Chiro.org - Chiropractic Resource Organization.     Support Chiropractic Research!

Chiro Org BLOG

Chiro Org BLOG

Leadership and Capacity Building in International Chiropractic Research

By |June 21, 2019|Categories: Uncategorized|

Leadership and Capacity Building in International Chiropractic Research: Introducing the Chiropractic Academy for Research Leadership (CARL)

The Chiro.Org Blog


SOURCE:   Chiropractic & Manual Therapies 2018 (Feb 6); 26: 5

Jon Adams, Greg Kawchuk, Alexander Breen, Diana De Carvalho, Andreas Eklund, Matthew Fernandez, Martha Funabashi, Michelle M. Holmes, Melker S. Johansson, Katie de Luca, Craig Moore, Isabelle Pagé, Katherine A. Pohlman, Michael S. Swain, Arnold Y. L. Wong, and Jan Hartvigsen

Faculty of Health,
University of Technology Sydney,
Sydney, Australia.


In an evidence-based health care environment, healthcare professions require a sustainable research culture to remain relevant. At present however, there is not a mature research culture across the chiropractic profession largely due to deficiencies in research capacity and leadership, which may be caused by a lack of chiropractic teaching programs in major universities. As a response to this challenge the Chiropractic Academy for Research Leadership, CARL, was created with the aim of develop a global network of successful early-career chiropractic researchers under the mentorship of three successful senior academics from Australia, Canada, and Denmark. The program centres upon an annual week-long program residential that rotates continental locations over the first three-year cycle and between residentials the CARL fellows work on self-initiated research and leadership initiatives.

Through a competivite application process, the first cohort was selected and consists of 13 early career researchers from five professions in seven countries who represent diverse areas of interests of high relevance for chiropractic. The first residential was held in Odense, Denmark, with the second being planned in April 2018 in Edmonton, Canada, and the final residential to be held in Sydney, Australia in 2019.

There are more articles like this @ our:

Chiropractic Research Section

(more…)

The Research Crisis in American Institutions of Complementary and Integrative Health

By |June 18, 2019|Categories: Chiropractic Research|

The Research Crisis in American Institutions of Complementary and Integrative Health:
One Proposed Solution for the Chiropractic Profession

The Chiro.Org Blog


SOURCE:   Chiropractic & Manual Therapies 2019 (Jun 17); 27: 32

Ian D. Coulter and Patricia M. Herman

RAND Corporation,
1776 Main Street, P.O. Box 2138,
Santa Monica, CA 90407-2138, USA


A crisis confronts the Complementary and Integrative Health (CIH) teaching institutions in the US. Research infrastructure is needed to build and sustain productive research programs and retain their own research faculty. In most health professions, this infrastructure is largely built through research grants. In CIH, most educational institutions are funded through student tuition, which has historically also had to be the source for building their research programs. Only a limited number of these institutions have emerged as National Institute of Health (NIH) grant-funded programs. As a result, the American chiropractic institutions have seen a retrenchment in the number of active research programs. In addition, although research training programs e.g., NIH’s K awards are available for CIH researchers, these programs generally result in these researchers leaving their institutions and depriving future CIH practitioners of the benefit of being trained in a culture of research.

One proposed solution is to leverage the substantial research infrastructure and long history of collaboration available at the RAND Corporation (https://www.rand.org) This article presents the proposed five components of the RAND Center for Collaborative CIH Research and the steps required to bring it to being:

1)   the CIH Research Network –   an online resource and collaborative site for CIH researchers;

2)   the CIH Research Advisory Board –   the governing body for the Center selected by its members;

3)   the RAND CIH Interest Group –   a group of RAND researchers with an interest in and who could provide support to CIH research;

4)   CIH Researcher Training –   access to existing RAND research training as well as the potential for the Center to provide a research training home for those with training grants; and

5)   CIH RAND Partnership for Research –   a mentorship program to support successful CIH research.

By necessity the first step in the Center’s creation would be a meeting between the heads of interested CIH institutions to work out the details and to obtain buy-in.

The future success of CIH-directed research on CIH will require a pooling of talent and resources across institutions; something that the American chiropractic institutions have not yet been able to achieve. This article discusses one possible solution.

There are more articles like this @ our:

Chiropractic Research Section

(more…)

A Narrative Review of Lumbar Fusion Surgery With Relevance to Chiropractic Practice

By |June 6, 2019|Categories: Guidelines, Low Back Pain|

A Narrative Review of Lumbar Fusion Surgery With Relevance to Chiropractic Practice

The Chiro.Org Blog


SOURCE:   J Chiropractic Medicine 2016 (Dec);   15 (4):   259–271

Clinton J. Daniels, DC, MS,
Pamela J. Wakefield, DC,
Glenn A. Bub, DC,
James D. Toombs, MD

Veteran Affairs Saint Louis Health Care System,
St. Louis, MO.


OBJECTIVE:   The purpose of this narrative review was to describe the most common spinal fusion surgical procedures, address the clinical indications for lumbar fusion in degeneration cases, identify potential complications, and discuss their relevance to chiropractic management of patients after surgical fusion.

METHODS:   The PubMed database was searched from the beginning of the record through March 31, 2015, for English language articles related to lumbar fusion or arthrodesis or both and their incidence, procedures, complications, and postoperative chiropractic cases. Articles were retrieved and evaluated for relevance. The bibliographies of selected articles were also reviewed.

RESULTS:   The most typical lumbar fusion procedures are posterior lumbar interbody fusion, anterior lumbar interbody fusion, transforaminal interbody fusion, and lateral lumbar interbody fusion. Fair level evidence supports lumbar fusion procedures for degenerative spondylolisthesis with instability and for intractable low back pain that has failed conservative care. Complications and development of chronic pain after surgery is common, and these patients frequently present to chiropractic physicians. Several reports describe the potential benefit of chiropractic management with spinal manipulation, flexion-distraction manipulation, and manipulation under anesthesia for postfusion low back pain. There are no published experimental studies related specifically to chiropractic care of postfusion low back pain.

There are more articles like this @ our:

Low Back Pain Guidelines Page and the:

Low Back Pain and Chiropractic Page

(more…)

Who Will Have Sustainable Employment After a Back Injury?

By |June 1, 2019|Categories: Clinical Prediction Rule, Return To Work|

Who Will Have Sustainable Employment After a Back Injury? The Development of a Clinical Prediction Model in a Cohort of Injured Workers

The Chiro.Org Blog


SOURCE:   J Occup Rehabil. 2017 (Sep); 27 (3): 445–455

Heather M. Shearer, Pierre Cote, Eleanor Boyle, Jill A. Hayden, John Frank, William G. Johnson

UOIT-CMCC Center for the Study of Disability Prevention and Rehabilitation,
University of Ontario Institute of Technology,
2000 Simcoe St. North,
Oshawa, ON, L1H 7K4, Canada.


Our objective was to develop a clinical prediction model to identify workers with sustainable employment following an episode of work-related low back pain (LBP).

Methods   We used data from a cohort study of injured workers with incident LBP claims in the USA to predict employment patterns 1 and 6 months following a workers’ compensation claim. We developed three sequential models to determine the contribution of three domains of variables:

(1)   basic demographic/clinical variables;

(2)   health-related variables; and

(3)   work-related factors.

Multivariable logistic regression was used to develop the predictive models. We constructed receiver operator curves and used the c-index to measure predictive accuracy.

Results   Seventy-nine percent and 77 % of workers had sustainable employment at 1 and 6 months, respectively. Sustainable employment at 1 month was predicted by initial back pain intensity, mental health-related quality of life, claim litigation and employer type (c-index = 0.77). At 6 months, sustainable employment was predicted by physical and mental health-related quality of life, claim litigation and employer type (c-index = 0.77). Adding health-related and work-related variables to models improved predictive accuracy by 8.5 and 10 % at 1 and 6 months respectively.

Conclusion   We developed clinically-relevant models to predict sustainable employment in injured workers who made a workers’ compensation claim for LBP. Inquiring about back pain intensity, physical and mental health-related quality of life, claim litigation and employer type may be beneficial in developing programs of care. Our models need to be validated in other populations.

KEYWORDS: &nbsp Back injuries; Employment; Return to work


From the FULL TEXT Article:

Introduction

There are more articles like this @ our:

The RETURN TO WORK Section and the:

Clinical Prediction Rule Page

(more…)

Spinal Manipulation Therapy: Is It All About the Brain?

By |May 29, 2019|Categories: Neurology|

Spinal Manipulation Therapy: Is It All About the Brain? A Current Review of the Neurophysiological Effects of Manipulation

The Chiro.Org Blog


SOURCE:   Journal of Integrative Medicine 2019 (May 9) [Epub]

Giles Gyer, Jimmy Michael, James Inklebarger, Jaya Shanker Tedla

The London College of Osteopathic Medicine,
London NW1 6QH, United Kingdom.



Spinal manipulation has been an effective intervention for the management of various musculoskeletal disorders. However, the mechanisms underlying the pain modulatory effects of spinal manipulation remain elusive. Although both biomechanical and neurophysiological phenomena have been thought to play a role in the observed clinical effects of spinal manipulation, a growing number of recent studies have indicated peripheral, spinal and supraspinal mechanisms of manipulation and suggested that the improved clinical outcomes are largely of neurophysiological origin.

In this article, we reviewed the relevance of various neurophysiological theories with respect to the findings of mechanistic studies that demonstrated neural responses following spinal manipulation. This article also discussed whether these neural responses are associated with the possible neurophysiological mechanisms of spinal manipulation. The body of literature reviewed herein suggested some clear neurophysiological changes following spinal manipulation, which include neural plastic changes, alteration in motor neuron excitability, increase in cortical drive and many more. However, the clinical relevance of these changes in relation to the mechanisms that underlie the effectiveness of spinal manipulation is still unclear. In addition, there were some major methodological flaws in many of the reviewed studies. Future mechanistic studies should have an appropriate study design and methodology and should plan for a long-term follow-up in order to determine the clinical significance of the neural responses evoked following spinal manipulation.

(more…)