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Expectations for Recovery Important in the Prognosis

By Frank M. Painter|July 23, 2017|Patient Expectations|

Expectations for Recovery Important in the Prognosis of Whiplash Injuries

SOURCE: PLoS Med. 2008 (May 13); 5 (5): e105

Lena W Holm , Linda J Carroll,
J. David Cassidy, Eva Skillgate, Anders Ahlbom

Division of Epidemiology,
Institute of Environmental Medicine,
Karolinska Institutet, Stockholm, Sweden.

BACKGROUND: Individuals’ expectations on returning to work after an injury have been shown to predict the duration of time that a person with work-related low back pain will remain on benefits; individuals with lower recovery expectations received benefits for a longer time than those with higher expectations. The role of expectations in recovery from traumatic neck pain, in particular whiplash-associated disorders (WAD), has not been assessed to date to our knowledge. The aim of this study was to investigate if expectations for recovery are a prognostic factor after experiencing a WAD.

METHODS AND FINDINGS: We used a prospective cohort study composed of insurance claimants in Sweden. The participants were car occupants who filed a neck injury claim (i.e., for WAD) to one of two insurance companies between 15 January 2004 and 12 January 2005 (n = 1,032). Postal questionnaires were completed shortly (average 23 d) after the collision and then again 6 mo later.

Expectations for recovery were measured with a numerical rating scale (NRS) at baseline, where 0 corresponds to “unlikely to make a full recovery” and 10 to “very likely to make a full recovery.” The scale was reverse coded and trichotomised into NRS 0, 1-4, and 5-10. The main outcome measure was self-perceived disability at 6 mo postinjury, measured with the Pain Disability Index, and categorised into no/low, moderate, and high disability. Multivariable polytomous logistic regression was used for the analysis.

There was a dose response relationship between recovery expectations and disability. After controlling for severity of physical and mental symptoms, individuals who stated that they were less likely to make a full recovery (NRS 5-10), were more likely to have a high disability compared to individuals who stated that they were very likely to make a full recovery (odds ratio [OR] 4.2 [95% confidence interval (CI) 2.1 to 8.5]. For the intermediate category (NRS 1-4), the OR was 2.1 (95% CI 1.2 to 3.2). Associations between expectations and disability were also found among individuals with moderate disability.

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Whiplash and Chiropractic Page and the:

Outcome Assessment Page and the:

Chiropractic and Spinal Pain Page

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Systematic Review of Self-Reported Prognosis

By Frank M. Painter|July 21, 2017|Chiropractic Management, Mild Traumatic Brain Injury|

Systematic Review of Self-Reported Prognosis in Adults After Mild Traumatic Brain Injury: Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis

The Chiro.Org Blog

Arch Phys Med Rehabil. 2014 (Mar); 95 (3 Suppl): S132–151

J. David Cassidy, PhD, DrMedSc, Carol Cancelliere, DC, MPH,
Linda J. Carroll, PhD, Pierre Côté, DC, PhD,
Cesar A. Hincapié, DC, MHSc, Lena W. Holm, et al.

Institute of Sports Science and Clinical Biomechanics,
Faculty of Health, University of Southern Denmark,
Odense, Denmark

OBJECTIVE: To update the mild traumatic brain injury (MTBI) prognosis review published by the World Health Organization Task Force in 2004.

DATA SOURCES: MEDLINE, PsycINFO, Embase, CINAHL, and SPORTDiscus were searched from 2001 to 2012. We included published, peer-reviewed studies with more than 30 adult cases.

STUDY SELECTION: Controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to assess subjective, self-reported outcomes. After 77,914 titles and abstracts were screened, 299 articles were eligible and reviewed for scientific quality. This includes 3 original International Collaboration on MTBI Prognosis (ICoMP) research studies.

DATA EXTRACTION: Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. Two reviewers independently reviewed each study and tabled data from accepted articles. A third reviewer was consulted for disagreements.

DATA SYNTHESIS: Evidence from accepted studies was synthesized qualitatively into key findings, and prognostic information was prioritized according to design as exploratory or confirmatory. Of 299 reviewed studies, 101 (34%) were accepted and form our evidence base of prognostic studies. Of these, 23 addressed self-reported outcomes in adults, including 2 of the 3 original ICoMP research studies. These studies show that common postconcussion symptoms are not specific to MTBI/concussion and occur after other injuries as well. Poor recovery after MTBI is associated with poorer premorbid mental and physical health status and with more injury-related stress. Most recover over 1 year, but persistent symptoms are more likely in those with more acute symptoms and more emotional stress.

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Mild Traumatic Brain Injury Page

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Sport Concussion Knowledge and Clinical Practices

By Frank M. Painter|July 19, 2017|Concussion, Mild Traumatic Brain Injury|

Sport Concussion Knowledge and Clinical Practices: A Survey of Doctors of Chiropractic With Sports Certification

The Chiro.Org Blog

SOURCE: J Chiropractic Medicine 2015 (Sep); 14 (3): 169–175

William J. Moreau, DC, DACBSP, CSCS,
Dustin C. Nabhan, DC, DACBSP, CSCS, RMSK,
Taylor Walden, BA

Managing Director,
United States Olympic Committee,
Colorado Springs, CO

OBJECTIVE: The purpose of this study is to describe the knowledge base and clinical practices regarding concussion by sports-certified doctors of chiropractic.

METHODS: A 21–item survey was distributed to the 312 attendees of the 2014 American Chiropractic Board of Sports Physicians Sports Sciences Symposium. Results were measured by frequency analysis and descriptive statistics for all surveys completed by sports-certified chiropractors.

RESULTS: Seventy-six surveys were returned by sports-certified doctors of chiropractic. All (N = 76) 100% of respondents believe that the evaluation of concussion should be performed by a health care provider with training in concussion. The respondents actively assess and manage concussion in adults (96%), adolescents (95%), and children (75%). A majority (79%) of respondents believe that the Sideline Concussion Assessment Tool–3 represents a current standard of care for the sideline evaluation of the athlete who possibly has sustained a sport concussion. Most respondents agreed or strongly agreed that manual therapies may be appropriate in certain circumstances in adults (80%) and minors (80%).

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Mild Traumatic Brain Injury Page

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The Reduction of Asthma Symptoms and Medication

By Frank M. Painter|July 18, 2017|Asthma, Chiropractic Care|

The Reduction of Asthma Symptoms and Medication After Chiropractic Care

The Chiro.Org Blog

SOURCE: Chiropractic J Australia 2017; 45: 138–143

Thomas A. Brozovich D.C.

Clinical Sciences,
Palmer College of Chiropractic,
Davenport, IA USA

Objective: To discuss the chiropractic management of a patient with asthma who was treated using chiropractic care.

Clinical features: A 5–year-old male with a history of asthma for 3–1/2 years sought chiropractic care for his asthma symptoms, which included tightness of the chest, shortness of breath, nasal congestion, and nonproductive cough that were not responding to allopathic treatment.

Intervention and Outcome: He was adjusted based on location of his subluxations (intersegmental joint dysfunction). He had 5 treatments over 3 days. Treatment consisted of chiropractic adjustment to the cervical and thoracic region. We observed a quick and drastic reduction in his symptoms and he has been able to reduce all of his medication over the next few months with the exception of a rescue inhaler of albuterol, which he needs only infrequently.

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Asthma and Chiropractic Page

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Fish-oil Supplementation Enhances the Effects of Strength

By Frank M. Painter|July 12, 2017|Nutrition, Omega-3 Fatty Acids|

Fish-oil Supplementation Enhances the Effects of Strength Training in Elderly Women

The Chiro.Org Blog

SOURCE: Am J Clin Nutr. 2012 (Feb); 95 (2): 428–436

Cintia LN Rodacki, André LF Rodacki,
Gleber Pereira, Katya Naliwaiko,

Paraná Federal University,
Setor de Ciências Biológicas,
Curitiba, Paraná, Brazil.

BACKGROUND: Muscle force and functional capacity generally decrease with aging in the older population, although this effect can be reversed, attenuated, or both through strength training. Fish oil (FO), which is rich in n-3 (omega-3) polyunsaturated fatty acids (PUFAs), has been shown to play a role in the plasma membrane and cell function of muscles, which may enhance the benefits of training. The effect of strength training and FO supplementation on the neuromuscular system of the elderly has not been investigated.

OBJECTIVE: The objective was to investigate the chronic effect of FO supplementation and strength training on the neuromuscular system (muscle strength and functional capacity) of older women.

DESIGN: Forty-five women (aged 64 ± 1.4 y) were randomly assigned to 3 groups. One group performed strength training only (ST group) for 90 d, whereas the others performed the same strength-training program and received FO supplementation (2 g/d) for 90 d (ST90 group) or for 150 d (ST150 group; supplemented 60 d before training). Muscle strength and functional capacity were assessed before and after the training period.

RESULTS: No differences in the pretraining period were found between groups for any of the variables. The peak torque and rate of torque development for all muscles (knee flexor and extensor, plantar and dorsiflexor) increased from pre- to posttraining in all groups. However, the effect was greater in the ST90 and ST150 groups than in the ST group. The activation level and electromechanical delay of the muscles changed from pre- to posttraining only for the ST90 and ST150 groups. Chair-rising performance in the FO groups was higher than in the ST group.

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Omega-3 Fatty Acids Page

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Schoolbags and Back Pain in Children Between 8 and 13 Years

By Frank M. Painter|July 9, 2017|Backpacks, Pediatrics|

Schoolbags and Back Pain in Children Between 8 and 13 Years: A National Study

The Chiro.Org Blog

SOURCE: Br J Pain. 2017 (May); 11 (2): 81–86 ~ FULL TEXT

Karl Spiteri, Maria-Louisa Busuttil,
Samuel Aquilina, Dorothy Gauci,
Erin Camilleri, and Victor Grech

Malta Association of Physiotherapists,
Gzira, Malta.

Schoolbag weight in schoolchildren is a recurrent and contentious issue within the educational and health sphere. Excessive schoolbag weight can lead to back pain in children, which increases the risk of chronic back pain in adulthood. There is limited research regarding this among the Maltese paediatric population. A cross-sectional study was undertaken across all schools in Malta among students aged 8–13 years (inclusive). Data were collected using a questionnaire detailing schoolbag characteristics, self-reported pain and demographic variables, such as age and gender. Structured interviews with participants were also carried out by physiotherapists. A total of 4,005 participants were included in the study, with 20% of the total Malta schoolchildren population. Over 70% of the subjects had a schoolbag that exceeded the recommended 10% bag weight to body ratio. A total of 32% of the sample complained of back pain, with 74% of these defining it as low in intensity on the face pain scale-revised. The presence of back pain was statistically related to gender, body mass index (BMI), school and bag weight to body weight ratio. After adjusting for other factors, self-reported back pain in schoolchildren is independently linked to carrying heavy schoolbags. This link should be addressed to decrease the occurrence of back pain in this age group.

From the FULL TEXT Article:

Introduction

Carrying schoolbags and school attendance is a daily routine for students. The incorrect handling of schoolbags with excessive bag weight can lead to back pain in children. [1–4] It is recommended that the total weight of the schoolbag does not exceed 10% of body weight. [1] The development of back pain in children is of concern since it increases the risk of developing chronic back pain in adulthood. [5] Studies have shown that the prevalence of low back pain in schoolchildren ranges from 25% to 55% in those aged between 10 and 15 years. [6–8] In most cases, the pain intensity is relatively low.[7]

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Backpacks and Children Page

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