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The Biomechanics of Spinal Manipulation

By |October 18, 2018|Categories: About Chiropractic Adjusting|

The Biomechanics of Spinal Manipulation

The Chiro.Org Blog


SOURCE:   J Bodyw Mov Ther. 2010 (Jul); 14 (3): 280–286

Walter Herzog, PhD

Faculty of Kinesiology,
University of Calgary,
Calgary, AB T2N 1N4, Canada.


Biomechanics is the science that deals with the external and internal forces acting on biological systems and the effects produced by these forces. Here, we describe the forces exerted by chiropractors on patients during high-speed, low-amplitude manipulations of the spine and the physiological responses produced by the treatments. The external forces were found to vary greatly among clinicians and locations of treatment on the spine. Spinal manipulative treatments produced reflex responses far from the treatment site, caused movements of vertebral bodies in the “para-physiological” zone, and were associated with cavitation of facet joints. Stresses and strains on the vertebral artery during chiropractic spinal manipulation of the neck were always much smaller than those produced during passive range of motion testing and diagnostic procedures.

Keywords:   Spinal manipulation; Mobilization; Continuous passive motion; Manipulable lesion; Functional spinal lesion;
Subluxation; Biomechanics



From the FULL TEXT Article:

Introduction

Chiropractic spinal manipulations are mechanical events. Clinicians exert a force of specific magnitudein a controlled direction to a target site,typically on the spine. High-velocity, low-amplitude (HVLA) manipulations are more frequently used by chiropractors than other treatment modalities, and they are of special interest, as force magnitudes and the rates of force application are high. HVLA treatments cause deformations of the spine and surrounding soft tissues and often elicit a cracking sound that has been identified as cavitation of spinal facet joints (Cascioli et al.,2003; Conway et al.,1993; Haas,1990; Herzog et al.,1993c; Mealand Scott,1986; Miereau et al., 1988; Reggars,1996). Despite the acknowledged nature of mechanical force application as a treatment modality (Triano,2000), and the accepted idea that HVLA treat ments produce mechanical effects (e.g., Triano and Schultz, 1997) at the treatment site, little is known about the biomechanics of spinal manipulation.

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Our Blog is Just a Tool. Do You Know How It Works?

By |October 18, 2018|Categories: Announcement|

Our Blog is Just a Tool.
Do You Know How It Works?

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…)

Is Neck Pain Associated with Worse Health-related Quality of Life 6 Months Later? A Population-based Cohort Study

By |October 16, 2018|Categories: Chronic Neck Pain|

Is Neck Pain Associated with Worse Health-related Quality of Life 6 Months Later? A Population-based Cohort Study

The Chiro.Org Blog


SOURCE:   Spine J. 2015 (Apr 1);   15 (4):   675–684

Paul S. Nolet, DC, MS, MPHa, Pierre Cote, DC, PhD, Vicki L. Kristman, PhD, Mana Rezai, DC, MHS, Linda J. Carroll, PhD, J. David Cassidy, DC, PhD, DrMedSc

Department of Graduate Education and Research,
Canadian Memorial Chiropractic College,
6100 Leslie Street,
North York, Ontario, Canada. M2H 3J1.


BACKGROUND CONTEXT:   Current evidence suggests that neck pain is negatively associated with health-related quality of life (HRQoL). However, these studies are cross-sectional and do not inform the association between neck pain and future HRQoL.

PURPOSE:   The purpose of this study was to investigate the association between increasing grades of neck pain severity and HRQoL 6 months later. In addition, this longitudinal study examines the crude association between the course of neck pain and HRQoL.

STUDY DESIGN:   This is a population-based cohort study.

PATIENT SAMPLE:     Eleven hundred randomly sampled Saskatchewan adults were included.

OUTCOME MEASURES:   Outcome measures were the mental component summary (MCS) and physical component summary (PCS) of the Short-Form-36 (SF-36) questionnaire.

METHODS:   We formed a cohort of 1,100 randomly sampled Saskatchewan adults in September 1995. We used the Chronic Pain Questionnaire to measure neck pain and its related disability. The SF-36 questionnaire was used to measure physical and mental HRQoL 6 months later. Multivariable linear regression was used to measure the association between graded neck pain and HRQoL while controlling for confounding. Analysis of variance and t tests were used to measure the crude association among four possible courses of neck pain and HRQoL at 6 months. The neck pain trajectories over 6 months were no or mild neck pain, improving neck pain, worsening neck pain, and persistent neck pain. Finally, analysis of variance was used to examine changes in baseline to 6-month PCS and MCS scores among the four neck pain trajectory groups.

RESULTS:   The 6-month follow-up rate was 74.9%. We found an exposure-response relationship between neck pain and physical HRQoL after adjusting for age, education, arthritis, low back pain, and depressive symptomatology. Compared with participants without neck pain at baseline, those with mild (β=–1.53, 95% confidence interval [CI]=–2.83, –0.24), intense (β=–3.60, 95% CI=–5.76, –1.44), or disabling (β=–8.55, 95% CI=–11.68, –5.42) neck pain had worse physical HRQoL 6 months later. We did not find an association between neck pain and mental HRQoL. A worsening course of neck pain and persistent neck pain were associated with worse physical HRQoL.

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Chronic Neck Pain and Chiropractic Page

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Group and Individual-level Change on Health-related Quality of Life in Chiropractic Patients with Chronic Low Back or Neck Pain

By |October 13, 2018|Categories: Chronic Neck Pain, Low Back Pain|

Group and Individual-level Change on Health-related Quality of Life in Chiropractic Patients with Chronic Low Back or Neck Pain

The Chiro.Org Blog


SOURCE:   Spine (Phila Pa 1976). 2018 (Oct 11) [Epub]

Ron D. Hays, Ph.D., Karen L. Spritzer, B.S., Cathy D. Sherbourne, Ph.D., Gery W. Ryan, Ph.D., Ian D. Coulter, Ph.D.

Division of General Internal Medicine & Health Services Research
UCLA Department of Medicine
911 Broxton Avenue
Los Angeles, CA


STUDY DESIGN:   Prospective observational study.

OBJECTIVE:   To evaluate group-level and individual-level change in health-related quality of life among persons with chronic low back pain or neck pain receiving chiropractic care in the United States.

SUMMARY OF BACKGROUND DATA:   Chiropractors treat chronic low back and neck pain, but there is limited evidence of the effectiveness of their treatment

METHODS:   A 3–month longitudinal study of 2,024 patients with chronic low back pain or neck pain receiving care from 125 chiropractic clinics at 6 locations throughout the United States was conducted. Ninety-one percent of the sample completed the baseline and 3–month follow-up survey (n = 1,835). Average age was 49, 74% females, and most of the sample had a college degree, were non-Hispanic White, worked full-time, and had an annual income of $60,000 or more. Group-level (within group t-tests) and individual-level (coefficient of repeatability) changes on the Patient-Reported Outcomes Measurement Information System (PROMIS) v2.0 profile measure was evaluated: 6 multi-item scales (physical functioning, pain, fatigue, sleep disturbance, social health, emotional distress) and physical and mental health summary scores.

RESULTS:   Within group t-tests indicated significant group-level change (p < 0.05) for all scores except for emotional distress, and these changes represented small improvements in health (absolute value of effect sizes ranged from 0.08 for physical functioning to 0.20 for pain). From 13% (physical functioning) to 30% (PROMIS-29 Mental Health Summary Score) got better from baseline to 3 months later according to the coefficient of repeatability.

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Low Back Pain and Chiropractic
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Chronic Neck Pain and Chiropractic Page

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New Law Protects Chiropractors Who Travel with Sports Teams

By |October 5, 2018|Categories: Uncategorized|

New Law Protects Chiropractors Who Travel with Sports Teams

The Chiro.Org Blog


SOURCE:   American Chiropractic Association
Annette Bernat
American Chiropractic Association


Arlington, Va.– The American Chiropractic Association (ACA) is pleased to announce that Congress has approved legislation that will protect chiropractors who travel with sports teams by ensuring that their license and liability insurance remains in effect even when they cross state lines.

The Sports Medicine Licensure Clarity Act of 2018, as the bill is known, was included in a larger, unrelated piece of legislation (H.R. 302) that passed the Senate overwhelmingly on Oct. 3. The president is expected to sign the bill in the next several days.

As the bill was being drafted, ACA lobbyists and volunteers worked closely with Rep. Brett Guthrie (R-Ky.), the chief House sponsor, and the House Committee on Energy and Commerce to ensure that doctors of chiropractic would be included in the bill’s final language. The original version may have excluded chiropractors from the list of included “sports medicine professionals.”

“This legislation not only protects chiropractors and other health professionals who travel with sports teams, it also ensures consistency of care for the athletes who rely on them,” said ACA President N. Ray Tuck, Jr., DC.
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The Nordic Maintenance Care Program: Effectiveness of Chiropractic Maintenance Care Versus Symptom-guided Treatment for Recurrent and Persistent Low Back Pain

By |September 17, 2018|Categories: Maintenance Care|

The Nordic Maintenance Care Program: Effectiveness of Chiropractic Maintenance Care Versus Symptom-guided Treatment for Recurrent and Persistent Low Back Pain – A Pragmatic Randomized Controlled Trial

The Chiro.Org Blog


SOURCE:   PLoS One. 2018 (Sep 12); 13 (9): e0203029

Andreas Eklund, Irene Jensen, Malin Lohela-Karlsson, Jan Hagberg, Charlotte Leboeuf-Yde, Alice Kongsted, Lennart Bodin, Iben Axén

Karolinska Institutet,
Institute of Environmental Medicine,
Unit of Intervention and Implementation Research for Worker Health,
Stockholm, Sweden.


BACKGROUND:   For individuals with recurrent or persistent non-specific low back pain (LBP), exercise and exercise combined with education have been shown to be effective in preventing new episodes or in reducing the impact of the condition. Chiropractors have traditionally used Maintenance Care (MC), as secondary and tertiary prevention strategies. The aim of this trial was to investigate the effectiveness of MC on pain trajectories for patients with recurrent or persistent LBP.

METHOD:   This pragmatic, investigator-blinded, two arm randomized controlled trial included consecutive patients (18-65 years old) with non-specific LBP, who had an early favorable response to chiropractic care. After an initial course of treatment, eligible subjects were randomized to either MC or control (symptom-guided treatment). The primary outcome was total number of days with bothersome LBP during 52 weeks collected weekly with text-messages (SMS) and estimated by a GEE model.

RESULTS:   Three hundred and twenty-eight subjects were randomly allocated to one of the two treatment groups. MC resulted in a reduction in the total number of days per week with bothersome LBP compared with symptom-guided treatment. During the 12 month study period, the MC group (n = 163, 3 dropouts) reported 12.8 (95% CI = 10.1, 15.5; p = <0.001) fewer days in total with bothersome LBP compared to the control group (n = 158, 4 dropouts) and received 1.7 (95% CI = 1.8, 2.1; p = <0.001) more treatments. Numbers presented are means. No serious adverse events were recorded.

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Maintenance Care and Chiropractic Page

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