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 235 records · Page 13Linked to original sources
PubMedDate not supplied

Dose-response for chiropractic care of chronic low back pain.

BACKGROUND CONTEXT: There have been no trials of optimal chiropractic care in terms of number of office visits for spinal manipulation and other therapeutic modalities. PURPOSE: To conduct a pilot study to make preliminary identification of the effects of number of chiropractic treatment visits for manipulation with and without physical modalities (PM) on chronic low back pain and disability. STUDY DESIGN/SETTING: Randomized controlled trial with a balanced 4x2 factorial design. Conducted in the faculty practice of a chiropractic college outpatient clinic. PATIENT SAMPLE: Seventy-two patients with chronic, nonspecific low back pain of mechanical origin. MAIN OUTCOME MEASURES: Von Korff pain and disability (100-point) scales. METHODS: Patients were randomly allocated to visits (1, 2, 3 or 4 visits/week for 3 weeks) and to treatment regimen (spinal manipulation only or spinal manipulation with PM). All patients received high-velocity low-amplitude spinal manipulation. Half received one or two of the following PM at each visit: soft tissue therapy, hot packs, electrotherapy or ultrasound. RESULTS: Pain intensity: At 4 weeks, there was a substantial linear effect of visits favoring a larger number of visits: 5.7 points per 3 visits (SE=2.3, p=.014). There was no effect of treatment regimen. At 12 weeks, the data suggested the potential for a similar effect of visits on patients receiving both manipulation and PM. Functional disability: At 4 weeks, a visits effect was noted (p=.018); the slope for group means was approximately 5 points per 3 visits. There were no group differences at 12 weeks. CONCLUSIONS: There was a positive, clinically important effect of the number of chiropractic treatments for chronic low back pain on pain intensity and disability at 4 weeks. Relief was substantial for patients receiving care 3 to 4 times per week for 3 weeks.

Adult↗
PubMed2006

Utilization and costs of chiropractic care for work-related low back injuries: do payment policies make a difference?

BACKGROUND: Chiropractic care is frequently used in the treatment of work-related low back pain. Chiropractors have been shown to be more sensitive to cost-sharing than other providers. PURPOSE: This study examined the differences in utilization and costs of chiropractic care for work-related low back injuries in seven jurisdictions and whether these differences can be associated with workers' compensation (WC) payment policies. STUDY DESIGN: A retrospective analysis of WC data from a single insurer. METHODS: Analyzed data included individuals with chiropractic care performed between 1999 and 2002. Utilization (visits and services per person, services per visit) and costs (cost per person and cost per visit) were examined. Actual reimbursement index was developed to proxy payment policies based on actual payments made to chiropractors. RESULTS: Utilization and costs varied significantly across the analyzed states. Restrictive payment policies were associated with lower costs of chiropractic care and lower number of services per visit, but had no impact on visits or services per person. CONCLUSIONS: Findings indicate necessary components of effective cost containment, even in the presence of utilization adjustment.

Adult↗
PubMed2003

Herbal and nutrient supplementation practices of chiropractic patients: an Australian case study.

BACKGROUND: Escalating interest in alternative health care has resulted in increased use of nutritional supplements and herbs by consumers. A number of these neutraceuticals interact with prescription drugs and may have adverse effects. OBJECTIVE: This study explored the extent to which chiropractic patients are likely to inform their chiropractic practitioner of their medication practices. METHOD: A case study that included patients attending 21 chiropractic clinics in 5 states and the Australian Capital Territory was undertaken. Seven hundred fifty-eight patients provided information on their nutritional and herbal supplementation practices. Data were collected using a questionnaire that inquired about general life-style and sought particular information about self-initiated and professionally recommended medication practices. A list of medications that could influence coagulation was provided. Patients were specifically requested to indicate whether they had informed their chiropractor about any of the medications, herbs, or nutrients they were taking. RESULTS: More than 1 in 3 of the chiropractic patients in this study were taking, either on the advice of a health professional or, more often, on their own initiative, a nutritional supplement and/or herb. Yet, chiropractors were only occasionally informed about the medication practices of their patients. CONCLUSION: In view of the potential health risks and drug interactions, chiropractors should routinely inquire whether their patients are taking herbs or nutritional supplements.

Australia↗
PubMedDate not supplied

Lateral cervical curve changes in patients receiving chiropractic care after a motor vehicle collision: a retrospective case series.

OBJECTIVE: To examine radiological changes of the lateral cervical curve in patients who received chiropractic care after motor vehicle collisions. DESIGN: A retrospective case series. Thirteen patients who had received chiropractic care after motor vehicle collisions were selected from a northeastern Washington chiropractic office. Patients had a lateral cervical radiograph taken prior to the initiation of chiropractic treatment and a comparative lateral cervical radiograph subsequent to a period of care. Cases were included if they met the previously stated criteria and if the radiographs were of sufficient quality to determine the lateral cervical curve from C2-C7. RESULTS: Adjustments rendered using an Activator Adjusting Instrument. Eleven of the subjects were also instructed to perform stretching exercises. Compared to the initial lateral cervical radiograph, the comparative radiographs demonstrated a mean increase in cervical lordosis between C2 and C7 of 6.4 degrees (SD = 8.2). The standard error estimate of the population was 2.3 degrees, with a 95% confidence interval of 1.4 degrees to 11.4 degrees. CONCLUSION: There was a mean increase in the cervical lordosis of 6.4 degrees (SD = 8.2). The standard error estimate of the population was 2.3 degrees, with a 95% confidence interval of 1.4 degrees to 11.4 degrees. We were not able to determine the individual effects of adjustment, stretching, and natural progression of the condition. The results suggest that further study of this phenomenon should be undertaken.

Accidents, Traffic↗
PubMedDate not supplied

Dietary diversity: case study of fruit and vegetable consumption by chiropractic patients.

BACKGROUND: A distinct health advantage has been linked with eating a wide variety of fresh fruit and vegetables. OBJECTIVE: This study explores the diversity of fruits and vegetables consumed by chiropractic patients and inquires into their preferred purchasing patterns. METHOD: A case study that included patients attending 24 chiropractic practices in 5 states and the Australian Capital Territory was undertaken. Seven hundred eighty-two patients were asked to complete a questionnaire providing general information about their life-style and particular information about the number of servings of fruits and vegetables that they usually consumed. RESULTS: Although overall chiropractic patients reported adhering to a number of healthy life-style behaviors, participants in this study would benefit from eating a greater diversity of fruits and vegetables. CONCLUSION: In view of the substantial health benefits associated with eating a wide variety of fruits and vegetables, it is suggested that chiropractic patients be encouraged to follow a color code system for purchasing their fresh produce.

Activities of Daily Living↗
PubMed1999

A psychological profile of fibromyalgia patients: a chiropractic case study.

BACKGROUND: Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain and tenderness. Reversible modulation of the pain threshold is believed to contribute to the pathogenesis of this condition, and psychosocial stress is known to alter the pain threshold. OBJECTIVE: To describe and compare the psychological profile of fibromyalgia patients attending chiropractic clinics in Australia. SETTING: Chiropractic clinics located in 5 Australian states and the Australian capital territory with practices in inner city, suburban, coastal, and rural areas were included. SUBJECTS: Chiropractic patients with acute and chronic biomechanical conditions, fibromyalgia, and who were undergoing maintenance care were included in the study. METHOD: A case study to explore the psychological profile of fibromyalgia patients was undertaken. The Distress and Risk Assessment Method (DRAM) and Sense of Coherence (SOC) questionnaires were used to ascertain and compare the distress, sense of coherence, and manageability levels of patients with fibromyalgia with patients having maintenance chiropractic care. Purposive sampling of practitioners and convenience sampling of patients fulfilling the study's inclusion criteria were undertaken. Patients were asked to complete two questionnaires and chiropractors to complete one questionnaire and an interview. RESULTS: While more than half of the patients in the fibromyalgia group were distressed, fewer than 1 in 7 maintenance patients were found to be distressed according to the DRAM questionnaire. With several individual exceptions, fibromyalgia patients also tended to have lower SOC and manageability scores than the maintenance group. CONCLUSION: This study supports the view that fibromyalgia may represent a problem of coping with various environmental stresses, including psychosocial stresses. However, owing to individual variation, a diagnosis of fibromyalgia at the clinical level does not accurately predict whether a particular patient is distressed or has a low SOC score. Screening of fibromyalgia patients may help determine whether intensive counseling and stress management by the chiropractor or another health professional should be contemplated.

Adaptation, Psychological↗
PubMed1999

Chiropractic care and ochronotic arthropathy.

OBJECTIVE: To discuss the case of a patient with ochronotic arthropathy whose symptoms were treated with chiropractic care. An emphasis is placed on this condition's radiographic features. CLINICAL FEATURES: A 59-year-old woman with pain in her low back, right knee, and left ankle sought chiropractic evaluation. Black pigmentation was found in the sclera of both eyes, and homogentisic acid was present in the urine. Orthopedic evaluation revealed uncomplicated, nonspecific joint pain, and radiographs demonstrated characteristic spinal changes. INTERVENTION AND OUTCOME: The patient was treated with chiropractic manipulation, physiotherapy modalities, bracing, and exercises. This type of therapy was successful in reducing the symptoms and helped decrease the severity and frequency of acute exacerbations. CONCLUSION: Ochronotic arthropathY is a rare metabolic disorder that can be diagnosed from spinal radiographs. Chiropractic care is an appropriate tool for reducing its symptomatology.

Arthritis↗
PubMedDate not supplied

Cost-effectiveness studies of medical and chiropractic care for occupational low back pain. a critical review of the literature.

BACKGROUND CONTEXT: Back pain is the single most costly work-related injury. Chiropractors and physicians are the main primary care providers for occupational low back pain (OLBP), but there is no consensus regarding the relative cost-effectiveness of these two modes of care. PURPOSE: To critically appraise and synthesize recent literature on the cost-effectiveness of medical and chiropractic care for OLBP, and to propose a cost-effectiveness methodology that integrates epidemiologic and economic methods for future studies. STUDY DESIGN: Literature review. MEDLINE was searched from 1990 through 1999. Nine articles that met the inclusion criteria were reviewed. The methodological quality of the articles was critically appraised independently by two epidemiologists using standardized review criteria. Two health economists reviewed the studies on cost-effectiveness. RESULTS: The current literature suggests that chiropractors and physicians provide equally effective care for OLBP but that chiropractic patients are more satisfied with their care. Evidence on the relative costs of medical and chiropractic care is conflicting. Several methodological deficiencies limit the validity of the reviewed studies. No studies combine high-quality cost data with adequate sample sizes and controls for confounding factors. CONCLUSION: Existing studies fail to clarify whether medical or chiropractic care is more cost effective. We suggest that future studies must combine epidemiologic and economic methods to answer the question adequately.

Chiropractic↗
PubMedDate not supplied

[Extensive spinal epidural hematoma--an uncommon entity following cervical chiropractic manipulation].

INTRODUCTION: Spinal epidural hematoma is a rare complication after chiropractic manipulation. In the literature, only three cases have been reported, which all necessitated surgical treatment. CASE: A 27-year-old woman was treated with cervical chiropractic manipulation (C5/6) and facet joint infiltration. 10 minutes later the patient presented signs of intracranial pressure with nausea, vertigo, headache and vomiting. The magnetic resonance imaging of the spine demonstrated an epidural hematoma extending from the cervical to the sacral spine. As the patient had no sensible or motor deficits and recovered quickly, surgical treatment was not necessary. A few days later the patient had a complete persisting remission of symptoms. CONCLUSION: If neurological deficits occur after chiropractic manipulation, a spinal epidural hematoma should be considered to provide adequate therapy without delay. The current case report shows an unusual expansion of the hematoma which has not described so far after chiropractic manipulation. But, in contrast to the three cases reported before, a surgical intervention was not necessary.

Adult↗
PubMed2001

The health information brochure: a useful tool for chiropractic practice?

BACKGROUND: It has been suggested that clinicians should be looking at new ways to enhance their patients' self-care. Patient education is one strategy that primary providers may use. OBJECTIVE: This study investigates the format in which patients would like to pursue their health education within the chiropractic clinic. METHODS: An exploratory study of chiropractic patients was undertaken to investigate patients' preferred health education formats, their commitment to pursuing health objectives, and their literacy level. Purposive sampling of 9 Australian chiropractic clinics was undertaken. Convenience sampling of patients attending these clinics resulted in 102 patients participating. Participants completed a questionnaire. A research assistant was available to clarify any questions. Data were collected and collated. A Likert scale was used to capture responses to questions ascertaining patient opinions. RESULTS: Patients considered health the most important of the life objectives listed; however, they preferred spending time with family to undertaking health- and fitness-promoting activity. More chiropractic patients opted for health information brochures than health promotion classes, personally supervised self-care programs, or practitioner-supervised self-care contracts. Patient literacy levels varied within and between clinics. CONCLUSIONS: Brochures may provide a definitive health information tool for chiropractors who limit their clinical role to primary contact and a helpful adjunct to patient education for chiropractors committed to a primary care role. However, care should be taken to select brochures consistent with the patients' literacy level. Tips for selecting and preparing suitable brochures are provided. The discrepancy between how greatly patients value health and how they prefer spending their time may have implications for successful behavior change. Brochures may not alone constitute adequate practitioner involvement.

Adult↗
PubMed2001

Unsubstantiated claims in patient brochures from the largest state, provincial, and national chiropractic associations and research agencies.

OBJECTIVE: To determine the presence or absence of claims for the clinical art of chiropractic that are not currently justified by available scientific evidence or are intrinsically untestable. DESIGN: A survey of patient education and promotional material produced by national, state, and provincial societies and research agencies in Canada and the United States. METHOD: Patient brochures were solicited from the 3 largest provincial, 3 largest state, and the 3 largest national professional associations in the United States and Canada. Similar requests were made of 2 research agencies supported by the national associations. Brochures were reviewed for the presence or absence of unsubstantiated claims. RESULTS: Of the 11 organizations sampled, 9 distribute patient brochures. Of these 9 organizations, all distribute patient brochures that make claims for chiropractic services that have not been scientifically validated. CONCLUSION: The largest professional associations in the United States and Canada distribute patient brochures that make claims for the clinical art of chiropractic that are not currently justified by available scientific evidence or that are intrinsically untestable. These assertions are self-defeating because they reinforce an image of the chiropractic profession as functioning outside the boundaries of scientific behavior.

Canada↗
PubMedDate not supplied

The centralization phenomenon in chiropractic spinal manipulation of discogenic low back pain and sciatica.

OBJECTIVE: To describe 3 cases of discogenic low back pain and leg pain in which the centralization phenomenon was used in determining chiropractic treatment and prognosis. CLINICAL FEATURES: Three men with low back pain and sciatica, positive straight leg raise, mild neurologic deficits, and evidence of discogenic disease requested chiropractic treatment. Two of the patients exhibited centralization of pain on provocation testing; the third did not. INTERVENTION AND OUTCOME: All patients were treated with chiropractic side-posture manipulation, ancillary therapies, and pain medications. The 2 subjects whose pain centralized had excellent outcomes to treatment. The one whose pain did not centralize had a poor outcome and eventually required surgery. CONCLUSION: Assessment of the centralization phenomenon provided valuable diagnostic and prognostic information regarding chiropractic side-posture manipulation in this case series.

Adult↗
PubMed2003

Evaluation of chiropractic management of pediatric patients with low back pain: a prospective cohort study.

BACKGROUND: Recent epidemiologic studies have estimated that the lifetime prevalence of low back pain (LBP) in children is approximately 50%, with almost 15% of children experiencing frequent or continual pain. A literature search revealed no published studies addressing conservative treatment of childhood LBP. OBJECTIVE: To describe chiropractic management of LBP in patients between the ages of 4 and 18 years, as well as outcomes and factors associated with the outcomes. METHODS: Prospective cohort study of consecutive pediatric patients with LBP seeing randomly selected chiropractors within the cities of Calgary, Alberta, and Toronto, Ontario, Canada. Follow-up data collection included the type and extent of treatment rendered and its outcome, which was measured with a 5-point subjective rating scale and a self-report pediatric visual analogue scale. RESULTS: Fifteen chiropractors provided data on 54 consecutive pediatric patients with LBP. The average age of the patients was 13.1 years, 57% were male, 61% were acute, with 47% attributing onset to a traumatic event (most commonly sports-related); 24% reported an episode duration of greater than 3 months. Almost 90% of cases presented with uncomplicated mechanical LBP, most frequently diagnosed as lumbar facet dysfunction or subluxation. Patients were managed with manipulation, with a minority (7.7%) receiving some form of active management. "Important" improvement was seen in 62% and 87% on the visual analogue and subjective scales, respectively, within a 6-week course of management (Kaplan-Meier survival analysis). Patients with chronic LBP were less likely to respond within the median number of treatments (relative risk = 2.1). CONCLUSIONS: Patients responded favorably to chiropractic management, and there were no reported complications. Future investigations should establish the natural history and compare chiropractic management with other forms of treatment to gain knowledge about the effectiveness of chiropractic in managing pediatric LBP.

Adolescent↗
PubMed2003

Is chiropractic evidence based? A pilot study.

OBJECTIVE: To calculate the proportion of care delivered in a chiropractic practice supported by good-quality clinical trials. DESIGN: Retrospective survey. METHODS: Data were collected from patient files relating to 180 consecutive patient visits in a suburban chiropractic practice in northern Spain. Each patient's presenting complaint was paired with the chiropractor's chosen primary intervention. Based on a literature review (Medline, Mantis, and nonautomated searches of local medical libraries), each presenting complaint-primary intervention pairing was categorized according to the level of supporting evidence as follows: Category I, intervention based on good quality clinical trial evidence; Category II, intervention based on poor-quality or no clinical trial evidence. To distinguish between good- and poor-quality clinical trials, studies were critically appraised and assigned quality scores. RESULTS: Of the 180 cases surveyed, 123 (68.3%) (95% CI, 61.5%-75.1%) were based on clinical trials of good methodologic quality (Category I). Only 57 (31.7%) (95% CI, 24.9%-38.5%) of the cases were based on poor-quality or no clinical trial evidence (Category II). CONCLUSIONS: When patients were used as the denominator, the majority of cases in a chiropractic practice were cared for with interventions based on evidence from good-quality, randomized clinical trials. When compared to the many other studies of similar design that have evaluated the extent to which different medical specialties are evidence based, chiropractic practice was found to have the highest proportion of care (68.3%) supported by good-quality experimental evidence.

Chiropractic↗
PubMed2003

Do chiropractic colleges' off-campus clinical sites offer diverse opportunities for learning? A preliminary study.

OBJECTIVE: This study involved the collection of data on the demographic characteristics and chief complaints of patients of chiropractic college teaching clinics to study whether patients who visited different types of teaching clinics were demographically or clinically dissimilar. It represents a first step toward our ability to collect data from teaching clinics to test for differences between specific clinic populations. DESIGN: Descriptive cross-sectional study, implemented through a survey of patients. A survey form and a data collection infrastructure already in place for an established practice-based research program allowed the application of existing resources in the teaching clinic environment. PARTICIPANTS: Participating clinics included on-campus, off-campus, and outreach teaching clinics of four chiropractic colleges. Recruitment took place by word of mouth; clinic directors volunteered to participate in the 1-week survey. The study population consisted of all patients, new and established and of any age, who came to participating clinics during the week of March 16-21, 1998. RESULTS: Fourteen participating clinics returned surveys on 1612 patients. The age, sex, and race of patients, and the nature, onset, and duration of their chief complaints were significantly different among the categories of teaching clinics. Salient dissimilarities occurred in racial distribution, types of chief complaint, and duration of chief complaint among the patient populations of different clinics. CONCLUSION: Different types of teaching clinics may facilitate greater diversity in the patient population seen by chiropractic students, broadening the clinical training of chiropractic students by providing diversity in clinical settings and patient populations.

Adolescent↗
PubMed2003

Empowerment of chiropractic faculty: a profile in context.

BACKGROUND: The primary resource base and core human capital in chiropractic education is found among its faculty. The chiropractic profession depends on a motivated faculty for continuous quality improvement and innovation in areas of curriculum, scholarship, and practice. Empowerment has been associated with increased intrinsic motivation. Assessments of attitudes of faculty in terms of empowerment, a set of cognitions created by the work environment, may inform executive decision making related to development of a productive professional work environment. OBJECTIVE: The goal of this exploratory study is to provide an initial understanding of empowerment among faculty in the organizational context of chiropractic education, to construct a profile of perceived faculty empowerment, and to inquire into potential associations between perceived empowerment and faculty demographic and workplace characteristics. STUDY DESIGN: This was a full faculty survey using descriptive statistics and multivariable analysis. METHODS: Surveys were distributed to full- and part-time faculty working in the United States and Canada. The survey was composed of Spreitzer's multidimensional measure of psychologic empowerment and additional items designed to measure faculty demographics and workplace variables including academic rank, years at the institution, years in higher education, sex, age, area of assignment, employment status, and academic rank. RESULTS: More than 54% of the study population (N = 609) completed and returned the instrument. The respondents were typically male (68.4%) and employed full-time (81.6%). Almost half (47.5%) of the respondents were assigned to the area of patient care at their institution. Area of assignment and employment status emerged as important variables for explaining the variance in dependent variable scores. CONCLUSION: The findings of this research provide a basic profile and some initial perspectives of empowerment in the context of the work environment of the chiropractic profession's learning institutions.

Adult↗
PubMed1998

Employer-sponsored health insurance for chiropractic services.

The use of chiropractors has increased substantially in recent years, and there is growing scientific evidence on the effectiveness of chiropractic treatment for common low back ailments. Despite the increased acceptance of chiropractic care, little is known about the prevalence of chiropractic coverage in employer health plans and the nature of such benefits when they are provided. This article reports on the extent and composition of chiropractic insurance among workers with employer-sponsored health insurance in 1993. The prevalence of the benefits in employer plans was examined, as was the extent to which plans are in compliance with state mandated benefits in this area. The authors also examined what the actual benefits consist of and how they compare with those for physician office visits and physical therapy.

Chiropractic↗
PubMed2005

Intracranial hypotension induced by cervical spine chiropractic manipulation.

STUDY DESIGN: Case report. OBJECTIVES: We report a case of intracranial hypotension ensuing after a spinal chiropractic manipulation leading to cerebrospinal fluid (CSF) isodense effusion in the upper cervical and thoracic spine. SUMMARY OF BACKGROUND DATA: The etiology of intracranial hypotension is not fully understood, but CSF leakage from spinal meningeal diverticula or dural tears may be involved. METHODS: A 36-year-old woman presented with neck and both shoulder pain 4 days earlier. She undertook a spinal chiropractic manipulation. After this maneuver, she complained of a throbbing headache with nausea and vomiting. Her headache worsened, and lying down gave the only measure of limited relief. In CSF study, it showed dry tapping. Brain MRI showed pachymeningeal gadolinum enhancement. Thoracic spine MRI showed CSF leakage. After admission to the hospital, she was treated by hydration and pain control over several days. However, her headache did not improve. RESULTS: She was treated by epidural blood patch. Afterwards, her headache was improved. This is the first case of spontaneous intracranial hypotension in which spinal chiropractic manipulation coincided with the development of symptoms and in which a CSF collection in the upper cervical and thoracic spine was demonstrated radiographically in Korea. CONCLUSIONS: From this case, we can understand the etiology of intracranial hypotension and consider the complication of chiropractic manipulation.

Adult↗