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Cost-effectiveness of Spinal Manipulation, Exercise, and Self-management for Spinal Pain Using an Individual Participant Data Meta-analysis Approach

By |November 15, 2018|Categories: Cost-Effectiveness|

Cost-effectiveness of Spinal Manipulation, Exercise, and Self-management for Spinal Pain Using an Individual Participant Data Meta-analysis Approach: A Study Protocol

The Chiro.Org Blog


SOURCE:   Chiropractic & Manual Therapies 2018; 26: 46

Brent Leininger, Gert Bronfort, Roni Evans, James Hodges, Karen Kuntz and John A. Nyman

Integrative Health & Wellbeing Research Program,
Earl E. Bakken Center for Spirituality & Healing,
University of Minnesota,
420 Delaware St SE,
Minneapolis, MN 55455, USA


Background   Spinal pain is a common and disabling condition with considerable socioeconomic burden. Spine pain management in the United States has gathered increased scrutiny amidst concerns of overutilization of costly and potentially harmful interventions and diagnostic tests. Conservative interventions such as spinal manipulation, exercise and self-management may provide value for the care of spinal pain, but little is known regarding the cost-effectiveness of these interventions in the U.S. Our primary objective for this project is to estimate the incremental cost-effectiveness of spinal manipulation, exercise therapy, and self-management for spinal pain using an individual patient data meta-analysis approach.

Methods/design   We will estimate the incremental cost-effectiveness of spinal manipulation, exercise therapy, and self-management using cost and clinical outcome data collected in eight randomized clinical trials performed in the U.S. Cost-effectiveness will be assessed from both societal and healthcare perspectives using QALYs, pain intensity, and disability as effectiveness measures. The eight randomized clinical trials used similar methods and included different combinations of spinal manipulation, exercise therapy, or self-management for spinal pain. They also collected similar clinical outcome, healthcare utilization, and work productivity data. A two-stage approach to individual patient data meta-analysis will be conducted.

There are more articles like this @ our:

The Cost-Effectiveness of Chiropractic Page and the:

Chiropractic and Spinal Pain Management Page and the:

Exercise and Chiropractic Care Page

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The Role of Vitamin D in the Pathogenesis of Adolescent Idiopathic Scoliosis

By |November 12, 2018|Categories: Scoliosis, Vitamin D|

The Role of Vitamin D in the Pathogenesis of Adolescent Idiopathic Scoliosis

The Chiro.Org Blog


SOURCE:   Asian Spine J. 2018 (Oct 16) [Epub]

Shu-Yan Ng, Josette Bettany-Saltikov, Irene Yuen Kwan Cheung, Karen Kar Yin Chan

Institute of Health and Social Care,
Teesside University,
Middlesbrough, UK.


FROM:  
Asian Spine J. 2018 (Oct 16) [Epub]
~ FULL TEXT


Several theories have been proposed to explain the etiology of adolescent idiopathic scoliosis (AIS) until present. However, limited data are available regarding the impact of vitamin D insufficiency or deficiency on scoliosis. Previous studies have shown that vitamin D deficiency and insufficiency are prevalent in adolescents, including AIS patients. A series of studies conducted in Hong Kong have shown that as many as 30% of these patients have osteopenia. The 25-hydroxyvitamin D3 level has been found to positively correlate with bone mineral density (BMD) in healthy adolescents and negatively with Cobb angle in AIS patients; therefore, vitamin D deficiency is believed to play a role in AIS pathogenesis. This study attempts to review the relevant literature on AIS etiology to examine the association of vitamin D and various current theories. Our review suggested that vitamin D deficiency is associated with several current etiological theories of AIS. We postulate that vitamin D deficiency and/or insufficiency affects AIS development by its effect on the regulation of fibrosis, postural control, and BMD. Subclinical deficiency of vitamin K2, a fat-soluble vitamin, is also prevalent in adolescents; therefore, it is possible that the high prevalence of vitamin D deficiency is related to decreased fat intake. Further studies are required to elucidate the possible role of vitamin D in the pathogenesis and clinical management of AIS.

There are more articles like this @ our:

Nutrition Section
and the:

Scoliosis and Chiropractic Page

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Our Blog is Just a Tool. Learn How To Use It Now

By |November 12, 2018|Categories: Announcement|

Our Blog is Just a Tool.
Learn How To Use It Now

The Chiro.Org Blog


SOURCE:   A Chiro.Org Editorrial


Every Blog post is an announcement of new material that was just added to one of our many Sections.

I have been compiling (and archiving) peer-reviewed articles since early 1996, and to date we have thousands of Abstracts, and many hundreds of Full-Text articles on a wide variety of subjects.

When enough material, relating to a particular topic was collected, it was gathered into a new Topical Page in one of our many Sections.

Each Topical page is located in the Section most associated with that topic.
Thus, our Attention Deficit Page is located (is a part of) our Pediatrics Section You get the idea.

Almost ALL of our Sections contain some, or many Topical collections. The LINKS Section is the most extreme example, because it contains 83 different topical pages.

All of the following are “active” Sections that are constantly adding new (and important) materials:

Acupuncture Section
Alternative Healing Abstracts
Case Studies
Chiropractic Assistants Section
Chiropractic Research Section
Documentation Section
The LINKS
Medicare Information
Nutrition Section
Pediatrics Section
Radiology Section
Stroke and Chiropractic Page
What is the Chiropractic Subluxation

These other valuable Sections are “archival” in nature, and contain
valuable tools for you to use freely:

Chiropractic History Section
Free Images Page
New DC’s Page
Office Forms Page
R.C. Schafer’s Rehab Monographs
Search Section


How Blog Posts Work

The following is a Graphic “screen grab” of a Blog Post from our Home Page. (more…)

Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception

By |November 8, 2018|Categories: Low Back Pain|

Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception

The Chiro.Org Blog


SOURCE:   Neuroscientist. 2018 (Nov 2) [Epub]

Michael Lukas Meier, Andrea Vrana1, and Petra Schweinhardt

Integrative Spinal Research,
Department of Chiropractic Medicine,
University Hospital Balgrist,
Zurich, Switzerland.


Motor control, which relies on constant communication between motor and sensory systems, is crucial for spine posture, stability and movement. Adaptions of motor control occur in low back pain (LBP) while different motor adaption strategies exist across individuals, probably to reduce LBP and risk of injury. However, in some individuals with LBP, adapted motor control strategies might have long-term consequences, such as increased spinal loading that has been linked with degeneration of intervertebral discs and other tissues, potentially maintaining recurrent or chronic LBP. Factors contributing to motor control adaptations in LBP have been extensively studied on the motor output side, but less attention has been paid to changes in sensory input, specifically proprioception.

Furthermore, motor cortex reorganization has been linked with chronic and recurrent LBP, but underlying factors are poorly understood. Here, we review current research on behavioral and neural effects of motor control adaptions in LBP. We conclude that back pain-induced disrupted or reduced proprioceptive signaling likely plays a pivotal role in driving long-term changes in the top-down control of the motor system via motor and sensory cortical reorganization. In the outlook of this review, we explore whether motor control adaptations are also important for other (musculoskeletal) pain conditions.

There are more articles like this @ our:

Low Back Pain and Chiropractic Page

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The Management of Common Recurrent Headaches by Chiropractors

By |November 5, 2018|Categories: Headache|

The Management of Common Recurrent Headaches by Chiropractors: A Descriptive Analysis of a Nationally Representative Survey

The Chiro.Org Blog


SOURCE:   BMC Neurol. 2018 (Oct 17); 18 (1): 171

Craig Moore, Andrew Leaver, David Sibbritt, and Jon Adams

Faculty of Health,
University of Technology Sydney,
Level 8, Building 10,
235-253 Jones Street Ultimo,
Sydney, NSW, 2007, Australia.


BACKGROUND:   Headache management is common within chiropractic clinical settings; however, little is yet known about how this provider group manage headache sufferers. The aim of this study is to report on the prevalence of headache patients found within routine chiropractic practice and to assess how chiropractors approach key aspects of headache management applicable to primary care settings.

METHODS:   A 31-item cross-sectional survey was distributed to a national sample of chiropractors (n = 1050) to report on practitioner approach to headache diagnosis, interdisciplinary collaboration, treatment and outcome assessment of headache patients who present with recurrent headache disorders.

RESULTS:   The survey attracted a response rate of 36% (n = 381). One in five new patients present to chiropractors with a chief complaint of headache. The majority of chiropractors provide headache diagnosis for common primary (84.6%) and secondary (90.4%) headaches using formal headache classification criteria. Interdisciplinary referral for headache management was most often with CAM providers followed by GPs. Advice on headache triggers, stress management, spinal manipulation, soft tissue therapies and prescriptive neck exercises were the most common therapeutic approaches to headache management.

There are more articles like this @ our:

Headache and Chiropractic Page

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Referred Pain from Myofascial Trigger Points in Head and Neck-shoulder Muscles Reproduces Head Pain Features in Children With Chronic Tension type Headache

By |October 21, 2018|Categories: Headache, Myofascial Disorder, Pediatrics|

Referred Pain from Myofascial Trigger Points in Head and Neck-shoulder Muscles Reproduces Head Pain Features in Children With Chronic Tension type Headache

The Chiro.Org Blog


SOURCE:   J Headache Pain. 2011 (Feb); 12 (1): 35–43

César Fernández-de-las-Peñas, Daniel M. Fernández-Mayoralas, Ricardo Ortega-Santiago, Silvia Ambite-Quesada, Domingo Palacios-Ceña and Juan A. Pareja

Department of Physical Therapy,
Occupational Therapy,
Rehabilitation and Physical Medicine,
Facultad de Ciencias de la Salud,
Universidad Rey Juan Carlos,
Avenida de Atenas s/n,
28922 Alcorcón, Madrid



Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children’s condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured.

The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (r (s) = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children.

There are more articles like this @ our:

Chiropractic Pediatrics Section
and the:

Headache and Chiropractic Page

(more…)