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Knowledge Transfer within the Canadian Chiropractic Community. Part 2: Narrowing the Evidence-Practice Gap

Chiro.Org Blog: In Part 1 of this series, [3] we presented an overview of the barriers that impede successful knowledge translation (KT) in the chiropractic profession. Now in Part 2, we provide an overview of KT strategies followed by a discussion of relevant KT efforts in the Canadian chiropractic community. This discussion will lead to a long-term vision of KT for Canadian chiropractic with suggestions to where KT can be applied or where current efforts can be augmented. The overall goal of this article is to present potential strategies for successful KT implementation in order to reduce the gap between current best evidence and its application in chiropractic practice. […]

Attitudes and Opinions of Doctors of Chiropractic Specializing in Pediatric Care Toward Patient Safety

Chiro.Org Blog: Compared with 2014 Agency for Healthcare Research and Quality physician referent data from medical offices, pediatric DCs appear to have more positive patient safety attitudes and opinions. Future patient safety studies need to prospectively evaluate safety performance with direct feedback from patients and compare results with these self-assessed safety attitudes, as well as make further use of this survey to develop a comparable database for spinal manipulation providers. […]

Subclinical Neck Pain and the Effects of Cervical Manipulation on Elbow Joint Position Sense

Chiro.Org Blog: These results suggest that asymptomatic people with a history of subclinical neck pain (SCNP) have reduced elbow JPS accuracy compared to those with no history of any neck complaints. Furthermore, the results suggest that adjusting dysfunctional cervical segments in people with SCNP can improve their upper limb JPS accuracy. […]

Association Between the Type of First Healthcare Provider and the Duration of Financial Compensation for Occupational Back Pain

Chiro.Org Blog: The type of healthcare provider first visited for back pain is a determinant of the duration of financial compensation during the first 5 months. Chiropractic patients experience the shortest duration of compensation, and physiotherapy patients experience the longest. These differences raise concerns regarding the use of physiotherapists as gatekeepers for the worker’s compensation system. […]

Early Predictors of Lumbar Spine Surgery After Occupational Back Injury

Chiro.Org Blog: In the D-RISC sample of 1885 workers, 174 (9.2%) had a lumbar spine surgery within 3 years. Baseline variables associated with surgery (P < 0.05) in the multivariate model included higher Roland-Morris Disability Questionnaire scores, greater injury severity, and surgeon as first provider seen for the injury. Reduced odds of surgery were observed for those younger than 35 years, females, Hispanics, and those whose first provider was a chiropractor. Approximately 42.7% of workers who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor. […]

The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems

Chiro.Org Blog: A total of 12,036 respondents with spine problems were included, including 4306 (35.8%) CAM users (40.8% in weighted sample). CAM users had significantly better self-reported health, education, and comorbidity compared with non-CAM users. Adjusted annual medical costs among CAM users was $424 lower (95% confidence interval: $240, $609; P<0.001) for spine-related costs, and $796 lower (95% confidence interval: $121, $1470; P = 0.021) for total health care cost than among non-CAM users. Average expenditure for CAM users, based on propensity matching, was $526 lower for spine-specific costs (P<0.001) and $298 lower for total health costs (P = 0.403). Expenditure differences were primarily due to lower inpatient expenditures among CAM users. […]

Psychological and Behavioral Differences Between Low Back Pain Populations

Chiro.Org Blog: This study has described patients seeking chiropractic primary care for LBP with regards to psychological and behavioral characteristics and compared them to the characteristics of patients from a sample at high risk of developing chronic disabling NP and/or LBP and long term sick leave in primary care, and two secondary care samples with chronic LBP. Contrary to the hypothesis the chiropractic primary care sample was more affected by pain and worse off with regards to psychological and behavioral characteristics compared to the other primary care sample. Based on these findings the 4 samples may be considered statistically and clinically different. […]

A Systematic Review Comparing the Costs of Chiropractic Care to other Interventions for Spine Pain in the United States

Chiro.Org Blog: This review identified 25 cost comparison studies related to chiropractic care for spine pain in the US and published in English since 1993. Although findings from the studies reviewed generally suggested that chiropractic care may be associated with lower health care costs when compared to care from other HCPs, the methods used in these studies differed widely, limiting their interpretation and generalizability. Additional research using more rigorous methods is needed to determine if differences in health care costs noted in these studies are attributable to the type of health care received for spine pain or patient sociodemographic, clinical, or other factors that may be unrelated to health care. […]

A Comparison of Chiropractic Manipulation Methods and Usual Medical Care for Low Back Pain

A Comparison of Chiropractic Manipulation Methods and Usual Medical Care for Low Back Pain: A Randomized Controlled Clinical Trial

The Chiro.Org Blog

SOURCE:   J Altern Complement Med. 2014 (May);   20 (5):   A22–23 Michael Schneider, Mitchell Haas, Joel Stevans, Ronald Glick, Doug Landsittel

University of Pittsburgh, Pittsburgh, PA, USA

Purpose:   […]

Glucose Metabolic Changes in the Brain and Muscles of Patients with Nonspecific Neck Pain Treated by Spinal Manipulation Therapy

Chiro.Org Blog: Changes in brain activity after SMT included activation of the dorsal anterior cingulate cortex, cerebellar vermis, and somatosensory association cortex and deactivation of the prefrontal cortex and temporal sites. Glucose uptake in skeletal muscles showed a trend toward decreased metabolism after SMT, although the difference was not significant. Other measurements indicated relaxation of cervical muscle tension, decrease in salivary amylase level (suppression of sympathetic nerve activity), and pain relief after SMT. […]

Manipulation of Dysfunctional Spinal Joints Affects Sensorimotor Integration in the Prefrontal Cortex

Chiro.Org Blog: This study resulted in two major findings. Firstly, this study reproduced previous findings of SEPs studies that have shown that adjusting dysfunctional spinal segments alters early sensorimotor integration (SMI) of input from the upper limb (as evidenced with a decrease in N30 SEP complex amplitudes). [3, 6, 21] The second major finding of this study was that we were able to show, using dipole source localization, that this change in SMI that occurs after spinal manipulation predominantly happens in the prefrontal cortex. […]

Clinical Practice Guidelines for the Noninvasive Management
of Low Back Pain

Chiro.Org Blog: Most high-quality guidelines recommend education, staying active/exercise, manual therapy and paracetamol/NSAIDs as first-line treatments for LBP. Recommendation of paracetamol for acute LBP is challenged by recent evidence and needs updating. […]

Cost Analysis Related to Dose-response of Spinal Manipulative Therapy for Chronic Low Back Pain

Chiro.Org Blog: This study shows that manipulation can have a modicum of benefit in LBP-related pain and disability without significantly increasing treatment or societal costs. In the main results paper reporting pain and disability on 100-point scales, Haas et al found an 8.6-point advantage in pain (p=.002) and 7.5-point advantage in disability (p=.011) for SMT 12 compared to the control at 12 weeks. In this study, we found that this benefit may occur without significant increases in costs of treatment or lost productivity. […]

Integration of Chiropractic Services in Military and Veteran Health Care Facilities

Chiro.Org Blog: Chiropractors collaboratively manage patients with other providers and focus on reducing morbidity for veterans and rehabilitating military service members to full duty status. Patient satisfaction with chiropractic services is high. Preliminary findings show that chiropractic management of common conditions shows significant improvement. […]

Wellness-related Use of Common Complementary Health Approaches Among Adults

Chiro.Org Blog: This report presents national estimates of selected wellness-related reasons for the use of natural product supplements, yoga, and spinal manipulation among U.S. adults in 2012. Self-reported perceived health outcomes were also examined. […]