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Frank M. Painter

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About Frank M. Painter

I was introduced to Chiro.Org in early 1996, where my friend Joe Garolis helped me learn HTML, the "mark-up language" for websites. We have been fortunate that journals like JMPT have given us permission to reproduce some early important articles in Full-Text format. Maintaining the Org website has been and remains my favorite hobby.

Contemporary Biopsychosocial Exercise Prescription for Chronic Low Back Pain

By |February 16, 2018|Exercise and Chiropractic|

Contemporary Biopsychosocial Exercise Prescription for Chronic Low Back Pain: Questioning Core Stability Programs and Considering Context

The Chiro.Org Blog


SOURCE:  

Peter Stilwell, B Kin, DC, MSc and Katherine Harman, PT, PhD

Dalhousie University,
5869 University Ave.
PO Box 15000
Halifax, NS B3H 4R2


This commentary explores the importance of considering the biopsychosocial model and contextual factors when prescribing exercise. Diverse exercise programs for patients with chronic low back pain (CLBP) produce similar outcomes, without one specific exercise protocol demonstrating clear superiority. One clear barrier to positive outcomes is poor exercise adherence. We suggest that there are certain common contextual factors present in all exercise prescription scenarios that may impact adherence and health-related outcomes. While challenging common core stability exercise prescription, we present an argument for enhancing and intentionally shaping the following contextual factors: the therapeutic alliance, patient education, expectations and attributions of therapeutic success or failure, and mastery or cognitive control over a problem. Overall, this commentary argues that to improve exercise adherence and outcomes in the CLBP population, the context in which exercise is delivered and the meaning patients embody need to be considered and shaped by clinicians.

KEYWORDS:   chiropractic; chronic; exercise; low back pain; prescription


From the FULL TEXT Article:

Burden of low back pain

Low back pain (LBP) is the leading cause of disability worldwide. [1] Many individuals with a LBP episode will not be pain-free within a year, despite seeking care from a general practitioner or chiropractor. [2] Although many individuals with acute LBP (pain for less than three weeks) see improvements over time; up to 73% will have a recurrence within 12 months. [3]

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Exercise and Chiropractic Page

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Evidence for Brain Glucose Dysregulation in Alzheimer’s disease

By |February 13, 2018|Alzheimer's Disease|

Evidence for Brain Glucose Dysregulation in Alzheimer’s disease

The Chiro.Org Blog


SOURCE:   Alzheimers Dement. 2017 (Oct 19) [Epub]

Yang An, Vijay R. Varma, Sudhir Varma, Ramon Casanova, Eric Dammer et al.

Laboratory of Behavioral Neuroscience,
National Institute on Aging (NIA),
National Institutes of Health (NIH),
Baltimore, MD, USA.


INTRODUCTION:   It is unclear whether abnormalities in brain glucose homeostasis are associated with Alzheimer’s disease (AD) pathogenesis.

METHODS:   Within the autopsy cohort of the Baltimore Longitudinal Study of Aging, we measured brain glucose concentration and assessed the ratios of the glycolytic amino acids, serine, glycine, and alanine to glucose. We also quantified protein levels of the neuronal (GLUT3) and astrocytic (GLUT1) glucose transporters. Finally, we assessed the relationships between plasma glucose measured before death and brain tissue glucose.

RESULTS:   Higher brain tissue glucose concentration, reduced glycolytic flux, and lower GLUT3 are related to severity of AD pathology and the expression of AD symptoms. Longitudinal increases in fasting plasma glucose levels are associated with higher brain tissue glucose concentrations.

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Nutrition Section

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Advancements in the Management of Spine Disorders

By |February 11, 2018|Chronic Neck Pain, Spinal Pain|

Advancements in the Management of Spine Disorders

The Chiro.Org Blog


SOURCE:   Best Pract Res Clin Rheumatol. 2012 (Apr); 26 (2): 263–280

Scott Haldeman, MD, Professor, Deborah Kopansky-Giles, DC, MSc, Eric L. Hurwitz, DC, PhD, Damian Hoy, BAppSc (Physio), MPH, PhD, W. Mark Erwin, DC, PhD, Simon Dagenais, DC, PhD, MSc, Greg Kawchuk, DC, PhD, Björn Strömqvist, MD, PhD, Nicolas Walsh, MD

Department of Neurology,
University of California,
Irvine, USA.


Spinal disorders and especially back and neck pain affect more people and have greater impact on work capacity and health-care costs than any other musculoskeletal condition. One of the difficulties in reducing the burden of spinal disorders is the wide and heterogeneous range of specific diseases and non-specific musculoskeletal disorders that can involve the spinal column, most of which manifest as pain. Despite, or perhaps because of its impact, spinal disorders remain one of the most controversial and difficult conditions for clinicians, patients and policymakers to manage. This paper provides a brief summary of advances in the understanding of back and neck pain over the past decade as evidenced in the current literature. This paper includes the following sections: a classification of spinal disorders; the epidemiology of spine pain in the developed and developing world; key advancements in biological and biomechanical sciences in spine pain; the current status of potential methods for the prevention of back and neck pain; rheumatological and systemic disorders that impact the spine; and evidence-based surgical and non-surgical management of spine pain.

The final section of this paper looks to the future and proposes actions and strategies that may be considered by the international Bone and Joint Decade (BJD), by providers, institutions and by policymakers so that we may better address the burden of spine disorders at global and local levels.


From the FULL TEXT Article:

Introduction

Spinal pain and its associated disorders affect more people and have greater impact on work capacity and health-care costs than any other musculoskeletal condition. Recent studies suggest that, in many societies, spinal disorders are a greater source of disability and impact the consumption of more health-care resources than any other class of diseases or health problems. [1] Despite, or perhaps because of its impact, spinal disorders remain one of the most controversial and difficult conditions for clinicians, patients and policymakers to manage.

One of the difficulties in reducing the impact of spinal pain is the wide and heterogeneous range of specific diseases and non-specific musculoskeletal disorders that can involve the spinal column, most of which manifest as spinal pain. These disorders have been classified in multiple ways but the most widely accepted classification includes four well-defined clinical categories as noted in Table 1.

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Chronic Neck Pain Page

Spinal Pain Management Page

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Positive Patient Outcome After Spinal Manipulation in a Case of Cervical Angina

By |February 8, 2018|Cervical Angina|

Positive Patient Outcome After Spinal Manipulation in a Case of Cervical Angina

The Chiro.Org Blog


SOURCE:   Man Ther. 2009 (Dec); 14 (6): 702–705

Steven R. Passmore, Andrew S. Dunn

Veterans Affairs of Western New York Health Care System,
Buffalo, New York, USA.


 

Introduction

When angina pectoris is suspected but adequately ruled out, upper anterior chest pain and related symptoms may be attributed to cervical angina, particularly in the presence of radiculopathy and myelopathy (Nakajima et al., 2006). Cervical angina is theorized to involve the C6, C7, or T1 nerve roots, and possibly the medial and lateral pectoral nerves (Jacobs, 1990; Freccero and Donovan, 2005). While the prevalence of cervical angina is not completely clear, it is described as a virtually unknown and neglected clinical syndrome that may not be uncommon but is under diagnosed (Nakajima et al., 2006; Christensen et al., 2005). Aside from cardiac enzyme and exercise tolerance testing, Christensen et al. (2005) suggest cervical angina is potentially recognized from true angina through manual palpation of the spine and thorax.


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There are more articles like this @ our:

What is the Chiropractic Subluxation Page

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Changes in Female Veterans’ Neck Pain Following Chiropractic Care at a Hospital for Veterans

By |February 7, 2018|Veterans|

Changes in Female Veterans’ Neck Pain Following Chiropractic Care at a Hospital for Veterans

The Chiro.Org Blog


SOURCE:   Complement Ther Clin Pract. 2018 (Feb); 30: 91–95

Kelsey L.Corcoran DC, Andrew S.Dunn DC, MEd, MS, Bart N.Green DC, MSEd, PhD, Lance R.Formolo DC, MS, Gregory P.Beehler PhD, MA

Chiropractic Department,
Medical Care Line,
VA Western New York,
3495 Bailey Ave,
Buffalo, NY 14215, USA


OBJECTIVE:   To determine if U.S. female veterans had demonstrable improvements in neck pain after chiropractic management at a Veterans Affairs (VA) hospital.

METHODS:   This was a retrospective cross-sectional study of medical records from female veterans attending a VA chiropractic clinic for neck pain from 2009 to 2015. Paired t-tests were used to compare baseline and discharge numeric rating scale (NRS) and Neck Bournemouth Questionnaire (NBQ) scores with a minimum clinically important difference (MCID) set at a 30% change from baseline.

RESULTS:   Thirty-four veterans met the inclusion criteria and received a mean of 8.8 chiropractic treatments. For NRS, the mean score improvement was 2.7 (95%CI, 1.9–3.5, p < .001). For the NBQ, the mean score improvement was 13.7 (95%CI, 9.9–17.5, p < .001). For the MCID, the average percent improvement was 45% for the NRS and 38% for the NBQ.

There are more articles like this @ our:

Chronic Neck Pain Page and the:

Chiropractic Care For Veterans Page

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The Impact of Pain-related Fear on Neural Pathways of Pain Modulation in Chronic Low Back Pain

By |February 5, 2018|Pain-related Fear|

The Impact of Pain-related Fear on Neural Pathways of Pain Modulation in Chronic Low Back Pain

The Chiro.Org Blog


SOURCE:   Pain Rep. 2017 (Apr 11); 2 (3): e601

Michael Lukas Meiera, Philipp Stampfli, Barry Kim Humphreys, Andrea Vrana, Erich Seifritz, Petra Schweinhardt

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


INTRODUCTION:   Pain-related fear plays a substantial role in chronic low back pain (LBP) by amplifying the experienced disability. Related dysfunctional emotions and cognitions may also affect sensory aspects of pain through a modulatory pathway in which the periaqueductal gray (PAG) and the amygdala play key roles.

OBJECTIVES:   We therefore hypothesized a differential amygdala-PAG functional connectivity (FC) in patients with chronic LBP that is modulated by the degree of pain-related fear.

METHODS:   We used data of a previously reported fMRI study where 20 chronic LBP patients (7 females, mean age = 39.35) and 20 healthy controls (12 females, mean age = 32.10) were asked to observe video clips showing potentially harmful and neutral activities for the back. Pain-related fear was assessed using the Tampa Scale of kinesiophobia (TSK) and Fear Avoidance Beliefs questionnaires (FABQ). Generalized psychophysiological interactions were used to reveal task-based FC.

RESULTS:   Compared to controls, patients exhibited a significant decrease in amygdala-PAG-FC (P = 0.022) during observation of harmful activities, but not of neutral activities. Furthermore, amygdala-PAG-FC correlated negatively with Tampa Scale of kinesiophobia scores in patients (R2 = 0.28, P = 0.01) but not with Fear Avoidance Beliefs questionnaires scores.

There are more articles like this @ our:

Low Back Pain Page and the:

Biopsychosocial Model Page and the:

Spinal Pain Management Page

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