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Song YP, Liu JL, Zong CZ, Zhang FS, Ren YF, Ching YL, Wang YX, Li WX, Zhao H, Huang YR, Gao K. A bibliometric study on trends in chiropractic research from 1920 to 2023. Complement Ther Med 2024; 82:103038. [PMID: 38582375 DOI: 10.1016/j.ctim.2024.103038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/25/2024] [Accepted: 04/03/2024] [Indexed: 04/08/2024] Open
Abstract
OBJECTIVE An increasing body of evidence suggests a positive role of chiropractic in the treatment of neuro-musculoskeletal disorders. This study aims to explore current research hotspots and trends, providing insights into the broad prospects of this field. METHODS A bibliometric review was conducted on all chiropractic articles included in the Web of Science Core Collection before December 31, 2023. RESULTS Over the past century, the volume of research in the field of chiropractic has been fluctuating annually, with four peaks observed in total. The United States, Canada, Australia, and the United Kingdom are leading countries. Chu, Eric Chun-Pu is the author with the most publications, while Bronfort, Gert has the highest total citation count. The University of Southern Denmark has produced the most publications, while Queens University - Canada is the most central institution. The Journal of Manipulative and Physiological Therapeutics is the journal with the most publications and citations, while the Journal of the American Medical Association is the most central journal. The two most-cited articles were both authored by Eisenberg DM. Emerging keywords include "chronic pain" and "skills". The theoretical mechanisms and scientific basis of chiropractic, its clinical practice and safety, education and training, integration with other disciplines, and patient experiences and satisfaction are the frontiers and hotspots of research. CONCLUSION This study integrates bibliometric analysis to summarize the current state of research and global network centers in the field of chiropractic, further highlighting the hotspots and trends in this field. However, Individual and national rankings should be interpreted with caution due to our focus on Web of Science rather than PubMed.
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Affiliation(s)
- Yi-Ping Song
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jia-Li Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Chen-Zhong Zong
- The Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Fang-Shuo Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yan-Feng Ren
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yuen-Lim Ching
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yi-Xiao Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Wen-Xun Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - He Zhao
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
| | - Yi-Ran Huang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.
| | - Kuo Gao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
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Di Donato M, Gray S, Sheehan LR, Buchbinder R, Iles R, Collie A. How Much Physiotherapy, Chiropractic, and Osteopathy Care Do Compensated Australian Workers with Low Back Pain Receive? A Retrospective Cohort Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10202-1. [PMID: 38761339 DOI: 10.1007/s10926-024-10202-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVES To identify the prevalence and frequency of physiotherapy, chiropractic, and/or osteopathy care in Australians with workers' compensation claims for low back pain (LBP). METHODS We included workers with accepted workers' compensation claims longer than 2 weeks from the Australian states of Victoria, Queensland, South Australia, and Western Australia. Workers were grouped by whether they attended physiotherapy, chiropractic, and/or osteopathy in the first 2 years of their claim. Descriptive statistics and logistic regression were used to describe differences between groups. Descriptive statistics and negative binomial regression were used to describe differences in the number of attendances in each group. RESULTS Most workers had at least one physical therapy attendance during the period of their claim (n = 23,619, 82.0%). Worker state, socioeconomic status, and remoteness were the largest contributing factors to likelihood of physical therapy attendance. Most workers only attended physiotherapy (n = 21,035, 89.1%, median of 13 times). Far fewer only attended chiropractic (n = 528, 2.2%, median of 8 times) or only osteopathy (n = 296, 1.3%, median of 10 times), while 1,750 (7.5%) attended for care with more than one type of physical therapy (median of 31 times). CONCLUSION Most Australian workers with workers' compensation time loss claims for LBP attend physiotherapy at least once during their claims. State of claim is the strongest predictor of which physical therapy profession they attend, possibly due to regional availability. Workers who see a physiotherapist have significantly more attendances. Future research should explore the relationship between these patterns of care and claimant outcomes, including work disability duration.
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Affiliation(s)
- Michael Di Donato
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne VIC 3000, Australia.
| | - Shannon Gray
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne VIC 3000, Australia
| | - Luke R Sheehan
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne VIC 3000, Australia
| | - Rachelle Buchbinder
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne VIC 3000, Australia
| | - Ross Iles
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne VIC 3000, Australia
| | - Alex Collie
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne VIC 3000, Australia
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Ravidutt M, Mahara S. The knowledge, attitudes and perceptions of physiotherapists and chiropractors in South Africa. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2024; 80:1922. [PMID: 38445218 PMCID: PMC10913180 DOI: 10.4102/sajp.v80i1.1922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/20/2023] [Indexed: 03/07/2024] Open
Abstract
Background Effective healthcare delivery occurs when health professionals collaborate and provide holistic, patient-centred care. Physiotherapists and chiropractors treat a common range of patients with an overlap in their scope of practice and modalities because of typical healthcare roles that could lead to 'perceived' animosity. Objectives To assess the knowledge, attitudes, and perceptions of qualified chiropractors and physiotherapists regarding each other's practice. Method A cross-sectional survey using an online questionnaire and analysed descriptively. Results Participants were chiropractors (n = 116) and physiotherapists (n = 190). Chiropractors achieved a mean knowledge score of 75.7%, with physiotherapists at 59.7% on the assessments of each other's patients; an average score of 85.3% and 72.0% respectively, on knowledge of treatment modalities; knowledge score of 82.4% and 77.3% respectively, on the conditions treated by the other professional. A total of 82.8% (n = 96) of chiropractors and 70.0% (n = 133) of physiotherapists indicated the other professionals' competence in treating neuromusculoskeletal conditions. Inter-professional referrals occurred between 81.9% of chiropractors (n = 95) and 55.3% of physiotherapists (n = 105). Chiropractors (69.0%, n = 80) and physiotherapists (55.3%, n = 105) wanted to collaborate to manage patients. Conclusion In the surveyed population in South Africa, chiropractors and physiotherapists had good knowledge, positive attitudes and perceptions of each other's practices, especially in the private sector. Clinical implications Inter-professional collaboration between chiropractors and physiotherapists should be encouraged so that healthcare delivery can be holistic and patient-centred for better clinical outcomes.
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Affiliation(s)
- Micaela Ravidutt
- Department of Chiropractic, Durban University of Technology, Durban, South Africa
| | - Sonill Mahara
- Department of Physiotherapy, University of KwaZulu-Natal, Durban, South Africa
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Burdick R, Corcoran KL, Zhao X, Lisi A. The rate of use of Veterans Affairs chiropractic care: a 5-year analysis. Chiropr Man Therap 2022; 30:4. [PMID: 35062971 PMCID: PMC8781440 DOI: 10.1186/s12998-022-00413-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/17/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The US Department of Veterans Affairs (VA) has initiated various approaches to provide chiropractic care to Veterans. Prior work has shown substantial increase in use of VA chiropractic care between fiscal years (FY) 2005-2016. However, the extent of the availability of these services to the Veteran population remains unclear. The purpose of this study was to analyze the rate of Veteran use of VA chiropractic services, both from on-site care at VA facilities and VA purchased care from community care providers. This study analyzed facility characteristics associated with chiropractic use by both care delivery mechanisms (on-site and in the community). METHODS Cross-sectional analyses of administrative data were conducted for FY 2014-2019. Data were obtained from VA's Corporate Data Warehouse. The variables extracted included number of unique Veterans receiving VA chiropractic care on-site and in the community, total Veteran population of the VA facilities, size of the VA chiropractic workforce (measured as Full-Time Equivalent, FTE), and facility characteristics (geographic region and the facility complexity). Descriptive statistics, mixed model, and multivariant models were used to analyze data. RESULTS Use of VA chiropractic care increased over the six-year period for both on-site and community care. National average for on-site use of the population was 1.27% in FY14 and 1.48% in FY19. Community care use was 0.29% and 1.76% for the same years. Use at individual facilities varied widely in each FY. Factors such as chiropractor FTE, geographic locations, and the complexity of the VA facility are associated with use of chiropractic services. CONCLUSION The VA has expanded the non-pharmacologic treatments available to Veterans by providing chiropractic services, yet chiropractic use remains low compared to other US populations. As Veterans have a high prevalence of pain and musculoskeletal conditions, continued work to assess and achieve the optimal levels of chiropractic use in this population is warranted.
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Affiliation(s)
- Ryan Burdick
- Center for Medical Informatics, Yale School of Medicine, Yale University, 300 George St, New Haven, CT, 06511, USA. .,Department of Physical Medicine and Rehabilitation, VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT, 06516, USA.
| | - Kelsey L. Corcoran
- grid.47100.320000000419368710Center for Medical Informatics, Yale School of Medicine, Yale University, 300 George St, New Haven, CT 06511 USA ,grid.281208.10000 0004 0419 3073Department of Physical Medicine and Rehabilitation, VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516 USA ,grid.281208.10000 0004 0419 3073Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516 USA
| | - Xiwen Zhao
- grid.47100.320000000419368710Center for Analytical Sciences, Yale School of Public Health, Yale University, 300 George St, New Haven, CT 06511 USA
| | - Anthony Lisi
- grid.47100.320000000419368710Center for Medical Informatics, Yale School of Medicine, Yale University, 300 George St, New Haven, CT 06511 USA ,grid.281208.10000 0004 0419 3073Department of Physical Medicine and Rehabilitation, VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516 USA ,grid.281208.10000 0004 0419 3073Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516 USA
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Csiernik B, Smith A, Plener J, Tibbles A, Young JJ. Intervention usage for the management of low back pain in a chiropractic teaching clinic. Chiropr Man Therap 2022; 30:3. [PMID: 35000607 PMCID: PMC8743057 DOI: 10.1186/s12998-022-00412-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Despite numerous low back pain (LBP) clinical practice guidelines, published studies suggest guideline nonconcordant care is still offered. However, there is limited literature evaluating the degree to which chiropractors, particularly students, follow clinical practice guidelines when managing LBP. The aim of this study was to evaluate the frequency of use of specific interventions for LBP by students at a chiropractic teaching clinic, mapping recommended, not recommend, and without recommendation interventions based on two clinical practice guidelines. Methods This was a retrospective chart review of patients presenting to the Canadian Memorial Chiropractic College teaching clinic with a new complaint of LBP from January to July 2019. Interventions provided under treatment plans for each patient were extracted. Interventions were classified as recommended, not recommended, or without recommendation according to two guidelines, the NICE and OPTIMa LBP guideline. Results 1000 patient files were identified with 377 files meeting the inclusion criteria. The most frequent interventions provided to patients were manipulation/mobilization (99%) and soft tissue therapy (91%). Exercise, localized percussion, and advice and/or education were included in just under half of the treatment plans. Patient files contained similar amounts of recommended (70%) and not recommended (80%) interventions according to the NICE guideline classification, with half the treatment plans including an intervention without recommendation. Under the OPTIMa acute guideline, patient files contained similar amounts of recommended and not recommended care, while more recommended care was provided than not recommended under the OPTIMa chronic guideline. Conclusions Despite chiropractic interns providing guideline concordant care for the majority of LBP patients, interventions classified as not recommended and without recommendation are still frequently offered. This study provides a starting point to understand the treatment interventions provided by chiropractic interns. Further research should be conducted to improve our understanding of the use of LBP guideline recommended care in the chiropractic profession. Trial registration Open Science Framework # g74e8.
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Affiliation(s)
- Ben Csiernik
- Canadian Memorial Chiropractic College, Toronto, Canada
| | - Ali Smith
- Canadian Memorial Chiropractic College, Toronto, Canada
| | - Joshua Plener
- Canadian Memorial Chiropractic College, Toronto, Canada.,University of Toronto, Toronto, Canada
| | | | - James J Young
- Canadian Memorial Chiropractic College, Toronto, Canada. .,Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark.
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Swain MS, Gliedt JA, de Luca K, Newell D, Holmes M. Chiropractic students' cognitive dissonance to statements about professional identity, role, setting and future: international perspectives from a secondary analysis of pooled data. Chiropr Man Therap 2021; 29:5. [PMID: 33526067 PMCID: PMC7851948 DOI: 10.1186/s12998-021-00365-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 01/14/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chiropractic students demonstrate philosophically opposing views about the chiropractic profession. The primary aim was to describe chiropractic students' responses to statements about chiropractic identity, role, setting, and future direction. A secondary aim was to describe the frequency of internally conflicting responses. METHODS Three datasets from Europe, North America, and Australia/New Zealand were pooled in a secondary data analysis. Chiropractic students from 25 chiropractic training institutions completed interrelating surveys (combined response rate 21.9%) between 2013 and 2018. The survey instrument investigated student viewpoints about chiropractic professional identity, role, practice setting and future direction of chiropractic practice. Student attitudes about chiropractic were described using weighted proportions to adjust for unequal population sampling across the three geographical regions. The frequency of concordant and discordant student responses was described by combining identity items with items that explored responses about practice role, setting and future direction. The relationship between student characteristics (age, sex, education, association membership and geographical region) and ideologically conflicting responses were assessed using the Chi-squared test and Cramér's V. RESULTS Data from 2396 student chiropractors (50.8% female; from Europe 36.2%, North America 49.6% and Australia/New Zealand 14.5%) were analysed. For identity, nearly half of the chiropractic students (weighted 45.1%) agreed that it is important for chiropractors to hold strongly to the traditional chiropractic theory that adjusting the spine corrects "dis-ease" and agreed (weighted 55.5%) that contemporary and evolving scientific evidence is more important than traditional chiropractic principles. The frequency of discordant (ideologically conflicting) student responses ranged from 32.5% for statements about identity versus role, to 51.4% for statements about identity versus future. There was no association between student age, sex and internally conflicting responses. Chiropractic students' professional association membership status, pre-chiropractic education and geographical region were associated with ideologically conflicting responses. CONCLUSIONS Chiropractic students in this analysis show traditional and progressive attitudes towards the chiropractic profession. Individual student responses frequently contradict in terms of professional ideology, but most (approximately half) students demonstrate concordant progressive and mainstream attitudes. Ideological conflict may raise concerns about some students' ability to learn and make clinical judgements, and potential for disharmony in the chiropractic fraternity.
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Affiliation(s)
- Michael S Swain
- Department of Chiropractic, Macquarie University, Balaclava Rd, Sydney, NSW, 2109, Australia. .,Chiropractic Academy of Research Leadership (CARL), Odense, Denmark.
| | - Jordan A Gliedt
- Logan University College of Chiropractic, Chesterfield, USA.,Medical College of Wisconsin, Milwaukee, USA
| | - Katie de Luca
- Department of Chiropractic, Macquarie University, Balaclava Rd, Sydney, NSW, 2109, Australia.,Chiropractic Academy of Research Leadership (CARL), Odense, Denmark
| | | | - Michelle Holmes
- Chiropractic Academy of Research Leadership (CARL), Odense, Denmark.,AECC University College, Bournemouth, UK
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7
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Roseen EJ, Kasali BA, Corcoran K, Masselli K, Laird L, Saper RB, Alford DP, Cohen E, Lisi A, Atlas SJ, Bean JF, Evans R, Bussières A. Doctors of chiropractic working with or within integrated healthcare delivery systems: a scoping review protocol. BMJ Open 2021; 11:e043754. [PMID: 33495261 PMCID: PMC7839851 DOI: 10.1136/bmjopen-2020-043754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Back and neck pain are the leading causes of disability worldwide. Doctors of chiropractic (DCs) are trained to manage these common conditions and can provide non-pharmacological treatment aligned with international clinical practice guidelines. Although DCs practice in over 90 countries, chiropractic care is rarely available within integrated healthcare delivery systems. A lack of DCs in private practice, particularly in low-income communities, may also limit access to chiropractic care. Improving collaboration between medical providers and community-based DCs, or embedding DCs in medical settings such as hospitals or community health centres, will improve access to evidence-based care for musculoskeletal conditions. METHODS AND ANALYSES This scoping review will map studies of DCs working with or within integrated healthcare delivery systems. We will use the recommended six-step approach for scoping reviews. We will search three electronic data bases including Medline, Embase and Web of Science. Two investigators will independently review all titles and abstracts to identify relevant records, screen the full-text articles of potentially admissible records, and systematically extract data from selected articles. We will include studies published in English from 1998 to 2020 describing medical settings that have established formal relationships with community-based DCs (eg, shared medical record) or where DCs practice in medical settings. Data extraction and reporting will be guided by the Proctor Conceptual Model for Implementation Research, which has three domains: clinical intervention, implementation strategies and outcome measurement. Stakeholders from diverse clinical fields will offer feedback on the implications of our findings via a web-based survey. ETHICS AND DISSEMINATION Ethics approval will not be obtained for this review of published and publicly accessible data, but will be obtained for the web-based survey. Our results will be disseminated through conference presentations and a peer-reviewed publication. Our findings will inform implementation strategies that support the adoption of chiropractic care within integrated healthcare delivery systems.
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Affiliation(s)
- Eric J Roseen
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
- New England Geriatric Research Education and Clinical Center, Boston Veterans Affairs Healthcare System, Boston, MA, USA
| | - Bolanle Aishat Kasali
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Kelsey Corcoran
- Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Kelsey Masselli
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Lance Laird
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Robert B Saper
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Daniel P Alford
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Ezra Cohen
- Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Anthony Lisi
- Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Steven J Atlas
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jonathan F Bean
- New England Geriatric Research Education and Clinical Center, Boston Veterans Affairs Healthcare System, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Roni Evans
- Integrative Health & Wellbeing Research Program, Earl E. Bakken Center for Spirituality and Healing, University of Minnesota, Minneapolis, MN, USA
| | - André Bussières
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Québec, Canada
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An unusual postural headache: a case report. Chiropr Man Therap 2020; 28:56. [PMID: 33183329 PMCID: PMC7664038 DOI: 10.1186/s12998-020-00347-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 10/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper presents a case of an evolving unusual thunderclap headache that presented to a chiropractor. CASE PRESENTATION The intense "migraine-like" headache was aggravated by standing up and relieved substantially when lying down. This low pressure, orthostatic headache was diagnosed as a spontaneous intracranial hypotension (SIH) secondary to a spontaneous tear of the dura. It was referred to the local hospital for management with autogolous blood injection to form an epidural blood patch of the defect. It resolved substantially within 3 days. CONCLUSIONS The significance of key features in the history and examination and how if not recognised and subsequently treated with manual therapy, the dural tear could be attributed to the treatment of the chiropractor, a treatment that would typically involve cervical manipulation. Discussion is provided of the implications of a missed diagnosis and possible subsequent chiropractic management with the evolving SIH being attributed to the chiropractic intervention rather than its true "spontaneous" nature.
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Christian L, Torsten L. “Models and theoretical frameworks for osteopathic care – A critical view and call for updates and research”. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2020.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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10
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Innes SI, Leboeuf-Yde C, Walker BF. The accreditation role of Councils on Chiropractic Education as part of the profession's journey from craft to allied health profession: a commentary. Chiropr Man Therap 2020; 28:40. [PMID: 32693804 PMCID: PMC7374969 DOI: 10.1186/s12998-020-00329-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 06/09/2020] [Indexed: 11/24/2022] Open
Abstract
Background Chiropractors see themselves as well positioned to provide safe, effective and economical care for the on-going financial burden that spinal pain imposes. However, in many places of the world, the chiropractic profession continues to find itself struggling to gain acceptance as a mainstream allied health care provider. There is evidence of the existence of undesirable chiropractic practice patterns and it is in part due to some of the world’s accredited chiropractic programs. This indicated a need for scrutiny of international chiropractic educational accreditation standards, which are the responsibility of Councils on Chiropractic Education (CCEs). To this end we reviewed an emerging body of evidence about the chiropractic educational system in order to identify issues and make recommendations that may enhance professional acceptance through improved graduate outcomes and hopefully the quality of patient care. This commentary summarises the findings of that research. Main text We reviewed recent relevant studies, including our own, into the role and function of CCEs and found that there is sufficient evidence to identify areas of concern that could be addressed, at least in part, by improvements to CCEs’ educational standards and processes. Areas included a lack of definitions for key terms such as, ‘chiropractic’, ‘diagnosis’, and ‘competency’, without which there can be no common understanding at a detailed level to inform graduate competencies and standards for a matching scope of practice. Further, there is some evidence to suggest that in some cases this level of detail is avoided in order to enable a “big tent” approach that allows for a diversity of approaches to clinical care to co-exist. This combined with the held view that chiropractic is “unique”, highly valued, and best understood by other chiropractors, explains how students and practitioners can cling to ‘traditional’ thinking. This has implications for public safety and patient quality of care. Conclusion If chiropractic care is to gain mainstream acceptance worldwide then it needs to adopt, through revitalised CCE accreditation standards and processes, those of other allied healthcare professions and wholeheartedly embrace science, evidence-based practice and patient centred care.
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Affiliation(s)
- Stanley I Innes
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia.
| | - Charlotte Leboeuf-Yde
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia.,Institute for Regional Health Research, University of Southern Denmark, DK-5000, Odense, Denmark
| | - Bruce F Walker
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia
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Innes SI, Kimpton A. Are Councils on Chiropractic Education expectations of chiropractic graduates changing for the better: a comparison of similarities and differences of the graduate competencies of the Chiropractic Council on Education-Australasia from 2009 to 2017. Chiropr Man Therap 2020; 28:30. [PMID: 32446310 PMCID: PMC7245770 DOI: 10.1186/s12998-020-00315-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 04/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Council on Chiropractic Education Australasia (CCE-A) is tasked with assessment and accreditation of chiropractic programs (CPs) in the Australasian community. To achieve this process the CCE-A has developed educational standards and graduate competencies which include minimum expectations of graduates prior to entry into the workforce. We sought to explore if these are changing overtime, and if so are these changes for the better. METHOD The CCE-A 2009 and 2017 Competency Standards were located and downloaded. The competencies were placed into tables for a comparative analyses in a systematic manner to enable the identification of similarities and differences. In addition, word counts were conducted for the most commonly occurring words and this took place in December 2019. RESULTS The 2017 competency standards were over three times smaller than the previous standards 2009 standards. More similarities than differences between the old and the new standards were found. There were 18 additions to the 2017 graduate competencies with many that were in unison with contemporary aspects of healthcare such as patient centred-care, respect for practitioner-patient boundaries and patient sexual orientation, transitioning patients to self-management, and consideration of improving lifestyle options. Some competencies were not bought forward to the new standards and included, among others, students being competent in screening for mental health conditions, an expectation to discuss cost of care, re-evaluating and monitoring patients at each visit, and knowing when to discharge patients. The competencies continued to be silent on known issues within the chiropractic profession of a lack of a definition for chiropractic that would inform scope of practice and the presence of vitalism within CPs. CONCLUSION There have been positive changes which reflect contemporary mainstream health care standards between CCE-A graduate competency revisions. The absence of a clear definition of chiropractic and its attendant scope of practice as well as continued silence on vitalism reflect known issues within the chiropractic profession. Recommendations are made for future accreditation standards to inform the required competencies and aid the integration of chiropractic into the broader health care community.
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Affiliation(s)
- Stanley I. Innes
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia
| | - Amanda Kimpton
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
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