Research

Newly Published Study Confirms That “Maintenance Care” Delivers!

By Frank M. Painter|January 26, 2011|Cost-Effectiveness, Low Back Pain, Research|

Newly Published Study Confirms
That “Maintenance Care” Delivers!

SOURCE: Spine (Phila Pa 1976) 2011 (Aug 15); 36 (18): 1427-37

Senna, Mohammed K. MD; Machaly, Shereen A. MD

Shereen A. Machaly, MD,
Rheumatology and Rehabilitation Department,
Mansoura Faculty of Medicine,
Mansoura University, Mansoura, Egypt;
shmach_237@hotmail.com

This new, single blinded placebo controlled study, conducted by the Faculty of Medicine at Mansoura University, conclusively demonstrates that maintenance care provides significant benefits for those with chronic low back pain. [1]

The authors concluded that spinal manipulation is effective for the treatment of chronic nonspecific LBP and that to obtain long-term benefit for the patient, this study suggests maintenance spinal manipulations after the initial intensive manipulative therapy can provide that additional benefit.

BACKGROUND: Spinal manipulation (SMT) is a common treatment option for low back pain. Numerous clinical trials have attempted to evaluate its effectiveness for different subgroups of acute and chronic LBP previously, but the efficacy of maintenance SMT in chronic non-specific LBP has never been studied. (more…)

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Historical Overview and Update on Subluxation Theories

By Frank M. Painter|January 7, 2011|Research, Subluxation|

Historical Overview and Update on Subluxation Theories

The Chiro.Org Blog

SOURCE: J Chiropractic Humanities 2010 (Dec); 17 (1): 22–32

By Howard Vernon, DC, PhD

Introduction

Manual therapy has, arguably, best been described by a Polish medical manipulation practitioner, Arkuszewski, [1] as “a mechanical therapy with reflex effects.” The phrase mechanical therapy can be further characterized by noting that it is performed in the musculoskeletal (MSK) system. The phrase reflex effects can be further qualified, at the very least, to indicate that these are “health-beneficial.” Therefore, a revised version would read as follows:

“a manually-performed mechanical therapy to the MSK system with health-beneficial reflex effects.”

This formulation also provides a basis for describing the primary disorder posited by chiropractic theory: subluxation. Recognizing that, for chiropractic, the subluxation has always been viewed as the “thing for which adjustment (manual therapy) is done,” a first-pass definition of subluxation, a la Arkuszewski, would be:

“a mechanical problem in the musculoskeletal system with health-deleterious reflex effects.”

Since the founding of chiropractic and the other manual therapy professions, 2 fundamental issues have vexed us:

What kind and location of mechanical problem in the MSK system qualifies as a subluxation (or any of the other terms used as synonyms within and outside of chiropractic)?
What kind of health-deleterious effects are specifically associated with subluxation?

The author recognizes that numerous others have attempted to review the subluxation concept, including recent excellent reviews by Gatterman, [2] Peters, [3] and Ebrall. [4] These previously published discussions are not reviewed here. What follows is a nonsystematic overview of selected developments in the profession that have addressed these 2 questions.

Discussion (more…)

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Homeopathic Consultations Linked to Benefits for Patients, Study Finds

By John Wiens DC|November 19, 2010|Research|

Source Science Daily

Scientists from the University of Southampton have found evidence suggesting that homeopathic consultations — but not homeopathic remedies — are associated with clinically relevant benefits for patients with active but relatively stable rheumatoid arthritis.

In a study published in the journal Rheumatology, the researchers found that arthritis patients significantly benefited when they received homeopathy alongside conventional treatment over a period of 6 months, but this improvement was due to homeopathy’s consultation process and not its remedies. (more…)

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New Study Finds Chiropractic Care Superior to Family Physician-directed Usual Care

By Frank M. Painter|October 7, 2010|Health Care Reform, Low Back Pain, News, Research|

New Study Finds Chiropractic Care Superior to Family Physician-directed Usual Care

The Chiro.Org Blog

SOURCE: Spine J. 2010 (Oct 2) [Epub ahead of print]

Bishop PB, Quon JA, Fisher CG, Dvorak MF.

International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada. paul.bishop@vch.ca

This newly published (Oct 2) study in Spine Journal compared family physician-directed usual care with evidence-based clinical practice guidelines (CPGs) (which includes reassurance and avoidance of passive treatments, acetaminophen, 4 weeks of lumbar chiropractic spinal manipulative care, and return to work within 8 weeks) on patients with acute low back pain. [1]

Evidence-based clinical practice guidelines (CPGs) for the management of patients with acute mechanical low back pain (AM-LBP) have been defined on an international scale. Multicenter clinical trials have demonstrated that most AM-LBP patients do not receive CPG-based treatments. To date, the value of implementing full and exclusively CPG-based treatment remains unclear. To determine if full CPGs-based study care (SC) results in greater improvement in functional outcomes than family physician-directed usual care (UC), a two-arm, parallel design, prospective, randomized controlled clinical trial using blinded outcome assessment was designed. Treatment was administered in a hospital-based spine program outpatient clinic. Patients were assessed by a spine physician, then randomized to SC (reassurance and avoidance of passive treatments, acetaminophen, 4 weeks of lumbar CSMT, and return to work within 8 weeks), or family physician-directed UC, the components of which were recorded. (more…)

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Study of Spinal Manipulative Therapy for Neck-Related Headaches

By Frank M. Painter|September 4, 2010|Headache, Research|

Study of Spinal Manipulative Therapy for Neck-Related Headaches

The Chiro.Org Blog

SOURCE: National Center for Complementary and Alternative Medicine

Previous research suggests that spinal manipulative therapy (SMT) may be helpful for various types of chronic headaches, including cervicogenic headache (CGH), which is associated with neck pain and dysfunction. In a recent randomized controlled trial, NCCAM-funded researchers from Western States Chiropractic College and other institutions evaluated the dose (number of treatments) and relative efficacy of SMT in a group of 80 patients with chronic CGH. (more…)

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Neck Pain Commentaries: Part 3

By Frank M. Painter|September 2, 2010|Editorial, Research, Safety|

Neck Pain Commentaries: Part 3

The Chiro.Org Blog

Today we will review a trial that Kaiser’s reviewers obviously ignored so that they could deny benefits for cervical adjusting.

Editorial Commentary:

First off, this article should have been very easy for their reviewers to find. Look at the title:

“The Benefits Outweigh the Risks for Patients Undergoing Chiropractic Care for Neck Pain”

This study was a prospective, multicenter, observational cohort study. Patients with neck pain of any duration, who fulfilled the inclusion criteria, were recruited in a practice-based study. Data were collected on the patients and from the chiropractors at baseline, the first 3 visits, and at 3 and 12 months.

Clinical outcome measures included

(1) neck pain in the 24 hours preceding the visit,
(2) neck disability,
(3) treatment satisfaction,
(4) global assessment, and
(5) adverse events. (more…)

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