July 2016
M T W T F S S
« Jun    
 123
45678910
11121314151617
18192021222324
25262728293031

Archives

Please support our Sponsors

Effect of Two Consecutive Spinal Manipulations in a Single Session on Myofascial Pain Pressure Sensitivity

Effect of Two Consecutive Spinal Manipulations in a Single Session on Myofascial Pain Pressure Sensitivity: A Randomized Controlled Trial

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc. 2016 (Jun); 60 (2): 137–145

Michelle A. Laframboise, BKin (Hons), DC, FRCCSS(C),
Howard Vernon, BA, DC, PhD, and
John Srbely, BSc, DC, PhD

Canadian Memorial Chiropractic College,
6100 Leslie Street,
Toronto, Canada;
Division of Graduate Studies,
Sports Sciences,
Canadian Memorial Chiropractic College.


OBJECTIVE:   To investigate the summative effect of two consecutive spinal manipulative therapy (SMT) interventions within the same session on the pain pressure sensitivity of neurosegmentally linked myofascial tissues.

METHODS:   26 participants were recruited and assessed for the presence of a clinically identifiable myofascial trigger point in the right infraspinatus muscle. Participants were randomly assigned to test or control group. Test group received two consecutive real cervical SMT interventions to C5-C6 segment while controls received one real SMT followed by one validated sham SMT intervention to C5-C6 segment. Participants received the two consecutive SMT interventions 30 minutes apart. Pain pressure threshold (PPT) readings were recorded at pre-SMT1 and 5, 10, 15, 20 and 25 minutes post-SMT1 and post-SMT2. PPT readings were normalized to pre-SMT1 values and averaged.

RESULTS:   Repeated measures ANOVA demonstrated a significant main effect of SMT intervention [F(1,24)=8.60, p<0.05] but not group [F(1.24)=0.01] (p=0.91). Post-hoc comparisons demonstrated a statistically significant (p<0.05) increase in SMT2 versus SMT1 (18%) in the test group but not in controls (4%) (p=0.82).

There are other articles like this @ our:

Myofascial Trigger Points (TrPs) Page

Continue reading Effect of Two Consecutive Spinal Manipulations in a Single Session on Myofascial Pain Pressure Sensitivity

A Cross-sectional Analysis of Clinical Outcomes Following Chiropractic Care in Veterans With and Without Post-traumatic Stress Disorder

A Cross-sectional Analysis of Clinical Outcomes Following Chiropractic Care in Veterans With and Without Post-traumatic Stress Disorder

The Chiro.Org Blog


SOURCE:   Mil Med. 2009 (Jun); 174 (6): 578–583

Andrew S. Dunn; Steven R. Passmore;
Jeanmarie Burke; David Chicoine

Chiropractic Service,
VA of Western New York Healthcare System,
3495 Bailey Avenue,
Buffalo, NY 14215, USA.


This study was a cross-sectional analysis of clinical outcomes for 130 veteran patients with neck or low back complaints completing a course of care within the chiropractic clinic at the VA of Western New York in 2006. Multivariate analysis of variance (MANOVA) was utilized, comparing baseline and discharge scores for both the neck and low back regions and for those patients with and without post-traumatic stress disorder (PTSD). Patients with PTSD (n = 21) experienced significantly lower levels of score improvement than those without PTSD (n = 119) on self-reported outcome measures of neck and low back disability. These findings, coupled with the theorized relationships between PTSD and chronic pain, suggest that the success of conservative forms of management for veteran patients with musculoskeletal disorders may be limited by the presence of PTSD. Further research is warranted to examine the potential contributions of PTSD on chiropractic clinical outcomes with this unique patient population.


From the FULL TEXT Article:

INTRODUCTION

A diagnosis of post-traumatic stress disorder (PTSD) can be conveyed when a person has been exposed to a traumatic event that could be perceived as threatening or that actually threatened the physical integrity of the individual or others, and his or her response involved fear, helplessness, or horror. [1] The person must also persistently re-experience the perception of the trauma and avoid reminders of the event while displaying symptoms of increased arousal (sleeplessness, irritability, outbursts) for at least 1 month, which disrupts their social, occupational, or other levels of functioning. [1]

There are more articles like this @ our:

Chiropractic Care For Veterans Page

Continue reading A Cross-sectional Analysis of Clinical Outcomes Following Chiropractic Care in Veterans With and Without Post-traumatic Stress Disorder

Assessment of Chiropractic Treatment for Active Duty, U.S. Military Personnel With Low Back Pain

Assessment of Chiropractic Treatment for Active Duty, U.S. Military Personnel With Low Back Pain: Study Protocol for a Randomized Controlled Trial

The Chiro.Org Blog


SOURCE:   Trials. 2016 (Feb 9);   17:   70

Christine M. Goertz, Cynthia R. Long, Robert D. Vining,
Katherine A. Pohlman, Bridget Kane, Lance Corber,
Joan Walter and Ian Coulter

Palmer College of Chiropractic,
Palmer Center for Chiropractic Research,
741 Brady Street, Davenport, IA, 52803, USA.
christine.goertz@palmer.edu


BACKGROUND:   Low back pain is highly prevalent and one of the most common causes of disability in U.S. armed forces personnel. Currently, no single therapeutic method has been established as a gold standard treatment for this increasingly prevalent condition. One commonly used treatment, which has demonstrated consistent positive outcomes in terms of pain and function within a civilian population is spinal manipulative therapy provided by doctors of chiropractic. Chiropractic care, delivered within a multidisciplinary framework in military healthcare settings, has the potential to help improve clinical outcomes for military personnel with low back pain. However, its effectiveness in a military setting has not been well established. The primary objective of this study is to evaluate changes in pain and disability in active duty service members with low back pain who are allocated to receive usual medical care plus chiropractic care versus treatment with usual medical care alone.

METHODS/DESIGN:   This pragmatic comparative effectiveness trial will enroll 750 active duty service members with low back pain at three military treatment facilities within the United States (250 from each site) who will be allocated to receive usual medical care plus chiropractic care or usual medical care alone for 6 weeks. Primary outcomes will include the numerical rating scale for pain intensity and the Roland-Morris Disability Questionnaire at week 6. Patient reported outcomes of pain, disability, bothersomeness, and back pain function will be collected at 2, 4, 6, and 12 weeks from allocation.

DISCUSSION:   Because low back pain is one of the leading causes of disability among U.S. military personnel, it is important to find pragmatic and conservative treatments that will treat low back pain and preserve low back function so that military readiness is maintained. Thus, it is important to evaluate the effects of the addition of chiropractic care to usual medical care on low back pain and disability.

There are more articles like this @ our:

Chiropractic Care For Veterans Page

Continue reading Assessment of Chiropractic Treatment for Active Duty, U.S. Military Personnel With Low Back Pain

Sophisticated Research Design in
Chiropractic and Manipulative Therapy: Part 3

Sophisticated Research Design in
Chiropractic and Manipulative Therapy;
“What You Learn Depends on How You Ask.”

Part C:  Mixed Methods:   “Why Can’t Science
And Chiropractic Just Be Friends?”

The Chiro.Org Blog


SOURCE:   Chiropractic Journal of Australia 2016; 44 (2): 1–21

Lyndon G. Amorin-Woods, BAppSci(Chiropractic), MPH

Senior Clinical Supervisor;
Murdoch University Chiropractic Clinic
School of Health Professions,
Discipline of Chiropractic
Murdoch University South Street campus,
90 South Street, Murdoch,
Western Australia 6150


Many commentators have recognised the limitations and inapplicability of the traditional quantitative pyramid hierarchy especially with respect to complementary and alternative (CAM) health care, observing the way Evidence-based Practice [EBP] is sometimes implemented is controversial, not only within the chiropractic profession, but in all other healthcare disciplines, including medicine itself.   A phased approach to the development and evaluation of complex interventions can help researchers define the research process and complex interventions may require use of both qualitative and quantitative methods.   The chiropractic profession has little to fear from evidence-based practice; in fact it should be used productively to improve patient care, clinical outcomes and the standing of the profession in the eyes of the public, other health professions and legislators.

Keywords Evidence-Based Practice; Mixed Methods; Research Design


INTRODUCTION

Many scientists have recognised the limitations and inapplicability of the traditional quantitative pyramid hierarchy especially with respect to complementary and alternative (CAM) health care, including chiropractic. Over the last decade some authors have suggested refinements of the model, for instance;   in the place of an evidence hierarchy, Jonas [1] suggested the construction of an “evidence house” with “rooms” for different types of information and purposes and later presented a refined circular model. [1]

Jonas [1] observed:

Continue reading Sophisticated Research Design in
Chiropractic and Manipulative Therapy: Part 3

Sophisticated Research Design in
Chiropractic and Manipulative Therapy: Part 2

Sophisticated Research Design in
Chiropractic and Manipulative Therapy;
“What You Learn Depends on How You Ask.”
 
Part B.   Qualitative Research;   Quality vs. Quantity

The Chiro.Org Blog


SOURCE:   Chiropractic Journal of Australia 2016; 44 (2): 1–14

Lyndon G. Amorin-Woods, BAppSci(Chiropractic), MPH

Senior Clinical Supervisor;
Murdoch University Chiropractic Clinic
School of Health Professions,
Discipline of Chiropractic
Murdoch University South Street campus,
90 South Street, Murdoch,
Western Australia 6150


The plethora of quantitative evidence in chiropractic science stands in contrast to the relative dearth of qualitative studies. This phenomenon exists in spite of the intuitive impression that chiropractic is indeed suitable for investigation with a variety of qualitative methodologies. There is a long tradition of qualitative investigation in the social sciences, which focuses on gathering rich experiential data, recognising both that health research deals with ‘real’ people, and that people are not predictable or pre-determined. Qualitative chiropractic research can examine various aspects of a “package” of care and the participants “care journey” and the interplay between verbal and nonverbal, including tactile interactions, which may be diagnostic or therapeutic. Research in chiropractic ideally integrates experience, neurobiology and nonlinear dynamic thinking. Many chiropractic scientists are used to only working with linear models, consequently they may be reluctant to adopt the nonlinear framework of complexity theory and recognise that the analysis of lived experience including subjective phenomena can be an integral part of studies in the chiropractic space.

Keywords Evidence-Based Practice; Qualitative Research; Research Design


INTRODUCTION

This paper examines the application of qualitative methodology in the chiropractic sector. Philosophers of science have long observed that the positivist paradigm that underpins quantitative research can itself easily become a dogma, they recognise that science can never ‘prove itself’ and many would no doubt agree with Dupre that it may indeed become a form of ‘scientific imperialism’. [1-3] There is thus an increasing recognition that devotion to a purely quantitative methodology in the health sciences is at best, ‘unbalanced’. [1] This paper will lead the reader through a preliminary description of qualitative research methodologies while providing an overview of the major paradigms on which qualitative research is based, along with selected chiropractic examples.

      Importance of Qualitative Research to
     Chiropractic Health Research

Continue reading Sophisticated Research Design in
Chiropractic and Manipulative Therapy: Part 2

Sophisticated Research Design in
Chiropractic and Manipulative Therapy: Part I

Sophisticated Research Design in
Chiropractic and Manipulative Therapy;
“What You Learn Depends on How You Ask.”

Part A. Quantitative Research: Size Does Matter

The Chiro.Org Blog


SOURCE:   Chiropractic Journal of Australia 2016; 44 (2): 1–21

Lyndon G. Amorin-Woods, BAppSci(Chiropractic), MPH

Murdoch University Chiropractic Clinic
School of Health Professions,
Discipline of Chiropractic
Murdoch University South Street campus,
90 South Street, Murdoch,
Western Australia 6150


Many chiropractors remain skeptical of evidence-based practice (EBP) and some may view it as an attack on the profession which they feel must be resisted. A counter-argument is centred on the primacy afforded quantitative methodology as epitomised by the randomised controlled trial (RCT). This defensive posture may be mitigated by recognising the role complex research has played in the legitimisation of the profession. The pre-eminence of the randomised controlled trial (RCT), considered by many as the gold-standard of evidence, has led some authors to go so far as to functionally disregard all evidence that is not an RCT. However, it is readily apparent the RCT is not always the most appropriate study design to gather evidence, especially in the CAM health sector. This paper discusses the role of sophisticated design in quantitative chiropractic research, presenting examples sequentially through the traditional quantitative hierarchy and concludes that optimal methodology depends on the research question. Research design must allow for the various dimensions of the (chiropractic) clinical encounter, and may be sophisticated at all levels, but must above all, be contextual. The ‘best available’ or most relevant evidence depends on what one needs for a specific purpose. A critical caution is the proviso that care must be exercised not to draw inappropriate conclusions such as causation from descriptive studies.

INDEX TERMS: Chiropractic; Evidence-Based Practice; Quantitative Evaluation; Research Design


INTRODUCTION

Proponents and detractors of evidence-based practice (EBP) in chiropractic, in common with the rest of healthcare, generally adopt antithetical positions characterised more by dogmatic convictions than by genuine debate. Some consider RCT evidence as the gold standard of sophisticated evidence, while others are highly critical. [1] The principal proposition of this paper will be that sophisticated research designs have an important role in generating new knowledge at all ‘levels’ of the hierarchy and should not be avoided because of the challenge presented by complexity. It is my view that a sequential analysis of the various study designs in clinical and health system research demonstrates that different designs have each added a unique dimension to the corpus of knowledge concerning chiropractic, manual therapy, spinal pain complementary medicine and human well-being. A study may reside ‘lower’ on the evidentiary hierarchy, but this certainly does not preclude it from being complex, sophisticated or valuable.

Continue reading Sophisticated Research Design in
Chiropractic and Manipulative Therapy: Part I

Effect of Spinal Manipulation on Pelvic Floor Functional Changes in Pregnant and Nonpregnant Women

Effect of Spinal Manipulation on Pelvic Floor Functional Changes in Pregnant and Nonpregnant Women:
A Preliminary Study

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2016 (Jun); 39 (5): 339–347

Heidi Haavik, BSc (Chiro), PhDip (Science), PhD,
Bernadette A. Murphy, DC, MSc, PhD,
Jennifer Kruger, BSc (Nursing), MSc, PhD

Director of Research,
Centre for Chiropractic Research,
New Zealand College of Chiropractic


OBJECTIVE:   The aim of this study was to investigate whether a single session of spinal manipulation of pregnant women can alter pelvic floor muscle function as measured using ultrasonographic imaging.

METHODS:   In this preliminary, prospective, comparative study, transperineal ultrasonographic imaging was used to assess pelvic floor anatomy and function in 11 primigravid women in their second trimester recruited via notice boards at obstetric caregivers, pregnancy keep-fit classes, and word of mouth and 15 nulliparous women recruited from a convenience sample of female students at the New Zealand College of Chiropractic. Following bladder voiding, 3-/4-dimensional transperineal ultrasonography was performed on all participants in the supine position. Levator hiatal area measurements at rest, on maximal pelvic floor contraction, and during maximum Valsalva maneuver were collected before and after either spinal manipulation or a control intervention.

RESULTS:   Levator hiatal area at rest increased significantly (P < .05) after spinal manipulation in the pregnant women, with no change postmanipulation in the nonpregnant women at rest or in any of the other measured parameters.

There are more articles like this @ our:

Chiropractic Pediatrics Section

Continue reading Effect of Spinal Manipulation on Pelvic Floor Functional Changes in Pregnant and Nonpregnant Women

Efficacy of Selected Complementary and Alternative Medicine Interventions For Chronic Pain

Efficacy of Selected Complementary and Alternative Medicine Interventions For Chronic Pain

The Chiro.Org Blog


SOURCE:   J Rehabil Res Dev. 2007; 44 (2): 195–222

Gabriel Tan, PhD, ABPP, Michael H. Craine, PhD,
Matthew J. Bair, MD, MS,
M. Kay Garcia, DrPH, MSN, RN, LAc,
James Giordano, PhD, Mark P. Jensen, PhD,
Shelley M. McDonald, MD

Department of Anesthesiology,
Michael E. DeBakey Department of Veterans Affairs (VA) Medical Center (VAMC),
2002 Holcombe Blvd,
Houston, TX 77030, USA


Complementary and alternative medicine (CAM) is a group of diverse medical and healthcare systems, therapies, and products that are not presently considered part of conventional medicine. This article provides an up-to-date review of the efficacy of selected CAM modalities in the management of chronic pain. Findings are presented according to the classification system developed by the National Institutes of Health National Center for Complementary and Alternative Medicine (formerly Office of Alternative Medicine) and are grouped into four domains: biologically based medicine, energy medicine, manipulative and body-based medicine, and mind-body medicine. Homeopathy and acupuncture are discussed separately as “whole or professionalized CAM practices.” Based on the guidelines of the Clinical Psychology Division of the American Psychological Association, findings indicate that some CAM modalities have a solid track record of efficacy, whereas others are promising but require additional research. The article concludes with recommendations to pain practitioners.


From the FULL TEXT Article:

INTRODUCTION

      Definition of Complementary and Alternative Medicine

Complementary and alternative medicine (CAM) is a group of diverse medical and healthcare systems, therapies, and products that are not presently considered part of conventional medicine. They are not generally provided by U.S. hospitals and clinics or widely taught in medical schools [1].

      Prevalence and Popularity of
     Complementary and Alternative Medicine Use

CAM modalities are widely used by the U.S. public. According to the Centers for Disease Control and Prevention (CDC), 62 percent of adults used some form of CAM during the past 12 months when the definition of CAM included prayer specifically for health reasons and 36 percent when prayer was excluded [2]. The most frequent conditions associated with CAM use included back pain, neck pain, joint pain, stiffness, anxiety, and depression (the latter two are commonly associated with chronic pain). CAM use increased substantially during the 1990s. The U.S. public spent an estimated $36 to $47 billion on CAM in 1997 alone [3]; between $12.2 and $19.6 billion were paid out-of-pocket for the services of CAM providers such as chiropractors, acupuncturists, and massage therapists. These fees are more than the U.S. public paid out-of-pocket for all hospitalizations in 1997 and half the amount of all out-of-pocket physician services for traditional care [4].

      Purpose of This Article

There are more articles like this @ our:

ALT-MED/CAM ABSTRACTS Page

Continue reading Efficacy of Selected Complementary and Alternative Medicine Interventions For Chronic Pain

Hospital-Based Chiropractic Integration Within a Large Private Hospital System in Minnesota

Hospital-Based Chiropractic Integration Within a
Large Private Hospital System in Minnesota:
A 10-Year Example

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2009 (Nov); 32 (9): 740–748

Richard A. Branson, DC

Director of Chiropractic Services,
Fairview Sports and Orthopedic Care,
Fairview Health System,
Burnsville, MN 55337, USA.


OBJECTIVE:   The purpose of this article is to describe a model of chiropractic integration developed over a 10-year period within a private hospital system in Minnesota.

METHODS:   Needs were assessed by surveying attitudes and behaviors related to chiropractic and complementary and alternative medicine (CAM) of physicians associated with the hospital. Analyzing referral and utilization patterns assessed chiropractic integration into the hospital system.

RESULTS:   One hundred five surveys were returned after 2 mailings for a response rate of 74%. Seventy-four percent of respondents supported integration of CAM into the hospital system, although 45% supported the primary care physician as the gatekeeper for CAM use. From 2006 to 2008, there were 8,294 unique new patients in the chiropractic program. Primary care providers (medical doctors and physician assistants) were the most common referral source, followed by self-referred patients, sports medicine physicians, and orthopedic physicians. Overall examination of the program identified that facilitators of chiropractic integration were (1) growth in interest in CAM, (2) establishing relationships with key administrators and providers, (3) use of evidence-based practice, (4) adequate physical space, and (5) creation of an integrated spine care program. Barriers were (1) lack of understanding of chiropractic professional identity by certain providers and (2) certain financial aspects of third-party payment for chiropractic.

There are more articles like this @ our:

TELL ME ABOUT CHIROPRACTIC Page

Continue reading Hospital-Based Chiropractic Integration Within a Large Private Hospital System in Minnesota

Mixed-Methods Research in a Complex Multisite Veterans Affairs’ Health Services Study

Mixed-Methods Research in a Complex Multisite Veterans Affairs’ Health Services Study

The Chiro.Org Blog


SOURCE:   Evid Based Complement Alternat Med. 2013: 701280

Raheleh Khorsan, Angela B. Cohen, Anthony J. Lisi,
Monica M. Smith, Deborah Delevan, Courtney Armstrong,
and Brian S. Mittman

VA Center for Implementation Practice and Research Support,
VA Greater Los Angeles Healthcare System,
16111 Plummer Street,
Sepulveda, Los Angeles, CA 91343, USA


Maximizing the quality and benefits of newly established chiropractic services represents an important policy and practice goal for the US Department of Veterans Affairs’ healthcare system. Understanding the implementation process and characteristics of new chiropractic clinics and the determinants and consequences of these processes and characteristics is a critical first step in guiding quality improvement. This paper reports insights and lessons learned regarding the successful application of mixed methods research approaches-insights derived from a study of chiropractic clinic implementation and characteristics, Variations in the Implementation and Characteristics of Chiropractic Services in VA (VICCS). Challenges and solutions are presented in areas ranging from selection and recruitment of sites and participants to the collection and analysis of varied data sources. The VICCS study illustrates the importance of several factors in successful mixed-methods approaches, including (1) the importance of a formal, fully developed logic model to identify and link data sources, variables, and outcomes of interest to the study’s analysis plan and its data collection instruments and codebook and (2) ensuring that data collection methods, including mixed-methods, match study aims. Overall, successful application of a mixed-methods approach requires careful planning, frequent trade-offs, and complex coding and analysis.


The Full-Text Article:

Introduction

There is growing consumer interest in complementary and alternative medicine (CAM) in the USA and internationally. [1-3] Healthcare systems have responded to this demand by offering a range of CAM services in outpatient and inpatient settings. [4, 5] Patients enrolled in the US Department of Veterans Affairs (VA) healthcare delivery system often use CAM services outside of VA but have a strong interest in receiving these services within the VA system. [6-11] In response, VA began providing selected in-house CAM services in about 2001. [12] VA’s most substantial undertaking in delivering any CAM-related service has been its introduction of chiropractic services.

There are more articles like this @ our:

Chiropractic Care For Veterans Page

Continue reading Mixed-Methods Research in a Complex Multisite Veterans Affairs’ Health Services Study

Trends in the Use and Characteristics of Chiropractic Services in the Department of Veterans Affairs

Trends in the Use and Characteristics of Chiropractic Services in the Department of Veterans Affairs

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2016 (Jun); 39 (5): 381-6

Anthony J. Lisi, DC, Cynthia A. Brandt, MD, MPH

Chiropractic Section Chief,
VA Connecticut Healthcare System,
West Haven, CT;
Assistant Clinical Professor,
Yale Center for Medical Informatics,
Yale University School of Medicine,
New Haven, CT.


OBJECTIVES:   The purpose of this study was to analyze national trends and key features of the Department of Veterans Affairs’ (VA’s) chiropractic service delivery and chiropractic provider workforce since their initial inception

METHODS:   This was a serial cross-sectional analysis of the VA administrative data sampled from the first record of chiropractic services in VA through September 30, 2015. Data were obtained from VA’s Corporate Data Warehouse and analyzed with descriptive statistics.

RESULTS:   From October 1, 2004, through September 30, 2015, the annual number of patients seen in VA chiropractic clinics increased from 4052 to 37349 (821.7%), and the annual number of chiropractic visits increased from 20072 to 159366 (693.9%). The typical VA chiropractic patient is male, is between the ages of 45 and 64, is seen for low back and/or neck conditions, and receives chiropractic spinal manipulation and evaluation and management services. The total number of VA chiropractic clinics grew from 27 to 65 (9.4% annually), and the number of chiropractor employees grew from 13 to 86 (21.3% annually). The typical VA chiropractor employee is a 45.9-year-old man, has worked in VA for 4.5 years, and receives annual compensation of $97860. VA also purchased care from private sector chiropractors starting in 2000, growing to 159533 chiropractic visits for 19435 patients at a cost of $11155654 annually.

There are more articles like this @ our:

Chiropractic Care For Veterans Page

Continue reading Trends in the Use and Characteristics of Chiropractic Services in the Department of Veterans Affairs

National Medicare Equality Petition

National Medicare Equality Petition

The Chiro.Org Blog


SOURCE:   American Chiropractic Association (ACA)


The Time for Change is NOW

The American Chiropractic Association (ACA) has launched a major grassroots campaign to enact federal legislation that would allow doctors of chiropractic (DC) to perform to the fullest scope of their license in Medicare. This initiative would significantly improve the health and wellness of our nation’s aging population — and your support is urgently needed.

The National Medicare Equality Petition will raise awareness of how the current Medicare system shortchanges seniors who want and need the essential services provided by doctors of chiropractic (DCs) to stay healthy, pain free and mobile, and how DCs can be a part of the solution for what ails the U.S. health care system.


Petition to White House and Members of Congress

Give Seniors the Medicare Coverage They Need and Deserve: Full Access to and Reimbursement for Services Provided by Doctors of Chiropractic


Studies have shown that essential services provided by doctors of chiropractic (DCs) can help aging Americans live healthier and happier lives, yet every day our nation’s seniors are being unjustly denied full access to Medicare covered services by doctors of chiropractic that could improve their quality of life.

Continue reading National Medicare Equality Petition

Does Cervical Spine Manipulation Reduce Pain in People With Degenerative Cervical Radiculopathy?

Does Cervical Spine Manipulation Reduce Pain in People With Degenerative Cervical Radiculopathy? A Systematic Review of the Evidence, and a Meta-analysis

The Chiro.Org Blog


SOURCE:   Clinical Rehabilitation 2016 (Feb); 30 (2): 145-155

Liguo Zhu, Xu Wei, Shangquan Wang

Department of Spine,
Wangjing Hospital, Beijing,
People’s Republic of China


OBJECTIVE:   To access the effectiveness and safety of cervical spine manipulation for cervical radiculopathy.

DATA SOURCES:   PubMed, the Cochrane Central Registry of Controlled Trials (CENTRAL) in the Cochrane Library, EMBASE, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Wanfang data, the website of Chinese clinical trial registry and international clinical trial registry by US National Institutes of Health.

REVIEW METHODS:   Randomized controlled trials that investigated the effects of cervical manipulation compared with no treatment, placebo or conventional therapies on pain measurement in patients with degenerative cervical radiculopathy were searched. Two authors independently evaluated the quality of the trials according to the risk of bias assessment provided by the PEDro (physiotherapy evidence database) scale. RevMan V.5.2.0 software was employed for data analysis. The GRADE approach was used to evaluate the overall quality of the evidence.

There are more articles like this @ our:

Radiculopathy and Chiropractic Page

Continue reading Does Cervical Spine Manipulation Reduce Pain in People With Degenerative Cervical Radiculopathy?

Aging Baby Boomers and the Rising Cost of Chronic Back Pain

Aging Baby Boomers and the Rising Cost of Chronic Back Pain: Secular Trend Analysis of Longitudinal Medical Expenditures Panel Survey Data for Years 2000 to 2007

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2013 (Jan); 36 (1): 2–11

Monica Smith, DC, PhD, Matthew A. Davis, DC, MPH,
Miron Stano, PhD, James M. Whedon, DC, MS

Adjunct Faculty (Off-Site),
National University Health Sciences,
Lombard, IL, USA.


OBJECTIVES:   The purposes of this study were to analyze data from the longitudinal Medical Expenditures Panel Survey (MEPS) to evaluate the impact of an aging population on secular trends in back pain and chronicity and to provide estimates of treatment costs for patients who used only ambulatory services.

METHODS:   Using the MEPS 2-year longitudinal data for years 2000 to 2007, we analyzed data from all adult respondents. Of the total number of MEPS respondent records analyzed (N = 71,838), we identified 12,104 respondents with back pain and further categorized 3842 as chronic cases and 8262 as nonchronic cases.

RESULTS:   Secular trends from the MEPS data indicate that the prevalence of back pain has increased by 29%, whereas chronic back pain increased by 64%. The average age among all adults with back pain increased from 45.9 to 48.2 years; the average age among adults with chronic back pain increased from 48.5 to 52.2 years. Inflation-adjusted (to 2010 dollars) biennial expenditures on ambulatory services for chronic back pain increased by 129% over the same period, from $15.6 billion in 2000 to 2001 to $35.7 billion in 2006 to 2007.

There are more articles like this @ our:

Low Back Pain and Chiropractic Page

Continue reading Aging Baby Boomers and the Rising Cost of Chronic Back Pain

Long-term Trajectories of Back Pain:
Cohort Study With 7-year Follow-up

Long-term Trajectories of Back Pain:
Cohort Study With 7-year Follow-up

The Chiro.Org Blog


SOURCE:   BMJ Open. 2013 (Dec 11); 3 (12): e003838

Kate M Dunn, Paul Campbell, and Kelvin P Jordan

Arthritis Research UK Primary Care Centre,
Institute of Primary Care and Health Sciences,
Keele University,
Newcastle, Staffordshire, UK.


OBJECTIVE:   To describe long-term trajectories of back pain.

DESIGN:   Monthly data collection for 6 months at 7-year follow-up of participants in a prospective cohort study.

SETTING:   Primary care practices in Staffordshire, UK.

PARTICIPANTS:   228 people consulting their general practitioners with back pain, on whom information on 6-month back pain trajectories had been collected during 2001-2003, and who had valid consent and contact details in 2009-2010, were contacted. 155 participants (68% of those contacted) responded and provided sufficient data for primary analyses.

OUTCOME MEASURES:   Trajectories based on patients’ self-reports of back pain were identified using longitudinal latent class analysis. Trajectories were characterised using information on disability, psychological status and presence of other symptoms.

RESULTS:   Four clusters with different back pain trajectories at follow-up were identified:

(1)   no or occasional pain
(2)   persistent mild pain
(3)   fluctuating pain and
(4)   persistent severe pain.

Trajectory clusters differed significantly from each other in terms of disability, psychological status and other symptoms. Most participants remained in a similar trajectory as 7 years previously (weighted κ 0.54; 95% CI 0.42 to 0.65).

There are more articles like this @ our:

Low Back Pain and Chiropractic Page

Continue reading Long-term Trajectories of Back Pain:
Cohort Study With 7-year Follow-up