Frank M. Painter

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

By Frank M. Painter|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

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…)

0

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

By Frank M. Painter|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 (F_1,840 = 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…)

0

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

By Frank M. Painter|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…)

0

Chiropractic Care for Workers with Low Back Pain

By Frank M. Painter|December 31, 2023|Chiropractic Management, Cost-Effectiveness of Chiropractic, Workers' Compensation|

Chiropractic Care for Workers with Low Back Pain

The Chiro.Org Blog

SOURCE: Workers Compensation Research Institute (May 17, 2022)
Dongchun Wang, Kathryn Mueller, Randall Lea, M.D., Donald R. Murphy

Related Topics: Medical Costs, Outcomes for Injured Workers, Physical Medicine, Utilization

Cambridge, MA, May 17, 2022 — Today, the Workers Compensation Research Institute (WCRI) announced the release of a new study on chiropractic care for low back pain. The study reveals substantial variation in the use of chiropractic care across 28 states and offers insights into the patterns and outcomes of chiropractic care.

“Chiropractors often participate in the delivery of physical medicine services for low back pain, but few workers received chiropractic care in states where employers or insurers control the selection of providers,” said John Ruser, WCRI’s president and CEO. “This study will be helpful for policymakers and stakeholders who are interested in re-evaluating the role of chiropractors, especially those who have been adopting evidence-based practices and contributing to cost-effective care.”

This study, Chiropractic Care for Workers with Low Back Pain, describes the prevalence of chiropractic care and provider patterns of physical medicine treatment for workers with low back pain. It provides some evidence as to how different provider patterns of physical medicine treatment are associated with variations in overall medical and indemnity costs, and the duration of temporary disability. The study also looks at the utilization of medical services, including magnetic imaging studies, opioid prescriptions, and pain management injections.

The following is a sample of the study’s key findings:

There are more articles like this @

WORKERS’ COMPENSATION Section

(more…)

0

International Peer-reviewed Chiropractic Pediatric History and Examination Forms for the Infant, Child, and Adolescent

By Frank M. Painter|December 29, 2023|Chiropractic Assessment, Office Forms|

International Peer-reviewed Chiropractic Pediatric History and Examination Forms for the Infant, Child, and Adolescent

The Chiro.Org Blog

SOURCE: J Clinical Chiropractic Pediatrics 2023 (Jun); 22 (1): 1958

OPEN ACCESS

Sue A. Weber BSc, DC, MScAPP

Chairperson/faculty European Academy Chiropractic
special interest group in pediatrics (FEAC)
Faculty Royal College of Chiropractors Pediatrics (FRCC)
Practitioner, Stockholm Sweden

The assessment of the pediatric patient is a specialized area of chiropractic practice, requiring additional knowledge and skills. In recognition of this, European Academy of Chiropractors’ special interest group for pediatrics together with an international group of pediatric musculoskeletal experts have expanded on the previously published basic history and examination forms for infants, children and adolescents. The aim of these forms is to further assist the chiropractor in identifying red flags and differentially diagnosing problems in musculoskeletal and mental health as they present throughout growth and development. The process of development of the forms is outlined, and the three forms are presented in this article.

Keywords: chiropractic pediatric, pediatric history form, pediatric examination form, pediatric red flags, pediatric musculoskeletal health.

From the Full-Text Article:

There are more articles like this @

PEDIATRICS Section

(more…)

0

A Systems Approach for Assessing Low Back Pain Care Quality in Veterans Health Administration Chiropractic Visits: A Cross-Sectional Analysis

By Frank M. Painter|December 28, 2023|Chiropractic Management, Veterans|

A Systems Approach for Assessing Low Back Pain Care Quality in Veterans Health Administration Chiropractic Visits: A Cross-Sectional Analysis

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther 2023 (Dec 22) [EPUB]

OPEN ACCESS

Ryan D. Muller, DC, MS • Sarah E. Graham, DC • Xiwen Zhao, MSPH • Anna R. Sites, MSN, RN • Kelsey L. Corcoran, DC • Anthony J. Lisi, DC

VA Connecticut Healthcare System,
West Haven, Connecticut;
Yale School of Medicine,
Yale University,
New Haven, Connecticut.

Objective: The purpose of this study was to explore a systemwide process for assessing components of low back pain (LBP) care quality in Veterans Health Administration (VHA) chiropractic visits using electronic health record (EHR) data.

thods: MeWe performed a cross-sectional quality improvement project. We randomly sampled 1000 on-station VHA chiropractic initial visits occurring from October 1, 2017, to September 30, 2018, for patients with no such visits within the prior 12 months. Characteristics of LBP visits were extracted from VHA national EHR data via structured data queries and manual chart review. We developed quality indicators for history and/or examination and treatment procedures using previously published literature and calculated frequencies of visits meeting these indicators.

There is more like this @

LOW BACK PAIN Section and

CHIROPRACTIC CARE FOR VETERANS Section

(more…)

0

About Frank M. Painter

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

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

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

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

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

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

Chiropractic Care for Workers with Low Back Pain

Chiropractic Care for Workers with Low Back Pain

International Peer-reviewed Chiropractic Pediatric History and Examination Forms for the Infant, Child, and Adolescent

International Peer-reviewed Chiropractic Pediatric History and Examination Forms for the Infant, Child, and Adolescent

A Systems Approach for Assessing Low Back Pain Care Quality in Veterans Health Administration Chiropractic Visits: A Cross-Sectional Analysis

A Systems Approach for Assessing Low Back Pain Care Quality in Veterans Health Administration Chiropractic Visits: A Cross-Sectional Analysis