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Clinical Classification in Low Back Pain: Best-evidence Diagnostic Rules Based on Systematic Reviews

Chiro.Org Blog: This is the first comprehensive systematic review of diagnostic accuracy studies that evaluate clinical examination findings for their ability to identify the most common patho-anatomical disorders in the lumbar spine. In some diagnostic categories we have sufficient evidence to recommend a CDR. In others, we have only preliminary evidence that needs testing in future studies. Most findings were tested in secondary or tertiary care. Thus, the accuracy of the findings in a primary care setting has yet to be confirmed. […]

Adherence to Clinical Practice Guidelines Among Three Primary Contact Professions

Chiro.Org Blog: To determine adherence to clinical practice guidelines in the medical, physiotherapy and chiropractic professions for acute and subacute mechanical low back pain through best-evidence synthesis of the healthcare literature. Of the three professions examined, 73% of chiropractors adhered to current clinical practice guidelines, followed by physiotherapists (62%) and then medical practitioners (52%). […]

A Diagnosis-based Clinical Decision Rule For Spinal Pain Part 2: Review Of The Literature

Chiro.Org Blog: Accurate diagnosis or classification of patients with spinal pain has been identified as a research priority [1]. We presented in Part 1 the theoretical model of an approach to diagnosis in patients with spinal pain [2]. This approach incorporated the various factors that have been found, or in some cases theorized, to be of importance in the generation and perpetuation of neck or back pain into an organized scheme upon which a management strategy can be based. The authors termed this approach a diagnosis-based clinical decision rule (DBCDR). The DBCDR is not a clinical prediction rule. It is an attempt to identify aspects of the clinical picture in each patient that are relevant to the perpetuation of pain and disability so that these factors can be addressed with interventions designed to improve them. The purpose of this paper is to review the literature on the methods involved in the DBCDR regarding reliability and validity and to identify those areas in which the literature is currently lacking. […]

A Theoretical Model For The Development Of A Diagnosis-based Clinical Decision Rule For The Management Of Patients With Spinal Pain

Chiro.Org Blog: Chronic spinal pain is an increasingly common problem in Western Society [1]. Spinal disorders exact great costs, in terms of both direct medical costs and indirect costs related to disability and lost productivity [1-3]. A number of researchers have attempted to improve our ability to identify the causes of spinal pain as well as to diagnose and treat patients with this problem. In spite of this, accurate diagnosis, leading to specific, targeted treatments, of patients with spinal pain has been elusive. […]

Stroke Numbers Are Up Worldwide

Chiro.Org Blog: The overall burden of stroke in terms of absolute numbers of people affected around the world is growing, especially in younger age groups and in low-to-middle-income countries, a global study showed. […]

Sports Management: Leg, Ankle, and Foot Injuries

Chiro.Org Blog: The lower leg, ankle, and foot work as a functional unit. Total body weight above is transmitted to the leg, ankle hinge, and foot in the upright position, and this force is greatly multiplied in locomotion. Thus the ankle and foot are uniquely affected by trauma and static deformities infrequently seen in other areas of the body. […]

Sports Management: Bone and Joint Injuries

Chiro.Org Blog: In traditional general medical practice, the musculoskeletal system is the most overlooked system in the body, yet it comprises over half the body mass. The relationship between structure and function, and the interrelationship between all body systems, cannot be denied. Muscles, bones, and connective tissues are involved in both local and systemic pathology, and in a wide assortment of functional and referred disturbances. Thus, great care must be taken in eliciting the details of a complaint when any musculoskeletal disorder is suspected. This section reviews the basis of alert management of bone and joint injuries within the health care of athletic and recreational injuries. […]

The Horizontal Neurologic Levels

Chiro.Org Blog: This chapter describes the basic functional anatomy and clinical considerations of the horizontal aspects of the supratentorial, posterior fossa, spinal, and peripheral levels of the nervous system. […]

The Longitudinal Neurologic Systems

Chiro.Org Blog: This chapter succinctly describes the basic structure and function of the six major longitudinal systems; viz, the sensory, motor, visceral, vascular, consciousness, and cerebrospinal fluid systems. […]

Sports Management: Introduction to Sports-related Health Care

Chiro.Org Blog: If you were to ask the average coach about the responsibilities of an athlete, he would most likely reply that he or she was to conduct one’s self to the credit of the team, play fair, obey the officials, keep in training, be a credit to the sport, follow the rules, and enjoy the game: win or lose. This is the rhetoric commonly spooned to the naively inclined. If it were true, fewer sports injuries would be suffered. With rare exception, even the Little Leaguer is commonly taught to WIN, drilled to disguise foul play from the eyes of the referees and umpires. Even in so-called noncontact sports, emphasis is often placed on getting the other team’s stars out of the game without causing injury to your own team. While conditioning is emphasized, the motivation is frequently on the preservation of a potential winning season rather than on prevention of a personal injury to a human being. […]

Clinical Biomechanics: Mechanical Concepts and Terms

Chiro.Org Blog: All motor activities such as walking, running, jumping, squatting, pushing, pulling, lifting, and throwing are examples of dynamic musculoskeletal mechanics. To better appreciate the sometimes simple and often complex factors involved, this chapter reviews the basic concepts and terms involved in maintaining static equilibrium. Static equilibrium is the starting point for all dynamic activities. […]

Clinical Biomechanics: General Spinal Biomechanics

Chiro.Org Blog: This chapter discusses the vertebral column as a whole and serves as a foundation for the following three chapters that consider the regional aspects of the spine and pelvis. Emphasis here is on gross structure, function, spinal kinematics, and other general biomechanical implications. […]

Earn 1 Credit of CE for Reading This Medscape Article on Fibromyalgia: “No Offense, Doctor, But I Want a Referral for My Pain”

Chiro.Org Blog: You are seeing a 42-year-old woman whom you diagnosed with fibromyalgia 4 weeks ago. Her main complaint continues to be diffuse, dull body pain, but she also reports occasional numbness in both hands. She says that she has felt fatigue for the past several years, and she blames poor sleep for this. She denies depression but says that she gets tearful when she thinks about her chronic symptoms and how they have limited her from what she has wanted to accomplish. […]

A Practical Guide to Avoiding Drug-Induced Nutrient Depletion

A little known, but potentially life-saving fact is that common medications deplete your body of a host of vital nutrients essential to your health. In this practical guide I’ll show you how to avoid drug-induced nutrient depletion and discuss options for replacing nutrient-robbing medications with natural supplements. […]

Initial Case Management Following Trauma

Chiro.Org Blog: Without a doubt, no other health-care approach equals the efficacy of chiropractic in the general field of conservative neuromusculoskeletal rehabilitation. For many centuries, therapeutic rehabilitation was a product of personal experience passed on from clinician to clinician. In the last 20 years, however, it has become an applied science. In its application, of course, much empiricism remains that can be called an intuitive art –and this is true for all forms of professional health care. […]