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The Quality of Life of Children Under Chiropractic Care Using PROMIS-25

By |January 2, 2018|Pediatrics|

The Quality of Life of Children Under Chiropractic Care Using PROMIS-25: Results from a Practice-Based Research Network

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SOURCE:   J Altern Complement Med. 2017 (Dec 20) [Epub]

Joel Alcantara, DC, Andrea E. Lamont, PhD,
Jeanne Ohm, DC, and Junjoe Alcantara, DC

The International Chiropractic Pediatric Association,
327N Middletown Road
Media, PA 610-565-2360


OBJECTIVES:   To characterize pediatric chiropractic and assess pediatric quality of life (QoL).

DESIGN:   A prospective cohort. Setting/Locations: Individual offices within a practice-based research network located throughout the United States.

SUBJECTS:   A convenience sample of children (8-17 years) under chiropractic care and their parents.

EXPOSURE:   Chiropractic spinal adjustments and adjunctive therapies.

OUTCOME MEASURES:   Survey instrument measuring sociodemographic information and correlates from the clinical encounter along with the Patient Reported Outcomes Measurement Information System (PROMIS)-25 to measure QoL (i.e., depression, anxiety, and pain interference). Sociodemographic and clinical correlates were analyzed using descriptive statistics (i.e., frequencies/percentages, means, and standard deviations). The PROMIS-25 data were analyzed using scoring manuals, converting raw scores to T score metric (mean = 50; SD = 10). A generalized linear mixed model was utilized to examine covariates (i.e., sex, number of visits, and motivation for care) that may have played an important role on the PROMIS outcome.

RESULTS:   The original data set consisted of 915 parent-child dyads. After data cleaning, a total of 881 parents (747 females, 134 males; mean age = 42.03 years) and 881 children (467 females and 414 males; mean age = 12.49 years) comprised this study population. The parents were highly educated and presented their child for mainly wellness care. The mean number of days and patient visits from baseline to comparative QoL measures was 38.12 days and 2.74 (SD = 2.61), respectively. After controlling for the effects of motivation for care, patient visits, duration of complaint, sex, and pain rating, significant differences were observed in the probability of experiencing problems (vs. no reported problems) across all QoL domains (Wald = 82.897, df = 4, p < 0.05). Post hoc comparisons demonstrated the children were less likely to report any symptoms of depression (Wald = 6.1474, df = 1, p < 0.05), anxiety (Wald = 20.603, df = 1, p < 0.05), fatigue (Wald = 22.191, df = 1, p < 0.05), and pain interference (Wald = 47.422, df = 1, p < 0.05) after a trial of chiropractic care.

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The Use of the RAND VSQ9 to Measure the Quality of Life and Visit-Specific Satisfaction of Pregnant Patients

By |December 25, 2017|Pediatrics|

The Use of the Patient Reported Outcomes Measurement Information System and the RAND VSQ9 to Measure the Quality of Life and Visit-Specific Satisfaction of Pregnant Patients Under Chiropractic Care Utilizing the Webster Technique

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SOURCE:   J Altern Complement Med. 2017 (Dec 20) [Epub]

Joel Alcantara, Andrea Lamont Nazarenko,
Jeanne Ohm, and Junjoe Alcantara

The International Chiropractic Pediatric Association,
Media, PA.


OBJECTIVE:   To quantify the quality of life (QoL) and visit-specific satisfaction of pregnant women.

DESIGN:   A prospective cohort within a practice-based research network (PBRN). Setting/locations: Individual chiropractic offices.

SUBJECTS:   Pregnant women (age ≥18 years) attending chiropractic care.

INTERVENTION(S):   Chiropractic care (i.e., The Webster Technique, spinal adjustments, and adjunctive therapies).

MAIN OUTCOME MEASURES:   The RAND VSQ9 to measure visit-specific satisfaction and the Patient Reported Outcomes Measurement Information System (PROMIS®)-29 to measure QoL.

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Pediatric Patients in Swiss Chiropractic Clinics

By |November 10, 2017|Pediatrics|

Pediatric Patients in Swiss Chiropractic Clinics:
A Questionnaire Survey

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SOURCE:   J Manipulative Physiol Ther. 2017 (Oct 24) [Epub]

Mette Hobaek Siegenthaler, DC, MSc

Holbeinpraxis,
Swiss Academy for Chiropractic,
Berne, Switzerland


OBJECTIVES:   The purpose of this study was to investigate practice characteristics of chiropractors who treat pediatric patients in Swiss chiropractic clinics.

METHODS:   An online survey questionnaire was created and tested for face and content validity. Participation by Swiss chiropractors was voluntary and anonymous and completed November to December 2015. The data were analyzed using SPSS. The analysis consisted of descriptive statistics.

RESULTS:   The sample consisted of 144 chiropractors, which represented a 53% response rate, and 98% of the responding practitioners treated patients younger than age 18. The proportion of pediatric patients treated was 8.7%. The most common pediatric age groups were schoolchildren and adolescents, with infants younger than 6 months being the third most common. Musculoskeletal complaints were the most common conditions treated in all age groups. In children younger than 2 years old, nonmusculoskeletal conditions were well represented. Prophylactic examination was common among children 6 years and younger.

A total of 61% of responding chiropractors received direct referrals from medical doctors and 56% received direct referrals from pediatricians. The most common age groups for referrals from pediatricians were schoolchildren and adolescents. Only 15% of the chiropractors wrote reports about their pediatric patients to their pediatrician often or regularly; 90% of the responding chiropractors stated they rarely or never refer to a pediatric specialist, and 80% of the chiropractors have never or have rarely been invited to attend medical congresses or to teach the pediatric health care community about chiropractic care for children.

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

By |March 24, 2017|Chiropractic Care, Pediatrics, Safety|

Attitudes and Opinions of Doctors of Chiropractic Specializing in Pediatric Care Toward Patient Safety: A Cross-sectional Survey

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SOURCE:   J Manipulative Physiol Ther. 2016 (Sep); 39 (7): 487–493

Katherine A. Pohlman, DC, MS, Linda Carroll, PhD,
Lisa Hartling, PhD, MSc, Ross Tsuyuki, PharmD, MSc,
Sunita Vohra, MD, MSc

Research Institute,
Parker University,
Dallas, TX.


OBJECTIVE:   The purpose of this cross-sectional survey was to evaluate attitudes and opinions of doctors of chiropractic (DCs) specializing in pediatric care toward patient safety.

METHODS:   The Medical Office Survey on Patient Safety Culture of the Agency for Healthcare Research and Quality was adapted for providers who use spinal manipulation therapy and sent out to 2 US chiropractic organizations’ pediatric council members (n = 400) between February and April 2014. The survey measured 12 patient safety dimensions and included questions on patient safety items and quality issues, information exchange, and overall clinic ratings. Data analyses included a percent composite average and a nonrespondent analysis.

RESULTS:   The response rate was 29.5% (n = 118). Almost one- third of respondents’ patients were pediatric (≤17 years of age). DCs with a pediatric certification were 3 times more likely to respond (P < .001), but little qualitative differences were found in responses. The patient safety dimensions with the highest positive composite percentages were Organizational Learning (both administration and clinical) and Teamwork (>90%). Patient Care Tracking/Follow-up and Work Pressure and Pace were patient safety dimensions that had the lowest positive composite scores (<85%). The responses also indicated that there was concern regarding information exchange with insurance/third-party payors. Two quality issues identified for improvement were (1) updating a patient’s medication list and (2) following up on critically abnormal results from a laboratory or imaging test within 1 day. The average overall patient safety rating score indicated that 83% of respondents rated themselves as “very good” or “excellent.”

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Neck Pain In Children

By |September 17, 2016|Neck Pain, Pediatrics|

Neck Pain In Children: A Retrospective Case Series

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SOURCE:   J Can Chiropr Assoc. 2016 (Sep); 60 (3): 212–219

Jocelyn Cox, BPhEd, DC,
Christine Davidian, DC, MSc,
Silvano Mior, DC, FCCS, PhD

Graduate Education and Research Department
of Canadian Memorial Chiropractic College


Introduction:   Spinal pain in the pediatric population is a significant health issue, with an increasing prevalence as they age. Pediatric patients attend for chiropractor care for spinal pain, yet, there is a paucity of quality evidence to guide the practitioner with respect to appropriate care planning.

Methods:   A retrospective chart review was used to describe chiropractic management of pediatric neck pain. Two researchers abstracted data from 50 clinical files that met inclusion criteria from a general practice chiropractic office in the Greater Toronto Area, Canada. Data were entered into SPSS 15 and descriptively analyzed.

Results:   Fifty pediatric neck pain patient files were analysed. Patients’ age ranged between 6 and 18 years (mean 13 years). Most (98%) were diagnosed with Grade I-II mechanical neck pain. Treatment frequency averaged 5 visits over 19 days; with spinal manipulative therapy used in 96% of patients. Significant improvement was recorded in 96% of the files. No adverse events were documented.

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Is There a Difference in Head Posture and Cervical Spine Movement in Children With and Without Pediatric Headache?

By |August 27, 2016|Headache, Pediatrics|

Is There a Difference in Head Posture and Cervical Spine Movement in Children With and Without Pediatric Headache?

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SOURCE:   Eur J Pediatr. 2013 (Oct); 172 (10): 1349–1356

Kim Budelmann, Harry von Piekartz, Toby Hall

University of Applied Science,
Osnabrück, Germany


Pediatric headache is an increasingly reported phenomenon. Cervicogenic headache (CGH) is a subgroup of headache, but there is limited information about cervical spine physical examination signs in children with CGH. Therefore, a cross-sectional study was designed to investigate cervical spine physical examination signs including active range of motion (ROM), posture determined by the craniovertebral angle (CVA), and upper cervical ROM determined by the flexion-rotation test (FRT) in children aged between 6 and 12 years. An additional purpose was to determine the degree of pain provoked by the FRT.

Thirty children (mean age 120.70 months [SD 15.14]) with features of CGH and 34 (mean age 125.38 months [13.14]) age-matched asymptomatic controls participated in the study. When compared to asymptomatic controls, symptomatic children had a significantly smaller CVA (p < 0.001), significantly less active ROM in all cardinal planes (p < 0.001), and significantly less ROM during the FRT (p < 0.001), especially towards the dominant headache side (p < 0.001). In addition, symptomatic subjects reported more pain during the FRT (p < 0.001) and there was a significant negative correlation (r = -0.758, p < 0.001) between the range recorded during the FRT towards the dominant headache side and FRT pain intensity score. This study found evidence of impaired function of the upper cervical spine in children with CGH and provides evidence of the clinical utility of the FRT when examining children with CGH.


From the FULL TEXT Article:

Introduction

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