Pediatrics

Effect of Chiropractic Intervention on Oculomotor and Attentional Visual Outcomes in Young Adults With Long-Term Mild Traumatic Brain Injury: A Randomized Controlled Trial

By Frank M. Painter|September 7, 2025|Mild Traumatic Brain Injury, Pediatrics|

Effect of Chiropractic Intervention on Oculomotor and Attentional Visual Outcomes in Young
Adults With Long-Term Mild Traumatic Brain Injury: A Randomized Controlled Trial

SOURCE: J Manipulative Physiol Ther 2024 (Jan); 47 (1-4): 1–11

Alice E. Cade PhD • Philip R.K. Turnbull PhD

Department Optometry & Vision Science,
University of Auckland, Auckland, New Zealand;
Centre for Chiropractic Research,
New Zealand College of Chiropractic,
Auckland, New Zealand.

Objective: This study aimed to establish if chiropractic care can improve oculomotor and cognitive symptoms in individuals with persistent postconcussion syndrome (PPCS).

Methods: A single-blind, randomized controlled intervention study recorded baseline computerized eye-tracker assessment (CEA) outcomes in 40 young adults with PPCS following mild traumatic brain injury. Participants were randomly allocated to either a chiropractic or age-matched active control intervention, and the change in CEA outcomes following intervention was compared between the chiropractic and control groups. A battery of CEAs including egocentric localization, fixation stability, pursuit, saccades, Stroop, and the vestibulo-ocular reflex, were used to assess oculomotor function, visual attention/processing, and selective attention.

Results: Relative to the control group, participants receiving the chiropractic intervention scored better in the Stroop test (P < .001), had improved gaze stability during both vestibulo-ocular reflex (P < .001) and fixation stability (P = .009), and a lower vertical error in egocentric localization (P < .001). However, performance was poorer in pursuits, where they had an increased tracking error (P < .001).

Conclusion: Chiropractic care in participants with PPCS significantly improved static and dynamic gaze stability, and performance in the Stroop test, compared with a control intervention. These results suggest that chiropractic care can offer a novel avenue for alleviating certain visual and cognitive symptoms in patients with PPCS. It also adds to the growing evidence that suggests that some longstanding PPCS visual symptoms may have a spinal or proprioceptive basis.

Keywords: Brain Concussion; Chiropractic; Eye-Tracking Technology; Postconcussion Syndrome; Proprioception.

From the Full-Text Article:

Introduction

Traumatic brain injury (TBI) is a change in typical brain function that affects neurologic function after an external force to the head. [1, 2] Diagnosis and categorization of TBI severity is currently subjective, open to bias, and predicting an individual’s outcome after injury is challenging. [3, 4] Although symptoms can vary depending on the neurologic area of injury, visual symptoms are common following even mild TBI (MTBI) owing to the many areas of the brain involved in processing vision [5] and controlling the eyes. Visual symptoms can include oculomotor dysfunction including disorders of convergence and accommodation, poorer fixation, slower or less accurate saccades, poorer pursuit movements, and modification of the vestibulo-ocular reflex (VOR). [6]

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Description of Recurrent Headaches in 7-14-year-old Children: Baseline Data From a Randomized Clinical Trial on Effectiveness of Chiropractic Spinal Manipulation in Children with Recurrent Headaches

By Frank M. Painter|February 2, 2023|Headache, Pediatrics|

Description of Recurrent Headaches in 7-14-year-old Children: Baseline Data From a Randomized Clinical Trial on Effectiveness of Chiropractic Spinal Manipulation in Children with Recurrent Headaches

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SOURCE: Chiropractic & Manual Therapies 2023 (Jan 30); 31 : 5

OPEN ACCESS

Kristina Boe Dissing, Werner Vach, Susanne Lynge, Henrik Wulff Christensen & Lise Hestbaek

Chiropractic Knowledge Hub,
Campusvej 55, 5230,
Odense M, Denmark.

Background: Headaches in children are poorly described and diagnosing can be challenging. Objectives are: (1) to describe headache characteristics and child characteristics, (2) to explore whether data can suggest a more diverse way to categorize headaches than traditionally.

Methods: Baseline data for a clinical trial included a questionnaire and a physical screening. Children’s characteristics and detailed description of headache symptoms were provided. Children were classified for migraine or tension-type-headache based on questionnaire data reported by children and parents. This required to apply slightly modified classification criteria and a “non-classifiable” group was added. Severity and symptoms, related to the migraine versus tension type distinction, were investigated to define a migraine-tension-type-index.

Results: 253 children were included. Mean pain intensity was 5.9/10. Over 2/3 of the children had headache for > 1 year, and > 50% for several days/week. Half of the children were non-classifiable, 22% were classified as migraine and 23% as tension-type headache. A migraine-tension-type-index was constructed and describes a continuous spectrum rather than two distinct groups.

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Adolescent Neck and Shoulder Pain–The Association with Depression, Physical Activity, Screen-based Activities, and Use of Health Care Services

By Frank M. Painter|November 11, 2022|Neck Pain, Pediatrics|

Adolescent Neck and Shoulder Pain–The Association with Depression, Physical Activity, Screen-based Activities, and Use of Health Care Services

The Chiro.Org Blog

SOURCE: J Adolesc Health 2014 (Sep); 55 (3): 366–372
Solbjørg Makalani Myrtveit, Børge Sivertsen, Ph.D., Jens Christoffer Skogen, Ph.D., Lisbeth Frostholm, Ph.D. et al

Department of Clinical Science,
University of Bergen,
Bergen, Norway

Purpose: Neck and shoulder pain is frequent in adolescents, and multiple factors seem to affect the risk of such symptoms. We aimed to investigate the prevalence of neck and shoulder pain in Norwegian adolescence and to examine whether behavioral and emotional factors were associated with the risk of neck and shoulder pain. Finally we aimed to investigate whether neck and shoulder pain was related to the use of health services.

Method: Data from the population-based study ung@hordaland were used. Participants were asked how often during the last 6 months they had experienced neck and shoulder pain. The association between frequent neck and shoulder pain and physical activity, symptoms of depression, and screen-based activities was evaluated using logistic regression analyses stratified by gender. The relative risk of visiting health services when reporting neck and shoulder pain was calculated using multiple logistic regression analyses.

Results: Frequent neck and shoulder pain was reported by 20.0% (1,797 of the total 8,990) and more often by girls than boys (p < .001). A high score of depressive symptoms was the strongest risk factor for neck and shoulder pain in both boys and girls (odds ratio = 6.14 [95% confidence interval 4.48-8.42] and odds ratio = 3.10 [95% confidence interval 2.63-3.67], respectively). Frequent screen-based activities slightly increased the risk while physical activity was protective. Individuals reporting neck and shoulder pain more often visited their general practitioner (47.1% vs. 31.8%) and school health services (24.6% vs. 13.5%).

Conclusion: Frequent neck and shoulder pain was reported in 20% of Norwegian adolescents. Symptoms of depression and screen-based activities increased the risk of neck and shoulder pain while physical activity was protective. Individuals reporting neck and shoulder pain visited health services more frequently than others.

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Why Aren’t Chiropractic Physicians Treating More Children

By Frank M. Painter|December 6, 2019|Pediatrics|

Why Aren’t Chiropractic Physicians Treating More Children with Complex Diagnoses?

A Commentary on Documenting P.A.R.T. for Diagnosing and Treating Special Needs Children

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SOURCE: Journal of Clinical Chiropractic Pediatrics 2019 (Nov); 18 (2)

Eric Epstein, DC, Jean Elizabeth Grabowski and Richard Duenas, DC, DABCN

Kentuckiana Children’s Center,
Louisville, KY

According to the Centers for Medicare and Medicaid Services (CMS) guidelines, chiropractors are deemed physicians in the Medicare system and for consistency throughout the term chiropractic physician will encompass chiropractor, chiropractic doctor, doctor of chiropractic and chiropractic physician. Chiropractic physicians must document subluxation of the spine through x-ray or physical examination.

The documentation of subluxation of the spine through physical examination includes the identification of two out of four criteria including:

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Prevalence and Incidence of Musculoskeletal Extremity

By Frank M. Painter|July 26, 2018|Musculoskeletal Complaints, Pediatrics|

Prevalence and Incidence of Musculoskeletal Extremity Complaints in Children and Adolescents. A Systematic Review

The Chiro.Org Blog

SOURCE: BMC Musculoskelet Disord. 2017 (Oct 18); 18 (1): 418

Signe Fuglkjer, Kristina Boe Dissing and Lise Hestbaek

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

BACKGROUND: It is difficult to gain an overview of musculoskeletal extremity complaints in childhood although this is essential to develop evidence-based prevention and treatment strategies. The objectives of this systematic review were therefore to describe the prevalence and incidence of musculoskeletal extremity complaints in children and adolescents in both general and clinical populations in relation to age, anatomical site and mode of onset.

METHODS: MEDLINE and EMBASE were electronically searched; risk of bias was assessed; and data extraction was individually performed by two authors.

RESULTS: In total, 19 general population studies and three clinical population studies were included with children aged 0–19 years. For most of the analyses, a division between younger children aged 0–12 years, and older children aged 10–19 years was used. Lower extremity complaints were more common than upper extremity complaints regardless of age and type of population, with the most frequent pain site changing from ankle/foot in the youngest to knee in the oldest. There were about twice as many non-traumatic as traumatic complaints in the lower extremities, whereas the opposite relationship was found for the upper extremities in the general population studies. There were relatively more lower extremity complaints in the general population studies than in the clinical population studies. The review showed no pattern of differences in reporting between studies of high and low risk of bias.

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Schoolbags and Back Pain in Children Between 8 and 13 Years

By Frank M. Painter|July 9, 2017|Backpacks, Pediatrics|

Schoolbags and Back Pain in Children Between 8 and 13 Years: A National Study

The Chiro.Org Blog

SOURCE: Br J Pain. 2017 (May); 11 (2): 81–86 ~ FULL TEXT

Karl Spiteri, Maria-Louisa Busuttil,
Samuel Aquilina, Dorothy Gauci,
Erin Camilleri, and Victor Grech

Malta Association of Physiotherapists,
Gzira, Malta.

Schoolbag weight in schoolchildren is a recurrent and contentious issue within the educational and health sphere. Excessive schoolbag weight can lead to back pain in children, which increases the risk of chronic back pain in adulthood. There is limited research regarding this among the Maltese paediatric population. A cross-sectional study was undertaken across all schools in Malta among students aged 8–13 years (inclusive). Data were collected using a questionnaire detailing schoolbag characteristics, self-reported pain and demographic variables, such as age and gender. Structured interviews with participants were also carried out by physiotherapists. A total of 4,005 participants were included in the study, with 20% of the total Malta schoolchildren population. Over 70% of the subjects had a schoolbag that exceeded the recommended 10% bag weight to body ratio. A total of 32% of the sample complained of back pain, with 74% of these defining it as low in intensity on the face pain scale-revised. The presence of back pain was statistically related to gender, body mass index (BMI), school and bag weight to body weight ratio. After adjusting for other factors, self-reported back pain in schoolchildren is independently linked to carrying heavy schoolbags. This link should be addressed to decrease the occurrence of back pain in this age group.

From the FULL TEXT Article:

Introduction

Carrying schoolbags and school attendance is a daily routine for students. The incorrect handling of schoolbags with excessive bag weight can lead to back pain in children. [1–4] It is recommended that the total weight of the schoolbag does not exceed 10% of body weight. [1] The development of back pain in children is of concern since it increases the risk of developing chronic back pain in adulthood. [5] Studies have shown that the prevalence of low back pain in schoolchildren ranges from 25% to 55% in those aged between 10 and 15 years. [6–8] In most cases, the pain intensity is relatively low.[7]

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