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Monthly Archives: January 2015

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Manual Therapy Followed by Specific Active Exercises

By |January 31, 2015|exercise, Spinal Manipulation|

Manual Therapy Followed by Specific Active Exercises Versus a Placebo Followed by Specific Active Exercises on the Improvement of Functional Disability in Patients with Chronic Non Specific Low Back Pain: A Randomized Controlled Trial

The Chiro.Org Blog


SOURCE:   BMC Musculoskelet Disord. 2012 (Aug 28);   13:   162

Pierre Balthazard, Pierre de Goumoens, Gilles Rivier,
Philippe Demeulenaere, Pierluigi Ballabeni, and Olivier Dériaz

Physiotherapy Department,
HES-SO University of Applied Sciences Western Switzerland-HESAV,
Avenue de Beaumont,
Lausanne 1011, Switzerland.
pbalthaz@hecvsante.ch


BACKGROUND:   Recent clinical recommendations still propose active exercises (AE) for CNSLBP. However, acceptance of exercises by patients may be limited by pain-related manifestations. Current evidences suggest that manual therapy (MT) induces an immediate analgesic effect through neurophysiologic mechanisms at peripheral, spinal and cortical levels. The aim of this pilot study was first, to assess whether MT has an immediate analgesic effect, and second, to compare the lasting effect on functional disability of MT plus AE to sham therapy (ST) plus AE.

METHODS:   Forty-two CNSLBP patients without co-morbidities, randomly distributed into 2 treatment groups, received either spinal manipulation/mobilization (first intervention) plus AE (MT group; n = 22), or detuned ultrasound (first intervention) plus AE (ST group; n = 20). Eight therapeutic sessions were delivered over 4 to 8 weeks. Immediate analgesic effect was obtained by measuring pain intensity (Visual Analogue Scale) before and immediately after the first intervention of each therapeutic session. Pain intensity, disability (Oswestry Disability Index), fear-avoidance beliefs (Fear-Avoidance Beliefs Questionnaire), erector spinae and abdominal muscles endurance (Sorensen and Shirado tests) were assessed before treatment, after the 8th therapeutic session, and at 3- and 6-month follow-ups.

There are many more articles like this @ our:

Low Back Pain and Chiropractic Page

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Risk of Stroke After Chiropractic Spinal Manipulation in Medicare B Beneficiaries Aged 66 to 99 Years With Neck Pain

By |January 30, 2015|Chiropractic Care, Stroke|

Risk of Stroke After Chiropractic Spinal Manipulation in Medicare B Beneficiaries Aged 66 to 99 Years With Neck Pain

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2015 (Feb); 38 (2): 93–101 ~ FULL TEXT

James M. Whedon, DC, MS, Yunjie Song, PhD, Todd A. Mackenzie, PhD,
Reed B. Phillips, DC, PhD, Timothy G. Lukovits, MD, Jon D. Lurie, MD, MS

The Dartmouth Institute for Health Policy & Clinical Practice,
Dartmouth College,
Grantham, NH.
james.m.whedon@hitchcock.org


OBJECTIVE:   The purpose of this study was to quantify risk of stroke after chiropractic spinal manipulation, as compared to evaluation by a primary care physician, for Medicare beneficiaries aged 66 to 99 years with neck pain.

METHODS:   This is a retrospective cohort analysis of a 100% sample of annualized Medicare claims data on 1 157 475 beneficiaries aged 66 to 99 years with an office visit to either a chiropractor or primary care physician for neck pain. We compared hazard of vertebrobasilar stroke and any stroke at 7 and 30 days after office visit using a Cox proportional hazards model. We used direct adjusted survival curves to estimate cumulative probability of stroke up to 30 days for the 2 cohorts.

RESULTS:   The proportion of subjects with stroke of any type in the chiropractic cohort was 1.2 per 1000 at 7 days and 5.1 per 1000 at 30 days. In the primary care cohort, the proportion of subjects with stroke of any type was 1.4 per 1000 at 7 days and 2.8 per 1000 at 30 days. In the chiropractic cohort, the adjusted risk of stroke was significantly lower at 7 days as compared to the primary care cohort (hazard ratio, 0.39; 95% confidence interval, 0.33-0.45), but at 30 days, a slight elevation in risk was observed for the chiropractic cohort (hazard ratio, 1.10; 95% confidence interval, 1.01-1.19).

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Stroke and Chiropractic Page

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Tissue Damage Markers After a Spinal Manipulation in Healthy Subjects

By |January 29, 2015|Safety, Spinal Manipulation|

Tissue Damage Markers After a Spinal Manipulation in Healthy Subjects: A Preliminary Report of a Randomized Controlled Trial

The Chiro.Org Blog


SOURCE:   Dis Markers. 2014; 2014 :815379

A. Achalandabaso, G. Plaza-Manzano, R. Lomas-Vega, A. Martínez-Amat,
M. V. Camacho, M. Gassó, F. Hita-Contreras, and F. Molina

Centro de Fisioterapia y Psicología Soluciona,
18002 Granada, Spain.


Spinal manipulation (SM) is a manual therapy technique frequently applied to treat musculoskeletal disorders because of its analgesic effects. It is defined by a manual procedure involving a directed impulse to move a joint past its physiologic range of movement (ROM). In this sense, to exceed the physiologic ROM of a joint could trigger tissue damage, which might represent an adverse effect associated with spinal manipulation. The present work tries to explore the presence of tissue damage associated with SM through the damage markers analysis. Thirty healthy subjects recruited at the University of Jaén were submitted to a placebo SM (control group; n = 10), a single lower cervical manipulation (cervical group; n = 10), and a thoracic manipulation (n = 10). Before the intervention, blood samples were extracted and centrifuged to obtain plasma and serum. The procedure was repeated right after the intervention and two hours after the intervention.

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Adding Chiropractic Manipulative Therapy to Standard Medical Care for Patients with Acute Low Back Pain:

By |January 28, 2015|Low Back Pain|

Adding Chiropractic Manipulative Therapy to Standard Medical Care for Patients with Acute Low Back Pain: Results of a Pragmatic Randomized Comparative Effectiveness Study

The Chiro.Org Blog


SOURCE:   Spine (Phila Pa 1976). 2013 (Apr 15);   38 (8):   627–634

Goertz, Christine M. DC, PhD; Long, Cynthia R. PhD;
Hondras, Maria A. DC, MPH; Petri, Richard MD;
Delgado, Roxana MS; Lawrence, Dana J. DC, MMedEd, MA;
Owens, Edward F. MS, DC; Meeker, William C. DC, MPH

Palmer Center for Chiropractic Research,
Davenport, IA 52803, USA.
christine.goertz@palmer.edu


STUDY DESIGN:   Randomized controlled trial.

OBJECTIVE:   To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (CMT) for the treatment of low back pain (LBP) among 18 to 35-year-old active-duty military personnel.

SUMMARY OF BACKGROUND DATA:   LBP is common, costly, and a significant cause of long-term sick leave and work loss. Many different interventions are available, but there exists no consensus on the best approach. One intervention often used is manipulative therapy. Current evidence from randomized controlled trials demonstrates that manipulative therapy may be as effective as other conservative treatments of LBP, but its appropriate role in the healthcare delivery system has not been established.

METHODS:   Prospective, 2-arm randomized controlled trial pilot study comparing SMC plus CMT with only SMC. The primary outcome measures were changes in back-related pain on the numerical rating scale and physical functioning at 4 weeks on the Roland-Morris Disability Questionnaire and back pain functional scale (BPFS).

RESULTS:   Mean Roland-Morris Disability Questionnaire scores decreased in both groups during the course of the study, but adjusted mean scores were significantly better in the SMC plus CMT group than in the SMC group at both week 2 (P < 0.001) and week 4 (P = 0.004). Mean numerical rating scale pain scores were also significantly better in the group that received CMT. Adjusted mean back pain functional scale scores were significantly higher (improved) in the SMC plus CMT group than in the SMC group at both week 2 (P < 0.001) and week 4 (P = 0.004).

There are many more articles like this @ our:

Low Back Pain and Chiropractic Page


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Life-Threatening Conditions That Walk:A Clinician’s Review

By |January 27, 2015|Diagnosis|

Life-Threatening Conditions That Walk:
A Clinician’s Review

The Chiro.Org Blog


SOURCE:   J Amer Chiropr Assoc 2013 (Sept);   50 (5):   8-17

David J. Schimp, DC, DACNB, DAAPM

Clinician and Associate Professor
Texas Chiropractic College


Dr. Schimp describes the six most common undiagnosed life-threatening conditions encountered by chiropractors.

ABSTRACT

Chiropractors are hybrid physicians with a broad skill set. DCs need the diagnostic acumen of orthopedists and neurologists, a fine manual therapist’s hands, a psychologist’s insights, and the capacity to instantly respond to the unexpected. As front-line health care professionals, we may find ourselves serving as ER physicians. When a previously undiagnosed life- threatening condition shows up, we must recognize the problem and triage the patient appropriately. This article will review the six most common undiagnosed life-threatening conditions encountered by chiropractors.

Keywords:   cancer, abdominal aortic aneurysm, deep-vein thrombosis, pulmonary embolism, venous thromboembolism, stroke, cerebrovascular accident, subdural hematoma, myocardial infarction, red flag assessment, life- threatening conditions, chiropractor, chiropractic physician


INTRODUCTION

Daniel, et al., have identified the six most common life-threatening conditions that a chiropractic physician is likely to encounter in clinical practice. [1] The goal of this article is to translate the current evidence-based knowledge of these conditions into a quick-scan diagnostic and management reference for cancer, abdominal aortic aneurysm, venous thromboembolism, stroke, myocardial infarction, and subdural hematoma.


I. CANCER

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WFC publishes suggested reading list of research papers

By |January 27, 2015|Research|

Source The World Federation of Chiropractic

The World Federation of Chiropractic (WFC) is pleased to announce the debut of an important, online, free service for the chiropractic profession and the public it serves – a Suggested Reading List of key research papers.

When you want an overview of research on a chiropractic topic, for yourself, for patients or to advocate for the profession, wouldn’t it be nice to have access to relevant papers collected in one location?

“That is the vision for this WFC project,” says WFC President Dr Greg Stewart of Canada. “The project is being led by Dr Greg Kawchuk of the University of Alberta, Chair of the WFC Research Council, who has brought together expert curators  from within the Research Council and abroad. We owe them a great debt for the expertise and hard work that has produced this exciting new service.”

The initial version of the Suggested Reading List goes live today at www.wfcsuggestedreadinglist.com  with 10 key papers curated in each of 21 subject areas.  These subject areas include cost-effectiveness of care, biomechanical and neurophysiological mechanisms of action, safety, pediatrics, wellness and many others. Each listed paper includes the published abstract and link to the original publication when available. Importantly, the site is searchable and visitors can leave suggestions for new topics and papers.

“This is just the beginning of this project,” explains Dr Kawchuk.  “We are already working on round two which will add new topic areas such as nutrition and public health.

This project has been possible because of generous sponsorship from NCMIC and Standard Process, two of the WFC’s long-standing and most supportive partners.

The WFC, whose members are 90 national associations of chiropractors worldwide including both the ACA and ICA in the USA, has been a non-governmental organization or NGO in official relations with the World Health Organization since 1997.  Its next major Congress is in Athens, Greece May 13-16, 2015. For more information visit www.wfc.org .