A united statement of the global chiropractic research community against the pseudoscientific claim that chiropractic care boosts immunity.

BACKGROUND: In the midst of the coronavirus pandemic, the International Chiropractors Association (ICA) posted reports claiming that chiropractic care can impact the immune system. These claims clash with recommendations from the World Health Organization and World Federation of Chiropractic. We discuss the scientific validity of the claims made in these ICA reports. MAIN BODY: We reviewed the two reports posted by the ICA on their website on March 20 and March 28, 2020. We explored the method used to develop the claim that chiropractic adjustments impact the immune system and discuss the scientific merit of that claim. We provide a response to the ICA reports and explain why this claim lacks scientific credibility and is dangerous to the public. More than 150 researchers from 11 countries reviewed and endorsed our response. CONCLUSION: In their reports, the ICA provided no valid clinical scientific evidence that chiropractic care can impact the immune system. We call on regulatory authorities and professional leaders to take robust political and regulatory action against those claiming that chiropractic adjustments have a clinical impact on the immune system

Early life illness factors as potential risk factors for back pain in adolescence and young adulthood

Low back pain is the leading cause of disability worldwide, affecting mainly adults but also children. Associations between chronic inflammatory conditions and low back pain have been found frequently in older populations. However, the nature of these relationships in younger populations is unknown. The overall objective of this thesis was to investigate if early life illness factors such as childhood illnesses are risk factors for back pain in adolescence or young adulthood. Our plan involved three parts. Part 1: Literature reviews. Part 2: Analyses of longitudinal data from the Raine Study. Part 3: Analyses of longitudinal data from the CHAMPS Study-DK. Through a two-part scoping review and a systematic review, we found that the most likely risk factors for incident back pain in young people are female sex, older age, psychological distress, and psychological features including emotional coping problems. Based on the findings of the Raine Study analyses we found that children with respiratory or atopic conditions such as asthma and allergic rhinitis, and those with several chronic inflammatory conditions are at increased odds of impactful low back pain in adolescence and young adulthood. Based on the findings of the CHAMPS Study-DK we found there were limited associations between cardiovascular disease risk factors and spinal pain in children and adolescents until the moderating role of health-related physical activity was considered. Furthermore, within both these young cohorts there did not appear to be any association between the inflammatory blood marker C-reactive protein and back pain. We concluded that there is some evidence that early life illness factors are risk factors for back pain in young populations, but more evidence is needed to determine if this involves a causal relationship. There appears to be an association between cardiovascular disease risk factors and spinal pain, however this relationship is dependent on sex, age, and health-related physical activity behaviour

A snapshot of the transition into retirement from academia in Australia during the COVID-19 pandemic: a qualitative study

Australia has an aging population with increasing numbers embarking on the major life transition to retirement when compared to previous decades. The Australian university sector has experienced considerable upheaval as it has undergone austerity measures to attempt to manage the impact of the pandemic. The objective of this study was to conduct interviews with Australian university academics who have recently transitioned into retirement, to explore their experience of transitioning to retirement in a COVID-19 environment. The study followed the COREQ guidelines for qualitative studies. Participants were selected based on having recently retired within the previous two years from an Australian university. We conducted semi-structured interviews to explore the participants’ in-depth experience of the transition to, as well the actual experience of retirement. Thematic analysis was conducted. Six participants with a mean age of 64.7 years were interviewed for this study. Five super-ordinate themes emerged; ‘dissatisfaction with the university,’ ‘desire to continue to be involved,’ ‘financial considerations,’ ‘loss of identity, meaning and belonging,’ and ‘the need to plan and maintain a structured life.’ Retirement was seen as an important change in life. There appeared to be a weighing up of the value of quality of life, perhaps influenced by a growing awareness of its shortness. The respondents believed it is extremely important to plan retirement and to start this process early. Proffered recommendations included the making of plans to remain mentally and physically active, and to maintain purpose into retirement

The interrater reliability of static palpation of the thoracic spine for eliciting tenderness and stiffness to test for a manipulable lesion

Abstract Background Despite widespread use by manual therapists, there is little evidence regarding the reliability of thoracic spine static palpation to test for a manipulable lesion using stiffness or tenderness as diagnostic markers. We aimed to determine the interrater agreement of thoracic spine static palpation for segmental tenderness and stiffness and determine the effect of standardised training for examiners. The secondary aim was to explore expert consensus on the level of segmental tenderness required to locate a “manipulable lesion”. Methods Two experienced chiropractors used static palpation of thoracic vertebrae on two occasions (pragmatic and standardised approaches). Participants rated tenderness on an 11-point numerical pain rating scale (NPRS) and raters judged segmental stiffness based on their experience and perception of normal mobility with the requested outcomes of hypomobile or normal mobility. We calculated interrater agreement using percent agreement, Cohen’s Kappa coefficients (κ) and prevalence-adjusted bias-adjusted Kappa coefficients (PABAK). In a preliminary study, an expert panel of 10 chiropractors took part in a Delphi process to identify the level of meaningful segmental tenderness required to locate a “manipulable lesion”. Results Thirty-six participants (20 female) were enrolled for the reliability study on the 13th March 2017. Mean (SD) age was 22.4 (3.4) years with an equal distribution of asymptomatic (n = 17) and symptomatic (n = 17) participants. Overall, the interrater agreement for spinal segmental stiffness had Kappa values indicating less than chance agreement [κ range − 0.11, 0.53]. When adjusted for prevalence and bias, the PABAK ranged from slight to substantial agreement [0.12–0.76] with moderate or substantial agreement demonstrated at the majority of spinal levels (T1, T2 and T6 to T12). Generally, there was fair to substantial agreement for segmental tenderness [Kappa range 0.22–0.77]. Training did not significantly improve interrater agreement for stiffness or tenderness. The Delphi process indicated that an NPRS score of 2 out of 10 identified a potential “manipulable lesion”. Conclusion Static palpation was overall moderately reliable for the identification of segmental thoracic spine stiffness and tenderness, with tenderness demonstrating a higher reliability. Also, an increased agreement was found within the mid-thoracic spine. A brief training intervention failed to improve reliability

Baseline descriptive demographics and cardiovascular risk variables for each study phase.

Baseline descriptive demographics and cardiovascular risk variables for each study phase.</p

Predictive margins of HOMA-IR and clustered cardiovascular risk for phase 1.

a. HOMA-IR in girls with 95% CI. b. HOMA-IR in boys with 95% CI. c. Clustered cardiovascular disease risk in girls with 95% CI. d. Clustered cardiovascular disease risk in boys with 95% CI. No significant 2-way interaction with cardiovascular disease risk factor and moderate-to-vigorous physical activity.</p

Predictive margins of HOMA-IR and clustered cardiovascular risk for phase 2.

a. HOMA-IR in girls with 95% CI. b. HOMA-IR in boys with 95% CI. c. Clustered cardiovascular disease risk in girls with 95% CI. d. Clustered cardiovascular disease risk in boys with 95% CI. *Significant 2-way interaction with cardiovascular disease risk factor and moderate-to-vigorous physical activity.</p

Number of weeks of reported spinal pain and non-traumatic spinal pain for each study phase.

Number of weeks of reported spinal pain and non-traumatic spinal pain for each study phase.</p

Associations between HOMA-IR and Clustered cardiovascular disease risk score and spinal pain.

Associations between HOMA-IR and Clustered cardiovascular disease risk score and spinal pain.</p