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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.
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Evaluating the Relationship Among Cavitation, Zygapophyseal Joint Gapping, and Spinal Manipulation: An Exploratory Case Series

By |November 28, 2015|Chiropractic Research|

Evaluating the Relationship Among Cavitation, Zygapophyseal Joint Gapping, and Spinal Manipulation: An Exploratory Case Series

The Chiro.Org Blog

SOURCE:   J Manipulative Physiol Ther. 2011 (Jan);   34 (1):   2–14

Gregory D. Cramer, DC, PhD, Kim Ross, DC, PhD, Judith Pocius, MS, Joe A. Cantu, DC, Evelyn Laptook, DC, Michael Fergus, DC, Doug Gregerson, DC, Scott Selby, DC, P.K. Raju, PhD

National University of Health Sciences,
Lombard, IL 60510, USA.
gcramer@nuhs.edu

OBJECTIVE:   This project determined the feasibility of conducting larger studies assessing the relationship between cavitation and zygapophyseal (Z) joint gapping following spinal manipulative therapy (SMT).

METHODS:   Five healthy volunteers (average age, 25.4 years) were screened and examined against inclusion and exclusion criteria. High-signal magnetic resonance imaging (MRI) markers were fixed to T12, L3, and S1 spinous processes. Scout images were taken to verify the location of the markers. Axial images of the L4/L5 and L5/S1 levels were obtained in the neutral supine position. Following the first MRI, accelerometers were placed over the same spinous processes; and recordings were made from them during side-posture positioning and SMT. The accelerometers were removed, and each subject was scanned in side-posture. The greatest central anterior to posterior Z joint spaces (gap) were measured from the first and second MRI scans. Values obtained from the first scan were subtracted from those of the second, with a positive result indicating an increase in gapping following SMT (positive gapping difference). Gapping difference was compared between the up-side (SMT) joints vs the down-side (non-SMT) joints and between up-side cavitation vs up-side noncavitation joints.

RESULTS:   Greater gapping was found in Z joints that received SMT (0.5 ± 0.6 mm) vs non-SMT joints (-0.2 ± 0.6 mm), and vertebral segments that cavitated gapped more than those that did not cavitate (0.8 ± 0.7 vs 0.4 ± 0.5 mm).

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What is the Chiropractic Subluxation Page

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Sympathetic and Parasympathetic Responses to Specific Diversified Adjustments to Chiropractic Vertebral Subluxations of the Cervical and Thoracic Spine

By |November 27, 2015|Blood Pressure|

Sympathetic and Parasympathetic Responses to Specific Diversified Adjustments to Chiropractic Vertebral Subluxations of the Cervical and Thoracic Spine

The Chiro.Org Blog

SOURCE:   J Chiropractic Medicine 2008 (Sep);   7 (3):   86–93

Arlene Welch, DC, Ralph Boone, PhD, DC

Instructor of Clinical Sciences and Health Center Faculty Doctor,
Sherman College of Straight Chiropractic,
Spartanburg, SC 29304

OBJECTIVE:   The aims of this study were to investigate the response of the autonomic nervous system based upon the area of the spine adjusted and to determine if a cervical adjustment elicits a parasympathetic response and if a thoracic adjustment elicits a sympathetic response.

METHODS:   Forty patients (25-55 years old) met inclusion criteria that consisted of normal blood pressure, no history of heart disease, and being asymptomatic. Patients were evaluated pre- and post-chiropractic adjustment for the following autonomic responses: blood pressure and pulse rate. Seven patients were measured for heart rate variability. The subjects received either a diversified cervical segment adjustment or a diversified thoracic segment adjustment.

RESULTS:   Diastolic pressure (indicating a sympathetic response) dropped significantly postadjustment among those receiving cervical adjustments, accompanied by a moderate clinical effect (0.50). Pulse pressure increased significantly among those receiving cervical adjustments, accompanied by a large effect size (0.82). Although the decrease in pulse pressure for those receiving thoracic adjustments was not statistically significant, the decrease was accompanied by a moderate effect size (0.66).

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Blood Pressure and Chiropractic Page

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Chiropractic Scoliosis Rehabilitation Treatment

By |November 26, 2015|Scoliosis|

Results of Chiropractic Scoliosis Rehabilitation Treatment at Two Years Post-skeletal Maturity in Identical Female Twins

The Chiro.Org Blog

SOURCE:   J Bodyw Mov Ther. 2015 (Oct);   19 (4):   592–596

Brian Dovorany, Mark W. Morningstar, Clayton Stitzel, Aatif Siddiqui

Private Practice of Chiropractic Medicine,
2031 S Webster Avenue,
Green Bay, WI 54301, USA

BACKGROUND:   Scoliosis treatment guidelines for non-operative management suggest that patients should be followed for two years beyond skeletal maturity to appropriately evaluate treatment effect. This report outlines the results of identical twin girls’ treatment with chiropractic rehabilitation treatment at two years post skeletal maturity.

FINDINGS:   The twins participated in a treatment lasting two weeks, followed by home care maintenance and periodic follow-ups for they reached skeletal maturity. Two year follow up showed reduced Cobb angles of 19° and 15°, respectively.

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Scoliosis and Chiropractic Page

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Chiropractic Spinal Manipulative Therapy for Migraine

By |November 24, 2015|Migraine|

Chiropractic Spinal Manipulative Therapy for Migraine: A Study Protocol of a Single-blinded Placebo-controlled Randomised Clinical Trial

The Chiro.Org Blog

SOURCE:   BMJ Open. 2015 (Nov 19);   5 (11):   e008095 ~ FULL TEXT

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

Head and Neck Research Group,
Research Centre, Akershus University Hospital,
Lørenskog, Norway Institute of Clinical Medicine,
Akershus University Hospital,
University of Oslo,
Nordbyhagen, Norway

INTRODUCTION:   Migraine affects 15% of the population, and has substantial health and socioeconomic costs. Pharmacological management is first-line treatment. However, acute and/or prophylactic medicine might not be tolerated due to side effects or contraindications. Thus, we aim to assess the efficacy of chiropractic spinal manipulative therapy (CSMT) for migraineurs in a single-blinded placebo-controlled randomised clinical trial (RCT).

METHOD AND ANALYSIS:   According to the power calculations, 90 participants are needed in the RCT. Participants will be randomised into one of three groups: CSMT, placebo (sham manipulation) and control (usual non-manual management). The RCT consists of three stages: 1 month run-in, 3 months intervention and follow-up analyses at the end of the intervention and 3, 6 and 12 months. The primary end point is migraine frequency, while migraine duration, migraine intensity, headache index (frequency x duration x intensity) and medicine consumption are secondary end points. Primary analysis will assess a change in migraine frequency from baseline to the end of the intervention and follow-up, where the groups CSMT and placebo and CSMT and control will be compared. Owing to two group comparisons, p values below 0.025 will be considered statistically significant. For all secondary end points and analyses, a p value below 0.05 will be used. The results will be presented with the corresponding p values and 95% CIs.

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Headache and Chiropractic Page

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Prediction of Pain Outcomes in a Randomized Controlled Trial of Dose-response of Spinal Manipulation for the Care of Chronic Low Back Pain

By |November 21, 2015|Chronic Pain, Low Back Pain|

Prediction of Pain Outcomes in a Randomized Controlled Trial of Dose-response of Spinal Manipulation for the Care of Chronic Low Back Pain

The Chiro.Org Blog

SOURCE:   BMC Musculoskelet Disord. 2015 (Aug 19);   16:   205 ~ FULL TEXT

Darcy Vavrek, Mitchell Haas, Moni Blazej Neradilek, and Nayak Polissar

University of Western States,
2900 NE 132nd Ave,
Portland, OR, 97230, USA

BACKGROUND:   No previous studies have created and validated prediction models for outcomes in patients receiving spinal manipulation for care of chronic low back pain (cLBP). We therefore conducted a secondary analysis alongside a dose-response, randomized controlled trial of spinal manipulation.

METHODS:   We investigated dose, pain and disability, sociodemographics, general health, psychosocial measures, and objective exam findings as potential predictors of pain outcomes utilizing 400 participants from a randomized controlled trial. Participants received 18 sessions of treatment over 6-weeks and were followed for a year. Spinal manipulation was performed by a chiropractor at 0, 6, 12, or 18 visits (dose), with a light-massage control at all remaining visits. Pain intensity was evaluated with the modified von Korff pain scale (0-100). Predictor variables evaluated came from several domains: condition-specific pain and disability, sociodemographics, general health status, psychosocial, and objective physical measures. Three-quarters of cases (training-set) were used to develop 4 longitudinal models with forward selection to predict individual “responders” (≥50% improvement from baseline) and future pain intensity using either pretreatment characteristics or post-treatment variables collected shortly after completion of care. The internal validity of the predictor models were then evaluated on the remaining 25% of cases (test-set) using area under the receiver operating curve (AUC), R(2), and root mean squared error (RMSE).

RESULTS:   The pretreatment responder model performed no better than chance in identifying participants who became responders (AUC = 0.479). Similarly, the pretreatment pain intensity model predicted future pain intensity poorly with low proportion of variance explained (R(2) = .065). The post-treatment predictor models performed better with AUC = 0.665 for the responder model and R(2) = 0.261 for the future pain model. Post-treatment pain alone actually predicted future pain better than the full post-treatment predictor model (R(2) = 0.350). The prediction errors (RMSE) were large (19.4 and 17.5 for the pre- and post-treatment predictor models, respectively).

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Low Back Pain and Chiropractic Page

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