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Yearly Archives: 2020

Predictors of Visit Frequency for Patients

By |May 20, 2020|Chronic Low Back Pain, Chronic Neck Pain|

Predictors of Visit Frequency for Patients Using Ongoing Chiropractic Care for Chronic Low Back and Chronic Neck Pain; Analysis of Observational Data

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SOURCE:   BMC Musculoskeletal Disorders 2020 (May 13); 21 (1): 298

Patricia M. Herman, PhD, Sarah E. Edgington, PhD, Eric L. Hurwitz, DC, PhD, & Ian D. Coulter, PhD

RAND Corporation,
Santa Monica, CA, USA.


 

Background:   Chronic spinal pain is prevalent, expensive and long-lasting. Several provider-based nonpharmacologic therapies have now been recommended for chronic low-back pain (CLBP) and chronic neck pain (CNP). However, healthcare and coverage policies provide little guidance or evidence regarding the long-term use of this care. To provide one glimpse into the long-term use of nonpharmacologic provider-based care, this study examines the predictors of visit frequency in a large sample of patients with CLBP and CNP using ongoing chiropractic care.

Methods:   Observational data were collected from a large national sample of chiropractic patients in the US with non-specific CLBP and CNP. Visit frequency was defined as average number of chiropractic visits per month over the 3-month study period. Potential baseline predictor variables were entered into two sets of multi-level models according to a defined causal theory-in this case, Anderson’s Behavioral Model of Health Services Use.

Results:   Our sample included 852 patients with CLBP and 705 with CNP. Visit frequency varied significantly by chiropractor/clinic, so our models controlled for this clustering. Patients with either condition used an average of 2.3 visits per month. In the final models visit frequency increased (0.44 visits per month, p = .008)

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The Global Spine Care Initiative: Resources

By |May 15, 2020|Global Spine Care Initiative|

The Global Spine Care Initiative:
Resources to Implement a Spine Care Program

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SOURCE:   European Spine Journal 2018 (Sep)

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Deborah Kopansky-Giles, Claire D. Johnson, Scott Haldeman, Roger Chou, Pierre Côté, Bart N. Green, et al.

Department of Research,
Canadian Memorial Chiropractic College,
Toronto, ON, Canada.



PURPOSE:   The purpose of this report is to describe the development of a list of resources necessary to implement a model of care for the management of spine-related concerns anywhere in the world, but especially in underserved communities and low- and middle-income countries.

METHODS:   Contents from the Global Spine Care Initiative (GSCI) Classification System and GSCI care pathway papers provided a foundation for the resources list. A seed document was developed that included resources for spine care that could be delivered in primary, secondary and tertiary settings, as well as resources needed

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The Global Spine Care Initiative: Classification

By |May 14, 2020|Global Spine Care Initiative|

The Global Spine Care Initiative:
Classification System for Spine-related Concerns

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SOURCE:   European Spine Journal 2018 (Sep)

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Scott Haldeman, Claire D. Johnson, Roger Chou, Margareta Nordin, Pierre Côté, Eric L. Hurwitz, et al.

Department of Epidemiology,
School of Public Health,
University of California Los Angeles,
Los Angeles, CA, USA



PURPOSE:    The purpose of this report is to describe the development of a classification system that would apply to anyone with a spine-related concern and that can be used in an evidence-based spine care pathway.

METHODS:  Existing classification systems for spinal disorders were assembled. A seed document was developed through round-table discussions followed by a modified Delphi process. International and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate.

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Manipulative Therapy for Children Complaining of Spinal Pain

By |April 29, 2020|Spinal Pain Management|

Potential Treatment Effect Modifiers for Manipulative Therapy for Children Complaining of Spinal Pain. Secondary Analyses of a Randomised Controlled Trial

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SOURCE:   Chiropractic & Manual Therapies 2019 (Dec 10)

Kristina Boe Dissing, Werner Vach, Jan Hartvigsen, Niels Wedderkopp & Lise Hestbæk

Department of Sports Science and Clinical Biomechanics,
Faculty of Health Sciences,
University of Southern Denmark,
Campusvej 55, DK-5230 Odense M, Denmark.


BACKGROUND:   In children, spinal pain is transitory for most, but up to 20% experience recurrent and bothersome complaints. It is generally acknowledged that interventions may be more effective for subgroups of those affected with low back pain. In this secondary analysis of data from a randomized clinical trial, we tested whether five indicators of a potential increased need for treatment might act as effect modifiers for manipulative therapy in the treatment of spinal pain in children. We hypothesized that the most severely affected children would benefit more from manipulative therapy.

METHOD:   This study was a secondary analysis of data from a randomised controlled trial comparing advice, exercises and soft tissue treatment with and without the years complaining of spinal pain. A text message system (SMS) and clinical examinations were used for data collection (February 2012 to April 2014).Five pre-specified potential effect modifiers were explored:

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Comparison of First-year Grade Point Averages

By |April 28, 2020|Chiropractic Education|

Comparison of First-year Grade Point Average and National Board Acores Between Alternative Admission Track Students in a Chiropractic Program who Took or Did Not Take Preadmission Science Courses

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SOURCE:   Journal of Chiropractic Education 2020 (Mar)

Carissa J. Manrique, PhD and Gene Giggleman, DVM

Department of General Education
Parker University
2540 Walnut Hill Lane,
Dallas, Texas 75229


Objective:   We compared first-year cumulative grade point average and a composite score on part I of the National Board of Chiropractic Examiners (NBCE) exam for first-year alternative admission track program (AATP) students who did and did not take three specific undergraduate courses: general chemistry, organic chemistry, and anatomy and physiology.

Methods:   All AATP students in 2015 (n = 50) were evaluated for the course history of general chemistry and anatomy and physiology compared to their first-year cumulative grade point average and NBCE part 1 scores using independent t-tests.

Results:   Students in the AATP who took general chemistry tended to score higher overall on the NBCE exams (p = .038, r = .229). Organic chemistry and anatomy and physiology had no statistical effect on improving board scores. First-year cumulative grade point average seemed to be unaffected by any of the undergraduate courses evaluated.

Conclusion:   There was a statistically significant difference in

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Patient Expectations as Predictors of Outcome

By |April 24, 2020|Patient Expectations|

Patient Expectations as Predictors of Outcome in Patients with Acute Low Back Pain

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SOURCE:   Journal of General Internal Medicine 2008 (Feb)

Samuel S. Myers MD, Russell S. Phillips MD, Roger B. Davis ScD, Daniel C. Cherkin PhD, Anna Legedza ScD, Ted J. Kaptchuk, Andrea Hrbek, Julie E. Buring ScD, Diana Post MD, Maureen T. Connelly MD, MPH & David M. Eisenberg MD

Department of Medicine,
Harvard Medical School,
Mount Auburn Hospital,
Cambridge, MA 02138, USA.



BACKGROUND:   Few studies have evaluated the association between patient expectations for recovery and clinical outcomes, and no study has evaluated whether asking patients to choose their therapy modifies such an association.

OBJECTIVE:   To evaluate the association between patients’ expectations and functional recovery in patients with acute low back pain (LBP), and to determine whether that association is affected by giving patients choice of therapy.

DESIGN AND PARTICIPANTS:   A secondary analysis of a randomized controlled trial comparing usual care alone to usual care plus choice of chiropractic, acupuncture, or massage in 444 adults with acute LBP, lasting less than 21 days.

MEASUREMENTS AND MAIN RESULTS:   Primary outcome was functional disability (Roland score) at 5 and 12 weeks.

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