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Monthly Archives: May 2011

25 Years of Whiplash Research

By |May 31, 2011|Research, Whiplash|

25 Years of Whiplash Research

The Chiro.Org Blog

SOURCE:   The American Chiropractor ~ September 2010

An interview with Arthur Croft, D.C.

Dr. Croft is the Founding Director of the Spine Research Institute of San Diego. He has been actively engaged in whiplash research for the past twenty-five years and has co-authored a best-selling textbook on whiplash (Whiplash Injuries: the Cervical Acceleration/Deceleration Syndrome, 3rd edition, 2002) and temporomandibular joint disorders (Whiplash and Temporomandibular Disorders: an Interdisciplinary Approach to Case Management), along with several other books, textbook chapters, and over 320 professional papers. He was the original developer of the now widely used whiplash (WAD) grading system, as well as the widely adopted treatment guidelines. Dr. Croft wrote and produced the Emmy-nominated video Whiplash, and the most recent human subjects crash test DVD’s, Machine vs. Man I and II and is the only chiropractic physician to conduct ongoing, full scale human volunteer crash testing.

Dr. Croft is a biomechanist, a trauma epidemiologist, and chiropractic orthopaedist and lectures extensively in the United States and abroad. He serves on the editorial boards of several professional peer-reviewed chiropractic, medical, and engineering journals, including Spine, Archives of Physical Medicine and Rehabilitation, SAE, JMPT, DC Tracts, Journal of Musculoskeletal Pain, Chiropractic Technique, and is a senior editor of the Journal of Whiplash-Related Disorders. He has served as faculty of University of California, San Diego, Southern California University of Health Sciences, Western States Chiropractic College, and New York Chiropractic College. In addition to his own research, Dr. Croft has contributed to several research steering committees and has participated in RAND projects, including the cervical spine manipulation study, and has served as a grant reviewer for the Foundation for Chiropractic Education and Research and the National Institutes of Health. Dr. Croft is also a certified accident reconstructionist (NUTI). He currently serves as a panelist on the International Whiplash Task Force. Dr. Croft’s focus is public health and injury prevention and he is very close to receiving his PhD in epidemiology.

In an interview with The American Chiropractor (TAC), Dr. Croft shares some of the wisdom his studies have distilled.

Dr. Croft, please tell our readers a bit about some of the things you have been able to discover regarding whiplash through research.

Croft:   Most of the discoveries concerning the whiplash phenomenon have come from the eight years of human subject crash testing we’ve done at the Spine Research Institute of San Diego. In many cases, our findings have been new and innovative and, in other cases, they have served to support or extend previous research or theory. We’ve found, for example, that occupant kinematics and biomechanics is much more complicated than previously thought and that smaller persons and larger persons have very different responses. [1] A small female will experience two to four times the head linear acceleration as a larger male in the same crash. The male, however, will experience greater rearward bending. (more…)

U.S. Navy Names DC to Musculoskeletal Board

By |May 27, 2011|News|

U.S. Navy Names DC to Musculoskeletal Board

The Chiro.Org Blog

SOURCE:   Dynamic Chiropractic

With his appointment to the board, Dr. William Morgan continues building bridges for the chiropractic profession.

William Morgan, DC, has been appointed to the United States Navy’s Musculoskeletal Continuum of Care Advisory Board (MCCAB), an entity created to address the prevalent musculoskeletal injuries sustained by U.S. armed forces personnel during active-duty operations.

Dr. Morgan, who also serves on the spine subcommittee within MCCAB – members of which include orthopedic surgeons, sports medicine physicians, physical medicine and rehabilitation physicians and physical therapists – will serve as the sole chiropractic representative to MCCAB, the Bureau of Medicine and Surgery (BUMED) and the U.S. Navy. The spine committee will develop care algorithms for treating musculoskeletal and spinal conditions and in so doing, help determine the future of musculoskeletal management in the U.S. armed forces.

Addressing Musculoskeletal Health Issues in the Armed Forces

The leading cause of medical evacuation from forward-deployed units is musculoskeletal complaints, not combat wounds, with a high percentage of the complaints being back and neck pain. The MCCAB intends to develop guidelines for best practices in the management of musculoskeletal conditions through collaboration between professions, standardized metrics/outcome measurements, evidence-based practices and increased access to care.

William Morgan This is a big step for chiropractic in the armed forces. Never before has a chiropractor been on a military medical board that will have this level of strategic planning and implementation of ideas. This advisory board will make decisions about the future direction of health care within the Navy and the Marine Corps (the Navy provides the medical care for both the Navy and the Marines). The development of the board and Dr. Morgan’s appointment to it suggests the Navy’s open-mindedness in addressing the need for better management of musculoskeletal conditions. (more…)

Pressed About Skeletal Injuries, Army Chief Cites Soldiers’ Poor Health

By |May 26, 2011|News|

Pressed About Skeletal Injuries, Army Chief Cites Soldiers’ Poor Health

The Chiro.Org Blog

SOURCE:   The Hill ~ The Congressional News Paper

By John T. Bennett

The Senate’s top appropriator is concerned about injuries spawned by the weight of gear soldiers carry into combat, but Army brass say the poor health of America’s youth is to blame also.

As the Army and other military services have fielded more and more advanced combat gear — especially electronics equipment — U.S. troops have been instructed to strap more and more weight to their bodies.

That means injuries, which does not sit well with Senate Appropriations Committee Chairman Daniel Inouye (D-Hawaii), a decorated World War II Army veteran. He said his combat pack and gear never weighed more than 25 pounds.

The average Army trooper’s gear now approaches 125 pounds, Inouye said, noting a 2001 Army Science Board study recommended no soldier should carry more than 50 pounds at a time.

During an Appropriations Defense subcommittee hearing Wednesday, Inouye told Army leaders he was “shocked” by a recent Johns Hopkins University study that found musculoskeletal spinal injuries are now “double that of combat injuries.”

What’s more, “musculoskeletal injuries have increased tenfold in the last four years,” Inouye said. “The cost of medical benefits or disability benefits exceed annually $500 million.”

Army Chief of Staff Gen. Martin Dempsey replied that the matter is a “constant issue” for service leaders, and one that crosses his desk at least once a week. (more…)

A Critical Piece of Quality Documentation: Outcomes Assessment

By |May 25, 2011|Documentation, Outcome Assessment|

A Critical Piece of Quality Documentation: Outcomes Assessment

The Chiro.Org Blog

SOURCE:   American Chiropractor 2011 (May) 33 (5): 28-34

by Steven Yeomans, D.C.

Today more than ever, chiropractors are faced with the challenge of running a busy practice and, at the same time, juggling the documenting requirements in light of Medicare audits, proving “medical necessity” to private insurers, and producing documentation that minimizes risk in this litigious world. The requirement of creating a legible, concise account of the patient encounter that includes patient centered functional goals and methods of tracking functional improvements that occur during care, emphasizes the need for the inclusion of outcomes assessment tools in the documentation process. The goal of this article is to provide you with the “knowledge ammunition” needed to accomplish this task without expending volumes of time and effort.

Outcomes assessment tool availability is not a new concept. Back in the 1970’s, long, impractical outcomes tools surfaced that were too cumbersome for routine use in a primary care setting, but shortly thereafter, in 1980, Fairbank introduced the Oswestry (Low Back) Disability Index (ODI). An interesting point is that the original purpose of the ODI was to identify patients that may require “…positive intervention” in the form of psychological care when scores exceeded 60% (defined as “crippled”).

However, it was (also) found to be an effective tool to be used in serial manner to show patient progress over time and identify endpoints of care or plateaus in progress, prompting a change in the treatment planning for the patient. This was followed by other “gold standard” tools including the Roland-Morris Low Back Disability Questionnaire in 1984, and the chiropractic contribution of Vernon and Mior’s Neck Disability Index in 1988.

A gradual increase in the use of these tools occurred in the 1990’s with introduction of many other condition specific tools for headaches, dizziness, carpal tunnel, shoulder pain, hip, knee, and ankle pain, as well as general health tools, and psychometric tools for depression and anxiety assessment. In fact, there are now so many tools available, it may be quite a challenge to decide which ones are most important. (more…)

Are Chiropractors Protecting Patients From Medical Care?

By |May 23, 2011|Low Back Pain|

Are Chiropractors Protecting Patients From Medical Care?

The Chiro.Org Blog

SOURCE:   Dynamic Chiropractic

By Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher

“Chiropractors might be preventing some of their patients from receiving procedures of unproven cost utility value or dubious efficacy.”

This quote comes from the latest study revealing chiropractic’s superiority to “traditional medical approaches.” Titled “Health Maintenance Care in Work-Related Low Back Pain and Its Association With Disability Recurrence,” the study was published in the April 2011 issue of the Journal of Occupational and Environmental Medicine. [1]

The study compares “physical therapy, chiropractic and (medical) physician services” as they relate to disability and health maintenance. As our front-page article underscores, investigators found that “the likelihood of recurrent disability due to LBP (low back pain) for recipients of services during the health maintenance care period by all other provider groups was consistently worse when compared with recipients of health maintenance care by chiropractors.”

The authors state that “by visiting only or mostly a chiropractor or becoming a chiropractic loyalist, the patients do not receive other traditional medical approaches.” While this is obvious, it is no less significant because those who do receive traditional medical care experienced a greater likelihood of recurrent disability. (more…)