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Frank M. Painter

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About Frank M. Painter

I was introduced to Chiro.Org in early 1996, where my friend Joe Garolis helped me learn HTML, the "mark-up language" for websites. We have been fortunate that journals like JMPT have given us permission to reproduce some early important articles in Full-Text format. Maintaining the Org website has been, and remains, my favorite hobby.

Who Will Have Sustainable Employment After a Back Injury?

By |June 1, 2019|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

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Spinal Manipulation Therapy: Is It All About the Brain?

By |May 29, 2019|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.

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Memorial Day (2019):
In Memory of Those Who Have Fallen

By |May 25, 2019|Uncategorized|

Memorial Day (2019)
In Memory of Those Who Have Fallen

The Chiro.Org Blog


The Bivouac of the Dead

The muffled drum’s sad roll has beat
The soldier’s last tattoo’
No more on life’s parade shall meet
That brave and fallen few;

On Fame’s eternal camping ground
Their silent tents are spread;
But Glory guards with solemn round
The bivouac of the dead.

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A Risk-benefit Assessment Strategy to Exclude Cervical Artery Dissection in Spinal Manual-therapy

By |May 25, 2019|Stroke|

A Risk-benefit Assessment Strategy to Exclude Cervical Artery Dissection in Spinal Manual-therapy: A Comprehensive Review

The Chiro.Org Blog


SOURCE:   Annals of Medicine 2019 (Mar 19): 1–10 [Epub]

Aleksander Chaibi & Michael Bjørn Russell

Head and Neck Research Group,
Research Centre, Akershus University Hospital,
Oslo, Norway.


Cervical artery dissection refers to a tear in the internal carotid or the vertebral artery that results in an intramural haematoma and/or an aneurysmal dilatation. Although cervical artery dissection is thought to occur spontaneously, physical trauma to the neck, especially hyperextension and rotation, has been reported as a trigger. Headache and/or neck pain is the most common initial symptom of cervical artery dissection. Other symptoms include Horner’s syndrome and lower cranial nerve palsy. Both headache and/or neck pain are common symptoms and leading causes of disability, while cervical artery dissection is rare. Patients often consult their general practitioner for headache and/or neck pain, and because manual-therapy interventions can alleviate headache and/or neck pain, many patients seek manual therapists, such as chiropractors and physiotherapists. Cervical mobilization and manipulation are two interventions that manual therapists use. Both interventions have been suspected of being able to trigger cervical artery dissection as an adverse event. The aim of this review is to provide an updated step-by-step risk-benefit assessment strategy regarding manual therapy and to provide tools for clinicians to exclude cervical artery dissection.

Key messages

  • Cervical mobilization and/or manipulation have been suspected to be able to trigger cervical artery dissection (CAD). However, these assumptions are based on case studies which are unable to established direct causality.

  • The concern relates to the chicken and the egg discussion, i.e. whether the CAD symptoms lead the patient to seek cervical manual-therapy or whether the cervical manual-therapy provoked CAD along with the non-CAD presenting complaint.

  • Thus, instead of proving a nearly impossible causality hypothesis, this study provide clinicians with an updated step-by-step risk–benefit assessment strategy tool to

    (a)   facilitate clinicians understanding of CAD,

    (b)   appraise the risk and applicability of cervical manual-therapy, and

    (c)   provide clinicians with adequate tools to better detect and exclude CAD in clinical settings.

There are more articles like this @ our:

STROKE AND CHIROPRACTIC Page

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Relationship Between Early Prescription Dispensing Patterns and Work Disability in a Cohort of Low Back Pain Workers’ Compensation Claimants

By |May 22, 2019|Workers' Compensation|

Relationship Between Early Prescription Dispensing Patterns and Work Disability in a Cohort of Low Back Pain Workers’ Compensation Claimants: A Historical Cohort Study

The Chiro.Org Blog


SOURCE:   Occup Environ Med. 2019 (May 15) [Epub]

Nancy Carnide, Sheilah Hogg-Johnson, Mieke Koehoorn, Andrea D Furlan1, Pierre Côté

Institute for Work and Health,
Toronto, Ontario, Canada.


OBJECTIVES:   To examine and compare whether dispensing of prescription opioids, non-steroidal anti-inflammatory drugs (NSAIDs) and skeletal muscle relaxants (SMRs) within 8 weeks after a work-related low back pain (LBP) injury is associated with work disability.

METHODS:   A historical cohort study of 55 571 workers’ compensation claimants with LBP claims in British Columbia from 1998 to 2009 was conducted using linked compensation, dispensing and healthcare data. Four exposures were constructed to estimate the effect on receipt of benefits and days on benefits 1 year after injury: drug class(es) dispensed, days’ supply, strength of opioids dispensed and average daily morphine-equivalent dose.

RESULTS:   Compared with claimants receiving NSAIDs and/or SMRs, the incidence rate ratio (IRR) of days on benefits was 1.09 (95% CI 1.04 to 1.14) for claimants dispensed opioids only and 1.26 (95% CI 1.22 to 1.30) for claimants dispensed opioids with NSAIDs and/or SMRs. Compared with weak opioids only, the IRR for claimants dispensed strong opioids only or strong and weak opioids combined was 1.21 (95% CI 1.12 to 1.30) and 1.29 (95% CI 1.20 to 1.39), respectively. The incident rate of days on benefits associated with each 7-day increase in days supplied of opioids, NSAIDs and SMRs was 10%, 4% and 3%, respectively. Similar results were seen for receipt of benefits, though effect sizes were larger.

There are more articles like this @ our:

WORKERS’ COMPENSATION Page

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Our Blog is Just a Tool. Learn How To Use It Now.

By |May 22, 2019|Announcement|

Our Blog is Just a Tool.
Learn How To Use It Now.

The Chiro.Org Blog


SOURCE:   A Chiro.Org Editorrial


Every Blog post is an announcement of new material that was just added to one of our many Sections.

I have been compiling (and archiving) peer-reviewed articles since early 1996, and to date we have over 5,000 Abstracts, and hundreds of Full-Text articles on a wide variety of subjects.

When enough material, relating to a particular topic was collected, it was gathered into a new Topical Page in one of our many Sections.

Each Topical page is located in the Section most associated with that topic. Thus, our Attention Deficit Page is located (is a part of) our Pediatrics Section   You get the idea.

Almost ALL of our Sections contain some, or many Topical collections. The LINKS Section is the most extreme example, because it contains 91 different topical pages.

All of the following are “active” Sections that are constantly adding new (and important) materials:

Acupuncture
Alternative Healing Abstracts
Case Studies
Chiropractic Assistants
Chiropractic Research
Documentation
The LINKS
Medicare Info
Nutrition
Pediatrics
Radiology
Stroke and Chiropractic Page
What is the Chiropractic Subluxation?

These other valuable Sections are “archival” in nature, and contain valuable tools for you to use freely:

Chiropractic History
Free Images
New DC’s
Office Forms
R.C. Schafer’s Rehab Monographs
Search Section


How Blog Posts Work

The following is a Graphic “screen grab” of a Blog Post from our Home Page. (more…)