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Yearly Archives: 2016

Chiropractic Spinal Manipulative Therapy For Migraine:
A Three-Armed, Single-Blinded, Placebo, Randomized Controlled Trial

By |October 14, 2016|Migraine|

Chiropractic Spinal Manipulative Therapy For Migraine: A Three-Armed, Single-Blinded, Placebo, Randomized Controlled Trial

The Chiro.Org Blog

SOURCE:   Eur J Neurol. 2016 (Oct 2) [Epub]

Aleksander Chaibi, Jurate Šaltyte Benth, Peter J Tuchin, Michael Bjørn Russell

Head and Neck Research Group,
Akershus University Hospital,
Lørenskog, Norway.

BACKGROUND AND PURPOSE:   To investigate the efficacy of chiropractic spinal manipulative therapy (CSMT) for migraineurs.

METHODS:   This was a prospective three-armed, single-blinded, placebo, randomized controlled trial (RCT) of 17 months duration including 104 migraineurs with at least one migraine attack per month. The RCT was conducted at Akershus University Hospital, Oslo, Norway. Active treatment consisted of CSMT, whereas placebo was a sham push manoeuvre of the lateral edge of the scapula and/or the gluteal region. The control group continued their usual pharmacological management. The RCT consisted of a 1-month run-in, 3 months intervention and outcome measures at the end of the intervention and at 3, 6 and 12 months follow-up. The primary end-point was the number of migraine days per month, whereas secondary end-points were migraine duration, migraine intensity and headache index, and medicine consumption.

RESULTS:   Migraine days were significantly reduced within all three groups from baseline to post-treatment (P < 0.001). The effect continued in the CSMT and placebo group at all follow-up time points, whereas the control group returned to baseline. The reduction in migraine days was not significantly different between the groups (P > 0.025 for interaction). Migraine duration and headache index were reduced significantly more in the CSMT than the control group towards the end of follow-up (P = 0.02 and P = 0.04 for interaction, respectively). Adverse events were few, mild and transient. Blinding was strongly sustained throughout the RCT.

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Preliminary Study Into The Components Of TheFear-Avoidance Model

By |October 5, 2016|Biopsychosocial Model|

Preliminary Study Into The Components of the Fear-Avoidance Model Of LBP:
Change After An Initial Chiropractic Visit And Influence On Outcome

The Chiro.Org Blog

SOURCE:   Chiropractic & Osteopathy 2010 (Jul 30); 18: 21

Jonathan R Field, Dave Newell, and Peter W McCarthy

Back2Health,
2 Charles Street,
Petersfield, Hants, GU32 3EH, UK.
jonathanfield@me.com

BACKGROUND:   In the last decade the sub grouping of low back pain (LBP) patients according to their likely response to treatment has been identified as a research priority. As with other patient groups, researchers have found few if any factors from the case history or physical examination that are helpful in predicting the outcome of chiropractic care. However, in the wider LBP population psychosocial factors have been identified that are significantly prognostic. This study investigated changes in the components of the LBP fear-avoidance beliefs model in patients pre- and post- their initial visit with a chiropractor to determine if there was a relationship with outcomes at 1 month.

METHODS:   Seventy one new patients with lower back pain as their primary complaint presenting for chiropractic care to one of five clinics (nine chiropractors) completed questionnaires before their initial visit (pre-visit) and again just before their second appointment (post-visit). One month after the initial consultation, patient global impression of change (PGIC) scores were collected. Pre visit and post visit psychological domain scores were analysed for any association with outcomes at 1 month.

RESULTS:   Group mean scores for Fear Avoidance Beliefs (FAB), catastrophisation and self-efficacy were all improved significantly within a few days of a patient’s initial chiropractic consultation. Pre-visit catastrophisation as well as post-visit scores for catastrophisation, back beliefs (inevitability) and self-efficacy were weakly correlated with patient’s global impression of change (PGIC) at 1 month. However when the four assessed psychological variables were dichotomised about pre-visit group medians those individuals with 2 or more high variables post-visit had a substantially increased risk (OR 36.4 (95% CI 6.2-213.0) of poor recovery at 1 month. Seven percent of patients with 1 or fewer adverse psychological variables described poor benefit compared to 73% of those with 2 or more.

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The Physiological Role of Tumor Necrosis Factor in Human Immunity and Its Potential Implications in Spinal Manipulative Therapy

By |October 1, 2016|Immune Function, Spinal Manipulation|

The Physiological Role of Tumor Necrosis Factor in Human Immunity and Its Potential

Implications in Spinal Manipulative Therapy:   A Narrative Literature Review

The Chiro.Org Blog

SOURCE:   J Chiropractic Medicine 2016 (Sep)

Liang Zhang, MD, PhD, Chao Hua Yao, MD

Palmer College of Chiropractic,
Florida Campus, Port Orange, FL;
Palmer Laboratory of Cell & Molecular Biology,
Palmer Center for Chiropractic Research,
Port Orange, FL.

OBJECTIVE:   Although tumor necrosis factor (TNF) is a well-known inflammatory cytokine in the pathological development of various human diseases, its physiological roles are not widely understood nor appreciated. The molecular mechanisms underlying spinal manipulation therapy (SMT) remain elusive. The relationship between TNF and SMT is unclear. Thus, we performed this literature review to better understand TNF physiology and its potential relationship with SMT, and we propose a novel mechanism by which SMT may achieve clinical benefits by using certain beneficial features of TNF.

METHODS:   We searched several databases for relevant articles published between 1975 and 2015 and then reexamined the studies from current immunophysiological perspectives.

RESULTS:   The history and recent progresses in TNF physiology research were explored. Conflicting reports on the relationship between TNF and SMT were identified. Based on the newly discovered interaction between TNF and regulatory T cells, we proposed a putative biphasic TNF response to SMT, which may resolve the conflicts in the reported observations and interpretations.

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Spinal Health: The Backbone of Chiropractic’s Identity

By |September 20, 2016|Chiropractic Identity|

Spinal Health: The Backbone of Chiropractic’s Identity

The Chiro.Org Blog

SOURCE:   Journal of Chiropractic Humanities 2016 [Epub]

Richard A. Brown, DC, LLM, FRCC

World Federation of Chiropractic
Toronto, ON

Objectives   The purpose of this commentary is to explore the concepts underpinning professional identity, assess their relevance to chiropractic, and propose a model by which a strong identity for the chiropractic profession may be achieved.

Discussion   The professional identity of chiropractic has been a constant source of controversy throughout its history. Attempts to establish a professional identity have been met with resistance from internal factions divided over linguistics, philosophy, technique, and chiropractic’s place in the health care framework. Consequently, the establishment of a clear identity has been challenging, and the chiropractic profession has failed to capitalize on its potential as the profession of spine care experts.

Recent identity consultations have produced similar statements that position chiropractors as spinal health and well-being experts. Adoption of this identity, however, has not been universal, perpetuating the uncertainty with which the public regards the chiropractic profession.

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Chiropractors As The Spinal Health Care Experts

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Neck Pain In Children

By |September 17, 2016|Neck Pain, Pediatrics|

Neck Pain In Children: A Retrospective Case Series

The Chiro.Org Blog

SOURCE:   J Can Chiropr Assoc. 2016 (Sep); 60 (3): 212–219

Jocelyn Cox, BPhEd, DC,
Christine Davidian, DC, MSc,
Silvano Mior, DC, FCCS, PhD

Graduate Education and Research Department
of Canadian Memorial Chiropractic College

Introduction:   Spinal pain in the pediatric population is a significant health issue, with an increasing prevalence as they age. Pediatric patients attend for chiropractor care for spinal pain, yet, there is a paucity of quality evidence to guide the practitioner with respect to appropriate care planning.

Methods:   A retrospective chart review was used to describe chiropractic management of pediatric neck pain. Two researchers abstracted data from 50 clinical files that met inclusion criteria from a general practice chiropractic office in the Greater Toronto Area, Canada. Data were entered into SPSS 15 and descriptively analyzed.

Results:   Fifty pediatric neck pain patient files were analysed. Patients’ age ranged between 6 and 18 years (mean 13 years). Most (98%) were diagnosed with Grade I-II mechanical neck pain. Treatment frequency averaged 5 visits over 19 days; with spinal manipulative therapy used in 96% of patients. Significant improvement was recorded in 96% of the files. No adverse events were documented.

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