Spinal Manipulation

The Chiropractic Care of Patients with Asthma

By Frank M. Painter|March 19, 2012|Asthma, Chiropractic Care, Placebo, Spinal Manipulation|

The Chiropractic Care of Patients with Asthma: A Systematic Review of the Literature to Inform Clinical Practice

SOURCE: Clinical Chiropractic 2012 (Mar); 15 (1): 23–30

Joel Alcantara, Joey D. Alcantara, Junjoe Alcantara

International Chiropractic Pediatric Association,
Media, 327 N Middletown Rd,
Media, PA 19063, USA

Introduction Estimates place some 300 million people worldwide suffer from asthma with 180,000 deaths attributed to the disease. The financial burden from Asthma in Western countries ranges from $300 to $1,300 per patient per year. In the United States, asthma medication costs between $1 billion and $6.2 billion per annum. With an increasing prevalence of 50% every decade, there is no question that the burden of asthma is tremendous. The prevalence of complementary and alternative medicine (CAM) use amongst adult asthmatics ranges from 4% to 79% whilst, in children, it ranges from 33% to 89%. Of the various practitioner-based CAM therapies, chiropractic stands as the most popular for both children and adults. As with other chiropractors, the authors aspire to the principles of evidence-based practice in the care of asthma sufferers. Recent systematic reviews of the literature places into question the effectiveness of chiropractic. To assuage the discord between our clinical experience and those of our patients with the dissonant literature, we performed a systematic review of the literature on the chiropractic care of patients with asthma.

Methods Our systematic review utilized the following databases for the years indicated: MANTIS [1965–2010]; Pubmed [1966–2010]; ICL [1984–2010]; EMBASE [1974–2010], AMED [1967–2010], CINAHL [1964–2010], Index to Chiropractic Literature [1984–2010], Alt-Health Watch [1965–2010] and PsychINFO [1965–2010]. Inclusion criteria for manuscript review were manuscripts of primary investigation/report published in peer-reviewed journals in the English language involving the care of asthmatic patients.

Results The studies found span of research designs from non-experimental to true experimental studies consisting of 3 randomized controlled clinical trials (RCTs), 10 case reports, 3 case series, 7 cohort studies, 3 survey studies, 5 commentaries8 and 6 systematic reviews. The lower level design studies provide some measure of evidence on the effectiveness of chiropractic care for patients with asthma while a critical appraisal of 3 RCTs revealed questionable validity of the sham SMTs involved and hence the conclusions and interpretations derived from them. The RCTs on chiropractic and asthma are arguably comparison trials rather than controlled clinical trials per se.

There are more articles like this @ our:

Asthma and Chiropractic Page

(more…)

5

Cerebral Perfusion in Patients with Chronic Neck and Upper Back Pain: Preliminary Observations

By Frank M. Painter|March 3, 2012|Spinal Manipulation, Subluxation|

Cerebral Perfusion in Patients with Chronic Neck and Upper Back Pain: Preliminary Observations

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2012 (Feb); 35 (2): 76-85

Maxim A. Bakhtadze, MD, PhD, Howard Vernon, DC, PhD, Anatoliy V. Karalkin, MD, PhD, Sergey P. Pasha, MD, PhD, Igor O. Tomashevskiy, MD, PhD, David Soave, MS

Center for Manual Therapy, Moscow, Russia.

OBJECTIVE: The purpose of this study was to determine the correlation between cerebral perfusion levels, Neck Disability Index (NDI) scores, and spinal joint fixations in patients with neck pain.

METHODS: Forty-five adult patients (29 were female) with chronic neck/upper thoracic pain during exacerbation were studied. The subjects were grouped according to NDI scores: mild, moderate, and severe. The number of painful/blocked segments in the cervical and upper thoracic spine and costovertebral joints, pain intensity using the visual analog scale, and regional cerebral blood flow of the brain using single-photon emission computed tomography (SPECT) were obtained. The SPECT was analyzed semi-quantitatively. Analysis of variance tests were conducted on total SPECT scores in each of the NDI groups (P < .05). Univariate correlations were obtained between blockage, pain, and SPECT scores, as well as age and duration. A multivariate analysis was then conducted.

RESULTS: Group 1 (mild) consisted of 14 patients. Cerebral perfusion measured by SPECT was normal in all 8 brain regions.

Group 2 (moderate) consisted of 16 patients. In this group, a decrease in cerebral perfusion was observed (range, 20%-35%), predominantly in the parietal and frontal zones. (more…)

1

Cerebral Metabolic Changes in Men After Chiropractic Spinal Manipulation for Neck Pain

By Frank M. Painter|March 2, 2012|Spinal Manipulation, Stress Reduction|

Cerebral Metabolic Changes in Men After Chiropractic
Spinal Manipulation for Neck Pain

The Chiro.Org Blog

SOURCE: Altern Ther Health Med. 2011 (Nov); 17 (6): 12-17

Takeshi Ogura, DC, PhD; Manabu Tashiro, MD, PhD;
Mehedi Masud, MD, PhD; Shoichi Watanuki et. al

Division of Cyclotron Nuclear Medicine,
Tohoku University, Sendai, Japan.

Background: Chiropractic spinal manipulation (CSM) is an alternative treatment for back pain. The autonomic nervous system is often involved in spinal dysfunction. Although studies on the effects of CSM have been performed, no chiropractic study has examined regional cerebral metabolism using positron emission tomography (PET).

Objective: The aim of the present study was to investigate the effects of CSM on brain responses in terms of cerebral glucose metabolic changes measured by [18F]fluorodeoxyglucose positron emission tomography (FDG-PET).

Methods: Twelve male volunteers were recruited. Brain PET scanning was performed twice on each participant, at resting and after CSM. Questionnaires were used for subjective evaluations. A visual analogue scale (VAS) was rated by participants before and after chiropractic treatment, and muscle tone and salivary amylase were measured.

(more…)

0

The Role of Chiropractic Care in Older Adults

By Frank M. Painter|February 26, 2012|Chiropractic Care, Health Care Reform, Research, Spinal Manipulation|

The Role of Chiropractic Care in Older Adults

The Chiro.Org Blog

SOURCE: Chiropractic & Manual Therapies 2012 (Feb 21), 20: 3

Paul E Dougherty, Cheryl Hawk, Debra K Weiner,
Brian Gleberzon, Kari Andrew, Lisa Killinger

There are a rising number of older adults; in the US alone nearly 20% of the population will be 65 or older by 2030. Chiropractic is one of the most frequently utilized types of complementary and alternative care by older adults, used by an estimated 5% of older adults in the U.S. annually. Chiropractic care involves many different types of interventions, including preventive strategies. This commentary by experts in the field of geriatrics, discusses the evidence for the use of spinal manipulative therapy, acupuncture, nutritional counseling and fall prevention strategies as delivered by doctors of chiropractic. Given the utilization of chiropractic services by the older adult, it is imperative that providers be familiar with the evidence for and the prudent use of different management strategies for older adults.

Introduction:

By 2030, nearly one in five U.S. residents is expected to be age 65 or older [1]. An estimated 14% of patients treated by doctors of chiropractic (DCs) are 65 and older [2]. The most common reason for an older adult to see a DC is musculoskeletal pain, most often lower back pain [3]. Although the most common reason for older adults seeking chiropractic care is for musculoskeletal symptoms, DCs may also provide a diverse range of services to these patients [4] .Given this fact, for the purpose of this manuscript chiropractic care will be defined as; “the provision by a doctor of chiropractic of services related to patient assessment, maintenance of health, prevention of illness, and treatment of illness or injury.” The focus of this manuscript is to describe the evidence for achievement of some of these goals in the older adult population. The purpose of this manuscript is to present an overview of information to the practicing chiropractor on utilization of specific management tools. This is not meant to be a systematic review of the literature or an evidence based guideline. The authors each have personal experience in evaluating and treating older adults as well as established expertise in research and publication in these areas. The authors recognize that there is a need for further research in the area of management of the older adult by DC’s and discuss in the conclusion future research considerations. (more…)

2

Chiropractic Research & Practice: State of the Art

By Frank M. Painter|February 24, 2012|Cost-Effectiveness, Evidence-based Medicine, Health Care Reform, Outcome Assessment, Patient Satisfaction, Prevention, Public Health, Research, Spinal Manipulation, Wellness Care|

Chiropractic Research & Practice State of the Art

The Chiro.Org Blog

SOURCE: Cleveland Chiropractic College

By Daniel Redwood, D.C., professor,
Cleveland Chiropractic College

Peer Reviewers: Carl S. Cleveland III, D.C., J.
Michael Flynn, D.C., Cheryl Hawk, D.C., PhD., and
Anthony Rosner, PhD.

Chiropractic Research & Practice

State of the Art

Since chiropractic’s breakthrough decade in the 1970s — when the U.S. federal government included chiropractic services in Medicare and federal workers’ compensation coverage, approved the Council on Chiropractic Education (CCE) as the accrediting body for chiropractic colleges, and sponsored a National Institutes of Health (NIH) conference on the research status of spinal manipulation — the profession has grown and matured into an essential part of the nation’s healthcare system.

Chiropractic was born in the United States in the late 19th century and the U.S. is home to approximately 65,000 of the world’s 90,000 chiropractors. [1] The chiropractic profession is the third largest independent health profession in the Western world, after medicine and dentistry. Doctors of chiropractic are licensed throughout the English-speaking world and in many other nations as primary contact providers, licensed for both diagnosis and treatment without medical referral. In 2005, the World Health Organization (WHO) published WHO Guidelines on Basic Training and Safety in Chiropractic, which documented the status of chiropractic education and practice worldwide and sought to ensure high standards in nations where chiropractic is in the early stages of development. [2]

Rigorous educational standards are supervised by government-recognized accrediting agencies in many nations, including CCE in the United States. After fulfilling college science prerequisites similar to those required to enter medical schools, chiropractic students must complete a chiropractic college program of four academic years, which includes a wide range of courses in anatomy, physiology, pathology, and diagnosis, as well as spinal adjusting, physiotherapy, rehabilitation, public health and nutrition. (more…)

1

A Systematic Review and Meta-analysis of Efficacy, Cost-effectiveness, and Safety of Selected Complementary and Alternative Medicine for Neck and Low-back Pain

By Frank M. Painter|January 2, 2012|Low Back Pain, Neck Pain, Spinal Manipulation|

A Systematic Review and Meta-analysis of Efficacy, Cost-effectiveness, and Safety of Selected Complementary and Alternative Medicine for Neck and Low-back Pain

The Chiro.Org Blog

SOURCE: Evid Based Complement Alternat Med [Epub 2011 Nov 24]

Andrea D. Furlan, Fatemeh Yazdi, Alexander Tsertsvadze, * Anita Gross, Maurits Van Tulder, Lina Santaguida, Joel Gagnier, Carlo Ammendolia, Trish Dryden, Steve Doucette, Becky Skidmore, Raymond Daniel, Thomas Ostermann, and Sophia Tsouros

Clinical Epidemiology Methods Centre,
Ottawa Hospital Research Institute,
University of Ottawa Evidence-Based Practice Center,
Box 208, Ottawa, ON, Canada K1H 8L6

Background: Back pain is a common problem and a major cause of disability and health care utilization.

Purpose: To evaluate the efficacy, harms, and costs of the most common CAM treatments (acupuncture, massage, spinal manipulation, and mobilization) for neck/low-back pain.

Data Sources: Records without language restriction from various databases up to February 2010.

Data Extraction: The efficacy outcomes of interest were pain intensity and disability.

Data Synthesis: Reports of 147 randomized trials and 5 non-randomized studies were included. CAM treatments were more effective in reducing pain and disability compared to no treatment, physical therapy (exercise and/or electrotherapy) or usual care immediately or at short-term follow-up. Trials that applied sham-acupuncture tended towards statistically non-significant results. In several studies, acupuncture caused bleeding on the site of application, and manipulation and massage caused pain episodes of mild and transient nature.

Conclusions: CAM treatments were significantly more efficacious than no treatment, placebo, physical therapy, or usual care in reducing pain immediately or at short-term after treatment. CAM therapies did not significantly reduce disability compared to sham. None of the CAM treatments was shown systematically as superior to one another. More efforts are needed to improve the conduct and reporting of studies of CAM treatments.

Introduction:

Back pain is a general term that includes neck, thoracic, and lower-back spinal pain. In the majority of cases, the aetiology of back pain is unknown and therefore is considered as “nonspecific back pain”. Back pain is considered “specific” if its aetiology is known (e.g., radiculopathy, discogenic disease). Although back pain is usually self-limited and resolves within a few weeks, approximately 10% of the subjects develop chronic pain, which imposes large burden to the health-care system, absence from work, and lost productivity [1]. In a recent study, the direct costs of back pain related to physician services, medical devices, medications, hospital services, and diagnostic tests were estimated to be US$ 91 billion or US$ 46 per capita [2]. Indirect costs related to employment and household activities were estimated to be between US$ 7 billion and US$ 20 billion, or between US$25 and US$ 71 per capita, respectively [3–5]. One study published in 2007 showed that the 3-month prevalence of back and/or neck pain in USA was 31% (low-back pain: 34 million, neck pain: nine million, both back and neck pain: 19 million) [6]. (more…)

6