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Characteristics of Older Adults with Back Pain Associated with Choice of First Primary Care Provider: A Cross-sectional Analysis from the BACE-N Cohort Study

By |January 20, 2022|Initial Provider, Medicare|

Characteristics of Older Adults with Back Pain Associated with Choice of First Primary Care Provider: A Cross-sectional Analysis from the BACE-N Cohort Study

The Chiro.Org Blog


SOURCE:   BMJ Open 2021 (Sep 17); 11 (9): e053229

Ørjan Nesse Vigdal, Kjersti Storheim, Rikke Munk Killingmo, Milada Cvancarova Småstuen, and Margreth Grotle

Department of Physiotherapy,
Oslo Metropolitan University,
Oslo, Norway



Objectives:   To describe characteristics of older adults with back pain in primary care, and to assess associations between patient characteristics and type of first primary care provider (general practitioner (GP), physiotherapist (PT) or chiropractor).

Design:   Cross-sectional analysis from the Back Complaints in the Elders-Norway cohort study.

Setting:   Norwegian GP, PT and chiropractic primary care centres.

Participants:   Patients aged ≥55 years seeking Norwegian primary care with a new episode of back pain were invited to participate. Between April 2015 and February 2020, we included 452 patients: 127 first visited a GP, 130 first visited a PT and 195 first visited a chiropractor.

Primary and secondary outcome measures:   For the first objective, the outcome measure was descriptive statistics of patient characteristics, covering the following domains: sociodemographic, general health, current and previous back pain, psychological and clinical factors. For the second objective, first primary care provider was the outcome measure. Associations between patient characteristics and visiting a GP or PT compared with a chiropractor were assessed with multiple multinomial regression analyses.

Results:   Median (IQR) age was 66 (59-72) years. Levels of back-related disability was moderate to severe, with a median (IQR) Roland-Morris Disability Questionnaire (range 0-24) score of 9 (5-13). Recurring episodes were common, 301 (67%) patients had monthly or yearly recurrences. Patients with worse back-related disability, longer duration of symptoms, lower expectations for full recovery and worse physical performance measured with the Back Performance Scale had higher odds of visiting a GP or PT compared with a chiropractor (p<0.05).

There is more like this @ our:

MEDICARE Section and the:

INITIAL PROVIDER/FIRST CONTACT Section

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Attitudes Towards Chiropractic: A Repeated Cross-sectional Survey of Canadian Family Physicians

By |January 19, 2022|All About Chiropractic, Cost-Effectiveness of Chiropractic|

Attitudes Towards Chiropractic: A Repeated Cross-sectional Survey of Canadian Family Physicians

The Chiro.Org Blog


SOURCE:   BMC Family Practice 2021 (Sep 15); 22 (1): 188

Jason W. Busse, DC, PhD; Sushmitha Pallapothu, BSc; Brian Vinh, BSc; Vivienne Lee, BSc; et. al.

Department of Health Research Methods,
Evidence, and Impact,
McMaster University,
Hamilton, ON, Canada.



Background:   Many primary care patients receive both medical and chiropractic care; however, interprofessional relations between physicians and chiropractors are often suboptimal which may adversely affect care of shared patients. We surveyed Canadian family physicians in 2010 to explore their attitudes towards chiropractic and re-administered the same survey a decade later to explore for changes in attitudes.

Methods:   A 50-item survey administered to a random sample of Canadian family physicians in 2010, and again in 2019, that inquired about demographic variables, knowledge and use of chiropractic. Imbedded in our survey was a 20-item chiropractic attitude questionnaire (CAQ); scores could range from 0 to 80 with higher scores indicating more positive attitudes toward chiropractic. We constructed a multivariable regression model to explore factors associated with CAQ scores.

Results:   Among eligible physicians, 251 of 685 in 2010 (37% response rate) and 162 of 2429 in 2019 (7% response rate) provided a completed survey. Approximately half of respondents (48%) endorsed a positive impression of chiropractic, 27% were uncertain, and 25% held negative views. Most respondents (72%) referred at least some patients for chiropractic care, mainly due to patient request or lack of response to medical care. Most physicians believed that chiropractors provide effective therapy for some musculoskeletal complaints (84%) and disagreed that chiropractic care was beneficial for non-musculoskeletal conditions (77%). The majority agreed that chiropractic care was a useful supplement to conventional care (65%) but most respondents (59%) also indicated that practice diversity among chiropractors presented a barrier to interprofessional collaboration. In our adjusted regression model, attitudes towards chiropractic showed trivial improvement from 2010 to 2019 (0.31 points on the 80-point CAQ; 95%CI 0.001 to 0.62). More negative attitudes were associated with older age (- 1.55 points for each 10-year increment from age 28; 95%CI – 2.67 to – 0.44), belief that adverse events are common with chiropractic care (- 1.41 points; 95% CI – 2.59 to – 0.23) and reported use of the research literature (- 6.04 points; 95% CI – 8.47 to – 3.61) or medical school (- 5.03 points; 95% CI – 7.89 to – 2.18) as sources of knowledge on chiropractic. More positive attitudes were associated with endorsing a relationship with a specific chiropractor (5.24 points; 95% CI 2.85 to 7.64), family and friends (4.06 points; 95% CI 1.53 to 6.60), or personal treatment experience (4.63 points; 95% CI 2.14 to 7.11) as sources of information regarding chiropractic.

There is more like this @ our:

COST-EFFECTIVENESS Section and the:

ALL ABOUT CHIROPRACTIC Section

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Our Blog is a Tool. Learn How to Use It Now

By |January 18, 2022|Uncategorized|

Our Blog is a Tool.
Learn How to Use It Now

The Chiro.Org Blog


A Chiro.Org Editorial


Every Blog post is an announcement of new material that was just added to one of our many Sections.

I have been compiling (and archiving) peer-reviewed articles since early 1996, and to date we have thousands of Abstracts, and many hundreds of Full-Text articles on a wide variety of subjects.

When enough material, relating to a particular topic was collected, it was gathered into a new Topical Page in one of our many Sections.

Each Topical page is located in the Section most associated with that topic.
Thus, our Attention Deficit Page is located (is a part of) our Pediatrics Section   You get the idea.

Almost ALL of our Sections contain some, or many Topical collections. The LINKS Section is the most extreme example, because it contains 84 different topical pages.

All of the following are “active” Sections that are constantly adding new (and important) materials:

Acupuncture
Alternative Healing Abstracts
Case Studies
Chiropractic Assistants
Chiropractic Research
Chronic Neck Pain
Conditions That Respond Well
Cost-Effectiveness of Chiropractic
Documentation
Global Burden of Disease
Headache and Chiropractic
Initial Provider/First Contact and Chiropractic
The LINKS
Low Back Pain and Chiropractic
Medicare Info
Non-pharmacologic Therapy and Chiropractic
Nutrition
Pediatrics
Radiology
The SEARCH Section
Stroke and Chiropractic
What is the Chiropractic Subluxation?
Whiplash and Chiropractic

These other Sections are “archival” in nature, and contain valuable tools:Chiropractic History
ChiroZine
Free Images
New DC’s
Office Forms
R.C. Schafer’s Rehab Monographs
The Wilk Antitrust Lawsuit


How Blog Posts Work

The following is a Graphic “screen grab” of a Blog Post from our Home Page.
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Care Outcomes for Chiropractic Outpatient Veterans (COCOV): A Qualitative Study with Veteran Stakeholders From a Pilot Trial of Multimodal Chiropractic Care

By |January 18, 2022|Chiropractic Management, Cost-Effectiveness, Veterans|

Care Outcomes for Chiropractic Outpatient Veterans (COCOV): A Qualitative Study with Veteran Stakeholders From a Pilot Trial of Multimodal Chiropractic Care

The Chiro.Org Blog


SOURCE:   Pilot Feasibility Stud 2022 (Jan 14); 8 (1): 6

Stacie A. Salsbury, Elissa Twist, Robert B. Wallace, Robert D. Vining, Christine M. Goertz & Cynthia R. Long

Palmer Center for Chiropractic Research,
Palmer College of Chiropractic,
741 Brady Street,
Davenport, Iowa, 52803, USA.



Background:   Low back pain (LBP) is common among military veterans seeking treatment in Department of Veterans Affairs (VA) healthcare facilities. As chiropractic services within VA expand, well-designed pragmatic trials and implementation studies are needed to assess clinical effectiveness and program uptake. This study evaluated veteran stakeholder perceptions of the feasibility and acceptability of care delivery and research processes in a pilot trial of multimodal chiropractic care for chronic LBP.

Methods:   The qualitative study was completed within a mixed-method, single-arm, pragmatic, pilot clinical trial of chiropractic care for LBP conducted in VA chiropractic clinics. Study coordinators completed semi-structured, in person or telephone interviews with veterans near the end of the 10–week trial. Interviews were audiorecorded and transcribed verbatim. Qualitative content analysis using a directed approach explored salient themes related to trial implementation and delivery of chiropractic services.

Results:   Of 40 participants, 24 completed interviews (60% response; 67% male gender; mean age 51.7 years). Overall, participants considered the trial protocol and procedures feasible and reported that the chiropractic care and recruitment methods were acceptable. Findings were organized into 4 domains, 10 themes, and 21 subthemes. Chiropractic service delivery domain encompassed 3 themes/8 subthemes: scheduling process (limited clinic hours, scheduling future appointments, attendance barriers); treatment frequency (treatment sufficient for LBP complaint, more/less frequent treatments); and chiropractic clinic considerations (hire more chiropractors, including female chiropractors; chiropractic clinic environment; patient-centered treatment visits). Outcome measures domain comprised 3 themes/4 subthemes: questionnaire burden (low burden vs. time-consuming or repetitive); relevance (items relevant for LBP study); and timing and individualization of measures (questionnaire timing relative to symptoms, personalized approach to outcomes measures). The online data collection domain included 2 themes/4 subthemes: user concerns (little difficulty vs. form challenges, required computer skills); and technology issues (computer/internet access, junk mail). Clinical trial planning domain included 2 themes/5 subthemes: participant recruitment (altruistic service by veterans, awareness of chiropractic availability, financial compensation); and communication methods (preferences, potential barriers).

There is more like this @ our:

LOW BACK PAIN Section and the:

COST-EFFECTIVENESS Section and the:

CHIROPRACTIC CARE FOR VETERANS Section

(more…)

Chiropractic Nimmo Receptor-Tonus Technique and McKenzie Self-Therapy Program in the Management of Adjacent Segment Disease: A Case Report

By |January 17, 2022|Adjacent Segment Disease, Case Studies, McKenzie, Myofascial Disorder, Myofascial Trigger Points|

Chiropractic Nimmo Receptor-Tonus Technique and McKenzie Self-Therapy Program in the Management of Adjacent Segment Disease: A Case Report

The Chiro.Org Blog


SOURCE:   J Chiropractic Medicine 2020 (Dec); 19 (4): 249–259

Emsal Salik, MD PhD; Ali Donat, DC; Mustafa Hulisi Ağaoğlu, DC

Chiropractic Program,
Health Sciences Institute,
Bahcesehir University,
Besiktas, Istanbul, Turkey



Objective:   The objective of the present study objective was to describe adjacent segment disease (ASD) from a chiropractic management prospective and subsequently to stimulate further research into the chiropractic therapeutic effects on such cases and to contribute to chiropractic literature.

Clinical features:   A 44–year-old woman had a history of lumbar stabilization revision operation by pedicle screw fixation for spondylolisthesis. Her intractable back pain episodes, which were diagnosed as ASD, began shortly after this surgery. At presentation, she was taking pregabalin 75 mg 2 times a day for postoperative neuropathic pain without any pain relief. Clinical testing revealed myofascial tender points reproducing the pain.

Intervention and outcome:   After taking the case history and performing a physical examination, the patient was managed with chiropractic Nimmo receptor-tonus technique in combination with McKenzie exercises. Nimmo was applied by manually pressing on clinically relevant points for 5 to 15 seconds in 11 visits over 3 weeks. The patient by herself did McKenzie exercises 5 to 10 times a day for 10 to 12 repetitions over 2 months. After 3 weeks of therapy, visual analog scale and Oswestry Disability Index scores were improved. Furthermore, because of the amelioration of the patient’s symptoms, her neurosurgeon successfully discontinued pregabalin 75 mg 2 times a day without negative consequences to care.

There is more like this @ our:

CASE STUDIES Section
and our


LOW BACK PAIN Section
and our


DISC HERNIATION Section

(more…)

Chiropractic Management of a Symptomatic Patient Who Previously Had Surgery for Cauda Equina Syndrome

By |January 15, 2022|Uncategorized|

Chiropractic Management of a Symptomatic Patient Who Previously Had Surgery for Cauda Equina Syndrome

The Chiro.Org Blog


SOURCE:   J Chiropractic Medicine 2021 (Jun); 20 (2): 85–89

Jonathan R. Cook, MChiro

24 Manor Gardens,
Millbrook, Cornwall,
PL10 1PR, United Kingdom



Objective:   The purpose of this report is to describe the outcomes of chiropractic care for a patient after surgery for cauda equina syndrome.

Clinical features:   Following surgery for cauda equina syndrome caused by a herniated lumbar disc at L5/S1, a 28-year old woman presented for chiropractic care with an 18-month history of lower back pain. She had bilateral L5 and S1 dermatome pain and paraesthesia; saddle

Intervention and outcome:   The patient received a variety of chiropractic manipulative techniques including cervical and thoracic spine manipulation, instrumented adjustments to the lumbar spine, and drop technique to the sacroiliac joints. Trigger point therapy was performed on the gluteus medius, quadratus lumborum, and piriformis muscles bilaterally. After 12 months, the patient reported a reduction in lower back and radicular leg pain, was able to reduce her use of opioid medications, and experienced improved lower limb function following chiropractic care.

Conclusion:   The patient responded favorably to a course of chiropractic care for symptoms remaining after surgery for cauda equina syndrome.

There is more like this @ our:

CASE STUDIES Section
and our

LOW BACK PAIN Section
and our

DISC HERNIATION Section

(more…)