Pediatrics

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

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.

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Is Back Pain During Childhood or Adolescence Associated with Muscle Strength, Muscle Endurance or Aerobic Capacity?

By Frank M. Painter|July 18, 2015|Back Pain, Pediatrics|

Is Back Pain During Childhood or Adolescence Associated with Muscle Strength, Muscle Endurance or Aerobic Capacity: Three Systematic Literature Reviews with one Meta-analysis

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2015 (Jul 16); 23: 21 ~ FULL TEXT

Arnaud Lardon, Charlotte Leboeuf-Yde, and
Christine Le Scanff

EA 4532 CIAMS,
Université Paris-Sud, UFR STAPS,
Orsay, 91405, France
alardon@ifec.net

Background Back pain is a common condition during childhood and adolescence. The causes of back pain are largely unknown but it seems plausible that some physical factors such as back muscle strength, back muscle endurance and aerobic capacity may play a role in its development, in particular in the early years.

Objectives The objectives of this review were to investigate in childhood and adolescence 1) if muscular strength in trunk extension is associated with back pain, 2) if muscular endurance in trunk extension is associated with back pain and 3) if aerobic capacity is associated with back pain.

Design Three systematic critical literature reviews with one meta-analysis.

Methods Systematic searches were made in June 2014 in PubMed, Embase and SportDiscus including longitudinal, retrospective or cross-sectional studies on back pain for subjects <20 years. Articles were accepted if they were written in French or English. The review process followed the AMSTAR recommendations. The possibility of conducting a meta-analysis was assessed for each research question.

Results Four articles were included for the first objective, four for the second and three for the last. None of the included articles found an association between back muscle strength in extension and back pain. For the second objective, a protective association between back muscle endurance in extension and back pain was found, later confirmed in a meta-analysis (OR = 0.75, 95 % CI 0.58-0.98). The association between aerobic capacity and back pain is not clear.

Conclusions High back muscle endurance in extension appears protective of back pain in youngsters, but the roles of high back muscle strength in extension and aerobic capacity are less clear.

Keywords: Back pain; Adolescent; Children; Back muscle endurance; Back muscle strength; Aerobic capacity; Meta-analysis; Systematic review

From the Full-Text Article:

Background

Pain is relatively common in childhood and adolescence [1]. For example, in a population of circa 3000 adolescents, 61 % reported musculoskeletal pain at least in one area [2]. Back pain (BP) was noted to be the second most common type with 25 % reporting daily complaints [2]. BP is common during childhood and has been shown to be a predictor of low back pain (LBP) in adulthood [3]. Therefore, more knowledge is needed about BP in the early years, as attention needs to be focused on this period of life.

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Spinal Pain in Adolescents

By Frank M. Painter|February 2, 2015|Pediatrics, Spinal Joint Pain, Spinal Manipulation|

Spinal Pain in Adolescents: Prevalence, Incidence, and Course: A School-based Two-year Prospective Cohort Study in 1,300 Danes Aged 11-13

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SOURCE: BMC Musculoskelet Disord. 2014 (May 29); 15: 187 ~ FULL TEXT

Ellen Aartun, Jan Hartvigsen, Niels Wedderkopp, and Lise Hestbaek

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

BACKGROUND: The severity and course of spinal pain is poorly understood in adolescents. The study aimed to determine the prevalence and two-year incidence, as well as the course, frequency, and intensity of pain in the neck, mid back, and low back (spinal pain).

METHODS: This study was a school-based prospective cohort study. All 5th and 6th grade students (11-13 years) at 14 schools in the Region of Southern Denmark were invited to participate (N=1,348). Data were collected in 2010 and again two years later, using an e-survey completed during school time.

RESULTS: The lifetime prevalence of spinal pain was 86% and 89% at baseline and follow-up, respectively. A group of 13.6% (95% CI: 11.8, 15.6) at baseline and 19.5% (95% CI: 17.1, 22.0) at follow-up reported that they had pain frequently. The frequency of pain was strongly associated with the intensity of pain, i.e., the majority of the participants reported their pain as relatively infrequent and of low intensity, whereas the participants with frequent pain also experienced pain of higher intensity. The two-year incidence of spinal pain varied between 40% and 60% across the physical locations. Progression of pain from one to more locations and from infrequent to more frequent was common over the two-year period.

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Improved Behavior and a Reduction in Violent Outbreaks in a 10-year-old Boy With Chiropractic Care

By Frank M. Painter|November 24, 2014|Pediatrics|

A Case Report of Improved Behavior and a Reduction in Violent Outbreaks in a 10-year-old Boy With Chiropractic Care

The Chiro.Org Blog

SOURCE: Journal on Clinical Chiropractic Pediatrics 2014; 14 (3)

Jonathan R Cook, MChiro, DC, LRCC

Private chiropractic practice,
United Kingdom Author
jon.chiro@gmail.com

Objective: To present a single case study in which a reduction in violent behavior with a 10-year old boy was achieved when the patient underwent chiropractic treatment.

Design: A case report. Setting: Private chiropractic practice.

Subjects: This case involved a 10-year-old male who presented with behavioral issues, including dramatic changes from a calm manner, to suddenly becoming violent. He was also reported to have difficulty sleeping due to emotional detachment disorder and frequently suffered from panic attacks. His mother also reported that he had difficulty noticing when he was sufficiently full following eating. His behavioral changes caused him to be suspended from school. Upper cervical, thoracic and lumbopelvic dysfunction were recorded in this case.

Methods: The patient received diversified low-force chiropractic manipulation to the spinal areas noted, including toggle-recoil and drop piece technique. His changes were recorded through the Measure Yourself Medical Outcome Profile (MYMOP) questionnaires over the course of his treatment. Treatment was provided over a 4-week, twice weekly period, with a MYMOP questionnaire being filled out after his 3rd, 6th and 8th adjustment.

Results: A reduction in a MYMOP score of 6/6 to 1.6/6 for behavior and violent outbreaks after 8 chiropractic adjustments. Further improvements were noticed with sleep and anxiety, as well as a dramatically improved awareness of feeling full after eating.

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Energy Drinks and Adolescents – What Should Health Practitioners Know?

By Frank M. Painter|July 24, 2014|Pediatrics|

Energy Drinks and Adolescents – What Should Health Practitioners Know?

The Chiro.Org Blog

SOURCE: Journal of Clinical Chiropractic Pediatrics 2012 (Dec); 13 (1): 1042-1044

Sharon Gordon, BAppSc(Chiro), DICCP

Private practice, Gippsland, Victoria, Australia.
Email: Sharon.gordon@rmit.edu.au

Energy Drinks are readily available in supermarkets throughout the world. There are currently no restrictions or guidelines on safe consumption by children. Energy drink consumption by adolescents is on the rise, as companies continue to aggressively market their product to this demographic. It has become socially acceptable for children to consume these drinks, as there is a perception that the products are safe. In addition, they have become a popular accessory in the youth extreme-sport culture. Overall, research on adolescent energy drink consumption is lacking, however side effects similar to that seen in adults, have been reported in the adolescent population. The chiropractor must be aware of these side effects, including how they may relate to presenting symptoms, and educate their patients on the dangers of energy drink consumption.

Key Words: energy drink, caffeine, adolescent, chiropractic

Objective

To review the literature on energy drink consumption amongst adolescents, and discuss the physiological effects that may present to the chiropractic office.

Methods

Scientific journal databases were searched, including PubMed, Medline, Proquest, Cochrane, CINAHL, Medscape, and Index to Chiropractic Literature. An open internet search was also performed.

Discussion

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