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Characteristics of Chiropractic Practitioners and Patients

By Frank M. Painter|April 13, 2017|Chiropractic Care|

Characteristics of Chiropractic Practitioners, Patients, and Encounters in Massachusetts and Arizona

J Manipulative Physiol Ther. 2005 (Nov); 28 (9): 645–653

Robert D. Mootz, DC, Daniel C. Cherkin, PhD,
Carson E. Odegard, DC, MPH, David M. Eisenberg, MD,
James P. Barassi, DC, Richard A. Deyo, MD, MPH

State of Washington,
Department of Labor and Industries,
Olympia 98504-4321, USA

OBJECTIVE: To describe chiropractic care using data collected at the time of each patient visit.

METHODS: Random samples of chiropractors licensed in Arizona and Massachusetts were recruited to participate in interviews about their training, demographics, and practice characteristics. Interviewees were then recruited to record information about patient condition, evaluation, care, and visit disposition on 20 consecutive patient visits.

RESULTS: Data for 2,550 chiropractic patient visits were recorded. Care for low back, head and neck pain accounted for almost three quarters of visits. Extremity conditions and wellness care accounted for approximately half of the remaining visits. Spinal and soft tissue examinations were the most frequently reported diagnostic procedures (80% and 56% of visits, respectively), and high-velocity spinal manipulation techniques were the most frequently reported therapeutic procedures (almost 85% of visits). Rehabilitation exercises, thermal modalities, electric stimulation, and counseling/education/self-care were each performed during approximately 25% of visits. Approximately 85% of patients seen were self-referred, whereas only approximately 5% came from medical physicians. Approximately 35% of visits had an expected source of payment directly from the patient. Approximately 80% of visits ended with a plan for the patient to return at a specified time.

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Do Older Adults with Chronic Low Back Pain Differ

By Frank M. Painter|April 11, 2017|Chiropractic Care, Low Back Pain|

Do Older Adults with Chronic Low Back Pain Differ from Younger Adults in Regards to Baseline Characteristics and Prognosis?

The Chiro.Org Blog

SOURCE: Eur J Pain. 2017 (Mar 14) [Epub]

Manogharan S, Kongsted A, Ferreira ML, Hancock MJ.

Faculty of Medicine and Health Science,
Macquarie University,
Sydney, NSW, Australia

BACKGROUND: Low back pain (LBP) in older adults is poorly understood because the vast majority of the LBP research has focused on the working aged population. The aim of this study was to compare older adults consulting with chronic LBP to middle aged and young adults consulting with chronic LBP, in terms of their baseline characteristics, and pain and disability outcomes over 1 year.

METHODS: Data were systematically collected as part of routine care in a secondary care spine clinic. At initial presentation patients answered a self-report questionnaire and underwent a physical examination. Patients older than 65 were classified as older adults and compared to middle aged (45-65 years old) and younger adults (17-44 years old) for 10 baseline characteristics. Pain intensity and disability were collected at 6 and 12 month follow-ups and compared between age groups.

RESULTS: A total of 14,479 participants were included in the study. Of these 3,087 (21%) patients were older adults, 6,071 (42%) were middle aged and 5,321 (37%) were young adults. At presentation older adults were statistically different to the middle aged and younger adults for most characteristics measured (e.g. less intense back pain, more leg pain and more depression); however, the differences were small. The change in pain and disability over 12 months did not differ between age groups.

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Low Back Pain and Chiropractic Page

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Knowledge Transfer within the Canadian Chiropractic Community

By Frank M. Painter|April 10, 2017|Chiropractic Care, Evidence-based Practice, Guidelines|

Knowledge Transfer within the Canadian Chiropractic Community. Part 2: Narrowing the Evidence-Practice Gap

The Chiro.Org Blog

SOURCE: J Can Chiropr Assoc. 2014 (Sep); 58 (3): 206–214

Greg Kawchuk, DC, MSc, PhD, Genevieve Newton, DC, PhD,
John Srbely, DC, PhD, Steven Passmore, Hons BKin, DC, PhD,
André Bussières, DC, FCCS (C), Jason W. Busse, DC, PhD,
and Paul Bruno, BHK, DC, PhD

Associate Professor and Canada Research Chair
in Spinal Function,
Faculty of Rehabilitation Medicine,
University of Alberta

Introduction

This two-part commentary aims to provide clinicians with a basic understanding of knowledge translation (KT), a term that is often used interchangeably with phrases such as knowledge transfer, translational research, knowledge mobilization, and knowledge exchange. [1] Knowledge translation, also known as the science of implementation, is increasingly recognized as a critical element in improving healthcare delivery and aligning the use of research knowledge with clinical practice. [2] The focus of our commentary relates to how these KT processes link with evidence-based chiropractic care.

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The Guidelines Section and the:

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Knowledge Transfer within the Canadian Chiropractic Community. Part 1: Understanding Evidence-Practice Gaps

By Frank M. Painter|April 9, 2017|Guidelines, Knowledge Transfer|

Knowledge Transfer within the Canadian Chiropractic Community. Part 1: Understanding Evidence-Practice Gaps

The Chiro.Org Blog

SOURCE: J Can Chiropr Assoc. 2013 (Jun); 57 (2): 111–115

Greg Kawchuk, DC, PhD, Paul Bruno, BHK, DC, PhD,
Jason W. Busse, DC, PhD, André Bussières, DC, FCCS(C), PhD,
Mark Erwin, DC, PhD, Steven Passmore, Hons BKin, DC, PhD,
and John Srbely, DC, PhD

Associate Professor and Canada Research Chair
in Spinal Function,
Faculty of Rehabilitation Medicine,
University of Alberta

Overview

This two-part commentary aims to provide a basic understanding of knowledge translation (KT), how KT is currently integrated in the chiropractic community and our view of how to improve KT in our profession. Part 1 presents an overview of KT and discusses some of the common barriers to successful KT within the chiropractic profession. Part 2 will suggest strategies to mitigate these barriers and reduce the evidence-practice gap for both the profession at large and for practicing clinicians.

Introduction

New knowledge is created at such a rapid pace that health care professionals find it difficult, if not impossible, to keep up to date. In a single day alone, 75 clinical trials and 11 systematic reviews are published. [1] As a result, it is incredibly difficult to keep up to date with the literature in order to implement new knowledge that may optimize patient care, increase benefits, or reduce harm. In an effort to promote evidence-based practice, many researchers and funding agencies are now focusing on processes to deliver emerging evidence successfully to clinicians and other stakeholders; this process has been termed KT.

What is KT?

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Spinal Pain in Danish School Children

By Frank M. Painter|April 7, 2017|Pediatrics, Spinal Joint Pain|

Spinal Pain in Danish School Children – How Often and How Long? The CHAMPS Study-DK

The Chiro.Org Blog

SOURCE: BMC Musculoskelet Disord. 2017 (Mar 27); 18 (1): 67

Kristina Boe Dissing, Lise Hestbæk, Jan Hartvigsen,
Christopher Williams, Steven Kamper, Eleanor Boyle,
and Niels Wedderkopp

Department of Sports Science and Clinical Biomechanics,
Faculty of Health Sciences,
University of Southern Denmark,
Campusvej 55, DK-5230, Odense M, Denmark.

BACKGROUND: Spinal pain in children and adolescents is a common condition, usually transitory, but the picture of spinal pain still needs elucidation, mainly due to variation in measurement methods. The aim of this study was to describe the occurrence of spinal pain in 8-15 year-old Danish school children, over a 3-year period. Specifically determining the characteristics of spinal pain in terms of frequency and duration.

METHODS: The study was a 3-year prospective longitudinal cohort study including 1,400 school children. The outcomes were based on weekly text messages (SMS) to the parents inquiring about the child’s musculoskeletal pain, and on clinical data from examinations of the children.

RESULTS: The 3-year prevalence was 55%. The prevalence was 29%, 33% and 31% for each of the three study years respectively, and increased statistically significantly with age, especially for lumbopelvic pain. Most children had few and short-lasting episodes with spinal pain, but more than one out of five children had three or more episodes during a study year and 17% of all episodes lasted for more than 4 weeks.

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Chiropractic Pediatrics Section

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Leg Pain Location and Neurological Signs Relate to Outcomes in Primary Care Patients with Low Back Pain

By Frank M. Painter|April 6, 2017|Clinical Decision Rule, Sciatica|

Leg Pain Location and Neurological Signs Relate to Outcomes in Primary Care Patients with Low Back Pain

The Chiro.Org Blog

SOURCE: BMC Musculoskelet Disord. 2017 (Mar 31); 18 (1): 133

Lisbeth Hartvigsen, Lise Hestbaek, Charlotte Lebouef-Yde,
Werner Vach and Alice Kongsted

Department of Sports Science and Clinical Biomechanics,
University of Southern Denmark

BACKGROUND: Low back pain (LBP) patients with related leg pain and signs of nerve root involvement are considered to have a worse prognosis than patients with LBP alone. However, it is unclear whether leg pain location above or below the knee and the presence of neurological signs are important in primary care patients. The objectives of this study were to explore whether the four Quebec Task Force categories (QTFC) based on the location of pain and on neurological signs have different characteristics at the time of care seeking, whether these QTFC are associated with outcome, and if so whether there is an obvious ranking of the four QTFC on the severity of outcomes.

METHOD: Adult patients seeking care for LBP in chiropractic or general practice were classified into the four QTFC based on self-reported information and clinical findings. Analyses were performed to test the associations between the QTFC and baseline characteristics as well as the outcomes global perceived effect and activity limitation after 2 weeks, 3 months, and 1 year and also 1-year trajectories of LBP intensity.

RESULTS: The study comprised 1,271 patients; 947 from chiropractic practice and 324 from general practice. The QTFC at presentation were statistically significantly associated with most of the baseline characteristics, with activity limitation at all follow-up time points, with global perceived effect at 2 weeks but not 3 months and 1 year, and with trajectories of LBP. Severity of outcomes in the QTFC increased from LBP alone, across LBP with leg pain above the knee and below the knee to LBP with nerve root involvement. However, the variation within the categories was considerable.

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Clinical Prediction Rule Page and the:

Low Back Pain and Chiropractic Page

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