Chiropractic & Manual Therapies最新文献

{"title":"The one-week prevalence of neck pain and low back pain in post-secondary students at two Canadian institutions.","authors":"Alexandra Campbell,&nbsp;Dan Wang,&nbsp;Krystle Martin,&nbsp;Pierre Côté","doi":"10.1186/s12998-023-00496-y","DOIUrl":"https://doi.org/10.1186/s12998-023-00496-y","url":null,"abstract":"<p><strong>Background: </strong>Low back and neck pain are common in the general population, but the prevalence among Canadian post-secondary students is not well known. We aimed to determine the one-week prevalence of neck pain (NP) and low back pain (LBP) among postsecondary students in Canada.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of students enrolled in the Faculty of Health Sciences and Faculty of Education at Ontario Tech University, and the Canadian Memorial Chiropractic College (CMCC) in the Fall of 2017. Neck and low back pain intensity in the past week were measured with the 11-point numerical rating scale. We report the cumulative, gender- and institution-specific one-week prevalence (95% CI) of any pain (1-10/10) and moderate to severe pain (≥ 3/10).</p><p><strong>Results: </strong>The one-week prevalence of any neck pain ranged from 45.4% (95% CI: 38.4, 52.4) in the Faculty of Education to 76.9% (95% CI: 72.9, 80.4) at CMCC. The one-week prevalence of neck pain ≥3/10 ranged from 44.4% (95% CI: 37.5, 51.4) in the Faculty of Education to 58.4% (95% CI: 54.0, 62.7) at CMCC. The one-week prevalence of any low back pain ranged from 60.9% (95% CI: 53.8, 67.5) in the Faculty of Education to 69.0% (95% CI: 64.8, 73.0) at CMCC, and the one-week prevalence of low back pain ≥ 3/10 ranged from 47.8% (95% CI: 43.4, 52.2) at CMCC to 55.1% (95% CI: 51.2, 58.9) in the Faculty of Health Sciences. The prevalence of any back or neck pain and pain ≥ 3/10 was consistently higher in females than males, with the largest difference seen for neck pain at CMCC.</p><p><strong>Conclusion: </strong>Most post-secondary students in our samples experienced LBP and NP in the past week. Overall, the one-week prevalence of NP and LBP was higher among chiropractic students and among females. This study should draw attention to school administrators about the burden of NP and LBP in post-secondary students.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"31 1","pages":"23"},"PeriodicalIF":1.9,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10391772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10026587","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":"Feasibility of a new clinical journal club implementation and its association with knowledge, attitudes, and application of evidence-based practice among chiropractic students and trainees: a before-and-after healthcare education improvement study.","authors":"Melanie Häusler, Rahim Lalji, Léonie Hofstetter, Cesar A Hincapié","doi":"10.1186/s12998-023-00494-0","DOIUrl":"10.1186/s12998-023-00494-0","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based practice (EBP) is the integration of best research evidence with clinical expertise and patients' values and preferences. Little is known about knowledge, attitudes, and application of EBP among chiropractic students and trainees. Our aims were to (1) examine the feasibility of implementing a new journal club format within a Swiss university chiropractic healthcare education setting, and (2) assess the associations between the new journal club implementation and EBP characteristics among chiropractic students.</p><p><strong>Methods: </strong>A before-and-after study was conducted through a newly implemented journal club with 5th and 6th year chiropractic students and postgraduate trainees between 1 and 2021 and 31 July 2021. The journal club was developed based on the \"community of practice\" and \"team-based learning\" conceptual frameworks. EBP knowledge, attitudes, personal application, and future use, were assessed with a validated questionnaire. We summarised participant characteristics using descriptive statistics, estimated before-and-after EBP total and subscale scores (i.e., knowledge, attitudes, personal application, and future use), and conducted an exploratory subgroup analysis based on journal club attendance (Group A: 3-5 sessions attended; Group B: ≤ 2 sessions attended).</p><p><strong>Results: </strong>Among 32 eligible students and trainees, 29 participants (mean age 26 years; 79% women) were enrolled: 25 (78%) responded to the pre- and 29 (91%) to the post-assessment surveys. Most (80%) were chiropractic students and 20% were postgraduate trainees. Group A consisted of 12 (41%) and Group B of 17 (59%) participants, respectively. We found reasonable feasibility for the new journal club format and our findings were compatible with no difference in before-and-after EBP scores (median EBP total score before: 72.6 [IQR, 63.7-77.4], and after: 73.4 [IQR, 61.3-78.2]). Exploratory subgroup analyses based on journal club attendance were consistent with our overall findings.</p><p><strong>Conclusion: </strong>Our study suggests that the newly implemented journal club and embedding chiropractic educational research within the journal club were feasible and acceptable. Small before-and-after differences in the EBP subscale scores for knowledge, attitudes, personal application, and future use were observed in chiropractic students and postgraduate trainees. The small study size and short timeframe during a single semester limit potential inferences.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"31 1","pages":"22"},"PeriodicalIF":1.9,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10367234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10199128","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":"Use of electronic patient records and encrypted email patient communication among Swiss chiropractors: a population-based cross-sectional study.","authors":"Cesar A Hincapié, Léonie Hofstetter, Rahim Lalji, Longin Korner, Mireille C Schläppi, Serafin Leemann","doi":"10.1186/s12998-023-00495-z","DOIUrl":"10.1186/s12998-023-00495-z","url":null,"abstract":"<p><strong>Background: </strong>The implementation of electronic health information technologies is a key target for healthcare quality improvement. Among Swiss chiropractors, reliable data on the use of electronic heath information technologies and distribution of the health workforce was lacking.</p><p><strong>Objectives: </strong>To estimate the prevalence of electronic patient record (EPR) and encrypted email communication use among Swiss chiropractors and describe the geographic distribution of chiropractors in Switzerland.</p><p><strong>Methods: </strong>Population-based cross-sectional study of all active practising members of the Swiss Chiropractic Association (ChiroSuisse) between 3 December 2019 and 31 January 2020. We asked about clinician and practice characteristics, EPR use for clinical record keeping, use of encrypted email for patient communication, and information on EPR and encrypted email communication products used. Multivariable logistic regression analyses assessed the associations between clinician and practice characteristics and (1) EPR use, and (2) encrypted email use.</p><p><strong>Results: </strong>Among 286 eligible Swiss chiropractors (193 [68%] men; mean age, 51.4 [SD, 11.2] years), 217 (76%) completed the survey (140 [65%] men; mean age 50.7 [11.2] years). Among respondents, 47% (95% confidence interval [CI], 40-54%) reported using an EPR in their practice, while 60% (95% CI, 54-67%) endorsed using encrypted email technology. Chiropractors aged ≥ 60 (versus those ≤ 39) years were 74% less likely to use an EPR system (OR 0.26, 95% CI 0.08 to 0.77), while clinicians from practices with 4 or more chiropractors (versus those from solo practices) were over 5 times more likely to report EPR use (OR 5.6, 2.1 to 16.5). Findings for factors associated with encrypted email use were similar. The density of chiropractors in Switzerland was 3.3 per 100,000 inhabitants.</p><p><strong>Conclusions: </strong>As of January 2020, 286 duly licensed chiropractors were available to provide musculoskeletal healthcare in Switzerland - just under 50% of responding Swiss chiropractors used an EPR system in clinical practice, while 60% used encrypted email technology. Better implementation of EPR and electronic health information technologies in Swiss chiropractic practice is possible and encouraged for the purpose of musculoskeletal healthcare quality improvement.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"31 1","pages":"21"},"PeriodicalIF":1.9,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10353203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9893112","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":"Potential effect modifiers for treatment with chiropractic manipulation versus sham manipulation for recurrent headaches in children aged 7-14 years: development of and results from a secondary analysis of a randomised clinical trial.","authors":"Susanne Lynge,&nbsp;Werner Vach,&nbsp;Kristina Boe Dissing,&nbsp;Lise Hestbaek","doi":"10.1186/s12998-023-00492-2","DOIUrl":"https://doi.org/10.1186/s12998-023-00492-2","url":null,"abstract":"<p><strong>Background: </strong>A recent randomized controlled trial (RCT) investigating the effect of chiropractic manipulation in 199 children aged 7-14 years with recurrent headaches demonstrated a significant reduction of number of days with headache and a better global perceived effect (GPE) in the chiropractic manipulation group compared to a sham manipulation group. However, potential modifiers for the effectiveness of chiropractic manipulation of children with recurrent headaches have never been identified. The present study is a secondary analysis of data from that RCT and will investigate potential effect modifiers for the benefit of chiropractic manipulation for children with headache.</p><p><strong>Methods: </strong>Sixteen potential effect modifiers were identified from the literature and a summary index was prespecified based on clinical experience. Relevant variables were extracted from baseline questionnaires, and outcomes were obtained by means of short text messages. The modifying effect of the candidate variables was assessed by fitting interaction models to the data of the RCT. In addition, an attempt to define a new summary index was made.</p><p><strong>Results: </strong>The prespecified index showed no modifying effect. Four single variables demonstrated a treatment effect difference of more than 1 day with headache per week between the lower and the upper end of the spectrum: intensity of headache (p = 0.122), Frequency of headache (p = 0.031), sleep duration (p = 0.243), and Socioeconomic status (p = 0.082). Five variables had a treatment effect difference of more than 0.7 points on the GPE scale between the lower and the upper end of the spectrum: Frequency of headache (p = 0.056), Sport activity (p = 0.110), Sleep duration (p = 0.080), History of neck pain (p = 0.011), and Headache in the family (0.050). A new summary index could be constructed giving highest weight to History of neck pain and Headache in the family and Frequency of headache. The index suggests a difference of about 1 point in GPE between low and high values of the index.</p><p><strong>Conclusion: </strong>Chiropractic manipulation offers a moderate benefit for a broad spectrum of children. However, it cannot be excluded that specific headache characteristics, family factors, or a history of neck pain may modify the effect. This question must be addressed in future studies.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (Albers et al in Curr Pain Headache Rep 19:3-4, 2015), identifier NCT02684916, registered 02/18/2016-retrospectively registered.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"31 1","pages":"20"},"PeriodicalIF":1.9,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10337090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9883387","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":"Investigating force-time characteristics of prone thoracic SMT and self-reported patient outcome measures: a feasibility study.","authors":"Grand Choi, Dominic Giuliano, Anthony Tibbles, Samuel J Howarth, Steve Tran, Joyce Lee, Martha Funabashi","doi":"10.1186/s12998-023-00491-3","DOIUrl":"10.1186/s12998-023-00491-3","url":null,"abstract":"<p><strong>Background: </strong>Spinal manipulative therapy (SMT) is commonly used to treat musculoskeletal conditions, including thoracic spine pain. Applying patient-specific force-time characteristics are believed to be important to improve SMT's effectiveness. Investigating SMT as part of a multimodal approach is fundamental to account for the complexity of chiropractic clinical practice. Therefore, pragmatic investigations balancing minimal disruptions to the clinical encounter at the same time as ensuring a robust data quality with rigorous protocols are needed. Consequently, preliminary studies are required to assess the study protocol, quality of data recorded and the sustainability of such investigation. Therefore, this study examined the feasibility of investigating SMT force-time characteristics and clinical outcome measures in a clinical setting.</p><p><strong>Methods: </strong>In this mixed-methods study, providers recorded thoracic SMT force-time characteristics delivered to patients with thoracic spinal pain during regular clinical encounters. Self-reported clinical outcomes of pain, stiffness, comfort during the SMT (using an electronic visual analogue scale), and global rating of change scale were measured before and after each SMT application. Feasibility was quantitatively assessed for participant recruitment, data collection and data quality. Qualitative data assessed participants' perceptions on the impact of data collection on patient management and clinical flow.</p><p><strong>Results: </strong>Twelve providers (58% female, 27.3 ± 5.0 years old) and twelve patients (58% female, 37.2 ± 14.0 years old) participated in the study. Enrolment rate was greater than 40%, data collection rate was 49% and erroneous data was less than 5%. Participant acceptance was good with both providers and patients reporting positive experience with the study.</p><p><strong>Conclusions: </strong>Recording SMT force-time characteristics and self-reported clinical outcome measures during a clinical encounter may be feasible with specific modification to the current protocol. The study protocol did not negatively impact patient management. Specific strategies to optimize the data collection protocol for the development of a large clinical database are being developed.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"31 1","pages":"19"},"PeriodicalIF":2.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10329299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9863276","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":"Identifying and addressing patient substance use: a survey of chiropractic clinicians.","authors":"Jordan A Gliedt,&nbsp;Maureen Reynolds,&nbsp;Steffany Moonaz,&nbsp;Cynthia R Long,&nbsp;Robb Russell,&nbsp;Michael J Schneider","doi":"10.1186/s12998-023-00490-4","DOIUrl":"10.1186/s12998-023-00490-4","url":null,"abstract":"<p><strong>Background: </strong>Chiropractors commonly encounter patients who present for spine pain with parallel substance use. There is currently no widespread training within the chiropractic profession to prepare chiropractors to recognize and address substance use in clinical practice. The purpose of this study was to examine chiropractors' confidence, self-perceptions, and interest in education associated with identifying and addressing patient substance use.</p><p><strong>Methods: </strong>A 10-item survey was developed by the authors. The survey addressed chiropractors' assessment of their training, experiences, and educational interest/needs regarding identifying and addressing patient substance use. The survey instrument was uploaded to Qualtrics and was electronically distributed to chiropractic clinicians at active and accredited English-speaking Doctor of Chiropractic degree programs (DCPs) in the United States.</p><p><strong>Results: </strong>A total of 175 individual survey responses were returned from a total of 276 eligible participants (63.4% response rate) from 16 out of 18 active and accredited English-speaking DCPs (88.8% of DCPs) in the United States. Nearly half of respondents strongly disagreed or disagreed (n = 77, 44.0%) that they were confident in their ability to identify patients who misuse prescription medication. The majority of respondents (n = 122, 69.7%) indicated that they did not have an established referral relationship with local clinical providers who provide treatment for individuals who use drugs or misuse alcohol or prescription medications. Most respondents strongly agreed or agreed (n = 157, 89.7%) that they would benefit from participating in a continuing education course on topics related to patients who use drugs or misuse alcohol or prescription medications.</p><p><strong>Conclusions: </strong>Chiropractors indicated a need for training to help them identify and address patient substance use. There is a demand among chiropractors to develop clinical care pathways for chiropractic referrals and collaboration with health care professionals who provide treatment for individuals who use drugs or misuse alcohol or prescription medications.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"31 1","pages":"18"},"PeriodicalIF":1.9,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10316550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892621","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":"Introducing Australia's clinical care standard for low back pain : A new clinical care standard provides evidence-based guidance to help clinicians deliver best care for people with low back pain.","authors":"Christopher G Maher, Aline Archambeau, Rachelle Buchbinder, Simon D French, Julia Morphet, Michael K Nicholas, Peter O'Sullivan, Marie Pirotta, Michael J Yelland, Leo Zeller, Nivene Saad, Elizabeth Marles, Alice L Bhasale, Christina Lane","doi":"10.1186/s12998-023-00485-1","DOIUrl":"10.1186/s12998-023-00485-1","url":null,"abstract":"","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"31 1","pages":"17"},"PeriodicalIF":1.9,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10273725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10010981","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":"COVID-19-specific adult basic life support guideline strategies for chiropractors and other healthcare providers to maximize the safety and efficacy of resuscitation: a commentary.","authors":"Chun-Cheung Woo","doi":"10.1186/s12998-023-00488-y","DOIUrl":"https://doi.org/10.1186/s12998-023-00488-y","url":null,"abstract":"<p><strong>Background: </strong>The emergence of an unprecedented novel severe acute respiratory syndrome coronavirus-2 (SARS-C0V-2), which causes the coronavirus disease 2019 (COVID-19) pandemic, has created new scenarios in basic life support (BLS) management. According to current evidence, SARS-CoV-2 can be transmitted airborne in aerosol particles during resuscitation. Research evidence found an alarming global increase in out-of-hospital cardiac arrests during the COVID-19 pandemic. Healthcare providers are legally obliged to respond to cardiac arrest as soon as possible. Chiropractors will likely encounter potential exercise-related and non-exercise-related cardiac emergencies at some point in their professional lives. They have a duty of care to respond to emergencies such as cardiac arrest. Chiropractors are increasingly involved in providing care, including emergency care, for athletes and spectators at sporting events. Also, exercise-related cardiac arrest in adult patients may occur during exercise testing or rehabilitation with exercise prescriptions in chiropractic and other healthcare settings. Little is known about the COVID-19 BLS guidelines for chiropractors. Knowledge of the current COVID-19-specific adult BLS guidelines is essential to developing an emergency response plan for the on-field and sideline management of exercise-related cardiac arrest and non-athletic, non-exercise-related cardiac arrest.</p><p><strong>Main text: </strong>Seven peer-reviewed articles on the COVID-19-specific BLS guidelines, including two updates, were reviewed for this commentary. Responding to the COVID-19 pandemic, the national and international resuscitation organizations recommended interim COVID-19-specific BLS guidelines with precaution, resuscitation, and education strategies. BLS safety is paramount. A precautionary approach with the bare minimum of appropriate personal protective equipment for resuscitation is recommended. There was disagreement among the COVID-19 BLS guidelines on the level of personal protective equipment. All healthcare professionals should also undergo self-directed BLS e-learning and virtual skill e-training. The summarized COVID-19-specific adult BLS guideline strategies and protocols are tabled, respectively.</p><p><strong>Conclusions: </strong>This commentary provides a practical overview and highlights current evidence-based intervention strategies of the COVID-19-specific adult BLS guidelines that may help chiropractors and other healthcare providers reduce BLS-related exposures to SARS-CoV-2 and the risks of SARS-CoV-2 transmission and maximize the efficacy of resuscitation. This study is relevant to and impacts future COVID-19-related research in areas such as infection prevention and control.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"31 1","pages":"16"},"PeriodicalIF":1.9,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9745494","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":"A new paradigm for musculoskeletal pain care: moving beyond structural impairments. Conclusion of a chiropractic and manual therapies thematic series.","authors":"Julie M Fritz,&nbsp;Alice Kongsted","doi":"10.1186/s12998-023-00484-2","DOIUrl":"https://doi.org/10.1186/s12998-023-00484-2","url":null,"abstract":"<p><p>This commentary closes the thematic series \"A new paradigm for musculoskeletal pain care: moving beyond structural impairments\". The papers published in the series point to key aspects of shifting the paradigm of musculoskeletal care from clinician-led management often focused on addressing presumed structural anomalies to partnering with patients to find individual strategies that empower patients towards self-management. Several papers in the series highlighted the need for developing patient-centred models of care that respect individual patient's needs and preferences. Also, the series pointed to different options for modes of delivery including mHealth and the challenges and opportunities they present for developing person-centred strategies. For health care to provide effective support for people with musculoskeletal pain conditions, there is a need to recognise that contextual factors, including a strong patient-provider alliance, clearly play an important, perhaps primary, role. Health care professions dealing with musculoskeletal pain conditions should engage in research to investigate effective ways to move this understanding into practice including how to train providers. We hope the work collected in this series will stimulate further questions and more research as musculoskeletal pain providers seek to make their care more person-centred.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"31 1","pages":"15"},"PeriodicalIF":1.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9575919","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":"The effectiveness of spinal manipulative therapy procedures for spine pain: protocol for a systematic review and network meta-analysis.","authors":"Casper G Nim,&nbsp;Sasha L Aspinall,&nbsp;Chad E Cook,&nbsp;Leticia A Corrêa,&nbsp;Megan Donaldson,&nbsp;Aron S Downie,&nbsp;Steen Harsted,&nbsp;Jan Hartvigsen,&nbsp;Hazel J Jenkins,&nbsp;David McNaughton,&nbsp;Luana Nyirö,&nbsp;Stephen M Perle,&nbsp;Eric J Roseen,&nbsp;James J Young,&nbsp;Anika Young,&nbsp;Gong-He Zhao,&nbsp;Carsten B Juhl","doi":"10.1186/s12998-023-00487-z","DOIUrl":"https://doi.org/10.1186/s12998-023-00487-z","url":null,"abstract":"<p><strong>Background: </strong>Spinal manipulative therapy (SMT) is a guideline-recommended treatment option for spinal pain. The recommendation is based on multiple systematic reviews. However, these reviews fail to consider that clinical effects may depend on SMT \"application procedures\" (i.e., how and where SMT is applied). Using network meta-analyses, we aim to investigate which SMT \"application procedures\" have the greatest magnitude of clinical effectiveness for reducing pain and disability, for any spinal complaint, at short-term and long-term follow-up. We will compare application procedural parameters by classifying the thrust application technique and the application site (patient positioning, assisted, vertebral target, region target, Technique name, forces, and vectors, application site selection approach and rationale) against: 1. Waiting list/no treatment; 2. Sham interventions not resembling SMT (e.g., detuned ultrasound); 3. Sham interventions resembling SMT; 4. Other therapies not recommended in clinical practice guidelines; and 5. Other therapies recommended in clinical practice guidelines. Secondly, we will examine how contextual elements, including procedural fidelity (whether the SMT was delivered as planned) and clinical applicability (whether the SMT is similar to clinical practice) of the SMT.</p><p><strong>Methods: </strong>We will include randomized controlled trials (RCT) found through three search strategies, (i) exploratory, (ii) systematic, and (iii) other known sources. We define SMT as a high-velocity low-amplitude thrust or grade V mobilization. Eligibility is any RCT assessing SMT against any other type of SMT, any other active or sham intervention, or no treatment control on adult patients with pain in any spinal region. The RCTs must report on continuous pain intensity and/or disability outcomes. Two authors will independently review title and abstract screening, full-text screening, and data extraction. Spinal manipulative therapy techniques will be classified according to the technique application and choice of application sites. We will conduct a network-meta analysis using a frequentist approach and multiple subgroup and sensitivity analyses.</p><p><strong>Discussion: </strong>This will be the most extensive review of thrust SMT to date, and will allow us to estimate the importance of different SMT application procedures used in clinical practice and taught across educational settings. Thus, the results are applicable to clinical practice, educational settings, and research studies. PROSPERO registration: CRD42022375836.</p>","PeriodicalId":48572,"journal":{"name":"Chiropractic & Manual Therapies","volume":"31 1","pages":"14"},"PeriodicalIF":1.9,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10210472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10149674","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}