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Tissue Damage Markers After a Spinal Manipulation in Healthy Subjects

By Frank M. Painter|January 29, 2015|Safety, Spinal Manipulation|

Tissue Damage Markers After a Spinal Manipulation in Healthy Subjects: A Preliminary Report of a Randomized Controlled Trial

SOURCE: Dis Markers. 2014; 2014 :815379

A. Achalandabaso, G. Plaza-Manzano, R. Lomas-Vega, A. Martínez-Amat,
M. V. Camacho, M. Gassó, F. Hita-Contreras, and F. Molina

Centro de Fisioterapia y Psicología Soluciona,
18002 Granada, Spain.

Spinal manipulation (SM) is a manual therapy technique frequently applied to treat musculoskeletal disorders because of its analgesic effects. It is defined by a manual procedure involving a directed impulse to move a joint past its physiologic range of movement (ROM). In this sense, to exceed the physiologic ROM of a joint could trigger tissue damage, which might represent an adverse effect associated with spinal manipulation. The present work tries to explore the presence of tissue damage associated with SM through the damage markers analysis. Thirty healthy subjects recruited at the University of Jaén were submitted to a placebo SM (control group; n = 10), a single lower cervical manipulation (cervical group; n = 10), and a thoracic manipulation (n = 10). Before the intervention, blood samples were extracted and centrifuged to obtain plasma and serum. The procedure was repeated right after the intervention and two hours after the intervention.

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Adding Chiropractic Manipulative Therapy to Standard Medical Care for Patients with Acute Low Back Pain:

By Frank M. Painter|January 28, 2015|Low Back Pain|

Adding Chiropractic Manipulative Therapy to Standard Medical Care for Patients with Acute Low Back Pain: Results of a Pragmatic Randomized Comparative Effectiveness Study

The Chiro.Org Blog

SOURCE: Spine (Phila Pa 1976). 2013 (Apr 15); 38 (8): 627–634

Goertz, Christine M. DC, PhD; Long, Cynthia R. PhD;
Hondras, Maria A. DC, MPH; Petri, Richard MD;
Delgado, Roxana MS; Lawrence, Dana J. DC, MMedEd, MA;
Owens, Edward F. MS, DC; Meeker, William C. DC, MPH

Palmer Center for Chiropractic Research,
Davenport, IA 52803, USA.
christine.goertz@palmer.edu

STUDY DESIGN: Randomized controlled trial.

OBJECTIVE: To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (CMT) for the treatment of low back pain (LBP) among 18 to 35-year-old active-duty military personnel.

SUMMARY OF BACKGROUND DATA: LBP is common, costly, and a significant cause of long-term sick leave and work loss. Many different interventions are available, but there exists no consensus on the best approach. One intervention often used is manipulative therapy. Current evidence from randomized controlled trials demonstrates that manipulative therapy may be as effective as other conservative treatments of LBP, but its appropriate role in the healthcare delivery system has not been established.

METHODS: Prospective, 2-arm randomized controlled trial pilot study comparing SMC plus CMT with only SMC. The primary outcome measures were changes in back-related pain on the numerical rating scale and physical functioning at 4 weeks on the Roland-Morris Disability Questionnaire and back pain functional scale (BPFS).

RESULTS: Mean Roland-Morris Disability Questionnaire scores decreased in both groups during the course of the study, but adjusted mean scores were significantly better in the SMC plus CMT group than in the SMC group at both week 2 (P < 0.001) and week 4 (P = 0.004). Mean numerical rating scale pain scores were also significantly better in the group that received CMT. Adjusted mean back pain functional scale scores were significantly higher (improved) in the SMC plus CMT group than in the SMC group at both week 2 (P < 0.001) and week 4 (P = 0.004).

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Life-Threatening Conditions That Walk: A Clinician’s Review

By Frank M. Painter|January 27, 2015|Diagnosis|

Life-Threatening Conditions That Walk: A Clinician’s Review

The Chiro.Org Blog

SOURCE: J Amer Chiropr Assoc 2013 (Sept); 50 (5): 8-17

David J. Schimp, DC, DACNB, DAAPM

Clinician and Associate Professor
Texas Chiropractic College

Dr. Schimp describes the six most common undiagnosed life-threatening conditions encountered by chiropractors.

ABSTRACT

Chiropractors are hybrid physicians with a broad skill set. DCs need the diagnostic acumen of orthopedists and neurologists, a fine manual therapist’s hands, a psychologist’s insights, and the capacity to instantly respond to the unexpected. As front-line health care professionals, we may find ourselves serving as ER physicians. When a previously undiagnosed life- threatening condition shows up, we must recognize the problem and triage the patient appropriately. This article will review the six most common undiagnosed life-threatening conditions encountered by chiropractors.

Keywords: cancer, abdominal aortic aneurysm, deep-vein thrombosis, pulmonary embolism, venous thromboembolism, stroke, cerebrovascular accident, subdural hematoma, myocardial infarction, red flag assessment, life- threatening conditions, chiropractor, chiropractic physician

INTRODUCTION

Daniel, et al., have identified the six most common life-threatening conditions that a chiropractic physician is likely to encounter in clinical practice. [1] The goal of this article is to translate the current evidence-based knowledge of these conditions into a quick-scan diagnostic and management reference for cancer, abdominal aortic aneurysm, venous thromboembolism, stroke, myocardial infarction, and subdural hematoma.

I. CANCER

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WFC publishes suggested reading list of research papers

By John Wiens DC|January 27, 2015|Research|

Source The World Federation of Chiropractic

The World Federation of Chiropractic (WFC) is pleased to announce the debut of an important, online, free service for the chiropractic profession and the public it serves – a Suggested Reading List of key research papers.

When you want an overview of research on a chiropractic topic, for yourself, for patients or to advocate for the profession, wouldn’t it be nice to have access to relevant papers collected in one location?

“That is the vision for this WFC project,” says WFC President Dr Greg Stewart of Canada. “The project is being led by Dr Greg Kawchuk of the University of Alberta, Chair of the WFC Research Council, who has brought together expert curators from within the Research Council and abroad. We owe them a great debt for the expertise and hard work that has produced this exciting new service.”

The initial version of the Suggested Reading List goes live today at www.wfcsuggestedreadinglist.com with 10 key papers curated in each of 21 subject areas. These subject areas include cost-effectiveness of care, biomechanical and neurophysiological mechanisms of action, safety, pediatrics, wellness and many others. Each listed paper includes the published abstract and link to the original publication when available. Importantly, the site is searchable and visitors can leave suggestions for new topics and papers.

“This is just the beginning of this project,” explains Dr Kawchuk. “We are already working on round two which will add new topic areas such as nutrition and public health.

This project has been possible because of generous sponsorship from NCMIC and Standard Process, two of the WFC’s long-standing and most supportive partners.

The WFC, whose members are 90 national associations of chiropractors worldwide including both the ACA and ICA in the USA, has been a non-governmental organization or NGO in official relations with the World Health Organization since 1997. Its next major Congress is in Athens, Greece May 13-16, 2015. For more information visit www.wfc.org .

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A Health Care System in Transformation: Making the Case for Chiropractic

By Frank M. Painter|January 17, 2015|Health Care Reform|

A Health Care System in Transformation: Making the Case for Chiropractic

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2012 (Dec 6);20(1):37 ~ FULL TEXT

Richard Brown

The Lansdown Clinic,
High Street,
Stroud, Gloucestershire, GL5 1AU,
United Kingdom.

There are a number of factors that have conspired to create a crisis in healthcare. In part, the successes of medical science and technologies have been to blame, for they have led to survival where lives would previously have been cut short. An informed public, aware of these technological advances, is demanding access to the best that healthcare has to offer. At the same time the burden of chronic disease in an increasing elderly population has created a marked growth in the need for long term care. Current estimates for expenditure predict a rapid escalation of healthcare costs as a proportion of the GDP of developed nations, yet at the same time a global economic crisis has necessitated dramatic cuts in health budgets. This unsustainable position has led to calls for an urgent transformation in healthcare systems. This commentary explores the present day healthcare crisis and looks at the opportunities for chiropractors as pressure intensifies on politicians and leaders in healthcare to seek innovative solutions to a failing model. Amidst these opportunities, it questions whether the chiropractic profession is ready to accept the challenges that integration into mainstream healthcare will bring and identifies both pathways and potential obstacles to acceptance.

Keywords: Chiropractic, Healthcare transformation, Healthcare reform

From the Full-Text Article:

Background

A need for transformation in healthcare systems throughout the globe has long been recognised [1-3]. Social reform, improvements in living conditions and the positive impact of public health initiatives have all conspired to enhance quantity and quality of life [4]. As the baby boomers of the post World War Two era move into their twilight years enjoying a range of activities that would have left their ancestors aghast [5], western societies have experienced a steady increase in the size of the ageing population as communities dance, jog, cycle and gyrate their way into their eighties and nineties [6].

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Immediate Effect of Spinal Manipulative Protocols on Kicking Speed Performance in Soccer Players

By Frank M. Painter|January 15, 2015|Chiropractic Care, Sport Performance|

A Non-randomised Experimental Feasibility Study Into the Immediate Effect of Three Different Spinal Manipulative Protocols on Kicking Speed Performance in Soccer Players

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2015 (Jan 13)

Kyle Colin Deutschmann, Andrew Douglas Jones, Charmaine Maria Korporaal

Department of Chiropractic and Somatology,
Chiropractic Programme,
Durban University of Technology,
Durban, South Africa

Background The most utilized soccer kicking method is the instep kicking technique. Decreased motion in spinal joint segments results in adverse biomechanical changes within in the kinematic chain. These changes may be linked to a negative impact on soccer performance. This study tested the immediate effect of lumbar spine and sacroiliac manipulation alone and in combination on the kicking speed of uninjured soccer players.

Methods This 2010 prospective, pre-post experimental, single-blinded (subject) required forty asymptomatic soccer players, from regional premier league teams, who were purposively allocated to one of four groups (based on the evaluation of the players by two blinded motion palpators). Segment dysfunction was either localized to the lumbar spine (Group 1), sacroiliac joint (Group 2), the lumbar spine and sacroiliac joint (Group 3) or not present in the sham laser group (Group 4). All players underwent a standardized warm-up before the pre-measurements. Manipulative intervention followed after which post-measurements were completed. Measurement outcomes included range of motion changes (digital inclinometer); kicking speed (Speed Trac™ Speed Sport Radar) and the subjects’ perception of a change in kicking speed. SPSS version 15.0 was used to analyse the data, with repeated measures ANOVA and a p-value <0.05 (CI 95%).

Results Lumbar spine manipulation resulted in significant range of motion increases in left and right rotation. Sacroiliac manipulation resulted in no significant changes in the lumbar range of motion. Combination manipulative interventions resulted in significant range of motion increases in lumbar extension, right rotation and right SI joint flexion. There was a significant increase in kicking speed post intervention for all three manipulative intervention groups (when compared to sham). A significant correlation was seen between Likert based-scale subjects’ perception of change in kicking speed post intervention and the objective results obtained.

Conclusions This pilot study showed that lumbar spine manipulation combined with SI joint manipulation, resulted in an effective intervention for short-term increases in kicking speed / performance. However, the lack of an a priori analysis, a larger sample size and an unblinded outcome measures assessor requires that this study be repeated, addressing these concerns and for these outcomes to be validated.

From the FULL TEXT Article:

Introduction

The instep kicking technique is the most commonly used kicking technique in soccer, which allows the development of an optimum kicking speed [1-3]. This kicking technique requires that the power is generated through the co-ordinated effort of the muscles and the motion of all the joints involved (viz. lumbar spine, sacroiliac joint, hip, knee and foot and ankle) [4, 5]. Thus, this kicking technique’s biomechanics are seen as a segmented motion pattern sequence which initiates from the at the spine and moves distally down the open biomechanical chain [4-7]. As, the lumbar spine and sacroiliac joint are both proximal parts of this biomechanical chain, they form the basis for motion which follows the open chain movement pattern, and thus initiate the forward motion during kicking [2, 5]. Thus musculoskeletal co-ordination forms the basis for the kicking action and closely controls the compression forces being transferred towards the spine, stabilising and keeping the upper body balanced and upright, whilst transmitting the requires forces down the kinematic chain [8].

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