Chiropractic & osteopathy最新文献

{"title":"Chiropractic approach to the management of children.","authors":"Sharon A Vallone,&nbsp;Joyce Miller,&nbsp;Annica Larsdotter,&nbsp;Jennifer Barham-Floreani","doi":"10.1186/1746-1340-18-16","DOIUrl":"https://doi.org/10.1186/1746-1340-18-16","url":null,"abstract":"<p><strong>Background: </strong>Chiropractic (Greek: done by hand) is a health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. There is an emphasis on manual techniques, including joint adjustment and/or manipulation, with a particular focus on joint subluxation (World Health Organization 2005) or mechanical lesion and restoring function. The chiropractor's role in wellness care, prevention and treatment of injury or illness is based on education in anatomy and physiology, nutrition, exercise and healthy lifestyle counseling as well as referral to other health practitioners. Depending on education, geographic location, scope of practice, as well as consumer preference, chiropractors may assume the role of primary care for families who are pursuing a more natural and holistic approach to health care for their families.</p><p><strong>Objective: </strong>To present a perspective on current management of the paediatric patient by members of the chiropractic profession and to make recommendations as to how the profession can safely and effectively manage the paediatric patient.</p><p><strong>Discussion: </strong>The chiropractic profession holds the responsibility of ethical and safe practice and requires the cultivation and mastery of both an academic foundation and clinical expertise that distinguishes chiropractic from other disciplines.Research into the effectiveness of chiropractic care for paediatric patients has lagged behind that of adult care, but this is being addressed through educational programs where research is now being incorporated into academic tracks to attain advanced chiropractic degrees.</p><p><strong>Conclusion: </strong>Studies in the United States show that over the last several decades, chiropractors are the most common complementary and alternative medicine providers visited by children and adolescents. Chiropractors continue to seek integration with other healthcare providers to provide the most appropriate care for their paediatric patients.In the interest of what is best for the paediatric population in the future, collaborative efforts for research into the effectiveness and safety of chiropractic care as an alternative healthcare approach for children should be negotiated and are welcomed.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 ","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2010-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-18-16","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29033442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chiropractic diagnosis and management of non-musculoskeletal conditions in children and adolescents.","authors":"Randy J Ferrance,&nbsp;Joyce Miller","doi":"10.1186/1746-1340-18-14","DOIUrl":"https://doi.org/10.1186/1746-1340-18-14","url":null,"abstract":"<p><strong>Background: </strong>A great deal has been published in the chiropractic literature regarding the response, or lack thereof, of various common pediatric conditions to chiropractic care. The majority of that literature is of low scientific value (that is, case reports or case series). The purpose of this review is to summarize the literature from the point of view of clinicians, rather than researchers, and to discuss some additional detail of the conditions themselves.</p><p><strong>Methods: </strong>Databases searched were PubMed, Mantis, Index to Chiropractic Literature, and CINAHL. Keywords were chiropractic paired with colic, crying infant, nocturnal enuresis, asthma, otitis media and attention deficit hyperactivity disorder.</p><p><strong>Results: </strong>Most of the published literature centers around case reports or series. The more scientifically rigorous studies show conflicting results for colic and the crying infant, and there is little data to suggest improvement of otitis media, asthma, nocturnal enuresis or attention deficit hyperactivity disorder.</p><p><strong>Discussion: </strong>The efficacy of chiropractic care in the treatment of non-musculoskeletal disorders has yet to be definitely proven or disproven, with the burden of proof still resting upon the chiropractic profession.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 ","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2010-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-18-14","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29033439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evidence base for chiropractic treatment of musculoskeletal conditions in children and adolescents: The emperor's new suit?","authors":"Lise Hestbaek,&nbsp;Mette Jensen Stochkendahl","doi":"10.1186/1746-1340-18-15","DOIUrl":"https://doi.org/10.1186/1746-1340-18-15","url":null,"abstract":"<p><p> Five to ten percent of chiropractic patients are children and adolescents. Most of these consult because of spinal pain, or other musculoskeletal complaints. These musculoskeletal disorders in early life not only affect the quality of children's lives, but also seem to have an impact on adult musculoskeletal health. Thus, this is an important part of the chiropractors' scope of practice, and the objective of this review is to assess the evidence base for manual treatment of musculoskeletal disorders in children and adolescents.Randomized, quasi-randomized and non-randomized clinical studies were included if they investigated the effect of manual therapy on musculoskeletal disorders in children and/or adolescents. The MEDLINE and MANTIS databases were searched, and studies published in English, Danish, Swedish or Norwegian were included.Only three studies were identified that in some way attempted to look at the effectiveness of manual therapy for children or adolescents with spinal problems, and none of these was a randomized controlled clinical trial. As for the rest of the musculoskeletal system, only one study of temporomandibular disorder was identified.With this review, we have detected a paradox within the chiropractic profession: Although the major reason for pediatric patients to attend a chiropractor is spinal pain, no adequate studies have been performed in this area. It is time for the chiropractic profession to take responsibility and systematically investigate the efficiency of joint manipulation of problems relating to the developing musculoskeletal system.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 ","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2010-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-18-15","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29033440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chiropractic care for paediatric and adolescent Attention-Deficit/Hyperactivity Disorder: A systematic review.","authors":"Fay Karpouzis, Rod Bonello, Henry Pollard","doi":"10.1186/1746-1340-18-13","DOIUrl":"10.1186/1746-1340-18-13","url":null,"abstract":"<p><strong>Background: </strong>Psychostimulants are first line of therapy for paediatric and adolescent AD/HD. The evidence suggests that up to 30% of those prescribed stimulant medications do not show clinically significant outcomes. In addition, many children and adolescents experience side-effects from these medications. As a result, parents are seeking alternate interventions for their children. Complementary and alternative medicine therapies for behavioural disorders such as AD/HD are increasing with as many as 68% of parents having sought help from alternative practitioners, including chiropractors.</p><p><strong>Objective: </strong>The review seeks to answer the question of whether chiropractic care can reduce symptoms of inattention, impulsivity and hyperactivity for paediatric and adolescent AD/HD.</p><p><strong>Methods: </strong>Electronic databases (Cochrane CENTRAL register of Controlled Trials, Cochrane Database of Systematic reviews, MEDLINE, PsycINFO, CINAHL, Scopus, ISI Web of Science, Index to Chiropractic Literature) were searched from inception until July 2009 for English language studies for chiropractic care and AD/HD. Inclusion and exclusion criteria were applied to select studies. All randomised controlled trials were evaluated using the Jadad score and a checklist developed from the CONSORT (Consolidated Standards of Reporting Trials) guidelines.</p><p><strong>Results: </strong>The search yielded 58 citations of which 22 were intervention studies. Of these, only three studies were identified for paediatric and adolescent AD/HD cohorts. The methodological quality was poor and none of the studies qualified using inclusion criteria.</p><p><strong>Conclusions: </strong>To date there is insufficient evidence to evaluate the efficacy of chiropractic care for paediatric and adolescent AD/HD. The claim that chiropractic care improves paediatric and adolescent AD/HD, is only supported by low levels of scientific evidence. In the interest of paediatric and adolescent health, if chiropractic care for AD/HD is to continue, more rigorous scientific research needs to be undertaken to examine the efficacy and effectiveness of chiropractic treatment. Adequately-sized RCTs using clinically relevant outcomes and standardised measures to examine the effectiveness of chiropractic care verses no-treatment/placebo control or standard care (pharmacological and psychosocial care) are needed to determine whether chiropractic care is an effective alternative intervention for paediatric and adolescent AD/HD.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 ","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2010-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2891800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29033437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between data obtained through real-time data capture by SMS and a retrospective telephone interview.","authors":"Bendt Johansen, Niels Wedderkopp","doi":"10.1186/1746-1340-18-10","DOIUrl":"10.1186/1746-1340-18-10","url":null,"abstract":"<p><strong>Background: </strong>The aims of the current study were: a) to quantitatively compare data obtained by Short Message Service (SMS) with data from a telephone interview, b) to investigate whether the respondents had found it acceptable to answer the weekly two SMS questions, c) to explore whether an additional weekly third SMS question would have been acceptable, and d) to calculate the total cost of using the SMS technology.</p><p><strong>Methods: </strong>SMS technology was used each week for 53 weeks to monitor 260 patients with low back pain (LBP) in a clinical study. Each week, these patients were asked the same two questions: \"How many days in the past week have you had problems due to LBP?\" and \"How many days in the past week have you been off work due to LBP problems?\" The last 31 patients were also contacted by telephone 53 weeks after recruitment and asked to recall the number of days with LBP problems and days off work for the a) past week, b) past month, and c) past year. The two sets of answers to the same questions for these patients were compared. Patients were also asked whether a third SMS question would have been acceptable. The test-retest reliability was compared for 1-week, 1-month, and 1-year. Bland-Altman limits of agreement were calculated. The two quantitative questions were reported as percentages. Actual costs for the SMS-Track-Questionnaire (SMS-T-Q) were compared with estimated costs for paper version surveys.</p><p><strong>Results: </strong>There was high agreement between telephone interview and SMS-T-Q responses for the 1-week and 1-month recall. In contrast, the 1-year recall showed very low agreement. A third SMS question would have been acceptable. The SMS system was considerably less costly than a paper-based survey, beyond a certain threshold number of questionnaires.</p><p><strong>Conclusion: </strong>SMS-T-Q appears to be a cheaper and better method to collect reliable LBP data than paper-based surveys.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2010-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29013312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Illustrating risk difference and number needed to treat from a randomized controlled trial of spinal manipulation for cervicogenic headache.","authors":"Mitchell Haas, Michael Schneider, Darcy Vavrek","doi":"10.1186/1746-1340-18-9","DOIUrl":"10.1186/1746-1340-18-9","url":null,"abstract":"<p><strong>Background: </strong>The number needed to treat (NNT) for one participant to benefit is considered a useful, clinically meaningful way of reporting binary outcomes from randomized trials. Analysis of continuous data from our randomized controlled trial has previously demonstrated a significant and clinically important difference favoring spinal manipulation over a light massage control.</p><p><strong>Methods: </strong>Eighty participants were randomized to receive spinal manipulation or a light massage control (n = 40/group). Improvements in cervicogenic headache pain (primary outcome), disability, and number in prior four weeks were dichotomized into binary outcomes at two thresholds: 30% representing minimal clinically important change and 50% representing clinical success. Groups were compared at 12 and 24-week follow-up using binomial regression (generalized linear models) to compute the adjusted risk difference (RD) between groups and number needed to treat (NNT) after adjusting for baseline differences between groups. Results were compared to logistic regression results.</p><p><strong>Results: </strong>For headache pain, clinically important improvement (30% or 50%) was more likely for spinal manipulation: adjusted RD = 17% to 27% and NNT = 3.8 to 5.8 (p = .005 to .028). Some statistically significant results favoring manipulation were found for headache disability and number.</p><p><strong>Conclusion: </strong>Spinal manipulation demonstrated a benefit in terms of a clinically important improvement of cervicogenic headache pain. The use of adjusted NNT is recommended; however, adjusted RD may be easier to interpret than NNT. The study demonstrated how results may depend on the threshold for dichotomizing variables into binary outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NLM identifier NCT00246350.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2010-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2893201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29012305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Nordic back pain subpopulation program: can low back pain patterns be predicted from the first consultation with a chiropractor? A longitudinal pilot study.","authors":"Alice Kongsted,&nbsp;Charlotte Leboeuf-Yde","doi":"10.1186/1746-1340-18-8","DOIUrl":"https://doi.org/10.1186/1746-1340-18-8","url":null,"abstract":"<p><strong>Background: </strong>It is widely believed that non-specific low back pain (LBP) consists of a number of subgroups which should be identified in order to improve treatment effects. In order to identify subgroups, patient characteristics that relate to different outcomes are searched for. However, LBP is often fluctuating or recurring rather than clearly limited in time. Therefore it would be relevant to consider outcome after completed treatment from a longitudinal perspective (describing \"course patterns\") instead of defining it from an arbitrarily selected end-point.</p><p><strong>Aims: </strong>The objectives of this pilot study were to investigate the interobserver reliability of a diagnostic classification system and to evaluate whether diagnostic classes or other baseline characteristics are associated with the LBP course pattern over a period of 18 weeks.</p><p><strong>Methods: </strong>Patients visiting one of 7 chiropractors because of LBP were classified according to a diagnostic classification system, which includes end-range loading, SI-joint pain provocation tests, neurological examination and tests for muscle tenderness and abnormal nerve tension. In addition, age, gender, duration of pain and presence of leg pain were registered in the patient's file. By weekly SMS-messages on their mobile phones, patients were asked how many days they had LBP the preceding week, and these answers were transformed into pain course patterns and the total number of LBP days.</p><p><strong>Results: </strong>A total of 110 patients were included and 76 (69%) completed follow-up. Thirty-five patients were examined by two chiropractors. The agreement regarding diagnostic classes was 83% (95% CI: 70 - 96). The diagnostic classes were associated with the pain course patterns and number of LBP days. Patients with disc pain had the highest number of LBP days and patients with muscular pain reported the fewest (35 vs. 12 days, p < 0.01). Men had better outcome than women (17 vs. 29 days, p < 0.01) and patients without leg pain tended to have fewer LBP days than those with leg pain (21 vs.31 days, p = 0.06). Duration of LBP at the first visit was not associated with outcome.</p><p><strong>Conclusions: </strong>The study indicated that there is a clinically meaningful relationship between diagnostic classes and the course of LBP. This should be evaluated in more depth.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 ","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2010-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-18-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28954724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chiropractic management of patients post-disc arthroplasty: eight case reports.","authors":"Julie O'Shaughnessy,&nbsp;Marc Drolet,&nbsp;Jean-François Roy,&nbsp;Martin Descarreaux","doi":"10.1186/1746-1340-18-7","DOIUrl":"https://doi.org/10.1186/1746-1340-18-7","url":null,"abstract":"<p><strong>Background: </strong>When conservative therapies for low back pain (LBP) are not effective, elective surgery may be proposed to these patients. Over the last 20 years, a new technology, disc replacement, has become increasingly popular because it is believed to maintain or restore the integrity of spinal movement and minimize the side-effects compared to fusion. Although disc replacement may relieve a patient from pain and related disability, soreness and stiffness of the lumbopelvic region seem to be common aftermaths of the surgery. This prospective case series was undertaken to identify and describe potential adverse events of lumbar spinal manipulation, a common therapy for low back pain, in a group of patients with symptoms after disc prostheses.</p><p><strong>Cases presentation: </strong>Eight patients who underwent lumbar spine total disc replacement were referred by an orthopaedic surgeon for chiropractic treatments. These patients had 1 or 2 total lumbar disc replacements and were considered stable according to the surgical protocol but presented persistent, post-surgical, non-specific LBP or pelvic pain. They were treated with lumbar spine side posture manipulations only and received 8 to 10 chiropractic treatments based on the clinical evolution and the chiropractor's judgment. Outcome measures included benign, self-limiting, and serious adverse events after low back spinal manipulative therapy. The Oswestry Disability Index, a pain scale and the fear avoidance belief questionnaire were administered to respectively assess disability, pain and fear avoidance belief about work and physical activity. This prospective case series comprised 8 patients who all had at least 1 total disc replacement at the L4/L5 or L5/S1 level and described persistent post-surgical LBP interfering with their daily activities. Commonly-reported side-effects of a benign nature included increased pain and/or stiffness of short duration in nearly half of the chiropractic treatment period. No major or irreversible complication was noted.</p><p><strong>Conclusions: </strong>During the short treatment period, no major complication was encountered by the patients. Moreover, the benign side-effects reported after lumbar spine manipulation were similar in nature and duration to those frequently experienced by the general population.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2010-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-18-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28937444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neck pain and anxiety do not always go together.","authors":"Corrie Myburgh,&nbsp;Kirsten K Roessler,&nbsp;Anders H Larsen,&nbsp;Jan Hartvigsen","doi":"10.1186/1746-1340-18-6","DOIUrl":"https://doi.org/10.1186/1746-1340-18-6","url":null,"abstract":"<p><p>Chronic pain and psychosocial distress are generally thought to be associated in chronic musculoskeletal disorders such as non-specific neck pain. However, it is unclear whether a raised level of anxiety is necessarily a feature of longstanding, intense pain amongst patient and general population sub-groups. In a cohort of 70 self-selected female, non-specific neck pain sufferers, we observed relatively high levels of self-reported pain of 4.46 (measured on the 11 point numerical pain rating scale (NRS-101)) and a longstanding duration of symptoms (156 days/year). However, the mean anxiety scores observed (5.49), fell well below the clinically relevant threshold of 21 required by the Beck Anxiety Inventory. The cohort was stratified to further distinguish individuals with higher pain intensity (NRS>6) and longer symptom duration (>90 days). Although a highly statistically significant difference (p = 0.000) was subsequently observed with respect to pain intensity, in the resulting sub-groups, none such a difference was noted with respect to anxiety levels. Our results indicate that chronic, intense pain and anxiety do not always appear to be related. Explanations for these findings may include that anxiety is not triggered in socially functional individuals, that individual coping strategies have come into play or in some instances that a psychological disorder like alexithymia could be a confounder. More studies are needed to clarify the specific role of anxiety in chronic non-specific musculoskeletal pain before general evidence-driven clinical extrapolations can be made.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2010-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-18-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28770503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Nordic maintenance care program--time intervals between treatments of patients with low back pain: how close and who decides?","authors":"Kjerstin F Sandnes,&nbsp;Charlotte Bjørnstad,&nbsp;Charlotte Leboeuf-Yde,&nbsp;Lise Hestbaek","doi":"10.1186/1746-1340-18-5","DOIUrl":"https://doi.org/10.1186/1746-1340-18-5","url":null,"abstract":"<p><strong>Background: </strong>The management of chiropractic patients with acute and chronic/persistent conditions probably differs. However, little is known on this subject. There is, for example, a dearth of information on maintenance care (MC). Thus it is not known if patients on MC are coerced to partake in a program of frequent treatments over a long period of time, or if they are actively involved in designing their own individualized treatment program.</p><p><strong>Objectives: </strong>It was the purpose of this study to investigate how chiropractic patients with low back pain were scheduled for treatment, with special emphasis on MC. The specific research questions were: 1. How many patients are on maintenance care? 2) Are there specific patterns of intervals between treatments for patients and, if so, do they differ between MC patients and non-MC patients? 3. Who decides on the next treatment, the patient, the chiropractor or both, and are there any differences between MC patients and non-MC patients?</p><p><strong>Methods: </strong>Chiropractic students, who during their summer holidays were observers in chiropractic clinics in Norway and Denmark, recorded whether patients were classified by the treating chiropractor as a MC-patient or not, dates for last and subsequent visits, and made a judgement on whether the patient or the chiropractor decided on the next appointment.</p><p><strong>Results: </strong>Observers in the study were 16 out of 30 available students. They collected data on 868 patients from 15 Danish and 13 Norwegian chiropractors. Twenty-two percent and 26%, respectively, were classified as MC patients. Non-MC patients were most frequently seen within 1 week. For MC patients, the previous visit was most often 2-4 weeks prior to the actual visit, and the next appointment between 1 and 3 months. This indicates a gradual increase in intervals. The decision of the next visit was mainly made by the chiropractor, also for MC patients. However, the study samples of chiropractors appear not to be representative of the general Danish and Norwegian chiropractic profession and the patients may also have been non-representative.</p><p><strong>Conclusion: </strong>There were two distinctly different patterns for the time period between visits for MC patients and non-MC patients. For non-MC patients, the most frequent interval between visits was one week and for MC patients, the period was typically between two weeks and three months. It was primarily the chiropractor who made the next visit-decision. However, these results can perhaps not be extrapolated to other groups of patients and chiropractors.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2010-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-18-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28759893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}