BLOG – Page 95 – Chiropractic Resource Organization

What Have We Learned From Ten Years of Trajectory Research in Low Back Pain?

By Frank M. Painter|May 25, 2016|Low Back Pain, Research|

What Have We Learned From Ten Years of Trajectory Research in Low Back Pain?

SOURCE: BMC Musculoskelet Disord. 2016 (May 21); 17 (1): 220

Alice Kongsted, Peter Kent, Iben Axen, Aron S. Downie, and Kate M. Dunn

The Nordic Institute of Chiropractic and Clinical Biomechanics,
Odense, Denmark.
a.kongsted@nikkb.dk

BACKGROUND: Non-specific low back pain (LBP) is often categorised as acute, subacute or chronic by focusing on the duration of the current episode. However, more than twenty years ago this concept was challenged by a recognition that LBP is often an episodic condition. This episodic nature also means that the course of LBP is not well described by an overall population mean. Therefore, studies have investigated if specific LBP trajectories could be identified which better reflect individuals’ course patterns. Following a pioneering study into LBP trajectories published by Dunn et al. in 2006, a number of subsequent studies have also identified LBP trajectories and it is timely to provide an overview of their findings and discuss how insights into these trajectories may be helpful for improving our understanding of LBP and its clinical management.

DISCUSSION: LBP trajectories in adults have been identified by data driven approaches in ten cohorts, and these have consistently demonstrated that different trajectory patterns exist. Despite some differences between studies, common trajectories have been identified across settings and countries, which have associations with a number of patient characteristics from different health domains. One study has demonstrated that in many people such trajectories are stable over several years. LBP trajectories seem to be recognisable by patients, and appealing to clinicians, and we discuss their potential usefulness as prognostic factors, effect moderators, and as a tool to support communication with patients.

There are more articles like this @ our:

Low Back Pain and Chiropractic Page

(more…)

0

Variations in Patterns of Utilization and Charges for the Care of Headache in North Carolina, 2000-2009: A Statewide Claims’ Data Analysis

By Frank M. Painter|May 22, 2016|Headache|

Variations in Patterns of Utilization and Charges for the Care of Headache in North Carolina, 2000-2009: A Statewide Claims’ Data Analysis

The Chiro.Org Blog

SOURCE: J Manip Physiol Ther. 2016 (May); 39 (4): 229–239

Eric L. Hurwitz, DC, PhD, Maria Vassilaki, MD, MPH, PhD,
Dongmei Li, PhD, Michael J. Schneider, DC, PhD,
Joel M. Stevans, DC, Reed B. Phillips, DC, PhD,
Shawn P. Phelan, DC, Eugene A. Lewis, DC, MPH,
Richard C. Armstrong, MS, DC

Office of Public Health Studies,
University of Hawai`i at M?noa,
Honolulu, HI.

OBJECTIVES: The purpose of the study was to compare patterns of utilization and charges generated by medical doctors (MDs), doctors of chiropractic (DCs), and physical therapists (PTs) for the treatment of headache in North Carolina.

METHODS: Retrospective analysis of claims data from the North Carolina State Health Plan for Teachers and State Employees from 2000 to 2009. Data were extracted from Blue Cross Blue Shield of North Carolina for the North Carolina State Health Plan using International Classification of Diseases, Ninth Revision, diagnostic codes for headache. The claims were separated by individual provider type, combination of provider types, and referral patterns.

RESULTS: The majority of patients and claims were in the MD-only or MD plus referral patterns. Chiropractic patterns represented less than 10% of patients. Care patterns with single-provider types and no referrals incurred the least charges on average for headache. When care did not include referral providers or services, MD with DC care was generally less expensive than MD care with PT. However, when combined with referral care, MD care with PT was generally less expensive. Compared with MD-only care, risk-adjusted charges (available 2006-2009) for patients in the middle risk quintile were significantly less for DC-only care.

There are more articles like this @ our:

Headache and Chiropractic Page

(more…)

0

Variations in Patterns of Utilization and Charges for the Care of Neck Pain in North Carolina, 2000 to 2009: A Statewide Claims’ Data Analysis

By Frank M. Painter|May 21, 2016|Chronic Neck Pain|

Variations in Patterns of Utilization and Charges for the Care of Neck Pain in North Carolina, 2000 to 2009: A Statewide Claims’ Data Analysis

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2016 (May); 39 (4): 240–251

Eric L. Hurwitz, DC, PhD, Dongmei Li, PhD, Jenni Guillen, MS,
Michael J. Schneider, DC, PhD, Joel M. Stevans, DC,
Reed B. Phillips, DC, PhD, Shawn P. Phelan, DC,
Eugene A. Lewis, DC, MPH, Richard C. Armstrong, MS, DC,
Maria Vassilaki, MD, MPH, PhD

Office of Public Health Studies,
University of Hawaii at Manoa,
Honolulu, HI.

OBJECTIVES: The purpose of the study was to compare utilization and charges generated by medical doctors (MD), doctors of chiropractic (DC) and physical therapists (PT) by provider patterns of care for the treatment of neck pain in North Carolina.

METHODS: This was an analysis of neck-pain-related closed claim data from the North Carolina State Health Plan for Teachers and State Employees (NCSHP) from 2000 to 2009. Data were extracted from Blue Cross Blue Shield of North Carolina for the NCSHP using ICD-9 diagnostic codes for uncomplicated neck pain (UNP) and complicated neck pain (CNP).

RESULTS: Care patterns with single-provider types and no referrals incurred the least average charges for both uncomplicated neck pain (UNP) and complicated neck pain (CNP). When care did not include referral providers or services, for either UNP or CNP, MD care with PT was generally less expensive than MD care with DC care. However, when care involved referral providers or services, MD and PT care was on average more expensive than MD and DC care for either UNP or CNP. Risk-adjusted charges for patients in the middle quintile of risk (available 2006-2009) were lower for chiropractic patients with or without medical care or referral care to other providers.

There are more articles like this @ our:

Chronic Neck Pain and Chiropractic Page

(more…)

0

The Effect of Chiropractic Techniques on the Cobb Angle in Idiopathic Scoliosis Arising in Adolescence

By Frank M. Painter|May 20, 2016|Scoliosis, Uncategorized|

The Effect of Chiropractic Techniques on the Cobb Angle in Idiopathic Scoliosis Arising in Adolescence

The Chiro.Org Blog

SOURCE: J Phys Ther Sci. 2016 (Apr); 28 (4): 1106–1110

Sunghak Byun, PhD and Dongwook Han, PhD, PT

Department of Physical Therapy,
College of Health and Welfare,
Silla University, Republic of Korea.

Purpose The purpose of this study was to examine whether chiropractic techniques would reduce the curvature of idiopathic scoliosis, which commonly occurs in elementary school children.

Subjects The subjects of this study were 5 healthy elementary students who listened to an explanation of the study methods and purpose of the study and agreed to participate in the experiment.

Methods The Cobb angle was measured by taking an X-ray (FCT-1, Dongmun, Goyangsi, Republic of Korea) taken from the rear, using X-ray film. The method of intervention this study used was application of chiropractic techniques. Spinal correction was carried out for 30 minutes per session, which included soft tissue massage, 3 times a week for 8 weeks.

Results It was established that the Cobb angle was noticeably decreased after 4 weeks of the intervention. Post Hoc analysis revealed that the Cobb angle noticeably decreased after 4 weeks compared with the Cobb angle before the chiropractic techniques were applied. However, no significant difference in Cobb angle was evident after the fourth week.

There are more articles like this @ our:

Scoliosis and Chiropractic Page

(more…)

0

Vertical Posture and Head Stability in Patients With Chronic Neck Pain

By Frank M. Painter|May 19, 2016|Chronic Neck Pain, Whiplash|

Vertical Posture and Head Stability in Patients With Chronic Neck Pain

The Chiro.Org Blog

SOURCE: J Rehabil Med. 2003 (Sep); 35 (5): 229–235

P. Michaelson, M. Michaelson, S. Jaric, M .L. Latash, P. Sjölander, M. Djupsjöbacka

Southern Lapland Research Department
Vilhelmina, Sweden.

OBJECTIVE: To evaluate postural performance and head stabilization of patients with chronic neck pain.

DESIGN: A single-blind comparative group study.

SUBJECTS: Patients with work-related chronic neck pain (n = 9), with chronic whiplash associated disorders (n = 9) and healthy subjects (n = 16).

METHODS: During quiet standing in different conditions (e.g. 1 and 2 feet standing, tandem standing, and open and closed eyes) the sway areas and the ability to maintain the postures were measured. The maximal peak-to-peak displacement of the centre of pressure and the head translation were analysed during predictable and unpredictable postural perturbations.

RESULTS: Patients with chronic neck pain, in particular those with whiplash-associated disorders, showed larger sway areas and reduced ability to successfully execute more challenging balance tasks. They also displayed larger sway areas and reduced head stability during perturbations.

There are more articles like this @ our:

The Whiplash Page and the:

Chronic Neck Pain and Chiropractic Page

(more…)

0

Variations in Patterns of Utilization and Charges for the Care of Low Back Pain in North Carolina, 2000 to 2009: A Statewide Claims’ Data Analysis

By Frank M. Painter|May 18, 2016|Cost-Effectiveness, Low Back Pain|

Variations in Patterns of Utilization and Charges for the Care of Low Back Pain in North Carolina, 2000 to 2009: A Statewide Claims’ Data Analysis

The Chiro.Org Blog

SOURCE: J Manip Physiol Ther. 2016 (May); 39 (4): 252–262

Eric L. Hurwitz, DC, PhD, Dongmei Li, PhD,
Jenni Guillen, MS, Michael J. Schneider, DC, PhD,
Joel M. Stevans, DC, Reed B. Phillips, DC, PhD,
Shawn P. Phelan, DC, Eugene A. Lewis, DC, MPH,
Richard C. Armstrong, MS, DC,
Maria Vassilaki, MD, MPH, PhD

Office of Public Health Studies,
University of Hawai`i at M?noa,
Honolulu, HI.

OBJECTIVES: The purpose of the study was to compare utilization and charges generated by medical doctors (MD), doctors of chiropractic (DC) and physical therapists (PT) by patterns of care for the treatment of low back pain in North Carolina.

METHODS: This was an analysis of low-back-pain-related closed claim data from the North Carolina State Health Plan for Teachers and State Employees from 2000 to 2009. Data were extracted from Blue Cross Blue Shield of North Carolina for the North Carolina State Health Plan using International Classification of Diseases, 9th Revision diagnostic codes for:

uncomplicated low back pain (ULBP) and
complicated low back pain (CLBP).

RESULTS: Care patterns with single-provider types and no referrals incurred the least charges on average for both ULBP and CLBP. When care did not include referral providers or services, for ULBP, MD and DC care was on average $465 less than MD and PT care. For CLBP, MD and DC care averaged $965 more than MD and PT care. However, when care involved referral providers or services, MD and DC care was on average $1600 less when compared to MD and PT care for ULBP and $1885 less for CLBP. Risk-adjusted charges (available 2006-2009) for patients in the middle quintile of risk were significantly less for DC care patterns.

There are more articles like this @ our:

Low Back Pain and Chiropractic Page

(more…)

0