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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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Clinical Examination Findings as Prognostic Factors in Low Back Pain

By |November 24, 2017|Clinical Decision-making|

Clinical Examination Findings as Prognostic Factors in Low Back Pain: A Systematic Review of the Literature

The Chiro.Org Blog

SOURCE:   Chiropractic & Manual Therapies 2015 (Mar 23); 23: 13

Lisbeth Hartvigsen, Alice Kongsted, and Lise Hestbaek

Department of Sports Science and Clinical Biomechanics,
University of Southern Denmark,
Odense, Denmark.

BACKGROUND:   There is a strong tradition of performing a clinical examination of low back pain (LBP) patients and this is generally recommended in guidelines. However, establishing a pathoanatomic diagnosis does not seem possible in most LBP patients and clinical tests may potentially be more relevant as prognostic factors. The aim of this review of the literature was to systematically assess the association between low-tech clinical tests commonly used in adult patients with acute, recurrent or chronic LBP and short- and long-term outcome.

METHODS:   MEDLINE, Embase, and MANTIS were searched from inception to June 2012. Prospective clinical studies of adult patients with LBP with or without leg pain and/or signs of nerve root involvement or spinal stenosis, receiving non-surgical or no treatment, which investigated the association between low-tech clinical tests and outcome were included. Study selection, data extraction and appraisal of study quality were performed independently by two reviewers.

RESULTS:   A total of 5,332 citations were retrieved and screened for eligibility, 342 articles were assessed as full text and 49 met the inclusion criteria. Due to clinical and statistical heterogeneity, qualitative synthesis rather than meta-analysis was performed. Associations between clinical tests and outcomes were often inconsistent between studies. In more than one third of the tests, there was no evidence of the tests being associated with outcome. Only two clinical tests demonstrated a consistent association with at least one of the outcomes: centralization and non-organic signs.

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Low Back Pain and Chiropractic Page

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Clinical Prediction Rule Page

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The Infant with Dysfunctional Feeding Patterns

By |November 21, 2017|Breastfeeding Dysfunction|

The Infant with Dysfunctional Feeding Patterns – The Chiropractic Assessment

The Chiro.Org Blog

SOURCE:   J Clin Chiropractic Pediatrics 2016 (May);   15 (2)

Sharon Vallone, DC, FICCP and
Faraneh Carnegie-Hargreaves, DC

Private practice,
South Windsor,
Connecticut, USA

The World Health Organization recommends exclusive breastfeeding for the first 6 months of an infant’s life, followed by the introduction of complementary foods while breastfeeding for 2 years and beyond. Early and consistent breastfeeding support can often make the difference in a dyad’s ability to establish a functional breastfeeding relationship. While challenged dyads can sometimes accomplish competent breastfeeding given appropriate support, necessary interventions, and an opportunity to learn; timing is critical when a neonate has not been transferring adequate milk volume or is managing feeding in a passive or compensatory manner.

Chiropractors should be most familiar with the diagnosis and treatment of musculoskeletal dysfunctions that could result in an inability to feed. They should also recognize and treat the compensatory changes that will develop in a healthy, neurotypical neonate who is challenged by an inability to feed efficiently in order to prevent the evolution of long term physiologic and postural ramifications.

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Evaluation and Treatment of Breastfeeding Difficulties

By |November 18, 2017|Breastfeeding Dysfunction|

Evaluation and Treatment of Breastfeeding Difficulties Associated with Cervicocranial Dysfunction:
A Chiropractic Perspective

The Chiro.Org Blog

SOURCE:   J Clin Chiropractic Pediatrics 2016 (Dec); 15 (3): 1301

Sharon Vallone, DC, FICCP

Private Practice,
KIDSPACE Adaptive Play and Wellness,
South Windsor, Connecticut, USA

Increasingly, parents are presenting to the chiropractic office with the chief complaint of breastfeeding dysfunction. Early and consistent breastfeeding support is paramount to the dyad’s ability to establish a functional breastfeeding relationship. It is critical that chiropractors treating this population recognize feeding dysfunction and understand the mechanics of breastfeeding, what might alter those mechanics, and the importance of the role of the International Board Certified Lactation Consultant (IBCLC) in supporting the restoration of functional breastfeeding after the chiropractic adjustments have reduced the neuromusculoskeletal (NMSK) dysfunction. This paper outlines some of the mechanical dysfunctions that might interfere with the normal transfer of milk for a neonate.

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Prevalence of Musculoskeletal Dysfunction in Infants

By |November 17, 2017|Musculoskeletal Dysfunction|

Prevalence of Musculoskeletal Dysfunction in Infants Presenting for Chiropractic Care in Norway: A Cross-sectional Study

The Chiro.Org Blog

SOURCE:   J Clin Chiropractic Pediatrics 2017 (Sep); 16(1): 1355

Catherin Alvestad Slettebo, DC, MSc, Joyce E. Miller, DC, PhD

AECC University,
Bournemouth, UK

Background:   Musculoskeletal (MSK) injuries are common though considered under-recognized at birth. There are no gold standard routines for examination of the musculoskeletal system in infants, and very little research that investigates clinical examination and MSK findings in infants under the age of six months.

Objectives:   The objectives were to determine the prevalence of neck dysfunction, postural spine problems, and their possible association with parent reported behavioral problems such as suboptimal breastfeeding and supine sleeping in infants younger than six months of age. The aim of this study was to observe any associations between MSK problems of infancy and common behavioral and public health issues. Methods: This is a cross sectional questionnaire based observational study in a clinical population. Mothers of infants presented to chiropractic clinics in Norway filled in a questionnaire on the first visit, and this was followed by a clinical examination and questionnaire completed by the Doctors of Chiropractic on the same day.

Results:   In total, 90 infants enrolled in the study. A total of 56 infants (66%) had postural problems. Favorite side of cervical rotation (N=41; 75%) was the most common dysfunction in supine lying. Neck hyperextension was present in 21 infants (38%). The inability to rotate their head equally side to side was present in 49 children (54%). In total 22 (24%) of the infants did not have the ability to sleep or lie comfortably supine. Suboptimal breastfeeding was reported by 22 (25%) parents, and 10 (12%) of the mothers reported pain during feeding. TMJ imbalance was identified in 16 infants (19%). There were statistically significant associations between suboptimal breastfeeding and TMJ imbalance, suboptimal rooting/sucking reflexes, inability to turn head and neck equally and painful breastfeeding, respectively.

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Chiropractic Management of Infantile Torticollis

By |November 11, 2017|Infantile Torticollis|

Chiropractic Management of Infantile Torticollis With Associated Abnormal Fixation of One Eye: A Case Report

The Chiro.Org Blog

SOURCE:   J Chiropr Med 2015 (Mar); 14 (1): 51-56

Mette Hobaek Siegenthaler, DC, MSc

Holbeinpraxis,
Swiss Academy for Chiropractic,
Berne, Switzerland.

OBJECTIVE:   The purpose of this case report is to describe the chiropractic management of a child with abnormal fixation of one eye and torticollis.

CLINICAL FEATURES:   A mother presented with a concern regarding her 23-month-old son who had a history of torticollis and an abnormal fixation of the right eye. She noticed the head tilt when he was about 7 months old and abnormal alignment of the right eye when the boy was 18 months old. At 15 months when he took his first steps, his head tilt became worse. At 21 months old, a neurological and orthopedic examination at the regional university children`s hospital ruled out presence of a tumor of the cervical spine or posterior fossa. The orthopedist sent the baby for chiropractic evaluation and treatment. Chiropractic exam found decreased active and passive range of motion in the cervical spine and no evidence of mass or contracture of the sternocleidomastoid muscle. Segmental palpation showed a decreased joint play and pain reaction at level C1/C2 on the right.

INTERVENTION AND OUTCOME:   The chiropractic treatment consisted of spinal manipulative therapy of the cervical spine in addition to massage and stretching of the neck muscles. Within a period of 4 weeks (3 chiropractic treatments) the torticollis was nearly resolved and the abnormal fixation of the right eye was no longer apparent. No relapse of the symptomatology was observed at a follow-up consultation at 26 months.

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