Journal of Manipulative and Physiological Therapeutics最新文献

{"title":"Effect of Aerobic Exercise on the Levels of Pain, Quality of Life, and Alexithymia in Alexithymic Individuals With Chronic Pain: A Single-Blinded Randomized Controlled Trial","authors":"Mustafa Savas Torlak PhD,&nbsp;Bayram Sonmez Unuvar PhD,&nbsp;Hasan Gercek MsD","doi":"10.1016/j.jmpt.2023.04.007","DOIUrl":"10.1016/j.jmpt.2023.04.007","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to investigate the effects of aerobic exercise on pain, degree of alexithymia<span>, and quality of life in individuals with alexithymia and chronic pain.</span></p></div><div><h3>Methods</h3><p>A total of 40 participants who scored 61 or higher on the Toronto Alexithymia Scale-20 (TAS-20) were included in the study. The sample was subdivided into 2 groups using a computerized randomization<span> program: an aerobic exercise group (n = 20) and a control group (n = 20). Participants in the aerobic exercise group underwent a 30-minute jogging protocol at 60% to 90% of maximum heart rate 3 days per week for 8 weeks under the supervision of a physiotherapist. Participants in the control group continued their daily physical activities. Outcome measures were the TAS-20, visual analog scale, Graded Chronic Pain Scale, and 36-Item Short Form Health Survey.</span></p></div><div><h3>Results</h3><p>There was no statistically significant difference between the demographics of the 2 groups (<em>P</em> &gt; .05). There was a statistically significant improvement in TAS-20, Graded Chronic Pain Scale, visual analog scale, and 36-Item Short Form Health Survey scores of the participants in the aerobic exercise group compared to the control group (<em>P</em> ˂ .05).</p></div><div><h3>Conclusion</h3><p>Aerobic exercise had a positive effect on pain, quality of life, and degree of alexithymia in individuals with alexithymia and chronic pain.</p></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"45 9","pages":"Pages 652-659"},"PeriodicalIF":1.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825695","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":"Patient Characteristics and Clinical Outcomes Associated With Conservative Treatment for Spine Pain in Women Experiencing Socioeconomic Challenges","authors":"Sophie Morham ,&nbsp;Amber Reichardt ,&nbsp;Audrey Toth DC ,&nbsp;Gerald Olin DC ,&nbsp;Katherine Pohlman DC, PhD ,&nbsp;Steven R. Passmore DC, PhD","doi":"10.1016/j.jmpt.2023.04.001","DOIUrl":"10.1016/j.jmpt.2023.04.001","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to describe patient demographics and pain changes for women over the course of care in a chiropractic program.</p></div><div><h3>Methods</h3><p>We performed a retrospective cross-sectional analysis of a prospective quality assurance database from the Mount Carmel Clinic (MCC) in Winnipeg, Manitoba, Canada. Pain scores were reported on an 11-point Numeric Rating Scale. Baseline and discharge Numeric Rating Scale scores were compared for each spinal and extremity region through Wilcoxon signed rank tests to determine if clinically meaningful or statistically significant differences were present.</p></div><div><h3>Results</h3><p>The sample population attained was 348 primarily middle-aged (mean = 43.0, SD = 14.96) women with obesity (body mass index = 31.3 kg/m², SD = 7.89) referred to the MCC chiropractic program by their primary care physician (65.2%) for an average of 15.6 (SD = 18.49) treatments. Clinically meaningful median baseline to discharge changes in pain by spine region were observed (Cervical = −2, Thoracic = −2, Lumbar = −3, Sacroiliac = −3), each of which yielded statistical significance (<em>P</em> &lt; .001).</p></div><div><h3>Conclusion</h3><p>This retrospective analysis found that the MCC chiropractic program serves middle-aged women with obesity experiencing socioeconomic challenges. Pain reductions were reported, regardless of the region of complaint, temporally associated with a course of chiropractic care.</p></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"45 9","pages":"Pages 633-640"},"PeriodicalIF":1.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0161475423000131/pdfft?md5=e98e2d86174dbf77211dd886dc70ed7a&pid=1-s2.0-S0161475423000131-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9834555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrepant Perceptions of Biopsychosocial and Active Care Recommendations Between Doctors of Chiropractic and Midlife and Older Adult Patients: A Descriptive Survey","authors":"Anna-Marie L. Ziegler MM, DC ,&nbsp;Stacie A. Salsbury PhD, RN ,&nbsp;Michele Maiers DC, MPH, PhD","doi":"10.1016/j.jmpt.2023.04.003","DOIUrl":"10.1016/j.jmpt.2023.04.003","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to assess perceptions about the inclusion of biopsychosocial and active care recommendations during chiropractic clinical encounters between doctors of chiropractic (DCs) and their midlife and older adult patients and to identify whether there were any discrepancies between their recollections.</p></div><div><h3>Methods</h3><p>This descriptive cross-sectional survey was part of a mixed-methods research project designed to gather information about the role of electronic health interventions for midlife and older adults who use chiropractic care. For this study, a convenience sample of 29 DCs and 48 chiropractic patients aged 50 years and older from 2 metropolitan areas in the United States completed online surveys between December 2020 and May 2021. The survey matched questions about components of chiropractic care discussed by patients and providers over 12 months. We used descriptive statistics to explore congruence in perceptions between groups and qualitative content analysis to describe DC perceptions of working with this population.</p></div><div><h3>Results</h3><p>Doctors of chiropractic and patients agreed (&gt;90%) that pain management was the top reason midlife and older adults seek chiropractic care, yet differed in their prioritization of maintenance/wellness care, physical function/rehabilitation, and injury treatment as care drivers. While DCs reported frequent discussions about psychosocial recommendations, fewer patients reported talking about treatment goals (51%), self-care (43%), stress reduction (33%), or the impact of psychosocial factors (23%) and beliefs/attitudes (33%) on spinal health. Patients reported varied recollections about discussing activity limitations (2%) and exercise promotion (68%), being taught exercises (48%), or reassessing exercise progress (29%), which differed from higher levels reported by DCs. Qualitative themes from DCs included psychosocial considerations in patient education, importance of exercise/movement, role of chiropractic in lifestyle changes, and reimbursement limitations for older patients.</p></div><div><h3>Conclusion</h3><p>Doctors of chiropractic and their patients reported discrepant perceptions about biopsychosocial and active care recommendations during clinical encounters. Patients reported modest emphasis on exercise promotion and limited discussion on self-care, stress reduction, and psychosocial factors related to spine health compared to the recollections of DCs who reported frequent discussions of these topics.</p></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"45 9","pages":"Pages 623-632"},"PeriodicalIF":1.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0161475423000143/pdfft?md5=e50fb362c5b92e23dc0f85355243f2f4&pid=1-s2.0-S0161475423000143-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9834583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Gluteus Medius Trigger Points With Hip Passive Range of Movement and Muscle Strength in Adults With Chronic Nonspecific Low Back Pain: A Cross-Sectional Study","authors":"Marianne Carroll MHSc ,&nbsp;Richard Ellis PhD ,&nbsp;Susan Kohut MHSc ,&nbsp;Nick Garrett PhD ,&nbsp;César Fernández-de-las-Peñas PhD","doi":"10.1016/j.jmpt.2023.03.001","DOIUrl":"10.1016/j.jmpt.2023.03.001","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to investigate whether there is a relationship between gluteus medius trigger points with hip passive range of motion and hip muscle strength in people with chronic nonspecific low back pain (LBP).</p></div><div><h3>Methods</h3><p><span><span>This was a cross-sectional, blinded study that took place in 2 rural communities in New Zealand. Assessments were carried out in physiotherapy clinics in these towns. A total of 42 participants over 18 years old experiencing chronic nonspecific LBP were recruited. After meeting inclusion criteria, participants completed the following 3 questionnaires: Numerical Pain Rating Scale, </span>Oswestry Disability Index, and Tampa Scale of Kinesiophobia. The primary researcher (a physiotherapist) assessed each participant's bilateral hip passive range of movement (using an inclinometer) and muscle strength (using a dynamometer). Following this, a blinded trigger point assessor examined the </span>gluteus medius muscles for the presence of active and latent trigger points.</p></div><div><h3>Results</h3><p>General linear modeling using univariate analysis revealed that there was a positive association between hip strength and trigger point status (P =.03 left internal rotation, P =.04 right internal rotation, and P =.02 right abduction). Participants with no trigger points showed higher strength values (eg, right internal rotation standard error: 0.64), and those with trigger points showed lower strength. Overall, muscles exhibiting latent trigger points were the weakest (eg, right internal rotation standard error: 0.67).</p></div><div><h3>Conclusion</h3><p>The presence of active or latent gluteus medius trigger points was associated with hip weakness in adults with chronic nonspecific LBP. There was no association between gluteus medius trigger points and hip passive range of movement.</p></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"45 9","pages":"Pages 641-651"},"PeriodicalIF":1.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825710","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":"Application of Feedback Type on Performance of Abdominal Drawing-In Maneuver in Healthy Adults: A Quasi-Experimental Study of Motor Control and Motor Learning","authors":"Farhad Haeri PT, DPT,&nbsp;Dennis Torre PT, PhD","doi":"10.1016/j.jmpt.2023.04.004","DOIUrl":"10.1016/j.jmpt.2023.04.004","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this study was to compare the effects of verbal, tactile-verbal, and visual feedback on muscle activation of the lumbar stabilizers relative to extremity movers during an abdominal drawing-in maneuver when feedback is withheld.</p></div><div><h3>Methods</h3><p>This quasi-experimental study equally divided 54 healthy adults into 3 feedback groups (verbal, tactile-verbal, and visual) who trained twice per week over a 4-week period to perform supine abdominal drawing-in maneuvers. The percentage of maximum voluntary isometric contraction<span> of rectus abdominis, multifidus (MF), erector spinae, and hamstrings (HS) as an outcome measure was acquired using surface electromyography. A 2-way factorial analysis of variance with bootstrapping allowed for comparison of post-pre difference scores across the interaction of feedback and muscle groups.</span></p></div><div><h3>Results</h3><p>Hamstring activation decreased in those receiving tactile-verbal feedback relative to an increase in participants given visual feedback. Furthermore, when using verbal feedback, HS activity increased relative to a decline in rectus abdominis, and when presenting visual feedback, HS activity increased relative to a decrease in MF. However, no post-pre changes were seen across muscles with tactile-verbal feedback.</p></div><div><h3>Conclusion</h3><p>Although tactile-verbal feedback did not increase MF recruitment, it produced less HS activity than visual feedback. Undesirable HS recruitment may reflect boredom or feedback dependency.</p></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"45 9","pages":"Pages 671-680"},"PeriodicalIF":1.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9832085","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":"Characteristics of Chiropractic Patients in the Veterans Health Administration During the COVID-19 Pandemic: A Cross-Sectional Analysis","authors":"Gregory R. Roytman DC ,&nbsp;Kei-Hoi Cheung PhD ,&nbsp;Harini Bathulapalli MPH ,&nbsp;Christine M. Goertz DC, PhD ,&nbsp;Cynthia R. Long PhD, PStat ,&nbsp;Anthony J. Lisi DC","doi":"10.1016/j.jmpt.2023.04.002","DOIUrl":"10.1016/j.jmpt.2023.04.002","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to determine whether patient characteristics were associated with face-to-face (F2F) and telehealth visits for those receiving chiropractic care for musculoskeletal conditions in the US Veterans Health Administration (VHA) during the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>A retrospective cross-sectional analysis of all patients (veterans, dependents, and spouses) who received chiropractic care nationwide at the VHA from March 1, 2020, to February 28, 2021, was performed. Patients were allocated into 1 of the following 3 groups: only telehealth visits, only F2F visits, and combined F2F and telehealth visits. Patient characteristics included age, sex, race, ethnicity, marital status, and Charlson Comorbidity Index. Multinomial logistic regression estimated associations of these variables with visit type.</p></div><div><h3>Results</h3><p>The total number of unique patients seen by chiropractors between March 2020 and February 2021 was 62 658. Key findings were that patients of non-White race and Hispanic or Latino ethnicity were more likely to attend telehealth-only visits (Black [odds ratio 1.20, 95% confidence interval {1.10-1.31}], other races [1.36 {1.16-1.59}], and Hispanic or Latino [1.35 {1.20-1.52}]) and combination telehealth and F2F care (Black [1.32 {1.25-1.40}], other races [1.37 {1.23-1.52}], and Hispanic or Latino [1.63 {1.51-1.76}]). Patients younger than 40 years of age were more likely to choose telehealth visits ([1.13 {1.02-1.26}], 66-75 years [1.17 {1.01-1.35}], and &gt;75 years [1.26 {1.06-1.51}] vs those 40-55 years of age). Sex, visit frequency, and Charlson Comorbidity Index showed significant relationships as well, while marital status did not.</p></div><div><h3>Conclusion</h3><p>During the COVID-19 pandemic, VHA patients with musculoskeletal complaints using chiropractic telehealth were more ethnically and racially diverse than those using F2F care alone.</p></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"45 9","pages":"Pages 615-622"},"PeriodicalIF":1.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10254439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Whole-Body Vibration Exercise on Hamstrings-to-Quadriceps Ratio, Walking Performance, and Postural Control in Children With Hemiparetic Cerebral Palsy: A Randomized Controlled Trial","authors":"Rania G. Hegazy PT, MSc, PhD ,&nbsp;Amr A. Abdel-aziem PT, MSc, PhD","doi":"10.1016/j.jmpt.2023.04.011","DOIUrl":"10.1016/j.jmpt.2023.04.011","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to investigate the effect of whole-body vibration (WBV) exercises combined with traditional physiotherapy on the hamstrings-to-quadriceps (H:Q) ratio, walking ability, and control of posture in children with hemiparetic cerebral palsy (CP).</p></div><div><h3>Methods</h3><p>A total of 34 children with spastic hemiparetic CP (boys and girls) participated in this 2-arm, parallel, randomized controlled trial<span>. The inclusion criteria were spasticity ranging from 1 to 1+, gross level skills (I and II), at least 1 meter tall, standing alone, and walking forward and backward. They were randomly allocated to the control group (traditional physiotherapy) and study group and were treated by the same physiotherapy program combined with WBV training (3 times per week for 2 successive months). Quadriceps and hamstring muscle strength, walking performance, and postural control were evaluated before and after intervention by a blinded assessor.</span></p></div><div><h3>Results</h3><p>The post-intervention values of the hamstring and quadriceps muscle force, gross motor function, and stability indices of the 2 groups were higher than the pre-values (<em>P</em> &lt; .05). In addition, the post-values of the study group were higher than those of the control group (<em>P</em> &lt; .05). Regarding the H:Q ratio, there was no significant difference between pre-values or the post-values of both groups (<em>P</em> = .948 and <em>P</em> = .397, respectively). There were no significant differences between the pre- and post-values of each group (<em>P</em> = .500 and <em>P</em> = .195, respectively).</p></div><div><h3>Conclusion</h3><p>Eight weeks of WBV training combined with traditional physiotherapy was more effective than traditional physiotherapy alone in improving walking ability and postural control. Furthermore, the combined intervention strengthened the quadriceps and hamstring muscles, with no change in the H:Q ratio in children with hemiparetic CP.</p></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"45 9","pages":"Pages 660-670"},"PeriodicalIF":1.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825712","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":"Inside front cover Editorial board","authors":"","doi":"10.1016/S0161-4754(23)00041-6","DOIUrl":"https://doi.org/10.1016/S0161-4754(23)00041-6","url":null,"abstract":"","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"45 9","pages":"Page IFC"},"PeriodicalIF":1.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0161475423000416/pdfft?md5=11007769fbfc37c75305634a83174372&pid=1-s2.0-S0161475423000416-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136906009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TOC","authors":"","doi":"10.1016/S0161-4754(23)00042-8","DOIUrl":"https://doi.org/10.1016/S0161-4754(23)00042-8","url":null,"abstract":"","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"45 9","pages":"Page A1"},"PeriodicalIF":1.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0161475423000428/pdfft?md5=30491f794b6a09380f3b620ee09a6b59&pid=1-s2.0-S0161475423000428-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136984552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to the Engagement of Complementary and Integrative Health Providers in Public Health Responses to COVID-19: Recommendations From a Multidisciplinary Expert Panel","authors":"Margaret D. Whitley PhD, MPH ,&nbsp;Ian D. Coulter PhD ,&nbsp;Raheleh Khorsan PhD ,&nbsp;Patricia M. Herman ND, PhD","doi":"10.1016/j.jmpt.2023.04.009","DOIUrl":"10.1016/j.jmpt.2023.04.009","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this project was to explore barriers to the involvement of complementary and integrative health (CIH) providers in the public health response to COVID-19 and potential solutions for future involvement in public health crises.</p></div><div><h3>Methods</h3><p>An expert panel of 10 people, which included doctors of chiropractic, naturopathic doctors, public health practitioners, and researchers from the United States, was convened for a day-long online panel discussion. Facilitators asked panelists how CIH practitioners could contribute and be mobilized. We summarized themes and recommendations from the discussion.</p></div><div><h3>Results</h3><p>Despite their skills and resources, few CIH providers participated in public health efforts like testing and contact tracing during the COVID-19 pandemic. Panelists described that CIH professionals may not have participated in those efforts due to the CIH providers possibly not having sufficient public health training and limited contact with public health professionals, as well as policy and financial challenges during the pandemic. Panelists proposed solutions to these barriers, including more public health training, stronger formal relationships between CIH and public health organizations, and improved financial support for both CIH care and public health efforts.</p></div><div><h3>Conclusion</h3><p>Through an expert panel discussion, we identified barriers that hindered the involvement of CIH providers in the public health response to the COVID-19 pandemic. During future pandemics in the United States, public health planners should recognize CIH providers as part of the existing labor resource, with clinical expertise and community-level connections that can be called upon in a crisis. During future events, CIH professional leaders should be more proactive in seeking out a supportive role and sharing their knowledge, skills, and expertise.</p></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"45 8","pages":"Pages 566-574"},"PeriodicalIF":1.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10254438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10172680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}