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Yearly Archives: 2024

Enhancing Ccomprehensive Primary Care by Integrating Chiropractic Led Musculoskeletal Care Into Interprofessional Teams Through Supporting Education, Competency Attainment, and Optimizing Integration

By |September 7, 2024|Spinal Pain Management|

Enhancing Ccomprehensive Primary Care by Integrating Chiropractic Led Musculoskeletal Care Into Interprofessional Teams Through Supporting Education, Competency Attainment, and Optimizing Integration

The Chiro.Org Blog

SOURCE:   Healthc Manage Forum 2024 (Sep); 37 (1_suppl): 55S–61S

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Silvano Mior, DC, FCCS, PhD • Diana De Carvalho, DC, PhD • Jairus Quesnele, DC, FCCS, APP • Sheilah Hogg-Johnson, PhD • Pegah Rahbar, BSc, DC • Megan Logeman, BSc, PMP

Canadian Memorial Chiropractic College,
Toronto, Ontario, Canada.

Musculoskeletal (MSK) conditions are the leading cause of disability, resulting in up to 40% of visits to family physicians. Current primary care workforce shortages in Canada require other providers to maximize scopes of practice. Few MSK providers have been trained in team-based primary care settings. Study objectives included: (1) educating participating primary care teams through synchronous education, (2) educating Canadian primary care providers through asynchronous education, and (3) integrating chiropractors into primary care teams, whilst evaluating team MSK care knowledge/attitudes and integration experience. Results indicated improvements in collaborative competency, improved understanding and attitudes to chiropractic, and the importance of providing MSK care within funded primary care. Teams employed unique approaches to integrating chiropractors and indicated high demand for their services by patients and providers. Provision of MSK care without economic barrier is desirable and highly valued by teams. Chiropractors are well suited to participate in funded primary care teams in Canada.

From the FULL TEXT Article:

Introduction

Musculoskeletal (MSK) conditions are the leading cause of disability in Canada and a significant burden to people, health systems, and economies. [1] In most Canadian provinces, public funding for MSK care is limited, posing a significant barrier to patient access. In the United States, MSK complaints are the most common reason for primary care appointments, accounting for approximately 40% of encounters, [2] highlighting the importance of strengthening MSK expertise in primary care to impact patient outcomes. One solution is to provide integrated MSK care (embedding MSK care providers such as chiropractors and physiotherapists) as part of comprehensive primary care.

Currently, few MSK health providers have been formally trained in Interprofessional Collaboration (IPC), limiting integration and optimization of team-based patient-centred care. Interprofessional Education (IPE) supports the development of a competent health workforce and helps mitigate the current fragmentation of care in health service delivery. [3]

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DD Palmer and the Egyptian Connection:
A Short Report

By |September 1, 2024|Subluxation|

DD Palmer and the Egyptian Connection:
A Short Report

The Chiro.Org Blog

SOURCE:   Asia-Pacific Chiropractic Journal 2024; 5 (1)

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Phillip Ebrall, BAppSc (Chiropr), PhD

Editor, Asia-Pacific Chiropractic Journal

This paper describes the first known description of the ‘idea of subluxation’ as a small dysfunction in the spine which affected a person’s health and function. The authoritative source document is the Edwin Smith Manuscript, introduced to the world in the 1920s. This paper reports this interpretation of Egyptian medical writings dating from 1,600 BC and earlier, in which small spinal dysfunctions were noted and clinically managed.

Indexing Terms:   Subluxation, Edwin Smith, chiropractic, Egyptian medical writings

From the FULL TEXT Article:

Introduction


Figure 1

Clues to the antiquity of the idea that DD Palmer codified as ‘subluxated vertebrae modulating tone’ came as early as 1905 [1] when he referred to ‘Chinese and Egyptian history … system of healing … Manual Therapeutics.’ (Figure 1)

Palmer alluded to this history [2] in his 1906 text co-written with his son, BJ Palmer but was clear in his 1910 tome, on p. 12, [3] where he wrote:

‘Dr. Atkinson [4–6] has frequently informed me that the replacing of displaced vertebrae for the relief of human ills had been known and practiced by the ancient Egyptians for at least 3000 years.’

and on p. 13:

‘many of the methods employed in ancient Greece and older Egypt are being restored’

In 1914 Palmer wrote: [7, p. 8]

‘The principles which form chiropractic science have always existed; and are now being revealed to the world by D. D. Palmer’

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EVOLUTION OF THE SUBLUXATION THEORY Section

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Development, Validation and Use of Custom Software for the Analysis of Pain Trajectories

By |August 18, 2024|Low Back Pain, Trajectories of Back Pain|

Development, Validation and Use of Custom Software for the Analysis of Pain Trajectories

The Chiro.Org Blog

SOURCE:   Sci Rep 2024 (Aug 12); 14 (1): 18719

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M. R. van Ittersum • A. de Zoete • M. Rubinstein • Al-Madfai
A. Kongsted • P. McCarthy

Chiropractie Groesbeek,
Nijmeegsebaan 32, 6561 KG,
Groesbeek, The Netherlands.

In chronic musculoskeletal conditions, the prognosis tends to be more informative than the diagnosis for the future course of the disease. Many studies have identified clusters of patients who seemingly share similar pain trajectories. In a dataset of low back pain (LBP) patients, pain trajectories have been identified, and distinct trajectory types have been defined, making it possible to create pattern recognition software that can classify patients into respective pain trajectories reflecting their condition. It has been suggested that the classification of pain trajectories may create clinically meaningful subgroups of patients in an otherwise heterogeneous population of patients with LBP. A software tool was created that combined the ability to recognise the pain trajectory of patients with a system that could create subgroups of patients based on their characteristics. This tool is primarily meant for researchers to analyse trends in large heterogeneous datasets without large losses of data. Prospective analysis of pain trajectories is not directly helpful for clinicians. However, the tool might aid in the identification of patient characteristics which have predictive capabilities of the most likely trajectory a patient might experience in the future. This will help clinicians to tailor their advice and treatment for a specific patient.

Subject terms:   Data mining, Chronic pain, Prognosis

From the FULL TEXT Article:

Introduction

In chronic musculoskeletal diseases, diagnosis alone is often insufficient to inform patients and clinicians about the future course of the disease. [1] Most chronic musculoskeletal diseases, such as low back pain (LBP), are caused by a complex combination of biological, psychological, social, and genetic factors that influence the course of the disease. [2] It is therefore argued that prognosis, which considers all of these elements, might be a better framework to inform patients and clinicians about the likely course of the disease. [1]

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MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis

By |June 26, 2024|Low Back Pain, Radiology|

MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis

The Chiro.Org Blog

SOURCE:   AJNR Am J Neuroradiol 2015 (Dec)

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W. Brinjikji • F.E. Diehn • Jarvik
C.M. Carr • Murad • P.H. Luetmera

Department of Neurological Surgery and Health Services,
Comparative Effectiveness Cost and Outcomes Research Center (J.G.J.)
Department of Radiology (J.G.J.),
University of Washington,
Seattle, Washington.

Background and purpose:   Imaging features of spine degeneration are common in symptomatic and asymptomatic individuals. We compared the prevalence of MR imaging features of lumbar spine degeneration in adults 50 years of age and younger with and without self-reported low back pain.

Materials and methods:   We performed a meta-analysis of studies reporting the prevalence of degenerative lumbar spine MR imaging findings in asymptomatic and symptomatic adults 50 years of age or younger. Symptomatic individuals had axial low back pain with or without radicular symptoms. Two reviewers evaluated each article for the following outcomes: disc bulge, disc degeneration, disc extrusion, disc protrusion, annular fissures, Modic 1 changes, any Modic changes, central canal stenosis, spondylolisthesis, and spondylolysis. The meta-analysis was performed by using a random-effects model.

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RADIOLOGY Section and the

LOW BACK PAIN Section

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A Retrospective Analysis of the Incidence of Severe Adverse Events Among Recipients of Chiropractic Spinal Manipulative Therapy

By |June 24, 2024|Adverse Events, Spinal Manipulation|

A Retrospective Analysis of the Incidence of Severe Adverse Events Among Recipients of Chiropractic Spinal Manipulative Therapy

The Chiro.Org Blog

SOURCE:   Sci Rep 2023 (Jan 23); 13 (1): 1254

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Eric Chun-Pu Chu • Robert J Trager
Linda Yin-King Lee • Imran Khan Niazi

New York Chiropractic and Physiotherapy Centre,
EC Healthcare, 41/F Langham Place Office Tower,
8 Argyle Street, Kowloon, Hong Kong.

This study examined the incidence and severity of adverse events (AEs) of patients receiving chiropractic spinal manipulative therapy (SMT), with the hypothesis that < 1 per 100,000 SMT sessions results in a grade ≥ 3 (severe) AE. A secondary objective was to examine independent predictors of grade ≥ 3 AEs. We identified patients with SMT-related AEs from January 2017 through August 2022 across 30 chiropractic clinics in Hong Kong. AE data were extracted from a complaint log, including solicited patient surveys, complaints, and clinician reports, and corroborated by medical records. AEs were independently graded 1–5 based on severity (1–mild, 2–moderate, 3–severe, 4–life-threatening, 5–death). Among 960,140 SMT sessions for 54,846 patients, 39 AEs were identified, two were grade 3, both of which were rib fractures occurring in women age > 60 with osteoporosis, while none were grade ≥ 4, yielding an incidence of grade ≥ 3 AEs of 0.21 per 100,000 SMT sessions (95% CI 0.00, 0.56 per 100,000). There were no AEs related to stroke or cauda equina syndrome. The sample size was insufficient to identify predictors of grade ≥ 3 AEs using multiple logistic regression. In this study, severe SMT-related AEs were reassuringly very rare.

Subject terms:   Adverse effects, Rehabilitation

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ADVERSE EVENTS Section

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