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Monthly Archives: October 2013


Dose-response and Efficacy of Spinal Manipulation for Care of Chronic Low Back Pain: A Randomized Controlled Trial

By |October 29, 2013|Chiropractic Care, Low Back Pain|

Dose-response and Efficacy of Spinal Manipulation for Care of Chronic Low Back Pain: A Randomized Controlled Trial

The Chiro.Org Blog

SOURCE:   Spine J. 2013 Oct 16. [Epub ahead of print]

Mitchell Haas, DC, Darcy Vavrek, ND, David Peterson, DC,
Nayak Polissar, PhD, Moni B. Neradilek, MS

Center for Outcomes Studies,
University of Western States,
2700 NE 132nd Ave., Portland, OR 97230, USA.

BACKGROUND CONTEXT:   There have been no full-scale trials of the optimal number of visits for the care of any condition with spinal manipulation.

PURPOSE:   To identify the dose-response relationship between visits to a chiropractor for spinal manipulation and chronic low back pain (cLBP) outcomes and to determine the efficacy of manipulation by comparison with a light massage control.

STUDY DESIGN/SETTING:   Practice-based randomized controlled trial.

PATIENT SAMPLE:   Four hundred participants with cLBP.

OUTCOME MEASURES:   The primary cLBP outcomes were the 100-point modified Von Korff pain intensity and functional disability scales evaluated at the 12- and 24-week primary end points. Secondary outcomes included days with pain and functional disability, pain unpleasantness, global perceived improvement, medication use, and general health status.

METHODS:   One hundred participants with cLBP were randomized to each of four dose levels of care: 0, 6, 12, or 18 sessions of spinal manipulation from a chiropractor. Participants were treated three times per week for 6 weeks. At sessions when manipulation was not assigned, they received a focused light massage control. Covariate-adjusted linear dose effects and comparisons with the no-manipulation control group were evaluated at 6, 12, 18, 24, 39, and 52 weeks.


The Effect of Application Site of Spinal Manipulative Therapy (SMT) on Spinal Stiffness

By |October 28, 2013|Chiropractic Research, Spinal Manipulation|

The Effect of Application Site of Spinal Manipulative Therapy (SMT) on Spinal Stiffness

The Chiro.Org Blog

SOURCE:   Spine J. 2013 Oct 16 [Epub ahead of print]

Tiffany L. Edgecombe, PhD, Greg N. Kawchuk, DC, PhD, Cynthia R. Long, PhD, Joel G. Pickar, DC, PhD

Department of Physical Therapy, University of Alberta, 8205 114 St, Corbett Hall, Edmonton, AB, Canada T6G 2G4

BACKGROUND CONTEXT:   Like other factors that can influence treatment efficacy (eg, dosage, frequency, time of day), the site of treatment application is known to affect various physical interventions such as topical anesthetics and cardiopulmonary resuscitation. Like these examples, spinal manipulative therapy (SMT) is a physical intervention that may exhibit maximal benefit when directed to a specific site. Whereas numerous studies of SMT efficacy have produced mixed results, few studies have taken into account the site of SMT application.

PURPOSE:   To determine if the site of SMT application modulates the effect of SMT in an anesthetized feline model.

STUDY DESIGN:   Spinal manipulative therapy applied to specific anatomic locations randomized in a Latin square design with a no-SMT control.

OUTCOME MEASURES:   Physiologic measures (spinal stiffness).

METHODS:   Simulated SMT was delivered by a validated mechanical apparatus to the intact lumbar spine of eight anesthetized felines at four unique sites: L6 spinous process, left L6 lamina, left L6 mammillary process, and L7 spinous process. To measure spinal stiffness, a separate indentation load was applied mechanically to the L6 spinous process before and after each SMT application. Spinal stiffness was calculated from the resulting force-displacement curve as the average stiffness (k) and terminal instantaneous stiffness (TIS).


Stroke Numbers Are Up Worldwide

By |October 24, 2013|Clinical Decision-making, Stroke|

Stroke Numbers Are Up Worldwide

The Chiro.Org Blog

SOURCE:   MedPage Today ~ Oct 23, 2013

By Todd Neale, Senior Staff Writer

Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

The overall burden of stroke in terms of absolute numbers of people affected around the world is growing, especially in younger age groups and in low-to-middle-income countries, a global study showed.

In 2010, there were 16.9 million people who had a first stroke, 33 million stroke survivors, and 5.9 million people who died from a stroke — increases of 68%, 84%, and 26% respectively since 1990, according to Valery Feigin, MD, of the Auckland University of Technology in New Zealand, and colleagues.

Major Points:

  • Despite declining rates of nonfatal and fatal stroke, the overall burden of stroke in terms of absolute numbers of people affected around the world is growing, especially in low-to-middle-income countries, a study found.
  • Note that another analysis showed that hemorrhagic — and not ischemic — stroke accounted for the majority of the worldwide burden of deaths and disability-adjusted life years lost due to stroke.


Most Parents Want to Email Doctors, But Not So Many Want to Pay

By |October 23, 2013|Health Care, Online Consultations|

Most Parents Want to Email Doctors, But Not So Many Want to Pay

The Chiro.Org Blog

SOURCE:   Psych Central ~ October 22, 2013

By Rick Nauert PhD Senior News Editor

Reviewed by John M. Grohol, Psy.D.

A new national survey finds that most parents want online options from kids’ health care providers, but half say it should be free, according to a new University of Michigan Hospital National Poll on Children’s Health.

In the poll, 77 percent of parents said they would be likely to seek email advice for their children’s minor illness if that service were available. Only 6 percent of parents said they could currently get that email advice from their child’s health care provider.

Parents in the poll reported a range of co-pays charged for office visits, from nothing to $30 per visit.

But about half of those polled felt any charge for an email consultation should be less than that of an office visit. And 48 percent of those polled felt an online consultation should be free.

The poll surveyed 1,420 parents with a child aged 0 to 17 years old.

“Most parents know it can be inconvenient to schedule and get to an office visit for a sick child. An email consultation would prevent the hassles of scheduling and allow sick children to remain at home. Email also could be available after hours when their caregiver’s office is closed, said Sarah J. Clark, M.P.H.

“But many health care providers don’t have co-pays established for this kind of consultation, so we decided to ask parents what they think.”


A Canadian Lawyer’s Rant

By |October 18, 2013|Editorial, Uncategorized|

A Canadian Lawyer’s Rant

The Chiro.Org Blog

SOURCE:   A Chiro.Org Editorial about
Canadian Family Physcian 2013(Oct); 59 (10): 1052

After reading the first 2 paragraphs of this… what… letter to the editor? … I had some thoughts…

As an attorney and advocate for patient safety, I believe the authors of the Motherisk article that appeared in the August 2013 issue of Canadian Family Physician give an insufficient account of the risks that might be associated with chiropractic treatment of pregnant patients.1

Many chiropractors continue to base their treatments on the “detection” and “correction” of “subluxations,” ill-defined and unproven spinal lesions unknown to the medical profession. Nevertheless, chiropractors “adjust” these subluxations with any number of treatments, including manual therapy. Thus, the physician whose patient is receiving manual therapy from a chiropractor might be wholly unaware that the chiropractor is actually adjusting these nonexistent subluxations. These adjustments cannot effectively treat back pain or any other condition or disease.

Have we been hoist on our own petard?

I love how this author ramps up his misinformation campaign, stating that the subluxation is: first


unproven, and their final death stroke:


Then, emboldened, he crows that:

“These adjustments cannot effectively treat back pain”

At this point, I am rolling in the aisles!


World Spine Day – October 16th

By |October 15, 2013|News|


Every year on October 16th people from around the world join together to raise awareness on World Spine Day as part of the Bone and Joint Decade’s Action Week.

Spinal disorders, such as back pain, neck pain, scoliosis and disc disease, to name a few are common, and they can have a profound effect on a person’s overall health, impacting a person’s ability to work, to enjoy everyday activities and even disrupting healthy sleep patterns.

Research has demonstrated that poor postures and inactivity can contribute to the development of back pain and other spinal disorders.

The good news is that many of these common problems can be easily avoided!

That’s why this year’s theme for World Spine Day is “Straighten Up and Move,” focusing on the importance of proper posture and movement in maintaining good spinal health. To help mark World Spine Day, participating health care providers and organizations around the world will provide important information, tips and tools to help prevent many of these spinal disorders.

WSD received several nominations from across the globe, representing several organizations
and professions all with special interest in spinal health for the interim WSD International
Organizing Committee (IOC). The WSD IOC will be responsible for providing input regarding
themes, content, resource materials and formation of a permanent committee.
Committee members will include:
Dr. Ina Diener- South African Society of Physiotherapy (South Africa)
Dr. Veronika Fialka-Moser- Medizinische Universität Wien (Austria)
Dr. Deborah Kopansky-Giles, BJD ICC and World Federation of Chiropractic (Canada)
Dr. Jennifer Nash, World Spine Day (Canada)
Nick Pahl- British Acupuncture Council (United Kingdom)
Marilyn Pattison- World Federation of Occupational Therapists (Australia)