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Treatment Targets of Exercise for Persistent Non-specific Low Back Pain: A Consensus Study

By Frank M. Painter|March 24, 2023|Chiropractic Management, Exercise and Chiropractic, Low Back Pain|

Treatment Targets of Exercise for Persistent Non-specific Low Back Pain: A Consensus Study

SOURCE: Physiotherapy 2021 (Sep); 112: 78–86
Lianne Wood, Annette Bishop, Martyn Lewis, Rob J E M Smeets, Gert Bronfort, Jill A Hayden, Nadine E Foster

Primary Care Centre Versus Arthritis,
School of Primary, Community and Social Care,
Faculty of Medicine and Health Sciences,
Keele University,
Newcastle-under-Lyme ST5 5BG, UK

FROM: Br J Sports Med 2020

Objectives: Despite several hundred previous randomised controlled trials (RCTs), the key treatment targets of exercise for persistent non-specific low back pain (NSLBP) remain unclear. This study aimed to generate consensus about the key treatment targets of exercise interventions for patients with NSLBP.

Design: Consensus was generated using modified nominal group technique in two, sequential, workshops. The results of a previous systematic review informed the first, national, workshop idea generation and the results of this workshop informed the second, international, workshop. The authors generated a starting list of 30 treatment targets from the systematic review. A pre-specified consensus threshold of 75% was used in the voting stage.

Participants: Workshop participants included people with experience of using exercise to manage their persistent NSLBP, clinicians who prescribe exercise for persistent NSLBP, and researchers who design and evaluate exercise interventions in RCTs. All participants generated, voted and ranked the treatment targets in each workshop using an online platform.

Results: A total of 39 participants contributed to the consensus (15 in the national workshop and 24 in the international workshop), comprising two people with NSLBP, six clinicians and 31 researchers/clinicians. A total of 40 exercise treatment targets were generated, and 25 were retained after voting and ranking. The prioritised targets of exercise for persistent NSLBP were: improving function, improving quality of life, reducing pain, meeting patient-specific goals and reducing fear of movement.

There is more like this @ our:

LOW BACK PAIN Section and the:

EXERCISE AND CHIROPRACTIC Section

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Happy St. Patricks Day

By Frank M. Painter|March 15, 2023|Announcement|

Happy St. Patricks Day

The Chiro.Org Blog

May the road rise up to meet you.
May the wind always be at your back.
May the sun shine warm upon your face,
and rains fall soft upon your fields.
And until we meet again,
May God hold you in the palm of His hand.

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

By Frank M. Painter|March 14, 2023|About Our Blog|

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 86 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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Mechanisms of Chiropractic Spinal Manipulative Therapy for Patients with Chronic Primary Low Back Pain: Protocol for a Mechanistic Randomized Placebo-controlled Trial

By Frank M. Painter|February 25, 2023|Chiropractic Management, Low Back Pain, Spinal Joint Pain|

Mechanisms of Chiropractic Spinal Manipulative Therapy for Patients with Chronic Primary Low Back Pain: Protocol for a Mechanistic Randomized Placebo-controlled Trial

The Chiro.Org Blog

SOURCE: BMJ Open 2023 (Feb 10); 13 (2): e065999

OPEN ACCESS

Carlos Gevers-Montoro, Arantxa Ortega-De Mues, Mathieu Piché

Real Centro Universitario Escorial Maria Cristina,
San Lorenzo de El Escorial, Spain.

Introduction: Chronic low back pain (CLBP) is a highly prevalent and disabling condition. Identifying subgroups of patients afflicted with CLBP is a current research priority, for which a classification system based on pain mechanisms was proposed. Spinal manipulative therapy (SMT) is recommended for the management of CLBP. Yet, little data are available regarding its mechanisms of action, making it difficult to match this intervention to the patients who may benefit the most. It was suggested that SMT may influence mechanisms associated with central sensitisation. Therefore, classifying patients with CLBP according to central sensitisation mechanisms may help predict their response to SMT.

Methods and analysis: This protocol describes a randomised placebo-controlled trial aiming to examine which variables linked to central sensitisation may help predict the clinical response to SMT in a cohort of patients with CLBP. One hundred patients with chronic primary low back pain will be randomised to receive 12 sessions of SMT or placebo SMT over a 4–week period. Pain intensity and disability will be assessed as primary outcomes after completing the 4–week treatment (primary endpoint), and at 4–week and 12–week follow-ups. Baseline values of two pain questionnaires, lumbar pressure pain thresholds, concentrations of an inflammatory cytokine and expectations of pain relief will be entered as predictors of the response to SMT in a multiple regression model. Changes in these variables after treatment will be used in a second multiple regression model. The reference values of these predictors will be measured from 50 age and sex-matched healthy controls to allow interpretation of values in patients. Mixed analyses of variance will also be conducted to compare the primary outcomes and the predictors between groups (SMT vs placebo) over time (baseline vs post-treatment).

There is more like this @ our:

LOW BACK PAIN Section and the:

SPINAL PAIN MANAGEMENT Section

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Description of Recurrent Headaches in 7-14-year-old Children: Baseline Data From a Randomized Clinical Trial on Effectiveness of Chiropractic Spinal Manipulation in Children with Recurrent Headaches

By Frank M. Painter|February 2, 2023|Headache, Pediatrics|

Description of Recurrent Headaches in 7-14-year-old Children: Baseline Data From a Randomized Clinical Trial on Effectiveness of Chiropractic Spinal Manipulation in Children with Recurrent Headaches

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2023 (Jan 30); 31 : 5

OPEN ACCESS

Kristina Boe Dissing, Werner Vach, Susanne Lynge, Henrik Wulff Christensen & Lise Hestbaek

Chiropractic Knowledge Hub,
Campusvej 55, 5230,
Odense M, Denmark.

Background: Headaches in children are poorly described and diagnosing can be challenging. Objectives are: (1) to describe headache characteristics and child characteristics, (2) to explore whether data can suggest a more diverse way to categorize headaches than traditionally.

Methods: Baseline data for a clinical trial included a questionnaire and a physical screening. Children’s characteristics and detailed description of headache symptoms were provided. Children were classified for migraine or tension-type-headache based on questionnaire data reported by children and parents. This required to apply slightly modified classification criteria and a “non-classifiable” group was added. Severity and symptoms, related to the migraine versus tension type distinction, were investigated to define a migraine-tension-type-index.

Results: 253 children were included. Mean pain intensity was 5.9/10. Over 2/3 of the children had headache for > 1 year, and > 50% for several days/week. Half of the children were non-classifiable, 22% were classified as migraine and 23% as tension-type headache. A migraine-tension-type-index was constructed and describes a continuous spectrum rather than two distinct groups.

There is more like this @ our:

HEADACHE Section and the:

PEDIATRICS Section

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Chiropractic Lexicon: Useful or Not?

By Frank M. Painter|January 7, 2023|Subluxation|

Chiropractic Lexicon: Useful or Not?

The Chiro.Org Blog

SOURCE: Asia Pacific Chiropractic Journal 2023; 3.3
David Cahill, BAppSc(Chiro)

President,
Australian Chiropractors Association

Obtaining an ultimate definition of this ‘something’ we have been addressing, successfully, for over 125 years is elusive, yet this allows flexibility when defining it within different contexts. This provides space for chiropractors to do this (both consciously and subconsciously) every day in practice, and over time to use their growing experience to add complexity and subtlety to their conceptual framework, and their application of their science and art. Millions of patients over the years would attest to the value in that.

Indexing Terms: chiropractic; subluxation; definition; lexicon; rhetoric

From the FULL TEXT Article:

We all address something

For well over a century, chiropractors have successfully been addressing ‘something’, primarily within the spine and its adjacent structures. They observed a phenomenon and devised ways to impact upon it. This resulted in health outcomes significant enough to grow a profession, and an associated body of literature evidence.

Words were chosen

It was chosen early on to use the term subluxation, which is understandable as it often feels to palpation that some sort of misplacement is involved. Right from the very start, it was more than a ‘bone out of place’. Neurological involvement was part of the concept from the beginning, endeavouring to explain the body-wide effects that were observed.

Concepts were developed

Over the years, conceptual frameworks for the ‘something’ were developed. This conceptual development was significantly clinician-driven and therefore, one would imagine, informed and motivated by patient outcomes; to this day our great strength. With time, these frameworks gained considerable complexity, and diversity. Again, this is understandable, as human beings are both complex and diverse. For example, the SOT group had a focus on dural attachments, CSF flow, and their relationship to the functioning of the sacrum and cranium; the various upper cervical techniques zeroed-in on adjusting C0, C1 and C2; Logan had more of a base-up approach, as did Gonstead, etc.

There are more articles like this @ our:

SUBLUXATION Section

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