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Frank M. Painter

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.

A Randomized Controlled Trial Comparing Different Sites of High-velocity Low Amplitude Thrust on Sensorimotor Integration Parameters

By |March 17, 2024|Sensorimotor Integration, Subluxation|

A Randomized Controlled Trial Comparing Different Sites of High-velocity Low Amplitude Thrust on Sensorimotor Integration Parameters

The Chiro.Org Blog


SOURCE:   Scientific Reports 2024 (Jan 12); 14 (1): 1159

Imran Khan Niazi • Muhammad Samran Navid • Christopher Merkle • Imran Amjad
Nitika Kumari • Robert J Trager • Kelly Holt • Heidi Haavik

Centre for Chiropractic Research,
New Zealand College of Chiropractic,
Auckland, New Zealand



Increasing evidence suggests that a high-velocity, low-amplitude (HVLA) thrust directed at a dysfunctional vertebral segment in people with subclinical spinal pain alters various neurophysiological measures, including somatosensory evoked potentials (SEPs). We hypothesized that an HVLA thrust applied to a clinician chosen vertebral segment based on clinical indicators of vertebral dysfunction, in short, segment considered as “relevant” would significantly reduce the N30 amplitude compared to an HVLA thrust applied to a predetermined vertebral segment not based on clinical indicators of vertebral dysfunction or segment considered as “non-relevant”. In this double-blinded, active-controlled, parallel-design study, 96 adults with recurrent mild neck pain, ache, or stiffness were randomly allocated to receiving a single thrust directed at either a segment considered as “relevant” or a segment considered as “non-relevant” in their upper cervical spine. SEPs of median nerve stimulation were recorded before and immediately after a single HVLA application delivered using an adjusting instrument (Activator). A linear mixed model was used to assess changes in the N30 amplitude. A significant interaction between the site of thrust delivery and session was found (F1,840 = 9.89, p < 0.002). Pairwise comparisons showed a significant immediate decrease in the N30 complex amplitude after the application of HVLA thrust to a segment considered "relevant" (- 16.76 ± 28.32%, p = 0.005). In contrast, no significant change was observed in the group that received HVLA thrust over a segment considered "non-relevant" (p = 0.757). Cervical HVLA thrust applied to the segment considered as "relevant" altered sensorimotor parameters, while cervical HVLA thrust over the segment considered as "non-relevant" did not. This finding supports the hypothesis that spinal site targeting of HVLA interventions is important when measuring neurophysiological responses. Further studies are needed to explore the potential clinical relevance of these findings.

There are more articles like this @

SUBLUXATION Section

(more…)

Association Between Chiropractic Spinal Manipulation and Cauda Equina Syndrome in Adults With Low Back Pain: Retrospective Cohort Study of US Academic Health Centers

By |March 17, 2024|Cauda Equina Syndrome, Low Back Pain|

Association Between Chiropractic Spinal Manipulation and Cauda Equina Syndrome in Adults With Low Back Pain: Retrospective Cohort Study of US Academic Health Centers

The Chiro.Org Blog


SOURCE:   PLoS One 2024 (Mar 11); 19 (3): e0299159
Robert J. Trager • Anthony N. Baumann • Jaime A. Perez
Jeffery A. Dusek • Romeo-Paolo T. Perfecto • Christine M. Goertz

Connor Whole Health,
University Hospitals Cleveland Medical Center,
Cleveland, Ohio, United States of America.



Background:   Cauda equina syndrome (CES) is a lumbosacral surgical emergency that has been associated with chiropractic spinal manipulation (CSM) in case reports. However, identifying if there is a potential causal effect is complicated by the heightened incidence of CES among those with low back pain (LBP). The study hypothesis was that there would be no increase in the risk of CES in adults with LBP following CSM compared to a propensity-matched cohort following physical therapy (PT) evaluation without spinal manipulation over a three-month follow-up period.

Methods:   A query of a United States network (TriNetX, Inc.) was conducted, searching health records of more than 107 million patients attending academic health centers, yielding data ranging from 20 years prior to the search date (July 30, 2023). Patients aged 18 or older with LBP were included, excluding those with pre-existing CES, incontinence, or serious pathology that may cause CES.
Patients were divided into two cohorts:

(1)   LBP patients receiving CSM or
(2)   LBP patients receiving PT evaluation without spinal manipulation.

There are more articles like this @

LOW BACK PAIN Section

(more…)

Our Blog is a Tool. Learn How to Use It Now

By |February 19, 2024|Announcement|

Our Blog is a Tool.
Learn How to Use It Now

The Chiro.Org Blog


A Chiro.Org Editorial


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 thousands of Abstracts, and many 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 86 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
Chronic Neck Pain
Conditions That Respond Well
Cost-Effectiveness of Chiropractic
Documentation
Global Burden of Disease
Headache and Chiropractic
Initial Provider/First Contact and Chiropractic
The LINKS
Low Back Pain and Chiropractic
Medicare Info
Non-pharmacologic Therapy and Chiropractic
Nutrition
Pediatrics
Radiology
The SEARCH Section
Stroke and Chiropractic
What is the Chiropractic Subluxation?
Whiplash and Chiropractic


These other Sections are “archival” in nature, and contain valuable tools:

Chiropractic History
ChiroZine
Free Images
New DC’s
Office Forms
R.C. Schafer’s Rehab Monographs
The Wilk Antitrust Lawsuit


How Blog Posts Work

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

Association Between Spinal Manipulative Therapy and Lumbar Spine Reoperation After Discectomy: A Retrospective Cohort Study

By |February 18, 2024|Failed Back Surgery Syndrome, Low Back Pain, Lumbosacral Radiculopathy|

Association Between Spinal Manipulative Therapy and Lumbar Spine Reoperation After Discectomy: A Retrospective Cohort Study

The Chiro.Org Blog


SOURCE:   BMC Musculoskelet Disord 2024 (Jan 10); 25 (1): 46
Robert J. Trager, Jordan A. Gliedt Collin M. Labak,Clinton J. Daniels, and Jeffery A. Dusek

Connor Whole Health,
University Hospitals Cleveland Medical Center,
Cleveland, OH, USA.



Background:   Patients who undergo lumbar discectomy may experience ongoing lumbosacral radiculopathy (LSR) and seek spinal manipulative therapy (SMT) to manage these symptoms. We hypothesized that adults receiving SMT for LSR at least one year following lumbar discectomy would be less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT, over two years’ follow-up.

Methods:   We searched a United States network of health records (TriNetX, Inc.) for adults aged ≥ 18 years with LSR and lumbar discectomy ≥ 1 year previous, without lumbar fusion or instrumentation, from 2003 to 2023. We divided patients into two cohorts: (1) chiropractic SMT, and (2) usual care without chiropractic SMT. We used propensity matching to adjust for confounding variables associated with lumbar spine reoperation (e.g., age, body mass index, nicotine dependence), calculated risk ratios (RR), with 95% confidence intervals (CIs), and explored cumulative incidence of reoperation and the number of SMT follow-up visits.

Results:   Following propensity matching there were 378 patients per cohort (mean age 61 years). Lumbar spine reoperation was less frequent in the SMT cohort compared to the usual care cohort (SMT: 7%; usual care: 13%), yielding an RR (95% CIs) of 0.55 (0.35-0.85; P = 0.0062). In the SMT cohort, 72% of patients had ≥ 1 follow-up SMT visit (median = 6).

There are more articles like this @

FAILED BACK SURGERY Section

(more…)

A Randomized Controlled Trial Comparing Different Sites of High-velocity Low Amplitude Thrust on Sensorimotor Integration Parameters

By |January 29, 2024|Sensorimotor Integration, Subluxation|

A Randomized Controlled Trial Comparing Different Sites of High-velocity Low Amplitude Thrust on Sensorimotor Integration Parameters

The Chiro.Org Blog


SOURCE:   Scientific Reports 2024 (Jan 12); 14 (1): 1159

Imran Khan Niazi • Muhammad Samran Navid • Christopher Merkle • Imran Amjad
Nitika Kumari • Robert J Trager • Kelly Holt • Heidi Haavik

Centre for Chiropractic Research,
New Zealand College of Chiropractic,
Auckland, New Zealand



Increasing evidence suggests that a high-velocity, low-amplitude (HVLA) thrust directed at a dysfunctional vertebral segment in people with subclinical spinal pain alters various neurophysiological measures, including somatosensory evoked potentials (SEPs). We hypothesized that an HVLA thrust applied to a clinician chosen vertebral segment based on clinical indicators of vertebral dysfunction, in short, segment considered as “relevant” would significantly reduce the N30 amplitude compared to an HVLA thrust applied to a predetermined vertebral segment not based on clinical indicators of vertebral dysfunction or segment considered as “non-relevant”. In this double-blinded, active-controlled, parallel-design study, 96 adults with recurrent mild neck pain, ache, or stiffness were randomly allocated to receiving a single thrust directed at either a segment considered as “relevant” or a segment considered as “non-relevant” in their upper cervical spine. SEPs of median nerve stimulation were recorded before and immediately after a single HVLA application delivered using an adjusting instrument (Activator). A linear mixed model was used to assess changes in the N30 amplitude. A significant interaction between the site of thrust delivery and session was found (F1,840 = 9.89, p < 0.002). Pairwise comparisons showed a significant immediate decrease in the N30 complex amplitude after the application of HVLA thrust to a segment considered "relevant" (- 16.76 ± 28.32%, p = 0.005). In contrast, no significant change was observed in the group that received HVLA thrust over a segment considered "non-relevant" (p = 0.757). Cervical HVLA thrust applied to the segment considered as "relevant" altered sensorimotor parameters, while cervical HVLA thrust over the segment considered as "non-relevant" did not. This finding supports the hypothesis that spinal site targeting of HVLA interventions is important when measuring neurophysiological responses. Further studies are needed to explore the potential clinical relevance of these findings.

There are more articles like this @

SUBLUXATION Section

(more…)

Clinical Indicators for Recommending Continued Care to Patients with Neck Pain in Chiropractic Practice: A Cohort Study

By |January 1, 2024|Maintenance Care, Patient Satisfaction|

Clinical Indicators for Recommending Continued Care to Patients with Neck Pain in Chiropractic Practice: A Cohort Study

The Chiro.Org Blog


SOURCE:   Chiropractic & Manual Therapies 2023 (Aug 31); 31: 33

  OPEN ACCESS   

Birgitte Lawaetz Myhrvold • Nina K Vøllestad • Pernille Irgens • Hilde Stendal Robinson • Iben Axén

Department of Interdisciplinary Health Sciences,
Institute of Health and Society,
University of Oslo, P.O. Box 1089,
0317, Blindern, Oslo, Norway.



Background:   Chiropractors’ clinical indicators for recommending preventive continued care to patients with low back pain include previous pain episodes, a history of long pain duration and improvement after initial treatment. Our objectives were, in a cohort of patients with neck pain, to examine whether these clinical indicators were associated with being recommended continued care beyond 4 weeks, and if so whether this recommendation was dependent of chiropractor characteristics, as well as if the number of clinical indicators influenced this recommendation.

Methods:   In this multi-center observational study, 172 patients seeking care for a new episode of neck pain in chiropractic practice in Norway were included between September 2015 and May 2016. The chiropractors treated their patients as per usual, and for this study, baseline data and 4-week follow-up data were used.

Patient data included the clinical indicators

(1)   previous episodes of neck pain,
(2)   a history of long duration neck pain and
(3)   improvement four weeks after initial treatment.

There is more like this @

MAINTENANCE CARE Section and the

CHRONIC NECK PAIN Section

(more…)