library, Pedro with the following terms: idiopathic scoliosis combined with chiropractic; manipulation; mobilization; manual therapy; massage; osteopathy; and therapeutic manipulation. The criteria for inclusion were as follows: Any kind of research; diagnosis of adolescent idiopathic scoliosis; patients treated exclusively by one of the procedures established as a standard for this review (chiropractic manipulation, osteopathic techniques, massage); and outcome in Cobb degrees. Results We founded 145 texts, but only three papers were relevant to our study. However, no one of the three satisfied all the required inclusion criteria because they were characterized by a combination of manual techniques and other therapeutic approaches. Conclusion The lack of any kind of serious scientific data does not allow us to draw any conclusion on the efficacy of manual therapy as an efficacious technique for the treatment of Adolescent idiopathic scoliosis. PMID:18211702
Taylor, Shane H; Arnold, Nicole D; Biggs, Lesley; Colloca, Christopher J; Mierau, Dale R; Symons, Bruce P; Triano, John J
Over the past decade, mechanical adjusting devices (MADs) were a major source of debate within the Chiropractors’ Association of Saskatchewan (CAS). Since Saskatchewan was the only jurisdiction in North America to prohibit the use of MADs, the CAS established a committee in 2001 to review the literature on MADs. The committee evaluated the literature on the efficacy, safety, and uses of moving stylus instruments within chiropractic practice, and the educational requirements for chiropractic practice. Following the rating criteria for the evaluation of evidence, as outlined in the Clinical Guidelines for Chiropractic Practice in Canada (1994), the committee reviewed 55 articles – all of which pertained to the Activator. Of the 55 articles, 13 were eliminated from the final study. Of the 42 remaining articles, 6 were rated as class 1 evidence; 11 were rated as class 2 evidence and 25 were rated as class 3 evidence. In this article – the first in a series of two – the background and the methods utilized by the MAD committee’s activities are described, as well as the results for the review of the literature on efficacy. Of the 21 articles related to efficacy, five were identified as Class 1 evidence; 4 were identified as Class 2 evidence; and 12 were identified as Class 3. Overall, the committee reached consensus that the MAD procedures using the Activator were as effective as manual (HVLA) procedures in producing clinical benefit and biological change. A minority report was also written, arguing that there was not enough evidence to support or refute the efficacy of MADs. PMID:17549220
Avrahami, Daniel; Pajaczkowski, Jason A.
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
Blanchette, Marc-André; Cassidy, J. David; Rivard, Michèle; Dionne, Clermont E.
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
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
Nash, J; Johnson, C D; Green, B N
Following closely upon the controversial introduction of the Neurocalometer in 1924, the announcement of the Hole-In-One (HIO) theory created yet another significant stir in the chiropractic profession in the early 1930s. Surprisingly, no one has ever tried to trace the history of HIO using primary reference material. Today, numerous spin-off techniques from HIO exist. Some claim that B.J. Palmer invented HIO while others say it was Aleck August Wernsing, D.C., from California. Was it really B.J. Palmer's idea, or did he get it from Wernsing? In this paper the authors have attempted to trace the origins of HIO theory.
Brown, Douglas M.
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
Complementary and alternative medicine (CAM) is a diverse group of health care practices and products that fall outside the realm of traditional Western medical theory and practice and that are used to complement or replace conventional medical therapies. The use of CAM has increased over the past two decades, and surveys have shown that up to 44% of patients with epilepsy are using some form of CAM treatment. This article reviews the CAM modalities of meditation, yoga, relaxation techniques, biofeedback, nutritional and herbal supplements, dietary measures, chiropractic care, acupuncture, Reiki, and homeopathy and what is known about their potential efficacy in patients with epilepsy.
Kidd, J Randy
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.
Seffinger, Michael; Adams, Alan; Najm, Wadie; Dickerson, Vivian; Mishra, Shiraz I; Reinsch, Sibylle; Murphy, Linda
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.
Complementary and alternative medicine use Chiropractic care 8,424 (10.9) (8.0) (14.8) Herbal therapy 7,312 (9.5) (8.6) (10.7) Acupuncture 1,289 (1.7) (1.7...with postwar handgrip strength. Mil Med 2000;165:165e8.  Smith TC, Heller JM, Hooper TI, Gackstetter GD, Gray GC. Are vet - erans of the Gulf War...5] Smith TC, Gray GC, Weir JC, Heller JM, Ryan MAK. Gulf War vet - erans and Iraqi nerve agents at Khamisiyah. Postwar hospitalization data revisited
Henson, Steve W; Pressley, Milton; Korfmann, Scott
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
Kitchen, Robert G; Waddell, Brad M; Willson, Robert D
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
Casualty Care is JTF CapMed’s number one priority 2011 MHS Conference JTF CapMed Relationships 3 JTF SECRETARY OF DEFENSE DEPUTY SECRETARY OF DEFENSE... Care • Consolidated Cancer Center • Gynecological Oncology • Prostate Oncology • Breast Cancer • Medical Oncology • Surgical Oncology • Comprehensive...Health • Inpatient Pediatric • Breast Center • Nuclear Medicine • Laser Eye Center • Oral Surgery • Chiropractic Services • Pain Clinic • Rheumatology
Medical/Dental benefit expansion ($59) • Medical record privacy ($30) • Custodial care ($15) • Chiropractic health care ($12) FY 2002 (annual cost...Retiree Health Care Fund $11B Numbers may not add due to rounding. Defense Health Program $28B In-Patient Out-Patient $7B Other Private Sector Care $2B...Private Sector Care $11B Appropriation Totals ($B) O&M …………………………… 20 MilPers ………………………….. 6 RDT&E, MilCon, Procurement … 1 Active Duty & TRICARE Prime
TRICARE PRIME Remote ADFM ($65) • Medical/Dental benefit expansion ($59) • Medical record privacy ($30) • Custodial care ($15) • Chiropractic health care ...39B DoD Medicare Eligible Retiree Health Care Fund $11B Numbers may not add due to rounding. Defense Health Program $28B In-Patient Out-Patient $7B...Other Private Sector Care $2B Private Sector Care $11B Appropriation Totals ($B) O&M …………………………… 20 MilPers ………………………….. 6 RDT&E, MilCon, Procurement
The Missouri Board of Chiropractic Examiners will decide later this year if [name removed]' license should be revoked or suspended because [name removed] allegedly told an HIV-positive patient that he had been cured. [Name removed] denies claiming that the patient was cured by his Interro machine. The patient claims he and his wife then decided to have children. The mother gave birth in 1992, and although the infant is not infected, the mother is. The patient's mother-in-law testified that [name removed] had assured her that the patient's virus had been absolutely eradicated by his treatments.
Diakow, P R; Gadsby, T A; Gadsby, J B; Gleddie, J G; Leprich, D J; Scales, A M
A retrospective study of 400 pregnancies and deliveries was undertaken by interview of 170 consecutive female patients presenting to five chiropractic offices in the Niagara Peninsula. Back pain was reported during 42.5% (170) of the pregnancies and 44.7% (179) of the deliveries. There was a statistically significant association between back pain during the two events (p less than .001). Of the 170 pregnancies with reported back pain, 72% (122) also reported back labor. A subsample of 170 painful pregnancies was divided into those that had received manual manipulation and those that had not. The treated group experienced less pain during labor (p less than .001).
Murphy, P A; Kronenberg, F; Wade, C
Complementary and alternative medicine is becoming an established intervention modality within the contemporary health care system. Various forms of complementary and alternative medicine are used by patients and practitioners alike, including chiropractic, massage, botanical medicine, homeopathy, and energy therapies. The National Center for Complementary and Alternative Medicine was established within the National Institutes of Health to facilitate evaluation of these alternative therapies, establish an information clearinghouse, and promote research in the field. This article discusses several aspects of complementary and alternative medicine, relates them to women's health, and describes the need for a research agenda to evaluate the impact of the complementary and alternative medicine modalities used for important conditions affecting women.
Tuchin, Peter; Perle, Stephen
In reviewing Melikyan et al., we discuss what we think are weaknesses in the case report. The authors did not report on known risk factors for cerebrovascular accident and vertebral artery dissection. Known symptoms that appear early in vertebral artery dissection were not reported or denied, specifically related to changes in the patient's pattern of neck pain. Causality was assumed when only a weak temporal relation was involved. Finally, the case report makes it appear that the manipulation was performed by someone other than a chiropractor but therefore erroneously uses chiropractic in the title. PMID:27413722
Brown, Douglas M.
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
Peregoy, Jennifer A.; Clarke, Tainya C.; Jones, Lindsey I.; Stussman, Barbara J.; Nahin, Richard L.
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
Keating, Joseph C; Charlton, Keith H; Grod, Jaroslaw P; Perle, Stephen M; Sikorski, David; Winterstein, James F
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
Siordia, Lawrence; Keating, Joseph C
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.
Siordia, Lawrence; Keating, Joseph C
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
Kobsar, Bradley; Alcantara, Joel
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.
Chaibi, Aleksander; Tuchin, Peter J; Russell, Michael Bjørn
Migraine occurs in about 15% of the general population. Migraine is usually managed by medication, but some patients do not tolerate migraine medication due to side effects or prefer to avoid medication for other reasons. Non-pharmacological management is an alternative treatment option. We systematically reviewed randomized clinical trials (RCTs) on manual therapies for migraine. The RCTs suggest that massage therapy, physiotherapy, relaxation and chiropractic spinal manipulative therapy might be equally effective as propranolol and topiramate in the prophylactic management of migraine. However, the evaluated RCTs had many methodological shortcomings. Therefore, any firm conclusion will require future, well-conducted RCTs on manual therapies for migraine.
Introduction: The purpose of this study was to analyze the curriculum of one chiropractic college in order to discover if there were any implicit consensus definitions of the term subluxation. Methods: Using the software WordSmith Tools, the corpus of an undergraduate chiropractic curriculum was analyzed by reviewing collocated terms and through discourse analysis of text blocks containing words based on the root ‘sublux.’ Results: It was possible to identify 3 distinct concepts which were each referred to as ‘subluxation:’ i) an acute or instantaneous injurious event; ii) a clinical syndrome which manifested post-injury; iii) a physical lesion, i.e. an anatomical or physiological derangement which in most instances acted as a pain generator. Conclusions: In fact, coherent implicit definitions of subluxation exist and may enjoy broad but subconscious acceptance. However, confusion likely arises from failure to distinguish which concept an author or speaker is referring to when they employ the term subluxation. PMID:27385839
Loranger, Michel; Treboz, Julien; Boucher, Jean-Alexandre; Nougarou, François; Dugas, Claude; Descarreaux, Martin
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
Pribicevic, Mario; Pollard, Henry
Background This paper describes the clinical management of four cases of shoulder impingement syndrome using a conservative multimodal treatment approach. Clinical Features Four patients presented to a chiropractic clinic with chronic shoulder pain, tenderness in the shoulder region and a limited range of motion with pain and catching. After physical and orthopaedic examination a clinical diagnosis of shoulder impingement syndrome was reached. The four patients were admitted to a multi-modal treatment protocol including soft tissue therapy (ischaemic pressure and cross-friction massage), 7 minutes of phonophoresis (driving of medication into tissue with ultrasound) with 1% cortisone cream, diversified spinal and peripheral joint manipulation and rotator cuff and shoulder girdle muscle exercises. The outcome measures for the study were subjective/objective visual analogue pain scales (VAS), range of motion (goniometer) and return to normal daily, work and sporting activities. All four subjects at the end of the treatment protocol were symptom free with all outcome measures being normal. At 1 month follow up all patients continued to be symptom free with full range of motion and complete return to normal daily activities. Conclusion This case series demonstrates the potential benefit of a multimodal chiropractic protocol in resolving symptoms associated with a suspected clinical diagnosis of shoulder impingement syndrome. PMID:16168053
Horseman, Ian; Morningstar, Mark W.
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
Whedon, James M.; Glassey, Donald
We hypothesize that stasis of the cerebrospinal fluid (CSF) occurs commonly and is detrimental to health. Physiologic factors affecting the normal circulation of CSF include cardiovascular, respiratory, and vasomotor influences. The CSF maintains the electrolytic environment of the central nervous system (CNS), influences systemic acid-base balance, serves as a medium for the supply of nutrients to neuronal and glial cells, functions as a lymphatic system for the CNS by removing the waste products of cellular metabolism, and transports hormones, neurotransmitters, releasing factors, and other neuropeptides throughout the CNS. Physiologic impedance or cessation of CSF flow may occur commonly in the absence of degenerative changes or pathology and may compromise the normal physiologic functions of the CSF. CSF appears to be particularly prone to stasis within the spinal canal. CSF stasis may be associated with adverse mechanical cord tension, vertebral subluxation syndrome, reduced cranial rhythmic impulse, and restricted respiratory function. Increased sympathetic tone, facilitated spinal segments, dural tension, and decreased CSF flow have been described as closely related aspects of an overall pattern of structural and energetic dysfunction in the axial skeleton and CNS. Therapies directed at affecting CSF flow include osteopathic care (especially cranial manipulation), craniosacral therapy, chiropractic adjustment of the spine and cranium, Network Care (formerly Network Chiropractic), massage therapy (including lymphatic drainage techniques), yoga, therapeutic breathwork, and cerebrospinal fluid technique. Further investigation into the nature and causation of CSF stasis, its potential effects upon human health, and effective therapies for its correction is warranted. PMID:19472865
Chaibi, Aleksander; Šaltytė Benth, Jūratė; Bjørn Russell, Michael
At present, no consensus exists among clinical and academic experts regarding an appropriate placebo for randomized controlled trials (RCTs) of spinal manipulative therapy (SMT). Therefore, we investigated whether it was possible to conduct a chiropractic manual-therapy RCT with placebo. Seventy migraineurs were randomized to a single-blinded placebo-controlled clinical trial that consisted of 12 treatment sessions over 3 months. The participants were randomized to chiropractic SMT or placebo (sham manipulation). After each session, the participants were surveyed on whether they thought they had undergone active treatment ("yes" or "no") and how strongly they believed that active treatment was received (numeric rating scale 0-10). The outcome measures included the rate of successful blinding and the certitude of the participants' beliefs in both treatment groups. At each treatment session, more than 80% of the participants believed that they had undergone active treatment, regardless of group allocation. The odds ratio for believing that active treatment was received was >10 for all treatment sessions in both groups (all p < 0.001). The blinding was maintained throughout the RCT. Our results strongly demonstrate that it is possible to conduct a single-blinded manual-therapy RCT with placebo and to maintain the blinding throughout 12 treatment sessions given over 3 months.
Blanchette, Marc-André; Pham, Ai-Thu; Grenier, Julie-Marthe
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
Ohlsen, Bahia A.
Objective The purpose of this case study is to describe the treatment using acupuncture and spinal manipulation for a patient with a chronic tension-type headache and episodic migraines. Clinical Features A 32-year-old woman presented with headaches of 5 months' duration. She had a history of episodic migraine that began in her teens and had been controlled with medication. She had stopped taking the prescription medications because of gastrointestinal symptoms. A neurologist diagnosed her with mixed headaches, some migrainous and some tension type. Her headaches were chronic, were daily, and fit the International Classification of Headache Disorders criteria of a chronic tension-type headache superimposed with migraine. Intervention and Outcome After 5 treatments over a 2-week period (the first using acupuncture only, the next 3 using acupuncture and chiropractic spinal manipulative therapy), her headaches resolved. The patient had no recurrences of headaches in her 1-year follow-up. Conclusion The combination of acupuncture with chiropractic spinal manipulative therapy was a reasonable alternative in treating this patient's chronic tension-type headaches superimposed with migraine. PMID:23449932
Howell, Emily R.
Objective Two case reports review the chiropractic treatment and rehabilitation management of Symphysis Pubis Dysfunction (SPD). Clinical features Patient 1: a 35-year-old female presented at 30 weeks pregnant with severe left sided Symphysis Pubis Dysfunction and low back pain. Patient 2: a 33-year-old female also 30 weeks pregnant, presented with right sided Symphysis Pubis Dysfunction and sacroiliac pain. Intervention and Outcome Treatment included soft tissue therapy, pregnancy support belt, side-lying mobilizations, pelvic blocks and instrument-assisted pubic symphysis adjustments. Home advice included: ice, staying active, moving as a unit, stretching, use of a pillow between the knees while sleeping, regular breaks from sitting and pelvic floor (Kegel) exercises. Both patients reported some relief with treatment and home care. Post-partum, rehabilitation exercises were prescribed to restore muscular endurance, control and pelvic stability. On long-term follow-up patient 1 reported no pubic symphysis pain, but some low back pain secondary to a subsequent knee injury. Patient 2 reported being mostly pain free with a rare re-exacerbation of pubic symphysis pain. Summary Conservative chiropractic management appears to reduce pain and improve mobility and function for SPD. Post partum rehabilitation of the associated lumbo-pelvic musculature with specific stabilization exercises is recommended to reduce pain, improve long term outcomes and prevent chronicity. PMID:22675223
Blanchette, Marc-André; Pham, Ai-Thu; Grenier, Julie-Marthe
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.
Shekelle, P G; Markovich, M; Louie, R
Back pain is a common illness and chiropractors provide a large proportion of back pain care in the United States. This is the first study to systematically compare chiropractic patients with those who saw other providers for back pain. The authors analyzed data from the RAND Health Insurance Experiment, a community-based study of the use of health services. Insurance claims forms were examined for all visits specified by the patient as occurring for back pain. Visits were grouped into episodes using decision rules and clinical judgment. The primary provider of back pain care was defined as the provider who delivered most of the services. Sociodemographic and health status and attitudes variables of patients were examined for association with the choice of chiropractor. Multivariate logistic regression models were constructed to calculate adjusted odds ratios for independent predictors. There were 1020 episodes of back pain care made by 686 different persons and encompassing 8825 visits. Results indicated that chiropractors were the primary provider for 40% of episodes, and retained as primary provider a greater percentage of their patients (92%) who had a second episode of back pain care than did medical doctors. Health insurance experiment site, white race, male sex, and high school education were independent predictors of choosing a chiropractor. Conclusions suggested that chiropractors were the choice of one third of all patients who sought back pain care, and provided care for 40% of all episodes of care. Geographic site, education, gender, and income were independent patient factors predicting chiropractic use.
Chaibi, Aleksander; Šaltytė Benth, Jūratė; Bjørn Russell, Michael
At present, no consensus exists among clinical and academic experts regarding an appropriate placebo for randomized controlled trials (RCTs) of spinal manipulative therapy (SMT). Therefore, we investigated whether it was possible to conduct a chiropractic manual-therapy RCT with placebo. Seventy migraineurs were randomized to a single-blinded placebo-controlled clinical trial that consisted of 12 treatment sessions over 3 months. The participants were randomized to chiropractic SMT or placebo (sham manipulation). After each session, the participants were surveyed on whether they thought they had undergone active treatment (“yes” or “no”) and how strongly they believed that active treatment was received (numeric rating scale 0–10). The outcome measures included the rate of successful blinding and the certitude of the participants’ beliefs in both treatment groups. At each treatment session, more than 80% of the participants believed that they had undergone active treatment, regardless of group allocation. The odds ratio for believing that active treatment was received was >10 for all treatment sessions in both groups (all p < 0.001). The blinding was maintained throughout the RCT. Our results strongly demonstrate that it is possible to conduct a single-blinded manual-therapy RCT with placebo and to maintain the blinding throughout 12 treatment sessions given over 3 months. PMID:26145718
Whedon, James M; Glassey, Donald
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.
Walker, L A; Budd, S
There is no legislation that restricts the practice of CAM in the UK apart from the practice of chiropractic and osteopathy and limits on advertising the treatments of certain conditions such as cancer and tuberculosis. The UK government has increasingly recognised the need for comprehensive regulation of CAM, though it abandoned its original plan for a single overarching regulatory body. Initiatives to examine and hasten the process of regulation have included setting up a central, well-recognised charitable body to facilitate progress for individual professions, and an authoritative survey of the existing professional organisations. One pathway open to individual professions is statutory self-regulation, which requires a single governing body, a systematic corpus of knowledge, recognised training courses and demonstrated efficacy. The other pathway is voluntary self-regulation. Chiropractic and osteopathy have adopted statutory self-regulation, though this has proved expensive for individual members of these professions. A recent House of Lords report on CAM has recommended that the herbal medicine and acupuncture professions should also develop a system of statutory regulation. Other professions, such as aromatherapy, are in the process of establishing single professional bodies as a first step towards self-regulation. Among the issues that remain to be resolved is the relationship between the CAM professions and statutory registered practitioners who also practise CAM.
Clarke, David B; Doel, Marcus A; Segrott, Jeremy
In conjunction with its growing popularity, complementary and alternative medicine (CAM) in the United Kingdom has witnessed increasing professionalization, partly prompted by the landmark Parliamentary Inquiry that reported in November 2000. Professionalization has become a significant strategy for practitioner associations and a key focus for the government, media, and patient groups. It is being driven by concern over the interests of patients and consumers, and in relation to the possible integration of certain forms of CAM into publicly funded healthcare. It is, moreover, being reconfigured in explicitly national terms. This paper draws on research into practitioner associations representing nine CAM modalities in the UK-aromatherapy, Chinese herbal medicine, chiropractic, crystal healing, feng shui, 'lay' homeopathy, medical homeopathy, osteopathy, and Radionics-, examining the recent wave of professionalization in relation to Foucault's concern with 'techniques of the self.' It highlights the contrasting experience of an association of Chinese herbalists seeking statutory self-regulation (SSR) and an association of chiropractors that was instrumental in securing SSR for chiropractic.
White, Kristin E.
Objective The purpose of this case report is to describe and discuss the clinical presentation, diagnosis, and management of 3 female long distance runners with high hamstring tendinopathy. Clinical Features Three female runners presented to a chiropractic office with proximal hamstring pain that was aggravated by running. Increasing mileage, hills, and/or interval training preceded the onset of symptoms in each case. The subjects all displayed weakness of the hip abductors, pelvic joint dysfunction, hamstring tightness, and ischial tuberosity tenderness. Other clinical findings included overpronation, proprioceptive weakness, and lumbar dysfunction. Intervention and Outcome All 3 patients were treated with Graston Instrument Assisted Soft Tissue Mobilization, lumbopelvic manipulation, and electrical muscle stimulation with ultrasound. Active exercise focused on hamstring stretching and strengthening, gluteal strengthening, and proprioceptive training. The 3 runners seen in this clinic had resolution of hamstring pain in an average of 13 treatments and were able to continue competing without restriction. Conclusion Runners with high hamstring tendinopathy may respond favorably to conservative chiropractic treatment and active rehabilitation with minimal time off of training. PMID:22014863
Brown, Douglas M
The Canadian Memorial Chiropractic College (CMCC) or it’s agents, have been seeking some form of university affiliation for at least 30 years, yet to date those efforts have been fruitless. It has been said that one’s success is not measured by the position you have attained - but by the obstacles you have had to overcome to get there. CMCC has run into many stumbling blocks on the road to amalgamation. This triad of papers, Part 1 (JCCA 1992; 36(1):33-37) and Part III to follow at a later date, will endeavour to describe and document those barriers and the resourceful attempts that have been marshalled to surmount them. Part I, 1945 to 1969, concentrates on the first recorded proposals, emanating from the Western Divisions of the Canadian Chiropractic Association (CCA). Part II, 1969 to 1988, will outline the scattergun method that was used to approach numerous institutions, primarily in Ontario. Part III, 1988 to 1991, will focus on an account of the push for union with the University of Victoria, in British Columbia (U Vic).
Waalen, Judith K; Mior, Silvano A
This study examined a wide range of variables relating to the practice patterns of 692 Ontario chiropractors (approximately 30% of all registrants in the province) who subscribed to the Ontario Chiropractic Association’s Patient Management Program. It analyzed the 2000–2001 data of these chiropractors and provided important information on such factors as practitioner and patient demographics, practice profiles, and reimbursement patterns. The mean number of chiropractic treatments per patient for the year was 8.6 (sd = 3.4) and the mean treatment fee (above OHIP) per patient visit was $17.60 (sd = 5.0). Nearly one third of patient treatments were for lumbar complaints, and more than one-third of the patients were between 35 and 50 years of age. The mean annual gross income of the chiropractors in this study was $148,824 (sd = $86,391), with the male practitioners having a statistically significantly higher mean income ($161,363) than their female counterparts ($108,126). Practice location was significantly related to income, with postal code ‘M’ (Toronto) having the lowest mean income level. The overwhelming majority of practitioners (85%) used Diversified Technique as their primary treatment procedure, while ‘modalities’ was the most commonly selected adjunctive treatment procedure (29%). This study sheds new light on the associations among such factors as practitioner gender, practice location, and level of income. PMID:17549148
Ward, John; Sorrels, Ken; Coats, Jesse; Pourmoghaddam, Amir; DeLeon, Carlos; Daigneault, Paige
Purpose: The purpose of this study was to pilot test our study procedures and estimate parameters for sample size calculations for a randomized controlled trial to determine if bilateral sacroiliac (SI) joint manipulation affects specific gait parameters in asymptomatic individuals with a leg length inequality (LLI). Methods: Twenty-one asymptomatic chiropractic students engaged in a baseline 90-second walking kinematic analysis using infrared Vicon® cameras. Following this, participants underwent a functional LLI test. Upon examination participants were classified as: left short leg, right short leg, or no short leg. Half of the participants in each short leg group were then randomized to receive bilateral corrective SI joint chiropractic manipulative therapy (CMT). All participants then underwent another 90-second gait analysis. Pre- versus post-intervention gait data were then analyzed within treatment groups by an individual who was blinded to participant group status. For the primary analysis, all p-values were corrected for multiple comparisons using the Bonferroni method. Results: Within groups, no differences in measured gait parameters were statistically significant after correcting for multiple comparisons. Conclusions: The protocol of this study was acceptable to all subjects who were invited to participate. No participants refused randomization. Based on the data collected, we estimated that a larger main study would require 34 participants in each comparison group to detect a moderate effect size. PMID:24587501
Background Low back pain (LBP) is a prevalent condition and a socioeconomic problem in many countries. Due to its recurrent nature, the prevention of further episodes (secondary prevention), seems logical. Furthermore, when the condition is persistent, the minimization of symptoms and prevention of deterioration (tertiary prevention), is equally important. Research has largely focused on treatment methods for symptomatic episodes, and little is known about preventive treatment strategies. Methods/Design This study protocol describes a randomized controlled clinical trial in a multicenter setting investigating the effect and cost-effectiveness of preventive manual care (chiropractic maintenance care) in a population of patients with recurrent or persistent LBP. Four hundred consecutive study subjects with recurrent or persistent LBP will be recruited from chiropractic clinics in Sweden. The primary outcome is the number of days with bothersome pain over 12 months. Secondary measures are self-rated health (EQ-5D), function (the Roland Morris Disability Questionnaire), psychological profile (the Multidimensional Pain Inventory), pain intensity (the Numeric Rating Scale), and work absence. The primary utility measure of the study is quality-adjusted life years and will be calculated using the EQ-5D questionnaire. Direct medical costs as well as indirect costs will be considered. Subjects are randomly allocated into two treatment arms: 1) Symptom-guided treatment (patient controlled), receiving care when patients feel a need. 2) Preventive treatment (clinician controlled), receiving care on a regular basis. Eligibility screening takes place in two phases: first, when assessing the primary inclusion/exclusion criteria, and then to only include fast responders, i.e., subjects who respond well to initial treatment. Data are collected at baseline and at follow-up as well as weekly, using SMS text messages. Discussion This study investigates a manual strategy (chiropractic
Biondi, David M
Primary headache disorders are often accompanied by neck pain or other symptoms referable to neck muscles. Therefore, physical therapy and other physical treatments are commonly prescribed for headache management. A medical literature review was completed in order to gather information regarding the efficacy of selected physical modalities in the treatment of primary and cervicogenic headache disorders. After analyzing the collected data, expert opinions were developed regarding the utility and efficacy of selected physical modalities in the management of primary and cervicogenic headaches. Based on this review, the following four expert opinions are presented: physical therapy is more effective than massage therapy or acupuncture for the treatment of tension-type headache and appears to be most beneficial for patients with a high frequency of headache attacks. Physical therapy is most effective for the treatment of migraine when combined with other treatments such as thermal biofeedback, relaxation training and exercise. Chiropractic manipulation demonstrated a trend towards benefit in the treatment of tension-type headache, but evidence is weak. Chiropractic manipulation is probably more effective in the treatment of tension-type headache than it is in the treatment of migraine. In general, strong evidence is lacking regarding the efficacy of these treatments in reducing headache frequency, intensity, duration and disability in many commonly encountered clinical situations. Many of the published case series and controlled studies are of low quality. Physical treatments are unlikely to pose a significant risk, with the exception of high velocity chiropractic manipulation of the neck. Consideration must be given to financial costs and lost treatment opportunity by prescribing potentially ineffective treatment. In the absence of clear evidence regarding their role in treatment, physicians and patients are advised to make cautious and individualized judgments about
Pelletier, Jacques C
Introduction Returning an athlete to play following a spinal or concussive injury remains a challenge for the health practitioner making the decision. Among the possible mechanisms responsible for such injuries in amateur football, the concept of “spearing” has attracted a great deal of attention in sport medicine. Objective The purpose of this paper is to present a review of the diagnosis and treatment of the potentially catastrophic neck and head injuries caused by spearing in Canadian amateur football and to suggest the role the chiropractic profession can have in their prevention. It proposes to follow the recommendations advocated by the National Capital Amateur Football Association (NCAFA) athletic trainers group, led by a chiropractor. Methods Information regarding the concepts and prevention of “spearing”, concussion and spinal injuries at the amateur football level in both the United States and Canada was obtained using the following computerized search methods: PubMed – MeSH (via the National Center for Biotechnology Information (NCBI); The Index to Chiropractic Literature (ICL); Google Scholar Beta. Recent (2005) information on sports related spinal injuries and concussion were obtained by attendance at the 2005 Sports Related Concussion and Spine Injury Conference. Foxborough, Massachusetts. From a total of 698 references, 63 were retained. Conclusion Literature search yields very little information regarding Canadian statistics for amateur football neck and head injuries. The author encourages such injury data collecting and proposes that original Canadian studies and statistical analyses be carried out, such as those from diverse sports groups in the United States and abroad.1, 2, 3 The NCAFA group of trainers recommends a changing of the rules for “spearing” within the league and advocates gathering of Canadian based sports injury statistics. It also recognizes the need for public presentations (of concussion/spinal injuries).5 This
Marchand, Andrée-Anne; O’Shaughnessy, Julie; Descarreaux, Martin
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
Gala, Thaddeus R.; Seaman, David R.
Objective This purpose of this case study is to describe a natural method to help in management of obstructive sleep apnea syndrome (OSAS), which is known to be a common and debilitating condition. Clinical Features Obstructive sleep apnea syndrome is typically managed with a continuous positive airway pressure (CPAP) device, which the patient wears during sleep to help maintain respiration. This report describes the chiropractic management and resolution of OSAS with dietary modifications in a 55-year-old man who wore a CPAP for 10 years. Intervention and Outcome After adhering to dietary modifications for 3 months, the patient no longer required the use of the CPAP device and continues to have a normal active lifestyle almost 7 years later. Conclusion Dietary modifications may be an effective tool to improve the management of OSAS. PMID:22014867
Martin, Brett R.; Seaman, David R.
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
Gilmour, Joan; Harrison, Christine; Asadi, Leyla; Cohen, Michael H; Vohra, Sunita
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.
Giles, L G; Walker, B F
Spinal pain of mechanical origin, with or without referred pain, is a serious health problem suffered by many Australians. In order to help patients with this ailment, and to investigate this costly and debilitating condition, the National Centre for Multidisciplinary Studies of Back Pain was established at Townsville General Hospital as a joint venture between James Cook University of North Queensland and the Northern Regional Health Authority. The Centre has a multidisciplinary clinical team including a chiropractor. The Centre functions successfully, contributes to the public health of the community and shows that a multidisciplinary clinical team which includes a chiropractor can work harmoniously in an Australian hospital setting. The need for such a centre is demonstrated by an ever increasing demand for its professional services in Townsville as indicated by a review of the number of new patients and overall patient visits. The Centre could act as a model for the inclusion of chiropractic into the Australian hospital setting.
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
Haussler, Kevin K
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.
Richards, Dennis; Emmanuel, Elizabeth; Grace, Sandra
This article is part of a project investigating chiropractors' beliefs on the role of vitalism in their philosophical and practice approaches and how that might contribute to addressing current epidemics of non-communicable diseases. It aims to present atomism, reductionism, materialism and mechanism as fundamental ontologies in biomedicine and to examine what role these might play in its struggle to deal with these epidemics; to present vitalism as a fundamental ontology existing in chiropractic along with these ontologies of biomedicine; and to discuss how imbalances in the use of these ontologies and practices stemming from them might be contributing to difficulties in addressing these epidemics. The use of more balanced approaches by chiropractors involving not only mechanistic biomedical ontologies but also an increased focus on vitalism might offer value in addressing these epidemics and should be investigated.
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
Stilwell, Peter; Harman, Katherine; Hsu, William; Seaman, Brian
Background: Musculoskeletal injuries stemming from forceful muscular contractions during seizures have been documented in the literature. Reports of multiple seizure-induced spinal fractures, in the absence of external trauma and without risk factors for fracture, are rare. Case Presentation: A 28-year-old male, newly diagnosed with epilepsy, presented to a chiropractic clinic with the complaint of mid-thoracic pain beginning after a tonic-clonic seizure with no associated external trauma. Radiographs revealed the impression of five new vertebral compression fractures from T4 to T8. Discussion: This report highlights the importance of a complete history and examination of patients with a history of tonic-clonic seizures and back pain, especially when considering spinal adjustments. Summary: This case report presents an argument that a tonic-clonic seizure, in the absence of external trauma or significant risk factors for fracture, resulted in multiple vertebral compression fractures. PMID:27713581
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. ().
Vining, Robert; Potocki, Eric; Seidman, Michael; Morgenthal, A. Paige
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
Longacre, McKenna; Silver-Highfield, Ellen; Lama, Puja; Grodin, Michael
Survivors of torture and refugee trauma often have increased needs for mental and physical healthcare. This is due in part to the complex sequelae of trauma, including chronic pain, major depressive disorder, posttraumatic stress disorder (PTSD) and somatization. This article reviews the scientific medical literature for the efficacy and feasibility of some complementary and alternative medicine (CAM) modalities including meditation, Ayurveda, pranayama/yogic breathing, massage/body-work, dance/movement, spirituality, yoga, music, Traditional Chinese Medicine and acupuncture, qigong, t'ai chi, chiropractic, homeopathy, aromatherapy and Reiki specifically with respect to survivors of torture and refugee trauma. We report that preliminary research suggests that the certain CAM modalities may prove effective as part of an integrated treatment plan for survivors of torture and refugee trauma. Further research is warranted.
Biomechanics is the science that deals with the external and internal forces acting on biological systems and the effects produced by these forces. Here, we describe the forces exerted by chiropractors on patients during high-speed, low-amplitude manipulations of the spine and the physiological responses produced by the treatments. The external forces were found to vary greatly among clinicians and locations of treatment on the spine. Spinal manipulative treatments produced reflex responses far from the treatment site, caused movements of vertebral bodies in the "para-physiological" zone, and were associated with cavitation of facet joints. Stresses and strains on the vertebral artery during chiropractic spinal manipulation of the neck were always much smaller than those produced during passive range of motion testing and diagnostic procedures.
De Carvalho, Diana; Citro, Mark; Tibbles, Anthony
This case study explores the incidence of rhabdomyolysis in a HIV positive patient that was taking a lipid lowering drug and a protease inhibitor concurrently while under chiropractic treatment for generalized muscular soreness. Dyslipidemia is a very common problem both in the general and HIV population, with many patients being prescribed lipid lowering drugs. While extremely rare, adverse effects of lipid lowering drugs have been documented to include myopathy such as rhabdomyolysis. It is imperative that chiropractors are aware of the possible adverse side effect of lipid lowering drug therapy in their patients complaining of musculoskeletal pain. It is even more important that chiropractors treating the HIV population are aware of the potential interactions between these medications and protease inhibitors to cause myopathy.
Knutson, Gary A.; Owens, Edward F.
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.
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.
Sierpina, Victor; Kreitzer, Mary Jo
Content on integrative healthcare and complementary and alternative medicine (CAM) is now being taught in hundreds of educational programs across the country. Nursing, medical, osteopathic, chiropractic, acupuncture, naturopathic, and other programs are finding creative and innovative ways to include these approaches in new models of education and practice. This column spotlights such innovations in integrative healthcare and CAM education and presents readers with specific educational interventions that they can adapt into new or ongoing educational efforts at their institution or program. We invite readers to submit brief descriptions of efforts in their institutions that reflect the creativity, diversity, and interdisciplinary nature of the field. Please submit to Dr. Sierpina at firstname.lastname@example.org or Dr. Kreitzer at email@example.com. Submissions should be brief, no more than 300 to 400 words. Please include any Web site or other resource that is relevant as well as contact information.
Stainsby, Brynne; Howitt, Scott; Porr, Jason
Objective: To detail the presentation of three health care workers diagnosed with sudden acute respiratory syndrome (SARS) who later presented to a CMCC teaching clinic with neuromusculoskeletal sequelae and underwent conservative treatments. This case series aims to inform practitioners of the potential pathogenesis of these neuromuscular complaints and describes their treatment in a chiropractic practice. Clinical Features: Three patients presented with a variety of neurological, muscular and joint findings. Conservative treatment was aimed at decreasing hypertonic muscles, increasing joint mobility, and improving ability to perform activities of daily living. Intervention and Outcome: The conservative treatment approach utilized in these cases involved spinal manipulative therapy, soft tissue therapy, modalities, and rehabilitation. Outcome measures included subjective pain ratings, disability indices, and return to work. Conclusion: Three patients previously diagnosed with SARS presented with neuromusculoskeletal complaints and subjectively experienced intermittent relief of pain and improvement in disability status after conservative treatments. PMID:21403780
Goldford, Richard J
Pelvic fractures are a relatively uncommon presentation to a chiropractic office. A case is presented of pelvic fractures following a motor vehicle accident that initially went undetected despite a set of lumbar spine and pelvic radiographs. The condition was only discovered when the patient continued to suffer hip and buttock pain that was not improving in a reasonable period of time. Follow-up radiographs revealed well healing, stable pelvic fractures. The classification of pelvic fractures as well as the importance of a high index of suspicion in dealing with patients who have been involved in motor vehicle accidents is discussed. The importance of obtaining an accurate diagnosis and its relevance to duration of disability is highlighted. ImagesFigure 1Figure 2
Upchurch, Dawn M; Wexler Rainisch, Bethany K
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.
Brett, Jennifer; Brimhall, Joseph; Healey, Dale; Pfeifer, Joseph; Prenguber, Marcia
This review examines the educational accreditation standards of four licensed complementary and alternative medicine (CAM) disciplines (naturopathic medicine, chiropractic health care, acupuncture and oriental medicine, and massage therapy), and identifies public health and other competencies found in those standards that contribute to cooperation and collaboration among the health care professions. These competencies may form a foundation for interprofessional education. The agencies that accredit the educational programs for each of these disciplines are individually recognized by the United States Department (Secretary) of Education. Patients and the public are served when healthcare practitioners collaborate and cooperate. This is facilitated when those practitioners possess competencies that provide them the knowledge and skills to work with practitioners from other fields and disciplines. Educational accreditation standards provide a framework for the delivery of these competencies. Requiring these competencies through accreditation standards ensures that practitioners are trained to optimally function in integrative clinical care settings.
Mühlemann, Daniel; Mühlemann, Malin B
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.
Cohain, Judy Slome
Techniques for turning a term breech baby are 1). External cephalic version (ECV) using hands and ultrasound only; 2). Acupuncture point stimulation, by needle or moxibustion; 3). Chiropractic "Webster" technique; 4). Hypnotherapy; and 5). Special exercises. Fifty % of breech fetuses at 34 weeks will turn by themselves to head down by 38 weeks. Therefore, to be considered effective, a technique for turning breech must turn the baby and keep it turned more than 50% of the time. Only ECV with an experienced practitioner has been documented to have a greater than 50% success rate at 37 weeks; in 95% of cases the head stays down. Most women experience the fetus turning by hand as quick but very painful. "Unstable lie" is sometimes used as a baseless excuse for inducing labor after the baby turns from breech to head down. (firstname.lastname@example.org).
Bergman, A; Henderson, M; Cline, J L
Most health care utilization and cost control programs focus on inpatient care or on high-cost, catastrophic illnesses or injuries. Recently, however, Parkside Health Management Corporation has developed a utilization review program that targets treatments and high-technology procedures performed primarily in an outpatient setting, as well as specific inpatient procedures not included in other review programs. These include chiropractic, podiatric, and physical therapy treatments; cesarean section; and endoscopy, ultrasound in pregnancy, and lithotripsy. The treatments/procedures examined in this program, called Technology and Outpatient Review (TOR), account for approximately 6% of claims expenses. Bigel Institute for Health Policy researchers are evaluating a pilot test to determine TOR's effect on health care costs and utilization, appropriateness, and patient satisfaction.