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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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Exploring Patient Satisfaction

By |September 24, 2014|Chiropractic Care, Patient Satisfaction|

Exploring Patient Satisfaction: A Secondary Analysis of a Randomized Clinical Trial of Spinal Manipulation, Home Exercise, and Medication for Acute and Subacute Neck Pain

The Chiro.Org Blog

SOURCE:   J Manipulative Physiol Ther 2014 (Sep 5)

Brent D. Leininger, DC, Roni Evans, DC, PhD,
Gert Bronfort, DC, PhD

Research Fellow, Integrative Health & Wellbeing Research Program,
Center for Spirituality & Healing, University of Minnesota,
Minneapolis, MN.
lein0122@umn.edu

OBJECTIVE:   The purpose of this study was to assess satisfaction with specific aspects of care for acute neck pain and explore the relationship between satisfaction with care, neck pain, and global satisfaction.

METHODS:   This study was a secondary analysis of patient satisfaction from a randomized trial of spinal manipulation therapy (SMT) delivered by doctors of chiropractic, home exercise and advice (HEA) delivered by exercise therapists, and medication (MED) prescribed by a medical doctors for acute/subacute neck pain. Differences in satisfaction with specific aspects of care were analyzed using a linear mixed model. The relationship between specific aspects of care and (1) change in neck pain (primary outcome of the randomized trial) and (2) global satisfaction were assessed using Pearson’s correlation and multiple linear regression.

RESULTS:   Individuals receiving SMT or HEA were more satisfied with the information and general care received than MED group participants. Spinal manipulation therapy and HEA groups reported similar satisfaction with information provided during treatment; however, the SMT group was more satisfied with general care. Satisfaction with general care (r = -0.75 to -0.77; R2 = 0.55-0.56) had a stronger relationship with global satisfaction compared with satisfaction with information provided (r = -0.65 to 0.67; R2 = 0.39-0.46). The relationship between satisfaction with care and neck pain was weak (r = 0.17-0.38; R2 = 0.08-0.21).

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Patient Satisfaction With Chiropractic Page

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The Cellular and Molecular Biology of the Intervertebral Disc:A Clinician’s Primer

By |September 21, 2014|Continuing Education, Disc Injury|

The Cellular and Molecular Biology of the Intervertebral Disc: A Clinician’s Primer

The Chiro.Org Blog

SOURCE:   J Can Chiropr Assoc. 2014 (Sep);   58 (3):   246–257

W. Mark Erwin, DC, PhD and Katherine E. Hood, DC

Assistant Professor, Divisions of Neurological and Orthopaedic Surgery,
University of Toronto, Toronto Western Hospital;
Scientist, Toronto Western Research Institute;
Associate Professor, Research Canadian Memorial Chiropractic College.

Clinicians routinely encounter patients suffering from both degenerative and acute spinal pain, often as a consequence of pathology affecting the intervertebral disc (IVD). The IVD is a complex structure essential to spinal function and is subject to degenerative disease and injury. However, due to the complexity of spinal pain syndromes it is often difficult to determine the extent of the IVD’s contribution to the genesis of spinal pain. The location of the IVD is within close proximity to vital neural elements and may in the event of pathological change or injury compromise those structures. It is therefore important that clinicians performing manual therapy understand the cellular and molecular biology of the IVD as well as its clinical manifestation of degeneration/injury in order to safely manage and appreciate the role played by the disc in the development of mechanical spinal pain syndromes.

Keywords:   spine, degenerative, pain, disc, intervertebral

 

The Full-Text Article:

Introduction:

The intervertebral disc (IVD) is a complex structure positioned between two adjacent vertebrae where in addition to protecting the spinal cord and segmental spinal nerves it confers flexibility, multi-axial spinal motion and load transmission to the spine. The IVD is vulnerable to injury and degeneration often leading to pain syndromes however much remains to be discovered concerning the development of axial and radicular pain syndromes, the biology of the disc and the capacity of the IVD to repair itself after injury. [1] From the clinician’s perspective, familiarity with the biology of the IVD is vital in order to understand the natural history of disc-related injury/illness and to develop appropriate therapeutic strategies. The purpose of this review is to provide an overview of the salient characteristics of IVD pathology with a particular emphasis upon degenerative disease and its role in the generation of clinical spinal pain syndromes.

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Disc Herniation and Chiropractic Page

The disc as an organ:

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Chiropractic Treatment Helps Back-Related Leg Pain

By |September 16, 2014|Chiropractic Care, Low Back Pain|

Chiropractic Treatment Helps Back-Related Leg Pain

The Chiro.Org Blog

Spinal Manipulation and Home Exercise With Advice for Subacute and Chronic Back-Related Leg Pain: A Trial With Adaptive Allocation

SOURCE:   Annals of Internal Medicine 2014 (Sep 16); 161 (6): 381—391

Gert Bronfort, DC, PhD; Maria A. Hondras, DC, MPH;
Craig A. Schulz, DC, MS; Roni L. Evans, DC, PhD;
Cynthia R. Long, PhD; and Richard Grimm, MD, PhD

University of Minnesota,
Northwestern Health Sciences University,
and Berman Center for Outcomes and Clinical Research
at the Minneapolis Medical Research Foundation,
Minneapolis, Minnesota, and
Palmer Center for Chiropractic Research,
Davenport, Iowa

Chiropractic Treatment Helps Back-Related Leg Pain
FROM:   MedPage Today ~ September 16, 2014
By Shara Yurkiewicz , Staff Writer, MedPage Today

 

Patients with back-related leg pain who received spinal manipulative therapy (SMT) plus home exercise and advice (HEA) had less leg pain, lower back pain, and disability after 12 weeks than patients who received home exercise and advice alone, researchers reported.

At 1 year, those differences were no longer significant, wrote Gert Bronfort, DC, PhD, at Northwestern Health Sciences University in Bloomington, Minn., and colleagues in a study appearing in Annals of Internal Medicine. But patients experienced more global improvement, higher satisfaction, and lower medication use, the researchers reported.

The findings suggest that SMT in addition to HEA could be a safe and effective conservative, short-term treatment approach for back-related leg pain, the authors said.

“Prior to this study, SMT was considered a viable treatment option of what is known as ‘uncomplicated low back pain,’ which is low back pain without radiating pain to the leg,” authors Bronfort and Roni Evans, DC, PhD, at the University of Minnesota in Minneapolis, wrote in an email to MedPage Today.

“This study shows that for patients without progressive neurological deficits and serious identifiable causes (e.g., spinal fracture, etc.) SMT, coupled with home exercise and advice, may be helpful, and should be considered,” they added.

 

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Low Back Pain and Chiropractic Page

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Adherence to Clinical Practice Guidelines Among Three Primary Contact Professions

By |September 5, 2014|Chiropractic Care, Clinical Decision-making, Evidence-based Medicine, Guidelines|

Adherence to Clinical Practice Guidelines Among Three Primary Contact Professions: A Best Evidence Synthesis of the Literature for the Management of Acute and Subacute Low Back Pain

The Chiro.Org Blog

SOURCE:   J Can Chiropr Assoc 2014 (Sept);   58(3):   220–237

Lyndon G. Amorin-Woods, B.App.Sci (Chiropractic)
Randy W. Beck, BSc (Hons), DC, PhD, DACNB, FAAFN, FACFN, Gregory F. Parkin-Smith, MTech(Chiro), MBBS, MSc, DrHC, James Lougheed, BA (Hons), Alexandra P. Bremner, BSc (Hons), DipEd, GradDipAppStats, PhD

Senior Clinical Supervisor, School of Health Professions
Murdoch University
Enrolled student, Master of Public Health
School of Population Health Faculty of Medicine, Dentistry and Health Sciences
The University of Western Australia

Aim:   To determine adherence to clinical practice guidelines in the medical, physiotherapy and chiropractic professions for acute and subacute mechanical low back pain through best-evidence synthesis of the healthcare literature.

Methods:   A structured best-evidence synthesis of the relevant literature through a literature search of relevant databases for peer-reviewed papers on adherence to clinical practice guidelines from 1995 to 2013. Inclusion of papers was based on selection criteria and appraisal by two reviewers who independently applied a modified Downs & Black appraisal tool. The appraised papers were summarized in tabular form and analysed by the authors.

Results:   The literature search retrieved 23 potentially relevant papers that were evaluated for methodological quality, of which 11 studies met the inclusion criteria. The main finding was that no profession in the study consistently attained an overall high concordance rating. Of the three professions examined, 73% of chiropractors adhered to current clinical practice guidelines, followed by physiotherapists (62%) and then medical practitioners (52%).

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Practice Guidelines Page and the:

Evidence-based Practice Page

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Nutritional Factors Affecting Postpartum Depression

By |August 5, 2014|Nutrient Deficiency, Postpartum Depression, Supplementation|

Nutritional Factors Affecting Postpartum Depression

The Chiro.Org Blog

SOURCE:   J Clin Chiropractic Pediatrics 2011 (Jun);   12 (1):   849–860

Lia M. Nightingale, PhD

Assistant Professor, Division of Life Sciences,
Palmer College of Chiropractic,
1000 Brady Street, Davenport, IA 52803, USA.
Email: lia.nightingale@palmer.edu

Pregnancy and lactation represent a period of substantial physiological changes for the mother and increased nutritional requirements to meet these adjustments. A number of nutritional depletions occur during pregnancy. Serum concentrations of iron and folate take months before they normalize to pre-pregnancy levels. Additionally, many micronutrients required during pregnancy interfere with each other, making absorption difficult. Postpartum depression is the primary complication of childbirth, possibly caused by several nutritional and non-nutritional factors. The current review highlights the impact nutrition may have on the etiology of this debilitating disorder, most notably on prevention of inflammation and maintenance of a healthy central nervous system. The most notable nutritional deficiencies associated with postpartum depression include omega-3 fatty acids, folate, iron, and zinc; however, supplementation trials for prevention of postpartum depression are severely lacking. Practical recommendations are given to minimize micronutrient interference and reduce the risk of postpartum depression.

Key Words:   postpartum depression, nutrition, diet, folate, essential fatty acids, iron, zinc

 

From the Full-Text Article:

Introduction

Depression is the second leading cause of disability for those of reproductive age. [1] Although all forms of depression are devastating, postpartum depression (PPD) has long-lasting consequences for all family members involved. Postpartum depression is the most common complication of childbirth, defined as having major or minor depressive episodes that occur within 12 months after delivery. [2, 3] Postpartum depression has been associated with impaired mother-child interactions, poorer child development, and more violent behavior in children with mothers displaying PPD. [4-6]

Pregnancy is a time of increased nutritional requirements to support fetal growth and development. There are several lines of thought concerning the cause of PPD, including the link between nutritional intake and risk of depression. Therefore, the goal of this review is to examine maternal depletion of nutrients, assess whether these nutritional factors may play a role in PPD, and summarize simple recommendations to implement in practice.

Prevalence

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Women’s Health Page and the:

Chiropractic Pediatrics Page

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