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Assessment of Chiropractic Treatment for Active Duty, U.S. Military Personnel with Low Back Pain

By Frank M. Painter|February 20, 2016|Low Back Pain|

Assessment of Chiropractic Treatment for Active Duty, U.S. Military Personnel with Low Back Pain: Study Protocol for a Randomized Controlled Trial

SOURCE: Trials. 2016 (Feb 9); 17 (1): 70 ~ FULL TEXT

Christine M. Goertz, Cynthia R. Long, Robert D. Vining, Katherine A. Pohlman, Bridget Kane, Lance Corber, Joan Walter, and Ian Coulter

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

BACKGROUND: Low back pain is highly prevalent and one of the most common causes of disability in U.S. armed forces personnel. Currently, no single therapeutic method has been established as a gold standard treatment for this increasingly prevalent condition. One commonly used treatment, which has demonstrated consistent positive outcomes in terms of pain and function within a civilian population is spinal manipulative therapy provided by doctors of chiropractic. Chiropractic care, delivered within a multidisciplinary framework in military healthcare settings, has the potential to help improve clinical outcomes for military personnel with low back pain. However, its effectiveness in a military setting has not been well established. The primary objective of this study is to evaluate changes in pain and disability in active duty service members with low back pain who are allocated to receive usual medical care plus chiropractic care versus treatment with usual medical care alone.

METHODS/DESIGN: This pragmatic comparative effectiveness trial will enroll 750 active duty service members with low back pain at three military treatment facilities within the United States (250 from each site) who will be allocated to receive usual medical care plus chiropractic care or usual medical care alone for 6 weeks. Primary outcomes will include the numerical rating scale for pain intensity and the Roland-Morris Disability Questionnaire at week 6. Patient reported outcomes of pain, disability, bothersomeness, and back pain function will be collected at 2, 4, 6, and 12 weeks from allocation.

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Upper Cervical and Upper Thoracic Manipulation Versus Mobilization and Exercise in Patients with Cervicogenic Headache

By Frank M. Painter|February 10, 2016|Headache|

Upper Cervical and Upper Thoracic Manipulation Versus Mobilization and Exercise in Patients with Cervicogenic Headache: A Multi-center Randomized Clinical Trial

The Chiro.Org Blog

SOURCE: BMC Musculoskel Disord. 2016 (Feb 6); 17 (1): 64

James R. Dunning, Raymond Butts, Firas Mourad,
Ian Young, Cesar Fernandez-de-las Peñas st. al.

Alabama Physical Therapy & Acupuncture,
Montgomery, AL, USA

BACKGROUND: Although commonly utilized interventions, no studies have directly compared the effectiveness of cervical and thoracic manipulation to mobilization and exercise in individuals with cervicogenic headache (CH). The purpose of this study was to compare the effects of manipulation to mobilization and exercise in individuals with CH.

METHODS: One hundred and ten participants (n = 110) with CH were randomized to receive both cervical and thoracic manipulation (n = 58) or mobilization and exercise (n = 52). The primary outcome was headache intensity as measured by the Numeric Pain Rating Scale (NPRS). Secondary outcomes included headache frequency, headache duration, disability as measured by the Neck Disability Index (NDI), medication intake, and the Global Rating of Change (GRC). The treatment period was 4 weeks with follow-up assessment at 1 week, 4 weeks, and 3 months after initial treatment session. The primary aim was examined with a 2-way mixed-model analysis of variance (ANOVA), with treatment group (manipulation versus mobilization and exercise) as the between subjects variable and time (baseline, 1 week, 4 weeks and 3 months) as the within subjects variable.

RESULTS: The 2X4 ANOVA demonstrated that individuals with cervicogenic headache (CH) who received both cervical and thoracic manipulation experienced significantly greater reductions in headache intensity (p < 0.001) and disability (p < 0.001) than those who received mobilization and exercise at a 3-month follow-up. Individuals in the upper cervical and upper thoracic manipulation group also experienced less frequent headaches and shorter duration of headaches at each follow-up period (p < 0.001 for all). Additionally, patient perceived improvement was significantly greater at 1 and 4-week follow-up periods in favor of the manipulation group (p < 0.001).

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Safety of Chiropractic Manual Therapy for Children

By Frank M. Painter|February 7, 2016|Pediatrics|

Safety of Chiropractic Manual Therapy for Children: How Are We Doing?

The Chiro.Org Blog

J Clin Chiro Peds 2009 (Dec); 10 (2): 655–660 ~ FULL TEXT

Joyce Miller, BSc, DC, DABCO, PhD

Anglo European College of Chiropractic, Lead Tutor, MSc
Advanced Practice Chiropractic Pediatrics,
Bournemouth University.

Objectives: To assess the risk of adverse effects of chiropractic spinal manipulation in the pediatric population and to promote a culture of safety along with full reporting of adverse events in the chiropractic profession

Methods: Narrative review of all published reports of adverse effects of chiropractic pediatric spinal manipulation

Results: Adverse effects from chiropractic spinal manipulation are rare with 2 moderate and 4 severe events reported during a 59 year period with up to 30 million treatments estimated per year. Current reports show a very low rate (<1% in 8,290 treatments) of mild transient side effects lasting less than 24 hours.

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Prevalence and Tracking of Back Pain From Childhood to Adolescence

By Frank M. Painter|February 6, 2016|Pediatrics|

Prevalence and Tracking of Back Pain From Childhood to Adolescence

The Chiro.Org Blog

SOURCE: BMC Musculo Disord. 2011 (May 16); 12: 98 ~ FULL TEXT

Per Kjaer, Niels Wedderkopp, Lars Korsholm, and Charlotte Leboeuf-Yde

Institute of Sports Science and Clinical Biomechanics,
Part of Clinical Locomotion Network,
University of Southern Denmark,
Campusvej 55, DK-5230, Odense, Denmark

BACKGROUND: It is generally acknowledged that back pain (BP) is a common condition already in childhood. However, the development until early adulthood is not well understood and, in particular, not the individual tracking pattern. The objectives of this paper are to show the prevalence estimates of BP, low back pain (LBP), mid back pain (MBP), neck pain (NP), and care-seeking because of BP at three different ages (9, 13 and 15 years) and how the BP reporting tracks over these age groups over three consecutive surveys.

METHODS: A longitudinal cohort study was carried out from the years of 1997 till 2005, collecting interview data from children who were sampled to be representative of Danish schoolchildren. BP was defined overall and specifically in the three spinal regions as having reported pain within the past month. The prevalence estimates and the various patterns of BP reporting over time are presented as percentages.

RESULTS: Of the 771 children sampled, 62%, 57%, and 58% participated in the three back surveys and 34% participated in all three. The prevalence estimates for children at the ages of 9, 13, and 15, respectively, were for back pain (BP) 33%, 28%, and 48%; for low back pain (LBP) 4%, 22%, and 36%; for MBP 20%, 13%, and 35%; and for neck pain (NP) 10%, 7%, and 15%. Seeking care for BP increased from 6% and 8% at the two youngest ages to 34% at the oldest. Only 7% of the children who participated in all three surveys reported BP each time and 30% of these always reported no pain. The patterns of development differed for the three spinal regions and between genders. Status at the previous survey predicted status at the next survey, so that those who had pain before were more likely to report pain again and vice versa. This was most pronounced for care-seeking.

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An Investigation of Musculoskeletal Dysfunctions in Infants

By Frank M. Painter|February 5, 2016|Pediatrics|

An Investigation of Musculoskeletal Dysfunctions in Infants Including a Case Series of KISS Diagnosed Children

The Chiro.Org Blog

SOURCE: J Clin Chiro Peds 2012 (Jun); 13 (1): 958–967

Josefa Langkau and Joyce Miller BS, DC , DABCO, FCC (UK), FEAC, FACO(US)

Josefa Langkau
34 Morley Road,
BH5 2JL, Bournemouth, United Kingdom

Joyce Miller, BS, DC, DABCO, FCC (UK), FEAC, FACO(US)
Associate Professor, Anglo-European College of Chiropractic,
Bournemouth, United Kingdom

Objective: The purpose of this study was to describe etiology, presentation and treatment of musculoskeletal issues in early infancy by integrating a case series of infants diagnosed with kinematic imbalance due to suboccipital sprain (KISS) and treated in a teaching clinic in the United Kingdom with a critical review of the concept of KISS. The concept has been developed by Heiner Biedermann and medical doctors in Germany and contributed significantly to the development of manual therapy in
children in that country.

Methods: A literature review was conducted. The search was focused on German studies about KISS syndrome and English studies about musculoskeletal issues in infants. Search strategy: ZDB, ZB MED and PubMed and hand search in German libraries. The data were collected by survey via a data collection system and files in the Anglo European College of Chiropractic (AECC)
teaching clinic.

Results: The primary differences between the diagnosis and treatment recommended by Biedermann and that in the AECC clinic are 1) the recommended use of x-ray prior to treatment by Biedermann and 2) recommended force used in treatment (4 N at AECC versus 70 N with Biedermann).

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A Survey of Parent Satisfaction with Chiropractic Care of the Pediatric Patient

By Frank M. Painter|February 4, 2016|Patient Satisfaction, Pediatrics|

A Survey of Parent Satisfaction with Chiropractic Care of the Pediatric Patient

The Chiro.Org Blog

SOURCE: J Clinical Chirop Peds 2014 (Nov); 14 (3): 1167–1171

Ida Marie Navrud, DC, Joyce Miller, BSc, DC, DABCO, PhD,
Maja Eidsmo Bjørnli, DC, Cathrine Hjelle Feier, DC,
Tale Haugse, DC

Private practice, Norway

Introduction: Chiropractic is a common parental choice as a therapeutic intervention for numerous pediatric conditions. No studies investigating parent satisfaction with pediatric chiropractic care have been published to date.

Method: All infants aged 0-36 weeks and presenting to a chiropractic teaching clinic on the south coast of England between January 2011 and October 2013 were eligible for inclusion. Parents completed questionnaires, which rated their own and their infant’s characteristics prior to, and at the end of, a course of chiropractic care. Non-parametric tests were used to analyze before and after care scores.

Results: A total of 395 results were collected in this study. Satisfaction scores of 10/10 (“completely satisfied”) were reported by 75.1% (n=295) of the parents. There was a significant
improvement in parental distress (Median=5.0 before care, Median=2.0 after care, Z=-13.7, p<.001, r =-.49)
and infants’ sleep quality (Median=5.0 before care, Median=3.0 after care, Z=-10.5, p<.001, r =-.38). Satisfaction scores were found to have a small correlation with sleep quality (rs =-.21) after care, as well as a moderate correlation with distress (rs =-.31) and improvement scores (rs =.42), p<.01.

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