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The Role of Chiropractic Care in Older Adults

Chiro.Org Blog: While there is already substantial published research to assist the evidence-based DC in his/her care plan for the older adult, there is a need for well designed clinical trials and large observational studies to identify the most beneficial treatments, particularly for complementary and alternative interventions such as manual therapy including, but not limited to, spinal manipulative therapy and acupuncture. […]

National Clinical Guidelines for Non-surgical Treatment of Patients with Recent Onset Low Back Pain or Lumbar Radiculopathy

Chiro.Org Blog: Two multidisciplinary working groups developed two national clinical guidelines for non-surgical treatment in adult patients with non-specific low back pain (LBP) and lumbar radiculopathy (LR) of less than 12 weeks’ duration under the Danish Health Authority. The recommendations are based on limited evidence or on consensus, but are well aligned with recommendations from similar international guidelines. The guideline working groups strongly recommend that research efforts in relation to all aspects of the management of LBP and, in particular, LR be intensified. […]

Amount of Health Care and Self-care Following a Randomized Clinical Trial Comparing Flexion-distraction with Exercise Program for Chronic Low Back Pain

Chiro.Org Blog: Participants in the physical therapy group demonstrated on average significantly more visits to any health care provider and to a general practitioner during the year after trial care (p < 0.05). No group differences were noted in the number of visits to a chiropractor or physical therapist. Self-care was initiated by nearly every participant in both groups.   During a one-year follow-up, participants previously randomized to physical therapy attended significantly more health care visits than those participants who received chiropractic care. […]

Whiplash-associated Disorders: Who Gets Depressed? Who Stays Depressed?

Chiro.Org Blog: In a prior study we reported that post crash depression is common following crash related WAD. As a follow-up to that, we now report the characteristics that can assist clinicians to identify not only which patients are more likely to experience post-crash depression, but also identify which are at risk for a more severe course of depression. This is important because depressed mood in those with WAD is not only an additional health burden in itself, but is also associated with slower recovery. The most important characteristics in identifying those with WAD who are likely to experience depression were higher post crash pain, other post-crash symptoms, sustaining a fractured bone, the presence of post-crash anxiety, and the presence of prior mental health problems. […]

Expectations for Recovery Important in the Prognosis of Whiplash Injuries

Chiro.Org Blog: In conclusion, we suggest early assessment of expectations for recovery to be made, in order to identify people at risk for poor prognosis after WAD. Furthermore, controlled studies on interventions aimed at modifying expectations are warranted. Such studies could be conducted on the population level, similar to the successful media campaign on back pain beliefs, which decreased disability claims, both in terms of incidence and time on benefits. [31, 32] Alternatively interventions targeting persons in the acute phase of an injury should be evaluated. Finally, it is not inconceivable that our findings can be extended to persons with pain conditions other than WAD. […]

Systematic Review of Self-Reported Prognosis in Adults After Mild Traumatic Brain Injury

Chiro.Org Blog: Since the prognosis review of the WHO Collaborating Centre Task Force, there has been some progress in understanding MTBI prognosis. Our results add to the growing evidence that postconcussion symptoms are not specific to MTBI and occur commonly in the general population and after other nonhead injuries. Our results also confirm the importance of psychosocial determinants of recovery. We conclude that self-reported symptoms can be persistent after MTBI, and there is a need for more intervention research targeting modifiable prognostic factors. Finally, we found only 1 study of a clinical prediction rule, and we recommend more focus on this issue because it holds the potential of identifying those at risk of a poor recovery who might benefit from more focused clinical attention. […]

Sport Concussion Knowledge and Clinical Practices

Chiro.Org Blog: 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 SCAT3 as a sideline assessment tool. Manual therapy is considered by many chiropractors to be an appropriate treatment for concussion patients. Future research on concussion management is needed to understand the efficacy of manual therapies as components of multidisciplinary concussion management strategies. […]

The Reduction of Asthma Symptoms and Medication After Chiropractic Care

Chiro.Org Blog: This case study of a 5-year-old male with asthma following chiropractic treatment suggests that his asthma symptoms were reduced and controlled with chiropractic care. The quick and sudden change following chiropractic treatment eliminates natural history, which is seen sometimes in the allergenic type asthma cases where children outgrow the asthma. He was able to reduce the use of medications and demonstrate that chiropractic care reduced the chances of the symptoms worsening during episodes of exacerbation. Further investigation is warranted. […]

Fish-oil Supplementation Enhances the Effects of Strength Training in Elderly Women

Chiro.Org Blog: In conclusion, the use of fish oil (FO) supplementation in addition to strength training potentiates the neuromuscular system, enhancing the muscle strength and the functional capacity in elderly women. Thus, FO may be an attractive supplement for the elderly to maximize their neuromuscular responses to strength training, which is important to life quality. However, the supplementation length does not influence the strength-training effects. […]

Schoolbags and Back Pain in Children Between 8 and 13 Years

Chiro.Org Blog: Over 70% of the subjects had a schoolbag that exceeded the recommended 10% bag weight to body ratio. A total of 32% of the sample complained of back pain, with 74% of these defining it as low in intensity on the face pain scale-revised. The presence of back pain was statistically related to gender, body mass index (BMI), school and bag weight to body weight ratio. After adjusting for other factors, self-reported back pain in schoolchildren is independently linked to carrying heavy schoolbags. This link should be addressed to decrease the occurrence of back pain in this age group. […]

Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin

Chiro.Org Blog: Musculoskeletal sources of adult hip pain can be divided into posterior, lateral, and anterior categories. For posterior hip pain, select considerations include lumbar spine and femoroacetabular joint referral, sacroiliac joint pathology, piriformis syndrome, and proximal hamstring tendinopathy. Gluteal tendinopathy and iliotibial band thickening are the most common causes of lateral hip pain. Anterior hip pain is further divided into causes that are intra-articular (ie, labral tear, osteoarthritis, osteonecrosis) and extra-articular (ie, snapping hip and inguinal disruption [athletic pubalgia]). Entrapment neuropathies and myofascial pain should also be considered in each compartment. A limited number of historical features and physical examination tests for evaluation of adult hip pain are supported by the literature and are discussed in this article. […]

How Can Latent Trajectories of Back Pain be Translated into Defined Subgroups?

Chiro.Org Blog: This study was the first to demonstrate that suggested definitions of LBP trajectory subgroups can be readily applied to individuals’ observed data resulting in subgroups that match well with LCA-derived trajectory patterns. We suggest that the number of trajectory subgroups can be reduced by merging some subgroups with infrequent and mild LBP. Further, we suggest that minor fluctuations in pain intensity might be conceptualised as ‘ongoing LBP’. Lastly, we found clear support for distinguishing between fluctuating and episodic LBP.


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Cortical Changes in Chronic Low Back Pain

Chiro.Org Blog: There is increasing evidence that chronic pain problems are characterised by alterations in brain structure and function. Chronic back pain is no exception. There is a growing sentiment, with accompanying theory, that these brain changes contribute to chronic back pain, although empirical support is lacking. This paper reviews the structural and functional changes of the brain that have been observed in people with chronic back pain. […]