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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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Brain Impact: Concussions, Chiropractic and New Laws

By |January 3, 2012|Concussion, Education, Traumatic Brain Injury|

Brain Impact: Concussions, Chiropractic and New Laws

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic

By Robert “Skip” George, DC, CCSP, CSCS

Concussions are (finally) getting the attention of the athletic world, state governments and health care providers of all disciplines.

On Oct. 23, 2011, San Diego Chargers offensive guard Kris Dielman suffered a concussion during a football game against the New York Jets with 12:31 left to play.

He landed hard on the ground after a wicked collision with a Jets linebacker, then got up, wobbled and went back to playing the rest of the game, taking several more hits to the head. Neither the Chargers training staff nor the NFL referees recognized how serious his head injury was as he “waved off” his sideline training staff to return to the huddle. On the flight home to San Diego after the game, Dielman suffered a “grand mal” seizure and will most likely not play for the rest of the season.

Magnitude of the Problem

Concussions are getting much-needed attention in the press, especially given the short- and long-term cognitive loss, early-onset dementia, physical disability and even death resulting from traumatic brain injury (TBI). Chronic traumatic encephalopathy is a chronic, degenerative neurologic disease linked to repetitive head trauma and is known as an invisible killer that can make a 35-year-old brain look more like 80 years old.

There are 250,000 concussions annually in football alone. The prevalence in high-school and college athletics is a major concern, especially considering how big, fast and strong high-school and college athletes have become, and how their play emulates the professionals. This “evolution” is exacting a terrible toll regarding TBI in not only football, but also soccer, hockey, wrestling, water polo and cheerleading.

 

Three Purdue University professors tracked 21 football players from Lafayette Jefferson High School in Indiana. For two years they kept a record of every hit in practice and during games. They found that half of the players had neurophysiologic changes from contact. They also discovered that the repetitive hits the players were receiving had a cumulative effect on the brain and resulted in brain wave changes that mimicked concussion, even when the contact did not result in a concussion!

Concussion Basics

What is a concussion? It can be defined as “a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces” or “an immediate and transient loss of neuronal function secondary to trauma.” Signs and symptoms include but are not limited to thinking deficits, lack of sustained attention; amnesia; confused mental status; dazed look / vacant stare; slurred or incoherent speech; vomiting; nausea; emotional liability; slow motor or verbal response; memory deficits; poor coordination; dizziness; headache; restlessness; nervous weakness; exhaustion; and irritability. (more…)

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A Systematic Review and Meta-analysis of Efficacy, Cost-effectiveness, and Safety of Selected Complementary and Alternative Medicine for Neck and Low-back Pain

By |January 2, 2012|Low Back Pain, Neck Pain, Spinal Manipulation|

A Systematic Review and Meta-analysis of Efficacy, Cost-effectiveness, and Safety of Selected Complementary and Alternative Medicine for Neck and Low-back Pain

The Chiro.Org Blog

SOURCE:   Evid Based Complement Alternat Med [Epub 2011 Nov 24]

Andrea D. Furlan, Fatemeh Yazdi, Alexander Tsertsvadze, * Anita Gross, Maurits Van Tulder, Lina Santaguida, Joel Gagnier, Carlo Ammendolia, Trish Dryden, Steve Doucette, Becky Skidmore, Raymond Daniel, Thomas Ostermann, and Sophia Tsouros

Clinical Epidemiology Methods Centre,
Ottawa Hospital Research Institute,
University of Ottawa Evidence-Based Practice Center,
Box 208, Ottawa, ON, Canada K1H 8L6

Background: Back pain is a common problem and a major cause of disability and health care utilization.

Purpose: To evaluate the efficacy, harms, and costs of the most common CAM treatments (acupuncture, massage, spinal manipulation, and mobilization) for neck/low-back pain.

Data Sources: Records without language restriction from various databases up to February 2010.

Data Extraction: The efficacy outcomes of interest were pain intensity and disability.

Data Synthesis: Reports of 147 randomized trials and 5 non-randomized studies were included. CAM treatments were more effective in reducing pain and disability compared to no treatment, physical therapy (exercise and/or electrotherapy) or usual care immediately or at short-term follow-up. Trials that applied sham-acupuncture tended towards statistically non-significant results. In several studies, acupuncture caused bleeding on the site of application, and manipulation and massage caused pain episodes of mild and transient nature.

Conclusions: CAM treatments were significantly more efficacious than no treatment, placebo, physical therapy, or usual care in reducing pain immediately or at short-term after treatment. CAM therapies did not significantly reduce disability compared to sham. None of the CAM treatments was shown systematically as superior to one another. More efforts are needed to improve the conduct and reporting of studies of CAM treatments.

Introduction:

Back pain is a general term that includes neck, thoracic, and lower-back spinal pain. In the majority of cases, the aetiology of back pain is unknown and therefore is considered as “nonspecific back pain”. Back pain is considered “specific” if its aetiology is known (e.g., radiculopathy, discogenic disease). Although back pain is usually self-limited and resolves within a few weeks, approximately 10% of the subjects develop chronic pain, which imposes large burden to the health-care system, absence from work, and lost productivity [1]. In a recent study, the direct costs of back pain related to physician services, medical devices, medications, hospital services, and diagnostic tests were estimated to be US$ 91 billion or US$ 46 per capita [2]. Indirect costs related to employment and household activities were estimated to be between US$ 7 billion and US$ 20 billion, or between US$25 and US$ 71 per capita, respectively [3–5]. One study published in 2007 showed that the 3-month prevalence of back and/or neck pain in USA was 31% (low-back pain: 34 million, neck pain: nine million, both back and neck pain: 19 million) [6]. (more…)

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Chiropractic Management of Post-concussion Headache and Neck Pain In a Young Athlete and Implications For Return-To-Play

By |January 1, 2012|Diagnosis|

Chiropractic Management of Post-concussion Headache and Neck Pain In a Young Athlete and Implications For Return-To-Play

The Chiro.Org Blog

SOURCE:   Topics in Integrative Health Care 2011 (Oct 7); 2 (3)

Mark T. Pfefer, RN, MS, DC, Stephen R. Cooper, DC,
Angela M. Boyazis

Director of Research,
Cleveland Chiropractic College

Objective: Each year there are an estimated 1.6 to 3.8 million sports-related brain injuries; 136,000 of which occur in young athletes in the course of high school sports. The purpose of this article is to discuss the management and outcome of a post-concussive headache and neck pain in a young athlete and implications for return to play.

Clinical Features: A 16-year-old male athlete presented to a chiropractic clinic complaining of neck pain and daily headaches from a concussion while playing football 5 weeks previously.

Intervention and Outcome: A short course of diversified-type cervical and thoracic manipulation was applied with significant relief after the second treatment and resolution of symptoms after 5 visits performed over 2 weeks. The athlete was able to participate in a graduated return to play. Three months post-SRC the athlete was able to return to full game play symptom free.

Conclusion: Chiropractors who see athletes in their practices should be aware of SRC and return to play guidelines.

Introduction

Recently attention has been focused on sports-related concussions (SRC), in part due to the untimely concussion-related deaths of high school athletes, cognitive problems in professional football players, and head injuries sidelining professional hockey players for extended periods of time. Understanding the signs and symptoms of SRC and appropriate return-to-play recommendations is imperative to the safety of all athletes and young athletes in particular.

Each year in the United States, there are an estimated 1.6 to 3.8 million sports-related brain injuries; [1] 136,000 of which occur in young athletes in the course of high school sports. [2] However, these statistics may be grossly underestimated. McCrea and colleagues [3] found over half of a sample of high school football players did not report a head injury, even though it had occurred. One of the reasons for this is a failure of athletes to recognize their injury as significant. Delany and coworkers [4, 5] found that only 18.8% to 23.4% of concussed players in the Canadian Football League, and Canadian university football and soccer players realized they had sustained a concussion. Another factor in the underestimation of SRCs is the reporting of head injuries to untrained personnel, such as coaches or parents, who in turn may fail to recognize a concussion. [3, 6, 7]

There are many more articles like this @:

Headache and Chiropractic Page

(more…)

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Zen and the Art of Chiropractic Maintenance

By |December 29, 2011|Cost-Effectiveness, Maintenance Care|

Zen and the Art of Chiropractic Maintenance
An Inquiry Into Health Care Values

The Chiro.Org Blog

SOURCE:   Dynamic Chiropractic

By Anthony Rosner, PhD, LLD [Hon.], LLC

With all due respect to Robert Pirsig’s classic tome of the 1970s, [1] the book title couldn’t be more appropriately applied to both the state and lack of recognition of chiropractic health care.

As Pirsig explains in his introduction, the book itself isn’t an expostulation on orthodox Zen Buddhist philosophies, or for that matter motorcycles. Rather, it describes a journey with philosophical reflections along the way.

The same might be said of chiropractic’s own journey, in this case seeking proper recognition. In particular, chiropractic from the point of view of a variety of third-party payers has been repeatedly turned down for reimbursement when it comes to matters of maintenance or preventive therapy. Completely counterintuitive, you might say, in light of the repeated and sometimes urgent declarations that we hear to the effect that the only way to control the runaway costs and inefficiency of American health care is to emphasize preventive care, placing it at the highest rather than lowest priority of interventions. [2]

The evidence from recent research clearly demonstrates that the provision of maintenance or preventive measures from chiropractors appears to deliver tangible benefits, with major impacts upon our health care system:

Cost-Effectiveness

As part of a comprehensive geriatric assessment program, the RAND Corporation studied a subpopulation of patients who were under chiropractic care compared to those who were not, and found that the individuals under continuing chiropractic care were:

  • free from the use of a nursing home (95.7 percent vs. 80.8 percent);
  • free from hospitalizations for the past 23 years (73.9 percent vs. 52.4 percent);
  • more likely to report a better health status;
  • more likely to exercise vigorously;
  • and more likely to be mobile in the community (69.6 percent vs. 46.8 percent).

Although it is impossible to clearly establish causality, it is clear that continuing chiropractic care is among the attributes of the cohort of patients experiencing substantially fewer costly health care interventions. [3] (more…)

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Humorous Haiku

By |December 28, 2011|Humor|

Humorous Haiku

The Chiro.Org Blog

And now for something completely different…

Sound Familiar?

The web site you seek
Cannot be located but
Countless more exist.

 

 

Computer Nightmare

A crash reduces
Your expensive computer
To a simple stone.

 

 

Dead Monitors

First snow, then silence.
This thousand-dollar screen dies
So beautifully.

 

 

Computer Nightmare II

Three things are certain:
Death, taxes, and lost data.
Guess which has occurred.

 

 

Lost Data

You step in the stream,
But the water has moved on.
This page is not here.

 

 

Computer Nightmare III

Out of memory.
We wish to hold the whole sky,
But we never will

 

 

Like a bird

I wish I could fly,
especially this moment.
High-speed police chase

 

 

Dad’s Advice

My dad once told me
son, you need to get a job.
What was he thinking?

 

 

Special thanks to:
Humorous Haiku,   Computer Haiku,   Humorous Haiku II

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