Journal of Manipulative and Physiological Therapeutics最新文献

{"title":"Training, Professional Skills, and Experiences of Doctors of Chiropractic Working in U.S. Federally Qualified Health Centers: A Mixed Methods Study.","authors":"Andrea K Albertson, Michele J Maiers, Alane G Lucht, Paul Ratté, Charles E Sawyer","doi":"10.1016/j.jmpt.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.jmpt.2025.09.007","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to examine the training, professional skills, and experiences of Doctors of Chiropractic (DCs) working in Federally Qualified Health Centers (FQHCs).</p><p><strong>Methods: </strong>Identified FQHC-employed DCs in the United States were invited to participate in a survey about their training and practice, administered between November and December 2023. A subset of these DCs, along with FQHC administrators and colleagues, participated in qualitative interviews to explore their experiences and the skills necessary for a DC to practice effectively in FQHCs, between February and May 2024. Survey analysis utilized descriptive statistics and content analysis, while reflexive thematic analysis was applied to the interviews by identifying notable themes and creating a codebook.</p><p><strong>Results: </strong>Of 206 DCs invited, 101 completed the survey (49.0%). Respondents averaged 18.2 years in practice (range: 1-48), and 44.8% participated in the Public Services Loan Forgiveness program. Fewer than half reported prior experience in multidisciplinary settings (47.4%), additional training through certificates (43.8%), or advanced degrees (28.1%). Many (41.8%) reported using a non-English language with patients, predominantly Spanish (80.5%). DCs frequently performed joint manipulation and soft tissue therapies, primarily for spinal and chronic pain. Interviews involved 12 DCs, 10 administrators, and 7 colleagues. Each group appreciated DCs' instructional abilities (eg, communication, patient education), patient-centered orientation, and interprofessional competencies (eg, teamwork, collaboration). DCs valued providing chiropractic access to underserved communities and focusing on patient care over business practices.</p><p><strong>Conclusions: </strong>DCs working in FQHCs demonstrated a \"team mentality\" including patient-centered care, interprofessional collaboration, and communication. Their integration into FQHCs enhances team-based care and expands access to nonpharmacologic pain management.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Integrated Neuromuscular Inhibition Versus Postisometric Relaxation Technique on Rhomboid Latent Myofascial Trigger Points: A Randomized Clinical Trial.","authors":"Aliaa M Elabd, Omar M Elabd, Waleed T Mansour, Radwa F Hammam","doi":"10.1016/j.jmpt.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.jmpt.2025.09.006","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to compare the efficacy of the Integrated Neuromuscular Inhibition Technique (INIT) and postisometric relaxation (PIR) techniques on rhomboid muscle latent trigger points (LTrPs).</p><p><strong>Methods: </strong>Seventy-five patients with rhomboid muscle LTrPs were randomly divided into 3 groups and treated for 4 weeks: group A (control): conventional treatment (infrared radiation, ultrasonic therapy, and transcutaneous electrical nerve stimulation); group B: PIR with conventional treatment; and group C: INIT with conventional treatment. Pre- and post-treatment measurements were taken for shoulder pain and disability, neck pain intensity, neck disability, and pressure pain threshold (PPT) at 3 spots on each side. A 2-way MANOVA was used for data analysis.</p><p><strong>Results: </strong>Group C experienced significantly lower shoulder pain and disability than A and B and less neck pain intensity than A. Both groups, B and C, had significantly higher PPT for the upper and lower right points than A. PPT for the right middle, upper, and lower left points was higher in Group C than in A or B. Group C had a higher PPT of the middle-left point than A. There were significant changes in all outcomes within all groups (P < .05), except that the control group showed no significant alterations in PPT measurements.</p><p><strong>Conclusions: </strong>Both approaches help treat rhomboids and muscle LTrPs when combined with conventional treatment, even though INIT may be more successful than PIR.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Acupressure on Pain, Functional Status, and Quality of Life in Individuals With Knee Osteoarthritis.","authors":"Tugba Aydemir, Rabiye Çirpan, Pınar Tekinsoy Kartin","doi":"10.1016/j.jmpt.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.jmpt.2025.09.001","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to ascertain the impact of acupressure on pain perception, functional status, and overall quality of life in individuals afflicted with knee OA.</p><p><strong>Methods: </strong>The research was executed as an experimental study employing both pre- and post-test assessments, featuring a control group. Ninety participants were divided into 2 groups: acupressure and control. The acupressure intervention was administered twice weekly, once daily, for a duration of 4 weeks, totaling eight sessions. It adhered to the guidelines for acupuncture application as outlined by the researcher, targeting 6 specific acupuncture points. Data were collected both before and after the acupressure sessions, utilizing assessment tools such as the Visual Analogue Scale (VAS), the 36-Item Short-Form Health Survey (SF-36), and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC).</p><p><strong>Results: </strong>The study was conducted with a total of 90 participants, comprising 45 individuals in the acupressure group (comprising 88.9% females, with a mean age of 62.88 ± 9.55 years) and 45 individuals in the control group (also comprising 88.9% females, with a mean age of 58.93 ± 10.19 years). Before the acupressure intervention, the acupressure group exhibited higher scores in pain, stiffness, and physical function compared to the control group. Nevertheless, after the interventions, a noteworthy enhancement was detected in the VAS scores, WOMAC scores, and SF-36 scores within the acupressure group (P < .001).</p><p><strong>Conclusion: </strong>In conclusion, acupressure was found to reduce pain severity and enhance the functional status and quality of life in patients diagnosed with knee OA.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, ID: NCT05238350.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurophysiological Outcomes of Human Touch and Related Clinical Assessments: A Scoping Review.","authors":"Manuela Deodato, Miriam Martini, Alessandro Tamma, Andrea Nitri, Raffaele Ornello, Ilaria Frattale, Eleonora De Matteis, Paolo Manganotti, Valeria Caponnetto","doi":"10.1016/j.jmpt.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.jmpt.2025.08.002","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to summarize literature exploring pain modulation pathways in healthy humans undergoing human-hand touch via professional care without specific intervention as comparator. A secondary aim was to describe the clinical outcomes considered in the literature reporting neurophysiological outcomes.</p><p><strong>Methods: </strong>A scoping review was performed on PubMed, Scopus, and Web of Science up to 10 September 2022. Included studies had to be primary and describe a human-hand touch intervention performed by professionals on healthy humans. Studies that described only patient-reported outcome measures or drug administration to subjects during touch stimulation were excluded. The study design, Country, setting, type of sample and number of subjects, age, number of females, intervention, type of professionals involved, assessed outcomes, and results were extracted.</p><p><strong>Results: </strong>We included 1 observational study, 4clinical trials, and 5 randomized studies involving 323 subjects, conducted in clinical (n = 3) or academic (n = 7) settings. The summary of the findings suggest that human touch may induce activation and functional neurophysiological change in \"pain matrix\" through a convergence of the exteroceptive and interoceptive sensations which comes from lamina I to insula cortex and thalamus. This brain activation may be correlated with clinical improvements, especially in weight gain for preterm/neonates, and in pain modulation for adults. Dynamic human touch may be more pleasant and useful in pain relief than static touch and non-human touch. Finally, the cognitive status of operators may play a role in brain change of touched subjects.</p><p><strong>Conclusions: </strong>This scoping review identified literature that suggests human touch may be associated with a central convergence and elaboration of sensory information from external and internal milieu, but also with a bi-directional cognitive modulation between operator and touched subject.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Craniocervical Flexion Test Reference Values and Relationship With Age and Sex in Healthy Adults: A Cross-Sectional Study.","authors":"Carlos Antonio Zárate-Tejero, Orosia Lucha-López, Lindsay Brandt, John Krauss, Mar Hernández-Secorún, César Hidalgo-García, Pere Ramón Rodríguez-Rubio","doi":"10.1016/j.jmpt.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.jmpt.2025.09.005","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to establish reference values for the Craniocervical Flexion Test (CCFT) in healthy volunteers and to explore the relationship between age and sex on the CCFT.</p><p><strong>Methods: </strong>This prospective, observational, cross-sectional study was developed in the assessment room of the Physiotherapy department at the Universitat Internacional de Catalunya. The study included healthy subjects between 18 and 75 years old. CCFT and sociodemographic variables, such as pain or physical activity, were collected. Linear regression models were developed with age and sex as the only predictor variables. Adjusted models were developed factoring in the sociodemographic information.</p><p><strong>Results: </strong>A total of 122 volunteers (61 males, 61 females) between 18 and 75 years old participated in the study. The mean CCFT for the sample was 25.48 (3.3) mm Hg. Linear regression model by sex showed a coefficient of 1.11 mm Hg (CI 95%: -0.06, 2.29; p = .062) with men demonstrating 1.11 mm Hg more than women. Linear regression models by age strata showed a coefficient of -0.17 mm Hg (CI 95%: -0.51, 0.18 p = .347) for each decade of age. Variables related to sociodemographic information showed no significant effect.</p><p><strong>Conclusion: </strong>Gender and age have no relationship with the results of CCFT in healthy volunteers. The reference value for the Craniocervical flexion test in 122 healthy adults was 25.48 (3.30) mm Hg. This value may help therapists examine/set goals for patients with head/neck pain.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and Validity of the Cartesian Optoelectronic Dynamic Anthropometer Motion Analysis System to Measure Cervical Range of Motion in Healthy Participants.","authors":"Jie Li, Zefeng Yu, Pan Diao, Dong Wang, Haopeng Li, Xijing He, Fang Wang","doi":"10.1016/j.jmpt.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.jmpt.2025.09.003","url":null,"abstract":"<p><strong>Objective: </strong>The Cartesian Optoelectronic Dynamic Anthropometer (CODA) motion analysis system is a new instrument that measures 3-dimensional joint movement. The study aimed to investigate the reliability and validity of the CODA motion analysis system in assessing the cervical range of motion in healthy people.</p><p><strong>Methods: </strong>A total of 41 healthy participants were included. Movements in 3 planes (flexion and extension, right and left lateral bending, and right and left axial rotation) were measured by using the CODA motion analysis system. The results for flexion-extension and lateral bending movements were compared with those obtained by a standard inclinometer. Intraobserver and interobserver reliability and validity were assessed using the intraclass correlation coefficient (ICC) method. SE of measurement (SEM) and minimal detectable change (MDC) values were also calculated to identify the measurement errors.</p><p><strong>Results: </strong>High interobserver reliability (ICC range, 0.89-0.94) and validity (ICC range, 0.73-0.89) were found for all 3 planes, while the intraobserver reliability (ICC range, 0.76-0.92) was high, except for right lateral bending (ICC, 0.76) and left axial rotation movements (ICC, 0.84). All SEM and MDC values for intraobserver, interobserver, and criterion validity studies were less than 5° and 10°, respectively. Percentage of SEM of ≤10% and percentage of MDC of ≤30% were obtained for all variables.</p><p><strong>Conclusion: </strong>The CODA motion analysis system is a highly reliable, noninvasive, easy-to-use, and reproducible 3-dimensional device for measuring cervical range of motion. It demonstrated good reliability for flexion-extension and lateral bending movements.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate Effects of Manual Therapy Techniques on Ankle Dorsiflexion: A Randomized Clinical Trial.","authors":"Matheus de Castro Silva, Arthur de Sá Ferreira, Rodrigo de Marche Baldon, Carolina Lins, Gustavo Martins de Andrade, Gustavo Barros Braga de Castro Pereira, Natalia Camin Silva, Lilian Ramiro Felício","doi":"10.1016/j.jmpt.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.jmpt.2025.09.002","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to evaluate the effects of combined techniques on ROM, performance, and dynamic postural balance in young adults.</p><p><strong>Methods: </strong>Sixty participants were recruited, with a mean age of 25.35 (±8.00) years and ankle dorsiflexion ROM below 40° in closed kinetic chain (CKC). The participants were randomly divided into 2 groups: Joint mobilization based on the Mulligan Concept (Group 1); Joint mobilization based on the Mulligan Concept, together with the Maitland Method (Group 2). The participants were evaluated preintervention (A0), immediately after the intervention (A1), and 3 to 4 days after the intervention (A2).</p><p><strong>Primary outcome: </strong>DF ROM in CKC.</p><p><strong>Secondary outcomes: </strong>ROM in open kinetic chain, performance, and balance.</p><p><strong>Results: </strong>Group 2 presented superior performance in the Triple Hop Test in evaluations A1 (Cohen's d = 1.45) and A2 (Cohen's d = 1.21), and after the intervention (A2) showed greater displacement (Cohen's d = 3.22) in the Y Balance Test. Both groups showed increases of DF ROM in CKC and performance.</p><p><strong>Conclusions: </strong>The combination of joint mobilization techniques can provide additional benefits in functional performance. Both techniques are effective for increasing ankle DF ROM.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Initial Trial Planning for Low Back Pain Among Veterans Health Administration Chiropractors: A Descriptive Observational Survey.","authors":"Victoria A Bensel, Paul E Dougherty, Brenda T Fenton, Anthony J Lisi","doi":"10.1016/j.jmpt.2025.08.007","DOIUrl":"https://doi.org/10.1016/j.jmpt.2025.08.007","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to assess how chiropractors within the Veterans Health Administration (VHA) determine their perceived-optimal dosage (number of visits and trial duration) when planning initial trials of care for patients with low back pain, and to describe factors perceived to influence these decisions, as well as barriers and facilitators to implementation.</p><p><strong>Methods: </strong>A cross-sectional electronic survey was distributed to all chiropractors with an active VHA appointment as of July 1, 2024 (N = 384). The survey, based on prior qualitative interviews and pilot testing, included a clinical vignette and questions related to perceived-optimal visit number and duration, modifying factors, and implementation. Descriptive and inferential statistics (Pearson's chi-squares) were used to analyze responses in SAS 9.4.</p><p><strong>Results: </strong>A total of 181 VHA chiropractors completed the survey (47.1% response rate). The most frequently reported perceived-optimal initial trial was 6 visits over 6 weeks (21.5%). Respondents reported that increasing patient age, higher pain intensity, greater functional impairment, and shorter duration of symptoms would increase the planned visit dosage. There was considerable variation in chiropractors' perceptions of the ideal initial treatment trial. Most clinicians (62%) reported they were able to implement their preferred initial trial less than half of the time. The same barriers (including number of available chiropractic clinicians and treatment rooms) and facilitators (including the ability to collaborate with non-DC clinicians and the presence of clinical support staff) were reported by both the <25% and ≥75% optimal implementation groups. However, more chiropractors in the <25% optimal implementation group reported barriers than did those in the ≥75% optimal implementation group for the number of DC Clinicians (74% vs 39%, p = .0002), and clinical access parameters (67% vs 36%, p = .0002).</p><p><strong>Conclusions: </strong>This study revealed that VHA chiropractors reported variable perceived-optimal initial trial dosages and endorsed several clinical and system-level factors that influence trial planning. Reported barriers to implementation were common, particularly those related to staffing and space limitations, with more chiropractors in the low implementation group reporting barriers.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Spinal Manipulation on Eye and Head Movement Performance in Participants With Chronic Neck Pain: An Observational Study.","authors":"Geoffrey M Gelley, Steven R Passmore, Cheryl M Glazebrook, Brian J MacNeil","doi":"10.1016/j.jmpt.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.jmpt.2025.08.006","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine the immediate effects of spinal manipulation (SM) on motor performance of eye and head movement tasks in symptomatic and asymptomatic participants with chronic neck pain.</p><p><strong>Methods: </strong>This observational study utilized a between and within group analyses to assess the effects of cervical SM in symptomatic (n = 20) and asymptomatic (n = 20) groups. Participants performed goal-directed eye and head movement tasks before and after cervical SM, to identify changes in eye and head motor performance. Eye and head movement time (MT) was analyzed as a primary outcome. Secondary outcomes included eye and head peak velocity and time to peak velocity.</p><p><strong>Results: </strong>During the eye movement task, there was no significant effect of SM on MT. During the head movement task, there was a significant SM by group interaction for MT and significant effect of SM on MT during the amplitude and width conditions within the symptomatic group indicating that head MTs were reduced in both analyses.</p><p><strong>Conclusion: </strong>There was no effect of SM on eye MTs. However, the significant effect of SM on head MT provides evidence for changes in head control following SM. Given the SM targeted the cervical spine, the changes in MT were only present for head movements, we propose the observed changes may result from both neuromuscular and sensorimotor adaptations following SM.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Describing Congruence Between Procedural Codes and Medical Record Text in Veterans Health Administration Chiropractic Notes.","authors":"Samuel M Schut, Sarah E Graham, Anna R Sites, Brian C Coleman, Anthony J Lisi","doi":"10.1016/j.jmpt.2025.08.003","DOIUrl":"10.1016/j.jmpt.2025.08.003","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to describe congruence between Current Procedural Terminology (CPT) codes and text documentation of therapeutic procedures from chiropractic notes in the Veterans Health Administration (VHA).</p><p><strong>Methods: </strong>A manual chart review of national electronic health record data was performed. We randomly sampled 1000 on-station VHA chiropractic visits occurring from October 1, 2017 to September 30, 2018 among patients lacking such visits within the prior 12 months. CPT and documented text procedures were extracted. We excluded evaluation and management codes and mapped only therapeutic procedures to 6 categories. Utilizing a novel rating system evaluating congruence between CPT and procedures recorded in text, 2 analyses were performed based upon the inclusion or exclusion of patient education codes.</p><p><strong>Results: </strong>CPT data from 808 included notes were abstracted and analyzed. Of these, 239 (29.6%) were rated completely congruent, and 513 (63.5%) partially congruent. In an analysis of 790 notes from which patient education CPT codes were excluded, 404 (51.1%) were completely congruent and 329 (41.4%) partially congruent.</p><p><strong>Conclusion: </strong>Congruence between CPT coding and text documentation of therapeutic procedures in VHA chiropractic initial visits was generally high. Areas of variable congruence, especially the low presence of patient education codes, highlight the limitations in using CPT codes alone to describe VHA chiropractic care.</p>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}