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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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Individual Courses of Low Back Pain in Adult Danes

By |February 7, 2017|Low Back Pain|

Individual Courses of Low Back Pain in Adult Danes: A Cohort Study with 4-Year and 8-Year Follow-up

The Chiro.Org Blog

SOURCE:   BMC Musculoskelet Disord. 2017 (Jan 21); 18 (1): 28

Per Kjaer, Lars Korsholm, Charlotte Leboeuf-Yde, Lise Hestbaek and Tom Bendix

Department of Sports Science and Clinical Biomechanics,
University of Southern Denmark,
Campusvej 55, DK-5230,
Odense M, Denmark.

BACKGROUND:   Few longitudinal studies have described the variation in LBP and its impact over time at an individual level. The aims of this study were to:

1)     determine the prevalence of LBP in three surveys over a 9-year period in the Danish general population, using five different definitions of LBP,

2)     study their individual long-term courses, and

3)     determine the odds of reporting subsequent LBP when having reported previous LBP.

METHODS:    A cohort of 625 men and women aged 40 was sampled from the general population. Questions about LBP were asked at ages 41, 45 and 49, enabling individual courses to be tracked across five different definitions of LBP. Results were reported as percentages and the prognostic influence on future LBP was reported as odds ratios (OR).

RESULTS:    Questionnaires were completed by 412 (66%), 348 (56%) and 293 (47%) persons respectively at each survey. Of these, 293 (47%) completed all three surveys. The prevalence of LBP did not change significantly over time for any LBP past year: 69, 68, 70%; any LBP past month: 42, 48, 41%; >30 days LBP past year: 25, 27, 24%; seeking care for LBP past year: 28, 30, 36%; and non-trivial LBP, i.e. LBP >30 days past year including consequences: 18, 20, 20%. For LBP past year, 2/3 remained in this category, whereas four out of ten remained over the three time-points for the other definitions of LBP. Reporting LBP defined in any of these ways significantly increased the odds for the same type of LBP 4 years later. For those with the same definition of LBP at both 41 and 45 years, the risk of also reporting the same at 49 years was even higher, regardless of definition, and most strongly for seeking care and non-trivial LBP (OR 17.6 and 18.4) but less than 11% were in these groups.

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Chiropractic Rehabilitation of a Scoliosis Family

By |February 4, 2017|Scoliosis|

Chiropractic Rehabilitation of a Scoliosis Family: Results from a 9-Year Follow-Up

The Chiro.Org Blog

SOURCE:   Journal of Therapy and Rehab 2017 (Jan); 5 (1): 29–35

Mark W. Morningstar, Aatif Siddiqui,
Clayton Stitzel, Brian Dovorany

Natural Wellness & Pain Relief Center,
Grand Blanc, MI, USA

Scoliosis bracing is typically prescribed when the curvature reaches to between 30°–50°. Although there has been a vast amount of bracing literature published, the results remain equivocal. Many patients face issues of compliance, comfort, and decreased self-esteem due to social stigmas with bracing. This has caused many patients to seek non-bracing options. Although these treatments are plausible, they lack the research background that bracing has. Therefore, many physicians are reluctant to prescribe exercise-based rehabilitation for their scoliosis patients.

This study reports on 3 patients who sought non-bracing, exercise-based chiropractic rehabilitation for their scoliosis. Their results before, after, and at long term follow up are included.

Key words:   Chiropractic, Scoliosis, Spine, Rehabilitation

From the Full-Text Article:

Introduction

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Mild Traumatic Brain Injury After Motor Vehicle Collisions: What Are the Symptoms and Who Treats Them?

By |January 29, 2017|Chronic Neck Pain, Whiplash|

Mild Traumatic Brain Injury After Motor Vehicle Collisions: What Are the Symptoms and Who Treats Them? A Population-Based 1-Year Inception Cohort Study

The Chiro.Org Blog

SOURCE:   Arch Phys Med Rehab 2014 (Mar); 95 (3 Sup): S286–294

Jan Hartvigsen, PhD, Eleanor Boyle, PhD, J. David Cassidy, PhD, DrMedSc, Linda J. Carroll, PhD

Institute of Sports Science and Clinical Biomechanics,
University of Southern Denmark, Odense, Denmark;
Nordic Institute of Chiropractic and Clinical Biomechanics,
Odense, Denmark.

OBJECTIVE:   To describe the 1-year course of symptoms following mild traumatic brain injury (MTBI) sustained in a motor vehicle collision as well as patterns of care-seeking.

DESIGN:   One-year follow-up of a population-based inception cohort.

SETTING:   The province of Saskatchewan, Canada, with a population of about 1,000,000 inhabitants.

PARTICIPANTS:   Persons (N=1716) sustaining an MTBI during a car collision between November 1997 and December 1999.

INTERVENTIONS:   Not applicable.

MAIN OUTCOME MEASURES:   We report the prevalence of sleep disturbances, tiredness, dizziness, forgetfulness, vision problems, hearing problems, headache, neck pain, mid back pain, and low back pain at 6 weeks and 3, 6, 9, and 12 months postcollision. At the same time points, we report self-reported care-seeking from registered health care professionals.

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Chronic Neck Pain and Chiropractic Page

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Dose-response of Spinal Manipulation for Cervicogenic Headache: Study Protocol for a Randomized Controlled Trial

By |January 25, 2017|Cervicogenic Headache|

Dose-response of Spinal Manipulation for Cervicogenic Headache: Study Protocol for a Randomized Controlled Trial

The Chiro.Org Blog

Chiropractic & Manual Therapies 2016 (Jun 8); 24: 23 ~ FULL TEXT

Linda Hanson, Mitchell Haas, Gert Bronfort, Darcy Vavrek, Craig Schulz, Brent Leininger, Roni Evans, Leslie Takaki and Moni Neradilek

Center for Outcome Studies,
The University of Western States,
2900 NE 132nd Ave,
Portland, OR 97230 USA.

BACKGROUND:   Cervicogenic headache is a prevalent and costly pain condition commonly treated by chiropractors. There is evidence to support the effectiveness for spinal manipulation, but the dose of treatment required to achieve maximal relief remains unknown. The purpose of this paper is to describe the methodology for a randomized controlled trial evaluating the dose-response of spinal manipulation for chronic cervicogenic headache in an adult population.

METHODS/DESIGN:   This is a mixed-methods, two-site, prospective, parallel groups, observer-blind, randomized controlled trial conducted at university-affiliated research clinics in the Portland, OR and Minneapolis, MN areas. The primary outcome is patient reported headache frequency. Other outcomes include self-reported headache intensity, disability, quality of life, improvement, neck pain intensity and frequency, satisfaction, medication use, outside care, cervical motion, pain pressure thresholds, health care utilization, health care costs, and lost productivity. Qualitative interviews are also conducted to evaluate patients’ expectations of treatment.

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Headache and Chiropractic Page

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GRADE: An Emerging Consensus on Rating Quality of Evidence and Strength of Recommendations

By |January 23, 2017|Guidelines|

GRADE: An Emerging Consensus on Rating Quality of Evidence and Strength of Recommendations

The Chiro.Org Blog

Brit Med J 2008 (Apr 26); 336 (7650): 924–926 ~ FULL TEXT

Gordon H Guyatt, Andrew D Oxman, Gunn E Vist, Regina Kunz, Yngve Falck-Ytter

CLARITY Research Group,
Department of Clinical Epidemiology and Biostatistics,
Room 2C12, 1200 Main Street,
West Hamilton, ON, Canada L8N 3Z5

 

Guidelines are inconsistent in how they rate the quality of evidence and the strength of recommendations. This article explores the advantages of the GRADE system, which is increasingly being adopted by organisations worldwide.

 

From the FULL TEXT Article

Summary points

  • Failure to consider the quality of evidence can lead to misguided recommendations; hormone replacement therapy for post-menopausal women provides an instructive example
  • High quality evidence that an intervention’s desirable effects are clearly greater than its undesirable effects, or are clearly not, warrants a strong recommendation
  • Uncertainty about the trade-offs (because of low quality evidence or because the desirable and undesirable effects are closely balanced) warrants a weak recommendation
  • Guidelines should inform clinicians what the quality of the underlying evidence is and whether recommendations are strong or weak
  • The Grading of Recommendations Assessment, Development and Evaluation (GRADE ) approach provides a system for rating quality of evidence and strength of recommendations that is explicit, comprehensive, transparent, and pragmatic and is increasingly being adopted by organisations worldwide

Introduction:

Guideline developers around the world are inconsistent in how they rate quality of evidence and grade strength of recommendations. As a result, guideline users face challenges in understanding the messages that grading systems try to communicate. Since 2006 the BMJ has requested in its “Instructions to Authors” on bmj.com that authors should preferably use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system for grading evidence when submitting a clinical guidelines article. What was behind this decision?

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Interdisciplinary Practice Models for Older Adults With Back Pain

By |January 15, 2017|Interdisciplinary Practice, Interprofessional Collaboration|

Interdisciplinary Practice Models for Older Adults With Back Pain: A Qualitative Evaluation

The Chiro.Org Blog

SOURCE:   Gerontologist. 2017 (Jan 11) [Epub]

Stacie A. Salsbury, PhD, RN, Christine M. Goertz, DC, PhD,
Robert D. Vining, DC, Maria A. Hondras, DC, MPH, PhD,
Andrew A. Andresen, MD, Cynthia R. Long, PhD,
Kevin J. Lyons, PhD, Lisa Z. Killinger, DC and
Robert B. Wallace, MD, MS

Palmer Center for Chiropractic Research,
Palmer College of Chiropractic,
Davenport, Iowa.

PURPOSE:   Older adults seek health care for low back pain from multiple providers who may not coordinate their treatments. This study evaluated the perceived feasibility of a patient-centered practice model for back pain, including facilitators for interprofessional collaboration between family medicine physicians and doctors of chiropractic.

DESIGN AND METHODS:   This qualitative evaluation was a component of a randomized controlled trial of 3 interdisciplinary models for back pain management: usual medical care; concurrent medical and chiropractic care; and collaborative medical and chiropractic care with interprofessional education, clinical record exchange, and team-based case management. Data collection included clinician interviews, chart abstractions, and fieldnotes analyzed with qualitative content analysis. An organizational-level framework for dissemination of health care interventions identified norms/attitudes, organizational structures and processes, resources, networks-linkages, and change agents that supported model implementation.

RESULTS:   Clinicians interviewed included 13 family medicine residents and 6 chiropractors. Clinicians were receptive to interprofessional education, noting the experience introduced them to new colleagues and the treatment approaches of the cooperating profession. Clinicians exchanged high volumes of clinical records, but found the logistics cumbersome. Team-based case management enhanced information flow, social support, and interaction between individual patients and the collaborating providers. Older patients were viewed positively as change agents for interprofessional collaboration between these provider groups.

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Low Back Pain and Chiropractic Page

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