Pediatrics

Injuries in the Pediatric Patient

By Frank M. Painter|December 25, 2015|Pediatrics, Radiology|

Injuries in the Pediatric Patient: Review of Key Acquired and Developmental Issues

J Clin Chiro Peds 2009 (Dec); 10 (2): 665—670 ~ FULL TEXT

Beverly L. Harger, D.C., D.A.C.B.R., and Kim Mullen, D.C.

Department of Radiology,
Western States Chiropractic College,
Portland, Oregon

Key words: pediatric trauma, growth plate fractures, slipped capital femoral epiphysis, incomplete fractures, torus fracture, spondylolysis, pars interarcularis defects, single photon emission computed tomography, Scheuermann’s disease, ring apophyseal fracture.

Introduction

A plethora of conditions specifically target children and adolescents which are not prevalent in the adult population. Understanding the age-related differences in this population can help clinicians improve diagnosis and therefore management of these conditions. Though it is beyond the scope of this paper to extensively address diseases targeting the pediatric population, common key injuries will be discussed with emphasis on the role imaging plays in establishing accurate diagnosis.

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Resolution of Conductive Hearing Loss Due to Otitis Media after Chiropractic Treatment

By Frank M. Painter|December 10, 2015|Otitis Media, Pediatrics|

Resolution of Conductive Hearing Loss Due to Otitis Media after Chiropractic Treatment

The Chiro.Org Blog

SOURCE: J Clinical Chiropractic Pediatrics 2011 (Dec); 12 (2)

Peri Dwyer, DC, DICCP and James Boysen, DC

Private practice,
Tallahassee, Florida, USA

Objective: To describe the chiropractic management of a patient with otitis media and conductive hearing loss.

Clinical Features: Parents of a 6-year-old male sought chiropractic care for the child’s measured conductive hearing loss on puretone audiometry, fluid in both ears and repeated bouts of otitis media. Prior treatment included several rounds of antibiotics starting at 14 months and myringotomy at age 3.

Intervention And Outcome: Treatment consisted of cervical, thoracic and pelvic manual manipulative therapy along with cranial manipulation. After 6 chiropractic adjustments, the child was asymptomatic, and remained free of otitis media symptoms on long-term follow-up. Nineteen months after commencement of treatment, a repeat audiogram was performed, showing normal hearing in both ears.

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Pain Characteristics of Adolescent Spinal Pain

By Frank M. Painter|December 4, 2015|Pediatrics, Spinal Joint Pain|

Pain Characteristics of Adolescent Spinal Pain

The Chiro.Org Blog

SOURCE: BMC Pediatr. 2015 (Apr 17); 15 (1): 42 ~ FULL TEXT

Brigitte Wirth and B Kim Humphreys

Institute of Human Movement Sciences and Sport,
ETH Zurich, Wolfgang Pauli Str. 27,
Zurich, 8093, Switzerland

BACKGROUND: Although adolescent spinal pain increases the risk for chronic back pain in adulthood, most adolescents can be regarded as healthy. The aim of the present study was to provide data on localization, intensity and frequency of adolescent spinal pain and to investigate which physical and psycho-social parameters predict these pain characteristics.

METHOD: On the occasion of Spine Day, an annual event where children and adolescents are examined by chiropractors on a voluntary basis for back problems, 412 adolescents (10 to 16 years) were tested (by questionnaire and physical examination). Pain characteristics (localization, intensity, and frequency) were identified and evaluated using descriptive statistics. Regression analyses were performed to investigate possible influencing psycho-social and physical influence factors.

RESULTS: Adolescents who suffered from pain in more than one spinal area reported higher pain intensity and frequency than those with pain in only one spinal area. Sleep disorders were a significant predictor for pain in more than one spinal area (p < 0.01) as well as a trend for frequent pain (p = 0.06). Adolescents with frequent pain showed impaired balance on one leg standing with closed eyes (p = 0.02).

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Developmental Advancements Following Chiropractic Care in a Four-year-old Child

By Frank M. Painter|November 18, 2015|Developmental Delay, Dyspraxia, Pediatrics|

Developmental Advancements Following Chiropractic Care in a Four-year-old Child With Dyspraxia and Associated Developmental Delays: A Case Report

The Chiro.Org Blog

SOURCE: Journal of Clinical Chiropractic Pediatrics 2015; 15 (1) ~ FULL TEXT

Jordenne Troy 1, Tara Dennis 1 and Alice Cade 2 BSc, B Chiro, DICCP

1. Senior Intern,
New Zealand College of Chiropractic,
Auckland, New Zealand

2. Lecturer and Intern Mentor,
New Zealand College of Chiropractic,
Auckland, New Zealand

Objective: To present the chiropractic management of a 4-year-old child diagnosed with dyspraxia and concomitant vertebral subluxations.

Clinical Features: A four-year-old boy with a history of developmental motor delays was presented by his mother for chiropractic evaluation. The child was previously diagnosed with dyspraxia at one year of age, based on a delay in developmental milestones being met; specifically of speech and fine motor control. The patient was 1.25-years-old before starting to walk and 3-years-old before being able to produce any basic sounds such as “Ma” or “Da”.

At the commencement of chiropractic care the child was undergoing concomitant speech therapy; six weeks of intensive repetitive therapy was the average amount of time required for the patient to learn and retain one new sound or word.

Intervention: Modified Diversifed (Touch-and-hold) and Sacro-Occipital Techniques were utilized to reduce subluxation indicators through the cranium, upper cervical and lumbopelvic spine. Fifteen adjustments were administered over a 4-month period.

Outcome: The child experienced a number of developmental advancements over the duration of chiropractic care, specifically in speech, fine motor control and coordination. After 8 visits the patient learned 20 new words in one week, after 12 visits all primitive reflexes were tested to be within normal limits and after 15 visits their vocabulary consisted of hundreds of words and continued to expand.

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A Proposed Model With Possible Implications for Safety and Technique Adaptations for Chiropractic Spinal Manipulative Therapy for Infants and Children

By Frank M. Painter|October 2, 2015|Pediatrics|

A Proposed Model With Possible Implications for Safety and Technique Adaptations for Chiropractic Spinal Manipulative Therapy for Infants and Children

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2013 (Jul 8) [Epub] ~ FULL TEXT

Aurélie M. Marchand, DC, MScACPP

Doctor of Chiropractic,
Private Practice,
Padova, Italy.
aureliemarchand@hotmail.com

OBJECTIVE: A literature review of tensile strength of adults and pediatric human spine specimens was performed to gather information about biomechanical forces and spinal differences of adults and children and to synthesize these findings into a scaling model to guide safety and clinical decisions for spinal manipulative therapy (SMT) for children and infants.

METHODS: The literature search was performed using PubMed from inception to November 2012 with no filters or language restrictions. The search included terms related to pediatric spine biomechanics and tensile strength. Studies included those in which human tensile strengths necessary to create anatomical damage in the cervical, thoracic, or lumbar spine of pediatric human subjects were recorded. The pediatric population was defined as human subjects from birth to 18 years old. Biomechanical findings were used to propose a scaling model based on specimen age and differences in tensile strengths. A model of care was proposed using the scaling model and the existing literature on pediatric technique adaptations.

RESULTS: Nine experimental studies were selected, 5 in the pediatric population (46 specimens) and 4 in the adult population (47 specimens). Mean tensile strengths were estimated, and ratios were used to describe differences between 4 age groups. The preliminary model of care proposed includes maximum loading forces by age group. From these studies, a model showed a nonlinear increase in the cervical spine tensile strengths based on specimen age.

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High Prevalence of Daily and Multi-site pain — A Cross-sectional Population-based Study Among 3000 Danish Adolescents

By Frank M. Painter|July 19, 2015|Back Pain, Pediatrics|

High Prevalence of Daily and Multi-site pain — A Cross-sectional Population-based Study Among 3000 Danish Adolescents

The Chiro.Org Blog

SOURCE: BMC Pediatr. 2013 (Nov 19); 13: 191 ~ FULL TEXT

Michael S Rathleff, Ewa M Roos, Jens L Olesen, and Sten Rasmussen

HEALTH,
Aarhus University,
Vennelyst Boulevard 9,
8000 Aarhus C, Denmark.
misr@rn.dk

BACKGROUND: Daily pain and multi-site pain are both associated with reduction in work ability and health-related quality of life (HRQoL) among adults. However, no population-based studies have yet investigated the prevalence of daily and multi-site pain among adolescents and how these are associated with respondent characteristics. The purpose of this study was to investigate the prevalence of self-reported daily and multi-site pain among adolescents aged 12-19 years and associations of almost daily pain and multi-site pain with respondent characteristics (sex, age, body mass index, HRQoL and sports participation).

METHODS: A population-based cross-sectional study was conducted among 4,007 adolescents aged 12-19 years in Denmark. Adolescents answered an online questionnaire during physical education lessons. The questionnaire contained a mannequin divided into 12 regions on which the respondents indicated their current pain sites and pain frequency (rarely, monthly, weekly, more than once per week, almost daily pain), characteristics, sports participation and HRQoL measured by the EuroQoL 5D. Multivariate regression was used to calculate the odds ratio for the association between almost daily pain, multi-site pain and respondent characteristics.

RESULTS: The response rate was 73.7%. A total of 2,953 adolescents (62% females) answered the questionnaire. 33.3% reported multi-site pain (pain in > 1 region) while 19.8% reported almost daily pain. 61% reported current pain in at least one region with knee and back pain being the most common sites. Female sex (OR: 1.35-1.44) and a high level of sports participation (OR: 1.51-2.09) were associated with increased odds of having almost daily pain and multi-site pain. Better EQ-5D score was associated with decreased odds of having almost daily pain or multi-site pain (OR: 0.92-0.94).

CONCLUSION: In this population-based cohort of school-attending Danish adolescents, nearly two out of three reported current pain and, on average, one out of three reported pain in more than one body region. Female sex, and high level of sports participation were associated with increased odds of having almost daily pain and multi-site pain. The study highlights an important health issue that calls for investigations to improve our understanding of adolescent pain and our capacity to prevent and treat this condition.

From the Full-Text Article:

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