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Monthly Archives: December 2013

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A Randomised Controlled Trial of Preventive Spinal Manipulation With and Without a Home Exercise Program For Patients With Chronic Neck Pain

By |December 25, 2013|Chiropractic Care, Chronic Pain, Evidence-based Medicine|

A Randomised Controlled Trial of Preventive Spinal Manipulation With and Without a Home Exercise Program For Patients With Chronic Neck Pain

The Chiro.Org Blog


SOURCE:   BMC Musculoskelet Disord. 2011 (Feb 8);   12:   41

Johanne Martel, Claude Dugas, Jean-Daniel Dubois, and Martin Descarreaux

Département de Chiropratique,
Université du Québec à Trois-Rivières,
Trois-Rivières G9A 5H7, Canada.


Background:   Evidence indicates that supervised home exercises, combined or not with manual therapy, can be beneficial for patients with non-specific chronic neck pain (NCNP). The objective of the study is to investigate the efficacy of preventive spinal manipulative therapy (SMT) compared to a no treatment group in NCNP patients. Another objective is to assess the efficacy of SMT with and without a home exercise program.

Methods:   Ninety-eight patients underwent a short symptomatic phase of treatment before being randomly allocated to either an attention-group (n = 29), a SMT group (n = 36) or a SMT + exercise group (n = 33). The preventive phase of treatment, which lasted for 10 months, consisted of meeting with a chiropractor every two months to evaluate and discuss symptoms (attention-control group), 1 monthly SMT session (SMT group) or 1 monthly SMT session combined with a home exercise program (SMT + exercise group). The primary and secondary outcome measures were represented by scores on a 10-cm visual analog scale (VAS), active cervical ranges of motion (cROM), the neck disability index (NDI) and the Bournemouth questionnaire (BQ). Exploratory outcome measures were scored on the Fear-avoidance Behaviour Questionnaire (FABQ) and the SF-12 Questionnaire.

Results:   Our results show that, in the preventive phase of the trial, all 3 groups showed primary and secondary outcomes scores similar to those obtain following the non-randomised, symptomatic phase. No group difference was observed for the primary, secondary and exploratory variables. Significant improvements in FABQ scores were noted in all groups during the preventive phase of the trial. However, no significant change in health related quality of life (HRQL) was associated with the preventive phase.

There are more articles like this @ our:

Chronic Neck Pain and Chiropractic Page and our

Maintenance Care, Wellness and Chiropractic Page

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Our Annual Research Donation

By |December 19, 2013|Announcement|

Our Annual Research Donation

The Chiro.Org Blog


The Board of Chiro.Org held their annual Board meeting in November and unanimously approved a $3000 donation to Chiropractic Research to the ICPA. This will be the twelfth year in a row that Chiro.org has made a research tithe. Our total contribution to date is $24,000.

This year also marks our 10th year supporting the International Chiropractic Pediatric Association’s research projects, always aimed at demonstrating the benefits of chiropractic care for children.

A big ‘thank you‘ to our sponsors because, without them we wouldn’t have been able to donate so much back to Chiropractic.

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Chiropractors as Primary Spine Care Providers:Precedents and Essential Measures

By |December 16, 2013|Health Care Reform, Primary Care|

Chiropractors as Primary Spine Care Providers:
Precedents and Essential Measures

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc. 2013 (Dec); 57 (4): 285–291

W. Mark Erwin, DC, PhD, A. Pauliina Korpela, BSc, and Robert C. Jones, DC APC

Assistant Professor, Divisions of Orthopaedic and Neurological Surgery, University of Toronto, Toronto Western Hospital, Scientist, Toronto Western Research Institute ; Associate Professor, Research, Canadian Memorial Chiropractic College.


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

Keywords: primary care, spine, chiropractor


Introduction:

Between 1999 and 2008 the mean inflationary adjusted costs for ambulatory neck and/or back pain in the United States increased by a factor of 95%. [1] According to the study by Davis et al the largest proportion of increased costs are associated with specialty visits rather than primary consultations, clearly indicating that spine care places a tremendous burden upon the health care system. [1] Davis et al make recommendations with respect to cost containment for spine-related disorders which are similar to those put forth by Maniadakis and Gray ten years ago; and many of these revolve around reducing the reliance on specialty management. [2] A number of professionals with diverse backgrounds (chiropractors, massage therapists, physical therapists, osteopaths, and physicians) care for spinal pain patients. However unlike some other health care professions that have focused upon the management of condition-specific maladies, no one group has chosen to do so for certain aspects of the spine patient. Perhaps lessons learned from other condition-specific professions such as optometry and podiatry could provide important guidance in this regard.


Precedents for Professional Growth and Development:

You may also enjoy our new

Primary Care and Chiropractic Page

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A Review of the Beneficial and Harmful Effects of Laughter

By |December 14, 2013|Humor, Iatrogenic Injury, Laughter|

A Review of the Beneficial and Harmful Effects of Laughter

The Chiro.Org Blog


SOURCE:   British Medical Journal 2013 (Dec 13); 347: f7274

R E Ferner, honorary professor of clinical pharmacology [12],
J K Aronson, fellow [3]


Research

Christmas 2013: Food For Thought

Laughter and MIRTH (Methodical Investigation of Risibility, Therapeutic and Harmful): Narrative Synthesis

Every December, the BMJ publishes hilarious Christmas research.

Their 2013 offerings are now online at:

http://www.bmj.com/research


A big Thanks to Anne Taylor-Vaisey


Objective   To review the beneficial and harmful effects of laughter.

Design   Narrative synthesis.

Data sources and review methods   We searched Medline (1946 to June 2013) and Embase (1974 to June 2013) for reports of benefits or harms from laughter in humans, and counted the number of papers in each category.

Results   Benefits of laughter include reduced anger, anxiety, depression, and stress; reduced tension (psychological and cardiovascular); increased pain threshold; reduced risk of myocardial infarction (presumably requiring hearty laughter); improved lung function; increased energy expenditure; and reduced blood glucose concentration.

However, laughter is no joke — dangers include syncope, cardiac and oesophageal rupture, and protrusion of abdominal hernias (from side splitting laughter or laughing fit to burst), asthma attacks, interlobular emphysema, cataplexy, headaches, jaw dislocation, and stress incontinence (from laughing like a drain). Infectious laughter can disseminate real infection, which is potentially preventable by laughing up your sleeve. As a side effect of our search for side effects, we also list pathological causes of laughter, among them epilepsy (gelastic seizures), cerebral tumours, Angelman’s syndrome, strokes, multiple sclerosis, and amyotrophic lateral sclerosis or motor neuron disease.

Conclusions   Laughter is not purely beneficial. The harms it can cause are immediate and dose related, the risks being highest for Homeric (uncontrollable) laughter. The benefit-harm balance is probably favourable. It remains to be seen whether sick jokes make you ill or jokes in bad taste cause dysgeusia, and whether our views on comedians stand up to further scrutiny.


Introduction

“Mirth . . . prorogues life, whets the wit, makes the body young, lively, and fit for any manner of employment.”

— Robert Burton, The Anatomy of Melancholy (1621)

The BMJ has not dealt seriously with laughter since 1899, when an editorialist, following an Italian correspondent’s suggestion that telling jokes could treat bronchitis, proposed the term “gelototherapy” (in Greek gelōs means laughter; in Italian gelato means ice cream). [1] The journal had, a year before, described heart failure following prolonged laughter in a 13 year old girl. [2]


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