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Conservative Spine Care: Opportunities to Improve the Quality

By Frank M. Painter|February 21, 2018|Integrative Care|

Conservative Spine Care: Opportunities to Improve the Quality and Value of Care

SOURCE: Popul Health Manag. 2013 (Dec); 16 (6): 390–396

Thomas M. Kosloff, DC, David Elton, DC, Stephanie A. Shulman, DVM, MPH, Janice L. Clarke, RN, Alexis Skoufalos, EdD, and Amanda Solis, MS

Physical Health, Optum Health,
Kingston, New York.

Low back pain (LBP) has received considerable attention from researchers and health care systems because of its substantial personal, social, work-related, and economic consequences. A narrative review was conducted summarizing data about the epidemiology, care seeking, and utilization patterns for LBP in the adult US population. Recommendations from a consensus of clinical practice guidelines were compared to findings about the current state of clinical practice for LBP. The impact of the first provider consulted on the quality and value of care was analyzed longitudinally across the continuum of episodes of care. The review concludes with a description of recently published evidence that has demonstrated that favorable health and economic outcomes can be achieved by incorporating evidence-informed decision criteria and guidance about entry into conservative low back care pathways.

From the FULL TEXT Article:

Introduction

The united states has the most expensive and complex health care system in the world, [1] yet the magnitude of funds spent on the system has failed to provide commensurate benefits in terms of quality, access, and cost performance. [2]

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Core and Complementary Chiropractic

By Frank M. Painter|February 20, 2018|Chiropractic Care|

Core and Complementary Chiropractic:
Lowering Barriers to Patient Utilization of Services

The Chiro.Org Blog

SOURCE: J Chiropractic Humanities 2016 (Sep 15); 23 (1): 1-13

John J. Triano, DC, PhD and Marion McGregor, DC, PhD

Graduate Education and Research Program,
Canadian Memorial Chiropractic College,
Toronto, ON, Canada

OBJECTIVE: The use of chiropractic services has stalled while interest in accessing manipulation services is rising. The purpose of this paper is to consider this dilemma in the context of the dynamics of professional socialization, surveys of public attitudes, and a potential strategic action.

DISCUSSION: This is a reflection work grounded in the literature on professional socialization and the attitudes held regarding chiropractic in modern society, to include its members, and in original data on training programs. Data were interpreted on the background of the authors’ cross-cultural experiences spanning patient care, research, education, and interprofessional collaboration. Recommendation on a strategic action to counter barriers in patient referrals was synthesized. Professional socialization is the process by which society enables professional privilege. Illustration of typical and divergent professional socialization models emerged that explain cognitive dissonance toward the profession. Questions of trust are commensurate with the experiences during patient encounters rather than with a common identity for the profession. Diversity among encounters perpetuates the uncertainty that affects referral sources. Commonality as an anchor for consistent professional identity and socialization through the content of core chiropractic, defined by training and practice, offers a means to offset uncertainty. Complementary chiropractic, analogous to complementary medicine, provides an outlet under professional socialization for the interests to explore additional methods of care.

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Tone as a Health Concept: An Analysis

By Frank M. Painter|February 19, 2018|Chiropractic Care|

Tone as a Health Concept: An Analysis

The Chiro.Org Blog

SOURCE: Complement Ther Clin Pract. 2017 (Nov); 29: 27–34

Donald McDowall, Elizabeth Emmanuel, Sandra Grace, Marilyn Chaseling

School of Health and Human Sciences,
Gold Coast, Southern Cross University,
Lismore, NSW, Australia

STUDY DESIGN: Concept analysis.

INTRODUCTION: This paper is a report on the analysis of the concept of tone in chiropractic.

PURPOSE: The purpose of this paper is to clarify the concept of tone as originally understood by Daniel David Palmer from 1895 to 1914 and to monitor its evolution over time.

METHODS: Data was sourced from Palmer’s original work, published between 1895 and 1914. A literature search from 1980 to 2016 was also performed on the online databases CINHAL, PubMed and Scopus with key terms including ‘tone’, ‘chiropractic’, ‘Palmer’, ‘vitalism’, ‘health’, ‘homeostasis’, ‘holism’ and ‘wellness’. Finally hand-searches were conducted through chiropractic books and professional literature from 1906 to 1980 for any references to ‘tone’. Rodgers’ evolutionary method of analysis was used to categorise the data in relation to the surrogates, attributes, references, antecedents and consequences of tone.

RESULTS: A total of 49 references were found: five from publications by Palmer; three from the database searches, and; the remaining 41 from professional books, trade journals and websites.

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Contemporary Biopsychosocial Exercise Prescription for Chronic Low Back Pain

By Frank M. Painter|February 16, 2018|Exercise and Chiropractic|

Contemporary Biopsychosocial Exercise Prescription for Chronic Low Back Pain:
Questioning Core Stability Programs and Considering Context

The Chiro.Org Blog

SOURCE: J Can Chiropr Assoc. 2017 (Mar); 61 (1): 6–17

Peter Stilwell, B Kin, DC, MSc and Katherine Harman, PT, PhD

Dalhousie University,
5869 University Ave.
PO Box 15000
Halifax, NS B3H 4R2

This commentary explores the importance of considering the biopsychosocial model and contextual factors when prescribing exercise. Diverse exercise programs for patients with chronic low back pain (CLBP) produce similar outcomes, without one specific exercise protocol demonstrating clear superiority. One clear barrier to positive outcomes is poor exercise adherence. We suggest that there are certain common contextual factors present in all exercise prescription scenarios that may impact adherence and health-related outcomes. While challenging common core stability exercise prescription, we present an argument for enhancing and intentionally shaping the following contextual factors: the therapeutic alliance, patient education, expectations and attributions of therapeutic success or failure, and mastery or cognitive control over a problem. Overall, this commentary argues that to improve exercise adherence and outcomes in the CLBP population, the context in which exercise is delivered and the meaning patients embody need to be considered and shaped by clinicians.

KEYWORDS: chiropractic; chronic; exercise; low back pain; prescription

From the FULL TEXT Article:

Burden of low back pain

Low back pain (LBP) is the leading cause of disability worldwide. [1] Many individuals with a LBP episode will not be pain-free within a year, despite seeking care from a general practitioner or chiropractor. [2] Although many individuals with acute LBP (pain for less than three weeks) see improvements over time; up to 73% will have a recurrence within 12 months. [3]

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Evidence for Brain Glucose Dysregulation in Alzheimer’s Disease

By Frank M. Painter|February 13, 2018|Alzheimer's Disease|

Evidence for Brain Glucose Dysregulation in Alzheimer’s Disease

The Chiro.Org Blog

SOURCE: Alzheimers Dement. 2017 (Oct 19) [Epub]

Yang An, Vijay R. Varma, Sudhir Varma, Ramon Casanova, Eric Dammer et al.

Laboratory of Behavioral Neuroscience,
National Institute on Aging (NIA),
National Institutes of Health (NIH),
Baltimore, MD, USA.

INTRODUCTION: It is unclear whether abnormalities in brain glucose homeostasis are associated with Alzheimer’s disease (AD) pathogenesis.

METHODS: Within the autopsy cohort of the Baltimore Longitudinal Study of Aging, we measured brain glucose concentration and assessed the ratios of the glycolytic amino acids, serine, glycine, and alanine to glucose. We also quantified protein levels of the neuronal (GLUT3) and astrocytic (GLUT1) glucose transporters. Finally, we assessed the relationships between plasma glucose measured before death and brain tissue glucose.

RESULTS: Higher brain tissue glucose concentration, reduced glycolytic flux, and lower GLUT3 are related to severity of AD pathology and the expression of AD symptoms. Longitudinal increases in fasting plasma glucose levels are associated with higher brain tissue glucose concentrations.

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Advancements in the Management of Spine Disorders

By Frank M. Painter|February 11, 2018|Chronic Neck Pain, Spinal Pain|

Advancements in the Management of Spine Disorders

The Chiro.Org Blog

SOURCE: Best Pract Res Clin Rheumatol. 2012 (Apr); 26 (2): 263–280

Scott Haldeman, MD, Professor, Deborah Kopansky-Giles, DC, MSc, Eric L. Hurwitz, DC, PhD, Damian Hoy, BAppSc (Physio), MPH, PhD, W. Mark Erwin, DC, PhD, Simon Dagenais, DC, PhD, MSc, Greg Kawchuk, DC, PhD, Björn Strömqvist, MD, PhD, Nicolas Walsh, MD

Department of Neurology,
University of California,
Irvine, USA.

Spinal disorders and especially back and neck pain affect more people and have greater impact on work capacity and health-care costs than any other musculoskeletal condition. One of the difficulties in reducing the burden of spinal disorders is the wide and heterogeneous range of specific diseases and non-specific musculoskeletal disorders that can involve the spinal column, most of which manifest as pain. Despite, or perhaps because of its impact, spinal disorders remain one of the most controversial and difficult conditions for clinicians, patients and policymakers to manage. This paper provides a brief summary of advances in the understanding of back and neck pain over the past decade as evidenced in the current literature. This paper includes the following sections: a classification of spinal disorders; the epidemiology of spine pain in the developed and developing world; key advancements in biological and biomechanical sciences in spine pain; the current status of potential methods for the prevention of back and neck pain; rheumatological and systemic disorders that impact the spine; and evidence-based surgical and non-surgical management of spine pain.

The final section of this paper looks to the future and proposes actions and strategies that may be considered by the international Bone and Joint Decade (BJD), by providers, institutions and by policymakers so that we may better address the burden of spine disorders at global and local levels.

From the FULL TEXT Article:

Introduction

Spinal pain and its associated disorders affect more people and have greater impact on work capacity and health-care costs than any other musculoskeletal condition. Recent studies suggest that, in many societies, spinal disorders are a greater source of disability and impact the consumption of more health-care resources than any other class of diseases or health problems. [1] Despite, or perhaps because of its impact, spinal disorders remain one of the most controversial and difficult conditions for clinicians, patients and policymakers to manage.

One of the difficulties in reducing the impact of spinal pain is the wide and heterogeneous range of specific diseases and non-specific musculoskeletal disorders that can involve the spinal column, most of which manifest as spinal pain. These disorders have been classified in multiple ways but the most widely accepted classification includes four well-defined clinical categories as noted in Table 1.

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Conservative Spine Care: Opportunities to Improve the Quality

Conservative Spine Care: Opportunities to Improve the Quality and Value of Care

Core and Complementary Chiropractic

Core and Complementary Chiropractic: Lowering Barriers to Patient Utilization of Services

Tone as a Health Concept: An Analysis

Tone as a Health Concept: An Analysis

Contemporary Biopsychosocial Exercise Prescription for Chronic Low Back Pain

Contemporary Biopsychosocial Exercise Prescription for Chronic Low Back Pain: Questioning Core Stability Programs and Considering Context

Evidence for Brain Glucose Dysregulation in Alzheimer’s Disease

Evidence for Brain Glucose Dysregulation in Alzheimer’s Disease

Advancements in the Management of Spine Disorders

Advancements in the Management of Spine Disorders

Core and Complementary Chiropractic:
Lowering Barriers to Patient Utilization of Services

Contemporary Biopsychosocial Exercise Prescription for Chronic Low Back Pain:
Questioning Core Stability Programs and Considering Context