Chiropractic & Manual Therapies最新文献

{"title":"Cross-sectional analysis of online information on low back pain across South African chiropractic websites.","authors":"J Redelinghuys, F Ismail","doi":"10.1186/s12998-025-00591-2","DOIUrl":"https://doi.org/10.1186/s12998-025-00591-2","url":null,"abstract":"<p><strong>Background: </strong>Rising low back pain (LBP) prevalence and increased patient reliance on online health resources necessitate critically evaluating how chiropractic websites represent common musculoskeletal conditions. This study analyzed LBP-related content shared by South African chiropractic websites to assess the credibility of available information.</p><p><strong>Methods: </strong>A cross-sectional content evaluation was conducted between 2 June 2024 and 21 July 2024 on 333 South African chiropractic websites, identified using a Google search cross-referenced with the Allied Health Professions Council of South Africa registry. Four key areas were evaluated, including (1) contributors to, (2) diagnostic approaches for, (3) possible treatment approaches for and 4) indicators for seeking professional treatment for LBP. Sociodemographic factors such as educational background, sex, and practice ownership structure were considered. A pilot ensured data collection standardization. Content and statistical analysis explored information, citation frequency and identified trends in chiropractic online health communication.</p><p><strong>Results: </strong>The analysis revealed significant variability of LBP-related content across chiropractic websites. Of the 333 websites analyzed, most chiropractors were trained at UJ (58.1%) and DUT (29.2%). Sex distribution showed 55.3% were female-owned. The highest concentration of chiropractic websites was in Gauteng, the Western Cape, and KwaZulu-Natal. Regarding the 4 key areas, mechanical contributors to LBP were predominant (65.2%), diagnostic approaches (56.7%), treatment approaches (79.6%) and explicit guidance on when to seek care (47.4%) was mentioned in the websites. Only 13.5% of websites cite sources of the information shared. Chiropractors trained at UJ and DUT emphasized evidence-based treatments, while those trained internationally referenced alternative methods. Sex differences showed males focusing on diagnostic tools and treatment protocols, while females emphasized holistic care and lifestyle modifications.</p><p><strong>Conclusion: </strong>This study highlights the need for improved LBP information quality and consistency on South African chiropractic websites. The structured subjective content evaluation revealed notable gaps in content depth, specificity, and evidence-based citations. Sociodemographic factors, including educational background and sex, influenced the presentation of information. Future research should prioritize developing standardized and evidence-based guidelines for chiropractic websites to improve access to online health information and patient education and ensure accurate, reliable health information delivery.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"33 1","pages":"28"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683424","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":"No drugs, more sex? And Rock'n Roll: effective non-operative treatments and practical management strategies for older adults with lumbar spinal stenosis.","authors":"Carlo Ammendolia","doi":"10.1186/s12998-025-00590-3","DOIUrl":"https://doi.org/10.1186/s12998-025-00590-3","url":null,"abstract":"<p><p>Lumbar spinal stenosis is a growing problem among older adults, associated with significant disability and socio-economic burden. Neurogenic claudication is the most common clinical syndrome caused by LSS with pain being the predominant symptom and limited walking the main impairment. Lumbar spinal stenosis can also impact sexual function in older adults, necessitating greater awareness of this association. Pain and impaired function can lead to psychosocial distress, including hopelessness, anxiety, and isolation, further compounding disability. Recent clinical practice guidelines recommend non-operative treatment as the first-line approach, including manual therapy, exercise, and education. However, these guidelines lack details on the practical application of these interventions in clinical practice. This narrative review explores the epidemiology of lumbar spinal stenosis, the evidence supporting non-operative care, and practical management strategies. It also highlights the relationship between sexual dysfunction and lumbar spinal stenosis.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"33 1","pages":"27"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683425","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":"Dry cupping therapy combined with conventional therapy does not provide additional benefits over conventional therapy alone in patients with non-specific chronic low back pain: a randomized trial.","authors":"Renjie Xu, Yun Yang, Chengjie Yan, Zhou Li, Chaochen Zhao, Jingming Ma, Guangxu Xu","doi":"10.1186/s12998-025-00588-x","DOIUrl":"10.1186/s12998-025-00588-x","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic non-specific low back pain (CNLBP) is a complex and heterogeneous condition, and it is necessary to explore new treatment approaches. We evaluated whether the addition of dry cupping therapy to guideline‑based conventional therapy would further improve clinical outcomes in CNLBP.</p><p><strong>Methods: </strong>Thirty-six patients with CNLBP were recruitedand randomly divided into two groups: the control group and the intervention group. The intervention group received cupping therapy in addition to the control group (core stabilization exercises, spinal manipulation and education) for 4 weeks. The primary outcome was the visual analog scale (VAS) for pain intensity. Secondary outcomes were the Roland Morris disability questionnaire (RMDQ), and pressure pain thresholds (PPT) at bilateral Shenshu (BL23), Qihaishu (BL24), and Dachangshu (BL25) acupuncture points.</p><p><strong>Results: </strong>At week 4 the between‑group difference in resting pain was trivial (median difference 0.0 cm, 95% CI - 1.0 to 1.0). Neither clinically important nor statistically significant differences were detected in disability or PPTs. Both groups improved substantially from baseline.</p><p><strong>Conclusion: </strong>In this randomized trial, adding dry cupping to conventional therapy offered no additional benefit over conventional therapy alone for pain, disability or PPT in CNLBP. Larger, multicentre trials with longer follow‑up and standardized negative pressures are warranted.</p><p><strong>Trial registration: </strong>ChiCTR2300069398, http://www.chictr.org.cn , Registration Date: March 15, 2023.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"33 1","pages":"26"},"PeriodicalIF":2.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310556","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":"Efficacy of different biomechanical strategies for modulating force-time parameters of high-velocity low-amplitude manipulation of the thoracic spine: a randomized crossover experimental study.","authors":"Grand Choi, Averie McGuinty, Nicole Meaghan Smith, Erinn McCreath Frangakis, David Starmer, Samuel J Howarth, Simon Wang","doi":"10.1186/s12998-025-00585-0","DOIUrl":"10.1186/s12998-025-00585-0","url":null,"abstract":"<p><strong>Background: </strong>Manual therapy, including high-velocity low-amplitude spinal manipulation (HVLA-SM), is a complex motor task performed by trained individuals. The ability to modulate the magnitude of applied forces is an attribute of proficiency that is challenging for providers and students. Adopting different biomechanical strategies may facilitate force modulation by practitioners performing HVLA-SM. This study evaluated the efficacy of different biomechanical strategies on force-time characteristics of prone thoracic HVLA-SM.</p><p><strong>Methods: </strong>A randomized crossover experimental design was used. Data were collected between October 2022 and May 2023 from chiropractic students at the Canadian Memorial Chiropractic College who performed HVLA-SM targeted to the thoracic spine of a prone-lying manikin using as much force as possible in each of six different strategies. Strategies (S1 to S6) were specifically developed to successively increase a person's ability to produce force while performing HVLA-SM. Force-time parameters for the HVLA-SM trials were recorded. Peak force was the primary outcome of interest while preload force, load rate, and time to peak force were analyzed as secondary measures.</p><p><strong>Results: </strong>Data were collected from 97 participants (51 female). Peak force increased successively from S1 to S5 with moderate effects (- 0.45 ≤ effect size ≤ -0.72). There was no statistical difference in either peak force or load rate between S5 and S6. Load rate also did not statistically increase between S3 and S4 where different muscle groups were targeted to produce force. The strategy with the highest peak force (S6) also demonstrated the lowest preload force.</p><p><strong>Conclusions: </strong>Strategies used in this study effectively facilitated modulation of force-time characteristics of prone thoracic HVLA-SM. Thus, training approaches may consider introducing people to different biomechanical strategies to enhance HVLA-SM force modulation.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"33 1","pages":"25"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276268","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":"Reporting the standard error of the mean: a critical analysis of three journals in manual medicine.","authors":"Alen Manovic, Ebba Immelsjö, Iben Axen, Per J Palmgren","doi":"10.1186/s12998-025-00587-y","DOIUrl":"10.1186/s12998-025-00587-y","url":null,"abstract":"<p><strong>Background: </strong>In the realm of biomedical research articles, authors typically utilize descriptive statistics to outline the characteristics of their study samples. The standard deviation (SD) serves to illustrate variability among the individuals in a sample, whereas the standard error of the mean (SEM) conveys the level of uncertainty associated with the sample mean's representation of the population mean. It is not unusual for authors of scientific articles to incorrectly utilize the SEM rather than the SD when explaining data variability. This is problematic because the SEM is consistently smaller than the SD, which could cause readers to underestimate variation in the data. In medical journals, inappropriate use has been found in 14-64% of articles. Moreover, in the field of musculoskeletal health and manual medicine, there is a noticeable absence of literature on the appropriate presentation of statistics.</p><p><strong>Aim: </strong>The aim of this study was to map the frequency of inappropriate reporting of SEM in articles published over a three-year period in three prominent journals in manual medicine.</p><p><strong>Methods: </strong>In this critical analysis, all articles in three journals - BMC Chiropractic and Manual Therapies (CMT), Journal of Manipulative and Physiological Therapeutics (JMPT) and Musculoskeletal Science and Practice: An International Journal of Musculoskeletal Physiotherapy (MSP) - published between 2017 and 2019 were analysed based on descriptive statistics that inappropriately or vaguely reported SEMs.</p><p><strong>Results: </strong>In total, 790 articles were analysed from the three journals, 487 of which were found to report the SEM. Among these articles, we identified a frequency of 1.4% of inadequate SEM use. The investigation also showed that in 2.5% of the cases, authors did not clarify whether the ± sign presented in text, tables or figures expressed SDs or SEMs.</p><p><strong>Conclusion: </strong>There was a low frequency (1.4%) of inaccurately reported SEMs in scientific journals focusing on manual medicine, which was notably lower than studies conducted in other fields. Additionally, it was noted that in 2.5% of the articles, the ± sign was not adequately defined, which could lead to confusion among readers and hinder the interpretation of the results.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"33 1","pages":"23"},"PeriodicalIF":2.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227224","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":"\"They knew how to take care of people\": a qualitative study on older adults with chronic low back pain perspectives of an exercise plus education program.","authors":"Fabianna Resende de Jesus-Moraleida, Ana Carla Lima Nunes, Crislaine Silva Costa, Lara Figueiredo Vasconcelos, Nathalia Costa","doi":"10.1186/s12998-025-00586-z","DOIUrl":"10.1186/s12998-025-00586-z","url":null,"abstract":"<p><strong>Background: </strong>Exercise therapy and education are first-line care for those with chronic low back pain (CLBP), but information on its applicability in older adults is limited, and adherence to non-pharmacological treatments in this population is challenging. This study explored perspectives of older adults with CLBP on a group-based exercise plus education program supported by text messages-PAT-Back.</p><p><strong>Methods: </strong>This descriptive qualitative study was embedded in a feasibility randomized controlled trial (RCT) with older adults aged ≥ 60 with CLBP who participated PAT-Back. PAT-Back consisted of pain education, group and home-based exercises, with the latter being supported by text messages. After the feasibility RCT finished, we conducted 14 (13 women, 1 man) semi-structured interviews with participants. Interview questions were designed to elicit participants' reflections on the program, including its impact on symptoms and factors that facilitated and hindered participation. Transcripts were thematically analyzed.</p><p><strong>Results: </strong>We identified four themes related to participants' perspectives on PAT-Back: 1) It takes more than intrinsic motivation: Participation in the PAT-Back program was linked to family and peer social support, clinician's supervision, caring clinicians and inaccessibility to treatments; 2) PAT-Back exceeded expectations: Before the intervention older adults did not expect or believed exercise would reduce pain, but this changed as they experienced improvements while engaging in the program; 3) Coexisting comorbidities, challenges with mobility and transport got in the way: at times, having pain in other body sites and not having access to transport and/or safe environments hindered exercise participation; 4) Technology can be both helpful and challenging: motivational text messages were perceived as beneficial by some, but others highlighted challenges related to access and technology literacy.</p><p><strong>Conclusions: </strong>Older adults' experiences in exercise and education programs for CLBP may be enhanced by social support (from clinicians, peers, family members), access to healthcare and embodied experiences of improvement. Such experiences can also be hindered by comorbidities and broader factors, such as safety to exercise outdoors. Exercise and education interventions for this population should be tailored at the conception phase to meet their needs, especially regarding social support and environmental infrastructure to promote participation and improve symptoms.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"33 1","pages":"24"},"PeriodicalIF":2.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227223","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":"Where are the chiropractic clinical outcomes registries? A scoping review.","authors":"Joel Carmichael, Kent Stuber, Katherine A Pohlman, Amy Ferguson, Michele Maiers","doi":"10.1186/s12998-025-00583-2","DOIUrl":"10.1186/s12998-025-00583-2","url":null,"abstract":"<p><strong>Objective: </strong>This scoping review maps chiropractic-specific clinical outcomes registries.</p><p><strong>Introduction: </strong>Clinical outcomes registries track patient outcomes to improve evidence-based practice and quality of care; however, their role in chiropractic remains unclear.</p><p><strong>Methods: </strong>This research adhered to Joanna Briggs Institute's scoping review outline and methodology, as well as the PRISMA-ScR guidelines. Five databases were searched on January 9, 2025, with subsequent search of grey literature and citation tracking. Sources were included if they described chiropractic-specific registries that reported clinical outcomes data. Two reviewers independently screened 604 citations, extracting data into Excel. Variables included registry characteristics and clinical outcomes collected.</p><p><strong>Results: </strong>Only one dedicated chiropractic clinical outcomes registry was identified: Spine IQ, launched in 2016 in the US with approximately 50 chiropractors submitting data on over 2000 low back pain patients. Spine IQ collected patient-reported outcome measures including the Oswestry Disability Index, Bournemouth Questionnaire, and the PROMIS physical function measure. By 2018, Spine IQ had completed its pilot phase and planned expansion to 100 clinics. Three sources were excluded: one spine registry not collecting chiropractic outcomes and two databases that included chiropractic data in publications but did not qualify as registries.</p><p><strong>Conclusions: </strong>This review identified only Spine IQ as a dedicated chiropractic clinical outcomes registry, revealing a significant gap in registry infrastructure within the profession globally. The profession should explore the development of registries to enhance care quality, societal impact, and opportunities for collaborative research.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"33 1","pages":"22"},"PeriodicalIF":2.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144107","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":"Contextual factors related to aging determine force-based manipulation dosage: a prospective cross-sectional study.","authors":"Michele J Maiers, Alexander R Sundin, Ryan J Oster, Steven Kreul, Quinn Malone, Steven R Passmore","doi":"10.1186/s12998-025-00584-1","DOIUrl":"10.1186/s12998-025-00584-1","url":null,"abstract":"<p><strong>Background: </strong>Contextual factors influence clinicians' delivery of force-based manipulation (FBM), like spinal manipulative therapy (SMT). It is particularly important to discern how contextual factors interact with therapeutic forces delivered to an older adult population, to minimize risk and identify ideal dosage. This study aimed to determine whether contextual factors pertaining to aging result in the modulation of kinetic and kinematic parameters used by experienced clinicians when delivering SMT.</p><p><strong>Methods: </strong>Participants were randomly presented with a series of 12 AI-generated patient vignettes, featuring both visual and auditory content and representing varying age-related contextual factors. Factors included chronological (35-, 65- and 85-year-old), pathological (\"healthy\" vs degenerative spine), and felt (perceived as \"young\" vs. \"old\") age. Participants delivered SMT to a human analogue manikin based on each vignette, presented six times in randomized order. Kinetic and kinematic parameters were collected and analyzed for differences between \"young\" and \"old\" contextual factors of age, using a 3-way repeated measures ANOVA model.</p><p><strong>Results: </strong>Sixteen licensed chiropractors (8 female, 8 male) participated, with an average age of 45.4 (SD = 9.7, range 34-64) years and 18.3 (SD = 10.8, range 5-39) years of experience. A main effect in peak force was found for both chronological (F(_2,30) = 26.18; p <.001, η_p² = 0.636) and pathological age (F(_1,15) = 11.58; p =.004, η_p² = 0.436), following a stepwise progression of decreased force with increased age and with pathology. No statistically significant differences were found in peak force based on felt age, or in time to peak force for any factor. A main effect was found for chronological age with peak acceleration (F(_2,20) = 9.50; p <.001, η_p² = 0.487) and peak velocity (F(_2,20) = 7.20; p =.004, η_p² = 0.419), but not for pathological or felt age. There was a significant difference in time to peak velocity for felt age (F(_1,10) = 12.23; p =.006, η_p² = 0.550), with a shorter time to peak velocity in response to vignettes with older felt age.</p><p><strong>Conclusion: </strong>Contextual factors of aging modulated certain kinetic and kinematic characteristics when delivering SMT. This provides evidence that practitioners differentially discern aspects of aging to inform how they deliver FBM dosage. Future research is needed to identify ideal kinetic and kinematic characteristics based on considerations of aging.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"33 1","pages":"20"},"PeriodicalIF":2.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120498","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":"Prognostic factors associated with improvement in patients with an episode of non-specific low back pain without radicular syndrome: a prospective observational exploratory study.","authors":"Gaetan Barbier, Martin Descarreaux, François Cottin, Arnaud Lardon","doi":"10.1186/s12998-025-00580-5","DOIUrl":"10.1186/s12998-025-00580-5","url":null,"abstract":"<p><strong>Background: </strong>Low back pain is a leading cause of disability worldwide, with most cases classified as non-specific(NSLBP). While manual therapy appears effective for treating NSLBP, further research is needed to identify candidate baseline factors associated with improvement to help tailor personalized treatment strategies. This prospective observational exploratory study, therefore, aims to identify candidate prognostic factors collected at baseline that are associated with short-term improvement in people with NSLBP.</p><p><strong>Methods: </strong>This study was conducted in chiropractic clinics across France between March 1, 2022, and February 28, 2023. Adults with a new episode of NSLBP were included. Baseline data, including individual, clinical, and therapist-related candidate factors, were collected before and during the initial consultation. Participants were considered improved if they: (i) reported \"all better\" or \"better\" on perceived global change, (ii) achieved a 20-point improvement on both Visual Analog Scales (VAS for intensity and unpleasantness) or scored 0 on reassessment, and (iii) showed a 30% improvement on the Oswestry Disability Index (ODI) at 7 days and 4 weeks post-consultation. Missing data were handled using multiple imputation with chained equations (MICE). Logistic regression analyses (univariate and multivariable with spline terms when superior fit was demonstrated) identified candidate prognostic factors associated with clinical improvement.</p><p><strong>Results: </strong>Out of 1,394 patients contacted, 241 met the inclusion criteria, and 207 completed at least one follow-up assessment. After imputation and multivariable analysis, duration of episode (spline 1: 0.94[0.89-1.00]), Number of painful sites (0.75[0.62-0.92]), negative treatment expectations (0.48 [0.25-0.94]), disability score (spline 1: 0.94[0.89-1.00], spline 2: 0.77[0.62-0.96]), and pain intensity (1.05 [1.02-1.07]) were associated with improvement at 7 days. At 4 weeks, disability score (spline 1: 1.24[1.07-1.45], spline 2: 0.77[0.63-0.95]), pain intensity (1.02 [1.00-1.04]), episode duration (spline 1: 0.95[0.91-1.00]), new patient (0.50 [0.28-0.91]), and clinican's prognosis (3.89 [1.49-10.10]) were associated with improvement.</p><p><strong>Conclusion: </strong>Less-studied factors, such as negative treatment expectations, clinician's prognosis, number of therapists, and perceived stiffness, highlighted significant associations with improvement in this exploratory phase. These findings suggest that incorporating these factors may be used when updating existing models.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"33 1","pages":"21"},"PeriodicalIF":2.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120698","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":"Attitudes towards chiropractic: a survey of Canadian sport and exercise medicine physicians.","authors":"Cameron Borody, Janet D'Arcy, Jaime Waters, Mark Leung, Jason Busse","doi":"10.1186/s12998-025-00581-4","DOIUrl":"10.1186/s12998-025-00581-4","url":null,"abstract":"<p><strong>Background: </strong>Previous surveys of physicians revealed diverse attitudes towards chiropractic. One of several strategies proposed by leaders in chiropractic to support the advancement of the profession in North America is to increase opportunities for interprofessional collaboration. One area where chiropractic has achieved some degree of integration in Canada is in the field of sports medicine. A result of the increased integration of chiropractic in the field of sports medicine has been more opportunity for interprofessional collaboration, development of interprofessional relationships and increased exposure to chiropractic. The attitudes of Canadian sport and exercise medicine physicians (CSPs) towards chiropractic are unknown. The purpose of this study is to determine the attitudes and their contributing factors of CSPs toward chiropractic and its use for treatment of athletes and/or Canadians who are participating in sports or exercise (ACSE).</p><p><strong>Methods: </strong>An invitation to complete the survey was included in a newsletter emailed to active physician members of CASEM (Canadian Academy of Sports and Exercise Medicine) in March and April 2023 and attendees of their symposium. The survey included the Chiropractic Attitude Questionnaire (CAQ), which allowed respondents to indicate their attitudes towards chiropractic care for ACSE using a 5-point Likert scale. The responses to the CAQ were the primary outcome measure. Descriptive statistics, including mean, median, standard deviation, maximum, minimum and range, regression analysis, t-tests, and ANOVAs were used to analyse the data.</p><p><strong>Results: </strong>Seventy CSPs completed the survey (response rate: 11%). The summed CAQ scores ranged from 0 to 68 with a mean of 39.03 and a standard deviation of 15.30. CSPs who worked with a chiropractor in a multidisciplinary setting hold a more positive opinion of chiropractic. An independent samples t-test indicated that there was a significant difference between CAQ scores for those with experience of working with a chiropractor (M = 42.03, SD = 14.99) and those without (M = 29.41, SD = 13.10); t(58) = 3.27, p < 0.05.</p><p><strong>Conclusions: </strong>CSPs attitudes toward chiropractic and its use for treatment of ACSE range from very positive to extremely negative. CSPs who reported to have worked with a chiropractor have more positive attitudes than those that have not.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"33 1","pages":"19"},"PeriodicalIF":2.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112308","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}