Chiropractic & osteopathy最新文献

{"title":"Commentary on the United Kingdom evidence report about the effectiveness of manual therapies.","authors":"Scott Haldeman,&nbsp;Martin Underwood","doi":"10.1186/1746-1340-18-4","DOIUrl":"https://doi.org/10.1186/1746-1340-18-4","url":null,"abstract":"<p><p>This is an accompanying commentary on the article by Gert Bronfort and colleagues about the effectiveness of manual therapy. The two commentaries were provided independently and combined into this single article by the journal editors.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2010-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-18-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28738753","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":"Effectiveness of manual therapies: the UK evidence report.","authors":"Gert Bronfort,&nbsp;Mitch Haas,&nbsp;Roni Evans,&nbsp;Brent Leininger,&nbsp;Jay Triano","doi":"10.1186/1746-1340-18-3","DOIUrl":"https://doi.org/10.1186/1746-1340-18-3","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions.</p><p><strong>Methods: </strong>The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs.</p><p><strong>Results: </strong>By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines.Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments.</p><p><strong>Conclusions: </strong>Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation, or for Stage 1 hypertension when added to an antihypertensive diet. In children, the evidence is inconclusive regarding the effectiveness for otitis media and enuresis, and it is not effective for infantile colic and asthma when compared to sham manipulation.Massage is effective in adults for chronic low back pain and chronic neck pain. The evidence is inconclusive for knee osteoarthritis, fibromyalgia, myofascial pain syndrome, migraine headache, and premenstrual syndrome. In children, the evidence is inconclusive for asthma and infantile colic.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 ","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2010-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-18-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28738752","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: course patterns established through weekly follow-ups in patients treated for low back pain.","authors":"Alice Kongsted,&nbsp;Charlotte Leboeuf-Yde","doi":"10.1186/1746-1340-18-2","DOIUrl":"https://doi.org/10.1186/1746-1340-18-2","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) is known to have a fluctuating course. In clinical studies, when deciding on duration of treatment and time for follow-up, it is important to know at what point in time a definite pattern of recovery becomes apparent and at what time a possible recurrence is likely to occur. A detailed description of the pain pattern has been difficult to establish with commonly used methods for follow-up, and we now introduce data collection by means of text messaging on mobile phones. The purpose of this study was to describe the detailed course of LBP during 18 weeks in a population treated in the primary care sector by chiropractors.</p><p><strong>Methods: </strong>The study population consisted of 78 patients presenting to a chiropractor with LBP, who for at least 12 weeks responded to the questions sent by text messaging concerning 1) the number of LBP-days the preceding week and 2) the intensity of present LBP.</p><p><strong>Results: </strong>A rapid improvement was observed through weeks one to four. After week seven no further improvement happened, and from the 12(th )week there seemed to be a tendency towards worsening.</p><p><strong>Conclusions: </strong>We suggest that follow-ups in studies concerning primary sector LBP care are conducted in week seven after treatment was initiated and at some later point which cannot be established from this study. In clinical practice we recommend that patients' LBP status is systematically followed for the first four weeks since lack of improvement during that period should cause watchfulness.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2010-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-18-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28710621","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 relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain.","authors":"Amir M Arab, Mohammad R Nourbakhsh","doi":"10.1186/1746-1340-18-1","DOIUrl":"10.1186/1746-1340-18-1","url":null,"abstract":"<p><strong>Background: </strong>Shortening of the iliotibial band (ITB) has been considered to be associated with low back pain (LBP). It is theorized that ITB tightness in individuals with LBP is a compensatory mechanism following hip abductor muscle weakness. However, no study has clinically examined this theory. The purpose of this study was to investigate the muscle imbalance of hip abductor muscle weakness and ITB tightness in subjects with LBP.</p><p><strong>Methods: </strong>A total of 300 subjects with and without LBP between the ages of 20 and 60 participated in this cross-sectional study. Subjects were categorized in three groups: LBP with ITB tightness (n = 100), LBP without ITB tightness (n = 100) and no LBP (n = 100). Hip abductor muscle strength was measured in all subjects.</p><p><strong>Results: </strong>Analysis of Covariance (ANCOVA) with the body mass index (BMI) as the covariate revealed significant difference in hip abductor strength between three groups (P < 0.001). Post hoc analysis showed no significant difference in hip abductor muscle strength between the LBP subjects with and without ITB tightness (P = 0.59). However, subjects with no LBP had significantly stronger hip abductor muscle strength compared to subjects with LBP with ITB tightness (P < 0.001) and those with LBP without ITB tightness (P < 0.001).</p><p><strong>Conclusion: </strong>The relationship between ITB tightness and hip abductor weakness in patients with LBP is not supported as assumed in theory. More clinical studies are needed to assess the theory of muscle imbalance of hip abductor weakness and ITB tightness in LBP.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"18 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2010-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28715546","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 Subpopulation Research Programme: prediction of treatment outcome in patients with low back pain treated by chiropractors--does the psychological profile matter?","authors":"Charlotte Leboeuf-Yde,&nbsp;Annika Rosenbaum,&nbsp;Iben Axén,&nbsp;Peter W Lövgren,&nbsp;Kristian Jørgensen,&nbsp;Laszlo Halasz,&nbsp;Andreas Eklund,&nbsp;Niels Wedderkopp","doi":"10.1186/1746-1340-17-14","DOIUrl":"https://doi.org/10.1186/1746-1340-17-14","url":null,"abstract":"<p><strong>Background: </strong>It is clinically important to be able to select patients suitable for treatment and to be able to predict with some certainty the outcome for patients treated for low back pain (LBP). It is not known to what degree outcome among chiropractic patients is affected by psychological factors.</p><p><strong>Objectives: </strong>To investigate if some demographic, psychological, and clinical variables can predict outcome with chiropractic care in patients with LBP.</p><p><strong>Methods: </strong>A prospective multi-center practice-based study was carried out, in which demographic, clinical and psychological information was collected at base-line. Outcome was established at the 4(th )visit and after three months. The predictive value was studied for all base-line variables, individually and in a multivariable analysis.</p><p><strong>Results: </strong>In all, 55 of 99 invited chiropractors collected information on 731 patients. At the 4(th )visit data were available on 626 patients and on 464 patients after 3 months. Fee subsidization (OR 3.2; 95% CI 1.9-5.5), total duration of pain in the past year (OR 1.5; 95% CI 1.0-2.2), and general health (OR 1.2; 95% CI 1.1-1.4) remained in the final model as predictors of treatment outcome at the 4(th )visit. The sensitivity was low (12%), whereas the specificity was high (97%). At the three months follow-up, duration of pain in the past year (OR 2.1; 95% CI 1.4-3.1), and pain in other parts of the spine in the past year (OR1.6; 1.1-2.5) were independently associated with outcome. However, both the sensitivity and specificity were relatively low (60% and 50%). The addition of the psychological variables did not improve the models and none of the psychological variables remained significant in the final analyses. There was a positive gradient in relation to the number of positive predictor variables and outcome, both at the 4(th )visit and after 3 months.</p><p><strong>Conclusion: </strong>Psychological factors were not found to be relevant in the prediction of treatment outcome in Swedish chiropractic patients with LBP.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"17 ","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2009-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-17-14","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28620563","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":"An epidemiological examination of the subluxation construct using Hill's criteria of causation.","authors":"Timothy A Mirtz, Lon Morgan, Lawrence H Wyatt, Leon Greene","doi":"10.1186/1746-1340-17-13","DOIUrl":"10.1186/1746-1340-17-13","url":null,"abstract":"<p><strong>Background: </strong>Chiropractors claim to locate, analyze and diagnose a putative spinal lesion known as subluxation and apply the mode of spinal manipulation (adjustment) for the correction of this lesion.</p><p><strong>Aim: </strong>The purpose of this examination is to review the current evidence on the epidemiology of the subluxation construct and to evaluate the subluxation by applying epidemiologic criteria for it's significance as a causal factor.</p><p><strong>Methods: </strong>The databases of PubMed, Cinahl, and Mantis were searched for studies using the keywords subluxation, epidemiology, manipulation, dose-response, temporality, odds ratio, relative risk, biological plausibility, coherence, and analogy.</p><p><strong>Results: </strong>The criteria for causation in epidemiology are strength (strength of association), consistency, specificity, temporality (temporal sequence), dose response, experimental evidence, biological plausibility, coherence, and analogy. Applied to the subluxation all of these criteria remain for the most part unfulfilled.</p><p><strong>Conclusion: </strong>There is a significant lack of evidence to fulfill the basic criteria of causation. This lack of crucial supportive epidemiologic evidence prohibits the accurate promulgation of the chiropractic subluxation.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"17 ","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2009-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3238291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28542618","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":"A descriptive report of management strategies used by chiropractors, as reviewed by a single independent chiropractic consultant in the Australian workers compensation system.","authors":"Henry Pollard,&nbsp;Katie de Luca","doi":"10.1186/1746-1340-17-12","DOIUrl":"https://doi.org/10.1186/1746-1340-17-12","url":null,"abstract":"<p><strong>Background: </strong>In New South Wales, Australia, an injured worker enters the workers compensation system with the case often managed by a pre-determined insurer. The goal of the treating practitioner is to facilitate the claimant to return to suitable duties and progress to their pre-injury status, job and quality of life. Currently, there is very little documentation on the management of injured workers by chiropractors in the Australian healthcare setting. This study aims to examine treatment protocols and recommendations given to chiropractic practitioners by one independent chiropractic reviewer in the state of New South Wales, and to discuss management strategies recommended for the injured worker.</p><p><strong>Methods: </strong>A total of 146 consecutive Independent Chiropractic Consultant reports were collated into a database. Pain information and management recommendations made by the Independent Chiropractic Consultant were tabulated and analysed for trends. The data formulated from the reports is purely descriptive in nature.</p><p><strong>Results: </strong>The Independent Chiropractic Consultant determined the current treatment plan to be \"reasonable\" (80.1%) or \"unreasonable\" (23.6%). The consultant recommended to \"phase out\" treatment in 74.6% of cases, with an average of six remaining treatments. In eight cases treatment was unreasonable with no further treatment; in five cases treatment was reasonable with no further treatment. In 78.6% of cases, injured workers were to be discharged from treatment and 21.4% were to be reassessed for the need of a further treatment plan. Additional recommendations for treatment included an active care program (95.2%), general fitness program (77.4%), flexibility/range of movement exercises (54.1%), referral to a chronic pain specialist (50.7%) and work hardening program (22.6%).</p><p><strong>Conclusion: </strong>It is essential chiropractic practitioners perform 'reasonably necessary treatment' to reduce dependency on passive treatment, increase compliance to active care programs and reduce the progression to chronic pain states. It is recommended that common findings be integrated in further research, to improve the management of treatment for patients with an occupational injury.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"17 ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2009-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-17-12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28515543","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--individual patterns of low back pain established by means of text messaging: a longitudinal pilot study.","authors":"Alice Kongsted,&nbsp;Charlotte Leboeuf-Yde","doi":"10.1186/1746-1340-17-11","DOIUrl":"https://doi.org/10.1186/1746-1340-17-11","url":null,"abstract":"<p><strong>Background: </strong>Non-specific low back pain (LBP) is known to be a fluctuating condition and there is a growing realisation that it consists of different subgroups of patients. The detailed course of pain is not known since traditional methods of data collection do not allow very frequent follow-ups. This is a limitation in relation to identification of subgroups with different course patterns. The objective of this pilot study was to see if it is possible to identify characteristic course-patterns of non-specific LBP in patients treated in a primary care setting.</p><p><strong>Methods: </strong>Patients seeing a chiropractor for a new LBP episode were included after the first consultation and followed for 18 weeks by means of automatic short message service (SMS) received and returned on their mobile phones. Every week they were asked how many days they had experienced LBP in the preceding week. The course of pain was studied for each individual and described as an early course (1st - 4th week) and a late course (5th - 18th week), which was fitted into one of 13 predefined course patterns.</p><p><strong>Results: </strong>A total of 110 patients were included from 5 chiropractic clinics, and the study sample consisted of the 78 patients who participated at least until week 12. Nine of the predefined patterns were identified within this population. The majority of patients improved within the first four weeks (63%), and such early improvement was associated with a generally favourable course.</p><p><strong>Conclusion: </strong>Patients with nonspecific LBP were shown to have a number of different course-patterns. The next step is to explore whether the identified patterns relate to different LBP diagnoses.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"17 ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2009-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-17-11","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28513549","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":"Why do ineffective treatments seem helpful? A brief review.","authors":"Steve E Hartman","doi":"10.1186/1746-1340-17-10","DOIUrl":"10.1186/1746-1340-17-10","url":null,"abstract":"<p><p>After any therapy, when symptoms improve, healthcare providers (and patients) are tempted to award credit to treatment. Over time, a particular treatment can seem so undeniably helpful that scientific verification of efficacy is judged an inconvenient waste of time and resources. Unfortunately, practitioners' accumulated, day-to-day, informal impressions of diagnostic reliability and clinical efficacy are of limited value. To help clarify why even treatments entirely lacking in direct effect can seem helpful, I will explain why real signs and symptoms often improve, independent of treatment. Then, I will detail quirks of human perception, interpretation, and memory that often make symptoms seem improved, when they are not. I conclude that healthcare will grow to full potential only when judgments of clinical efficacy routinely are based in properly scientific, placebo-controlled, outcome analysis.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"17 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2009-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28431425","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":"Pain patterns and descriptions in patients with radicular pain: does the pain necessarily follow a specific dermatome?","authors":"Donald R Murphy,&nbsp;Eric L Hurwitz,&nbsp;Jonathan K Gerrard,&nbsp;Ronald Clary","doi":"10.1186/1746-1340-17-9","DOIUrl":"https://doi.org/10.1186/1746-1340-17-9","url":null,"abstract":"<p><strong>Background: </strong>It is commonly stated that nerve root pain should be expected to follow a specific dermatome and that this information is useful to make the diagnosis of radiculopathy. There is little evidence in the literature that confirms or denies this statement. The purpose of this study is to describe and discuss the diagnostic utility of the distribution of pain in patients with cervical and lumbar radicular pain.</p><p><strong>Methods: </strong>Pain drawings and descriptions were assessed in consecutive patients diagnosed with cervical or lumbar nerve root pain. These findings were compared with accepted dermatome maps to determine whether they tended to follow along the involved nerve root's dermatome.</p><p><strong>Results: </strong>Two hundred twenty-six nerve roots in 169 patients were assessed. Overall, pain related to cervical nerve roots was non-dermatomal in over two-thirds (69.7%) of cases. In the lumbar spine, the pain was non-dermatomal in just under two-thirds (64.1%) of cases. The majority of nerve root levels involved non-dermatomal pain patterns except C4 (60.0% dermatomal) and S1 (64.9% dermatomal). The sensitivity (SE) and specificity (SP) for dermatomal pattern of pain are low for all nerve root levels with the exception of the C4 level (Se 0.60, Sp 0.72) and S1 level (Se 0.65, Sp 0.80), although in the case of the C4 level, the number of subjects was small (n = 5).</p><p><strong>Conclusion: </strong>In most cases nerve root pain should not be expected to follow along a specific dermatome, and a dermatomal distribution of pain is not a useful historical factor in the diagnosis of radicular pain. The possible exception to this is the S1 nerve root, in which the pain does commonly follow the S1 dermatome.</p>","PeriodicalId":87173,"journal":{"name":"Chiropractic & osteopathy","volume":"17 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2009-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1746-1340-17-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28418040","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}