Frank M. Painter

Chiropractic and Complementary and Alternative Medicine

By Frank M. Painter|October 25, 2015|Chiropractic Care, Complementary and Alternative Medicine|

Chiropractic and CAM Utilization: A Descriptive Review

Chiropractic & Osteopathy 2007 (Jan 22); 15: 2 ~ FULL TEXT

Dana J Lawrence and William C Meeker

Research Department,
Palmer College of Chiropractic,
1000 Brady Street,
Davenport, IA 52803, USA.
dana.lawrence@palmer.edu

OBJECTIVE: To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions

DATA SOURCES: A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations.

DATA SELECTION: A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions.

DATA SYNTHESIS: Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form.

RESULTS: Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker’s compensation papers.

CONCLUSION: Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

From the FULL TEXT Article:

Background

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Chiropractic Use of Somatosensory Evoked Potentials (SEPs) in Research

By Frank M. Painter|October 23, 2015|Chiropractic Research, Education|

The Origin, and Application of Somatosensory Evoked Potentials as a Neurophysiological Technique to Investigate Neuroplasticity

The Chiro.Org Blog

SOURCE: J Can Chiropr Assoc. 2014 (Jun); 58 (2): 170–183 ~ FULL TEXT

Steven R. Passmore, DC, PhD, Bernadette Murphy, DC, PhD,
and Timothy D. Lee, PhD

McMaster University
University of Ontario,
Institute of Technology

Somatosensory evoked potentionals (SEPs) can be used to elucidate differences in cortical activity associated with a spinal manipulation (SM) intervention. The purpose of this narrative review is to overview the origin and application of SEPs, a neurophysiological technique to investigate neuroplasticity. Summaries of:

1) parameters for SEP generation and waveform recording;
2) SEP peak nomenclature, interpretation and generators;
3) peaks pertaining to tactile information processing (relevant to both chiropractic and other manual therapies);
4) utilization and application of SEPs;
5) SEPs concurrent with an experimental task and at baseline/control/pretest;
6) SEPs pain studies; and
7) SEPs design (pre/post) and neural reorganization/neuroplasticity; and
8) SEPs and future chiropractic research are all reviewed.

Understanding what SEPs are, and their application allows chiropractors, educators, and other manual therapists interested in SM to understand the context, and importance of research findings from SM studies that involve SEPs.

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Low Back Pain in Primary Care: A Description of 1250 Patients

By Frank M. Painter|October 17, 2015|Chiropractic Care, Chronic Pain, Low Back Pain|

Low Back Pain in Primary Care: A Description of 1250 Patients with Low Back Pain in Danish General and Chiropractic Practice

The Chiro.Org Blog

SOURCE: Int J Family Med. 2014 (Nov 4); 2014: 106102 ~ FULL TEXT

Lise Hestbaek, Anders Munck, Lisbeth Hartvigsen,
Dorte Ejg Jarbøl, Jens Søndergaard, and Alice Kongsted

Department of Sports Science and Clinical Biomechanics,
University of Southern Denmark,
5230 Odense, Denmark
l.hestbaek@nikkb.dk

Study Design. Baseline description of a multicenter cohort study.

Objective. To describe patients with low back pain (LBP) in both chiropractic and general practice in Denmark.

Background. To optimize standards of care in the primary healthcare sector, detailed knowledge of the patient populations in different settings is needed. In Denmark, most LBP-patients access primary healthcare through chiropractic or general practice.

Methods. Chiropractors and general practitioners recruited adult patients seeking care for LBP. Extensive baseline questionnaires were obtained and descriptive analyses presented separately for general and chiropractic practice patients, Mann-Whitney rank sum test and Pearson’s chi-square test, were used to test for differences between the two populations.

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Low Back Pain and Chiropractic Page

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Altered Central Integration of Dual Somatosensory Input After Cervical Spine Manipulation

By Frank M. Painter|October 9, 2015|Chiropractic Care, Spinal Manipulation, Subluxation|

Altered Central Integration of Dual Somatosensory Input After Cervical Spine Manipulation

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2010 (Mar); 33 (3): 178–188 ~ FULL TEXT

Heidi Haavik Taylor, PhD, BSc, Bernadette Murphy, PhD, DC

Director of Research,
New Zealand College of Chiropractic,
Auckland, New Zealand.
heidi.taylor@nzchiro.co.nz

OBJECTIVE: The aim of the current study was to investigate changes in the intrinsic inhibitory interactions within the somatosensory system subsequent to a session of spinal manipulation of dysfunctional cervical joints.

METHOD: Dual peripheral nerve stimulation somatosensory evoked potential (SEP) ratio technique was used in 13 subjects with a history of reoccurring neck stiffness and/or neck pain but no acute symptoms at the time of the study. Somatosensory evoked potentials were recorded after median and ulnar nerve stimulation at the wrist (1 millisecond square wave pulse, 2.47 Hz, 1 x motor threshold). The SEP ratios were calculated for the N9, N11, N13, P14-18, N20-P25, and P22-N30 peak complexes from SEP amplitudes obtained from simultaneous median and ulnar (MU) stimulation divided by the arithmetic sum of SEPs obtained from individual stimulation of the median (M) and ulnar (U) nerves.

RESULTS: There was a significant decrease in the MU/M + U ratio for the cortical P22-N30 SEP component after chiropractic manipulation of the cervical spine. The P22-N30 cortical ratio change appears to be due to an increased ability to suppress the dual input as there was also a significant decrease in the amplitude of the MU recordings for the same cortical SEP peak (P22-N30) after the manipulations. No changes were observed after a control intervention.

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What is the Chiropractic Subluxation Page and the:

Chronic Neck Pain and Chiropractic Page

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A Proposed Model With Possible Implications for Safety and Technique Adaptations for Chiropractic Spinal Manipulative Therapy for Infants and Children

By Frank M. Painter|October 2, 2015|Pediatrics|

A Proposed Model With Possible Implications for Safety and Technique Adaptations for Chiropractic Spinal Manipulative Therapy for Infants and Children

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2013 (Jul 8) [Epub] ~ FULL TEXT

Aurélie M. Marchand, DC, MScACPP

Doctor of Chiropractic,
Private Practice,
Padova, Italy.
aureliemarchand@hotmail.com

OBJECTIVE: A literature review of tensile strength of adults and pediatric human spine specimens was performed to gather information about biomechanical forces and spinal differences of adults and children and to synthesize these findings into a scaling model to guide safety and clinical decisions for spinal manipulative therapy (SMT) for children and infants.

METHODS: The literature search was performed using PubMed from inception to November 2012 with no filters or language restrictions. The search included terms related to pediatric spine biomechanics and tensile strength. Studies included those in which human tensile strengths necessary to create anatomical damage in the cervical, thoracic, or lumbar spine of pediatric human subjects were recorded. The pediatric population was defined as human subjects from birth to 18 years old. Biomechanical findings were used to propose a scaling model based on specimen age and differences in tensile strengths. A model of care was proposed using the scaling model and the existing literature on pediatric technique adaptations.

RESULTS: Nine experimental studies were selected, 5 in the pediatric population (46 specimens) and 4 in the adult population (47 specimens). Mean tensile strengths were estimated, and ratios were used to describe differences between 4 age groups. The preliminary model of care proposed includes maximum loading forces by age group. From these studies, a model showed a nonlinear increase in the cervical spine tensile strengths based on specimen age.

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Chiropractic Pediatrics Section

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Prognostic Factors for Recurrences in Neck Pain Patients Up to 1 Year After Chiropractic Care

By Frank M. Painter|September 28, 2015|Chronic Pain, Neck Pain|

Prognostic Factors for Recurrences in Neck Pain Patients Up to 1 Year After Chiropractic Care

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2015 (Sep 15 ~ FULL TEXT

Anke Langenfeld, MS, B. Kim Humphreys, DC, PhD,
Jaap Swanenburg, PhD, Cynthia K. Peterson, RN, DC, MMedEd, PhD

PhD Student,
CAPHRI School of Public Health and Primary Care,
Department of Epidemiology,
Maastricht University,
Maastricht, The Netherlands

OBJECTIVE: Information about recurrence and prognostic factors is important for patients and practitioners to set realistic expectations about the chances of full recovery and to reduce patient anxiety and uncertainty. Therefore, the purpose of this study was to assess recurrence and prognostic factors for neck pain in a chiropractic patient population at 1 year from the start of the current episode.

METHODS: Within a prospective cohort study, 642 neck pain patients were recruited by chiropractors in Switzerland. After a course of chiropractic therapy, patients were followed up for 1 year regarding recurrence of neck pain. A logistic regression analysis was used to assess prognostic factors for recurrent neck pain. The independent variables age, pain medication usage, sex, work status, duration of complaint, previous episodes of neck pain and trauma onset, numerical rating scale, and Bournemouth questionnaire for neck pain were analyzed. Prognostic factors that have been identified in previous studies to influence recovery of neck pain are psychologic distress, poor general health at baseline, and a previous history of pain elsewhere.

RESULTS: Five hundred forty five patients (341 females), with a mean age of 42.1 years (SD, 13.1) completed the 1-year follow-up period. Fifty-four participants (11%) were identified as “recurrent.” Prognostic factors associated with recurrent neck pain were previous episodes of neck pain and increasing age.

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Chronic Neck Pain and Chiropractic Page

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About Frank M. Painter

Chiropractic and Complementary and Alternative Medicine

Chiropractic and CAM Utilization: A Descriptive Review

Chiropractic Use of Somatosensory Evoked Potentials (SEPs) in Research

The Origin, and Application of Somatosensory Evoked Potentials as a Neurophysiological Technique to Investigate Neuroplasticity

Low Back Pain in Primary Care: A Description of 1250 Patients

Low Back Pain in Primary Care: A Description of 1250 Patients with Low Back Pain in Danish General and Chiropractic Practice

Altered Central Integration of Dual Somatosensory Input After Cervical Spine Manipulation

Altered Central Integration of Dual Somatosensory Input After Cervical Spine Manipulation

A Proposed Model With Possible Implications for Safety and Technique Adaptations for Chiropractic Spinal Manipulative Therapy for Infants and Children

A Proposed Model With Possible Implications for Safety and Technique Adaptations for Chiropractic Spinal Manipulative Therapy for Infants and Children

Prognostic Factors for Recurrences in Neck Pain Patients Up to 1 Year After Chiropractic Care

Prognostic Factors for Recurrences in Neck Pain Patients Up to 1 Year After Chiropractic Care