Chiropractic Care

Value of Chiropractic Services at an On-site Health Center

By Frank M. Painter|August 14, 2012|Chiropractic Care, Cost-Effectiveness|

Value of Chiropractic Services at an On-site Health Center

SOURCE: J Occup Environ Med. 2012 (Aug); 54 (8): 917-921 ~ FULL TEXT

Curt A. Krause, DC; Lisa Kaspin, PhD; Kathleen M. Gorman, MPH; Ross M. Miller, MD, MPH

From the Cerner Healthe Clinic (Dr Krause), Kansas City, MO; Cerner LifeSciences Consulting (Dr Kaspinand and Ms Gorman), Beverly Hills, CA; and Cerner Employer Services (Dr Miller), Cerner Corporation, Beverly Hills, CA.

OBJECTIVE: Chiropractic care offered at an on-site health center could reduce the economic and clinical burden of musculoskeletal conditions.

METHODS: A retrospective claims analysis and clinical evaluation were performed to assess the influence of on-site chiropractic services on health care utilization and outcomes.

RESULTS: Patients treated off-site were significantly more likely to have physical therapy (P < 0.0001) and outpatient visits (P < 0.0001). In addition, the average total number of health care visits, radiology procedures, and musculoskeletal medication use per patient with each event were significantly higher for the off-site group (all P < 0.0001). Last, headache, neck pain, and low back pain-functional status improved significantly (all P < 0.0001).

CONCLUSIONS: These results suggest that chiropractic services offered at on-site health centers may promote lower utilization of certain health care services, while improving musculoskeletal function.

There are many similar studies in our:

Cost-Effectiveness of Chiropractic Page

From the FULL TEXT Article:

Discussion

Although previous research has demonstrated the benefits of chiropractic care, to the best of our knowledge this study is the first to evaluate its impact when offered at an on-site health center. [6–10, 14–17] Given the convenience and quality of care provided by on-site health centers, it was hypothesized that on-site chiropractic care would be more beneficial than off-site clinic care. Despite some limitations that may have weakened the conclusions, the findings suggest on-site chiropractic services are associated with lower health care utilization of certain services and improved functional status of musculoskeletal conditions. (more…)

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The Nordic Maintenance Care Program: Maintenance Care – What Happens During the Consultation? Observations andPatient Questionnaires

By Frank M. Painter|August 11, 2012|Chiropractic Care, Maintenance Care, Spinal Manipulation|

The Nordic Maintenance Care Program: Maintenance Care –
What Happens During the Consultation? Observations and Patient Questionnaires

The Chiro.Org Blog

Chiropractic & Manual Therapies 2012 (Aug 10); 20 (1): 25

Marita Bringsli, Aurora Berntzen, Dorthe B Olsen, Charlotte Leboeuf-Yde and Lise Hestbaek

Background: Because maintenance care (MC) is frequently used by chiropractors in the management of patients with back pain, it is necessary to define the rationale, frequency and indications for MC consultations, and the contents of such consultations. The objectives of the two studies described in this article are: i) to determine the typical spacing between visits for MC patients and to compare MC and non-MC patients, ii) to describe the content of the MC consultation and to compare MC and non-MC patients and iii) to investigate the purposes of the MC program.

Method: In two studies, chiropractors who accepted the MC paradigm were invited to assist with the data collection. In study 1, patients seen by seven different chiropractors were observed by two chiropractic students. They noted the contents of the observed consultations. In study 2, ten chiropractors invited their MC patients to participate in an anonymous survey. Participants filled in a one page questionnaire containing questions on their view of the purposes and contents of their MC consultations. In addition, information was obtained on the duration between appointments in both studies.

Results: There were 178 valid records in study 1, and in study 2 the number of questionnaires received was 373. The time interval between MC visits was close to nine weeks and for non-MC consultations it was two weeks. The content of the consultations in study 1 was similar for MC and non-MC patients with treatment being the most time-consuming element followed by history taking/examination. MC consultations were slightly shorter than non-MC consultations. In study 2, the most common activities reported to have taken place were history taking and manipulative therapy. The most commonly reported purposes were to prevent recurring problems, to maintain best possible function and /or to stay as pain free as possible.

Conclusions: The results from these two studies indicate that MC consultations commonly take place with around two months intervals, and that history taking, examination and treatment are as important components in MC as in non-MC consultations. Further, the results demonstrate that most patients consider the goal to be secondary or tertiary prevention.

The FULL TEXT Article

Background:

Present level of evidence

Maintenance care (MC) is a concept well known among chiropractors, although it is poorly defined and rarely studied. A literature review published in 1996 concluded that there was no scientific evidence to support the claim that MC improves health status and recommended that a series of research actions should be taken [1]. (more…)

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A Theoretical Basis for Maintenance Spinal Manipulative Therapy for the Chiropractic Profession

By Frank M. Painter|July 17, 2012|Chiropractic Care, Maintenance Care, Spinal Manipulation|

A Theoretical Basis for Maintenance Spinal Manipulative Therapy for the Chiropractic Profession

The Chiro.Org Blog

SOURCE: J Chiropractic Humanities 2011 (Dec)

David N. Taylor

Director, Multimed Center, Inc., Greenfield, MA

The World Health Organization defines health as being “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity”. [ 1 ]

Given this broad definition of health, epistemological constructs borrowed from the social sciences may demonstrate health benefits not disclosed by randomized controlled trials.

Health benefits, such as improvement in self-reported quality-of-life (QOL), behaviors associated with decreased morbidity, patient satisfaction, and decreased health care costs, are reported in the following articles, and they make a compelling statement about the effects of chiropractic on general health.

OBJECT: The purpose of this article is to discuss a theoretical basis for wellness chiropractic manipulative care and to develop a hypothesis for further investigation.

METHODS: A SEARCH OF PUBMED AND OF THE MANUAL, ALTERNATIVE, AND NATURAL THERAPY INDEX SYSTEM WAS PERFORMED WITH A COMBINATION OF KEY WORDS: chiropractic, maintenance and wellness care, maintenance manipulative care, preventive spinal manipulation, hypomobility, immobility, adhesions, joint degeneration, and neuronal degeneration. Articles were collected, and trends were identified.

RESULTS: The search revealed surveys of doctors and patients, an initial clinical pilot study, randomized control trials, and laboratory studies that provided correlative information to provide a framework for development of a hypothesis for the basis of maintenance spinal manipulative therapy. Maintenance care optimizes the levels of function and provides a process of achieving the best possible health. It is proposed that this may be accomplished by including chiropractic manipulative therapy in addition to exercise therapy, diet and nutritional counseling, and lifestyle coaching.

(more…)

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TMJ Trauma and Its Rehabilitation

By Frank M. Painter|June 12, 2012|Chiropractic Care, Evaluation & Management, TMJ|

TMJ Trauma and Its Rehabilitation

The Chiro.Org Blog

Clinical Monograph 13

By R. C. Schafer, DC, PhD, FICC

TEMPOROMANDIBULAR JOINT DYSFUNCTION

Proper treatment of TMJ dysfunction must be based on a thorough case history, a complete physical workup, an evaluation of the cranial respiratory impulse and craniosacral mechanisms, and a detailed examination of the TMJ, cranium, and cervical spine. Unfortunately, radiographs to determine abnormal joint space are rarely successful unless over 30% of the bone has been destroyed.

A blow to the jaw is easily transmitted to the temporal bones. As mentioned previously, osteopathic research suggests that a subluxated temporal bone is often the focal fault. This is reported to be grossly indicated by flattening (temporal internal rotation) or protrusion (temporal external rotation) of an ear from the skull.

Symptomatology

The major symptoms of TMJ dysfunction are masticator muscle fatigue and pain, which are usually described as a severe, unilateral (rarely bilateral), dull facial ache that is often fairly localized to an area just anterior to the tragus of the ear. The onset of pain is gradual, progressively increasing over several days or months. It is aggravated by chewing and opening and closing the mouth. Precipitation is often made by eating an apple, a wide yawn, snorkeling, prolonged dental work, playing a wind instrument, prolonged chewing, a bump or pressure on the mandible, sleeping in the prone position, or a cervical whiplash.

You may also enjoy our page on:

Chiropractic Rehabilitation Page

(more…)

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Forearm and Wrist Trauma

By Frank M. Painter|June 11, 2012|Chiropractic Care, Diagnosis, Evaluation & Management|

Forearm and Wrist Trauma

The Chiro.Org Blog

Clinical Monograph 18

By R. C. Schafer, DC, PhD, FICC

As with most parts of the body, traumatic effects in the forearm or wrist may occur abruptly (eg, fracture, strain, sprain) or be the result of long-term microtrauma (eg, tunnel syndromes, arthritis, entrapment by scar tissue).

BACKGROUND

Screening injuries of the forearm and wrist

Joint Motion Restriction

Restriction in pronation suggests a disorder at the elbow, radioulnar articulation of the wrist, or within the forearm. Restriction in supination is associated with a disorder of the elbow or radioulnar articulation of the wrist. Thickened tissues may cause compression symptoms. A palpable nontender ganglion may be found on either the dorsal or volar aspect of the wrist, perceived as a pea-size or slightly larger jelly-like cyst.

Significance of Tenderness

Tenderness over the medial collateral ligament, which rises from the medial epicondyle, is a sign of valgus sprain. Muscle tenderness in the wrist flexor-extensor group is characteristic of flexor-pronator strain (eg, tennis, screwdriving motions). Tender, possibly taut, wrist extensors on the lateral aspect are often associated with tennis elbow. Tenderness in the first tunnel on the radial side is a common site for stenosing tenosynovitis associated with a positive Finkelstein’s sign. (more…)

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The Basis for Spinal Manipulation: Chiropractic Perspective of Indications and Theory

By Frank M. Painter|June 7, 2012|Chiropractic Care, Subluxation|

The Basis for Spinal Manipulation: Chiropractic Perspective of Indications and Theory

The Chiro.Org Blog

SOURCE: J Electromyogr Kinesiol. 2012 (Apr 16)

By Charles N.R. Henderson, DC, PhD

Palmer Center for Chiropractic Research, FL, United States

It is reasonable to think that patients responding to spinal manipulation (SM), a mechanically based therapy, would have mechanical derangement of the spine as a critical causal component in the mechanism of their condition. Consequently, SM practitioners routinely assess intervertebral motion, and treat patients on the basis of those assessments. In chiropractic practice, the vertebral subluxation has been the historical raison d’etre for SM. Vertebral subluxation is a biomechanical spine derangement thought to produce clinically significant effects by disturbing neurological function. (more…)

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Chiropractic Care

Value of Chiropractic Services at an On-site Health Center

Value of Chiropractic Services at an On-site Health Center

The Nordic Maintenance Care Program: Maintenance Care – What Happens During the Consultation? Observations andPatient Questionnaires

The Nordic Maintenance Care Program: Maintenance Care – What Happens During the Consultation? Observations and Patient Questionnaires

A Theoretical Basis for Maintenance Spinal Manipulative Therapy for the Chiropractic Profession

A Theoretical Basis for Maintenance Spinal Manipulative Therapy for the Chiropractic Profession

TMJ Trauma and Its Rehabilitation

TMJ Trauma and Its Rehabilitation

Forearm and Wrist Trauma

Forearm and Wrist Trauma

The Basis for Spinal Manipulation: Chiropractic Perspective of Indications and Theory

The Basis for Spinal Manipulation: Chiropractic Perspective of Indications and Theory

The Nordic Maintenance Care Program: Maintenance Care –
What Happens During the Consultation? Observations and Patient Questionnaires