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Outcomes Of Pregnant Patients With Low Back Pain Undergoing Chiropractic Treatment

By |August 9, 2016|Adverse Events, Pediatrics|

Outcomes Of Pregnant Patients With Low Back Pain Undergoing Chiropractic Treatment: A Prospective Cohort Study With Short Term, Medium Term and 1 Year Follow-up

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SOURCE:   Chiropractic & Manual Therapies 2014 (Apr 1); 22 (1): 15

Cynthia K Peterson, Daniel Mühlemann, Barry Kim Humphreys

Department of Chiropractic Medicine,
Orthopaedic University Hospital Balgrist,

University of Zürich,
Forchstrasse 340,
Zürich, Switzerland


This study, from the chiropractic researchers at the University of Zurich in Switzerland, demonstrates that chiropractic care helps reduce low back pain during pregnancy, and another study by this same group demonstrates the long-term benefits from chiropractic adjustments for lumbar disc herniations.

BACKGROUND:   Low back pain in pregnancy is common and research evidence on the response to chiropractic treatment is limited.

The purposes of this study are

1) to report outcomes in pregnant patients receiving chiropractic treatment

2) to compare outcomes from subgroups

3) to assess predictors of outcome.

METHODS:   Pregnant patients with low back or pelvic pain, no contraindications to manipulative therapy and no manual therapy in the prior 3 months were recruited.Baseline numerical rating scale (NRS) and Oswestry questionnaire data were collected. Duration of complaint, number of previous LBP episodes, LBP during a previous pregnancy, and category of pain location were recorded.The patient’s global impression of change (PGIC) (primary outcome), NRS, and Oswestry data (secondary outcomes) were collected at 1 week, 1 and 3 months after the first treatment. At 6 months and 1 year the PGIC and NRS scores were collected. PGIC responses of ‘better or ‘much better’ were categorized as ‘improved’.The proportion of patients ‘improved’ at each time point was calculated. Chi-squared test compared subgroups with ‘improvement’. Baseline and follow-up NRS and Oswestry scores were compared using the paired t-test. The unpaired t-test compared NRS and Oswestry scores in patients with and without a history of LBP and with and without LBP during a previous pregnancy. Anova compared baseline and follow-up NRS and Oswestry scores by pain location category and category of number of previous LBP episodes. Logistic regression analysis also was also performed.

RESULTS:   52% of 115 recruited patients ‘improved’ at 1 week, 70% at 1 month, 85% at 3 months, 90% at 6 months and 88% at 1 year. There were significant reductions in NRS and Oswestry scores (p < 0.0005). Category of previous LBP episodes number at one year (p = 0.02) was related to 'improvement' when analyzed alone, but was not strongly predictive in logistic regression. Patients with more prior LBP episodes had higher 1 year NRS scores (p = 0.013).

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Prevalence and Tracking of Back Pain
From Childhood to Adolescence

By |May 17, 2016|Pediatrics, Spinal Joint Pain|

Prevalence and Tracking of Back Pain
From Childhood to Adolescence

The Chiro.Org Blog


SOURCE:  

Per Kjaer, Niels Wedderkopp, Lars Korsholm
and Charlotte Leboeuf-Yde

Institute of Sports Science and Clinical Biomechanics,
Part of Clinical Locomotion Network,
University of Southern Denmark,
Campusvej 55, DK-5230, Odense, Denmark.


BACKGROUND:   It is generally acknowledged that back pain (BP) is a common condition already in childhood. However, the development until early adulthood is not well understood and, in particular, not the individual tracking pattern. The objectives of this paper are to show the prevalence estimates of BP, low back pain (LBP), mid back pain (MBP), neck pain (NP), and care-seeking because of BP at three different ages (9, 13 and 15 years) and how the BP reporting tracks over these age groups over three consecutive surveys.

METHODS:   A longitudinal cohort study was carried out from the years of 1997 till 2005, collecting interview data from children who were sampled to be representative of Danish schoolchildren. BP was defined overall and specifically in the three spinal regions as having reported pain within the past month. The prevalence estimates and the various patterns of BP reporting over time are presented as percentages.

RESULTS:   Of the 771 children sampled, 62%, 57%, and 58% participated in the three back surveys and 34% participated in all three. The prevalence estimates for children at the ages of 9, 13, and 15, respectively, were for BP 33%, 28%, and 48%; for LBP 4%, 22%, and 36%; for MBP 20%, 13%, and 35%; and for NP 10%, 7%, and 15%. Seeking care for BP increased from 6% and 8% at the two youngest ages to 34% at the oldest. Only 7% of the children who participated in all three surveys reported BP each time and 30% of these always reported no pain. The patterns of development differed for the three spinal regions and between genders. Status at the previous survey predicted status at the next survey, so that those who had pain before were more likely to report pain again and vice versa. This was most pronounced for care-seeking.

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Is Puberty a Risk Factor For Back Pain in the Young?

By |May 14, 2016|Low Back Pain, Pediatrics|

Is Puberty a Risk Factor For Back Pain in the Young?
A Systematic Critical Literature Review

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SOURCE:   Chiropractic & Manual Therapies 2014 (Oct 15); 22 (1): 27

Arnaud Lardon, Charlotte Leboeuf-Yde,
Christine Le Scanff and
Niels Wedderkopp

EA 4532 CIAMS, Université Paris-Sud,
UFR STAPS, 91405 Orsay, France ;
Institut Franco-Européen de Chiropraxie,
24 Bld Paul Vaillant Couturier,
94200 Ivry sur Seine, France.


BACKGROUND:   Back pain is a common condition that starts early in life and seems to increase markedly during puberty. A systematic review was performed in order to investigate the link between puberty and back pain, using some Bradford Hill criteria for causality.

OBJECTIVES:   We sought to obtain answers to the following questions: 1) Is there an association between puberty and back pain? If so, how strong is this association? And do the results remain unchanged also when controlling for age and sex? 2) Are the results of the studies consistent? 3) Is there a dose-response, showing a link between the increasing stages of puberty and the subsequent prevalence of back pain? 4) Is there a temporal link between puberty and back pain?

DESIGN:   A systematic critical literature review.

METHODS:   Systematic searches were made in March 2014 in PubMed, Embase, CINAHL and PsycINFO including longitudinal or cross-sectional studies on back pain for subjects <19 years, written in French or English. The review process followed the AMSTAR recommendations. Interpretation was made using some of the Bradford-Hill criteria for causality.

RESULTS:   Four articles reporting five studies were included, two of which were longitudinal. 1) Some studies show a weak and others a strong positive association between puberty and back pain, which remains after controlling for age and sex; 2) Results were consistent across the studies; 3) There was a linear increase of back pain according to the stage of puberty 4) Temporality has not been sufficiently studied.

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