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Epidemiology: Spinal Manipulation Utilization

By |May 22, 2018|Chiropractic Care|

Epidemiology:
Spinal Manipulation Utilization

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SOURCE:   J Electromyogr Kinesiol. 2012 (Oct); 22 (5): 648–654

Eric L. Hurwitz

Department of Public Health Sciences,
John A. Burns School of Medicine,
University of Hawaii,
M?noa, Honolulu, HI 96822, USA.


The objectives of this article are to

(1)   describe spinal manipulation use by time, place, and person, and

(2)   identify predictors of the use of spinal manipulation.

We conducted a systematic review of the English-language literature published from January 1, 1980 through June 30, 2011. Of 822 citations identified, 213 were deemed potentially relevant; 75 were included after further consideration. Twenty-one additional articles were identified from reference lists. The literature is heavily weighted toward North America, Europe, and Australia and thus largely precludes inferences about spinal manipulation use in other parts of the world. In the regions covered by the literature, chiropractors, osteopaths, and physical therapists are most likely to deliver spinal manipulation, often in conjunction with other conservative therapies.

Back and neck pain are the most frequent indications for receiving spinal manipulation; non-musculoskeletal conditions comprise a very small percentage of indications. Although spinal manipulation is more commonly used in adults than children, evidence suggests that spinal manipulation may be more likely used for non-musculoskeletal ailments in children than in adults. Patient satisfaction with spinal manipulation is very high.


From the Full-Text Article:

Introduction

Although spinal manipulation has been practiced for thousands of years in several cultures spanning the globe, it is most commonly associated with chiropractic and osteopathy, which originated in the late 1800s in the United States (Pettman, 2007). The purpose of this article is to review the literature on the use of spinal manipulation. Specifically, our objectives are twofold: (1) To describe spinal manipulation use by time (temporal trends), place (geographic distribution), and person (practitioner and patient), and (2) to identify predictors of the use of spinal manipulation.

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Patients Receiving Chiropractic Care in a Neurorehabilitation Hospital

By |May 18, 2018|Chiropractic Care|

Patients Receiving Chiropractic Care in a Neurorehabilitation Hospital: A Descriptive Study

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SOURCE:   J Multidiscip Healthc. 2018 (May 3); 11: 223–231

Robert D Vining, Stacie A Salsbury, W Carl Cooley, Donna Gosselin, Lance Corber, and Christine M Goertz

Palmer Center for Chiropractic Research,
Palmer College of Chiropractic,
Davenport, IA, USA.


OBJECTIVES:   Individuals rehabilitating from complex neurological injury require a multidisciplinary approach, which typically does not include chiropractic care. This study describes inpatients receiving multidisciplinary rehabilitation including chiropractic care for brain injury, spinal cord injury (SCI), stroke, and other complex neurological conditions.

DESIGN:   Chiropractic services were integrated into Crotched Mountain Specialty Hospital (CMSH) through this project. Patient characteristics and chiropractic care data were collected to describe those receiving care and the interventions during the first 15 months when chiropractic services were available.

SETTING:   CMSH, a 62–bed subacute multidisciplinary rehabilitation, skilled nursing facility located in Greenfield, New Hampshire, USA.

RESULTS:   Patient mean (SD) age (n=27) was 42.8 (13) years, ranging from 20 to 64 years. Males (n=18, 67%) and those of white race/ethnicity (n=23, 85%) comprised the majority. Brain injury (n=20) was the most common admitting condition caused by trauma (n=9), hemorrhage (n=7), infarction (n=2), and general anoxia (n=2). Three patients were admitted for cervical SCI, 1 for ankylosing spondylitis, 1 for traumatic polyarthropathy, and 2 for respiratory failure with encephalopathy. Other common comorbid diagnoses potentially complicating the treatment and recovery process included myospasm (n=13), depression (n=11), anxiety (n=10), dysphagia (n=8), substance abuse (n=8), and candidiasis (n=7). Chiropractic procedures employed, by visit (n=641), included manual myofascial therapies (93%), mechanical percussion (83%), manual muscle stretching (75%), and thrust manipulation (65%) to address patients with spinal-related pain (n=15, 54%), joint or regional stiffness (n= 14, 50%), and extremity pain (n=13, 46%). Care often required adapting to participant limitations or conditions. Such adaptations not commonly encountered in outpatient settings where chiropractic care is usually delivered included the need for lift assistance, wheelchair dependence, contractures, impaired speech, quadriplegia/paraplegia, and the presence of feeding tubes and urinary catheters.

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Nontraditional Therapies (Traditional Chinese Veterinary Medicine and Chiropractic) in Exotic Animals

By |April 22, 2018|Acupuncture, Chiropractic Care|

Nontraditional Therapies (Traditional Chinese Veterinary Medicine and Chiropractic) in Exotic Animals

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SOURCE:   Vet Clin North Am Exot Anim Pract. 2018 (May); 21 (2): 511–528

Jessica A. Marziani, DVM, CVA, CVC, CCRT

CARE Veterinary Services PLLC,
PO Box 132082, Houston, TX 77219, USA


The nontraditional therapies of Traditional Chinese Veterinary Medicine and chiropractic care are adjunct treatments that can be used in conjunction with more conventional therapies to treat a variety of medical conditions. Nontraditional therapies do not need to be alternatives to Western medicine but, instead, can be used simultaneously. Exotic animal practitioners should have a basic understanding of nontraditional therapies for both client education and patient referral because they can enhance the quality of life, longevity, and positive outcomes for various cases across multiple taxa.

Keywords:   Acupuncture; Alternative therapies; Chiropractic; Complementary therapies; Integrative therapies; Nontraditional therapies; Traditional Chinese Veterinary Medicine


From the FULL TEXT Article:

KEY POINTS

  • Nontraditional therapies can be used in conjunction with conventional Western therapies to enhance patient outcome.

  • Nontraditional therapies are often sought out by exotic pet owners; therefore,
    overall understanding is important for general practitioners.

  • Exotic animal species can benefit from the application of nontraditional therapies.

  • Traditional Chinese Veterinary Medicine is tailored to the individual patient
    to optimize health.

  • Chiropractic care can be used as preventative form of treatment and for
    chronic conditions.


INTRODUCTION

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The Provision of Chiropractic, Physiotherapy and Osteopathic Services Within the Australian Private Health-care System

By |April 20, 2018|Chiropractic Care|

The Provision of Chiropractic, Physiotherapy and Osteopathic Services Within the Australian Private Health-care System: A Report of Recent Trends

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SOURCE:   Chiropractic & Manual Therapies 2014 (Jan 15); 22 (1): 3

Roger M Engel, Benjamin T Brown, Michael S Swain, and Reidar P Lystad

Department of Chiropractic,
Macquarie University,
Balaclava Rd, North Ryde 2109,
Australia.


BACKGROUND:   Chiropractors, physiotherapists, and osteopaths receive training in the diagnosis and management of musculoskeletal conditions. As a result there is considerable overlap in the types of conditions that are encountered clinically by these practitioners. In Australia, the majority of benefits paid for these services come from the private sector. The purpose of this article is to quantify and describe the development in service utilization and the cost of benefits paid to users of these healthcare services by private health insurers. An exploration of the factors that may have influenced the observed trends is also presented.

METHODS:   A review of data from the Australian Bureau of Statistics, Australian Health Practitioner Regulation Agency, and the Australian Government Private Health Insurance Administration Council was conducted. An analysis of chiropractic, physiotherapy and osteopathic service utilisation and cost of service utilisation trend was performed along with the level of benefits and services over time.

RESULTS:   In 2012, the number of physiotherapists working in the private sector was 2.9 times larger than that of chiropractic, and 7.8 times that of the osteopathic profession. The total number of services provided by chiropractors, physiotherapists, and osteopaths increased steadily over the past 15 years. For the majority of this period, chiropractors provided more services than the other two professions. The average number of services provided by chiropractors was approximately two and a half times that of physiotherapists and four and a half times that of osteopaths.

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The Chiropractic Profession: A Scoping Review of Utilization Rates, Reasons for Seeking Care, Patient Profiles, and Care Provided

By |April 18, 2018|Chiropractic Care|

The Chiropractic Profession: A Scoping Review of Utilization Rates, Reasons for Seeking Care, Patient Profiles, and Care Provided

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SOURCE:   Chiropractic & Manual Therapies 2017 (Nov 22);   25:   35

Peter J. H. Beliveau, Jessica J. Wong, Deborah A. Sutton, Nir Ben Simon, André E. Bussières, Silvano A. Mior and Simon D. French

Department of Public Health Sciences,
Queen’s University,
Kingston, Canada.


BACKGROUND:   Previous research has investigated utilization rates, who sees chiropractors, for what reasons, and the type of care that chiropractors provide. However, these studies have not been comprehensively synthesized. We aimed to give a global overview by summarizing the current literature on the utilization of chiropractic services, reasons for seeking care, patient profiles, and assessment and treatment provided.

METHODS:   Systematic searches were conducted in MEDLINE, CINAHL, and Index to Chiropractic Literature using keywords and subject headings (MeSH or ChiroSH terms) from database inception to January 2016. Eligible studies: 1) were published in English or French; 2) were case series, descriptive, cross-sectional, or cohort studies; 3) described patients receiving chiropractic services; and 4) reported on the following theme(s): utilization rates of chiropractic services; reasons for attending chiropractic care; profiles of chiropractic patients; or, types of chiropractic services provided. Paired reviewers independently screened all citations and data were extracted from eligible studies. We provided descriptive numerical analysis, e.g. identifying the median rate and interquartile range (e.g., chiropractic utilization rate) stratified by study population or condition.

RESULTS:   The literature search retrieved 14,149 articles; 328 studies (reported in 337 articles) were relevant and reported on chiropractic utilization (245 studies), reason for attending chiropractic care (85 studies), patient demographics (130 studies), and assessment and treatment provided (34 studies). Globally, the median 12-month utilization of chiropractic services was 9.1% (interquartile range (IQR): 6.7%-13.1%) and remained stable between 1980 and 2015. Most patients consulting chiropractors were female (57.0%, IQR: 53.2%-60.0%) with a median age of 43.4 years (IQR: 39.6-48.0), and were employed (median: 77.3%, IQR: 70.3%-85.0%). The most common reported reasons for people attending chiropractic care were (median) low back pain (49.7%, IQR: 43.0%-60.2%), neck pain (22.5%, IQR: 16.3%-24.5%), and extremity problems (10.0%, IQR: 4.3%-22.0%). The most common treatment provided by chiropractors included (median) spinal manipulation (79.3%, IQR: 55.4%-91.3%), soft-tissue therapy (35.1%, IQR: 16.5%-52.0%), and formal patient education (31.3%, IQR: 22.6%-65.0%).

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Core and Complementary Chiropractic

By |February 20, 2018|Chiropractic Care|

Core and Complementary Chiropractic:
Lowering Barriers to Patient Utilization of Services

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SOURCE:   J Chiropractic Humanities 2016 (Sep 15);   23 (1):   1-13

John J. Triano, DC, PhD and Marion McGregor, DC, PhD

Graduate Education and Research Program,
Canadian Memorial Chiropractic College,
Toronto, ON, Canada


OBJECTIVE:   The use of chiropractic services has stalled while interest in accessing manipulation services is rising. The purpose of this paper is to consider this dilemma in the context of the dynamics of professional socialization, surveys of public attitudes, and a potential strategic action.

DISCUSSION:   This is a reflection work grounded in the literature on professional socialization and the attitudes held regarding chiropractic in modern society, to include its members, and in original data on training programs. Data were interpreted on the background of the authors’ cross-cultural experiences spanning patient care, research, education, and interprofessional collaboration. Recommendation on a strategic action to counter barriers in patient referrals was synthesized. Professional socialization is the process by which society enables professional privilege. Illustration of typical and divergent professional socialization models emerged that explain cognitive dissonance toward the profession. Questions of trust are commensurate with the experiences during patient encounters rather than with a common identity for the profession. Diversity among encounters perpetuates the uncertainty that affects referral sources. Commonality as an anchor for consistent professional identity and socialization through the content of core chiropractic, defined by training and practice, offers a means to offset uncertainty. Complementary chiropractic, analogous to complementary medicine, provides an outlet under professional socialization for the interests to explore additional methods of care.

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