Primary prevention in chiropractic practice: a systematic review

doi:10.1186/s12998-017-0140-4

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Chiropr Man Therap. 2017; 25: 9.

Published online 2017 Mar 20. doi: 10.1186/s12998-017-0140-4

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Table 4

The results in twenty-three articles on the use of primary prevention in chiropractic practice

Articles 1st author Yr of publication Country of study [Quality rating]	Chiropractors’ positive opinions on PP			Chiropractors’ use of PP			Patients’ reason for consulting (RfC)
	MSK prevention	General public health approach to PP unrelated to adjustments	Wellness likely to include adjustments	MSK prevention	General public health approach to PP unrelated to adjustments	Wellness likely to include adjustments	MSK prevention	General public health approach to PP unrelated to adjustments	Wellness likely to include adjustments
	1	2	3	4	5	6	7	8	9
Mootz (2005) [38] USA GOOD [100%]									Primary RfC: 4% ‘wellness’ (Arizona) 10% ‘wellness’ (Massachusetts)
Malmqvist (2008) [35] Finland GOOD [100%]						48% use ‘wellness’
French (2013) [39] Australia GOOD [92%]									RfC: 6% for ‘health maintenance or preventive care’
Allen- Unhammer (2016) [21] Norway GOOD [91%]							RfC: 1% for ‘prophylactic examination’
Leach (2011) [28] USA GOOD [90%]		94% positive to physical activity prescription 66% on tobacco cessation advice See Table 66	92% were ‘wellness-oriented’		86% prescribed physical activity or advised on this topic 60% advised on tobacco cessation See Table 66
Stuber (2013) [19] Canada GOOD [87%]					82% ‘’recommend dietary supplements (…) for general health and wellness”
McGregor (2014) [20] Canada GOOD [87%]			19% thought chiropractic subluxation is an obstruction to human health
McDonald (2004) [34] Several countries GOOD [85%]						94% included periodic MC/wellness care in their clinical routine
Brown (2014) [40] Australia GOOD [85%]									RfC: 21% for ‘general health and well-being’
Glithro (2015) [29] UK GOOD [85%]		81%* agreed that screening patients for skin lesions was part of their clinical role *Includes some DC students			Skin lesions: −94% screened each new patient −53% screened regular patients at every visit −73% screened regular patients at visits scheduled specifically for patient re-assessment.
Hawk (2004) [17] USA GOOD [80%]		91% positive to nutritional advice 95% on the prescription of physical activity 69% on tobacco cessation advice 57% on skin lesion screening See Table 66	93% had a positive attitude to subluxation screening	90% of chiropractors provide information on MSK risk reduction	86% gave nutritional advice 89% prescribed physical activity or advised on this topic 65% advised on tobacco cessation 46% screened for skin lesion See Table 66
Hestbaek (2009) [37] Denmark ACCEPTABLE [77%]							RfC: 7% for ‘prophylactic examination’		RfC: 2% for ‘general well being’
Pohlman (2016) [41] Several countries ACCEPTABLE [75%]									RfC: 18% for wellness
Fikar (2015) [31] UK ACCEPTABLE [70%]		62 to 97% considered lifestyle issues to be their responsibility to discuss		96% advised on poor posture 88% advised on ‘faulty movement patterns’	79% gave nutritional advice 92% prescribed physical activity or advised on this topic 57% advised on tobacco cessation See Table 66
Blanchette (2015) [36] Canada ACCEPTABLE [69%]						For 59% of patients Maintenance/ Wellness was the main sector of activity
Blum (2008) [18] Several countries ACCEPTABLE [64%]							RfC in asymptomatic patients: 12% for ‘prevention’ See Table 55	RfC in asymptomatic patients: 16% for being ‘at risk’ See Table 55	RfC in asymptomatic patients: 14% for ‘wellness’ See Table 55
Walker (2000) [33] USA ACCEPTABLE [62%]					77% used nutrition for ‘general healthful eating/nutrition’
Schneider (2015) [30] USA ACCEPTABLE [62%]			8% focused on ‘wellness/ prevention’
Allen- Unhammer (2016) [21] Norway (Part 2 – survey) ACCEPTABLE [62%]							RfC: <5% for infants <3 mo <10% for infants 4–23 mo ‘prophylactic examination’
Adams (2017) [32] Australia ACCEPTABLE [62%]				73% treated patients for ‘spinal health maintenance/prevention’.
Hawk (2001) [22] Several countries UNACCEPTABLE [57%]					48% used ‘diet/nutrition counselling for general health’ 46% used ‘exercise counseling’			RfC: <1% for disease prevention/health promotion through nutrition	RfC: 3% for disease prevention/health promotion through ‘subluxation correction’
Bussières (2015) [27] Canada UNACCEPTABLE [56%]			9% focused on ‘wellness/ prevention’
Marchand (2012) [26] Several countries UNACCEPTABLE [55%]							RfC: <1% for ‘posture screening Prevention’		RfC: <1% for ‘advice/check up birth check up’ Wellness
Alcantara (2008) [23] Several countries UNACCEPTABLE [43%]									RfC reported by DC 35% were reported as ‘wellness care’ RfC reported by patients 44% of parents gave ‘wellness care’ as the motivation to consult
Alcantara (2009) [24] Several countries UNACCEPTABLE [43%]									RfC reported by patients 35% ‘were reported as presenting for wellness care’ RfC reported by patients 47% ‘presented for wellness care’
Alcantara (2010) [25] Several countries UNACCEPTABLE [43%]						90%: used ‘wellness care’	RfC: 2% of DC have patients who consult for ‘postural improvement’		RfC: 17% of DC have patients who consult for ‘wellness care’

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MC: Maintenance Care/RfC: Reasons for Consulting/DC: chiropractors