Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CHIROPRACTIC”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources
PubMed1998

Reliability of spinal displacement analysis of plain X-rays: a review of commonly accepted facts and fallacies with implications for chiropractic education and technique.

BACKGROUND: Current medical, biomechanical, and chiropractic literature indicates that X-ray line drawing analysis for spinal displacement is reliable, with high Interclass Correlation Coefficients (ICCs) found in most studies. Normal sagittal spinal curvatures are being accepted as important clinical outcomes of care; however, just the opposite is taught in many chiropractic college radiology courses. OBJECTIVE: To review the current literature on X-ray line drawing reliability and abnormal static lateral positions. DATA SOURCES: Searches were performed on Medline, Chiro-LARS, MANTIS, and CINAHL on X-ray reliability, normal spinal position, and sagittal spinal curvatures as clinical outcomes. RESULTS: X-ray line drawing analysis for spinal displacement was found to have high reliability with a majority of ICCs in the .8-.9 range. The reliability for determining X-ray pathology was found to be only fair to good by both medical doctors and chiropractors and by both chiropractic and medical radiologists, with a majority of ICCs in the range .40-.75. Muscle spasms, facet hyperplasia, short pedicles and patient positioning errors have not been shown to alter sagittal plane alignment. The sagittal spinal curves are desirable clinical outcomes of care in surgery, physical therapy, rehabilitation and chiropractic. These results contradict common claims found in the indexed literature. CONCLUSION: X-ray line drawing is reliable. Normal values for the sagittal spinal curvatures exist in the literature. The normal sagittal spinal curvatures are important clinical outcomes of care. Patient positioning and postural radiographs are highly reproducible. When these standardized procedures are used, the pre-to-post alignment changes are a result of treatment procedures applied. Chiropractic radiology education and publications should reflect the recent literature, provide more support for X-ray line drawing analyses and applications of line drawing analyses for measuring spinal displacement on plain radiographs.

Anthropometry↗
PubMed1999

Preliminary study of the effects of a placebo chiropractic treatment with sham adjustments.

OBJECTIVE: To identify aspects of the delivery of placebo chiropractic treatments by using sham adjustments that may cause a treatment effect and that may affect the success of blinding. DESIGN AND SETTING: Two-period crossover design in a chiropractic college research clinic. SUBJECTS: Eighteen volunteer staff, students, and faculty of the chiropractic college who reported low-back pain within the last 6 months. INTERVENTIONS: Flexion-distraction technique was used to perform chiropractic adjustments, and a hand-held instrument (Activator adjusting instrument) with the pressure gauge set on the 0 was used to perform sham adjustments. The treatment period was 2 weeks, with a total of 4 visits. MAIN OUTCOME MEASURES: The Visual Analog Scale (VAS) for pain and Global Well-Being Scale (GWBS). RESULTS: Although VAS and GWBS scores improved with both treatments, a somewhat greater improvement occurred in most cases with the active treatment. Eight of 14 patients interviewed believed that the placebo had a treatment effect. CONCLUSION: This study provided preliminary information that was useful in planning the protocol for a placebo chiropractic treatment in the randomized clinical trial for which it was designed.

Adult↗
PubMed2005

The necessary future of chiropractic education: a North American perspective.

The chiropractic educational system in North America is currently in a state of flux. The attempted conversion of some chiropractic schools into "universities" and the want of university affiliation for chiropractic schools suggests that we are searching for a better alternative to the present system. In the early 20th century, the Flexner Report helped transform modern medical education into a discipline that relies on scientific and clinical knowledge. Some have wondered if it is time for a Flexner-type report regarding the education of doctors of chiropractic. This article outlines the current challenges within the chiropractic educational system and proposes positive changes for that system.

Journal Article↗
PubMed2000

A randomized controlled trial of chiropractic spinal manipulative therapy for migraine.

OBJECTIVE: To assess the efficacy of chiropractic spinal manipulative therapy (SMT) in the treatment of migraine. DESIGN: A randomized controlled trial of 6 months' duration. The trial consisted of 3 stages: 2 months of data collection (before treatment), 2 months of treatment, and a further 2 months of data collection (after treatment). Comparison of outcomes to the initial baseline factors was made at the end of the 6 months for both an SMT group and a control group. SETTING: Chiropractic Research Center of Macquarie University. PARTICIPANTS: One hundred twenty-seven volunteers between the ages of 10 and 70 years were recruited through media advertising. The diagnosis of migraine was made on the basis of the International Headache Society standard, with a minimum of at least one migraine per month. INTERVENTIONS: Two months of chiropractic SMT (diversified technique) at vertebral fixations determined by the practitioner (maximum of 16 treatments). MAIN OUTCOME MEASURES: Participants completed standard headache diaries during the entire trial noting the frequency, intensity (visual analogue score), duration, disability, associated symptoms, and use of medication for each migraine episode. RESULTS: The average response of the treatment group (n = 83) showed statistically significant improvement in migraine frequency (P < .005), duration (P < .01), disability (P < .05), and medication use (P< .001) when compared with the control group (n = 40). Four persons failed to complete the trial because of a variety of causes, including change in residence, a motor vehicle accident, and increased migraine frequency. Expressed in other terms, 22% of participants reported more than a 90% reduction of migraines as a consequence of the 2 months of SMT. Approximately 50% more participants reported significant improvement in the morbidity of each episode. CONCLUSION: The results of this study support previous results showing that some people report significant improvement in migraines after chiropractic SMT. A high percentage (>80%) of participants reported stress as a major factor for their migraines. It appears probable that chiropractic care has an effect on the physical conditions related to stress and that in these people the effects of the migraine are reduced.

Adolescent↗
PubMed1993

Chiropractic management of a hypertensive patient.

OBJECTIVE: Although many chiropractors may treat patients who have concomitant hypertensive disease, there is a paucity of literature on the nuances of case management for these patients. We report a patient who underwent a course of chiropractic care with a previous diagnosis of chronic essential hypertension. CLINICAL FEATURES: A 38-yr-old male presented for chiropractic care with complaints of hypertension, drug-related side effects and lower back pain. He was also receiving concurrent medical care for his hypertension. INTERVENTION AND OUTCOME: The patient received specific contact, short lever arm spinal adjustments as the primary mode of chiropractic care. During the course of chiropractic treatment, the patient's need for hypertensive medication was reduced. The patient's medical physician gradually withdrew the medication over 2 months. CONCLUSION: Specific contact short lever arm spinal adjustments may cause a hypotensive effect in a medicated hypertensive patient that may lead to complications (e.g., hypotension). Since a medicated hypertensive patient's blood pressure may fall below normal while he or she is undergoing chiropractic care, it is advised that the blood pressure be closely monitored and medications adjusted, if necessary, by the patient's medical physician.

Adult↗
PubMedDate not supplied

Three-dimensionality of direct contact forces in chiropractic spinal manipulative therapy.

OBJECTIVE: To perform three-dimensional (3-D) manual contact force measurements of chiropractic adjustments at the patient-chiropractor interface. METHODS: A new hand/palm-held computerized 3-D force measuring system was used to collect 3-D force data at the doctor-patient interface (direct measurement) during cervical, thoracic, and sacroiliac adjustments by 2 chiropractors on 10 healthy subjects. RESULTS: 3-D components of force were significantly greater than matching 1-dimensional (1-D) perpendicular force components, which have been the standard in direct measurement up until now. As well, 3-D components of force were significantly different between adjustment levels, suggesting different dynamics (kinetics) of adjustment techniques. Force magnitudes and statistically significant differences between loading rates and adjustment levels fit in the existing body of knowledge of chiropractic adjustment forces. CONCLUSION: To our knowledge, this is the first study which presents 3-D force-time histories of chiropractic adjustments recorded at the doctor-subject interface. Direct 3-D contact force data seem to have the potential to contribute to chiropractic research because of a more complete description of this biomechanical aspect of daily practice. Results can be used to study novice and experienced chiropractors' techniques and permit the development of training and evaluation protocols in teaching institutions.

Adult↗
PubMed2004

Original research published in the chiropractic literature: evaluation of the research report.

OBJECTIVE: To evaluate the quality of research reports published in the chiropractic literature. Data Sources Original research articles, defined as those reporting studies that included primary data collection, published in the 13 Chiropractic Research Journal Editors Council member journals from January 1999 through February 2000. METHODS: A 2-page checklist developed from review criteria used in the biomedical literature. Three doctoral-trained biostatisticians blinded to author identification and affiliation evaluated the articles. RESULTS: Of the 73 eligible articles, 21% lacked description of the study design, 77% did not provide a sample size justification, 26% reported inappropriate descriptive statistics, 26% reported conclusions not supported by the results, and 21% did not avoid redundancy of information presented in tables, figures, and text. Of the 55 articles with a primary objective of testing, 10 did not report any inferential statistics, 19 reported inappropriate inferential statistics, and 22 did not make the primary comparisons of interest clear. CONCLUSIONS: In this study, we evaluated the quality of the research report rather than the research itself. However, the value of the research articles is diminished by the poor quality of reporting, as well as the actual errors in data analysis. Yet, this problem is not unique to the chiropractic literature. It is recommended that all investigators submitting manuscripts to chiropractic journals use available guidelines in preparing their research reports and that reviewers use those same guidelines in critiquing the manuscripts.

Chiropractic↗
PubMedDate not supplied

Chiropractic clinical research: progress and recommendations.

OBJECTIVE: The purpose of this white paper is to help inform the chiropractic clinical research agenda with a focus on the United States. METHODS AND DISCUSSION: The recommendations and action items from 2 previous articles published in 1997 are discussed within the context of 3 broad topics: research culture, research infrastructure, and clinical research studies. Progress made toward the action items in these areas is summarized. A summary of findings is presented of the most influential clinical research studies during the past decade performed by or with major contributions by chiropractic investigators. In light of the current evidence and previous recommendations, new clinical research recommendations are proposed. CONCLUSIONS: Based on the assessment of the scientific literature and research currently underway, it is evident that members of the chiropractic research community have made important progress in becoming active players in the clinical research arena. During the past decade, the work of chiropractic researchers has contributed substantially to the amount and quality of the evidence for or against spinal manipulation in the management of low back pain, neck pain, headache, and other conditions.

Chiropractic↗
PubMed2006

History and overview of theories and methods of chiropractic: a counterpoint.

Spinal manipulation has been used for its therapeutic effects for at least 2500 years. Chiropractic as we know it today began a century ago in a simplistic manner but has developed into to a well-established profession with 33 colleges throughout the world. During the initial, bumpy years, many people thought it had little more value than a placebo. Nevertheless, there have always been satisfied recipients of chiropractic care during the years, and the profession slowly gained prominence--mostly by word of mouth. More recently, personal opinions based on isolated incidents have given way to the results of numerous clinical and basic science studies, primarily regarding low back pain. As of 2002, 43 randomized trials of spinal manipulation for low back pain had been published with 30 showing more improvement than with the comparison treatment, and none showing it to be less effective. Other studies have shown that chiropractic care compared with medical care is safer, costs no more and often costs much less, and has consistently greater patient satisfaction for treatment of similar conditions. Consequently, there is now better public and professional opinion of chiropractic with coverage by insurance companies and government agencies. That trend is likely to continue.

Chiropractic↗
PubMed1991

Evaluating primary practice: proposals for a modified model suited to chiropractic care.

Although chiropractic care is not yet considered to have achieved scientific validity, it enjoys widespread public acceptance. It is hypothesised that one of the barriers to chiropractic establishing scientific validity is the propensity of researchers to frame their randomized controlled clinical trials according to a biomedical rather than a biopsychosocial model. It is proposed that while chiropractic care should be required to establish a cause--effect relationship between spinal manipulation and clinical response, subjective patient--valued outcomes should also be monitored. For chiropractic care to be adequately assessed recognition needs to be given to the usefulness of qualitative measurements in health care. Interventions selected solely upon the basis of statistical significance run the risk of overlooking clinically meaningful outcomes.

Chiropractic↗
PubMedDate not supplied

A suspected case of ulnar tunnel syndrome relieved by chiropractic extremity adjustment methods.

BACKGROUND: There has been little published about ulnar tunnel syndrome (UTS) as it relates to the practice of chiropractic, despite chiropractors' apparent interest in nerve compression syndromes and a growing trend toward providing chiropractic extremity care. This syndrome is not very common and could be mistaken for carpal tunnel syndrome by practitioners who are not aware of the differences. OBJECTIVE: To discuss the case of a patient with ulnar tunnel syndrome whose symptoms were resolved by chiropractic extremity adjustment. Clinical features A 45-year-old female patient complained of numbness in her little finger. Standard orthopedic testing procedures for the wrist and hand reproduced the symptom, but tests for the cervical spine and thoracic outlet region were negative. Intervention and outcome Care for this patient consisted of adjustment procedures directed to the wrist, primarily the hamate and pisiform articulations with the triquetrum. Her symptoms were resolved in 4 office visits, with corresponding improvement in examination findings. CONCLUSIONS: This case report represents what a patient could expect during a typical chiropractic treatment. The examination and the care given were simple and cost-effective but might not be sufficient for a more complicated or persistent case. The costs for the care in this case were borne solely by the patient and were affordable. Hard conclusions cannot be reached without more sophisticated diagnostic procedures, additional similar cases, and controlled research conditions.

Female↗
PubMed2004

Applying evidence-based health care to musculoskeletal patients as an educational strategy for chiropractic interns (a one-group pretest-posttest study).

OBJECTIVE: To describe and measure the effectiveness of a problem-based educational strategy for teaching evidence-based health care (EBHC) to chiropractic interns, which focused on the development and appraisal of answerable clinical questions using actual musculoskeletal patients. METHODS: A 1-group pretest-posttest design (simple panel design) with investigator-blinded survey administration was used to measure effectiveness of educational activities using adult learning theory with a study population of interns (n=31) at a chiropractic college (Los Angeles College of Chiropractic, Southern California University of Health Sciences [LACC/SCUHS]) teaching clinic. Activities included 2 workshops on constructing clinical questions and critical appraisal of published research and independent patient-based EBHC assignments. A qualitative self-assessment survey was administered before and after a 6-week period of EBHC activities to measure their effectiveness. Sign tests and paired t tests were utilized to determine P values for significant difference of score results. RESULTS: Eighty-one percent of subjects completed the pretest-posttest surveys. All survey item responses showed an average increase in subjects' self-rating of skills and attitudes from pretest to posttest. There were statistically significant differences in interns' self-assessed ability to construct an answerable clinical question and appraise research articles and apply them to patient management, as well as their rating of importance of EBHC in patient decision making. CONCLUSIONS: The results of this study suggest that having chiropractic interns apply EBHC to actual musculoskeletal patients along with attending EBHC workshops had a positive impact on interns' perceived ability to practice EBHC.

Adult↗
PubMedDate not supplied

Reduction of cervical dystonia after an extended course of chiropractic manipulation: a case report.

OBJECTIVE: The diminution of the signs and symptoms of cervical dystonia following an extended course of specific chiropractic manipulation is described. CLINICAL FEATURES: A 38-year-old man had gross anterior-lateral torticollis, focal dystonia of the head and neck, and radicularlike pains which failed to respond to physical therapy, medication, and injection. INTERVENTIONS AND OUTCOMES: Two specific spinal manipulative technique systems unique to the chiropractic profession (Applied Biostructural Therapy [ABT] and Atlas Coccygeal Technique [ACT]) were applied to the patient. The patient's grading on a modified cervical dystonia scale dropped from a grade 16 to a grade 5 after an extended course of these specific chiropractic manipulative techniques. CONCLUSIONS: The application of Advanced Biostructural Therapy and Atlas Coccygeal chiropractic techniques for management of cervical dystonia is presented. Substantial reduction in the cervical dystonia rating scale was observed with this approach, even after standard medical interventions had failed.

Adult↗
PubMed2004

Chiropractic management of hip pain after conservative hip arthroplasty.

OBJECTIVES: To describe a case involving postsurgical hip pain that was successfully treated with a combination of chiropractic manipulation of the lumbar and pelvic region and low-tech rehabilitation 14 months postsurgery. CLINICAL FEATURES: A 45-year-old man had pain and difficulty with walking. He was diagnosed with bilateral avascular necrosis at the femoral heads. He had successful right hip arthroplasty (HA) surgery at the time of the original diagnosis and had 2 previous surgeries to the left hip joint to treat avascular necrosis, with the latter being hip arthroplasty. He had a chief complaint of left hip pain that radiated down the lateral thigh to the knee with a "clicking" of the hip noted at end range abduction and adduction, as well as an altered gait pattern associated with dysfunction of the left hip. INTERVENTION AND OUTCOME: He was treated with chiropractic manipulative therapy of the lumbar and sacroiliac joints and a rehabilitation program that consisted of in-office and home exercise programs. The patient experienced a decrease in the pain and an improvement in the flexibility and strength that led to an improved gait pattern and decreased pain. Outcomes were measured through active range of motion comparisons and use of the Harris Hip Scale Evaluation. CONCLUSIONS: Treatment of hip pain through chiropractic manipulation and rehabilitation is described. The patient had increases in active ranges of motion and Harris Hip scores. Additional studies should be done to evaluate the effects of chiropractic manipulations on patient outcomes following such surgeries.

Arthroplasty, Replacement, Hip↗
PubMedDate not supplied

Radiographic anomalies that may alter chiropractic intervention strategies found in a New Zealand population.

OBJECTIVE: To provide occurrence rates for anomalies discovered on radiographs in patients seeking chiropractic care. METHODS: One thousand four random patient files dated between 1997 and 2001 were obtained from the records of the outpatient clinic at the New Zealand College of Chiropractic. In cases in which radiographs were taken, the radiographic reports were analyzed by the authors for the presence of a number of anomalies. RESULTS: Eight hundred forty-seven full-spine radiographs were included in the study. Anomalies were found in 68% of patients who had radiographs taken. The 5 most frequently occurring anomalies in descending order were degenerative joint disease (23.8%), posterior ponticle (13.6%), soft tissue abnormalities (13.5%), transitional segments (9.8%), and spondylolisthesis (7.8%). Other noteworthy occurrences because of their generalized status as absolute contraindications to adjustment are fracture (6.6%), malignant tumor (0.8%-3.1%), abdominal aortic aneurysm (0.8%) and atlantoaxial instability (0.6%). CONCLUSION: A large percentage of patients presenting for chiropractic care have anomalies present on spinal radiographs. Further research and analysis is necessary to investigate the risk-verses-benefit ratio of spinal radiographs for chiropractic patients.

Adolescent↗
PubMed2005

Influence of axial rotation on chiropractic pelvic radiographic analysis.

OBJECTIVE: The aim of the study is to explore associations between axial (y-axis) rotation of the pelvis and pelvic radiographic measurements. STUDY DESIGN: Descriptive film statistics of an incrementally rotated pelvis and linear regression analysis were performed. METHODS: A phantom pelvic model was incrementally imaged (1 degrees increments) at 40-in source-to-image distance through 10 degrees of axial rotation. Chiropractic line drawing analysis was performed. The chiropractic examiner was blinded to the degree of rotation during the film analysis. Regression analysis was performed between axial rotation and pubic symphysis deviation, sacral width, and innominate and femur head heights. Each measurement corresponds to a chiropractic listing within the Gonstead system. RESULTS: Regression analysis revealed a strong association between the degree of axial rotation and each response variable: pubic symphysis deviation, sacral width, innominate height, and femur head height. The strongest relationship existed between y-axis rotation and pubic symphysis deviation. CONCLUSIONS: Chiropractic pelvic listings are strongly influenced by positioning of the subject. A few degrees of axial rotation may create apparent misalignments of several millimeters.

Chiropractic↗
PubMed2006

Chiropractic manipulation affects the difference between arterial systolic blood pressures on the left and right in normotensive subjects.

OBJECTIVE: The purpose of this study is to determine whether chiropractic manipulation is associated with any measurable changes in the difference between the arterial blood pressures on the left and right before and after treatment in normotensive subjects. METHODS: A nonrandomized, matched pair, controlled clinical trial, with the treatment (manipulation) group and control (resting) group matched for age and sex, was performed in chiropractic student clinics in London, UK. The treatment group consisted of 35 new patients presenting to a single student chiropractor between the start of April 2003 and the end of August 2003. The control group consisted of 35 nonpatients matched for sex and age. The intervention was chiropractic manipulation. Preintervention and postintervention systolic and diastolic blood pressures were recorded in both arms through the use of a digital oscillometric sphygmomanometer. RESULTS: A significant difference was found between the pre- and posttreatment blood pressure differences for systolic pressures (P = .01), but no significant difference was found in either set of control data or the treatment diastolic values. A significant difference was also found between the treatment and control group's preintervention systolic differences (P = .002), but not between the groups at any other time. CONCLUSION: Chiropractic treatment appears to have an effect on the difference in systolic blood pressure between the arms, which is not shown in the control group or the diastolic treatment group values. This may be attributable to a difference between the 2 groups' preintervention systolic values; however, there was no significant difference between the 2 groups after intervention.

Adolescent↗
PubMed2005

Alternatives in cancer pain treatment: the application of chiropractic care.

OBJECTIVES: To review written resources disclosing reliable facts and knowledge in chiropractic services in cancer pain management. DATA SOURCES: Conventional and biomedical and complementary and alternative medicine journals, electronic media, full text databases, electronic resources, books in print, and newsletters. CONCLUSION: The judicial use of chiropractic services in cancer patients appears to offer many economical and effective strategies for reducing the pain and suffering of cancer patients, as well as providing the potential to improve patient health overall. IMPLICATIONS FOR NURSING PRACTICE: Clinicians should assess and support the use of chiropractic services in cancer patients. Chiropractic is one of the leading alternatives to standard medical treatment in cancer pain management.

Humans↗