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Monthly Archives: September 2015


Prognostic Factors for Recurrences in Neck Pain Patients Up to 1 Year After Chiropractic Care

By |September 28, 2015|Chronic Pain, Neck Pain|

Prognostic Factors for Recurrences in Neck Pain Patients Up to 1 Year After Chiropractic Care

The Chiro.Org Blog

SOURCE:   J Manipulative Physiol Ther. 2015 (Sep 15 ~ FULL TEXT

Anke Langenfeld, MS, B. Kim Humphreys, DC, PhD,
Jaap Swanenburg, PhD, Cynthia K. Peterson, RN, DC, MMedEd, PhD

PhD Student,
CAPHRI School of Public Health and Primary Care,
Department of Epidemiology,
Maastricht University,
Maastricht, The Netherlands

OBJECTIVE:   Information about recurrence and prognostic factors is important for patients and practitioners to set realistic expectations about the chances of full recovery and to reduce patient anxiety and uncertainty. Therefore, the purpose of this study was to assess recurrence and prognostic factors for neck pain in a chiropractic patient population at 1 year from the start of the current episode.

METHODS:   Within a prospective cohort study, 642 neck pain patients were recruited by chiropractors in Switzerland. After a course of chiropractic therapy, patients were followed up for 1 year regarding recurrence of neck pain. A logistic regression analysis was used to assess prognostic factors for recurrent neck pain. The independent variables age, pain medication usage, sex, work status, duration of complaint, previous episodes of neck pain and trauma onset, numerical rating scale, and Bournemouth questionnaire for neck pain were analyzed. Prognostic factors that have been identified in previous studies to influence recovery of neck pain are psychologic distress, poor general health at baseline, and a previous history of pain elsewhere.

RESULTS:   Five hundred forty five patients (341 females), with a mean age of 42.1 years (SD, 13.1) completed the 1-year follow-up period. Fifty-four participants (11%) were identified as “recurrent.” Prognostic factors associated with recurrent neck pain were previous episodes of neck pain and increasing age.

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Chronic Neck Pain and Chiropractic Page


Report of the NIH Task Force on Research Standards for Chronic Low Back Pain

By |September 27, 2015|Chiropractic Research, Low Back Pain|

Report of the NIH Task Force on Research Standards for Chronic Low Back Pain

The Chiro.Org Blog

SOURCE:   Int J Ther Massage Bodywork. 2015 (Sep 1); 8 (3): 16–33 ~ FULL TEXT

Richard A. Deyo, MD, MPH, Samuel F. Dworkin, DDS, PhD,
Dagmar Amtmann, PhD, Gunnar Andersson, MD, PhD,
David Borenstein, MD, Eugene Carragee, MD,
John Carrino, MD, MPH, Roger Chou, MD, Karon Cook, PhD,
Anthony DeLitto, PT, PhD, Christine Goertz, DC, PhD,
Partap Khalsa, DC, PhD, John Loeser, MD, Sean Mackey, MD, PhD,
James Panagis, MD, James Rainville, MD, Tor Tosteson, ScD,
Dennis Turk, PhD, Michael Von Korff, ScD, and Debra K. Weiner, MD

Oregon Health and Sciences University,
Portland, OR.

Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients’ lives. Such cLBP is often termed non-specific, and may be due to multiple biologic and behavioral etiologies. Researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures, which impede comparisons and consensus. The NIH Pain Consortium therefore charged a Research Task Force (RTF) to draft standards for research on cLBP. The resulting multidisciplinary panel recommended using 2 questions to define cLBP; classifying cLBP by its impact (defined by pain intensity, pain interference, and physical function); use of a minimal data set to describe research participants (drawing heavily on the PROMIS methodology); reporting “responder analyses” in addition to mean outcome scores; and suggestions for future research and dissemination. The Pain Consortium has approved the recommendations, which investigators should incorporate into NIH grant proposals. The RTF believes these recommendations will advance the field, help to resolve controversies, and facilitate future research addressing the genomic, neurologic, and other mechanistic substrates of chronic low back pain. We expect the RTF recommendations will become a dynamic document, and undergo continual improvement.

KEYWORDS: &nbsp NIH Task Force; chronic low back pain; low back pain; minimum dataset; research standards

From the FULL TEXT Article:


The Institute of Medicine recently estimated that chronic pain affects about 100 million adults in the United States, with an estimated annual cost of $635 billion, including direct medical expenditures and loss of work productivity. [3] Activity-limiting low back pain (LBP), in particular, has a world-wide lifetime prevalence of about 39% and a similar annual prevalence of 38%. [61] The majority of people having LBP experience recurrent episodes. [62] The use of all interventions for treating chronic LBP (cLBP) increased from 1995–2010, including surgery, pharmacological, and non-pharmacological approaches. Despite increased utilization, however, the prevalence of symptoms and expenditures has increased. [37, 70, 91]

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Low Back Pain and Chiropractic Page


The 120th Anniversary of Chiropractic

By |September 18, 2015|Announcement|

The 120th Anniversary of Chiropractic

The Chiro.Org Blog

SOURCE:   Palmer College of Chiropractic

Happy Founder’s Day!

Most likely, this is the very first graduating class of Chiropractors in Davenport, Iowa.

Click on the graphic to see a larger version.

This year marks 120 years since chiropractic was founded.

Traditionally, Founder’s Day is celebrated on Sept. 18, the date which is on or near the anniversary of the first chiropractic adjustment by D.D. Palmer in Davenport, Iowa, in 1895.

Founder’s Day is the perfect opportunity to share chiropractic with the world!

Post information about it on your website, Facebook page and profile, Twitter, Instagram and anywhere else.

Need some content? Check out the results of the:

Gallup-Palmer report.

Thanks to Palmer College for access to this material!

How to Proceed When Evidence-based Practice Is Required But Very Little Evidence Available?

By |September 3, 2015|Evidence-based Practice|

How to Proceed When Evidence-based Practice Is Required But Very Little Evidence Available?

The Chiro.Org Blog

SOURCE:   Chiropractic & Manual Therapies 2013 (Jul 10); 21 (1): 24 ~ FULL TEXT

Charlotte Leboeuf-Yde, Olivier Lanlo and Bruce F Walker

The Spine Research Centre,
Hospital Lillebaelt, and Institute for Regional Health Research,
University of Southern Denmark,
Middelfart, Denmark.

BACKGROUND:   All clinicians of today know that scientific evidence is the base on which clinical practice should rest. However, this is not always easy, in particular in those disciplines, where the evidence is scarce. Although the last decades have brought an impressive production of research that is of interest to chiropractors, there are still many areas such as diagnosis, prognosis, choice of treatment, and management that have not been subjected to extensive scrutiny.

DISCUSSION:   In this paper we argue that a simple system consisting of three questions will help clinicians deal with some of the complexities of clinical practice, in particular what to do when clear clinical evidence is lacking. Question 1 asks: are there objectively tested facts to support the concept? Question 2: are the concepts that form the basis for this clinical act or decision based on scientifically acceptable concepts? And question three; is the concept based on long-term and widely accepted experience? This method that we call the “Traffic Light System” can be applied to most clinical processes.

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The Evidence-based Practice Page


Do Participants With Low Back Pain Who Respond to Spinal Manipulative Therapy Differ Biomechanically?

By |September 1, 2015|Chiropractic Care, Low Back Pain, Spinal Manipulation|

Do Participants With Low Back Pain Who Respond to Spinal Manipulative Therapy Differ Biomechanically From Nonresponders, Untreated Controls or Asymptomatic Controls?

The Chiro.Org Blog

SOURCE:   Spine 2015 (Sep 1);   40 (17):   1329–1337 ~ FULL TEXT

Wong, Arnold Y. L. PT, MPhil, PhD; Parent, Eric C. PT, PhD;
Dhillon, Sukhvinder S. MB, ChB, CCST; Prasad, Narasimha PhD;
Kawchuk, Gregory N. DC, PhD

Department of Rehabilitation Sciences,
The Hong Kong Polytechnic University,
Kowloon, Hong Kong

Department of Physical Therapy,
University of Alberta,
Alberta, Canada

FROM: University of Alberta ~ 8-31-2015

Researchers at the University of Alberta have found that spinal manipulation—applying force to move joints to treat pain, a technique most often used by chiropractors and physical therapists — does indeed have immediate benefits for some patients with low-back pain but does not work for others with low-back pain. And though on the surface this latest conflict might appear to muddy the waters further, the results point to the complexity of low-back pain and the need to treat patients differently, says lead author Greg Kawchuk.

“This study shows that, just like some people respond differently to a specific medication, there are different groups of people who respond differently to spinal manipulation.”

In a non-randomized control study, individuals with low-back pain received spinal manipulation during two treatment sessions that spanned a week. Participants reported their pain levels and disability levels after spinal manipulation, and researchers used ultrasound, MRI and other diagnostics to measure changes in each participant’s back, including muscle activity, properties within the intervertebral discs, and spinal stiffness.

A control group of participants with low-back pain underwent similar clinical examinations but did not receive spinal manipulation. A third group — those who did not have low-back pain symptoms — were also evaluated.

The people who responded to spinal manipulation reported less pain right away and showed improvement in back muscle thickness, disc diffusion and spinal stiffness. Those changes were great enough to exceed or equal the measures in the control groups and stayed that way for the week of treatment, the research team found.
A patient receives spinal manipulation treatment.

Kawchuk, who practised as a chiropractor before going on to obtain his PhD in biomechanics and bioengineering, said the results do not advocate one way or another for spinal manipulation but help explain why there has been so much conflicting data about its merits.

“Clearly there are some people with a specific type of back pain who are responding to this treatment and there are some people with another type of back pain who do not. But if you don’t know that and you mix those two groups together, you get an artificial average that doesn’t mean anything,” Kawchuk explained.

The research team is still fine-tuning how to distinguish who is a responder or non-responder before spinal manipulation is given; however, this study shows it can be used to identify an effective treatment course.

“Spinal manipulation acts so rapidly in responders that it could be used as a screening tool to help get the right treatment to the right patient at the right time.”

The study did not investigate the long-term effects of spinal manipulation, but this is next on the list for the researchers.

STUDY DESIGN:   Nonrandomized controlled study.

OBJECTIVE:   To determine whether patients with low back pain (LBP) who respond to spinal manipulative therapy (SMT) differ biomechanically from nonresponders, untreated controls or asymptomatic controls.

SUMMARY OF BACKGROUND DATA:   Some but not all patients with LBP report improvement in function after SMT. When compared with nonresponders, studies suggest that SMT responders demonstrate significant changes in spinal stiffness, muscle contraction, and disc diffusion. Unfortunately, the significance of these observations remains uncertain given methodological differences between studies including a lack of controls.

There are more articles like this @ our:

Low Back Pain and Chiropractic Page